The relationship between suicidality and depression

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Abstract
According to psychiatric classification systems and most influential psychological theories a close pathogenetic and/or causal relationship exists between suicidality and depression. However, upon reviewing the available empirical literature with respect to epidemiologic. post mortem, risk factor, follow-up, family, twin, adoption, biological, and therapy studies, this postulated close relationship could not be confirmed. Factors such as presence of any psychiatric disorder and personality traits such as impulsivity, aggressivity, addiction and suicide/suicide attempts in first degree relatives. as well as divorce, separation and parental discord, all seem to play an important role in the pathogenesis of suicidal behaviour. Furthermore, treatment studies with antidepressants, ECT, and lithium have only been able to demonstrate an antisuicidal effect for lithium. It remains an open question whether these factors play a independent role from depression or whether these factors have to be seen as additional to the depression. as operating factors for the development of suicide ideas. suicide attempts and suicide.