Lithium and suicidal behavior in major affective disorder: a case-control study.
OBJECTIVE
A number of studies have suggested that lithium may be particularly effective in reducing suicide risks among patients with major affective disorders. The design of many of these studies left them open to biases associated with treatment compliance, however.


METHODS
Subjects were drawn from a naturalistic, long-term follow-up of patients with major affective disorders. Fifteen who committed suicide while receiving somatotherapy where matched to non-suicidal patients who were similarly receiving somatotherapy at the same point in follow-up. The same procedure was followed for 41 patients who made a serious suicide attempt during follow-up.


RESULTS
Six (40.0%) of the patients who committed suicide, and eight (53.3%) of their controls, were thought to have been taking lithium in the preceding week. Among attempters and their controls, nine (22.0%) and eight (19.5%), respectively, were taking lithium.


CONCLUSIONS
These results do not support previous suggestions that lithium has uniquely antisuicidal properties. Other existing datasets should be explored with this design to establish whether lithium does, or does not, offer special protection against suicide.
Coryell
W
W
Department of Psychiatry, University of Iowa, Iowa City, 52242-1000, USA.
Arndt
S
S
Turvey
C
C
Endicott
J
J
Solomon
D
D
Mueller
T
T
Leon
A C
AC
Keller
M
M
D000328:Adult; D000341:Affective Disorders, Psychotic / Q000188:drug therapy* / Q000523:psychology; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008094:Lithium / Q000627:therapeutic use*; D008297:Male; D013405:Suicide / Q000523:psychology*; D013997:Time Factors; D000092864:Suicide Prevention
D008094:Lithium