@article{ref1,
title="Inverse association of anti-inflammatory prescription fills and suicide-related mortality in young adults: evidence from a nationwide study of Swedish regions, 2006-2021",
journal="Brain, behavior, and immunity health",
year="2023",
author="Andersson, Peter and Lundberg, Johan and Jarbin, Hakan and Jokinen, Jussi and Desai Boström, Adrian E.",
volume="31",
number="",
pages="e100665-e100665",
abstract="BACKGROUND: This cross-sectional study examined nationwide real-world associations between anti-inflammatory agent fills and suicide-related death rates in 20-24-year-olds across the 21 Swedish regions during 2006-2021. <br><br>METHODS: Nationwide Swedish registers were used to compare regional year-wise suicide-related mortality (SRM) and dispensations for anti-inflammatory agents (ATC-code: M01) in 20-24-year-olds. Dispensations for paracetamol (ATC-code: N02BE01) was applied as a control variable. Associations between regional year-wise SRM and dispensation rates were analyzed by sex-stratified zero-inflated generalized linear mixed effect models (GLMM). Dispensation rates of paracetamol and inflammatory agents were designated as independent fixed effects variables, and year and region constituted random-intercept effects. <br><br>RESULTS: Acetic acid derivatives and related substances (M01AB) and propionic acid derivates (M01A3) accounted for ∼71% of measured dispensation fills for anti-inflammatory agents. Diclofenac fills constituted ∼98% of the former category, whereas dispensations for Ibuprofen (∼21%), Naproxen (∼62%) and Ketoprofen (∼13%) constituted the most prescribed agents in the latter category. Regional yearly dispensation rates of anti-inflammatory agents in 20-24-year-old females were inversely associated with female SRM (β = -0.095, p = 0.0393, 95% CI -0.186, -0.005) - independent of paracetamol rates, which were unassociated to SRM (p = 0.2094). <br><br>RESULTS were confirmed in validation analyses for anti-inflammatory agents (OR = 0.7232, p = 0.0354, 95% CI [OR] 0.5347, 0.9781). No association was demonstrated in males (p = 0.833). <br><br>CONCLUSION: Anti-inflammatory agent dispensation rates were independently associated to lower suicide-related death rates in female 20-24-year-olds. This adds to growing evidence implicating inflammatory processes in mental disorders, warranting trials focusing on the suicide preventative potential of anti-inflammatories in young adults.<p /> <p>Language: en</p>",
language="en",
issn="2666-3546",
doi="10.1016/j.bbih.2023.100665",
url="http://dx.doi.org/10.1016/j.bbih.2023.100665"
}