Centre for Suicide Research, Odense, Denmark.
Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
Psychol Med. 2023 Sep;53(12):5510-5517. doi: 10.1017/S0033291722002719. Epub 2022 Aug 31.
It remains unclear how SSRIs and other antidepressants are associated with the risk of repeated suicide attempts. We aimed to analyse the association between redeemed antidepressant prescriptions and the risk of repeated suicide attempts, hypothesising that antidepressant treatment is associated with increased risk of repeated suicide attempts.
The study was based on Danish register data and a validated cohort of 1842 suicide attempts. We used three Cox regression models (crude, adjusted and propensity score matched) to analyse the data; these models included both static and dynamic time-dependent factors.
1842 individuals attempted suicide in the study period, with a total of 210 repeated attempts. Individuals redeeming antidepressant prescriptions were more likely to repeat a suicide attempt. All crude models showed all antidepressants to be significant risk factors (HR around 1.39), whereas all adjusted models showed all antidepressants to be insignificant risk factors.
We found no significant increased risk of repeated suicide attempts in individuals redeeming a prescription for any antidepressant (or only SSRIs) when considering the individuals' baseline risk of repetition. This study is based on validated suicide attempts, register data, and strong epidemiology designs, but it still has some limitations, and the results should be replicated and confirmed in other studies.
目前尚不清楚 SSRI 类抗抑郁药和其他抗抑郁药与反复自杀企图的风险有何关联。我们旨在分析已开具的抗抑郁药处方与反复自杀企图风险之间的关联，并假设抗抑郁治疗与反复自杀企图风险增加相关。
本研究基于丹麦登记数据和经过验证的 1842 例自杀企图队列。我们使用了三种 Cox 回归模型（原始、调整和倾向评分匹配）来分析数据；这些模型包括静态和动态时间依赖性因素。
在研究期间，有 1842 人尝试自杀，共有 210 人重复自杀企图。使用抗抑郁药处方的人更有可能重复自杀企图。所有原始模型均显示所有抗抑郁药均为显著风险因素（HR 约为 1.39），而所有调整模型均显示所有抗抑郁药均为非显著风险因素。
当考虑个体重复的基线风险时，我们发现使用任何抗抑郁药（或仅使用 SSRIs）处方的个体重复自杀企图的风险没有显著增加。本研究基于经过验证的自杀企图、登记数据和强大的流行病学设计，但仍存在一些局限性，结果应在其他研究中进行复制和确认。
