@article{3123905,
    title = "Psychotic (delusional) depression and suicidal attempts: a systematic review and meta-analysis",
    author = "Gournellis, R. and Tournikioti, K. and Touloumi, G. and Thomadakis, C. and Michalopoulou, P.G. and Christodoulou, C. and Papadopoulou, A. and Douzenis, A.",
    journal = "Acta Psychiatrica Scandinavica",
    year = "2018",
    volume = "137",
    number = "1",
    pages = "18-29",
    publisher = "Wiley-Blackwell Publishing Ltd",
    issn = "0001-690X, 1600-0447",
    doi = "10.1111/acps.12826",
    keywords = "Article;  delusion;  depressive psychosis;  Embase;  groups by age;  human;  medical literature;  Medline;  priority journal;  PsycINFO;  risk factor;  suicide attempt;  systematic review;  affective psychosis;  case control study;  delusion;  major depression;  meta analysis;  psychology;  statistics and numerical data;  suicide attempt, Affective Disorders, Psychotic;  Case-Control Studies;  Delusions;  Depressive Disorder, Major;  Humans;  Suicide, Attempted",
    abstract = "Objective: It still remains unclear whether psychotic features increase the risk of suicidal attempts in major depressive disorder. Thus, we attempted, through a systematic review coupled with a meta-analysis, to elucidate further whether unipolar psychotic depression (PMD) compared to non-PMD presents higher levels of suicidal attempts. Method: A systematic search was conducted in PubMed, EMBASE, PsycINFO as well as in various databases of the so-called gray literature for all studies providing data on suicidal attempts in PMD compared to non-PMD, and the results were then subjected to meta-analysis. Results: Twenty studies met our inclusion criteria, including in total 1,275 PMD patients and 5,761 non-PMD patients. An elevated risk for suicide attempt for PMD compared to non-PMD patients was found: The total (lifetime) fixed-effects pooled OR was 2.11 (95% CI: 1.81–2.47), and the fixed-effects pooled OR of the five studies of the acute phase of the disorder was 1.93 (95% CI: 1.33–2.80). This elevated risk of suicidal attempt for PMD patients remained stable across all age groups of adult patients. Conclusion: Despite data inconsistency and clinical heterogeneity, this systematic review and meta-analysis showed that patients with PMD are at a two-fold higher risk, both during lifetime and in acute phase, of committing a suicidal attempt than patients with non-PMD. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd"
}