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Regional clozapine, ECT and lithium usage inversely associated with excess suicide rates in male adolescents
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- Boström, Adrian Desai E. (author)
- Umeå University,Karolinska Institute,Umeå universitet,Psykiatri,Department of Women's and Children's Health/Neuropediatrics, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Stockholm, Sweden; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Karolinska University Hospital, SE-171 76, Stockholm, Sweden. adrian.desai.bostrom@ki.se,Umeå Univ, Dept Clin Sci Psychiat, Umeå, Sweden.;Karolinska Inst, Dept Womens & Childrens Hlth Neuropediat, Stockholm, Sweden.;Stockholm Health Care Serv, Stockholm, Sweden.;Karolinska Univ Hosp, Karolinska Inst, Ctr Psychiat Res, Dept Clin Neurosci, SE-17176 Stockholm, Sweden.;Karolinska Univ Hosp, Stockholm Hlth Care Serv, Ctr Psychiat Res, Dept Clin Neurosci, SE-17176 Stockholm, Sweden.
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- Andersson, Peter (author)
- Karolinska Institutet,Uppsala University,Karolinska Institute,Uppsala universitet,Centrum för klinisk forskning Dalarna,Karolinska Inst, Div Psychol, Dept Clin Neurosci, Stockholm, Sweden.
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- Rask-Andersen, Mathias, 1979- (author)
- Uppsala University,Uppsala universitet,Genomik och neurobiologi
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- 2023-03-14
- 2023
- English.
- In: Nature Communications. - : Nature Publishing Group. - 2041-1723. ; 14:1
- Journal article (peer-reviewed)
Abstract
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- Advanced psychiatric treatments remain uncertain in preventing suicide among adolescents. Across the 21 Swedish regions, using nationwide registers between 2016-2020, we found negative correlation between adolescent excess suicide mortality (AESM) and regional frequencies of clozapine, ECT, and lithium (CEL) usage among adolescents (β = -0.613, p = 0.0003, 95% CI: -0.338, -0.889) and males (β = -0.404, p = 0.009, 95% CI: -0.130, -0.678). No correlation was found among females (p = 0.197). Highest CEL usage among male adolescents was seen in regions with lowest quartile (Q1) AESM (W = 74, p = 0.012). Regional CEL treatment frequency in 15-19-year-olds was related to lower AESM in males, reflecting potential treatment efficacy, treatment compliance or better-quality mental health care. Suicide prevention may benefit from early recognition and CEL treatment for severe mental illness in male adolescents. The results indicate association but further research, using independent samples and both prospective and observational methodologies, is needed to confirm causality.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Psykiatri (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Psychiatry (hsv//eng)
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