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

Authors
Park, Seon-CheolLee, Min-SooHahn, Sang WooSi, Tian-MeiKanba, ShigenobuChong, Mian-YoonYoon, Chee KokUdomratn, PichetTripathi, AdarshSartorius, NormanShinfuku, NaotakaMaramis, Margarita M.Park, Yong Chon
Issue Date
12월-2016
Publisher
CAMBRIDGE UNIV PRESS
Keywords
Asians; depressive disorders; mood stabilisers; suicidal thoughts/acts
Citation
ACTA NEUROPSYCHIATRICA, v.28, no.6, pp.337 - 345
Indexed
SCIE
SCOPUS
Journal Title
ACTA NEUROPSYCHIATRICA
Volume
28
Number
6
Start Page
337
End Page
345
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/86592
DOI
10.1017/neu.2016.27
ISSN
0924-2708
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 chi(2) 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.
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