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Suicide mortality in patients on lithium maintenance therapy
Journal of Affective Disorders
|December 19, 1998
Summary
Maintenance treatment for mood disorders, including unipolar depression and bipolar disorders, significantly reduces suicide risk. This 18-year study found lithium therapy lowered suicide rates compared to untreated groups.
Area of Science:
- Psychiatry
- Clinical Psychology
Background:
- Mood disorders are recurrent, increasing long-term morbidity and suicide risk.
- Maintenance treatment is crucial for managing chronic mood disorders.
- Suicide remains a significant concern in patients with mood disorders.
Purpose of the Study:
- To evaluate the long-term effectiveness of maintenance treatment in reducing suicide rates.
- To compare suicide mortality in a treated cohort with historical data from untreated patients.
Main Methods:
- An 18-year follow-up of 103 patients (67 unipolar depression, 36 bipolar/schizo-affective) receiving lithium maintenance therapy.
- Inclusion criteria required at least three mood episodes for all participants.
- Suicide mortality was compared to published data from similar patient groups not receiving maintenance therapy.
Main Results:
- The overall standardized mortality ratio (SMR) for all causes was 0.93.
- Two suicides occurred during the study period.
- The suicide rate was 1.3 per 1000 patient-years, significantly lower than the 5.5 per 1000 patient-years reported for untreated groups.
Conclusions:
- Maintenance treatment, particularly with lithium, substantially reduces suicide rates in patients with mood disorders.
- Continuous adherence to maintenance therapy is associated with lower suicide risk.
- Specialist mood disorder clinics can effectively manage high-risk patients through long-term maintenance strategies.
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