Suicide ideation, stability of symptoms and effects of aerobic exercise in major depression

Excerpt

Suicide is one of the severest consequences of major psychiatric disorders. Among patients with depression, risk factors like duration of disease, living alone, younger age, childhood trauma and previous suicidality have been reported. In a 30-year prospectively followed-up population sample of 4.547 subjects, Angst et al. [1] found a 40.5 % lifetime prevalence rate of suicide ideation and a 6.6 % rate of suicide attempts. Suicide attempts occurred more frequently in females than in males. Main risk factors for suicidal ideation in women were low social support, frequent punishment in childhood, whereas in men, a depressive and anxious personality was predominant. Major risk factors for suicide attempts in women were a broken home and sexual abuse in childhood. Furthermore, in major depression, suicide and suicide attempts are symptoms of relapse. According to the literature, relapse rates vary between 40 and 85 %. In a prospective multicenter study of 458 naturalistically treated inpatients with major depression, Seemüller et al. [2] found at least one severe relapse in 33.6 % of the patients during the three-year follow-up. A shorter duration until severe relapse was associated with multiple hospitalizations, avoidant personality disorder, continuing antipsychotic medication, and lack of antidepressant treatment. In their longitudinal Zurich study, Rodgers et al. [3] investigated the role of sex on stability and transition patterns of depression symptom subtypes over 20 years in 322 patients. This is the first study showing that—based on psychosocial correlates—long-term stability and transition patterns differ by sex and depression subtypes. …