Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-10T16:17:03.620Z Has data issue: false hasContentIssue false
  • English
  • Français

Predictores psicopatológicos del suicidio en pacientes con depresión mayor durante un seguimiento de 5 años

Published online by Cambridge University Press:  12 May 2020

B. Schneider ,
M. Philipp  and
M. J. Müller
B. Schneider
Affiliation:
Centro de Psiquiatría, Departamento de Psiquiatría y Psicoterapia I, Universidad Johann Wolfgang Goethe, Frankfurt/Main, Heinrích-Hoffmann Str. 10, D-60528Frankfurt/Main, Alemania
M. Philipp
Affiliation:
Clínica Psiquiátrica Landshut, Alemania
M. J. Müller
Affiliation:
Departamento de Psiquiatría, Universidad de Mainz, Mainz, Alemania
Get access

Resumen

Objetivo:

se sabe perfectamente que el riesgo de suicido es más alto en los casos de trastor-no depresivo mayor en comparación con la población general. El propósito de este estudio era examinar qué síntomas psicopatológicos durante el episodio índice son predictores de un riesgo mayor de suicidio en el curso posterior de la depresión mayor.

Método:

Se determinaron datos de mortalidad a partir de un estudio prospectivo de 280 pacientes con depresión mayor (DSM-III-R, episodio único o recurrente) durante un pen’odo de seguimiento de 5 años. Se investigó el poder predictivo de diferentes síntomas depresivos, incluidos los psicóticos, para el riesgo de suicidio.

Resultados:

Los pacientes que se suicida-ron (N = 16) durante el período de seguimiento habían comunicado sigmficativamente más a menudo preocupaciones o ideas delirantes hipocondríacas (pero no ideas delirantes o preocupaciones de empo-brecimiento, culpa o pecado), pensamientos suicidas e intentos de suicidio, así como sentimientos de desesperanza grave durante el episodio índice, que los pacientes que todavía vivían o los que murieron por causas naturales.

Conclusión:

Estos síntomas parecen ser predictores tempranos útiles del riesgo de suicidio durante el curso posterior de la enfermedad. Se debería tener esto en cuenta para la prevención del suicidio en el curso de la depresión mayor.

Keywords

desesperanzadepresión mayorsíntomas psicóticosriesgo de suicidio
Type
Artículo original
Information
European Psychiatry (Ed. Española) , Volume 8 , Issue 8 , November 2001 , pp. 498 - 504
Copyright
Copyright © European Psychiatric Association 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bibliografía

Baldwin, RC.Delusional and non-delusional depression in late life: evidence for distinct sutypes. Br J Psychiatry 1988; 1 52: 39–44.CrossRefGoogle Scholar
Bebbington, PE.Monosymptomatic hypochondriasis, abnormal illness behaviour and suicide. Br J Psychiatry 1976; 128: 475–478.CrossRefGoogle ScholarPubMed
Beck, ATBrown, GBerchick, RJStewart, BLSteer, RA.Relationship between hopelessness and ultímate suicide: a replication with psychiatric outpatients. Am J Psychiatry 1990; 147: 190–195.Google ScholarPubMed
Beck, ATRush, AJShaw, BFEmergy, G.Kognitive Therapie der Depression. Aufl. Weinheim: Psychologie Verlags Unión; 1992.Google Scholar
Beck, ATSteer, RAKovacs, MGarrison, B.Hopelessness and eventual suicide: a 10-year prospective study of patients hospitalized with suicide ideation. Am J Psychiatry 1985; 142: 559–63.Google Scholar
Black, DWWinokur, GNasrallah, A.Affect of psychosis on suicide risk in 1,593 patients with unipolar and bipolar affective disorders. Am J Psychiatry 1988; 145: 849–852.Google Scholar
Charney, DSNelson, JC.Delusional and nondelusional unipolar depression: further evidence for distinct subtypes. Am J Psychiatry 1981; 138: 328–333.Google ScholarPubMed
Chiu, LPRimon, R.Interrelationship of hypochondriacal, paranoid, depressive, and suicidal symptoms in Chínese psychiatric patients. Psychopathology 1988; 21: 38–43.CrossRefGoogle ScholarPubMed
Coryell, WNoyes, RClancy, J.Excess mortality on panic disorders. A comparison with primary unipolar depression. Arch Gen Psychiatry 1982; 39: 701–703.CrossRefGoogle ScholarPubMed
Coryell, WNoyes, JHouse, D.Mortality among outpatients with anxiety disorders. Am J Psychiatry 1986; 143: 508–510.Google ScholarPubMed
Coryell, WJEndicott, JWinokur, G.Anxiety syndromes as epiphenomena of primary major depression. Outcome and familial psychopathology. Am J Psychiatry 1992; 149: 100–107.Google ScholarPubMed
Diekstra, RFW.Suicide and attempted suicides: an international perspective. Acta Psychiatr Scand 1989, Suppl 354: 1–24.CrossRefGoogle Scholar
Ettlinger, R.Evaluation of suicide prevention after attempted suicide. Acta Psychiatr Scand 1975; 260 (Suppl): 1–135.Google ScholarPubMed
Fava, GARafanelli, CGrandi, SCanestrari, RMorphy, M.Six-year outcome for cognitive behavioral treatment of residual symptoms in major depression. Am J Psychiatry 1998; 155: 1443–1445.CrossRefGoogle ScholarPubMed
Fawcett, JSchettner, WClark, DHedeker, DGibbons, RCoryell, W.Clinical predictors of suicide in patients with major affective disorders: a controlled prospective study. Am J Psychiatry 1987; 144: 35–40.Google ScholarPubMed
Fawcett, JScheftner, WAFogg, LClark, DCYoung, MAHedeker, D, et al. Time-related predictors of suicide in major afLective disorder. Am J Psychiatry 1990; 147: 1189–94.Google ScholarPubMed
Guze, SBRobins, E.Suicide and primary affective disorders. Br J Psychiatry 1970; 117: 437–438.CrossRefGoogle ScholarPubMed
Hamilton, M.Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol 1967; 6: 278–296.CrossRefGoogle ScholarPubMed
Hautzinger, M, de Jong-Meyer, RTreiber, RRudolf, GAEThien, U.Wirksamkeit kognitiver Verhaltenstherapie, Pharmakotherapie und deren Kombination bei nicht-endogenen, unipolaren Depressionen (Efficacy of cognitive behavior therapy, pharmacotherapy, and the combination of both in nonmelancholic, unipolar depre ssion). Z Klin Psychologie 1996; 25: 130–145.Google Scholar
Keller, FWolfersdorf, M.Hopelessness and the tendency to commit suicide in the course of depressive disorders. Crisis 1993; 14: 173–177.Google ScholarPubMed
Keller, F.Suizidalitat bei Depressiven mit begleitender Angsts-symptomatik. Psychiat Prax 1996; 23: 135–138.Google Scholar
Kovacs, MRush, AJBeck, AT.One-year follow-up of depressed patients treated with cognitive therapy or pharmacotherapy. Arch Gen Psychiatry 1981; 38: 33–39.CrossRefGoogle ScholarPubMed
Nordstróm, PAsberg, MAberg-Wistedt, ANordin, C.Attempted suicide predicts suicide risk in mood disorders. Acta Psychiatr Scand 1995; 92: 345–350.CrossRefGoogle ScholarPubMed
Noyes, R. JrSuicide and panic disorder: a review. J Affect Disord 1991; 22: 1–11.CrossRefGoogle ScholarPubMed
Parker, GHadzi Pavlovic, DHickie, IBoyce, PMitchell, PWilhelm, K, et al. 1. Distinguishing psychotic and non-psychotic melancholia. J Affect Disord 1991; 22: 135–148.CrossRefGoogle Scholar
Philipp, MDelmo, C.Polydiagnostisches Interview (PODI), Versión 2.1. Mainz: Psychiatrische Klinik der Johannes Gutenberg-Universitát Mainz; 1987.Google Scholar
Reynolds, CF 3rd Miller, MDPasternak, REFrank, EPerel, JMCornes, Cet al. Treatment of bereavement-related major depressive episodes in later lite: controlled study of acute and continuation treatment with nortriptyline and interpersonal psychotherapy. Am J Psychiatry 1999; 156: 202–208.Google Scholar
Roose, SGlassman, AWalsh, BWoodring, SVital-Hern, J.Depressions, delusions, and suicide. Am J Psychiatr 1983; 140: 1159–62.Google ScholarPubMed
Roy, A.Risk factors for suicide in psychiatric patients. Arch Gen Psychiatry 1982; 38: 400–405.Google Scholar
Simko, A.Zur Psychopathologie der Schuldwahndepression. In: Gross, GSchüttler, R, Eds. Empirische Forschung in der Psychiatrie. Stuttgart: Schattauer; 1983.Google Scholar
Weber, BPetersen, WKSchneider, BSimminger, DFritze, JMaurer, K.Selbstbeurteilung und Verlauf wahn-indizie-render dysfunktionaler Kognitionen bei stationar behan-delten depressiven Patienten. Nervenarzt 1998; 7: 592–9.CrossRefGoogle Scholar
Wolfersdorf, MKeller, FSteiner, BHole, G.Delusional depression and suicide. Acta Psychiatr Scand 1987; 76: 359–363.CrossRefGoogle ScholarPubMed
Wolfersdorf, M.Depressiver, Wahn, Todesangst und Suizid. Suizidprophylaxe 1987; 14: 260–282.Google Scholar