Differences in antipsychotic treatment between depressive patients with and without a suicide attempt

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Asp, MarieLund University,Lunds universitet,Psykiatri, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Enheten för klinisk suicidforskning,Forskargrupper vid Lunds universitet,Psychiatry (Lund),Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Unit for clinical suicide research,Lund University Research Groups,Region Skåne,Lund Univ, Sweden; Psychiat Clin Lund, Sweden (author)

Differences in antipsychotic treatment between depressive patients with and without a suicide attempt

Article/chapterEnglish2021

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Elsevier BV,2021

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LIBRIS-ID:oai:lup.lub.lu.se:fbfa6138-3e56-45d2-a8c9-f78a2fb9a43a
https://lup.lub.lu.se/record/fbfa6138-3e56-45d2-a8c9-f78a2fb9a43aURI
https://doi.org/10.1016/j.comppsych.2021.152264DOI
https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-178532URI

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Language:English
Summary in:English

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SwePubSwePub

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Subject category:art swepub-publicationtype
Subject category:ref swepub-contenttype

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Funding Agencies|province of Skane, Sweden; Swedish Research CouncilSwedish Research CouncilEuropean Commission [2020-01428]; Southern Health Care Region, Sweden
Background: Depressed suicide attempters are, according to some earlier studies, treated more often with antipsychotics than depressive non-suicide attempters. Cluster B personality disorders, especially borderline personality disorder, are associated with a high suicide risk, and antipsychotics are commonly used for the reduction of symptoms. However, no previous study has taken comorbid personality disorders into account when assessing the use of antipsychotics in patients with unipolar depression. Therefore, the aim of this study was to investigate the clinical selection of pharmacotherapy in unipolar depression with and without a previous suicide attempt, taking into account potential confounders such as cluster B personality disorders. Methods: The study sample consisted of 247 patients with unipolar depression. The study was approved by the Regional Ethical Review Board in Lund, Sweden. Study participants were recruited from 4 different secondary psychiatric care clinics in Sweden and were diagnosed according to the DSM-IV-TR with the MINI and SCID II. Previous and ongoing psychiatric treatments were investigated in detail and medical records were assessed. Results: Thirty percent of the patients had made previous suicide attempts. Depressed suicide attempters underwent both lifetime treatment with antipsychotics and an ongoing antipsychotic treatment significantly more often than non-attempters. Significances remained after a regression analysis, adjusting for cluster B personality disorders, symptom severity, age at the onset of depression, and lifetime psychotic symptoms. Conclusions: This is the first study to consider the effect of comorbidity with cluster B personality disorders when comparing treatment of depressive suicide and non-suicide attempters. Our findings suggest that suicide attempters are more frequently treated with antipsychotics compared to non-suicide attempters, regardless of cluster B personality disorder comorbidity. These findings are important for clinicians to consider and would also be relevant to future studies evaluating reduction of suicide risk with antipsychotics in patients with psychiatric comorbidity and a history of attempted suicide.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Psykiatri hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Psychiatry hsv//eng
Antipsychotics
Depression
Personality disorders
Psychiatric comorbidity
Suicidality
Suicide attempt
Depression; Suicidality; Suicide attempt; Antipsychotics; Personality disorders; Psychiatric comorbidity

Added entries (persons, corporate bodies, meetings, titles ...)

Ambrus, LiviaLund University,Lunds universitet,Psykiatri, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Enheten för klinisk suicidforskning,Forskargrupper vid Lunds universitet,Psychiatry (Lund),Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Unit for clinical suicide research,Lund University Research Groups,Region Skåne,Lund Univ, Sweden; Psychiat Clin Lund, Sweden(Swepub:lu)med-lau (author)
Reis, MargaretaLinköpings universitet,Linköping University,Avdelningen för klinisk kemi och farmakologi,Medicinska fakulteten(Swepub:liu)marre53 (author)
Manninen, SofieLund University,Lunds universitet,Enheten för klinisk suicidforskning,Forskargrupper vid Lunds universitet,Unit for clinical suicide research,Lund University Research Groups,Lund Univ, Sweden(Swepub:lu)so1218ma (author)
Fernström, JohanLund University,Lunds universitet,Psykiatri, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Enheten för klinisk suicidforskning,Forskargrupper vid Lunds universitet,Psychiatry (Lund),Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Unit for clinical suicide research,Lund University Research Groups,Region Skåne,Lund Univ, Sweden; Psychiat Clin Lund, Sweden(Swepub:lu)med-jnf (author)
Lindqvist, DanielLund University,Lunds universitet,Psykiatri, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Enheten för Biologisk Psykiatri och Precisionspsykiatri,Forskargrupper vid Lunds universitet,Psychiatry (Lund),Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Unit for Biological and Precision Psychiatry,Lund University Research Groups,Region Skåne,Lund Univ, Sweden; Psychiat Res Skane, Sweden(Swepub:lu)med-del (author)
Westrin, ÅsaLund University,Lunds universitet,Psykiatri, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Enheten för klinisk suicidforskning,Forskargrupper vid Lunds universitet,Psychiatry (Lund),Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Unit for clinical suicide research,Lund University Research Groups,Region Skåne,Lund Univ, Sweden; Psychiat Res Skane, Sweden(Swepub:lu)pski-awe (author)
Psykiatri, LundSektion IV (creator_code:org_t)

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