Risk factors for suicide in depression in Finland : first-hospitalized patients followed up to 24 years

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Aaltonen, K I, Isometsä, E, Sund, R & Pirkola, S 2019, ' Risk factors for suicide in depression in Finland : first-hospitalized patients followed up to 24 years ', Acta Psychiatrica Scandinavica, vol. 139, no. 2, pp. 154-163 . https://doi.org/10.1111/acps.12990

Title: Risk factors for suicide in depression in Finland : first-hospitalized patients followed up to 24 years
Author: Aaltonen, Kari I.; Isometsä, Erkki; Sund, Reijo; Pirkola, Sami
Contributor organization: Doctoral Programme in Clinical Research
Department of Psychiatry
Clinicum
University of Helsinki
Department of Social Research (2010-2017)
HUS Psychiatry
Date: 2019-02
Language: eng
Number of pages: 10
Belongs to series: Acta Psychiatrica Scandinavica
ISSN: 0001-690X
DOI: https://doi.org/10.1111/acps.12990
URI: http://hdl.handle.net/10138/299681
Abstract: Objective To examine longitudinally risk factors for suicide in depression, and gender differences in risk factors and suicide methods. Method We linked data from (i) The Finnish Hospital Discharge Register, (ii) the Census Register of Statistics Finland, and (iii) Statistics Finland's register on causes of deaths. All 56 826 first-hospitalized patients (25 188 men, 31 638 women) in Finland in 1991-2011 with a principal diagnosis of depressive disorder were followed up until death (2587 suicides) or end of the year 2014 (maximum 24 years). Results Clinical characteristics (severe depression adjusted hazard ratio [AHR] 1.19 [95% CI 1.08-1.30]; psychotic depression AHR 1.45 [1.30-1.62]; and comorbid alcohol dependence AHR 1.26 [1.13-1.41]), male gender (AHR 2.07 [1.91-2.24]), higher socioeconomic status and living alone at first hospitalization were long-term predictors of suicide deaths. Highest risk was associated with previous suicide attempts (cumulative probability 15.4% [13.7-17.3%] in men, 8.5% [7.3-9.7%] in women). Gender differences in risk factors were modest, but in lethal methods prominent. Conclusion Sociodemographic and clinical characteristics at first hospitalization predict suicide in the long term. Inpatients with previous suicide attempts constitute a high-risk group. Despite some gender differences in risk factors, those in lethal methods may better explain gender disparity in risk.
Subject: depression
suicide
cohort studies
risk factors
gender differences
GENDER DIFFERENCES
DISORDERS
REGISTER
NATIONWIDE
DISCHARGE
INDIVIDUALS
PREDICTORS
MORTALITY
SEVERITY
BEHAVIOR
3124 Neurology and psychiatry
Peer reviewed: Yes
Rights: cc_by_nc
Usage restriction: openAccess
Self-archived version: acceptedVersion


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