Suicidal Ideation among Patients with Major Depressive Disorder Living at High Altitude
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- Category: Vol. 82, December 2014
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Suicidal Ideation among Patients with Major Depressive Disorder Living at High Altitude, SAEED A. ASIRI
Abstract
Objective: To compare the prevalence of suicidal ideation among Saudi major depressive disorder (MDD) patients living at sea level with those living at high altitude.
Patients and Methods: All newly diagnosed adult Saudi MDD patients at Abha Psychiatric Hospital (n=69 patients) and Jizan Psychiatric Hospital (n=47 patients) during the period from January till December 2013 were included in this study. The diagnosis of depression for our cases was based on “Structured Clinical Interview for DSM-IV” (SCID), while suicidal ideation was assessed by the “Columbia-Suicide Severity Rating Scale” (C-SSRS). A venous blood sample was taken from each patient for the assessment of FT3, FT4 and TSH blood levels.
Results: The majority of MDD patients in both Jizan Psychiatric Hospital (JPH) and Abha Psychiatric Hospital (APH) were females (80.9% and 84.5%, respectively). Most cases belonged to the age group 25-50 years (64.7%). Mean blood levels of thyroid hormone (T3 and T4) were slightly lower in MDD patients living at high altitude than those at sea level, while the mean blood level of TSH in patients living at high altitude was slightly higher than that in patients living at sea level. Nine MDD patients (8%) had suicidal ideation. All 9 patients with suicidal ideation were females. The prev-alence of suicidal ideation was highest among older MDD patients (15.8%) and was higher among patients living at high altitude than those living at sea level (11.6% and 2.1%, respectively). FT3 blood level was significantly higher in patients with no suicidal ideation than those with suicidal ideation (4.81±0.93pmol/L and 4.01±1.36pmol/L, respectively, p=0.019). FT4 blood level was significantly higher in patients with no suicidal ideation than those with suicidal ideation (15.49±2.75pmol/L and 12.13±5.32pmol/L, respectively, p=0.007). TSH blood level was significantly lower in patients with no suicidal ideation than those with suicidal ideation (2.69±1.82mU/L and 5.51±2.86mU/L, respectively, p=0.001).
Conclusions: MDD among Saudi adults affects mainly females. Lower blood levels of FT3 and FT4 and higher blood level of TSH among MDD patients are significantly associated with suicidal ideation. Living at high altitude may be associated with a higher prevalence of suicidal ideation among MDD patients.