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Treatment Outcome in Suicidal vs. Non-Suicidal Elderly Patients

Received July 27, 2000; revised October 16, 2000; accepted October 30, 2000. From the Intervention Research Center for the Study of Late-Life Mood Disorders, Department of Psychiatry, University of Pittsburgh School of Medicine. Address correspondence to Dr. Szanto, 3811 O'Hara Street, Pittsburgh, PA 15213.

The authors investigated treatment outcome in elderly suicidal and non-suicidal patients with recurrent major depression. Patients without suicidal ideation in the current episode (Non-Ideators; n=150) were compared with 30 patients who expressed suicidal ideation (Ideators). Patients received combined pharmacotherapy and psychotherapy during acute and continuation treatment. Ideators had higher numbers of lifetime suicide attempts and reported significantly higher levels of depression, anxiety, and hopelessness before starting treatment. Ideators and Non-Ideators had almost identical remission rates (77% vs. 78%), but Ideators had higher relapse rates during continuation treatment (26% vs. 13%) and were more likely to receive augmentation pharmacotherapy. Anxiety and use of adjunctive medication, but not suicidal ideation, were negatively related to both remission and relapse. Our data suggest that elderly suicidal patients have an overall favorable treatment outcome. However, treatment response may be more brittle and may require the continuing use of adjunctive medications to prevent early relapse.

Key Words: Depression • Suicide • Treatment Outcome Studies

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