Factors Correlated With Suicidal Ideation in Major Depressive Disorder

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Higher rates of hopelessness, loneliness, anhedonia, social anxiety, and younger age were highly correlated with suicidal ideation in patients with major depressive disorder, based on a review of qualitative data.

There are differences in age, disease characteristics, and symptoms between people with major depressive disorder (MDD) and suicidal ideation (MDSI) and people with MDD without suicidal ideation (SI), according to results presented at the Psych Congress 2019, held October 3 to 6 in San Diego, California.

PatientsLikeMe is a web-based community and research platform of approximately 600,000 members who voluntarily report their symptoms and experiences with their disease, including treatment outcome. Investigators included data from members who joined between May 2007 and February 2018, comparing individuals with a reported diagnosis of MDSI (n=266) with individuals with MDD and no SI (n=11,963). The majority of members in both cohorts were women (MDSI: 72.9%; MDD: 83.3%) and white (MDSI: 87.5%; MDD: 86.7%).

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Members of the MDSI group were younger than members of the MDD group (median age, 36 vs 44 years, respectively), reported earlier onset of disease (before age 30 years; 83% vs 71%, respectively), and a longer diagnosis latency (median, 4 vs 2 years).  

The median number of psychiatric comorbidities was higher in MDSI (4 vs 3; P <.01). Compared with the MDD cohort, generalized anxiety disorder was higher in the MDSI cohort (63% vs 44%; P <.001) as was social anxiety disorder (45% vs 18%; P <.001). However, fibromyalgia was considerably lower in the MDSI cohort compared with the MDD cohort (10% vs 31%; P <.01).

In addition, members of the MDSI cohort more frequently reported unprompted symptoms, such as loneliness (24% vs 1.1%), hopelessness (23% vs 0.7%), and impulsivity (16% vs 0.3%) compared with members in the MDD cohort. Hopelessness, loneliness, anhedonia, social anxiety, and younger age were the major predictors of SI in MDD.

People in the MDSI cohort reported lower perceived effectiveness compared with people in the MDD cohort with commonly prescribed antidepressant treatments.

The study relied upon self-reported data provided by members of a specific web-based platform, which may not be reflective of the general population.

“Overall, results from the study can help guide clinical judgement to identify suicide-related risk among patients with MDD who may not voluntarily report suicidal ideation to health care providers,” the investigators concluded.

For more coverage of the Psych Congress 2019, click here.

Disclosure: This study was supported by funding from Janssen Research & Development LLC. All authors are employees of Janssen.


Borentain S, Nash A, Dayal R, DiBernardo A. Patient-reported outcomes in major depressive disorder with suicidal ideation: a real-world data analysis using PatientsLikeMe platform. Presented at: Psych Congress 2019; October 3-6, 2019; San Diego, CA. Poster 110.