Suicide rates

Leap into the Air (196). Wells continues In the year 1955 the suicide rate for the United States of America quadrupled any previous record. There was an enormous increase also in violent crime throughout the world. The thing had come upon an unprepared humanity it seemed as though human society was to be smashed by its own magnificent gains (196). This insight into the unexpectedly disastrous consequence of sudden scientific advances dominates most of the rest of the novel. 

Patients with mixed states often have comorbid alcohol and substance abuse, severe anxiety symptoms, a higher suicide rate, and a poorer prognosis. 

The result is that panic disorder, particularly when associated with agoraphobia, confers considerable social impairment. Patients with panic disorder are less productive at work, are prone to absenteeism, are less satished in family roles, and have higher mortality and suicide rates. In addition, the physical symptoms of panic disorder are frequently misattributed to medical conditions such as emphysema or heart disease and lead to the costly and inappropriate use of emergency room and other medical services. Panic disorder is costly both from an economic and a social perspective. 

Kates, Don B. Gun Laws around the World Do They Work National Rifle Association. Available online. URL http //www.nraila.org/Issues/ Articles/Read.aspx ID=72. Posted in October 1997. Describes gun laws, gun use, and homicide and suicide rates around the world and includes charts. The site argues that peaceful, well-ordered societies do not need gun laws to be that way and that violent, disordered societies do not benefit from gun laws. 

Khan A, Khan S, Kolts R, Brown WA (2003) Suicide rates in clinical trials of SSRls, other antidepressants, and placebo analysis of FDA reports. Am J Psychiatry 160 790-792 Klein DF (1964) Delineation of two drug-responsive anxiety syndromes. Psychopharma-cologia 5 397-408... 

One analysis (Angst and Wicki 1993) showed agoraphobia in 2.6% of control subjects, 2.8% of subjects with major depression, 7.4% of subjects with pure panic, and 28.0% of subjects with both panic disorder and major depression. Similarly, the attempted suicide rate was 3.5% among control subjects, 5.0% in subjects with pure panic, 13.0% in subjects with depression without panic, and 28.9% in patients with both panic disorder and major depression. These data underline the importance of recognizing and treating comorbid depression in patients with panic disorder. 

Older persons account for one-third of all suicides in the United States even though this group represents only 12% of the population ( 36). Suicide is even more often related to major depression in the elderly than in younger individuals in whom other causes such as substance abuse, bipolar disorder, schizophrenia, and personality disorders often play a major role. In fact, suicide rates are highest in older white men relative to any other segment of the population. For example, white men older than 85 years age commit suicide 30 times as frequently as black women. 

The suicide rate for bipoiar disorder is estimated to be about 10%. in untreated patients, it may be as high as 25% (16,17). Patients are at greater risk during a depressive or mixed episode of the disorder. Other important correlates include concurrent substance abuse and past suicide attempts ( 18). 

For more than 40 years, lithium has been the standard drug therapy for bipolar disorder, primarily because of the quantity and the quality of evidence supporting its role as an effective maintenance and prophylactic treatment. This latter point is a very important consideration, given the recurrent nature of this disorder. Thus, clinicians must choose the optimal strategy for acute treatment with the realization that most patients will need to continue drug therapy indefinitely. In addition, there is support for maintenance lithium s beneficial impact on the suicide rate in bipolar patients ( 73, 74). The author of these reports notes that the lower suicide risk associated with lithium treatment may be due to the following ... 

For example, completed suicide rates in 80- to 84-year-olds are more than twice the ratio in the general population (i.e., 26.5 versus 12.4/100,000). 

Although not generally recognized by medical or mental health practitioners, panic disorder patients have a suicide rate comparable with that of patients with major depression 20 to 40% of panic disorder patients report having made suicide attempts, and about half admit to having had suicidal ideation. This high rate of suicide attempts does not appear to be caused by the presence of depression in panic disorder patients. 

In view of the risk/benefit ratio for clozapine, this agent is not generally considered a first-line agent for the treatment of psychosis but one to consider when several other agents have failed. It is especially useful in quelling violence and aggression in difficult patients, may reduce suicide rates in schizophrenia, and may reduce tardive dyskinesia severity, especially over long treatment intervals. 

Mood symptoms of depression are associated with many conditions in addition to major depressive disorder, including mood and anxiety symptoms in schizophrenia, schizoaffective disorder, bipolar manic/depressed/mixed/rapid cycling states, organic mood disorders, psychotic depression, childhood and adolescent mood disorders, treatment-resistant mood disorders, and many more (see Chapter 10, Fig. 10-6). Atypical antipsychotics are enjoying expanded use for the treatment of symptoms of depression and anxiety in schizophrenia that are troublesome but not severe enough to reach the diagnostic threshold for a major depressive episode or anxiety disorder in these cases the antipsychotics are used not only to reduce such symptoms but hopefully also to reduce suicide rates, which are so high in schizophrenia (Fig. 11 — 53). Atypical antipsychotics may also be useful adjunctive treatments to anti-... 

Anonymous, Antidepressants have been associated with a higher suicide rate. WHO Drug Inf. 7 18-20, 1993. 

It is frequently claimed that lithium reduces the risk of suicide in people with manic depression. Meta-analyses of numerous diverse studies claim to show that people with manic depression or depression who take lithium have lower suicide rates than people who do not (Baldessarini et al. 2006). However the studies included in these analyses yield conflicting results. For example, a large British study found that people taking lithium had suicide rates that were 36 times higher than general population rates (Norton Whalley 1984). In addition, those studies that find an association between lithium and reduced rates of... 

World Health Organisation. Suicide rates (per 100,000) by gender, Ireland, 1950-2002. www.who.int/entity/mental health/media/irel.pdf. 2006. 

The FDA not only limited its suicidality warnings to children, adolescents, and young adults in the new warning but also declared that there was no increase in antidepressant-induced suicidality in adults beyond age 24 and, furthermore, that there was a reduction in risk with antidepressants compared to placebo in adults age 65 and older (GlaxoSmithKline, 2007). The FDA is inviting doctors to believe, based on a small number of elderly patients in short-term clinical trials, that antidepressants might even reduce the suicide rate among older patients. 

ECT is frequently justified as treatment of last resort in cases at high risk for suicide. But research uniformly shows that ECT has no beneficial effect on the suicide rate. Indeed, the most thorough study available, published in the British Journal of Psychiatry in 2007, found an overall increased rate of suicide in patients previously given ECT (Munk-Olsen et al., 2007). In addition, patients treated with ECT in the past week had a greatly increased risk of suicide compared with other patients (RR = 4.82, 95% Cl 2.22-10.95) (p. 437, emphasis added). 

Overall, there is little or nothing in the literature to suggest that ECT ameliorates suicide, whereas a significant body of literature confirms that it does not, and the most thorough study shows that it increases the overall suicide rate, including a major increase within the week after the last ECT. Once again, treatment opinions are not driven by empirical data. Instead, empirical data is ignored, distorted, or misrepresented to confirm treatment opinions. 

Van Pragg, H. (2003). A stubborn behaviour The failure of antidepressants to reduce suicide rates. World Journal of Biological Psychiatry, 4, 184—191. 

Educational policies and commercial marketing of antidepressant drugs have led to an increase in the detection and treatment of depression. Conceivably this may be associated with the fall in suicide rates noted in Finland. However, overdosage of tricyclic antidepressants continues to contribute to deaths from suicide. Whether completely replacing tricyclics with less toxic compounds would lower overall suicide rate remains controversial. 

The suicide rate for white males ages 15-24 has tripled since 1950. 

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