Antiepileptic Drugs for Bipolar Disorder and the Risk of Suicidal Behavior: A 30-Year Observational Study
Abstract
Objective:
Method:
Results:
Conclusions:
Method
Participants
Assessments
Classification of Antiepileptic Exposure
Statistical Analysis
Primary analyses: safety models.
Propensity for antiepileptic exposure.
Results
Study Sample
Characteristic | ||
---|---|---|
N | % | |
Gender | ||
Female | 122 | 61.3 |
Male | 77 | 38.7 |
Marital status | ||
Never married | 70 | 35.2 |
Married | 77 | 38.7 |
Divorced, separated, or widowed | 52 | 26.1 |
Hollingshead socioeconomic status scalea | ||
I | 4 | 2.0 |
II | 28 | 14.1 |
III | 68 | 34.2 |
IV | 56 | 28.1 |
V | 43 | 21.6 |
Intake site | ||
New York | 31 | 15.6 |
St. Louis | 41 | 20.6 |
Boston | 29 | 14.6 |
Iowa City | 56 | 28.1 |
Chicago | 42 | 21.1 |
Intake status | ||
Inpatient | 178 | 89.4 |
Outpatient | 21 | 10.6 |
Major depressive episodes before study intake | ||
0 | 43 | 21.6 |
1 | 32 | 16.1 |
2 | 30 | 15.1 |
3 | 19 | 9.5 |
4 | 17 | 8.5 |
5 or more | 58 | 29.1 |
Manic episodes prior to study intake | ||
0 | 93 | 46.7 |
1 | 30 | 15.1 |
2 | 21 | 10.6 |
3 or more | 55 | 27.6 |
Mean | SD | |
Global Assessment Scale score | 32.2 | 11.1 |
Hamilton Depression Rating Scaleb | 25.5 | 8.2 |
Age (years) | 36.7 | 12.9 |
Duration of follow-up (years) | 21.0 | 8.2 |
Antiepileptic Exposure
Propensity for Antiepileptic Exposure
Variable | Odds Ratio | 95% CI | z | p |
---|---|---|---|---|
Hollingshead socioeconomic status scaleb | ||||
I or II | 1.00 | |||
III | 1.52 | 0.62–3.75 | 0.91 | 0.364 |
IV | 0.64 | 0.23–1.79 | –0.85 | 0.394 |
V | 0.36 | 0.13–1.02 | –1.92 | 0.055 |
Marital status | ||||
Married | 1.00 | |||
Never married | 2.25 | 1.04–4.84 | 2.07 | 0.038 |
Divorced, separated, or widowed | 0.97 | 0.44–2.14 | –0.08 | 0.934 |
Site | ||||
New York | 1.00 | |||
St. Louis | 2.94 | 0.94–9.16 | 1.86 | 0.063 |
Boston | 1.67 | 0.43–6.53 | 0.74 | 0.459 |
Iowa City | 5.93 | 1.85–18.95 | 3.00 | 0.003 |
Chicago | 3.28 | 1.08–9.97 | 2.10 | 0.036 |
Gender | ||||
Female | 1.00 | |||
Male | 1.72 | 0.87–3.40 | 1.55 | 0.121 |
Severity of mania | 3.83 | 2.39–6.14 | 5.59 | <0.001 |
Severity of hypomania | 5.93 | 2.09–16.86 | 3.34 | 0.001 |
Antipsychotics in week prior to exposure interval | 0.50 | 0.32–0.79 | –2.97 | 0.003 |
Suicide attempt between intake and start of exposure interval | 1.66 | 0.93–2.95 | 1.71 | 0.086 |
Age | 1.06 | 1.03–1.08 | 4.68 | <0.001 |
Cumulative morbidity | 1.01 | 1.00–1.02 | 1.61 | 0.108 |
Primary Results: Safety Analyses
Discussion
Conclusions
Footnotes
References
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