Full Text Full Text (PDF) CME: Take the course for this article: AJP CME Course for July 2007: Suicide Attempts Among Patients Starting Depr... Alert me when this article is cited Alert me if a correction is posted Citation Map Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Articles & Searches Download to citation manager Citing Articles via HighWire Citing Articles via Google Scholar Articles by Simon, G. E. Articles by Savarino, J. Search for Related Content PubMed Citation Articles by Simon, G. E. Articles by Savarino, J. Depression Suicide Other Psychotherapy Antidepressants Epidemiology Related Articles

Suicide Attempts Among Patients Starting Depression Treatment With Medications or Psychotherapy

OBJECTIVE: This study compared the time patterns of suicide attempts among outpatients starting depression treatment with medication or psychotherapy. METHOD: Outpatient claims from a prepaid health plan were used to identify new episodes of depression treatment beginning with an antidepressant prescription in primary care (N=70,368), an antidepressant prescription from a psychiatrist (N=7,297), or an initial psychotherapy visit (N=54,123). Outpatient and inpatient claims were used to identify suicide attempts or possible suicide attempts during the 90 days before and 180 days after the start of treatment. RESULTS: Overall incidence of suicide attempt was highest among patients receiving antidepressant prescriptions from psychiatrists (1,124 per 100,000), lower among those starting psychotherapy (778 per 100,000), and lowest among those receiving antidepressant prescriptions in primary care (301 per 100,000). The pattern of attempts over time was the same in all three groups: highest in the month before starting treatment, next highest in the month after starting treatment, and declining thereafter. Results were unchanged after eliminating patients receiving overlapping treatment with medication and psychotherapy. Overall incidence of suicide attempt was higher in adolescents and young adults, but the time pattern was the same across all three treatments. CONCLUSIONS: The pattern of suicide attempts before and after starting antidepressant treatment is not specific to medication. Differences between treatments and changes over time probably reflect referral patterns and the expected improvement in suicidal ideation after the start of treatment.

Related Articles:

Antidepressants and Suicidal Behavior: Cause or Cure?

David Brent
Am J Psychiatry 2007 164: 989-991. [Full Text] [PDF]

This article has been cited by other articles:

				S. P. Kutcher MD and M. Szumilas HBSc Youth suicide prevention Can. Med. Assoc. J., January 29, 2008; 178(3): 282 - 285. [Full Text] [PDF]

				R. D. Gibbons, C. H. Brown, K. Hur, S. M. Marcus, D. K. Bhaumik, J. A. Erkens, R. M.C. Herings, and J. J. Mann Early Evidence on the Effects of Regulators' Suicidality Warnings on SSRI Prescriptions and Suicide in Children and Adolescents Am J Psychiatry, September 1, 2007; 164(9): 1356 - 1363. [Abstract] [Full Text] [PDF]

				Emerging Perspectives: Look Again -- SSRIs and Fewer Suicide Attempts Journal Watch Psychiatry, July 13, 2007; 2007(713): 1 - 1. [Full Text]

Get information about faster international access.

Privacy Policy

Copyright © 2007 American Psychiatric Association. All rights reserved.

Home | Search | Current Issue | Past Issues | Subscribe | All APPI Journals | Help | Contact Us