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Biomedical subjects

A Ohberg

Publications and source records attributed to A Ohberg.

7 recordsLinked to original sources
PubMed1998

Antidepressants and suicide mortality.

BACKGROUND: This paper presents a nationwide analysis of suicide mortality in Finland from 1990 to 1995, when the total use of antidepressants, especially that by selective serotonin reuptake inhibitors (SSRIs) expanded in the country. METHODS: Suicide rate was analysed by various methods including that by intake of antidepressants. Various antidepressants were compared by calculating fatal toxicity indices (FTI) by relating number of fatal poisonings by a drug to its consumption. RESULTS: The expanded use of antidepressants coincided with an increased number of deaths caused by these drugs. The proportion of suicides committed by use of antidepressants among all suicides increased from 5.6% to 8.4%. The total suicide rate, however, declined significantly. This was mainly accounted for by the reduced suicide rates by hanging and carbomonoxide poisoning, which outnumbered the increased figures of suicides by poisoning. On the whole, 82% of suicides by antidepressants were committed by use of tricyclics. Use of doxepin and amitriptyline remained steady, and their FTIs were constantly high. The lowest FTIs were associated with fluoxetine, citalopram, mianserin and moclobemide. LIMITATIONS: The method ignores causality between the increased use of SSRIs and suicide mortality. Various factors affecting risk of suicide or choice of a method remain outside the scope of the data. CONCLUSION: The increased use of SSRIs coincided with a significant decline in suicide mortality. However, suicides by use of antidepressants showed an upward trend. Therefore, in suicide prevention, risks and benefits of antidepressants should be considered in choosing treatment for depressive patients.

Antidepressive Agents, Tricyclic↗
PubMed1998

Suicides hidden among undetermined deaths.

The research phase of the National Suicide Prevention Project in Finland (from 1 April 1987 to 31 March 1988) included medico-legal investigation and psychological autopsy of all deaths suspected of being suicides, including 1397 official suicides and 61 undetermined deaths. In later analyses on suicide, undetermined cases were excluded. This paper presents an analysis of all officially classified undetermined deaths (n = 139) over the study period, consisting of all the initially suspected suicides (n = 61) and the remaining undetermined deaths (n = 78) where suicide could not be excluded. Poisoning by solids or liquids and drowning were the most common causes of all undetermined deaths. Suicidal intent was observed in 87% of undetermined deaths initially suspected of being suicides. In addition, 31% of these subjects had previously attempted suicide, and 34% had made suicidal threats. Depression was diagnosed in 23% of cases and alcohol dependence or abuse in 31% of cases. Undetermined deaths resembled suicides and appeared to reduce the suicide rate by 10%.

Adult↗
PubMed1997

Driver suicides.

BACKGROUND: To study driver suicides, all motor vehicle driver fatalities in Finland from 1987 to 1991 were analysed. METHOD: Cases were collected from all driver fatalities (n = 1419), as those that accident investigation teams considered possible suicides (n = 99). Drivers committing suicide classified according to ICD-9 by two forensic pathologists were selected as cases (n = 84). Drivers of unintentional motor vehicle fatalities served as the control group. RESULTS: While 5.9% of all driver fatalities were classified as suicides, the figure given in the official statistics was 2.6%. Driver suicides accounted for 1.2% of all suicides. Fifty per cent of driver suicides were committed by men aged between 15 and 34 years. The victims had often suffered from life-event stress, mental disorders and had alcohol misuse problems. The cases were usually head-on collisions between two vehicles with a large weight disparity. CONCLUSIONS: Misclassification of driver suicides does not significantly influence the total suicide rate. However, people who commit suicide by this method could often be recognised, and prevention of these events would improve traffic safety.

Accidents, Traffic↗
PubMed1996

Violent methods associated with high suicide mortality among the young.

OBJECTIVE: To present rates and trends in suicide methods, and associations between these, in male and female adolescents in the age groups 15 through 19 years and 20 through 24 years in Finland from 1947 through 1991. METHOD: Suicide rates were calculated on the basis of the mean same-age population, and suicide trends by each method were analyzed by using the Poisson regression model. For the rates and trends, 95% confidence intervals based on the Poisson distribution were calculated. RESULTS: The suicide rate revealed a sharp and significant increase between 1965 and 1975 for both male age groups. Firearms and hanging accounted for the majority of that increase. These figures, however, were not accompanied by similar changes in the availability of firearms during that period. Moreover, an increased total suicide rate as well as that by automobile exhaust fumes in young adults after 1982 coincided with a widely presented Finnish movie which featured this method of committing suicide. In young women, however, intake of solids and liquids remained the most common suicide method. CONCLUSION: Suicide rates increased, especially by violent methods, which contributed to the high suicide mortality rate among the young. These methods, except firearms, however, are often difficult to restrict. This fact underlines the importance of the integration of various preventive measures of cooperation between mental health professionals and other authorities and of the recognition and care of young people at high suicide risk.

Adolescent↗
PubMed1996

Alcohol and drugs in suicides.

BACKGROUND: Alcohol and drugs use were assessed in a nationwide one year suicide study in Finland. METHOD: Alcohol and drugs use were analysed in 1348 suicides, 96.5% of all suicides in the study year. Relative suicide risks for drugs were defined by relating the number of suicides committed by use of various drugs to drug availability. RESULTS: Alcohol was detected twice as often in men as in women; the opposite was the case with drugs. The drugs most commonly used for suicide were neuroleptics and antidepressants, which were, in 74.3% and 77.4% of the cases, respectively, the victims own prescribed drugs. Antidepressants were found in 19.0% of women and only 4.8% of men. Relative suicide risk for antidepressants varied substantially between different compounds. CONCLUSIONS: Undertreatment of depression is a challenge for suicide prevention. Those who commit suicide by antidepressants use their own drugs. Relative suicide risk for a drug should be considered when choosing treatment for depressive patients.

Adult↗
PubMed1995

Trends and availability of suicide methods in Finland. Proposals for restrictive measures.

BACKGROUND: Trends and availability of the methods used for suicide in Finland were analysed in order to base proposals for prevention of access to methods. METHODS: Finnish suicides from 1947 to 1990 were analysed by sex, age, time period and suicide method using confidence intervals for rates, chi 2 test for trends and suicide risks for different medicines. RESULTS: Suicide rate by parathion, a highly lethal pesticide and commonly used for suicide in the 1950s, decreased after its availability was restricted, but this was offset by an increased rate by other methods. Since 1982, the suicide risk for antidepressants and neuroleptics increased coincident with their availability, although that for barbiturates remained stable but high despite a reduction in availability. Suicide risk for antidepressants other than tricyclics decreased despite increased availability. CONCLUSION: Restriction of a method reduces its use for suicide, but other methods tend to replace it. Restrictive measures should focus on some specific situations. Antidepressants other than tricyclics are recommended for the treatment of suicidal depressive patients.

Adolescent↗