title: Use of antipsychotic medication and suicidality--the Northern Finland Birth Cohort 1966.
abstract: In addition to psychoses, antipsychotic drugs are nowadays also prescribed for other psychiatric disturbances, such as mood disorders. We wanted to find out whether there is any association between the use of antipsychotic drugs and suicidality in cases of psychotic and non-psychotic disorders. Our sample was the population-based Northern Finland 1966 Birth Cohort. Information on the use of prescribed drugs was collected in 1997 from the nationwide medication register and with a postal questionnaire (N = 8218). The presence of suicidal ideation was assessed cross-sectionally using the Symptom Check List-25 questionnaire. We studied associations between suicidal ideation, adjusted for symptoms of depression and anxiety, and antipsychotic medication in different diagnostic groups (schizophrenia, other psychosis and no psychosis). Individuals receiving antipsychotic medication (n = 70, 0.9%) had in general more suicidal ideation regardless of diagnostic group, although the associations diminished when taking other symptoms into account. There were no statistically significant differences between those taking typical and atypical antipsychotics. In the non-psychotic group, higher antipsychotic doses were associated with more suicidal ideation even when adjusted for symptoms of depression and anxiety (p < 0.05). In the cases of schizophrenia or other forms of psychosis, no such associations were observed. Our results suggest that one should take suicidal ideation into account when prescribing antipsychotic medication, especially for off-label use.
authors.affiliation: Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Oulu, Finland. inarissa@mail.student.oulu.fi
authors.forename: Ina
authors.initials: I
authors.lastname: Rissanen
authors.forename: Erika
authors.initials: E
authors.lastname: Jääskeläinen
authors.forename: Matti
authors.initials: M
authors.lastname: Isohanni
authors.forename: Hannu
authors.initials: H
authors.lastname: Koponen
authors.forename: Matti
authors.initials: M
authors.lastname: Joukamaa
authors.forename: Antti
authors.initials: A
authors.lastname: Alaräisänen
authors.forename: Jouko
authors.initials: J
authors.lastname: Miettunen
mesh_terms: D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D056687:Off-Label Use; D011446:Prospective Studies; D011618:Psychotic Disorders / Q000188:drug therapy; D012042:Registries; D012559:Schizophrenia / Q000188:drug therapy; D059020:Suicidal Ideation; D013405:Suicide / Q000706:statistics & numerical data*; D013406:Suicide, Attempted / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
chemical_list: D014150:Antipsychotic Agents