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Suicidal thoughts/acts and clinical correlates in patients with depressive disorders in Asians: results from the REAP-AD study

Published online by Cambridge University Press:  16 June 2016

Seon-Cheol Park ,
Min-Soo Lee ,
Sang Woo Hahn ,
Tian-Mei Si ,
Shigenobu Kanba ,
Mian-Yoon Chong ,
Chee Kok Yoon ,
Pichet Udomratn ,
Adarsh Tripathi  and
Norman Sartorius
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Seon-Cheol Park
Affiliation:
Department of Psychiatry, Inje University Haeundae Paik Hospital, Busan, Korea
Min-Soo Lee
Affiliation:
Department of Psychiatry, Korea University College of Medicine, Seoul, Korea
Sang Woo Hahn
Affiliation:
Department of Psychiatry, Soonchunhyang University Seoul Hospital, Seoul, Korea
Tian-Mei Si
Affiliation:
Peking University Institute of Mental Health, Beijing, China
Shigenobu Kanba
Affiliation:
Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
Mian-Yoon Chong
Affiliation:
School of Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, Kaohsiung, Taiwan
Chee Kok Yoon
Affiliation:
Department of Psychiatry and Mental Health, Tunku Abdul Rahman Institute of Neuroscience, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
Pichet Udomratn
Affiliation:
Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
Adarsh Tripathi
Affiliation:
King George’s Medical University, Chowk, Lucknow, India
Norman Sartorius
Affiliation:
Association for the Improvement of Mental Health Programs, Geneva, Switzerland
Naotaka Shinfuku
Affiliation:
Department of Social Welfare, School of Human Sciences, Seinan Gakuin University, Fukuoka, Japan
Margarita M. Maramis
Affiliation:
Department of Psychiatry, Faculty of Medicine, University of Airlangga/Dr. Soetomo General Hospital, Surabaya, Indonesia
Yong Chon Park*
Affiliation:
Department of Psychiatry, Hanyang University Guri Hospital, Guri, Korea Department of Psychiatry, Hanyang University College of Medicine, Seoul, Korea
*
Yong Chon Park, Department of Psychiatry, Hanyang University Guri Hospital, 249-1, Gyomun-dong, Guri 471-701, Republic of Korea. Tel: +82 31 560 2273; Fax: +82 31 554 2599; E-mail: hypyc@hanyang.ac.kr
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Abstract

Objective

Using data from the Research on Asian Psychotropic Prescription Patterns for Antidepressants (REAP-AD) study, we aimed to present the rates and clinical correlates of suicidal thoughts/acts in patients recruited from a total of 40 centres in 10 Asian countries/areas: China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, Singapore, Taiwan, and Thailand.

Methods

Data from 1122 patients with depressive disorders in the REAP-AD study were used. The ICD-10 was employed to diagnose depressive episodes and recurrent depressive disorder. The presence or absence of suicidal thoughts/acts and profile of other depressive symptoms was established using the National Institute for Health and Clinical Excellence guidelines for depression. Country/area differences in rates of suicidal thoughts/acts were evaluated with the χ2 test. In addition, depressive symptom profiles, other clinical characteristics, and patterns of psychotropic drug prescription in depressed patients with and without suicidal thoughts/acts were compared using analysis of covariance for continuous variables and logistic regression analysis for discrete variables to adjust the effects of covariates.

Results

The rates of suicidal thoughts/acts in 10 countries/areas varied from 12.8% in Japan to 36.3% in China. Patients with suicidal thoughts/acts presented more persistent sadness (adjusted odds ratio [aOR]=2.64, p<0.001), loss of interest (aOR=2.33, p<0.001), fatigue (aOR=1.58, p<0.001), insomnia (aOR=1.74, p<0.001), poor concentration (aOR=1.88, p<0.001), low self-confidence (aOR=1.78, p<0.001), poor appetite (aOR=2.27, p<0.001), guilt/self-blame (aOR=3.03, p<0.001), and use of mood stabilisers (aOR=1.79, p<0.001) than those without suicidal thoughts/acts.

Conclusion

Suicidal thoughts/acts can indicate greater severity of depression, and are associated with a poorer response to antidepressants and increased burden of illness. Hence, suicidal thoughts/acts can provide a clinical index reflecting the clinical status of depressive disorders in Asians.

Keywords

Asiansdepressive disordersmood stabiliserssuicidal thoughts/acts
Type
Original Articles
Information
Acta Neuropsychiatrica , Volume 28 , Issue 6 , December 2016 , pp. 337 - 345
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Copyright
© Scandinavian College of Neuropsychopharmacology 2016 

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