Citation

Zhang C, Zafari Z, Slejko JF, Castillo WC, Reeves GM, Dosreis S. Am. J. Epidemiol. 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, Oxford University Press)

DOI

10.1093/aje/kwad022

PMID

36708233

Abstract

Undertreatment of depression is common among children and adolescents, but evidence of the impact of undertreatment of depression on risk of suicide is limited due to low base rate of suicide in the population and lack of sufficient data source. We developed a microsimulation model that utilized evidence from multiple sources to study the impact of different duration of antidepressant treatment on suicide risk in a synthesized sample that was nationally representative of children and adolescents with MDD. Compared with receiving no treatment, suicide rate and risk of suicide attempt both decreased with increasing duration of antidepressant treatment [Suicide rate ratios: 12-week: 0.78 (95% credible interval (CI): 0.58, 1.15); 36-week: 0.65 (95% CI: 0.44, 0.90); 52-week: 0.63 (95% CI: 0.45, 0.72); Risk ratios of suicide attempt: 12-week: 0.68 (95% CI: 0.62, 0.69); 36-week: 0.56 (95% CI: 0.52, 0.57); 52-week: 0.55 (95%CI: 0.51, 0.56)]. The suicide rate and risk of suicide attempt were lower in children than those in adolescents. Males had a lower risk of suicide attempt but higher suicide rate than females. The findings from the microsimulation model show that completion of 12-36 weeks of antidepressant treatment may reduce suicide attempt and suicide among children and adolescents with MDD.

Language: en

Keywords

suicide; major depressive disorder; children and adolescents; computation-based models; microsimulation models