British Journal of Medicine and Medical Research, ISSN: 2231-0614,Vol.: 3, Issue.: 1 (January-March)

Original-research-article

Is the Total Score of the Hamilton Depression Rating Scale Associated with Suicide Attempts or Suicides?

Janus Christian Jakobsen1,2*, Erik Simonsen2, Kirsten Buch Rasmussen and Christian Gluud1 1Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 3344 Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.

2Psychiatric Research Unit, Copenhagen University Hospital and Region Zealand, Roskilde, Denmark.

Article Information

Editor(s):

(1) Anonymous.

Reviewers:

(1) Janet B. W. Williams, Columbia University, USA.

(2) Anonymous.

(3) Anonymous.

Complete Peer review History: http://www.sciencedomain.org/review-history/810

Abstracts

Background: Most evidence behind interventions for depression is, in essence, based on the total score of the 17-item Hamilton Depression Rating Scale (HDRS). We identified no systematic review or meta-analysis examining if a total 17-item HDRS score is associated with suicide attempts or suicides in depressive patients.

Methodology: Based on a systematic literature search CENTRAL in The Cochrane Library, MEDLINE, EMBASE, PsycInfo, and Science Citation Index Expanded, we systematically reviewed and meta-analysed observational studies examining if the total 17-item HDRS score is associated with suicide attempts or suicides.

Results: We identified and included ten cohort studies - seven retrospective and three prospective. All the studies were assessed as high risk of bias. Meta-analysis on the HDRS scores from three retrospective studies showed that depressive patients with a suicide attempt during the on-going depressive episode had a significantly higher score on the HDRS compared to non-suicidal patients (mean difference 6.31 HDRS; 95% confidence interval 4.72 to 7.91; P<0.00001, I2=0). However, meta-analyses of the HDRS scores from three prospective studies and four studies reporting retrospectively lifetime suicide attempts showed no significant differences between patients with or without a suicide attempt or suicide.

Conclusion: A total score on the HDRS does not seem to be associated with past or future suicide attempts or suicides. There seems to be a need for other assessment tools to predict and explain risks of suicidality.

Keywords :

Hamilton; predictors; suicide; suicidal tendencies; depression; observational studies; systematic review; meta-analysis.

Full Article - PDF Page 140-152

DOI : 10.9734/BJMMR/2013/1709