Citation

Valuck RJ, Libby AM, Benton TD, Evans DL. Prim. Psychiatry 2007; 14(11): 52-60.

Copyright

(Copyright © 2007, MBL Communications)

DOI

unavailable

PMID

unavailable

Abstract

INTRODUCTION: Depression is a risk factor for suicide and is prevalent among adult and pediatric populations. Associations between antidepressant use and suicidal behaviors have resulted in a black box warning about antidepressant use. This study examines annual rates of suicide attempts among managed-care enrollees and describes their demographics, diagnoses, and prior treatments.

METHODS: A retrospective case series was compiled from the PharMetrics Integrated Outcomes Database, representing 47 million covered lives from 1998-2005. Suicide attempts were identified from paid claims data using the International Classification of Diseases, Ninth Revision, Clinical Modification, and Tenth Revision diagnostic codes. Numbers of suicide attempters and population-based rates were measured annually. Demographic data, chronic disease, psychiatric diagnoses, and antidepressant use were described.

RESULTS: Among 10,914 attempters, subjects with one suicide attempt increased from.04% in 1998 to.13% in 2005. Most were female (72%), adult (63%), and lived in the Midwest (57%). The most frequent (38%) age group was 10-19 years of age. Over 50% had a diagnosis of depression (38%), anxiety (14%), or substance abuse (14%). Fifty-three percent were receiving antidepressants.

DISCUSSION: The findings in this study support the large body of evidence reporting higher risks of suicide attempts or completion among children and adolescents. The findings are also consistent with reports of lack of recognition and undertreatment of psychiatric illness, since 47% of suicide attempters in the present study were not receiving antidepressants at the time of the attempt.

CONCLUSION: While suicide attempters varied significantly in their demographic characteristics, psychiatric diagnosis and antidepressant use were similar in the majority of cases. Further studies should identify shared risk factors for suicide among those treated with antidepressants.

Language: en

Keywords

United States; adolescent; adult; human; suicide; female; male; depression; anxiety; drug use; suicide attempt; suicidal behavior; risk factor; substance abuse; article; major clinical study; mental disease; antidepressant agent; anxiolytic agent; retrospective study; school child; serotonin uptake inhibitor; chronic disease; psychotropic agent; psychiatric diagnosis; managed care; atypical antipsychotic agent; mood stabilizer