Suicide Attempt and Suicidal Drug Overdose in Chronic Obstructive Pulmonary Disease Patients With or Without Depression.

Chi-Yu Lin,Cheng-Li Lin,Tomor Harnod,Chia-Hung Kao

doi:10.3389/fpsyt.2020.00270

Abstract

BackgroundTo determine differences in the incidence and risks of suicide attempt (SA) and suicidal drug overdose (SDO) between chronic obstructive pulmonary disease (COPD) patients with and without comorbid depression by using data from Taiwan’s National Health Insurance Research Database.MethodsWe analyzed the data of patients aged ≥20 years who had received a COPD diagnosis between 2000 and 2012. These COPD patients were divided into those with and without depression, and they were compared against a cohort from the general population. We calculated adjusted hazard ratios and the corresponding 95% confidence intervals for SA and SDO in the three cohorts after adjustment for age, sex, and comorbidities.ResultsUntil the end of 2012, 5.81% of patients with COPD developed depression. The incidence of SA and SDO in COPD patients with and without depression was 29.7 and 4.69 per 10,000 person-years and 71.2 and 20.9 per 10,000 person-years, respectively. COPD patients with depression had 13.6- and 10.0-fold higher risks of SA and SDO, respectively, than did controls. Particularly, an increased risk of SA caused by the enhancement effects of depression on COPD was noted in patients aged less than 50 years.ConclusionSA and SDO risks are extremely high in Taiwanese COPD patients with depression. Our findings suggest that clinicians should be aware that for COPD patients with comorbid depression, prescribing a large amount of medications may be associated with SA risk through SDO.

Highlights

More than 800,000 people commit suicide every year, and the prevalence of completed suicide has progressively increased over the past decades [1]
Compared with the reference group for each variable, a significantly high suicide attempt (SA) risk was observed after adjustment for demographic characteristics and comorbidities in chronic obstructive pulmonary disease (COPD) patients, COPD patients without depression, and COPD
Patients with depression as well as in patients aged

Summary

Introduction

More than 800,000 people commit suicide every year, and the prevalence of completed suicide has progressively increased over the past decades [1]. Researchers have investigated interactions between suicidality and medical conditions for years; only few researchers have conducted population-based studies on this topic [9, 10]. In a recent large population-based crossnational study, Scott et al reported several physical conditions that are potential independent risk factors for suicidality [10]. Whether the probability of suicide is high in patients with chronic medical conditions or whether it is noted only in patients with specific disorders remains controversial [11]. To determine differences in the incidence and risks of suicide attempt (SA) and suicidal drug overdose (SDO) between chronic obstructive pulmonary disease (COPD) patients with and without comorbid depression by using data from Taiwan’s National Health Insurance Research Database

Methods

Results

Conclusion