Depression Kills In More Ways Than Suicide

People who suffer from depression are at increased risk for early death, but suicide is not as large a reason for that risk as is commonly thought, a research team has concluded from a review of scientific evidence. However, depression does appear to increase the risk of death by heart disease.

Suicide accounts for less than 1 percent of deaths among depressed patients in all but one of 26 studies of community and medical samples reviewed by by Lawson R. Wulsin, M.D., and colleagues at the University of Cincinnati and Harvard University, writing in the January-February issue of the journal, Psychosomatic Medicine.

Suicide, Wulsin says, "accounts for a small but important fraction of the total mortality associated with depression."

In all, the team examined 57 studies conducted between 1966 and 1996. Almost half of the studies found mixed or negative results on depression-related deaths among patients. However, in the studies of psychiatric samples reviewed, suicide accounted for 16 to 19 percent of the mortality. This, they note, is consistent with the often-quoted rate that 15 percent of persons with severe depressive disorders commit suicide.

At least five important factors influence the relationship between depression and increased death risk: chronic physical illness, smoking, alcohol abuse, poor self-care in times of physical illness, and, in psychiatric populations, suicide and related "accidents."

"It will take more rigorous study with better controls for influencing factors to identify who among the depressed are at greatest risk for early death," Wulsin says. "If we can do that we may establish a basis for interventions."

Psychosomatic Medicine is the official peer-reviewed journal of the American Psychosomatic Society, published bimonthly. For information about the journal, contact Joel E. Dimsdale, M.D., editor-in-chief, at 619-543-5468.

Posted by the Center for the Advancement of Health http://www.cfah.org. For information about the Center, call Richard Hebert, rhebert@cfah.org 202-387-2829.