Pitt researchers find fluctuation of depressive symptoms is a risk factor for suicide

A new study from University of Pittsburgh researchers finds that when predicting suicide risk in young adults, extra focus should be paid to the fluctuation of depressive symptoms.

These symptoms can include feelings of worthlessness, sadness or inappropriate guilt. People may also experience fatigue, or an inability to concentrate or a loss of interest or pleasure in activities.

Pitt psychiatrist Nadine Melhem, the study’s senior author, said the more severe and more variable these symptoms, the more at risk a patient is for suicide.  That means if a person is feeling better, their doctor shouldn’t assume they’re no longer at risk.

“We need to look at not just their current depressive symptoms, but their past depressive symptoms and how they have been changing in order to reduce the severity and fluctuations and potentially reducing the risk for suicide,’” she said.

The study’s volunteers comprised 663 young adults who had at least one parent with a mood disorder, which puts a person at higher risk for suicidal behavior. After following the participatents for more 12 years, researchers founds that individuals who had more flucutation in their depressive symptoms were more at risk for suicide.

Looking at how a patient’s mode fluctuates overtime may be a shift in how some clinicians diagnose and monitor patients. That’s because a doctor might interpet a temporary regression of symptoms as an improvement, when it actually might be an indicator of poor mental health. 

Such an assumption can result in patients and providers letting their guards down.

“When people feel better, they may be just hopeful about — you know, I’m feeling better. I’m fine. I may not need to seek treatment,” she said. “But then [depression] sneaks up again.”

Melhem and her collaborators used this finding on the importance of tracking the fluctuation of symptoms fluctation to create a new model for predicting suicide risk in young adults. The assessments looks at the variability of symptoms, along other risk factors including younger age, the presence of mood disorders or childhood abuse, and a personal or parental history of suicide attempts. 

If a person has three or more of these risk factors, the model indicates they are at higher risk for suicide. However, researchers still must test the diagonistic tool on more populations to determine its accuracy.

The study was published last week in the journal JAMA Psychiatry.

If you are in crisis, you can call the National Suicide Prevention Lifeline at 1-800-273-TALK or contact the Crisis Text Line by texting TALK to 741741.

This story comes from WESA, which receives funding from the University of Pittsburgh.