D. Conforti, C. Scarso, S. Cognolato, S. Dorz, G. Borgherini, G. Magni - Vol. 7, Settembre 2001, num.3
Testo Immagini Bibliografia Summary Riassunto Indice
Caratteristiche psicopatologiche
e intenzionalità suicidaria in un campione di pazienti depressi ospedalizzati
Psychopathological characteristics and
suicidal intention in a sample of depressed inpatients
Background
This paper reports on some of the results of an ongoing study carried-out on patients hospitalized in a unit specialized in the treatment of mood disorders.
Methods
Patients were consecutively recruited; the sample consisted in 156 patients who met the DSM-IV criteria for major depression, single episode or recurrent, in about 70% of cases; the remaining 30% had other mood disorders, including bipolar disorders I and II, adjustment disorder with depressed mood, dysthymia and mood disorders due to medical conditions. The diagnosis was made on the basis of a standardized interview (SCID I). At baseline and pre-arranged subsequent intervals, patients were subjected to a battery of tests for the symptomatological assessment of their clinical conditions (Hamilton Rating Scale for Depression, Montgomery-Åsberg Depression Rating scale, CGI, SCL90), their personality characteristics (SCID II), their degree of adjustment and the social support available to them (Social Adjustment Scale, Social Support Questionnaire). The group was divided into two subgroups on the basis of the patients’ suicidal intention, as assessed by the relevant item on the Hamilton scale (HAM-D) (cut-off > 2). The two subgroups (comprising 56 patients with a strong suicidal intention and 100 with poor suicidal inclination) were comparable in terms of age, gender, socio-demographic features and diagnosis in Axes I and II of the DSM-IV.
Results
At baseline, there were statistically significant differences between the two groups in the SCL-90 subscales for depression and interpersonal sensitivity, as well as for the global score emerging from the same scale. Some interesting significant differences also emerged for the scales administered by the clinician (HAM-D, MADRS, CGI), that were also confirmed to some degree at the time of discharge. Using logistic regression, potential predictors of suicidal intent were sought in the sample as a whole and in the two subgroups, using all the variables considered in the study in the model: the global score on the MADRS emerged as the most powerful predictor (accounting for 45% of the variance), while the score for somatic anxiety on the HAM-D emerged as a possible "protective" factor against such suicidal inclinations.
Conclusions
The magnitude of depression and interpersonal sensitivity predict suicidal intention.