‘Depressive Mixed States’ Often Precede Suicide Attempts

the Psychiatry Advisor take:

“Depressive mixed states,” where a patient is depressed, but also has symptoms of mania, is one of several bevavior patterns identified that often precedes suicide attempts, a discovery that may help clinicians treating depressed patients.

Dina Popovic, MD, PhD, of the Hospital Clinic of Barcelona, Spain, and colleagues, conducted the BRIDGE-II-MIX study, which included 2,811 depressed patients, 628 of whom had attempted suicide. The patients were interviewed by psychiatrists, with an eye toward the characteristics and behaviors of those who had attempted suicide.

Forty percent of depressed patients that attempted suicide had a mixed episode, and not just depression, the researchers found. Also, patients who exhibit mixed depressive episodes are at a significantly higher risk of suicide.

Further analysis of the interviews found that risky behavior, psychomotor agitation and impulsivity in a depressed patients increases their risk of attempting suicide by at least 50%.

“Most of these symptoms will not be spontaneously referred by the patient, the clinician needs to inquire directly, and many clinicians may not be aware of the importance of looking at these symptoms before deciding to treat depressed patients,” Popovic said in a statement.