Department of Psychiatry and Psychotherapy, University Regensburg, Regensburg , Germany.
Pharmacopsychiatry. 2011 Nov;44(7):324-30. doi: 10.1055/s-0031-1284428. Epub 2011 Oct 12.
There is an ongoing debate about a possibly enhanced risk of suicidal behaviour in some psychiatric patients due to psychopharmacotherapy. Our retrospective study aimed at analyzing the psychopharmacotherapy of 133 inpatient suicides and 133 controls by a matched pair design.
We analyzed all suicides (n = 133) reported in the AGATE study from 1991 to 2008. Besides evaluation of sociodemographic variables and suicide methods, we compared psychopharmacotherapy of suicides with schizophrenia (n = 59) and affective disorders (n = 59) to that of a matched control group.
Most suicides (n = 102, 76.7%) were judged not to be related to psychopharmacotherapy. In general, more psychopharmacological drugs were prescribed for suicides than for controls. Schizophrenic suicides received more low potency FGAs than their controls. More suicides with affective disorders than controls were treated with NASSAs, SNRIs, and high or low potency FGAs. In contrast to their controls, none of the suicides with affective disorders received lithium. NASSAs, SNRIs, and high or low potency FGAs predicted suicide in regression analysis for inpatients with affective disorders.
Differences in psychopharmacotherapy might mainly result from a recognized risk of suicide or a more severe degree of illness. However, the underrepresentation of lithium in the suicide groups is noticeable.
由于精神药理学治疗，一些精神科患者的自杀行为风险可能增加，这一问题目前仍存在争议。我们的回顾性研究旨在通过配对设计分析 133 例住院自杀患者和 133 例对照患者的精神药理学治疗情况。
我们分析了 1991 年至 2008 年 AGATE 研究报告的所有自杀病例（n=133）。除了评估社会人口统计学变量和自杀方法外，我们还将精神分裂症（n=59）和情感障碍（n=59）自杀患者的精神药理学治疗与匹配对照组进行了比较。
大多数自杀（n=102，76.7%）被认为与精神药理学治疗无关。一般来说，自杀患者服用的精神药物比对照患者多。精神分裂症自杀患者接受的低效能 FGAs 比对照患者多。接受 NASSAs、SNRIs、高或低效能 FGAs 的情感障碍自杀患者比对照患者多。与对照患者相比，没有情感障碍自杀患者接受锂治疗。NASSAs、SNRIs 和高或低效能 FGAs 在回归分析中预测了情感障碍住院患者的自杀。
精神药理学治疗的差异可能主要是由于自杀风险的认识或更严重的疾病程度。然而，锂在自杀组中的代表性不足是值得注意的。
