Death Ideation and Suicidal Ideation in a Community Sample Who Do Not Meet Criteria for Major Depression
Abstract
Abstract.Background: Suicide is strongly associated with depression, but many without depression have thoughts of death. Aims: To characterize persons who did not meet criteria for depressive illness but endorsed death ideation or suicidal ideation over the course of a 10-year follow-up. Method: Subjects included 753 participants of the Baltimore sample of the Epidemiologic Catchment Area Program, a population-based 10-year follow-up survey, who neither met criteria for major depressive disorder nor reported death or suicidal ideation in 1994. Results: Persons with death ideation or suicidal ideation in 2004 were generally distressed as measured by the General Health Questionnaire. At baseline, both groups endorsed difficulty with concentration, feeling unhappy, and taking things hard. Functional problems such as social withdrawal were endorsed by both groups. Those with suicidal ideation had a longer lifetime history of social phobia. Persons with death ideation did not use more health services but sought help from persons in their social network. Conclusion: Thoughts of death are associated with distress even in persons who do not have depressive illness. This group of persons may have subclinical depressive symptoms that will not be detected by depression screening. Detection of these persons will require broadening our concept of persons at risk.
References
(2002). Urinary incontinence and psychological distress in community-dwelling older adults. Journal of the American Geriatrics Society, 50(3), 489–495.
(2004). Personal characteristics of older primary care patients who provide a buccal swab for apolipoprotein E testing and banking of genetic material: The Spectrum Study. Community Genetics, 7(4), 202–210. 10.1159/000082263
(2014). Suicide later in life: Challenges and priorities for prevention. American Journal of Preventive Medicine, 47(3 Suppl 2), S244–250. 10.1016/j.amepre.2014.05.040
(1994). Identifying suicidal ideation in general medical patients. JAMA, 272(22), 1757–1762.
(1975). "Mini-mental state." A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189–198.
(1997). Depression without sadness: Functional outcomes of nondysphoric depression in later life. Journal of the American Geriatrics Society, 45(5), 570–578.
(1994). Subsyndromal symptomatic depression: A new mood disorder? Journal of Clinical Psychiatry, 55(Suppl), 18–28.
(2005). Physical health and mental disorder in elderly suicide: A case-control study. Aging & Mental Health, 9(6), 576–584. 10.1080/13607860500192973
(2006). Does every allusion to possible suicide require the same response? Journal of Family Practice, 55(7), 605–612.
(1982). Validity of the diagnostic interview schedule, version II: DSM-III diagnoses. Psychological Medicine, 12(4), 855–870.
(1994). The detection of mental disorders in the community using a 20-item interview version of the General Health Questionnaire. Acta Psychiatrica Scandinavica, 89(1), 14–20.
