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.
Int J Environ Res Public Health. 2018 Jun 21;15(7):1299. doi: 10.3390/ijerph15071299.
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.
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.
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.
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.
患有重性抑郁障碍（MDD）的自杀者常伴有其他合并症或共病诊断，且这些共病会增加自杀风险。本研究的目的首先是调查因自杀而死亡的严重抑郁症/忧郁症患者是否比匹配对照组有更多的其他精神障碍。其次，估计并比较严重抑郁症患者的总组中合并症和附加诊断的一般发生率与 MDD 的文献。
对在 1956 年至 1969 年期间被收入瑞典隆德大学精神病学部且随访至 2010 年的 100 例严重抑郁症/忧郁症（伴或不伴精神病性特征的 MDD：MDD-M/P）自杀者和匹配对照组进行了盲法记录评估。记录了除严重抑郁症以外的其他诊断。
自杀者和对照组中不到一半的人只有一种精神障碍（自杀组中为 47%，对照组中为 46%）。平均诊断数分别为 1.80 和 1.82。附加诊断与自杀风险增加无关。焦虑是最常见的诊断。疑诊精神分裂症/精神分裂样或附加强迫症症状的发生率高于预期，但酒精使用障碍并不常见。
在 MDD 中，伴发合并症/附加诊断的自杀风险增加似乎不适用于 MDD-M/P（重度抑郁症-抑郁/忧郁）患者。一些诊断，如精神分裂症/精神分裂样障碍，比预期更常见，这一点将进行讨论，并提出与 MDD-M/P 有遗传重叠的可能性。
