TY - JOUR TI - Psychotic (delusional) depression and suicidal attempts: a systematic review and meta-analysis AU - Gournellis, R. AU - Tournikioti, K. AU - Touloumi, G. AU - Thomadakis, C. AU - Michalopoulou, P.G. AU - Christodoulou, C. AU - Papadopoulou, A. AU - Douzenis, A. JO - Acta Psychiatrica Scandinavica PY - 2018 VL - 137 TODO - 1 SP - 18-29 PB - Wiley-Blackwell Publishing Ltd SN - 0001-690X, 1600-0447 TODO - 10.1111/acps.12826 TODO - 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 TODO - 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 ER -