Advanced

The very long-term course of severe depression, with focus on suicidality

Crona, Lisa LU (2015) In Lund University, Faculty of Medicine. Doctoral Dissertation Series 2015:140.
Abstract
Abstract

Objective: To study the very long-term course of severe depression and the subjects own experiences many years after a suicide attempt. Method: Patients diagnosed with severe depression/melancholia between 1956 and 1969 were interviewed 37- 53 years after index admission. Seventy-five telephone interviews were held and medical records were read in many cases. Long-term course of depression was evaluated by cluster analysis. Suicide attempts were related to the depressive course. Among those interviewed, 13 who made one or more suicide attempts were in 2013 asked to attend a qualitative interview. Semi-structured interviews were held, using an interview guide and analysed according to grounded theory technique. Result:... (More)
Abstract

Objective: To study the very long-term course of severe depression and the subjects own experiences many years after a suicide attempt. Method: Patients diagnosed with severe depression/melancholia between 1956 and 1969 were interviewed 37- 53 years after index admission. Seventy-five telephone interviews were held and medical records were read in many cases. Long-term course of depression was evaluated by cluster analysis. Suicide attempts were related to the depressive course. Among those interviewed, 13 who made one or more suicide attempts were in 2013 asked to attend a qualitative interview. Semi-structured interviews were held, using an interview guide and analysed according to grounded theory technique. Result: There was a short-term course, with or without recurrence, or a chronic course with or without late remission. Heredity for depression was significantly related to a chronic course, with or without late improvement. Twenty-nine subjects had attempted suicide, of whom 13 had made repeated attempts. The risk of attempting suicide decreased by 10% for every decade which depression occurred. Suicide attempts were made early in the course of depression, and there was a longer total time of depression after suicide attempts than before. Three categories where identified after a suicide attempt: coming under professional care, experiencing a relief in the personal situation and making a decision to continue to live. From these a core-category emerged labelled regaining control and taking care of oneself. Conclusion: Both long-term improvement and late recurrences are possible after a chronic course of severe depression. Our results also indicate that recovery from depression is not a precondition for ending suicidal behavior. Adding some kind of psychosocial treatment to initial somatic treatment seems important. (Less)
Please use this url to cite or link to this publication:
author
supervisor
opponent
  • Waern, Margda, Gothenburg University
organization
publishing date
type
Thesis
publication status
published
subject
keywords
life-chart, qualitative, suicide attempt, psychotic depression, long-term melancholia, depression
in
Lund University, Faculty of Medicine. Doctoral Dissertation Series
volume
2015:140
pages
83 pages
publisher
Department of Clinical Sciences, Lund University
defense location
Konferensrumn13, Baravägen 1C, Lund.
defense date
2015-12-16 09:00
ISSN
1652-8220
ISBN
978-91-7619-220-7
language
English
LU publication?
yes
id
365a7e1f-74de-44af-a581-8bf4f2d63d29 (old id 8229303)
date added to LUP
2015-11-26 09:26:45
date last changed
2016-09-19 08:44:46
@phdthesis{365a7e1f-74de-44af-a581-8bf4f2d63d29,
  abstract     = {Abstract<br/><br>
Objective: To study the very long-term course of severe depression and the subjects own experiences many years after a suicide attempt. Method: Patients diagnosed with severe depression/melancholia between 1956 and 1969 were interviewed 37- 53 years after index admission. Seventy-five telephone interviews were held and medical records were read in many cases. Long-term course of depression was evaluated by cluster analysis. Suicide attempts were related to the depressive course. Among those interviewed, 13 who made one or more suicide attempts were in 2013 asked to attend a qualitative interview. Semi-structured interviews were held, using an interview guide and analysed according to grounded theory technique. Result: There was a short-term course, with or without recurrence, or a chronic course with or without late remission. Heredity for depression was significantly related to a chronic course, with or without late improvement. Twenty-nine subjects had attempted suicide, of whom 13 had made repeated attempts. The risk of attempting suicide decreased by 10% for every decade which depression occurred. Suicide attempts were made early in the course of depression, and there was a longer total time of depression after suicide attempts than before. Three categories where identified after a suicide attempt: coming under professional care, experiencing a relief in the personal situation and making a decision to continue to live. From these a core-category emerged labelled regaining control and taking care of oneself. Conclusion: Both long-term improvement and late recurrences are possible after a chronic course of severe depression. Our results also indicate that recovery from depression is not a precondition for ending suicidal behavior. Adding some kind of psychosocial treatment to initial somatic treatment seems important.},
  author       = {Crona, Lisa},
  isbn         = {978-91-7619-220-7},
  issn         = {1652-8220},
  keyword      = {life-chart,qualitative,suicide attempt,psychotic depression,long-term melancholia,depression},
  language     = {eng},
  pages        = {83},
  publisher    = {Department of Clinical Sciences, Lund University},
  school       = {Lund University},
  series       = {Lund University, Faculty of Medicine. Doctoral Dissertation Series},
  title        = {The very long-term course of severe depression, with focus on suicidality},
  volume       = {2015:140},
  year         = {2015},
}