title: Diagnoses and prescriptions of antidepressants in suicides: Register findings from the Friuli Venezia Giulia Region, Italy, 2002-2008.
abstract: OBJECTIVE
  To explore to what extent and under which diagnoses individuals who committed suicide had received psychiatric in-patient care, and how many had previously committed non-lethal self-harm. To investigate the antidepressant treatment received by these individuals.
  
  
  METHODS
  Case-control study based on a health register.
  
  
  RESULTS
  Psychiatric hospitalisation was found in 31.2% of the cases and 2.3% of the controls, and was a strong predictor for suicide with an odds ratio (OR) = 19.5. This did not differ significantly between diagnostic categories (except anxiety disorders with OR = 5.3). Non-lethal self-harm in the study period was committed by 14.3% of the cases and 0.14% of the controls, and was twice as common in female cases than in male cases. Previous self-harm was a very strong independent predictor for suicide with OR = 53.1 when a single episode of self-harm had occurred, and OR = 98.0 for repeated episodes (adjusted for age, gender and hospitalisation). Only 16.1% of the cases were currently on antidepressant medication at the time of suicide.
  
  
  CONCLUSIONS
  Few of the suicides had previously been psychiatric in-patients. Even fewer had current prescriptions for antidepressants. This suggests that better diagnosis and treatment of psychiatric patients is an important suicide preventive intervention.
authors.affiliation: a Department of Clinical Neuroscience , Karolinska Institutet , Stockholm , Sweden ;|b Central Health Directorate/Classification Area, Friuli Venezia Giulia Region , Italian Collaborating Centre for the WHO Family of International Classifications , Udine , Italy ;
authors.forename: Giulio
authors.initials: G
authors.lastname: Castelpietra
authors.affiliation: c Department of Medical Sciences , University of Trieste , Trieste , Italy ;
authors.forename: Massimo
authors.initials: M
authors.lastname: Bovenzi
authors.affiliation: d Epidemiological Service , Central Health Directorate, Friuli Venezia Giulia Region , Udine , Italy ;
authors.forename: Elena
authors.initials: E
authors.lastname: Clagnan
authors.affiliation: c Department of Medical Sciences , University of Trieste , Trieste , Italy ;|e Department of Medical and Biological Sciences , University of Udine , Udine , Italy ;
authors.forename: Fabio
authors.initials: F
authors.lastname: Barbone
authors.affiliation: f Department of Experimental and Clinical Medical Sciences , University of Udine , Udine , Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Balestrieri
authors.affiliation: a Department of Clinical Neuroscience , Karolinska Institutet , Stockholm , Sweden ;
authors.forename: Göran
authors.initials: G
authors.lastname: Isacsson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D015897:Comorbidity; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012042:Registries; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000453:epidemiology*; D012737:Sex Factors; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data*; D055815:Young Adult; D000092864:Suicide Prevention
chemical_list: D000928:Antidepressive Agents
keywords: Antidepressants; case–control; psychiatric disorders; self-harm; suicide