Was risk of suicide underestimated?

Résumé

Comments on an article by A. Khan et al. (se. Khan et al. evaluated the mortality risk and risk of suicide among adult patients with a diagnosis of schizophrenia, depression, bipolar disorder, anxiety disorders, or attention-deficit/hyperactivity disorder participating in clinical trials conducted by pharmaceutical companies. They found that compared with placebo all active compounds, except for heterocyclic antidepressants, significantly reduced the risk of suicide. However, the average duration of placebo exposure was significantly shorter than that for psychotropic agents being evaluated. It is well known that the first time after first contact to psychiatric services and the first period after discharge, is associated with increased suicide risk and that the risk of suicide is reduced as time passes. Could the positive results found in the study partly be explained by comparison of periods with different levels of risk in the treatment arms owing to different length of follow-up? A person-year is not just a person-year, and early periods seem to be associated with higher risk of suicide compared with later periods. (PsycINFO Database Record (c) 2014 APA, all rights reserved) PSYCHOPATHOLOGIE PHARMACOTHÉRAPIE EFFICACITÉ MÉDICAMENT ARGUMENT