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Antidepressants increase risk of suicide attempt, but not completed suicide, in people with previous suicide attempts

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 Q Do antidepressants decrease suicide risk in people previously hospitalised for attempted suicide?

METHODS

Embedded ImageDesign:

Cohort study.

Embedded ImageFollow-up period:

Mean follow-up 3.4 years.

Embedded ImageSetting:

Finland; January 1997 to December 2003.

Embedded ImagePeople:

15 390 people (49% male; mean age 39 years) hospitalised for suicide attempt. Exclusions: psychosis or <10 years old.

Embedded ImageRisk factors:

Antidepressant use: data from the Social Insurance Institution of Finland indicated medication use. Follow-up was divided into periods of using and not using antidepressants; and the risks of attempted suicide, completed suicide and death compared during each period. Outcomes were compared for people currently on antidepressants, or had stopped, or had never taken antidepressants. Analyses were adjusted for suicide propensity score, number of antidepressant prescriptions obtained in the previous year, use of more than one antidepressant, number of severe suicide attempts requiring hospitalisation in the previous 5 years, number of suicide attempts requiring hospitalisation during follow-up, gender, age, and hospital district. Cox proportional analyses were used to calculate relative risks.

Embedded ImageOutcomes:

Suicide attempts leading to hospitalisation, completed …

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