Journal of affective disorders · 2025
Healthcare and psychiatric drug utilization after a suicide attempt in patients with depression: a register-based Swedish cohort study.
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Johansson Viktoria, Brenner Philip, Karlsson Pär, Feldman Adina L, Reutfors Johan
Аннотация
BACKGROUND: Suicide attempts (SA) are common in depression, yet little is known about healthcare utilization (HCU) and psychiatric drug utilization (PDU) following a SA. This study assesses and compares HCU and PDU patterns in patients with depression with and without a SA.
METHODS: We retrieved data from population-based registers on 359,276 patients with incident depression. Patients with a first-time SA (n = 16,748), were matched with comparators (n = 330,764). Patients with a history of SA (n = 11,764) were analyzed separately. Inpatient days, outpatient visits, and the amount of psychiatric medications were measured until five years after the SA.
RESULTS: Patients with a first-time SA had four times higher psychiatric inpatient HCU (ratio 3.8 [95 % CI 3.6-4.0]) and twice higher outpatient HCU (ratio 1.7 [95 % CI 1.7-1.8]) than comparators in the year following the SA. PDU was higher for most drug classes in the SA patients, with the largest difference observed for anxiolytics and sedatives (ratio 1.9 [95 % CI 1.8-1.9]). Higher HCU and PDU in SA patients persisted throughout the five-year follow-up period.
LIMITATIONS: Our data did not include depressed patients from primary care, indicating that the findings may be more generalizable to patients with moderate or severe depression.
CONCLUSIONS: Patients with depression who attempted suicide had higher HCU and PDU than comparators during the five-year follow-up period. The association between SA and increased HCU and PDU underscores the ongoing suffering of these individuals as well as the substantial burden placed on the healthcare system.
METHODS: We retrieved data from population-based registers on 359,276 patients with incident depression. Patients with a first-time SA (n = 16,748), were matched with comparators (n = 330,764). Patients with a history of SA (n = 11,764) were analyzed separately. Inpatient days, outpatient visits, and the amount of psychiatric medications were measured until five years after the SA.
RESULTS: Patients with a first-time SA had four times higher psychiatric inpatient HCU (ratio 3.8 [95 % CI 3.6-4.0]) and twice higher outpatient HCU (ratio 1.7 [95 % CI 1.7-1.8]) than comparators in the year following the SA. PDU was higher for most drug classes in the SA patients, with the largest difference observed for anxiolytics and sedatives (ratio 1.9 [95 % CI 1.8-1.9]). Higher HCU and PDU in SA patients persisted throughout the five-year follow-up period.
LIMITATIONS: Our data did not include depressed patients from primary care, indicating that the findings may be more generalizable to patients with moderate or severe depression.
CONCLUSIONS: Patients with depression who attempted suicide had higher HCU and PDU than comparators during the five-year follow-up period. The association between SA and increased HCU and PDU underscores the ongoing suffering of these individuals as well as the substantial burden placed on the healthcare system.