Depressive Symptoms on the Geriatric Depression Scale and Suicide Deaths in Older Middle-aged Men: A Prospective Cohort Study
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Objectives: Prospective evaluations of the associations between depressive symptoms and suicide deaths have been mainly performed in high-risk populations, such as individuals with psychiatric disorders or histories of self-harm. The purpose of this study was to prospectively examine whether more severe depressive symptoms assessed using the Geriatric Depression Scale (GDS) were associated with a greater risk of death from suicide in a general-risk population. Methods: A total of 113 478 men from the Korean Veterans Health Study (mean age, 58.9 years) who participated in a postal survey in 2004 were followed up for suicide mortality until 2010. Results: Over 6.4 years of follow-up, 400 men died by suicide (56.7 deaths per 100 000 person-years). More severe depressive symptoms were associated with greater risk of suicide death (p for trend <0.001). The unadjusted hazard ratios (HRs) in comparison to the absence of depression were 2.18 for mild depression, 2.13 for moderate depression, 3.33 for severe depression, and 3.67 for extreme depression. After adjusting for potential confounders, men with a potential depressive disorder had an approximate 90% higher mortality from suicide (adjusted HR, 1.92; 95% confidence interval [CI], 1.38 to 2.68; p<0.001) than men without depression. Each five-point increase in the GDS score was associated with a higher risk of death by suicide (adjusted HR, 1.22; p<0.001). The value of the area under the receiver operating characteristics curve of GDS scores for suicide deaths was 0.61 (95% CI, 0.58 to 0.64). Conclusions: Depressive symptoms assessed using the GDS were found to be a strong independent predictor of future suicide. However, the estimate of relative risk was weaker than would be expected based on retrospective psychological autopsy studies.
Abstract
Objectives: Prospective evaluations of the associations between depressive symptoms and suicide deaths have been mainly performed in high-risk populations, such as individuals with psychiatric disorders or histories of self-harm. The purpose of this study was to prospectively examine whether more severe depressive symptoms assessed using the Geriatric Depression Scale (GDS) were associated with a greater risk of death from suicide in a general-risk population. Methods: A total of 113 478 men from the Korean Veterans Health Study (mean age, 58.9 years) who participated in a postal survey in 2004 were followed up for suicide mortality until 2010. Results: Over 6.4 years of follow-up, 400 men died by suicide (56.7 deaths per 100 000 person-years). More severe depressive symptoms were associated with greater risk of suicide death (p for trend <0.001). The unadjusted hazard ratios (HRs) in comparison to the absence of depression were 2.18 for mild depression, 2.13 for moderate depression, 3.33 for severe depression, and 3.67 for extreme depression. After adjusting for potential confounders, men with a potential depressive disorder had an approximate 90% higher mortality from suicide (adjusted HR, 1.92; 95% confidence interval [CI], 1.38 to 2.68; p<0.001) than men without depression. Each five-point increase in the GDS score was associated with a higher risk of death by suicide (adjusted HR, 1.22; p<0.001). The value of the area under the receiver operating characteristics curve of GDS scores for suicide deaths was 0.61 (95% CI, 0.58 to 0.64). Conclusions: Depressive symptoms assessed using the GDS were found to be a strong independent predictor of future suicide. However, the estimate of relative risk was weaker than would be expected based on retrospective psychological autopsy studies.
참고문헌 (20)
- "OECD health statistics 2015; frequently requested data" (2015)[URL]
- Yoshimasu K, "Stress Research Group of the Japanese Society for Hygiene. Suicidal risk factors and completed suicide: meta-analyses based on psychological autopsy studies", Environ Health Prev Med, 13(5), pp.243~256 (2008)
- Hjelmeland H, "Psychological autopsy studies as diagnostic tools: are they methodologically flawed", Death Stud, 36(7), pp.605~626 (2012)
- Agerbo E, "High income, employment, postgraduate education, and marriage: a suicidal cocktail among psychiatric patients", Arch Gen Psychiatry, 64(12), pp.1377~1384 (2007)
- Bramness JG, "Self-reported mental health and its gender differences as a predictor of suicide in the middle-aged", Am J Epidemiol, 172(2), pp.160~166 (2010)
- Sun WJ, "Depressive symptoms and suicide in 56,000 older Chinese: a Hong Kong cohort study", Soc Psychiatry Psychiatr Epidemiol, 47(4), pp.505~514 (2012)
- Tamakoshi A, "Depressive mood and suicide among middle-aged workers: findings from a prospective cohort study in Nagoya, Japan", J Epidemiol, 10(3), pp.173~178 (2000)
- Yi SW, "Depressive symptoms and other risk factors predicting suicide in middle-aged men: a prospective cohort study among Korean Vietnam War veterans", PeerJ, 3, pp.e1071~ (2015)
- Schneider B, "Living alone, obesity, and smoking increase risk for suicide independently of depressive mood findings from the population-based MONICA", KORA Augsburg cohort study, 2014, pp.152-154, 416~421
- Yesavage JA, "Development and validation of a geriatric depression screening scale: a preliminary report", J Psychiatr Res, 17(1), pp.37~49 (1983)
- Cheng ST, "The geriatric depression scale as a screening tool for depression and suicide ideation: a replication and extention", Am J Geriatr Psychiatry, 18(3), pp.256~265 (2010)
- Heisel MJ, "Does the geriatric depression scale (GDS) distinguish between older adults with high versus low levels of suicidal ideation", Am J Geriatr Psychiatry, 13(10), pp.876~883 (2005)
- Ji Yang Kim, "Standardization of the Korean Version of the Geriatric Depression Scale: Reliability, Validity, and Factor Structure", PSYCHIATRY INVESTIGATION, 5(4), pp.232~238 (2008), 대한신경정신의학회
- Cho MJ, "Validation of geriatric depression scale, Korean version (GDS) in the assessment of DSM-III-R major depression", J Korean Neuropsychiatr Assoc, 38(1), pp.48~63 (1999)
- Yi SW, "Agent Orange exposure and disease prevalence in Korean Vietnam veterans: the Korean veterans health study", Environ Res, 133, pp.56~65 (2014)
- Parra Uribe I, "Attempted and completed suicide: not what we expected", J Affect Disord, 150(3), pp.840~846 (2013)
- Harriss L, "Suicidal intent in deliberate self-harm and the risk of suicide: the predictive power of the Suicide Intent Scale", J Affect Disord, 86(2-3), pp.225~233 (2005)
- McMillan D, "Can we predict suicide and non-fatal self-harm with the Beck Hopelessness Scale? A meta-analysis", Psychol Med, 37(6), pp.769~778 (2007)
- Jee SH, "Cardiovascular disease risk factors in relation to suicide mortality in Asia: prospective cohort study of over one million Korean men and women", Eur Heart J, 32(22), pp.2773~2780 (2011)
- Bjerkeset O, "Gender differences in the association of mixed anxiety and depression with suicide", Br J Psychiatry, 192(6), pp.474~475 (2008)