uu.seUppsala University Publications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Suicide seasonality and antidepressants: a register-based study in Sweden
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
Show others and affiliations
2013 (English)In: Acta Psychiatrica Scandinavica, ISSN 0001-690X, E-ISSN 1600-0447, Vol. 127, no 2, 117-125 p.Article in journal (Refereed) Published
Abstract [en]

Objective

Seasonality of completed suicides with a peak in spring and early summer is a well-documented finding. The circannual serotonergic functioning is hypothesized to be central in this phenomenon. Antidepressant medications exert their pharmacological action mainly by regulating serotonin. Our aim is to study the amplitude of the seasonal effect among suicide victims positive for different classes of antidepressants or without any antidepressants at the time of death.

Method

By using Swedish Registers, 12 448 suicides with forensic data for antidepressive medication and information on in-patient-treated mental disorder were identified during 1992-2003. Seasonality was estimated with a Poisson regression variant of the circular normal distribution of completed suicides.

Results

Higher suicide seasonality was found for individuals treated with selective serotonin reuptake inhibitor (SSRIs) compared to those with other antidepressant treatment or without any antidepressant treatment. The finding is more evident for men and violent suicide methods and those without history of in-patient treatment.

Conclusion

Our results provide preliminary support for the serotonergic hypothesis of suicide seasonality and raise the question of a possible accentuation of the natural suicide seasonality in patients treated with SSRIs, a hypothesis that warrants further investigation.

Place, publisher, year, edition, pages
2013. Vol. 127, no 2, 117-125 p.
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:uu:diva-189178DOI: 10.1111/j.1600-0447.2012.01891.xISI: 000313492300004PubMedID: 22676408OAI: oai:DiVA.org:uu-189178DiVA: diva2:580728
Available from: 2012-12-25 Created: 2012-12-25 Last updated: 2017-12-06Bibliographically approved
In thesis
1. Suicide Seasonality: Theoretical and Clinical Implications
Open this publication in new window or tab >>Suicide Seasonality: Theoretical and Clinical Implications
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Although suicide seasonality has been well-documented, surprisingly little is known about its underlying mechanisms.

Methods: In this thesis, data from three Swedish registers (Cause of Death Register, National Patient Register, Prescribed Drugs Register) and data from the Swedish Meteorological and Hydrological Institute were used.

In Study I, the amplitude of suicide seasonality was estimated in completed suicides in 1992-2003 in individuals with different antidepressant medications or without antidepressants.

In Study II, monthly suicide and sunshine data from 1992-2003 were used to examine the association between suicide and sunshine in groups with and without antidepressants.

In Study III, the relationship between season of initiation of antidepressant treatment and the risk of suicidal behavior was explored in patients with a new treatment episode with antidepressant medication.

In Study IV, the complex association between sunshine, temperature and suicidal behavior was investigated in patients with a new treatment episode with an antidepressant in two exposure windows (1-4 and 5-8 weeks) before the event.

Findings: Study I: Higher suicide seasonality was found in individuals treated with selective serotonin reuptake inhibitors (SSRIs) compared with those given a different antidepressant treatment or those without any antidepressant treatment.

Study II: In individuals treated with SSRIs, there was a positive association between sunshine and suicide, with the association stronger in men treated with SSRIs compared with men treated with other antidepressants. An effect modification by age was observed.

Study III: The elderly (65+) had a higher risk of suicide when initiating antidepressant treatment in summer and a higher risk of suicide attempt when starting antidepressant therapy in spring and summer. Younger patients (0-24) demonstrated a higher risk of suicide attempt when treatment was initiated in autumn.

Study IV: In the elderly (65+), a harmful association was observed between the risk of suicide attempt and the average daily temperature during the four weeks before the suicide attempt, as well as with average daily sunshine during both exposure windows (1-4 and 5-8 weeks) before the suicide attempt.

Significance: Our results provide epidemiological support for the role of the serotonergic system in seasonality of suicide in which both medication and climate may be involved.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2017. 74 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1383
Keyword
suicide, season, antidepressants, sunshine, temperature
National Category
Neurosciences
Research subject
Psychiatry
Identifiers
urn:nbn:se:uu:diva-330907 (URN)978-91-513-0108-2 (ISBN)
Public defence
2017-12-07, Gunnesalen, Ing 10, Akademiska sjukhuset, Uppsala, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2017-11-16 Created: 2017-10-15 Last updated: 2017-11-16

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Authority records BETA

Makris, Georgios D.Papadopoulos, F C

Search in DiVA

By author/editor
Makris, Georgios D.Papadopoulos, F C
By organisation
Psychiatry, University Hospital
In the same journal
Acta Psychiatrica Scandinavica
Psychiatry

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 394 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf