title: Serotonergic medication enhances the association between suicide and sunshine.
abstract: BACKGROUND
  An association between suicide and sunshine has been reported. The effect of sunshine on hormones and neurotransmitters such as serotonin has been hypothesized to exert a possible triggering effect on susceptible individuals. The aim of this study is to examine if there is an association between sunshine and suicide, adjusting for season, and if such an association differs between individuals on different antidepressants.
  
  
  METHODS
  By using Swedish Registers and the Swedish Meteorological and Hydrological Institute we obtained information, including forensic data on antidepressive medication for 12,448 suicides and data on monthly sunshine duration. The association between monthly suicide and sunshine hours was examined with Poisson regression analyses while stratifying for sex and age and controlling for time trend and season. These analyses were repeated in different groups of antidepressant treatment.
  
  
  RESULTS
  We found a significantly increased suicide risk with increasing sunshine in both men and women. This finding disappeared when we adjusted for season. Among both men and women treated with selective serotonin reuptake inhibitors (SSRIs) there was a positive association between sunshine and suicide even after adjustment for season and time trend for suicide. Pair comparisons showed that the sunshine-suicide association was stronger among men treated with SSRIs compared to other antidepressant medications or no medication at all.
  
  
  CONCLUSIONS
  Other meteorological factors were not controlled (i.e. temperature) for in the analyses.
  
  
  CONCLUSIONS
  There is an enhanced association between sunshine and suicide among those with SSRI medication, even after adjusting for season. This may have interesting theoretical and clinical implications.
authors.affiliation: Department of Neuroscience, Psychiatry, Uppsala University Hospital, Uppsala University, Uppsala SE-751 85, Sweden. Electronic address: makrisgeorge2@gmail.com.
authors.forename: Georgios D
authors.initials: GD
authors.lastname: Makris
authors.affiliation: Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Reutfors
authors.affiliation: Department of Mathematics, Uppsala University, Uppsala, Sweden.
authors.forename: Rolf
authors.initials: R
authors.lastname: Larsson
authors.affiliation: Department of Molecular Medicine and Surgery, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Psychiatry, Tiohundra AB, Norrtälje, Sweden.
authors.forename: Göran
authors.initials: G
authors.lastname: Isacsson
authors.affiliation: Department of Molecular Medicine and Surgery, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Psychiatry, Tiohundra AB, Norrtälje, Sweden.
authors.forename: Urban
authors.initials: U
authors.lastname: Ösby
authors.affiliation: Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Ekbom
authors.affiliation: Department of Neuroscience, Psychiatry, Uppsala University Hospital, Uppsala University, Uppsala SE-751 85, Sweden.
authors.forename: Lisa
authors.initials: L
authors.lastname: Ekselius
authors.affiliation: Department of Neuroscience, Psychiatry, Uppsala University Hospital, Uppsala University, Uppsala SE-751 85, Sweden.
authors.forename: Fotios C
authors.initials: FC
authors.lastname: Papadopoulos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003863:Depression / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012621:Seasons; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data; D013472:Sunlight / Q000009:adverse effects*; D013548:Sweden
chemical_list: D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors
keywords: Seasonality; Serotonin; Suicide