Suicide Rates Due to Depression Lower Than Thought
"Any suicide is one too many, but that does not mean we can't get more realistic about who is at risk," Bostwick tells WebMD. "We don't want to minimize any of this, but we are also selling medications based on these statistics. And there is a lot to suggest that we need to put our efforts toward the two-thirds of people who kill themselves who have never had any contact with mental health professionals."
Adds Bostwick: "the point is ... we can go around and around on this, but the number is incorrect, it is too broad and it is misquoted." He says it is time to change the numbers in the textbooks, and several depression experts who spoke to WebMD agree.
Donald W. Black, MD, professor of psychiatry at the University of Iowa School of Medicine, is an author of one of the textbooks that has quoted the 15% figure. After reading the paper, Black reviewed a passage himself and determined that he would need to make a correction to the text, which is in revision now.
When asked if his care of patients would change based on a lower number, Black replied, "absolutely not." He says he agrees with Bostwick that no matter what the suicide rate is, an accurate and thorough examination to determine someone's chance of committing suicide is an essential part of treatment.
"Depressed patients still have a much higher risk for suicide and suicidal behavior than the general population," says Black. "The greatest task of all psychiatrists is to ensure the safety of their patients. It doesn't reassure me. Every psychiatrist I know has had patients who killed themselves and we know personally what a tragedy it is."
"The main point is that the risk of suicide with depression is real, substantial, and higher than a nondepressed sample but not as high as previously reported because of the populations studied," says Andrew A. Nierenberg, MD, associate director of the Depression Clinical and Research Program at Massachusetts General Hospital, and an associate professor at Harvard Medical School, both in Boston.
But even though the rates are lower than previously believed, he emphasizes that we should never lose sight of the fact that "depression can be fatal."