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The frequency of depressive illness was investigated in 195 patients who had been referred consecutively after attempted suicide during the period 15. February 1989-15, October 1989. A total of 130 of these patients were admitted to hospital while the remainder were treated in the psychiatric emergency room or admission department. Registration of depressive symptoms on admission revealed that 85% had depressed mood and other depressive symptoms. According to the criteria established by Feighner et al. 51% suffered from definite depressive disease on admission. According to Zung's Depression Scale, 60% were depressed. On the basis of observations during hospitalization, 25% suffered from depressive disease according to the criteria established by Feighner et al. 19% of these patients suffered from endogenic depression according to the Newcastle I scale which corresponds to 5% of all the hospitalized patients with attempted suicide. Approximately 10% were treated with antidepressives. Only 8% were discharged with the diagnoses of endogenic or reactive psychoses (ICD-8). It is concluded that depressive symptoms occur in the majority of patients with attempted suicide but that slight non-endogenic depressive states are most commonly concerned and that many of these improve rapidly during hospitalization without medicinal treatment. Restraint should be observed in prescription of antidepressive medicine to patients with attempted suicide until the diagnosis of depressive disease is verified.

Primary non-endogenous depression was examined with respect to preceding life stress and instability of personality. A sample of 146 hospitalized patients suffering from primary endogenous depression, primary non-endogenous depression or depression secondary to a neurosis was interviewed for preceding personal loss and completed the Eysenck Personality Inventory after recovery. Presence of a preceding personal loss did not discriminate between the three types of depression. Only in personality patterns did primary non-endogenous depressives show features that have been attributed to reactive depression. The primary non-endogenous depressives were significantly more introverted and neurotic than the endogenous depressives, but had lower neuroticism scores than patients with depression secondary to neuroses. Two-thirds of all depressives were found to dissimulate on the Lie scale. Depressives secondary to neuroses showed significantly lower Lie scores than primary endogenous and non-endogenous depressives. High Lie scores were interpreted as expressions of denial or conformity.