Effect of lithium maintenance on suicidal behavior in major mood disorders

被引:118
作者
Tondo, L
Jamison, KR
Baldessarini, RJ
机构
[1] Univ Cagliari, Dept Psychol, Cagliari, Sardinia, Italy
[2] Lucio Bini Mood Disorders Ctr, Cagliari, Sardinia, Italy
[3] Johns Hopkins Univ, Sch Med, Dept Psychiat & Behav Sci, Baltimore, MD 21205 USA
[4] Massachusetts Gen Hosp, Bipolar & Psychot Disorders Program, McLean Div, Belmont, MA 02178 USA
[5] Massachusetts Gen Hosp, Psychopharmacol Program, McLean Div, Belmont, MA 02178 USA
[6] Harvard Univ, Sch Med, Dept Psychiat, Boston, MA 02115 USA
[7] Harvard Univ, Sch Med, Neurosci Program, Boston, MA 02115 USA
来源
NEUROBIOLOGY OF SUICIDE: FROM THE BENCH TO THE CLINIC | 1997年 / 836卷
关键词
MANIC-DEPRESSIVE PATIENTS; BIPOLAR DISORDER; MORTALITY; RISK; DISCONTINUATION; PREVENTION; ILLNESS; PROPHYLAXIS; POPULATION;
D O I
10.1111/j.1749-6632.1997.tb52369.x
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
We reviewed evidence of a possible antisuicide action of lithium maintenance treatment in mood disorders. Of 28 published studies involving: over 17,000 patients with major affective illnesses, most yielded supportive evidence: risk of suicides and attempts averaged 3.2 versus 0.37 per 100 patient-years without versus with lithium (8.6-fold difference). In a new study of 284 bipolar I- and II-disordered patients, corresponding rates (2.2 vs. 0.39/100 patient-years) differed by 5.6-fold (p < 0.001); moreover, after discontinuing lithium, rates of suicidal acts rose by 7-fold (16-fold within the first year), and fatalities increased by nearly 9-fold. Lithium maintenance treatment in recurring major mood disorders has strong evidence of antisuicide effects not demonstrated with any other mood stabilizer. Close association of suicide and depression in bipolar disorder emphasizes the need for improved identification and treatment of bipolar depression.
引用
收藏
页码:339 / 351
页数:13
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