Suicide risk in bipolar disorder during treatment with lithium and divalproex
Suicide risk in bipolar disorder during treatment with lithium and divalproex
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DOI：
10.1001/jama.290.11.1467
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发表时间：
2003-09-17
影响因子：
120.7
通讯作者：
Revicki, D
中科院分区：
文献类型：
--
作者：
Goodwin, FK;Fireman, B;Revicki, D
Context Several studies have suggested that lithium treatment reduces risk of suicide in bipolar disorder, but no research has examined suicide risk during treatment with divalproex, the most commonly prescribed mood-stabilizing drug in the United States.Objective To compare risk of suicide attempt and suicide death during treatment with lithium with that during treatment with divalproex.Design and Setting Retrospective cohort study conducted at 2 large integrated health plans in California and Washington.Patients Population-based sample of 20638 health plan members aged 14 years or older who had at least 1 outpatient diagnosis of bipolar disorder and at least 1 filled prescription for lithium, divalproex, or carbamazepine between January,1, 1994, and December 31, 2001. Follow-up for each individual began with first qualifying prescription and ended with death, disenrollment from the health plan, or end of the study period.Main Outcome Measures Suicide attempt, recorded as a hospital discharge diagnosis or an emergency department diagnosis; suicide death, recorded on death certificate.Results In both health plans, unadjusted rates were greater during treatment with divalproex than during treatment with lithium for emergency department suicide attempt (31.3 vs 10.8 per 1000 person-years; P
