Mayo Clinic study shows suicide rates overstated in people with depression

November 30, 2000

ROCHESTER, MINN. -- A Mayo Clinic study published in the December issue of the American Journal of Psychiatry debunks the commonly held notion that about 15 percent of people diagnosed with depression will commit suicide. After analyzing 100 suicide studies conducted over the past 30 years, Mayo Clinic researchers concluded that a more accurate suicide rate for patients with depression is 2 to 9 percent.

"A 15 percent suicide rate means that of six patients diagnosed with depression, one will commit suicide during his or her lifetime," says John Michael Bostwick, M.D., a Mayo Clinic psychiatrist and lead researcher on the study. "That's simply not true." Hierarchy of risk

The study found a stair-step hierarchy of suicide prevalence based on a patient's treatment history. A physician's clinical judgement about the level of treatment intensity required is a good indicator of who is at highest risk of suicide.

- Patients recently hospitalized for suicide after a suicide attempt or with suicidal thoughts were at the highest risk level, 8.6 percent. - Next were other patients with depression who had been hospitalized -- but not for suicide. Their risk of suicide was 4.1 percent.
- Outpatients treated for depression had a suicide risk of 2 percent.
- The risk for the general population is 1 percent.

"Finding that hospitalized patients are at highest risk may seem like stating the obvious, but despite thousands of studies, almost no definitive risk factors have been found to tell us who is most likely to commit suicide," says Dr. Bostwick. "From the public health perspective, the study shows that most effective suicide prevention efforts should target recent or repeatedly hospitalized patients." Why suicide rates are overstated

The 15 percent suicide rate, based on a 1970 study, is used in standard American medical school text books. It's too high, says Dr. Bostwick, because of a skewed statistical analysis. Dr. Bostwick explains the error using an example of 100 patients diagnosed with depression. After five years, 10 patients die and five of the deaths are from suicide. Using the standard method of calculating the deaths by suicide -- called general mortality prevalence -- the suicide rate is five out of 10 or 50 percent, even though 90 patients are still alive.

The Mayo Clinic research argues that the suicide rate should be calculated using a method called case fatality prevalence. For this example, that result would be 5 out of 100 or 5 percent.

"It's a magnitude of difference," says Dr. Bostwick. "Using this approach, the numbers show that suicide continues to be rare. The intent isn't to minimize the pain caused by any individual suicide -- it's devastating -- but rather to look at the prevalence more critically."

Another reason that the 15 percent suicide rate is no longer relevant is because the definition of depression has changed. In 1970, only people with serious mental illnesses (such as manic depression) were diagnosed with depression. Today the diagnosis has been greatly expanded to include many people with mild to moderate symptoms that can be treated by medication or therapy. Under this broader definition, up to 20 percent of Americans could be diagnosed with depression.

"We know that everyone who is diagnosed with depression shouldn't be treated the same," Dr. Bostwisk says. "This study gives physicians and families a more accurate picture of suicide risks and prevalence and helps minimize some of the hysteria that can come with a depression diagnosis."
-end-
Warning signs of suicide (from Mayo Clinic Family Health Book)

When a person displays warning signs of potential suicide, it is important to keep a close watch on him or her and to seek professional help as soon as possible. A person who is contemplating taking his or her own life may show one or more symptoms, but it is important to keep in mind that these warning signs are only guidelines. There is no one type of suicidal person.The risk that suicide actually will be completed is increased in older men, in people who have lost a spouse, in alcoholics, in those with a previous suicide attempts or in those with a family history of suicide. For more information on suicide, go to MayoClinic.com.

Mayo Clinic

Related Depression Articles from Brightsurf:

Children with social anxiety, maternal history of depression more likely to develop depression
Although researchers have known for decades that depression runs in families, new research from Binghamton University, State University of New York, suggests that children suffering from social anxiety may be at particular risk for depression in the future.

Depression and use of marijuana among US adults
This study examined the association of depression with cannabis use among US adults and the trends for this association from 2005 to 2016.

Maternal depression increases odds of depression in offspring, study shows
Depression in mothers during and after pregnancy increased the odds of depression in offspring during adolescence and adulthood by 70%.

Targeting depression: Researchers ID symptom-specific targets for treatment of depression
For the first time, physician-scientists at Beth Israel Deaconess Medical Center have identified two clusters of depressive symptoms that responded to two distinct neuroanatomical treatment targets in patients who underwent transcranial magnetic brain stimulation (TMS) for treatment of depression.

A biological mechanism for depression
Researchers report that in depressed individuals there are increased amounts of an unmodified structural protein, called tubulin, in lipid rafts compared with non-depressed individuals.

Depression in adults who are overweight or obese
In an analysis of primary care records of 519,513 UK adults who were overweight or obese between 2000-2016 and followed up until 2019, the incidence of new cases of depression was 92 per 10,000 people per year.

Why stress doesn't always cause depression
Rats susceptible to anhedonia, a core symptom of depression, possess more serotonin neurons after being exposed to chronic stress, but the effect can be reversed through amygdala activation, according to new research in JNeurosci.

Which comes first: Smartphone dependency or depression?
New research suggests a person's reliance on his or her smartphone predicts greater loneliness and depressive symptoms, as opposed to the other way around.

Depression breakthrough
Major depressive disorder -- referred to colloquially as the 'black dog' -- has been identified as a genetic cause for 20 distinct diseases, providing vital information to help detect and manage high rates of physical illnesses in people diagnosed with depression.

CPAP provides relief from depression
Researchers have found that continuous positive airway pressure (CPAP) treatment of obstructive sleep apnea (OSA) can improve depression symptoms in patients suffering from cardiovascular diseases.

Read More: Depression News and Depression Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.