Biomedical subjects

Dulal K Bhaumik

Publications and source records attributed to Dulal K Bhaumik.

3 recordsLinked to original sources

PubMed2006

The relationship between antidepressant prescription rates and rate of early adolescent suicide.

OBJECTIVE: In 2002, 264 children and adolescents ages 5-14 died by suicide in the United States, the fifth leading cause of death. Of these suicides, 260 were in the 10-14 year age group, making suicide the third largest cause of death behind accidents and malignancy. Although 60% of suicides in the general population occur in the midst of a mood disorder, usually untreated, little is known about the relationship between treatment of mood disorders and youth suicide. The FDA recently linked adverse event reports of suicidal ideation among children and adolescents in randomized controlled trials to selective serotonin reuptake inhibitors (SSRIs) and consequently required a change in labeling that included a black box warning regarding SSRI use for all age groups. Given that the age-adjusted suicide rate is about six times higher in 15-19 year olds compared with 10-14 year olds, the risk-benefit ratio may be different in younger children. Therefore, this study examined the association between antidepressant medication prescription rate and suicide rate in children ages 5-14 prior to the FDA findings by analyzing associations at the county level across the United States. METHOD: National county-level suicide rate data among children ages 5-14 were broken down by sex, income, and race during the period 1996-1998. National county-level antidepressant prescription rate data were expressed as number of pills prescribed per person. The primary outcome measure was the suicide rate in each county expressed as number of suicides for a given population size. RESULTS: After adjustment for sex, race, income, access to mental health care, and county-to-county variability in suicide rates, higher SSRI prescription rates were associated with lower suicide rates in children and adolescents. CONCLUSIONS: The aggregate nature of these observational data precludes a direct causal interpretation of the results. More SSRI prescriptions are associated with lower suicide rates in children and may reflect antidepressant efficacy, treatment compliance, better quality mental health care, and low toxicity in the event of a suicide attempt by overdose.

Adolescent↗

PubMed2005

The relationship between antidepressant medication use and rate of suicide.

BACKGROUND: Approximately 30 000 people die annually by suicide in the United States. Although 60% of suicides occur during a mood disorder, mostly untreated, little is known about the relationship between antidepressant medication use and the rate of suicide in the United States. OBJECTIVE: To examine the association between antidepressant medication prescription and suicide rate by analyzing associations at the county level across the United States. DESIGN: Analysis of National Vital Statistics from the Centers for Disease Control and Prevention. SETTING: All US counties. PARTICIPANTS: All US individuals who committed suicide between 1996 and 1998. MAIN OUTCOME MEASURES: National county-level suicide rate data are broken down by age, sex, income, and race for the period of 1996 to 1998. National county-level antidepressant prescription data are expressed as number of pills prescribed. The primary outcome measure is the suicide rate in each county expressed as the number of suicides for a given population size. RESULTS: The overall relationship between antidepressant medication prescription and suicide rate was not significant. Within individual classes of antidepressants, prescriptions for selective serotonin reuptake inhibitors (SSRIs) and other new-generation non-SSRI antidepressants (eg, nefazodone hydrochloride, mirtazapine, bupropion hydrochloride, and venlafaxine hydrochloride) are associated with lower suicide rates (both within and between counties). A positive association between tricyclic antidepressant (TCA) prescription and suicide rate was observed. Results are adjusted for age, sex, race, income, and county-to-county variability in suicide rates. Higher suicide rates in rural areas are associated with fewer antidepressant prescriptions, lower income, and relatively more prescriptions for TCAs. CONCLUSIONS: The aggregate nature of these observational data preclude a direct causal interpretation of the results. A high number of TCA prescriptions may be a marker for those counties with more limited access to quality mental health care and inadequate treatment and detection of depression, which in turn lead to increased suicide rates. By contrast, increases in prescriptions for SSRIs and other new-generation non-SSRIs are associated with lower suicide rates both between and within counties over time and may reflect antidepressant efficacy, compliance, a better quality of mental health care, and low toxicity in the event of a suicide attempt by overdose.

Adolescent↗

PubMed2004

Estimation and classification of fMRI hemodynamic response patterns.

In this paper, we propose an approach to modeling functional magnetic resonance imaging (fMRI) data that combines hierarchical polynomial models, Bayes estimation, and clustering. A cubic polynomial is used to fit the voxel time courses of event-related design experiments. The coefficients of the polynomials are estimated by Bayes estimation, in a two-level hierarchical model, which allows us to borrow strength from all voxels. The voxel-specific Bayes polynomial coefficients are then transformed to the times and magnitudes of the minimum and maximum points on the hemodynamic response curve, which are in turn used to classify the voxels as being activated or not. The procedure is demonstrated on real data from an event-related design experiment of visually guided saccades and shown to be an effective alternative to existing methods.

Bayes Theorem↗