The influence of thoughts of death and suicidal ideation on the course of depression in older depressed patients

International Journal of Geriatric PsychiatryBogers ICHM, et al. | July 21, 2016

In a study to examine the impact of suicidal thoughts and suicidal intent on elderly depression course, researchers found severe baseline and follow–up depression among those who exhibited thoughts of death or suicidal ideation, with the highest risk of being depressed at follow–up for patients with thoughts of suicide. Therefore, thoughts of death and thoughts of suicide should be considered as essential pointers to track the depression course.



  • In this research, using questions from the Composite International Diagnostic Interview, 378 depressed older persons were interrogated for thoughts of death and thoughts of suicide.
  • Again, 2 years later, participants were assessed for the presence of a DSM-IV-TR diagnosis of minor or major depression or dysthymia using the Composite International Diagnostic Interview.
  • The subjects were further assessed using the Inventory of Depressive Symptomatology every 6 months up till 3-year follow-up.


  • Thoughts of death as well as thoughts of suicide predicted double depression at follow-up (OR = 2.14 [95% CI: 1.04–4.40] and OR = 6.47 [95% CI: 2.22–3.02], respectively), compared with patients without these thoughts, as demonstrated by multinomial logistic regression.
  • Results lost significance when adjusted for baseline depression severity (OR = 1.17 [95% CI: 0.52–2.63] and OR = 2.57 [95% CI: 0.79–8.84], respectively).
  • As per mixed linear models, reference group showed lowest severity of depression, while symptoms decreased more over time in those with either thoughts of death or suicide.

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