title: Somatic disorders and antidepressant use in suicides: A population-based study from the Friuli Venezia Giulia region, Italy, 2003-2013.
abstract: BACKGROUND
  Many somatic disorders are complicated by depression and increase the risk of suicide. Little is known about whether antidepressants might reduce the suicidal risk in patients with somatic disorders.
  
  
  METHODS
  Data on diagnoses and antidepressant prescriptions were derived from the Social and Health Information System of the Friuli Venezia Giulia Region. Cases were all suicides that occurred in the region during the years 2003-2013 and were sex- and age-matched to controls from the general population. Conditional logistic regression analysis was used to assess the association between suicide and somatic disorders.
  
  
  RESULTS
  The suicide rate in Friuli Venezia Giulia decreased from 11.3 to 10.7 per 100,000 inhabitants during the years 2003-2013, however patients with somatic disorder had a three times increased risk of suicide. Elderly somatic patients' suicide risk was twice as high as younger patients. The risk increased from 2.6 to 9.8 times as the number of comorbid disorders increased from 1 to 4 and over. Although no significant risk of suicide in patients with somatic disorders was found when patients were adherent to antidepressants, only 11.5% of the suicides was adherent in the year prior to death.
  
  
  CONCLUSIONS
  Medical illnesses and underlying depressive symptoms may have a synergy effect on the risk of suicide, particularly in older patients and in patients with multiple morbidities. Since medically ill subjects adherent to antidepressants did not show a significant risk of suicide, early identification and adequate treatment of depression in somatic patients should be considered in order to prevent suicide.
authors.affiliation: Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden; Central Health Directorate/Classification Area, Friuli Venezia Giulia Region, Italian Collaborating Centre for the WHO Family of International Classifications, Udine, Italy. Electronic address: Giulio.Castelpietra@ki.se.
authors.forename: Giulio
authors.initials: G
authors.lastname: Castelpietra
authors.affiliation: Epidemiological Service, Regional Health Directorate, Friuli Venezia Giulia Region, Udine, Italy. Electronic address: michele.gobbato@uniud.it.
authors.forename: Michele
authors.initials: M
authors.lastname: Gobbato
authors.affiliation: Epidemiological Service, Regional Health Directorate, Friuli Venezia Giulia Region, Udine, Italy. Electronic address: francesca.valent@regione.fvg.it.
authors.forename: Francesca
authors.initials: F
authors.lastname: Valent
authors.affiliation: Department of Medical Sciences, University of Trieste, Trieste, Italy. Electronic address: bovenzi@units.it.
authors.forename: Massimo
authors.initials: M
authors.lastname: Bovenzi
authors.affiliation: Department of Medical Sciences, University of Trieste, Trieste, Italy; Department of Medical and Biological Sciences, University of Udine, Udine, Italy. Electronic address: fabio.barbone@uniud.it.
authors.forename: Fabio
authors.initials: F
authors.lastname: Barbone
authors.affiliation: Epidemiological Service, Regional Health Directorate, Friuli Venezia Giulia Region, Udine, Italy. Electronic address: elena.clagnan@regione.fvg.it.
authors.forename: Elena
authors.initials: E
authors.lastname: Clagnan
authors.affiliation: Department of Medical Sciences, University of Trieste, Trieste, Italy. Electronic address: e.pascolo@fmc.units.it.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Pascolo-Fabrici
authors.affiliation: Department of Experimental and Clinical Medical Sciences, University of Udine, Udine, Italy. Electronic address: matteo.balestrieri@uniud.it.
authors.forename: Matteo
authors.initials: M
authors.lastname: Balestrieri
authors.affiliation: Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden. Electronic address: osterlang@icloud.com.
authors.forename: Göran
authors.initials: G
authors.lastname: Isacsson
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000928:Antidepressive Agents / Q000506:poisoning* / Q000627:therapeutic use; D016022:Case-Control Studies; D015897:Comorbidity; D003866:Depressive Disorder / Q000150:complications / Q000188:drug therapy / Q000523:psychology; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000188:drug therapy / Q000523:psychology; D008875:Middle Aged; D012044:Regression Analysis; D012737:Sex Factors; D013001:Somatoform Disorders / Q000150:complications / Q000453:epidemiology* / Q000523:psychology*; D013405:Suicide / Q000706:statistics & numerical data*; D000092864:Suicide Prevention
chemical_list: D000928:Antidepressive Agents
keywords: Antidepressants; Case–control; Somatic disorders; Suicide