Is the Total Score of the Hamilton Depression Rating Scale Associated with Suicide Attempts or Suicides.
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Date
2013-01
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Abstract
Background: Most evidence behind interventions for depression is, in essence, based
on the total score of the 17-item Hamilton Depression Rating Scale (HDRS). We
identified no systematic review or meta-analysis examining if a total 17-item HDRS
score is associated with suicide attempts or suicides in depressive patients.
Methodology: Based on a systematic literature search CENTRAL in The Cochrane
Library, MEDLINE, EMBASE, PsycInfo, and Science Citation Index Expanded, we
systematically reviewed and meta-analysed observational studies examining if the total
17-item HDRS score is associated with suicide attempts or suicides.
Results: We identified and included ten cohort studies - seven retrospective and three
prospective. All the studies were assessed as high risk of bias. Meta-analysis on the
HDRS scores from three retrospective studies showed that depressive patients with a
suicide attempt during the on-going depressive episode had a significantly higher score
on the HDRS compared to non-suicidal patients (mean difference 6.31 HDRS; 95%
confidence interval 4.72 to 7.91; P<0.00001, I2=0). However, meta-analyses of the HDRS scores from three prospective studies and four studies reporting retrospectively
lifetime suicide attempts showed no significant differences between patients with or
without a suicide attempt or suicide.
Conclusion: A total score on the HDRS does not seem to be associated with past or
future suicide attempts or suicides. There seems to be a need for other assessment
tools to predict and explain risks of suicidality.
Description
Keywords
Hamilton, predictors, suicide, suicidal tendencies, depression, observational studies, systematic review, meta-analysis
Citation
Jakobsen Janus Christian, Simonsen Erik, Rasmussen Kirsten Buch, Gluud Christian. Is the Total Score of the Hamilton Depression Rating Scale Associated with Suicide Attempts or Suicides. British Journal of Medicine and Medical Research. 2013 Jan-Mar; 3(1): 140-152.