Diagnoses and prescriptions of antidepressants in suicides: Register findings from the Friuli Venezia Giulia Region, Italy, 2002-2008

Int J Psychiatry Clin Pract. 2016;20(2):121-4. doi: 10.3109/13651501.2016.1149196. Epub 2016 Apr 7.

Abstract

Objective: To explore to what extent and under which diagnoses individuals who committed suicide had received psychiatric in-patient care, and how many had previously committed non-lethal self-harm. To investigate the antidepressant treatment received by these individuals.

Methods: Case-control study based on a health register.

Results: Psychiatric hospitalisation was found in 31.2% of the cases and 2.3% of the controls, and was a strong predictor for suicide with an odds ratio (OR) = 19.5. This did not differ significantly between diagnostic categories (except anxiety disorders with OR = 5.3). Non-lethal self-harm in the study period was committed by 14.3% of the cases and 0.14% of the controls, and was twice as common in female cases than in male cases. Previous self-harm was a very strong independent predictor for suicide with OR = 53.1 when a single episode of self-harm had occurred, and OR = 98.0 for repeated episodes (adjusted for age, gender and hospitalisation). Only 16.1% of the cases were currently on antidepressant medication at the time of suicide.

Conclusions: Few of the suicides had previously been psychiatric in-patients. Even fewer had current prescriptions for antidepressants. This suggests that better diagnosis and treatment of psychiatric patients is an important suicide preventive intervention.

Keywords: Antidepressants; case–control; psychiatric disorders; self-harm; suicide.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antidepressive Agents / therapeutic use*
  • Case-Control Studies
  • Comorbidity
  • Drug Utilization / statistics & numerical data
  • Female
  • Hospitalization / statistics & numerical data
  • Hospitals, Psychiatric / statistics & numerical data
  • Humans
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Registries*
  • Risk Factors
  • Self-Injurious Behavior / epidemiology*
  • Sex Factors
  • Suicide / psychology*
  • Suicide / statistics & numerical data*
  • Suicide Prevention
  • Young Adult

Substances

  • Antidepressive Agents