@article{ref1,
title="The rapid suicide protection of mood stabilizers on patients with bipolar disorder: a nationwide observational cohort study in taiwan",
journal="Journal of affective disorders",
year="2016",
author="Tsai, Chia-Jui and Cheng, Chin and Chou, Po-Han and Lin, Ching-Heng and McInnis, Melvin G. and Chang, Chia-Li and Lan, Tsuo-Hung",
volume="196",
number="",
pages="71-77",
abstract="BACKGROUND: The suicide rate is high among bipolar disorder (BD) patients. Previous studies have focused on the anti-suicidal effect of long-term treatment with mood stabilizers but less on the immediate preventive effects of interventions. The aim of the study was to evaluate the short-term and immediate anti-suicidal effects of mood stabilizers on recent-onset BD patients. <br><br>METHODS: The National Health Insurance Database (NHID) of Taiwan was used to perform a nationwide cohort observation study of suicide behaviors in bipolar disorder. All the recent-onset BD patients (ICD-9-CM code 296 except 296.2 and 296.3) diagnosed between 2000-2005 were collected (n=5091) and followed through 2009. The primary endpoint was the presence of a suicide code or the end of observation; exposure to mood stabilizers in the final month of observation was the independent variable. <br><br>RESULTS: The hazard ratios (HRs) of suicide-related events, completed suicide, and all-cause mortality were significantly lower for those treated with lithium, divalproex, or carbamazepine compared with no use in the last month (HRs of suicide-related events were 0.10, 0.14 and 0.10, respectively, and all-cause mortality HRs were 0.03; P<0.0001); there was no significant difference in HR between the mood stabilizers. LIMITATIONS: The NIHD does not provide information on the severity, mood status, or treatment adherence of BD patients. Neither substance-related disorder nor personality disorder were included in the analysis. We focused on the effect of the final prescription time period, not the long-term protective effect. <br><br>CONCLUSIONS: The immediate recent use of any mood stabilizer significantly lowers the rate of death, suicide, or suicidal behavior in BD.<p /> <p>Language: en</p>",
language="en",
issn="0165-0327",
doi="10.1016/j.jad.2016.02.014",
url="http://dx.doi.org/10.1016/j.jad.2016.02.014"
}