Depressive mixed state and anxious distress as risk factors for suicidality during major depressive episodes

Accurately assessing and predicting suicidality in patients with depression are challenging for researchers and clinicians. We examined various risk factors for suicidality during major depressive episodes (MDE), especially focusing on depressive mixed state (DMX) and anxious distress (AD). We recruited 187 patients with MDE and divided them into two groups—with and without suicidality—defined as the cut-off score of 1 or more on the suicidality sub-item in the Quick Inventory of Depressive Symptomatology-Self Report. The presence of DMX was defined as a total score of 13 or more on the self-administered 8-item questionnaire for DMX. We used multivariate logistic regression analysis with the presence or absence of suicidality as a dependent variable for investigating factors associated with suicidality. The with suicidality group was younger and indicated a greater proportion of past suicide attempts, AD, and DMX than the without suicidality group. Logistic regression analysis revealed that AD (P = 0.047) and DMX (P = 0.018) were significantly associated with suicidality. AD and DMX may promote suicidality during MDE. These two psychopathological features should be carefully monitored and intensively treated for the prevention of suicide-related events.