Morgan Oliver, Griffiths Clare, Majeed Azeem
Department of Primary Care and Social Medicine, Faculty of Medicine, Imperial College London, London SW7 2AZ, UK.
J Public Health (Oxf). 2008 Mar;30(1):60-8. doi: 10.1093/pubmed/fdm085. Epub 2008 Jan 31.
In England, the impact of increased use of antidepressant medications is unclear. We examine associations between antidepressant use, suicide and antidepressant poisoning mortality, adjusted for important covariates.
Data on suicide and antidepressant poisoning mortality were provided by the Office for National Statistics. Prescription data were provided by the Department of Health. Age- and sex-specific prescribing rates were estimated from The Health Improvement Network primary care data. We measured the association between prescribing, suicide and poisoning mortality after adjusting for age, sex, calendar year, prescribing rates and use of newer antidepressants drugs.
The prevalence of antidepressant treatment increased during the 1990s for all age and sex groups. Treatment prevalence remained constant from 2002 but declined among children and adolescents. Between 1993 and 2004, age-standardized rates for suicide decreased from 98.2 to 81.3 per million populations and for antidepressants from 9.2 to 7.4 per million populations. Before adjustment, increased antidepressant prescribing was associated with a decrease in suicide (r(s) = -0.90, P < 0.001) and antidepressant poisoning mortality rates (r(s) = -0.65, P = 0.023). This association disappeared after adjustment.
In England, at a population level, there does not appear to be an association between antidepressant prescribing and antidepressant poisoning mortality or suicide.
在英国，抗抑郁药物使用增加所产生的影响尚不清楚。我们对重要协变量进行了调整，研究抗抑郁药物使用、自杀及抗抑郁药物中毒死亡率之间的关联。
自杀及抗抑郁药物中毒死亡率数据由英国国家统计局提供。处方数据由卫生部提供。年龄和性别特异性处方率根据健康改善网络初级保健数据估算得出。在对年龄、性别、日历年、处方率及新型抗抑郁药物使用情况进行调整后，我们测定了处方、自杀及中毒死亡率之间的关联。
20世纪90年代，所有年龄和性别人群的抗抑郁治疗患病率均有所上升。自2002年起，治疗患病率保持稳定，但儿童及青少年中的患病率有所下降。1993年至2004年间，年龄标准化自杀率从每百万人口98.2降至81.3，抗抑郁药物中毒死亡率从每百万人口9.2降至7.4。在进行调整之前，抗抑郁药物处方量增加与自杀率下降（r(s)= -0.90，P<0.001）及抗抑郁药物中毒死亡率下降（r(s)= -0.65，P = 0.023）相关。调整后，这种关联消失。
在英国，从人群水平来看，抗抑郁药物处方与抗抑郁药物中毒死亡率或自杀之间似乎并无关联。
