Family history of completed suicide and characteristics of major depressive disorder: a STAR*D (sequenced treatment alternatives to relieve depression) study

J Affect Disord. 2008 May;108(1-2):129-34. doi: 10.1016/j.jad.2007.10.011. Epub 2007 Nov 19.

Abstract

Background: Clinicians routinely ask patients with non-psychotic major depressive disorder (MDD) about their family history of suicide. It is unknown, however, whether patients with a family member who committed suicide differ from those without such a history.

Methods: Patients were recruited for the STAR*D multicenter trial. At baseline, patients were asked to report first-degree relatives who had died from suicide. Differences in demographic and clinical features for patients with and without a family history of suicide were assessed.

Results: Patients with a family history of suicide (n=142/4001; 3.5%) were more likely to have a family history of MDD, bipolar disorder, or any mood disorder, and familial substance abuse disorder, but not suicidal thoughts as compared to those without such a history. The group with familial suicide had a more pessimistic view of the future and an earlier age of onset of MDD. No other meaningful differences were found in depressive symptoms, severity, recurrence, depressive subtype, or daily function.

Conclusions: A history of completed suicide in a family member was associated with minimal clinical differences in the cross-sectional presentation of outpatients with MDD. Limitations of the study include lack of information about family members who had attempted suicide and the age of the probands when their family member died. STAR*D assessments were limited to those needed to ascertain diagnosis and treatment response and did not include a broader range of psychological measures.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Age of Onset
  • Antidepressive Agents, Second-Generation / therapeutic use
  • Bipolar Disorder / diagnosis
  • Bipolar Disorder / genetics*
  • Bipolar Disorder / psychology
  • Bipolar Disorder / therapy
  • Citalopram / therapeutic use
  • Cognitive Behavioral Therapy
  • Combined Modality Therapy
  • Depressive Disorder, Major / diagnosis
  • Depressive Disorder, Major / genetics*
  • Depressive Disorder, Major / psychology
  • Depressive Disorder, Major / therapy
  • Female
  • Genetic Predisposition to Disease / genetics
  • Genetic Predisposition to Disease / psychology
  • Humans
  • Male
  • Middle Aged
  • Mood Disorders / diagnosis
  • Mood Disorders / genetics*
  • Mood Disorders / psychology
  • Mood Disorders / therapy
  • Recurrence
  • Risk Factors
  • Substance-Related Disorders / diagnosis
  • Substance-Related Disorders / genetics
  • Substance-Related Disorders / psychology
  • Suicide / psychology*
  • Suicide, Attempted / psychology
  • Treatment Outcome

Substances

  • Antidepressive Agents, Second-Generation
  • Citalopram