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Antidepressant-treated patients in ambulatory care. Mortality during a nine-year period after first treatment.

https://arctichealth.org/en/permalink/ahliterature46433
Source
Br J Psychiatry. 1996 Nov;169(5):647-54
Publication Type
Article
Date
Nov-1996
Author
K. Bingefors
D. Isacson
L V Knorring
B. Smedby
K. Wicknertz
Author Affiliation
Department of Pharmacy, University Hospital, Uppsala University, Sweden.
Source
Br J Psychiatry. 1996 Nov;169(5):647-54
Date
Nov-1996
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Ambulatory Care - statistics & numerical data
Antidepressive Agents - adverse effects - therapeutic use
Cardiovascular Diseases - mortality
Cause of Death
Depressive Disorder - drug therapy - mortality - psychology
Female
Follow-Up Studies
Humans
Male
Middle Aged
Patient care team
Proportional Hazards Models
Risk
Survival Rate
Sweden - epidemiology
Abstract
BACKGROUND: Non-institutionalised patients treated with antidepressants have been shown to have indicators of a generalised vulnerability, such as high rates of health service use and excessive prescription drug use. Therefore, mortality in this patient group is of interest. METHOD: All first-incidence antidepressant users in a defined population during a five-year period were identified. Their total mortality during a nine-year follow-up was analysed. Cox proportional hazards regression was used to analyse total mortality, and mortality in cardiovascular disease, controlling for baseline chronic medical disease. RESULTS: Antidepressant treatment at the index date was a statistically significant predictor for increased long-term mortality in the over-65s, even when controlling for pre-existing chronic medical disease. Baseline ischaemic heart disease and concurrent antidepressant treatment significantly predicted mortality from cardiovascular causes. CONCLUSION: Prescribed antidepressant treatment identifies patients who are at risk of increased mortality. For the physician in ambulatory care, knowledge of a patient's antidepressant treatment history may be a valuable tool in managing patient care.
PubMed ID
8932897 View in PubMed
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Decreasing tendency of seasonality in suicide may indicate lowering rate of depressive suicides in the population.

https://arctichealth.org/en/permalink/ahliterature46296
Source
Psychiatry Res. 1998 Nov 16;81(2):233-40
Publication Type
Article
Date
Nov-16-1998
Author
Z. Rihmer
W. Rutz
H. Pihlgren
P. Pestality
Author Affiliation
Department of Psychiatry No. XIII, National Institute for Psychiatry and Neurology, Budapest, Hungary.
Source
Psychiatry Res. 1998 Nov 16;81(2):233-40
Date
Nov-16-1998
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Antidepressive Agents - administration & dosage
Cause of Death
Cross-Sectional Studies
Depressive Disorder - drug therapy - mortality - psychology
Female
Humans
Incidence
Male
Middle Aged
Research Support, Non-U.S. Gov't
Seasons
Suicide - prevention & control - psychology - trends
Sweden - epidemiology
Treatment Outcome
Abstract
The seasonality of suicide is well known and a repeatedly demonstrated phenomenon. The authors analyzed the seasonality of 148 suicide events on Gotland between 1981 and 1996. A marked and significant seasonality with a spring and summer peak was found between 1981 and 1989, when the prescription of antidepressants was relatively low and stable. However, this seasonality disappeared in the period between 1990 and 1996, when prescription of antidepressants increased dramatically, indicating that more and more depressed patients were pharmacologically treated. As the seasonality of suicide in the population is the reflection of the seasonal nature of depressive suicides, the result suggests that a decreasing tendency of seasonality in suicide may indicate the lowering rate of depressive suicides in the given population.
PubMed ID
9858039 View in PubMed
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Delicate considerations and blunt instruments.

https://arctichealth.org/en/permalink/ahliterature104242
Source
Can J Psychiatry. 2014 Mar;59(3):117
Publication Type
Article
Date
Mar-2014
Author
Scott B Patten
Source
Can J Psychiatry. 2014 Mar;59(3):117
Date
Mar-2014
Language
English
Publication Type
Article
Keywords
Adolescent
Antidepressive Agents - adverse effects
Canada
Causality
Depressive Disorder - drug therapy - mortality - psychology
Humans
Mental Disorders - mortality - psychology
Suicide - psychology - statistics & numerical data
Notes
Cites: Can J Psychiatry. 2014 Mar;59(3):118-924881159
Cites: Can J Psychiatry. 2014 Mar;59(3):152-924881164
Cites: Can J Psychiatry. 2014 Mar;59(3):141-724881162
Cites: Can J Psychiatry. 2014 Mar;59(3):131-4024881161
Cites: Can J Psychiatry. 2014 Mar;59(3):120-3024881160
PubMed ID
24881158 View in PubMed
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Does depression in older medical inpatients predict mortality?

https://arctichealth.org/en/permalink/ahliterature167603
Source
J Gerontol A Biol Sci Med Sci. 2006 Sep;61(9):975-81
Publication Type
Article
Date
Sep-2006
Author
Jane McCusker
Martin Cole
Antonio Ciampi
Eric Latimer
Sylvia Windholz
Eric Belzile
Author Affiliation
Department of Clinical Epidemiology and Community Studies, St. Mary's Hospital, 3830 Lacombe, Montreal (Quebec), Canada. jane.mccusker@mcgill.ca
Source
J Gerontol A Biol Sci Med Sci. 2006 Sep;61(9):975-81
Date
Sep-2006
Language
English
Publication Type
Article
Keywords
Age Distribution
Aged
Antidepressive Agents - therapeutic use
Cognition Disorders - epidemiology
Cohort Studies
Depression - drug therapy - mortality
Depressive Disorder - drug therapy - mortality
Drug Utilization - statistics & numerical data
Female
Hospitalization
Humans
Male
Multivariate Analysis
Psychiatric Status Rating Scales
Quebec - epidemiology
Severity of Illness Index
Abstract
Previous studies of the effect of depression on mortality among older medical inpatients have yielded inconsistent results. We examined the effects on mortality of both a diagnosis of depression at hospital admission and a history of previous depression, taking into account potential sources of bias (sample selection and confounding).
Medical inpatients aged 65+ with at most mild cognitive impairment were recruited at two Montreal hospitals and were screened for depression. All those with a diagnosis of major or minor depression (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition [DSM-IV] criteria) and a random sample of nondepressed patients were invited to participate. Baseline data included: history of previous depression, severity of physical illness, comorbidity, and health services utilization. Cox proportional hazards methods were used to analyze survival during the 16- to 52-month follow-up period.
Five hundred patients were enrolled; 116 (23.2%) had a history of previous depression. After adjustment for demographic factors, physical illness, cognitive impairment, and prior service utilization, the only depression group with significantly different mortality was patients with both current major depression and a history of depression, who had lower mortality than all other patient groups (hazard ratio 0.42; 95% confidence interval: 0.25, 0.70).
Among patients with no history of depression, a diagnosis of depression was not associated with mortality after adjustment for confounding by physical illness and other factors. Coincident major depression and history of depression was associated with decreased mortality.
Notes
Comment In: J Gerontol A Biol Sci Med Sci. 2007 Jul;62(7):796-7; author reply 79817634330
PubMed ID
16960030 View in PubMed
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Extended survival of patients on long-term lithium treatment.

https://arctichealth.org/en/permalink/ahliterature46495
Source
Can J Psychiatry. 1995 Jun;40(5):241-6
Publication Type
Article
Date
Jun-1995
Author
B. Ahrens
P. Grof
H J Möller
B. Müller-Oerlinghausen
T. Wolf
Author Affiliation
Department of Psychiatry, University of Ottawa, Royal Ottawa Hospital, Ontario.
Source
Can J Psychiatry. 1995 Jun;40(5):241-6
Date
Jun-1995
Language
English
Publication Type
Article
Keywords
Adult
Aged
Bipolar Disorder - drug therapy - mortality
Cardiovascular Diseases - mortality - prevention & control
Cause of Death
Depressive Disorder - drug therapy - mortality
Female
Follow-Up Studies
Humans
Lithium - adverse effects - therapeutic use
Male
Middle Aged
Mood Disorders - drug therapy - mortality - psychology
Psychotic Disorders - drug therapy - mortality
Research Support, Non-U.S. Gov't
Suicide - prevention & control - statistics & numerical data
Survival Rate
Abstract
OBJECTIVE: Findings from a recent international multi-centre trial are compatible with the idea that long-term lithium treatment extends the survival of patients suffering from affective disorders to match the general population. A similar reduction of mortality was found in Canadian patients, although important questions remained to be answered about cardiovascular and suicide mortality, and patient selection. METHOD: Based on data collected in a study (1) from lithium clinics in Canada, Denmark, Germany and Austria, an analysis was carried out of suicide and cardiovascular mortality in patients who received prophylactic lithium treatment. RESULTS: In patients given lithium for two years or longer (n = 641), both suicide and cardiovascular mortality were the same as, or only slightly higher than, in the general population; in patients given lithium for less than two years (n = 186), both mortalities remained high. The reduced mortality is not likely to be the result of selection because the patients who were treated briefly and those treated for a longer time did not differ in important mortality variables. CONCLUSIONS: In addition to its ability to prevent recurrences, prophylactic lithium treatment appears capable of reducing both the excess suicide risk and excess cardiovascular mortality of affective illness.
PubMed ID
7553542 View in PubMed
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Five-year mortality in lithium-treated manic-depressive patients.

https://arctichealth.org/en/permalink/ahliterature12098
Source
J Affect Disord. 1991 Jan;21(1):33-8
Publication Type
Article
Date
Jan-1991
Author
P. Vestergaard
J. Aagaard
Author Affiliation
Clinical Department A, Psychiatric Hospital, Risskov, Denmark.
Source
J Affect Disord. 1991 Jan;21(1):33-8
Date
Jan-1991
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Bipolar Disorder - drug therapy - mortality - psychology
Bronchitis - mortality
Cardiovascular Diseases - mortality
Cause of Death
Cross-Sectional Studies
Denmark - epidemiology
Depressive Disorder - drug therapy - mortality - psychology
Female
Humans
Incidence
Lithium - adverse effects - therapeutic use
Male
Middle Aged
Pneumonia - mortality
Prospective Studies
Risk factors
Suicide - psychology - statistics & numerical data
Survival Rate
Abstract
A hundred and thirty-three affective disorder patients who received prophylactic treatment with lithium were followed prospectively for 5 years and their mortality was recorded. Twenty-two patients died during the period, 13 from natural causes and nine from definite or probable suicide. The observed mortality was significantly greater than the expected overall, and also when natural causes and suicide were considered independently. No patients died from lithium intoxication or lithium-induced side effects. Patients who died from suicide were all bipolars or suffered from affective disorder with uncertain polarity. They were significantly younger than the patients who died from natural causes, they tended to lead isolated lives and they suffered a violent death. The older patients who died from natural causes had often had physical illness and alcohol abuse prior to the start of lithium treatment. The results of the study speak in favour of the establishment of comprehensive treatment programmes possibly in the framework of specialised affective disorder clinics.
PubMed ID
1827474 View in PubMed
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Increased use of antidepressants and decreasing suicide rates: a population-based study using Danish register data.

https://arctichealth.org/en/permalink/ahliterature93303
Source
J Epidemiol Community Health. 2008 May;62(5):448-54
Publication Type
Article
Date
May-2008
Author
Erlangsen A.
Canudas-Romo V.
Conwell Y.
Author Affiliation
National Centre for Register-based Research, University of Aarhus, Aarhus, Denmark. aer@ncrr.dk
Source
J Epidemiol Community Health. 2008 May;62(5):448-54
Date
May-2008
Language
English
Publication Type
Article
Keywords
Age Factors
Antidepressive Agents - therapeutic use
Denmark - epidemiology
Depressive Disorder - drug therapy - mortality
Drug Utilization
Female
Humans
Male
Middle Aged
Sex Factors
Suicide - psychology - trends
Abstract
OBJECTIVE: The objective of the present study was to examine if the change in the suicide rate is associated with individuals' use of antidepressants as has been suggested by ecological studies. DESIGN: Decomposition of suicide rates by antidepressant treatment group. SETTING: Population-based record linkage. PARTICIPANTS: All individuals aged 50 years and older living in Denmark between 1 January 1996 and 31 December 2000 (N = 2,100,808). MAIN OUTCOME MEASURES: Suicide rates are calculated according to current antidepressant treatment status (no treatment, tricyclic antidepressants (TCA), selective serotonin reuptake inhibitors (SSRI), other antidepressants). The change in the suicide rate during 1996-2000 was decomposed by treatment group. RESULTS: Only one in five older adults dying by suicide was in treatment at the time of death. Whereas the male suicide rate declined by 9.7 suicides per 100,000, recipients of antidepressants contributed to the decline by 0.9 suicides. Women redeeming antidepressant prescriptions accounted for 0.4 suicides of the observed reduction of 3.3 per 100,000. The average suicide rates for men receiving TCA and SSRI were 153.3 and 169.0 per 100,000 person-years, respectively. Among older women, both TCA and SSRI users had an average suicide rate of 68.8 per 100,000 over the period examined. CONCLUSIONS: Just a small proportion of older adults dying by suicide were found to be in treatment with antidepressants at the time of death. Individuals in active treatment with antidepressants seem to account for 10% of the decline in the suicide rate. Nevertheless, suicides might be prevented by more effective treatment.
PubMed ID
18413459 View in PubMed
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Mortality during initial and during later lithium treatment. A collaborative study by the International Group for the Study of Lithium-treated Patients.

https://arctichealth.org/en/permalink/ahliterature46526
Source
Acta Psychiatr Scand. 1994 Oct;90(4):295-7
Publication Type
Article
Date
Oct-1994
Author
B. Müller-Oerlinghausen
T. Wolf
B. Ahrens
M. Schou
E. Grof
P. Grof
G. Lenz
C. Simhandl
K. Thau
R. Wolf
Author Affiliation
Research Group for Clinical Psychopharmacology, Free University of Berlin, Germany.
Source
Acta Psychiatr Scand. 1994 Oct;90(4):295-7
Date
Oct-1994
Language
English
Publication Type
Article
Keywords
Adult
Bipolar Disorder - drug therapy - mortality - psychology
Cardiovascular Diseases - mortality
Cause of Death
Denmark - epidemiology
Depressive Disorder - drug therapy - mortality - psychology
Female
Germany - epidemiology
Humans
Life tables
Lithium - adverse effects - therapeutic use
Male
Middle Aged
Psychotic Disorders - drug therapy - mortality - psychology
Research Support, Non-U.S. Gov't
Risk factors
Suicide - prevention & control - psychology - statistics & numerical data
Abstract
We have previously shown that the mortality of patients with recurrent affective disorders in long-term lithium treatment is not higher than that of the general population. In the present study on 471 patients from Denmark and Germany, we examined mortality during the initial year of lithium treatment and during later lithium treatment. During initial lithium treatment, the total mortality was twice as high as in the general population (difference not significant) and the mortality due to suicide 16 times higher. During later lithium treatment, the mortality rates did not differ from those in the general population. Our results indicate that patients with frequent, often severe recurrences, those chosen for prophylactic lithium treatment, are at risk of high mortality, which then diminishes as the prophylactic action of the treatment takes effect.
PubMed ID
7832001 View in PubMed
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Mortality of patients who dropped out from regular lithium prophylaxis: a collaborative study by the International Group for the Study of Lithium-treated patients (IGSLI).

https://arctichealth.org/en/permalink/ahliterature46432
Source
Acta Psychiatr Scand. 1996 Nov;94(5):344-7
Publication Type
Article
Date
Nov-1996
Author
B. Müller-Oerlinghausen
T. Wolf
B. Ahrens
T. Glaenz
M. Schou
E. Grof
P. Grof
G. Lenz
C. Simhandl
K. Thau
P. Vestergaard
R. Wolf
Author Affiliation
Research Group of Clinical Psychopharmacology, Freie Universität Berlin, Germany.
Source
Acta Psychiatr Scand. 1996 Nov;94(5):344-7
Date
Nov-1996
Language
English
Publication Type
Article
Keywords
Antimanic Agents - adverse effects - therapeutic use
Austria - epidemiology
Bipolar Disorder - drug therapy - mortality - psychology
Cause of Death
Denmark - epidemiology
Depressive Disorder - drug therapy - mortality - psychology
Germany - epidemiology
Humans
Lithium - adverse effects - therapeutic use
Long-Term Care
Patient Dropouts - statistics & numerical data
Psychotic Disorders - drug therapy - mortality - psychology
Recurrence
Research Support, Non-U.S. Gov't
Suicide - prevention & control - psychology - statistics & numerical data
Survival Rate
Abstract
Excess mortality has repeatedly been found in patients with recurrent affective disorders. In previous studies our group has shown that during long-term lithium treatment the mortality of such patients is not significantly higher than that of the general population. In the present study, we extended our investigation to 273 patients from the earlier IGSLI cohort who subsequently dropped out from regular lithium prophylaxis. The standardized mortality ratio (SMR) for the whole group was 2.5, significantly higher (P
PubMed ID
9124081 View in PubMed
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Neuroleptic malignant syndrome-an 11-year longitudinal case-control study.

https://arctichealth.org/en/permalink/ahliterature122041
Source
Can J Psychiatry. 2012 Aug;57(8):512-8
Publication Type
Article
Date
Aug-2012
Author
René Ernst Nielsen
Signe Olrik Wallenstein Jensen
Jimmi Nielsen
Author Affiliation
Unit for Psychiatric Research, Aalborg Psychiatric Hospital, Aarhus University Hospital, Aalborg, Denmark. ren@rn.dk
Source
Can J Psychiatry. 2012 Aug;57(8):512-8
Date
Aug-2012
Language
English
Publication Type
Article
Keywords
Age Factors
Antipsychotic Agents - adverse effects - therapeutic use
Anxiety Disorders - drug therapy - mortality
Case-Control Studies
Cross-Sectional Studies
Data Collection
Delayed-Action Preparations
Dementia - drug therapy - mortality
Denmark
Depressive Disorder - drug therapy - mortality
Humans
Longitudinal Studies
Mental Disorders - drug therapy - mortality
Neuroleptic Malignant Syndrome - diagnosis - epidemiology - etiology - mortality
Psychotic Disorders - drug therapy - mortality
Registries
Retreatment
Risk factors
Sex Factors
Survival Rate
Abstract
To describe patients with neuroleptic malignant syndrome (NMS), to establish occurrence of NMS, to investigate risk factors of NMS, and to investigate mortality associated with NMS.
We conducted a longitudinal register linkage case-control study of NMS.
In health care registers covering the period from 1996 to 2007, we identified, among 224 372 patients with organic, psychotic, affective, or neurotic diagnosis, 83 patients with NMS, equivalent to an occurrence of 0.04%. Treatment with second-generation antipsychotics (SGAs) in the 3 months preceding admission increased the NMS risk (OR 4.66; 95% CI 1.96 to 11.10) and also first-generation antipsychotics (FGAs) of high potency (OR 23.41; 95% CI 5.29 to 103.61) and mid potency (OR 4.81; 95% CI 1.96 to 11.79), and depot antipsychotics (OR 4.53; 95% CI 1.60 to 12.80). Benzodiazepines (BDZs) also increased the risk of NMS (OR 3.43; 95% CI 1.68 to 12.80). NMS was associated with an increased mortality (HR 1.88; 95% CI 1.19 to 2.98) in patients, compared with sex-, age-, and diagnosis-matched control subjects, but no significant difference in mortality between patients and control subjects was observed after the initial 30 days (P = 0.27).
The occurrence of NMS is low, and the prediction of NMS is difficult. Previous treatment with FGAs, SGAs, and BDZs was identified as a risk factor for developing NMS. NMS increased mortality within 30 days after NMS.
PubMed ID
22854034 View in PubMed
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16 records – page 1 of 2.