Major Depression: Does a Gender-Based Down-Rating of Suicide Risk Challenge Its Diagnostic Validity?

Author:

Blair-West George W.1,Mellsop Graham W.2

Affiliation:

1. University of Queensland, Brisbane, Australia

2. South Auckland Clinical School, University of Auckland, Auckland, New Zealand

Abstract

Objective: This paper will summarize the authors' research that disproved the accepted lifetime suicide risk in major depression. It will then explore the pivotal issue of gender in understanding suicide risk in depression and raise questions as to whether this is adequately reflected in the current diagnostic construct of this condition. Method: The methods of two recent papers published by the authors are briefly recounted. In the first of these papers, an age-specific algorithm was developed to reflect the necessary mathematical relationship between the prevalence of major depression, total population suicide rates and suicide risk in depression. It allowed for deaths in each age group from other causes, corrected for official underreporting, and was calculated on the entire population of the USA. In the second paper this methodology was further refined and applied to gender and age data. Results: The suicide risk in major depression as it is currently defined diagnostically is of the order of 3.4% rather than the previously accepted figure of 15%. However, a single figure is misleading as it averages two highly disparate figures of almost 7% for men and only 1% for women. In youths (< age 25) the male : female ratio is even higher (10:1). Conclusions: Among sufferers of major depression, men and those who have been hospitalized have a much greater risk of suicide. These findings are sensitive to diagnostic inclusivity (the algorithm's denominator) which raises the question as to whether women with a depressive illness are more likely to be correctly identified than male sufferers? An argument is made for a gender-based nosological revision of the diagnostic criteria. In the interim, given the treatable morbidity of depression and the availability of safe, welltolerated antidepressants, there is a prima facie case for lowering our threshold of treatment in men and youths presenting with a history of anger dyscontrol, or substance abuse, who have decompensated from previous levels of functioning and who show features of either typical or atypical depression.

Publisher

SAGE Publications

Subject

Psychiatry and Mental health,General Medicine

Cited by 22 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3