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Abstract
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Background and objectives: There are many ecological studies in the literature which have reported inverse connections between suicide rates and the use of antidepressants (ADs), suggesting that the increase in antidepressant use could be the cause of the decrease in suicide rates. ("antidepressant theory").
Methods: Authors in an earlier study has shown that aggregate studies have many theoretical-methodological problems. In this paper they detail the practical issues. They have collected ecological (aggregate) studies which found no inverse (or mixed) relationship between increasing AD use and decreasing suicide rates. There was also studied the distribution of the antidepressants use of the different diagnostic groups.
Results: 1. In the aggregate studies there is not known the really use of AD of suicide victims which clearly implies that possibility of ecological fallacy. 2. In several countries the decrease in suicide rates started earlier than a measurable increase in the sale of ADs. 3. Authors revealed on a database, that only 53.93% of the ADs were purchased per year for the patients with F25 and F30-39 ICD codes, who carries a high suicide risk.
Conclusions: The results called into question the theory, that the increase in antidepressant use could be the determinant reason of the decrease in suicide rates in a given population. The results of all ecological studies in suicide research are questionable where the distribution of antidepressant use is not separated according to medical indication. The results of the ecological models should be treated with caution in general.
Keywords: suicide rate, antidepressants, ecological studies, methodological problems.
The Hungarian version of this paper is: Zonda, T., Bozsonyi, K., & Kmetty, Z. Öngyilkosság és antidepresszívumok, ökológiai vizsgálatok. Mentálhigiéné es Pszichoszomatika, 2016, 17(2):97-116.
Language: en |