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Abstract
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PURPOSE: To assess exposure to antidepressants (AD) before and after non-fatal self-harm (SH) in older adults and to examine one-year rates and risk factors for subsequent SH.
METHODS: Longitudinal national register-based retrospective cohort study of Swedish residents aged 75+ (N = 2775) with treatment at hospital or specialist outpatient clinic in connection with SH between January 1, 2006, and December 31, 2013. The cohort was followed for one year after the index episode. Exposure to AD was assessed at index and at subsequent SH. Cox regression analysis was used to assess factors associated with one-year repeat SH.
RESULTS: At the index episode, 51% were prevalent AD users; 23% started AD during the following year. Overall 12% of prevalent AD users, 8% of AD non-users, and 6% of AD new users repeated SH or died by suicide. About two-thirds of these subsequent behaviors occurred within 3 months after the index episode. Men had increased risk of subsequent SH (Hazard ratio [HR] 1.38, 95% CI: 1.09 to 1.74); older age (> 85 years) was associated with a lower risk (HR 0.72, CI 95% 0.55-0.93). Users of AD did not have an increased risk of repeat SH.
CONCLUSIONS: Half of older adults who self-harmed were prevalent AD users and a further one fourth started an AD within one year after the index SH. Antidepressant use was not associated with increased risk of subsequent SH in this high-risk cohort of older adults. This article is protected by copyright. All rights reserved.
Language: en |