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Int. J. Environ. Res. Public Health 2018, 15(7), 1299;

Aspects of Additional Psychiatric Disorders in Severe Depression/Melancholia: A Comparison between Suicides and Controls and General Pattern

Department of Clinical Sciences Helsingborg, SE 251 87 Helsingborg, Sweden
Department of Clinical Sciences, University of Lund, Division of Psychiatry; Skåne University Hospital, Baravägen 1, SE-221 85 Lund, Sweden
Centre of Suicide Prevention, University Hospital Amager, Digevej 110, DK-2300 Copenhagen, Denmark
Author to whom correspondence should be addressed.
Received: 7 May 2018 / Revised: 6 June 2018 / Accepted: 19 June 2018 / Published: 21 June 2018
(This article belongs to the Special Issue Suicide Risk and Mental Disorders)
PDF [567 KB, uploaded 21 June 2018]


Objective: Additional and comorbid diagnoses are common among suicide victims with major depressive disorder (MDD) and have been shown to increase the suicide risk. The aim of the present study was first, to investigate whether patients with severe depression/melancholia who had died by suicide showed more additional psychiatric disorders than a matched control group. Second, general rates of comorbid and additional diagnoses in the total group of patients were estimated and compared with literature on MDD. Method: A blind record evaluation was performed on 100 suicide victims with severe depression/melancholia (MDD with melancholic and/or psychotic features: MDD-M/P) and matched controls admitted to the Department of Psychiatry, Lund, Sweden between 1956 and 1969 and monitored to 2010. Diagnoses in addition to severe depression were noted. Results: Less than half of both the suicides and controls had just one psychiatric disorder (47% in the suicide and 46% in the control group). The average number of diagnoses was 1.80 and 1.82, respectively. Additional diagnoses were not related to an increased suicide risk. Anxiety was the most common diagnosis. Occurrence of suspected schizophrenia/schizotypal or additional obsessive-compulsive symptoms were more common than expected, but alcohol use disorders did not appear very frequent. Conclusions: The known increased risk of suicide in MDD with comorbid/additional diagnoses does not seem to apply to persons with MDD-M/P (major depressive disorder-depression/Melancholia). Some diagnoses, such as schizophrenia/schizotypal disorders, were more frequent than expected, which is discussed, and a genetic overlap with MDD-M/P is proposed. View Full-Text
Keywords: Melancholia; comorbidity; suicide; long-term follow-up Melancholia; comorbidity; suicide; long-term follow-up

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Heu, U.; Bogren, M.; Wang, A.G.; Brådvik, L. Aspects of Additional Psychiatric Disorders in Severe Depression/Melancholia: A Comparison between Suicides and Controls and General Pattern. Int. J. Environ. Res. Public Health 2018, 15, 1299.

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