Suicide and depression

Introduction Suicide is a complex and multicausal phenomenon. It has a strong association with mental disorders, particularly major depressive disorder. Suicidal behaviors (both fatal and non-fatal) in patients with mood disorders are determined by their severity. Suicidal acts likely occur during depressive episodes, less often during mixed states, and very rarely in hypomania. However, the prevalence of suicidal behaviors in depressive disorders might be over-represented as a result of the misdiagnosis of normal sadness as a psychiatric disorder. There is a large amount of evidence showing that antidepressants are effective in preventing suicidal behaviors in mood disorders, but their effect remains controversial in young patients. The reduction in suicide is more prominent when combining pharmacotherapy and psychotherapy, rather than either therapy alone. This chapter reports on the epidemiology of suicidal behaviors in each type of mood disorder, discusses the boundaries between sadness and depressive disorders in relation to suicide, and highlights possible prevention strategies for suicide in patients with mood disorders.