The International Handbook of Suicide Prevention: Research, Policy and Practice

By Rory C. O’Connor; Jane Pirkis | Go to book overview

4
Major Mood Disorders
and Suicidal Behavior

Zoltán Rihmer and Peter Döme


Introduction

Major mood disorders (both unipolar major depression and bipolar disorder) are associated with a substantial burden of illness-related health and economic problems. Given the 12–17% lifetime prevalence of unipolar major depressive episode and 1.3%–5.0% lifetime prevalence of bipolar I and bipolar II disorders (Rihmer & Angst, 2009), they are among the most frequent and also the potentially most lifethreatening psychiatric illnesses (Angst, Angst, Gerber-Werder, & Gamma, 2005; Goodwin & Jamison, 2007; Hawton, Sutton, Haw, Sinclair, & Harris, 2005; Rihmer, 2005). In spite of the great clinical and public health significance of major mood disorders, people with these disorders are still under-referred, underdiagnosed, and undertreated (Dunner, 2003; Rihmer & Angst, 2005). This is particularly true for those who die by suicide and for those who attempt suicide and receive medical attention: more than 90% of them have at least one Axis I (mostly untreated) major mental disorder, most frequently a major depressive episode (56–87%), substance-use disorders (26–55%), and/or schizophrenia (6–13%). Comorbid anxiety and personality disorders are also frequently present, but they are rare as principal (or sole) diagnoses (Balázs, Lecrubier, Csiszér, Koszták, & Bitter, 2003; Goodwin & Jamison, 2007; Hawton, Saunders, Topiwala, & Haw, 2013; Hawton et al., 2005; Rihmer, 2007; Rihmer, Benazzi, & Gonda, 2007; Rihmer, Rózsa, Rihmer, & Gonda, 2009; Tondo, Isacsson, & Baldessarini, 2003). Although suicidal behavior (suicide and suicide attempts) is very rare in the absence of current major mental disorders, it is not their linear/direct consequence. It is a very complex and multicausal human behavior, involving some personality characteristics as well as several psychosocial and cultural components that play an important role not only in the development of suicidal processes but also in the recognition and management of suicidal risk.

The International Handbook of Suicide Prevention, Second Edition. Edited by Rory C. O’Connor and Jane Pirkis. © 2016 John Wiley & Sons, Ltd. Published 2016 by John Wiley & Sons, Ltd.

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