TABLE 1.
Summary of the Participant's characteristics
| Study | Sample (Stimulation group) | Diagnosis and diagnosis instruments | Male | Female | Mean age (SD) | Treatment | Suicide characteristics compared | Medication | |
|---|---|---|---|---|---|---|---|---|---|
| Kellner et al. (2005) | 444 | Unipolar MDD, DSM‐IV, 24‐HDRS≥21 | 141 | 303 | 55.6 ± 16.8 | Bifrontal ECT; Bifrontal ECT+pharmacotherapy | Suicidal ideation of 24‐HDRS | Nortriptyline+lithium | |
| Brådvik and Berglund (2006) | 195 | Melancholia, DSM‐IV and a multiaxial diagnostic schedule at discharge | / | / | / | Pharmacotherapy; ECT; ECT+continuation treatment with antidepressants | Suicidal gestures, occurrence of suicide attempt | Antidepressant pharmacotherapy | |
| Liang et al. (2017) | 487 | Unipolar disorder or bipolar disorder, ICD−9‐CM | 174 | 313 | 38.5 ± 14.2 (ECT group) | ECT | Completed suicide | Not specified | |
| Ahmadi et al. (2015) | 92 | Both MDD and PTSD, DSM‐IV and ICD | 78 | 14 | 52 ± 12 (MDD and PTSD with ECT) | Bifrontal ECT | Completed suicide | Antidepressant monotherapy | |
| Keshtkar et al., 2011 | 40 | MDD, DSM‐IV | 21 | 52 | 35.6 ± 8.1 (ECT group) | Bilateral ECT, active rTMS | Suicide ideation of BDI and HDRS | Not specified | |
| Patel et al. (2006) | 30 | Bipolar disorder, Major depression, Schizoaffective disorder, DSM‐IV | 19 | 11 | 32.9 ± 11.3 (Mental ill, ECT group) | Bilateral ECT | Suicide ideation of 24‐BPRS | Psychotropic medications | |
| 37.7 ± 9.1 (Mental ill substance abuse, ECT group) | |||||||||
| Ciapparelli et al. (2001) | 64 | Mixed mania and bipolar depression, DSM‐IV | 40 | 24 | 38.0 ± 11.8 (mixed mania) | Bilateral ECT | Suicide ideation of MADRS | Lithium, anticonvulsants, TCAs, SSRIs, neuroleptics | |
| 40.5 ± 14.3 (bipolar depression) | |||||||||
| Veltman et al. (2018) | 89 | Unipolar MDD, DSM‐IV, MINI | 30 | 59 | 73.4 ± 9.8 | Bilateral, unilateral ECT | Suicidal ideation of MADRS | Antipsychotics were tapered off before starting ECT but were allowed if clinically indicated | |
| Hunt et al. (2011) | 71 | Affective disorder, schizophrenia, alcohol dependence, drug dependence, personality disorder, anxiety disorders, etc, / | / | / | 54 (group received ECT at the time of death) | ECT | Completed suicide | Not specified | |
| Munk‐Olsen et al. (2007) | 783 | Schizophrenia, schizoaffective disorders, bipolar disorders, unipolar depressive disorders, other nonaffective psychosis, other disorders, ICD‐8, and ICD‐10 | / | / | / | Bilateral, unilateral ECT | Completed suicide | Not specified | |
| Popiolek et al. (2018) | 109 | Bipolar depression, ICD‐10 | / | / | / | cECT | Suicide attempt or completed suicide | Not specified | |
| Black et al. (1989) | 372 | Primary unipolar, secondary unipolar, bipolar depressives, DSM‐III | / | / | / | ECT, an adequate trial of antidepressants, an inadequate trial of antidepressants, a group receiving neither ECT nor antidepressants | Completed suicide | Antidepressant monotherapy | |
| Brunoni, Júnior, et al. (2013) and Brunoni, Valiengo et al. (2013) | 28 | Major depression (single episode, recurrent, or bipolar), MINI‐PLUS, MADRS, CGI | 28 | 28 | 52 ± 17 (ECT Plus Pharmacotherapy) | cECT | Suspected suicide and suicide attempt | Pharmacotherapy alone | |
| 62 ± 13 (Pharmacotherapy alone) | |||||||||
| Avery and Winokur (1978) | 257 | Manic‐depressive, depressed; manic‐depressive, circular or mixed; psychotic depressive reaction; involutional melancholia; depressive neurosis; and schizoaffective, DSM‐I or DSM‐II | / | / | / | ECT, antidepressant therapy, and neither ECT nor antidepressants | Suicidal ideation, suicide attempt and completed suicide | Imipramine, amitriptyline, desipramine, or nortriptyline | |
| Sun et al. (2016) | 27 | TRD, DSM‐IV | 12 | 15 | 46.0 ± 15.3 | MST | Suicidal ideation of SSI | Benzodiazepine medication | |
| Sun et al. (2018) | 23 | TRD, DSM‐IV | 11 | 12 | 45.0 ± 12.2 | MST | Suicidal ideation of SSI | Antidepressant, antipsychotic, benzodiazepine, lithium, pregabalin | |
| Weissman et al. (2018) | 156 | TRD, DSM‐IV | 59 | 97 | Blumberger et al (2012) | Blumberger et al. (2016) | Bilateral rTMS; L‐DLPFC‐rTMS and a sham control condition | Suicidal ideation of HDRS | Not specified |
| 58.0 ± 12.5 (Bilateral) | 46.4 ± 12.5 (Bilateral) | ||||||||
| 48.9 ± 13.4 (Unilateral) | 46.5 ± 14.1 (Unilateral) | ||||||||
| 45.8 ± 13.4 (Sham) | 48.1 ± 12.0 (Sham) | ||||||||
| Wall et al. (2011) | 8 | MDD, DSM‐IV, CDRS‐R ≥ 40 | 1 | 7 | 16.5 | L‐DLPFC‐rTMS | Suicide ideation of the Suicide Severity Rating Scale | SSRI | |
| Hadley et al. (2011) | 19 | Depressive episode, BDI≥12 | 8 | 11 | 48 ± 16 | L‐DLPFC‐rTMS | Suicidal ideation of SSI | Not specified | |
| Desmyter et al. (2016) | 50 | TRD, MINI, 17‐HDRS≥14 | 15 | 35 | 41.9 ± 11.77 | L‐DLPFC iTBS‐sham, sham‐L‐DLPFC iTBS | Suicidal ideation of SSI | No medication | |
| George et al. (2014) | 41 | Unipolar or bipolar depression, DSM‐IV, SSI≥12, 3 of HDRS≥3 | 35 | 6 | 42.5 ± 15.7 | L‐DLPFC‐rTMS, sham stimulation | Suicidal ideation of SSI | Not specified | |
| Desmyter et al. (2014) | 12 | TRD, MINI | 5 | 7 | 44.91 ± 10.8 | L‐DLPFC iTBS, sham stimulation | Suicidal ideation of SSI | No medication | |
| Baeken et al. (2019) | 45 | MDD, MINI | 12 | 33 | 44 ± 19 | L‐DLPFC iTBS‐sham, sham‐L‐DLPFC iTBS | Suicidal ideation of SSI | No medication | |
| Croarkin et al. (2018) | 19 | TRD, ATHF | 6 | 13 | 16.0 ± 1.29 | L‐DLPFC‐rTMS | Suicidal ideation of C‐SSRS and CDRS‐R | SSRI or SNRI | |
| Berlim et al. (2014) | 17 | MDD, MINI, 21‐HAMD≥18 | 13 | 4 | 47.12 ± 13.26 | L‐DLPFC DTMS | Suicidal ideation of SSI | Not specified | |
| Brunoni, Júnior, et al. (2013) and Brunoni, Valiengo, et al. (2013) | 120 | Acute depressive episode, MINI | 38 | 82 | 46.4 ± 14 (Placebo) | Sertraline‐only, tDCS‐only, combined‐treatment, placebo | Suicide ideation of MADRS | Sertraline, benzodiazepine | |
Abbreviations: 24‐BPRS, 24‐item Brief Psychiatric Rating Scale; ATHF, Antidepressant Treatment History Form; BDI, Beck Depression Inventory; CDRS‐R, Children's Depression Rating Scale‐Revised; cECT, continuation ECT; DSM‐IV, Diagnostic and Statistical Manual of Mental Disorders, IV Edition;DTMS, deep transcranial magnetic stimulation; HDRS, Hamilton depression scale; ICD, The International Statistical Classification of Diseases and Related Health Problems; iTBS, intermittent theta burst stimulation; L‐DLPFC, Left dorsolateral prefrontal cortex; MADRS, Montgomery–Asberg Depression Rating Scale; MINI, The Mini International Neuropsychiatric Interview; MMSE, Mini‐Mental State Examination; PTSD, post‐traumatic stress disorder; rTMS, repetitive transcranial magnetic stimulation; SNRIs, Serotonin and Noradrenaline Reuptake Inhibitors; SSI, Beck Scale of Suicidal Ideation; SSI‐CV, Beck Scale for Suicide Ideation‐Chinese Version; SSRIs, Selective Serotonin Reuptake Inhibitors; TRD, treatment‐resistant depression.