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Prevalence of subthreshold forms of psychiatric disorders in persons making suicide attempts in Hungary

Published online by Cambridge University Press:  16 April 2020

J. Balázs ,
I. Bitter ,
Y. Lecrubier ,
N Csiszér  and
G. Ostorharics
J. Balázs*
Affiliation:
Department of Psychiatry and Psychotherapy, Semmelweis University Budapest, Hungary
I. Bitter
Affiliation:
Department of Psychiatry and Psychotherapy, Semmelweis University Budapest, Hungary
Y. Lecrubier
Affiliation:
Inserm U 302, Hôpital de la Salpêtrière, Paris, France
N Csiszér
Affiliation:
Elisabeth Hospital and Outpatient Clinic, Budapest, Hungary
G. Ostorharics
Affiliation:
Gyõr M.S. Megyei Petz Aladár Hospital, Gyõr, Hungary
*
*Correspondence and reprints: Judit Balázs: [email protected]
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Summary

Background – Suicide and suicide attempts have been associated to psychiatric illnesses; however, little is known about the role in suicide risk of those symptoms that do not meet the full criteria for a DSM-IV disorder. The aim of this study was to examine the prevalence of subthreshold psychiatric disorders among suicide attempters in Hungary. Methods – Using a modified structured interview (Mini International Neuropsychiatric Interview) determining 16 Axis I psychiatric diagnoses and their subthreshold forms defined by the DSM-IV and a semistructured interview collecting background information, the authors examined 140 consecutive suicide attempters, aged 18–65 years. Results – Eighty-three-point-six percent of the attempters had one or more current threshold diagnoses on Axis I and in addition more than three-quarters (78.6%) of the subjects had at least one subthreshold diagnosis. Six-point-four percent of the subjects (N = 9) had neither subthreshold nor threshold diagnoses at the time of their suicide attempts. Ten percent of the subjects (N = 14), not meeting the full criteria for any DSM-IV diagnoses, had at least one subthreshold diagnosis. In 68.6% of the subjects (N = 96), both subthreshold and threshold disorders were diagnosed at the time of their suicide attempts. The number of subthreshold and threshold diagnoses were positively and significantly related (χ2 = 5.12, df = 1, P < 0.05). Sixty-three-point-six percent of the individuals received two or more current threshold diagnoses on Axis I and 44.3% of the individuals (N = 62) had two or more subthreshold diagnoses at the time of their suicide attempts. Limitations – The subthreshold definitions in this study included only those forms of the disorders which required the same duration as the criteria DSM-IV disorder with fewer symptoms. Conclusions – Suicide attempts showed a very high prevalence of subthreshold disorders besides psychiatric disorders meeting the full criteria required according to the DSM-IV. Subthreshold forms of mental disorders need to be taken into account in suicide prevention.

Keywords

co-morbidityM.I.N.Isubthreshold diagnosissuicide attempt
Type
Original article
Information
European Psychiatry , Volume 15 , Issue 6 , September 2000 , pp. 354 - 361
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2000

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References

Akiskal, H.S., Judd, L.L., Gillin, C., Lemmi, H.Subthreshold depression: clinical and polysomnographic validation of dysthymic, residual and masked forms J Affect Disord 45 1997 53–63CrossRefGoogle ScholarPubMed
American Psychiatric Association Diagnostic and statistical manual of mental disorders. Fourth ed 1994 American Psychiatric Association Press Washington, DCGoogle Scholar
Angst, J.Recurrent brief depression: a new concept of depression Pharmacopsychiatry 23 1990 63–66CrossRefGoogle ScholarPubMed
Angst, J., Merikengas, K., Scheiddeger, P., Wicki, W.Recurrent brief depression: a new subtype of affective disorder J Affect Disord 19 1990 87–89CrossRefGoogle ScholarPubMed
Angst, J., Merikangas, K.R., Preising, M.Subthreshold syndromes of depression and anxiety in the community J Clin Psychiatry 58 Suppl 8 1997 6–10Google Scholar
Arato, M., Demeter, E., Rihmer, Z., Somogyi, E.Retrospective psychiatric assessment of 200 suicides in Budapest Acta Psychiatr Scand 77 1988 454–456CrossRefGoogle ScholarPubMed
Balázs, J., Bitter, I., Hideg, K., Vitrai, J.A M.I.N.I. és a M.I.N.I. Plusz kérdõív magyar nyelvû változatának kidolgozása (The Hungarian version of the M.I.N.I. and the M.I.N.I. Plus) Psychiatr Hung 13 1998 160–168Google Scholar
Barrett, J.E., Barrett, H.A., Oxman, T.E., Gerber, P.D.The prevalence of psychiatric disorders in a primary care practice Arch Gen Psychiatry 45 1988 1100–1106CrossRefGoogle Scholar
Barraclough, B., Bunch, J., Nelson, B., Sainsbury, P.A hundred cases of suicide: clinical aspects Br J Psychiatry 125 1974 355–373CrossRefGoogle ScholarPubMed
Beautrais, A.L., Joyce, P.R., Mulder, R.T., Fergusson, D.M., Deavoll, B.J., Nightingale, S.K.Prevalence and comorbidity of mental disorders in persons making serious suicide attempts: a case-control study Am J Psychiatry 153 1996 1009–1014Google ScholarPubMed
Berkman, L.F., Berkman, C.S., Kasl, S., Freeman, D.H. Jr, Leo, L., Ostfeld, A.M.Depressive symptoms in relation to physical health and functioning in the elderly Am J Epidemiol 124 1986 372–388CrossRefGoogle ScholarPubMed
Beskow, J.Suicide and mental disorders in Swedish men Acta Pscychiatr Scand 277 Suppl 1979 1–138Google Scholar
Broadhead, W.E., Blazer, D.G., George, L.K., Tse, C.K.Depression, disability days, and days lost from work in a prospective epidemiologic survey JAMA 264 1990 2524–2528CrossRefGoogle Scholar
Calzavara, L.M., Coates, R.A., Raboud, J.M., Farewell, W.T., Read, S.E., Shephered, F.A. et al. Ongoing high-risk sexual behaviors in relation to recreational drug use in sexual encounters: analysis of 5 years of data from the Toronto Sexual Contact Study Ann Epidemiol 3 1992 272–280CrossRefGoogle Scholar
Carlier, I.V.E., Gersons, B.P.R.Partial posttraumatic stress disorder (PTSD): the issue of psychological scars and the occurance of PTSD symptoms J Nerv Ment Dis 183 1995 107–109CrossRefGoogle Scholar
Cheng, A.T.A.Mental illness and suicide Arch Gen Psychiatry 52 1995 594–603CrossRefGoogle ScholarPubMed
Conwell, Y., Duberstein, P.R., Cox, C., Herrmann, J.H., Forbes, N.T., Caine, E.D.Relationships of age and Axis I diagnoses in victims of completed suicide: a psychological autopsy study Am J Psychiatry 153 1996 1001–1008Google ScholarPubMed
Coulehan, J.L., Schulberg, H.C., Block, M.R., Janosky, J.E., Arena, V.C.Depressive symptomatology and medical co-morbidity in a primary care clinic Int J Psychiatry M 20 1990 335–347CrossRefGoogle Scholar
Davidson, J.R.T., Hughes, D.C., George, L.K., Blazer, D.G.The boundary of social phobia: exploring the threshold Arch Gen Psychiatry 51 1994 975–983CrossRefGoogle ScholarPubMed
Escobar, J.I., Golding, J.M., Hough, R.L., Karno, M., Burnam, M.A., Wells, K.B.Somatization in the community: relationship to disability and use of services Am J Public Health 77 1987 837–840CrossRefGoogle ScholarPubMed
Henriksson, M.M., Aro, H.M., Martutunen, M.J., Heikkinen, M.E., Isometsä, E.T., Kuoppasalmi, K.I. et al. Mental disorders and comorbidity in suicide Am J Psychiatry 150 1993 935–940Google ScholarPubMed
Horwath, E., Johnson, J., Klerman, G.L., Weissman, M.M.Depressive symptoms as relative and attributable risk factors for first-onset major depression Arch Gen Psychiatry 49 1992 817–823CrossRefGoogle ScholarPubMed
Isometsä, E.T., Henriksson, M.M., Aro, H.M., Heikkinen, M.E., Kuoppasalmi, K.I., Lönnqvist, J.K.Suicide in major depression Am J Psychiatry 151 1994 530–536Google ScholarPubMed
Jenkins, R., Harvey, S., Butler, T., Thomas, R.L.A six-year longitudinal study of the occupational consequences of drinking over ‘safe limits’of alcohol Br J Ind M 49 1992 369–374Google ScholarPubMed
Johnson, J., Weissman, M.M., Klerman, G.L.Service utilization and social morbidity associated with depressive symptoms in the community JAMA 267 1992 1478–1483CrossRefGoogle Scholar
Judd, L.L., Rapaport, M.H., Paulus, M.P., Brown, J.L.Subsyndromal symptomatic depression: a new mood disorder? J Clin Psychiatry 55 1994 18S–28SGoogle ScholarPubMed
Judd, L.L.Mood disorders in the general population represent an important and wordwide health problem Int Clin Psychopharmacol 10 Suppl 4 1995 5–10CrossRefGoogle Scholar
Judd, L.L., Paulus, M.P., Wells, K.B., Rapaport, M.H.Socioeconomic burden of subsyndromal depressive symptoms and major depression in a sample of the general population Am J Psychiatry 153 1996 1411–1417Google Scholar
Judd, L.L., Akiskal, H.S., Maser, J.D., Zeller, J.D., Ednicott, J., Coryell, W. et al. A prospective 12-year study of subsyndromal depressive symptoms and unipolar major depressive disorders Arch Gen Psychiatry 55 1998 694–700CrossRefGoogle ScholarPubMed
Katon, W., Lin, E., von Korff, M., Bush, T., Walker, E., Simon, G. et al. The predictors of persistence of depression in primary care J Affect Disord 31 1994 81–90CrossRefGoogle ScholarPubMed
Keller, M.B.Course, outcome and impact on the community Acta Psychiatr Scand 89 Suppl 383 1994 24–34CrossRefGoogle Scholar
Kendler, K.S., Gardner, C.O.Boundaries of major depression: an evaluation of DSM-IV criteria Am J Psychiatry 155 1998 172–177Google ScholarPubMed
Klerman, G.L., Weissman, M.M., Ouellette, R., Johnson, J., Greenwald, S.Panic attacks in the community: social morbidity and health care utilization JAMA 265 1991 742–746CrossRefGoogle ScholarPubMed
Lecrubier, Y., Sheehan, D.V., Weiller, E., Amorim, P., Bonora, I., Sheehan, H.K. et al. The MINI International Neuropsychiatric Interview (M.I.N.I.) a short diagnostic structured interview: reliability and validity according to the CIDI Eur Psychiatry 12 1997 224–231CrossRefGoogle Scholar
Leon, A.C., Portera, L., Weissman, M.M.The social costs of anxiety disorders Br J Psychiatry 166 1995 19–22CrossRefGoogle Scholar
Liebowitz, M.R.Mixed anxiety and depression: should it be included in DSM-IV? J Clin Psychiatry 54 1993 48–78Google ScholarPubMed
Maier, W., Gänsicke, M., Weiffenbach, O.The relationship between major and subthreshold variants of uniploar depression J Affect Disord 45 1997 41–51CrossRefGoogle Scholar
Olfson, M., Broadhead, W.E., Weissman, M.M., Leon, A.C., Farber, L., Hoven, C. et al. Subthreshold psychiatric symptoms in a primary care group practice Arch Gen Psychiatry 53 1996 880–886CrossRefGoogle Scholar
Philipp, M.The risk of minor depression in families of probands with major depression: sex differences and familiality Eur Arch Psychiatry Clin Neurosci 242 1992 89–92Google Scholar
Rapaport, M.M., Judd, L.L.Minor depressive disorder and subsyndromal depressive symptoms: functional impairment and response to treatment J Affect Disord 48 1998 227–232CrossRefGoogle ScholarPubMed
Rich, C.L., Young, D., Fowler, R.C.San Diego suicide study, I: young vs old subjects Arch Gen Psychiatry 43 1986 577–582CrossRefGoogle Scholar
Rick, K., Schweizer, E.The clinical presentation of generalized anxiety in primary-care settings: practical concept of classification and management J Clin Psychiatry 58 Suppl 11 1997 4–10Google Scholar
Runeson, B.Mental disorders in youth suicide: DSM-III-R axes I and II Acta Pscychiatr Scand 79 1989 490–497CrossRefGoogle ScholarPubMed
Schnurr, P.P., Friedmann, M.J., Rosenberg, S.D.Premilitary MMPI scores as predictors of combat-related PTSD symptoms Am J Psychiatry 150 1993 479–483Google ScholarPubMed
Sheehan, D.V., Lecrubier, Y., Sheehan, H.K., Amorim, P., Janavs, J., Weiller, E. et al. The MINI International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10 J Clin Psychiatry 59 Suppl 20 1998 22–33Google ScholarPubMed
Sheehan, D.V., Lecrubier, Y., Sheehan, H.K., Janavs, J., Weiller, E., Keskiner, A. et al. Reliability and validity of the MINI International Neuropsychiatric Interview (MINI) according to the SCID-P Eur Psychiatry 12 1997 232–241CrossRefGoogle Scholar
Skodol, A.E., Schwartz, S., Dohrenwend, B.P., Levav, I., Shrout, P.E.Minor depression in a cohort of young adults in Israel Arch Gen Psychiatry 51 1994 542–551CrossRefGoogle Scholar
Solomon, S., Canino, G.Appropriateness of the DSM-III-R criteria for post-traumatic stress disorder Compr Psychiatry 31 1990 227–237CrossRefGoogle Scholar
Suominen, K., Henriksson, M., Suokas, J., Isometsä, E., Ostamo, A., Lönnqvist, J.Mental disorders and comorbidity in attempted suicide Acta Psychiatr Scand 94 1996 234–240CrossRefGoogle ScholarPubMed
Stein, M.B., Walker, J.R., Hazen, A.L., Forde, D.R.Full and partial posttraumatic stress disorder: findings from a community survey Am J Psychiatry 154 1997 1114–1119Google ScholarPubMed
Van Trigt, L., Kreuger, H., Westerman, R.F., Hull, F.M.Morbidity at an Amsterdam inner-city clinic in relation to drug use Fam Pract 6 1989 299–302CrossRefGoogle ScholarPubMed
Webb, G.R., Redman, S., Hennrikus, D.J., Kelman, G.R., Gibberd, R.W., Sanson-Fisher, R.W.The relationships between high-risk and problem drinking and the occurrence of work injuries and related absences J Stud Alcohol 55 1994 434–446CrossRefGoogle ScholarPubMed
Weissman, M.M., Leaf, P.J., Bruce, M.L., Florio, L.Rates, risks, comorbidity and treatment Am J Psychiatry 145 1988 815–819Google ScholarPubMed
Wells, K.B., Stewart, A., Hays, R.D., Burnam, M.A., Rogers, W., Daniels, M. et al. The functioning and well-being of depressed patients: results from the Medical Outcomes Study JAMA 262 1989 914–919CrossRefGoogle ScholarPubMed
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