Relating irritability and suicidal ideation using mood and anxiety.

Content Provider	Europe PMC
Author	Malhi, Gin Bell, Erica Das, Pritha Outhred, Tim
Copyright Year	2019
Abstract	Background Suicide is common in the context of depression and bipolar disorders, but there remains a lack of understanding as to how suicide ideation, a common symptom of mood disorders, progresses to suicidal behaviour. Irritability, a feature of some types of depression, is thought to contribute to the development of suicidal behaviour, but these associations are not well established. Objective To examine the relationship between irritability and suicide ideation according to the subtype of depression expressed in patients with mood disorder. Methods 75 patients with mood disorders seen at the CADE (Clinical Assessment Diagnostic Evaluation) Clinic underwent clinical assessment for suicidal ideation (Paykel Suicide Scale), symptom severity (Young Mania Rating Scale (YMRS), Hamilton Rating Scale for Depression (HAM-D) (anxious depression), Montgomery-Åsberg Depression Rating Scale (MADRS) (melancholic depression)) and irritability (item 5 of the YMRS). Findings Interestingly, irritability correlated with mania (r=0.734, p<0.001 (YMRS)) and depressive symptom scores (r=0.369, p<0.001 (MADRS); r=0.477, p<0.001 (HAM-D)), which in turn correlated with suicide ideation scores (r=0.364, p<0.01 (MADRS); r=0.275, p=0.017 (HAM-D)). However, despite this indirect association, there was no direct correlation between irritability and suicide ideation (r=0.050, p>0.05). Conclusions The nature of the relationship between irritability and suicidal ideation is determined by the emotional context within which irritability operates. Clinical implications Findings suggest that rather than examining irritability alone, consideration of the subtype of depression, especially that of anxious depression, should be paramount in assessing suicide risk.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC10270456&blobtype=pdf
ISSN	13620347
Volume Number	22
DOI	10.1136/ebmental-2019-300100
PubMed Central reference number	PMC10270456
Issue Number	3
PubMed reference number	31248975
Journal	Evidence-Based Mental Health [Evid Based Ment Health]
e-ISSN	1468960X
Language	English
Publisher	BMJ Publishing Group
Publisher Date	2019-06-27
Publisher Place	BMA House, Tavistock Square, London, WC1H 9JR
Access Restriction	Open
Rights License	© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
Subject Keyword	irritability suicide depression anxiety melancholia major depressive disorder bipolar disorder bipolar depression
Content Type	Text
Resource Type	Article
Subject	Psychiatry and Mental Health