Antidepressant Therapy in Severe Depression May Have Different Effects on Ego-Dystonic and Ego-Syntonic Suicidal Ideation

Abstract EN

The objective of the present study was to investigate whether ego-dystonic and ego-syntonic suicidal ideation occurred at different frequencies during antidepressant therapy.

A blind evaluation has been performed on records of 100 suicides with a primary severe depression and 100 matched controls, admitted to the Department of Psychiatry, Lund, Sweden.

Ego-dystonic suicidal ideation was more commonly reported during adequate treatment as compared to ego-syntonic ideation (P=.004).

Men who committed suicide during adequate antidepressant therapy more often reported ego-dystonic suicidal ideation earlier in their lives compared with those who were not treated (P=.0377).

This may indicate that treatment failure for ego-dystonic ideation was a precursor of their suicides.

Consequently, ego-dystonic ideation seems to show a poorer response to antidepressant therapy as compared to ego-syntonic ideation, which may be more directly related to depression.

Ego-dystonic ideation is proposed to be related to depressive psychosis.