Major depression, physical illness, and suicidal ideation in primary care

Renee D. Goodwin, Kurt Kroenke, Christina W. Hoven, Robert L. Spitzer

Research output: Contribution to journalArticle

110 Citations (Scopus)

Abstract

Objective: To determine the association between major depression and suicidal ideation and the role of physical illness in this link among primary care patients. Method: More than 3,000 randomly selected primary care patients at eight sites across the United States completed the PRIME-MD PHQ, a screen for mental disorders for use in primary care. Physicians independently diagnosed physical illnesses. Multiple logistic regression analyses were used to determine the relationship between PRIME-MD depression, physical illness, and suicidal ideation. Results: Pulmonary disease was associated with an increased likelihood of suicidal ideation, even among patients without major depression [odds ratio = 1.9 (1.04, 3.4)]. There was evidence of statistical interaction between pulmonary disease and depression in increasing the odds of suicidal ideation. Specifically, patients with pulmonary disease without depression, those with depression without pulmonary disease, and patients with both pulmonary disease and depression had significantly increased odds of suicidal ideation with odd ratios of 1.9 (1.04, 3.4), 7.4 (5.6, 9.7), and 9.6 (5.1, 18.0), respectively. Conclusions: These data suggest that some physical disorders may be associated with increased suicidal ideation in primary care and may also play a role in the relationship between depression and suicidal ideation among primary care patients. Primary care physicians may wish to engage in an in-depth evaluation of psychiatric problems, especially current suicidal ideation, among patients with specific ongoing physical illnesses.

Original languageEnglish (US)
Pages (from-to)501-505
Number of pages5
JournalPsychosomatic Medicine
Volume65
Issue number4
DOIs
StatePublished - Jul 1 2003

Fingerprint

Suicidal Ideation
Primary Health Care
Depression
Lung Diseases
Odds Ratio
Primary Care Physicians
Mental Disorders
Psychiatry
Logistic Models
Regression Analysis
Physicians

Keywords

  • Comorbidity
  • Depression
  • Physical illness
  • Primary care
  • Pulmonary disease
  • Suicidal ideation

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Psychology(all)

Cite this

Major depression, physical illness, and suicidal ideation in primary care. / Goodwin, Renee D.; Kroenke, Kurt; Hoven, Christina W.; Spitzer, Robert L.

In: Psychosomatic Medicine, Vol. 65, No. 4, 01.07.2003, p. 501-505.

Research output: Contribution to journalArticle

Goodwin, Renee D. ; Kroenke, Kurt ; Hoven, Christina W. ; Spitzer, Robert L. / Major depression, physical illness, and suicidal ideation in primary care. In: Psychosomatic Medicine. 2003 ; Vol. 65, No. 4. pp. 501-505.
@article{bcc55f31312949f9996dd94948cf22da,
title = "Major depression, physical illness, and suicidal ideation in primary care",
abstract = "Objective: To determine the association between major depression and suicidal ideation and the role of physical illness in this link among primary care patients. Method: More than 3,000 randomly selected primary care patients at eight sites across the United States completed the PRIME-MD PHQ, a screen for mental disorders for use in primary care. Physicians independently diagnosed physical illnesses. Multiple logistic regression analyses were used to determine the relationship between PRIME-MD depression, physical illness, and suicidal ideation. Results: Pulmonary disease was associated with an increased likelihood of suicidal ideation, even among patients without major depression [odds ratio = 1.9 (1.04, 3.4)]. There was evidence of statistical interaction between pulmonary disease and depression in increasing the odds of suicidal ideation. Specifically, patients with pulmonary disease without depression, those with depression without pulmonary disease, and patients with both pulmonary disease and depression had significantly increased odds of suicidal ideation with odd ratios of 1.9 (1.04, 3.4), 7.4 (5.6, 9.7), and 9.6 (5.1, 18.0), respectively. Conclusions: These data suggest that some physical disorders may be associated with increased suicidal ideation in primary care and may also play a role in the relationship between depression and suicidal ideation among primary care patients. Primary care physicians may wish to engage in an in-depth evaluation of psychiatric problems, especially current suicidal ideation, among patients with specific ongoing physical illnesses.",
keywords = "Comorbidity, Depression, Physical illness, Primary care, Pulmonary disease, Suicidal ideation",
author = "Goodwin, {Renee D.} and Kurt Kroenke and Hoven, {Christina W.} and Spitzer, {Robert L.}",
year = "2003",
month = "7",
day = "1",
doi = "10.1097/01.PSY.0000041544.14277.EC",
language = "English (US)",
volume = "65",
pages = "501--505",
journal = "Psychosomatic Medicine",
issn = "0033-3174",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Major depression, physical illness, and suicidal ideation in primary care

AU - Goodwin, Renee D.

AU - Kroenke, Kurt

AU - Hoven, Christina W.

AU - Spitzer, Robert L.

PY - 2003/7/1

Y1 - 2003/7/1

N2 - Objective: To determine the association between major depression and suicidal ideation and the role of physical illness in this link among primary care patients. Method: More than 3,000 randomly selected primary care patients at eight sites across the United States completed the PRIME-MD PHQ, a screen for mental disorders for use in primary care. Physicians independently diagnosed physical illnesses. Multiple logistic regression analyses were used to determine the relationship between PRIME-MD depression, physical illness, and suicidal ideation. Results: Pulmonary disease was associated with an increased likelihood of suicidal ideation, even among patients without major depression [odds ratio = 1.9 (1.04, 3.4)]. There was evidence of statistical interaction between pulmonary disease and depression in increasing the odds of suicidal ideation. Specifically, patients with pulmonary disease without depression, those with depression without pulmonary disease, and patients with both pulmonary disease and depression had significantly increased odds of suicidal ideation with odd ratios of 1.9 (1.04, 3.4), 7.4 (5.6, 9.7), and 9.6 (5.1, 18.0), respectively. Conclusions: These data suggest that some physical disorders may be associated with increased suicidal ideation in primary care and may also play a role in the relationship between depression and suicidal ideation among primary care patients. Primary care physicians may wish to engage in an in-depth evaluation of psychiatric problems, especially current suicidal ideation, among patients with specific ongoing physical illnesses.

AB - Objective: To determine the association between major depression and suicidal ideation and the role of physical illness in this link among primary care patients. Method: More than 3,000 randomly selected primary care patients at eight sites across the United States completed the PRIME-MD PHQ, a screen for mental disorders for use in primary care. Physicians independently diagnosed physical illnesses. Multiple logistic regression analyses were used to determine the relationship between PRIME-MD depression, physical illness, and suicidal ideation. Results: Pulmonary disease was associated with an increased likelihood of suicidal ideation, even among patients without major depression [odds ratio = 1.9 (1.04, 3.4)]. There was evidence of statistical interaction between pulmonary disease and depression in increasing the odds of suicidal ideation. Specifically, patients with pulmonary disease without depression, those with depression without pulmonary disease, and patients with both pulmonary disease and depression had significantly increased odds of suicidal ideation with odd ratios of 1.9 (1.04, 3.4), 7.4 (5.6, 9.7), and 9.6 (5.1, 18.0), respectively. Conclusions: These data suggest that some physical disorders may be associated with increased suicidal ideation in primary care and may also play a role in the relationship between depression and suicidal ideation among primary care patients. Primary care physicians may wish to engage in an in-depth evaluation of psychiatric problems, especially current suicidal ideation, among patients with specific ongoing physical illnesses.

KW - Comorbidity

KW - Depression

KW - Physical illness

KW - Primary care

KW - Pulmonary disease

KW - Suicidal ideation

UR - http://www.scopus.com/inward/record.url?scp=0041461853&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0041461853&partnerID=8YFLogxK

U2 - 10.1097/01.PSY.0000041544.14277.EC

DO - 10.1097/01.PSY.0000041544.14277.EC

M3 - Article

C2 - 12883095

AN - SCOPUS:0041461853

VL - 65

SP - 501

EP - 505

JO - Psychosomatic Medicine

JF - Psychosomatic Medicine

SN - 0033-3174

IS - 4

ER -