NEW YORK (Reuters Health) Aug 07 - Results of a new study reinforce previous analyses that show increased suicide attempts and completed suicides among children and adolescents treated for depression. Adults do not appear to share this increased risk.
"It is important to move beyond ecologic studies to examine longitudinal population-based data that include temporal relationships between antidepressant drug use and suicide attempts and death for individual patients," Dr. Mark Olfson and his co-investigators write in their paper in the Archives of General Psychiatry for August.
To that end, Dr. Olfson, from the College of Physicians and Surgeons of Columbia University in New York, and his team designed a case-control study, using data provided by the center for Medicare and Medicaid Services, to evaluate the risk of suicide among patients following discharge after hospitalization for treatment of depression.
This latter criterion "sought to ensure that cases (suicide attempt and suicide death) and controls (no suicide attempt and no suicide death) who did and did not receive antidepressant treatment had a high and comparable level of illness severity."
Each case of attempted or completed suicide was matched to as many as five controls by age, sex, race or ethnicity, state of residence, date of hospital discharge, substance use disorder, recent suicide attempt, and recent treatment with psychotropic drugs other than antidepressants.
Included were 263 children and adolescents who attempted suicide, and 8 who completed suicide. Corresponding numbers among adults were 621 and 86.
The results showed that children and adolescents treated with an antidepressant drug were significantly more likely to attempt suicide than those who were not (OR 1.52). However, the relationship was significant only among white children and adolescents, but not among minority patients.
The results also showed that children and adolescents who completed suicide were significantly more likely to have been treated with antidepressants (OR, 15.62). However, Dr. Olfson's group urges caution in interpreting this finding, since it is based on only 8 suicide deaths.
No such association was observed among adults.
"These findings support careful clinical monitoring during antidepressant drug treatment of severely depressed young people," the team concludes.
Arch Gen Psychiatry 2006;63:865-872.
