| Title |
Early treatment with talk therapy or antidepressants in severely bereaved people and risk of suicidal behavior and psychiatric illness: an instrumental variable analysis
|
|---|---|
| Published in |
Clinical Epidemiology, August 2018
|
| DOI | 10.2147/clep.s157996 |
| Pubmed ID | |
| Authors |
Morten Fenger-Grøn, Maiken Ina Siegismund Kjaersgaard, Erik Thorlund Parner, Mai-Britt Guldin, Peter Vedsted, Mogens Vestergaard |
| Abstract |
Losing a loved one to death is a common and natural life-course experience. Still, bereavement has been associated with an increased risk of suicidal behavior and psychiatric hospitalization and little is known of how to counter these adverse events. We aimed to study the effect of early treatment in primary care with talk therapy (TT) or antidepressants (AD) in severely bereaved people. We conducted a population-based cohort study including 207,435 adult Danes who experienced a severe loss in 1996-2013. We compared treatment and no treatment with either of the two treatment regimens within 6 months after the loss. The main outcome was a serious mental health condition (defined as suicide, deliberate self-harm, or psychiatric hospitalization) occurring >6 months after bereavement. Adjusted risk differences (RDs) 2 years after bereavement were calculated using both standard regression analysis and instrumental variable analysis (IVA) in which estimated physician preferences for treatment served as instruments. The standard adjusted regression analysis showed a higher risk of developing a serious mental health condition associated with both TT (RD, 7.1; 95% CI, 5.0 to 9.1 per 1000 people) and AD (RD, 30.1; 95% CI, 25.7 to 34.6 per 1000 people). The IVA, which was used to control for unmeasured confounding, showed that TT was associated with a lower risk of a serious mental health condition (RD, -17.1; 95% CI, -30.7 to -3.5 per 1000 people), whereas the results were inconclusive for AD (RD, -8.6; 95% CI, -62.6 to 45.4 per 1000 people). This study suggests that early treatment with TT is associated with reduced long-term risk of serious mental health conditions in severely bereaved people. No clear benefit or harm of treatment with AD after bereavement was ascertained since the statistical precision was low. |
X Demographics
The data shown below were collected from the profiles of 13 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 3 | 23% |
| United Kingdom | 1 | 8% |
| Greece | 1 | 8% |
| Unknown | 8 | 62% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 11 | 85% |
| Practitioners (doctors, other healthcare professionals) | 2 | 15% |
Mendeley readers
The data shown below were compiled from readership statistics for 34 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 34 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 7 | 21% |
| Student > Bachelor | 6 | 18% |
| Student > Master | 5 | 15% |
| Student > Ph. D. Student | 3 | 9% |
| Student > Doctoral Student | 2 | 6% |
| Other | 2 | 6% |
| Unknown | 9 | 26% |
| Readers by discipline | Count | As % |
|---|---|---|
| Psychology | 8 | 24% |
| Medicine and Dentistry | 7 | 21% |
| Nursing and Health Professions | 3 | 9% |
| Business, Management and Accounting | 1 | 3% |
| Economics, Econometrics and Finance | 1 | 3% |
| Other | 4 | 12% |
| Unknown | 10 | 29% |
Attention Score in Context
This research output has an Altmetric Attention Score of 36. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 28 December 2023.
All research outputs
#1,127,982
of 25,584,565 outputs
Outputs from Clinical Epidemiology
#46
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Outputs of similar age
#23,615
of 342,399 outputs
Outputs of similar age from Clinical Epidemiology
#3
of 36 outputs
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