1 The Depressed Suicidal Patient Assessment and Treatment CHARLES B. NEMEROFF, MICHAEL T. COMPTON, AND JOSEPH BERGER Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia 30322, USA ABSTRACT: Depressive disorders are associated with significant psychoso- cial impairment and disability. Depression should be thoroughly evaluat- ed, as should current and past suicidality and potential risk factors for suicide. Mortality by suicide characterizes the course of major affective disorders in approximately 15% of those suffering from these illnesses. Several neurobiological correlates of suicidality have been discovered. Treatment of depression with suicidality may involve hospitalization, pharmacotherapy, electroconvulsive therapy, and psychotherapy. Special populations include children and adolescents, the elderly, medically ill pa- tients, patients with comorbid personality disorders, and patients with co- morbid substance abuse disorders. Clinicians encountering patients with depressive disorders should be proficient in the assessment and treatment of depression with suicidality. KEYWORDS: Depression; Suicide INTRODUCTION A thorough understanding of the treatment of the depressed suicidal pa- tient is imperative for psychiatrists, other physicians, and mental health pro- fessionals encountering these severely affectively ill patients. According to the National Comorbidity Survey, the lifetime prevalence of major depres- sion in the general U.S. population is 17.1% for men and 21.3% for women. 1 Due to the high prevalence and significant morbidity and psychosocial im- pairment associated with this disorder, primary care and specialized physi- cians as well as psychiatrists should be proficient in the evaluation of depression. Suicidal thoughts and/or behaviors should be assessed in each pa- tient with a depressive syndrome. Address for correspondence: Dr. Charles B. Nemeroff, Emory University School of Medi- cine, Department of Psychiatry and Behavioral Sciences, 1639 Pierce Drive, Suite 4000, Atlanta, GA 30322. Voice: 404/727-8382; fax: 404/727-3233. cnemero@emory.edu