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Depression can lead to suicide

Suicide risk can be high among people who are depressed and this calls for constant monitoring, say researchers.

Anjali Singh Deswal, Nature World Report, Aug 31, 2015

The statistics for suicide are frightening. Suicide is one of the leading causes of death among young people. The World Health Organisation states that more than 800,000 people die worldwide by suicide every year, and about 20 times that number attempt suicide.

Risky behaviors like reckless driving, nervous behavior such as agitation, hand wringing or pacing, can be signs that depressed people suffer from suicide risk.

Other warning signs like doing things without thinking about the after effects are also a part of suicidal tendencies. Depressed people with any of these symptoms are at least 50 percent more likely to attempt suicide, the new study found.

"It has long been known that those patients with depression who also experience anxiety and/or agitation are more likely to attempt or complete suicide," said Dr Donald Malone, chair of psychiatry and psychology at the Cleveland Clinic.

"Assessing these symptoms in every depressed patient we see is extremely important, and has immense therapeutical implications," study lead author Dr Dina Popovic, of the Hospital Clinic de Barcelona, in Spain, said in a news release from the European College of Neuropsychopharmacology (ECNP).

Popovic's team carried out a study on more than 2800 people who were depressed and this included about 630 who had attempted suicide. The researchers conducted in-depth interviews with each patient, and especially looked for differences in behaviors between depressed people who had attempted suicide and those who had not.

"Most of these symptoms will not be spontaneously referred by the patient, so the clinician needs to inquire directly," Popovic said.

It was seen that about 40 percent of all the depressed patients who attempted suicide had a 'mixed episode' rather than just depression. This means that the risk of suicide is higher in people who suffer from mixed depression.

The researchers reported that the standard criteria for diagnosing depression spotted only 12 percent of patients with mixed depression. In contrast, using the new criteria identified 40 percent of these patients, Popovic's team said.

However, the impulsive and risky behavior outlined in the new study can also increase the likelihood of someone who is depressed to act on thoughts to end his or her life.

The recognition of increased activation in the context of a severe depression is an important practical challenge. While many psychiatrists recognize that this constitutes an additional risk for suicide, and would welcome better scales for its identification, the question of treatment remains challenging.

Furthermore, the researchers have discovered that in accordance to the standard mental health guidelines, individuals at risk cannot be easily identified because when they used their own methods.

Researchers ask that psychiatrists evaluate an individual's family history, treatments and how well they have scored by using the Global Assessment of Functioning scale. This test can rate an individual's ability to function well in work, social and individual settings.

The findings were scheduled for presentation at the ECNP's annual meeting in Amsterdam.

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