Presence of suicidality as a prognostic indicator

Background: Suicidal symptoms in depression are often thought to predict a higher severity of illness and a worse prognosis. Aims: To determine if suicidal ideation at the time of treatment for major depression can predict response to antidepressant medication in primary care. Settings and design: A retrospective analysis of subjects receiving anti-depressant drugs in a primary care setting Methods and material: Nine depressed patients (14%) who acknowledged suicidality on the PHQ-9 depression scale were followed up for and compared to a group of 54 (86%) depressed patients (controls) who did not have suicidal thoughts for four months. All were given treatment with antidepressants and followed with a disease management protocol where the PHQ-9 was used as a systematic outcome measure. Statistical analysis: Descriptive measures and t-tests were utilized to show statistical significance. Results: There were no statistical differences in remission from depressive symptoms based on the PHQ-9 scale after antidepressant treatment, between patients with suicidal thoughts (56%) and those without (44%). Conclusion: The presence of suicidality as a depressive symptom did not predict poorer clinical outcome when treating depression in the primary care setting in the patients studied.