Depression and suicidal behaviour

Depression Depression afflicts people of all ages. It has a long historical past and has been described for centuries by poets, philosophers and physicians, and depicted in the works of some of the most creative artists. Depressive disorders are referred to as mood disorders because the predominant feature is a disturbance in mood. They are classified into major depressive disorder, dysthymic disorder, depressive disorder not otherwise specified, bipolar disorders I and II, cyclothymic disorder, bipolar disorder not otherwise specified, mood disorder due to a general medical condition, substance-induced mood disorder and mood disorder not o therw ise spec i f ied_ . Var ious psychopathological conditions have been identified as co-morbid or risk factors in the aetiology of suicidal behaviour, especially depression. This is also true for South Africa. A recent South African study reported that depression was the most common diagnosis, being present in nearly twothirds (63.9%) of non-fatal suicidal patients seen in a large academic hospital. Some 25 years ago depression was already considered such a major problem in South Africa that a group of experts conceived a national treatment programme. Depression which may co-occur with medical or psychiatric/psychological disorders may also be brought on by the use of certain medications. Other risk factors for depression include a personal or family history of depressive disorder, prior suicide attempts, substance use, lack of social support, and stressful life events. South African studies have also indicated a high incidence of depression in suicidal school children, findings which are of increasing concern. A sad mood is normally not considered to have passed into a clinical depression at a specific point. Usually it is diagnosed when the patient’s depressed mood persists for too long, has become pathological and interferes with the index patient’s psychosocial, biovegetative and other functioning. Therefore a combination of intensity, severity and duration of the depressive symptoms are significant markers in depression.