Bingefors K, Isacson D, Knorring L V, Smedby B, Wicknertz K
Department of Pharmacy, University Hospital, Uppsala University, Sweden.
Br J Psychiatry. 1996 Nov;169(5):647-54. doi: 10.1192/bjp.169.5.647.
Non-institutionalised patients treated with antidepressants have been shown to have indicators of a generalised vulnerability, such as high rates of health service use and excessive prescription drug use. Therefore, mortality in this patient group is of interest.
All first-incidence antidepressant users in a defined population during a five-year period were identified. Their total mortality during a nine-year follow-up was analysed. Cox proportional hazards regression was used to analyse total mortality, and mortality in cardiovascular disease, controlling for baseline chronic medical disease.
Antidepressant treatment at the index date was a statistically significant predictor for increased long-term mortality in the over-65s, even when controlling for pre-existing chronic medical disease. Baseline ischaemic heart disease and concurrent antidepressant treatment significantly predicted mortality from cardiovascular causes.
Prescribed antidepressant treatment identifies patients who are at risk of increased mortality. For the physician in ambulatory care, knowledge of a patient's antidepressant treatment history may be a valuable tool in managing patient care.
已证明接受抗抑郁药治疗的非住院患者具有全身易损性指标，如高医疗服务使用率和过度使用处方药。因此，该患者群体的死亡率备受关注。
确定在五年期间特定人群中所有首次使用抗抑郁药的患者。分析他们在九年随访期间的总死亡率。采用Cox比例风险回归分析总死亡率以及心血管疾病死亡率，并对基线慢性疾病进行控制。
即使在控制了既往慢性疾病的情况下，首次使用抗抑郁药治疗在统计学上仍是65岁以上人群长期死亡率增加的显著预测因素。基线缺血性心脏病和同时进行的抗抑郁药治疗显著预测了心血管原因导致的死亡率。
开具抗抑郁药治疗可识别出死亡率增加风险的患者。对于门诊护理医生而言，了解患者的抗抑郁药治疗史可能是管理患者护理的宝贵工具。
