SSRIs and risk of suicide attempts in young people – A Danish observational register-based historical cohort study, using propensity score

<p><i>Background:</i> SSRIs are widely used in the treatment of mental illness for both children and adults. Studies have found a slightly increased risk of suicidal thoughts and suicide attempts in young people using SSRIs but SSRIs’ impact on risk for suicides in youth is not well-established. <i>Aim:</i> Is there indication that SSRIs might raise risk for suicide attempts in young people? <i>Methods:</i> We used an observational register-based historical cohort design, a large cohort of all Danish individuals born in 1983–1989 (n = 392,458) and a propensity score approach to analyse the impact from SSRIs on risk for suicide attempts. Every suicide attempt and redeemed prescription of SSRIs was analysed by Cox regression. <i>Results:</i> We found a significant overlap between redeeming a prescription on SSRIs and subsequent suicide attempt. The risk for suicide attempt was highest in the first 3 months after redeeming the first prescription. The hazard ratio for suicide attempts after redeeming a prescription was estimated to 5.23, 95% CI 4.82–5.68. <i>Conclusion:</i> We conclude that the risk of suicide attempt is higher for young people in the first months after redeeming their first prescription for SSRIs, compared to non-users. For SSRI users with lower propensity score (fewer risk factors for SSRIs) the risk of suicide attempt is estimated to be highest. Although the design may miss some explicit reason for prescription of SSRIs and SSRIs might be a marker for those in high risk rather than a causal risk factor, we would recommend systematic risk assessment in the period after redeeming the first prescription.</p

Distribution of 6 aspects and a global measure of psychosocial work conditions

<p><b>Copyright information:</b></p><p>Taken from "Global measure of satisfaction with psychosocial work conditions versus measures of specific aspects of psychosocial work conditions in explaining sickness absence"</p><p>http://www.biomedcentral.com/1471-2458/8/270</p><p>BMC Public Health 2008;8():270-270.</p><p>Published online 1 Aug 2008</p><p>PMCID:PMC2518561.</p><p></p

Incidence rate ratios and cumulative incidences (by 40^th birthday) for suicide, attempted suicide and violent criminal offending in the study cohort born 1971–2002: all immigrants combined versus native Danes.

<p>^a Incidence rate ratio adjusted for age and calendar year period. Further adjustment for secondary care treated parental mental illness had only a minor impact on the observed strengths of association.</p><p>Incidence rate ratios and cumulative incidences (by 40^th birthday) for suicide, attempted suicide and violent criminal offending in the study cohort born 1971–2002: all immigrants combined versus native Danes.</p

Incidence rate ratios for attempted suicide and violent offending stratified by socioeconomic status (SES) in the study cohort born 1971–2002: immigrant subgroups vs. native Danes.

<p>^a Incidence rate ratio adjusted for age and calendar year period. In this table only statistically significant IRRs are highlighted using bold text. Further adjustment for secondary care treated parental mental illness had only a minor impact on the observed strengths of association</p><p>Incidence rate ratios for attempted suicide and violent offending stratified by socioeconomic status (SES) in the study cohort born 1971–2002: immigrant subgroups vs. native Danes.</p

Incidence rate ratios for attempted suicide and violent offending stratified by socioeconomic status in the study cohort born 1971–2002: all immigrants combined versus native Danes.

<p>^a Stratification by SES level was made according to parental income, educational attainment and employment status (as is described in detail in the Methods section, p7).</p

Incidence rate ratios and cumulative incidences (by 40^th birthday) for attempted suicide and violent criminal offending in the study cohort born 1971–2002: immigrant subgroups versus native Danes.

<p>^a Incidence rate ratio adjusted for age and calendar year period. Further adjustment for secondary care treated parental mental illness had only a minor impact on the observed strengths of association.</p><p>Incidence rate ratios and cumulative incidences (by 40^th birthday) for attempted suicide and violent criminal offending in the study cohort born 1971–2002: immigrant subgroups versus native Danes.</p

Cumulative incidence curves for attempted suicide and violent offending in the study cohort born 1971–2002: immigrant subgroups and native Danes.

<p>Cumulative incidence curves for attempted suicide and violent offending in the study cohort born 1971–2002: immigrant subgroups and native Danes.</p

Characteristics of the study population.

<p>Characteristics of the study population.</p

Hazard ratios (HRs) for asthma hospitalization according to bereavement stratified on age at the time of exposure and latency time since bereavement.

*<p>Adjusted for country, mother’s country of origin, maternal age at delivery, maternal parity, maternal social status at birth, sex of the child, low birth weight, calendar year of birth, and family history of asthma</p

Hazard ratios (HRs) for asthma hospitalization in childhood according to bereavement.

*<p>Adjusted for country, mother’s country of origin, maternal age at delivery, maternal parity, maternal social status at birth, low birth weight, sex of the child, calendar year of birth, and family history of asthma</p