Autor:innen:
C. Correll (Berlin/New York, US)
F. Bermpohl (Berlin, DE)
P. Falkai (München, DE)
A. Reif (Frankfurt am Main, DE)
M. Adli (Berlin, DE)
F. Dafsari (Berlin, DE)
M. Bauer (Berlin, DE)
C. Otte (Berlin, DE)
A. Meyer-Lindenberg (Mannheim, DE)
V. Nöhles (Berlin, DE)
Background: Patients with major depressive disorder (MDD), a common and severe mental disorder, are often treated as inpatients, partly because of suicidality. However, there are no approved treatments and only few studies have characterized inpatients with MDD and suicidality in detail .
Methods: The investigator-initiated OASIS-D study, funded by Janssen-Cilag GmbH, assessed consecutively hospitalized patients with MDD at 8 German psychiatric university hospitals to identify those with suicidality and its correlates.
Results: Of 1,358 inpatients (age=43.6±15.8 years, females=53.2%), 66.5% had severe MDD without psychosis and 22.5% had moderately severe MDD, with 17.8% having treatment-resistant MDD. Inpatient referrals were most frequently by the patient (38.2%), followed by outpatient care providers (16.9%), family/friends (9.7%), and inpatient care providers or ambulance (8.9%, each). Of these admissions, 42.4% represented a psychiatric emergency, with suicidality being the reason in 27%. Altogether, 70.8% had at least current passive suicidal ideation (SI, lifetime=88.1%),including passive SI (26.2%), active SI without plan (14.7%), active SI with plan (14.0%), and active SI with plan+intent (15.9%), while 10.7% had attempted suicide ≤2 weeks before admission (lifetime=35.6%). Drug-induced mental and behavioral disorders (33.9%) were the most frequent comorbid disorders, followed by personality disorders (7.8%). Upon admission, 66.3% were receiving psychiatric medications, including antidepressants (54.7%, SSRIs=21.9%, SNRIs=16.9%, NaSSas=13.0%), 2nd-generation antipsychotics (22.5%), anxiolytics (10.9%) antiepileptics (4.9%), and lithium (3.8%). Altogether, 11.7% reported nonadherence to medications within 6 months of admission.
Conclusions: In adults admitted for MDD, suicidality was common, representing a psychiatric emergency in 27% of patients. Usual-care treatments and outcomes of suicidality in hospitalized adults with MDD require further study.