RESUMO
The authors determined differential clinical correlates of active suicidal ideation vs. passive death wish in elderly patients with recurrent major depression. Measures of lifetime suicidal behavior and ratings of suicidal ideation, hopelessness, and depression determined "ideator" status. Active and Passive Ideators as well as Non-Ideators were then compared. Sixty percent of Active Ideators endorsed disgust or self-hatred items on the Beck Depression Inventory, compared with only 25% of Passive Ideators and 20% of Non-Ideators. However, these data challenge the clinical utility of distinguishing active and passive suicidal ideation among such patients because the two groups overall appear to be more alike than different, and ideator status (passive vs. active) may change during an episode. Clinicians should therefore not be less clinically vigilant if such patients' suicidal ideation is "only" passive.
RESUMO
The authors compared the 2-year survival rates of patients with 1) mixed clinical presentations (n=58), 2) major depression without cognitive impairment (n = 51), and 3) primary degenerative dementia without depression (n = 34). Two-year survival rates were 100% in healthy controls, 91% in patients with major depression, and 76.1% and 78.3%, respectively, in patients with primary degenerative dementia and mixed symptoms. Patients with cognitive impairment (either primary degenerative dementia or mixed symptoms) were 2.55 times more likely to die within the 2-year follow-up than patients with major depression. These data are consistent with previous observations that survival rates of elderly patients with organic mental syndromes are lower than those of elderly patients with "functional" or "psychogenic" disorders.