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S34.02 - Prediction and prevention of suicide in mood disorders

Published online by Cambridge University Press:  16 April 2020

Z. Rihmer*
Affiliation:
Deparmtent of Clinical and Theorethical Mental Health, Semmelweis Medical University, Budapest, Hungary

Abstract

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Background and Aims:

Major mood disorders are quite prevalent, but frequently underreferred, underdiagnosed and undertreated illnesses. The early recognition and appropriate treatment of unipolar and bipolar mood disorders is particularly important, since untreated mood disorders carry extremely high risk of both attempted and committed suicide. Recent studies clearly show that suicidal behaviour in patients with major mood disorders is state and severity dependent and this means that suicidality markedly decreases or vanishes after clinical recovery from major depressive episode or from dysphoric mania. However, since the majority of mood disorder patients never committ and more than half of them never attempt suicide, special clinical characteristics of the illness as well as some familial and psycho-social factors should also play a contributory role in this self-destructive behavuour.

Results:

Considering the clinically explorable suicide risk factors in patients with mood disorders (family and/or personal history of suicidal behaviour, early onset of the disorder, severe depressive episode/hopelessness, agitated/mixed depression, bipolar II diagnosis, comorbid Axis I and Axis II disorders, adverse life situations, lack of social and medical support), in the majority of the cases, suicidal behaviour is predictable with a good chance. There are also several evidences that (succesfull) long-term treatment of unipolar depressives (with antidepressants and/or lithium) and bipolar patients (with mood stabilizers and with antidepressants/antipsychotics) substantially reduces the risk of attempted and completed suicide, even in this high-risk population. Most recent studies also show that supplementary psycho-social interventions (psychoeducation, and targeted psychotherapies) further improve the results.

Type
Symposium: Pharmacological prevention of suicide
Copyright
Copyright © European Psychiatric Association 2008
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