Death by suicide long after electroconvulsive therapy : is the sense of coherence test of Antonovsky a predictor of mortality from depression?
Original version
Berg, J.E. (2010). Death by suicide long after electroconvulsive therapy : is the sense of coherence test of Antonovsky a predictor of mortality from depression?. Mental Illness, 2 (3), 11-15 http://dx.doi.org/10.4081/mi.2010.e3Abstract
Prediction of increased risk of suicide is difficult.
We had the opportunity to follow up 20
patients receiving electroconvulsive therapy
(ECT) because of severe depression. They
filled in the Antonovsky sense of coherence
test (SOC) and Beck depression inventory
(BDI) before and after a series of ECT treatments.
Seventeen surviving patients had a
mean observation time of 20.6 months, whereas
the three deceased patients had 11.3
months. There was a lower mean age at onset
of illness and a longer mean duration of disease
in the deceased. Other clinical parameters
did not differ. The surviving patients had a
significant decrease on the BDI from 35 to 18
(P<0.001) and an increase on the SOC test
after ECT from 2.45 to 3.19 (P<0.001), indicating
both less depression and better functioning
in life. The deceased had a larger change
on the BDI from 32 to 13, not attaining significance
because of the low number of deceased.
The SOC test, however, did not increase to a
purported normal level; that is, from 2.43 to
2.87. Although the SOC scale has been shown
to predict mortality in substance abusers, the
SOC test has not been part of earlier reviews of
predictive power. Tentatively, a low pathological
score on the SOC test may indicate low
sense of coherence in life that might increase
the propensity for suicide. These preliminary
results need replication in larger studies.