Prevalence and Correlates of Suicide Attempts in Chinese Outpatients With First‐Episode and Drug‐Naïve Psychotic Major Depressive Disorder at Different Ages of Onset

BACKGROUND: Prior research has shown varying suicide attempt rates based on the age of onset in major depressive disorder (MDD) patients. However, there is a paucity of research on psychotic major depressive disorder (PMD) patients. This study aimed to assess the prevalence and correlates of suicide attempts in PMD patients stratified by age of onset. METHODS: Totally, 1718 first-episode drug-naïve MDD outpatients were recruited, divided into early-age onset (EAO) and middle-age onset (MAO) based on the first episode before age 45/after age 45. Clinical severity was assessed using the Hamilton Depression Rating Scale (HAMD), the Hamilton Anxiety Rating Scale (HAMA) and the Positive and Negative Syndrome Scale (PANSS) positive subscale. In addition, thyroid hormone and glucolipid metabolism indicators were measured. RESULTS: In EAO PMD patients, HAMA scale score and thyroid-stimulating hormone (TSH) levels were associated with suicide attempts. The area under the receiver operating characteristic curve (AUROC) was 0.892. In MAO PMD patients, TSH and diastolic blood pressure were associated with suicide attempts. The AUROC was 0.862. CONCLUSION: This study demonstrates that the prevalence and correlates of suicide attempts vary among PMD patients with different ages of onset. Age of onset should be considered in the prevention and treatment of suicide attempts in patients with PMD.