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Healthcare and psychiatric drug utilization after a suicide attempt in patients with depression: a register-based Swedish cohort study

Year: 2025

Type: article

Abstract: 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. 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. 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. 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. 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. • Depressed suicide attempters had higher healthcare utilization than non-attempters. • Psychiatric inpatient care was four times higher in first-time suicide attempters. • Suicide attempters had higher psychiatric drug utilization than non-attempters. • Highest anxiolytics and sedative volumes were prescribed to the suicide attempters. • The higher healthcare utilization among suicide attempters persisted for five years.

Source: Journal of Affective Disorders

DOI: 10.1016/j.jad.2025.04.034

Authors: Viktoria Johansson, Philip Brenner, Pär Karlsson, Adina L. Feldman, Johan Reutfors

Institutions: Karolinska Institutet, Umeå University

Language: English

Topic: Suicide and Self-Harm Studies

Subfield: Clinical Psychology

Field: Psychology

Domain: Social Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,790