Association between medication and risk of suicide, attempted suicide and death in nationwide cohort of suicidal patients with schizophrenia

Authors

  • Jari Haukka PhD,

    Corresponding author
    1. Department of Mental Health and Alcohol Research, National Public Health Institute, FIN-00300 Helsinki, Finland
    • Dept of Mental Health and Alcohol Research, National Public Health Institute, FIN-00300 Helsinki, Finland.
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  • Jari Tiihonen PhD, MD,

    1. Department of Forensic Psychiatry, University of Kuopio, Finland
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  • Tommi Härkänen PhD,

    1. Department of Health and Functional capacity, National Public Health Institute, FIN-00300 Helsinki, Finland
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  • Jouko Lönnqvist PhD, MD

    1. Department of Mental Health and Alcohol Research, National Public Health Institute, FIN-00300 Helsinki, Finland
    2. Department of Psychiatry, University of Helsinki and Helsinki University Central Hospital, Finland
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Errata

This article is corrected by:

  1. Errata: Erratum: Association between medication and risk of suicide, attempted suicide and death in nationwide cohort of suicidal patients with schizophrenia Volume 20, Issue 10, 1113, Article first published online: 26 September 2011

  • No conflict of interest was declared.

Abstract

Purpose

Mortality among schizophrenia patients is substantially higher than in the general population. The aim of this study was to investigate, in a nationwide cohort of suicidal schizophrenic individuals, how the risks of suicide, severe suicide attempts and death are associated with usage of antidepressant or antipsychotic treatment.

Methods

The study population included all individuals in Finland who were hospitalised with a diagnosis of attempted suicide between 1 January 1997 and 31 December 2003, who also had at least one hospitalisation due to schizophrenia diagnosis (ICD-10 F20), and were at least 16 years old when the index hospitalisation began. Cox's proportional hazards modelling and Bayesian intensity estimation were used in the analysis.

Results

There were 1611 patients with a mean follow-up time of 4.3 years. Current use of antipsychotics was associated with decreased mortality due to suicide (HR 0.52, 95% CI 0.34–0.81, p = 0.004), but no significant decrease in mortality was observed during current use of antidepressants (0.66, 0.41–1.08, p = 0.099), when compared to past use. In more detailed analysis when current users were compared to non-users, olanzapine, and mixed use of antipsychotics, were associated with reduced all-cause mortality, and mixed use also with reduced risk of suicide mortality. Current use of citalopram was associated with decreased all-cause and suicide mortality.

Conclusions

In a population of suicidal schizophrenic individuals antipsychotic medication, treatment was associated with lower mortality from suicide and all-causes. Antidepressive medication was associated with lower all-cause mortality when used in combination with antipsychotics. Copyright © 2008 John Wiley & Sons, Ltd.

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