Del Matto L, Muscas M, Murru A, Verdolini N, Anmella G, Fico G, Corponi F, Carvalho A F, Samalin L, Carpiniello B, Fagiolini A, Vieta E, Pacchiarotti I
Department of Molecular Medicine, University of Siena School of Medicine and Department of Mental Health, University of Siena Medical Center (AOUS), Viale Mario Bracci 16, 53100, Siena, Italy.
Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Italy.
Neurosci Biobehav Rev. 2020 Sep;116:142-153. doi: 10.1016/j.neubiorev.2020.06.017. Epub 2020 Jun 16.
Suicide contributes to 1-4 % of deaths worldwide every year. We conducted a systematic review aimed at summarizing evidence on the use of lithium for the prevention of suicide risk both in mood disorders and in the general population. We followed the PRISMA methodology (keywords: "lithium", "suicide" AND "suicidal" on Pubmed, Cochrane CENTRAL, Clinicaltrial.gov, other databases). Inclusion criteria: lithium therapy in mood disorder or found in drinking water or scalp in the general population. Exclusion criteria: no lithium administration. From 918 screened references, 18 prospective (number of participants: 153786), 10 retrospective (number of participants: 61088) and 16 ecological studies (total sample: 2062) were included. Most of the observational studies reported a reduction in suicide in patients with mood disorders. All studies about lithium treatment's duration reported that long-term lithium give more benefits than short-term lithium in suicide risk The evidence seems to attribute an intrinsic anti-suicidal property of lithium, independent of its proven efficacy as a mood stabilizer.
自杀每年导致全球1%至4%的死亡。我们进行了一项系统综述，旨在总结有关锂在预防情绪障碍和普通人群自杀风险方面应用的证据。我们遵循PRISMA方法（在PubMed、Cochrane CENTRAL、Clinicaltrial.gov及其他数据库中使用关键词：“锂”、“自杀”以及“自杀性的”）。纳入标准：情绪障碍中的锂治疗，或在普通人群的饮用水或头皮中发现锂。排除标准：未使用锂。从918篇筛选出的参考文献中，纳入了18项前瞻性研究（参与者数量：153786）、10项回顾性研究（参与者数量：61088）和16项生态学研究（总样本：2062）。大多数观察性研究报告称情绪障碍患者的自杀率有所降低。所有关于锂治疗持续时间的研究均表明，长期使用锂在降低自杀风险方面比短期使用锂更有益。证据似乎表明锂具有内在的抗自杀特性，这与其作为情绪稳定剂已证实的疗效无关。
