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Psychiatry Investig > Volume 20(1); 2023 > Article
Psychiatry Investigation 2023;20(1):9-17.
DOI: https://doi.org/10.30773/pi.2022.0147    Published online January 25, 2023.
The Change of Suicidal Ideation Over a 12-Week Naturalistic Treatment of Depression: Comparison Between Young People and Older Adults
Young-Eun Jung1  , Tae-Youn Jun2  , Young Sup Woo2  , Hyeon Woo Yim3  , Jung-Bum Kim4  , Jae-Min Kim5  , Ho-Jun Seo6 
1Department of Psychiatry, School of Medicine, Jeju National University, Jeju, Republic of Korea
2Department of Psychiatry, St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
3Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
4Department of Psychiatry, School of Medicine, Keimyung University, Daegu, Republic of Korea
5Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
6Department of Psychiatry, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
Correspondence: Ho-Jun Seo ,Tel: +82-31-249-8038, Fax: +82-31-248-6758, Email: healm@catholic.ac.kr
Received: June 1, 2022   Revised: August 2, 2022   Accepted: August 11, 2022   Published online: January 25, 2023
Abstract
Objective
We investigated the differences in suicidality between young people and older adults with depression over the course of 12-week naturalistic treatment with antidepressants.
Methods
A total of 565 patients who had moderate to severe depression (Hamilton Depression Rating Scale [HAM-D] score ≥14) and significant suicidal ideation (Beck Scale for Suicide Ideation [SSI-B] score ≥6) were recruited from 18 hospitals. Participants were classified into two groups: the younger group (13–24 years of age, n=82) and the older group (≥25 years of age, n=483). Total scores over time on the SSI-B, HAM-D, and Hamilton Anxiety Rating Scale (HAM-A) were assessed and compared between the two groups.
Results
At baseline, the younger group had lower HAM-D scores (21.0 vs. 22.2; p=0.028) but higher SSI-B scores (19.4 vs. 15.6; p<0.001) compared with the older group. The overall 12-week proportion of patients with resolved suicidality was 44.1% in the younger group and 69.2% in the older group. Although the improvement in the HAM-D and HAM-A scores did not differ between the groups, suicidal ideation in the younger group remained more severe than in the older group throughout the treatment. The ratio of the subjects who achieved HAM-D remission or response but did not achieve SSI-B remission was significantly higher in the younger group than in the older group.
Conclusion
These data suggest that in depressed youths, suicide risk is a serious concern throughout the course of depression even when favorable treatment outcomes are obtained.
Key words   Suicide; Depression; Anxiety; Antidepressants; Treatment
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