Treatment-resistant depression and risk of all-cause mortality and suicidality in Danish patients with major depression

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Treatment-resistant depression and risk of all-cause mortality and suicidality in Danish patients with major depression. / Gronemann, Frederikke Hørdam; Jørgensen, Martin Balslev; Nordentoft, Merete; Andersen, Per Kragh; Osler, Merete.

I: Journal of Psychiatric Research, Bind 135, 2021, s. 197-202.

Publikation: Bidrag til tidsskriftTidsskriftartikelfagfællebedømt

Harvard

Gronemann, FH, Jørgensen, MB, Nordentoft, M, Andersen, PK & Osler, M 2021, 'Treatment-resistant depression and risk of all-cause mortality and suicidality in Danish patients with major depression', Journal of Psychiatric Research, bind 135, s. 197-202. https://doi.org/10.1016/j.jpsychires.2021.01.014

APA

Gronemann, F. H., Jørgensen, M. B., Nordentoft, M., Andersen, P. K., & Osler, M. (2021). Treatment-resistant depression and risk of all-cause mortality and suicidality in Danish patients with major depression. Journal of Psychiatric Research, 135, 197-202. https://doi.org/10.1016/j.jpsychires.2021.01.014

Vancouver

Gronemann FH, Jørgensen MB, Nordentoft M, Andersen PK, Osler M. Treatment-resistant depression and risk of all-cause mortality and suicidality in Danish patients with major depression. Journal of Psychiatric Research. 2021;135:197-202. https://doi.org/10.1016/j.jpsychires.2021.01.014

Author

Gronemann, Frederikke Hørdam ; Jørgensen, Martin Balslev ; Nordentoft, Merete ; Andersen, Per Kragh ; Osler, Merete. / Treatment-resistant depression and risk of all-cause mortality and suicidality in Danish patients with major depression. I: Journal of Psychiatric Research. 2021 ; Bind 135. s. 197-202.

Bibtex

@article{c0c520d0790748cba2fe6630bdcce22d,
title = "Treatment-resistant depression and risk of all-cause mortality and suicidality in Danish patients with major depression",
abstract = "Objective: Treatment-resistant depression (TRD) has been associated with higher mortality and risk of suicide, but this has mainly been showed in few studies which did not include self-harm. The aim was to investigate the association of TRD with all-cause mortality, suicide and self-harm in a nationwide cohort of patients with major depression and explore any differences in relation to patient characteristics. Methods: First-time hospital contacts for major depression between January 1, 1996 and December 31, 2014 were identified in Danish patient registers (ICD-10: F32 and F33). TRD was defined as two shifts in antidepressant treatment, assessed from one year prior depression diagnosis until one year after. Information on mortality, suicide and self-harm was obtained from Danish registers and associations between TRD and the three prognostic outcomes were analyzed using Cox Proportional Hazard Regression. Results: TRD was not associated with all-cause mortality the first year of follow-up (adjusted HR (aHR) 1.04, 95% confidence interval (CI) [0.98–1.11]), and the HR for mortality was lower the following 1–5 years. However, TRD was associated with higher rates of suicide (0–1 year: aHR 2.20, 95% CI [1.77–2.74]; 1–5 years: aHR 1.70, 95% CI [1.42–2.03]) and self-harming behavior (0–1 year: aHR 1.51, 95% CI [1.36–1.66]; 1–5 years: aHR 1.59, 95% CI [1.48–1.70]). The above risk estimates varied only slightly across sociodemographic and clinical patient characteristics. Conclusions: Patients with TRD have higher rates of suicide and self-harm compared with non-TRD patients, whereas there seems to be no increase overall in all-cause mortality – in fact, there was a lower rate at follow-up after 1 year. We found only a few differences in HRs for mortality or suicidality across patient characteristics.",
keywords = "Major depressive disorder, Mortality, Self-harm, Suicide, Treatment-resistant depression",
author = "Gronemann, {Frederikke H{\o}rdam} and J{\o}rgensen, {Martin Balslev} and Merete Nordentoft and Andersen, {Per Kragh} and Merete Osler",
year = "2021",
doi = "10.1016/j.jpsychires.2021.01.014",
language = "English",
volume = "135",
pages = "197--202",
journal = "Journal of Psychiatric Research",
issn = "0022-3956",
publisher = "Pergamon Press",

}

RIS

TY - JOUR

T1 - Treatment-resistant depression and risk of all-cause mortality and suicidality in Danish patients with major depression

AU - Gronemann, Frederikke Hørdam

AU - Jørgensen, Martin Balslev

AU - Nordentoft, Merete

AU - Andersen, Per Kragh

AU - Osler, Merete

PY - 2021

Y1 - 2021

N2 - Objective: Treatment-resistant depression (TRD) has been associated with higher mortality and risk of suicide, but this has mainly been showed in few studies which did not include self-harm. The aim was to investigate the association of TRD with all-cause mortality, suicide and self-harm in a nationwide cohort of patients with major depression and explore any differences in relation to patient characteristics. Methods: First-time hospital contacts for major depression between January 1, 1996 and December 31, 2014 were identified in Danish patient registers (ICD-10: F32 and F33). TRD was defined as two shifts in antidepressant treatment, assessed from one year prior depression diagnosis until one year after. Information on mortality, suicide and self-harm was obtained from Danish registers and associations between TRD and the three prognostic outcomes were analyzed using Cox Proportional Hazard Regression. Results: TRD was not associated with all-cause mortality the first year of follow-up (adjusted HR (aHR) 1.04, 95% confidence interval (CI) [0.98–1.11]), and the HR for mortality was lower the following 1–5 years. However, TRD was associated with higher rates of suicide (0–1 year: aHR 2.20, 95% CI [1.77–2.74]; 1–5 years: aHR 1.70, 95% CI [1.42–2.03]) and self-harming behavior (0–1 year: aHR 1.51, 95% CI [1.36–1.66]; 1–5 years: aHR 1.59, 95% CI [1.48–1.70]). The above risk estimates varied only slightly across sociodemographic and clinical patient characteristics. Conclusions: Patients with TRD have higher rates of suicide and self-harm compared with non-TRD patients, whereas there seems to be no increase overall in all-cause mortality – in fact, there was a lower rate at follow-up after 1 year. We found only a few differences in HRs for mortality or suicidality across patient characteristics.

AB - Objective: Treatment-resistant depression (TRD) has been associated with higher mortality and risk of suicide, but this has mainly been showed in few studies which did not include self-harm. The aim was to investigate the association of TRD with all-cause mortality, suicide and self-harm in a nationwide cohort of patients with major depression and explore any differences in relation to patient characteristics. Methods: First-time hospital contacts for major depression between January 1, 1996 and December 31, 2014 were identified in Danish patient registers (ICD-10: F32 and F33). TRD was defined as two shifts in antidepressant treatment, assessed from one year prior depression diagnosis until one year after. Information on mortality, suicide and self-harm was obtained from Danish registers and associations between TRD and the three prognostic outcomes were analyzed using Cox Proportional Hazard Regression. Results: TRD was not associated with all-cause mortality the first year of follow-up (adjusted HR (aHR) 1.04, 95% confidence interval (CI) [0.98–1.11]), and the HR for mortality was lower the following 1–5 years. However, TRD was associated with higher rates of suicide (0–1 year: aHR 2.20, 95% CI [1.77–2.74]; 1–5 years: aHR 1.70, 95% CI [1.42–2.03]) and self-harming behavior (0–1 year: aHR 1.51, 95% CI [1.36–1.66]; 1–5 years: aHR 1.59, 95% CI [1.48–1.70]). The above risk estimates varied only slightly across sociodemographic and clinical patient characteristics. Conclusions: Patients with TRD have higher rates of suicide and self-harm compared with non-TRD patients, whereas there seems to be no increase overall in all-cause mortality – in fact, there was a lower rate at follow-up after 1 year. We found only a few differences in HRs for mortality or suicidality across patient characteristics.

KW - Major depressive disorder

KW - Mortality

KW - Self-harm

KW - Suicide

KW - Treatment-resistant depression

U2 - 10.1016/j.jpsychires.2021.01.014

DO - 10.1016/j.jpsychires.2021.01.014

M3 - Journal article

C2 - 33493949

AN - SCOPUS:85099642966

VL - 135

SP - 197

EP - 202

JO - Journal of Psychiatric Research

JF - Journal of Psychiatric Research

SN - 0022-3956

ER -

ID: 256069783