BMJ  2006;332:1154 (13 May), doi:10.1136/bmj.332.7550.1154

Letter

Depression should be managed like a chronic disease

Myth of 15% suicide rate was promulgated again

The first 150 words of the full text of this article appear below.

EDITOR—Scott's editorial arguing that depression should be managed as a chronic disease perpetuates the myth that 15% of people with depression will eventually commit suicide.¹

A much cited meta-analysis in 1970 found that 15% of people with depression committed suicide.² It focused primarily on people admitted with severe depression, so it should never have been generalised to the broader population of people with depression.

Several rigorous studies have subsequently been published refuting the 15% claim. A meta-analysis by Bostwick and Pankratz found a hierarchy of lifetime suicide prevalences: 8.6% in people ever admitted for suicidality, 4% in patients admitted with affective disorder but not specifically for suicidality, and 2.2% in mixed inpatient and outpatient populations.³

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Boardman and Healy analysed data from a database of suicide cases in North Staffordshire, and used psychiatric prevalences from the US national comorbidity survey to calculate lifetime suicide risk in people . . . [Full text of this article]

Department of Public Health, Flinders University, Box 2100, Adelaide, SA 5001, Australia melissa.raven@flinders.edu.au

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Depression should be managed like a chronic disease

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