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http://dx.doi.org/10.24304/kjcp.2018.28.4.308

Visual Analysis of Regional Variations in Antidepressant Use and Suicide Rate  

Kim, Ho-Jung (College of Pharmacy, Yeungnam University)
Lee, Iyn-Hyang (College of Pharmacy, Yeungnam University)
Publication Information
Korean Journal of Clinical Pharmacy / v.28, no.4, 2018 , pp. 308-319 More about this Journal
Abstract
Background: Some mental illnesses such as depression are known to be one of the risk factors of suicide and proper antidepressant therapy can reduce suicidal behavior. Objectives: This study aimed to analyze regional variations in antidepressant consumption and adherence, suicide rate, prevalence of suicide related mental disorders, and access to relevant healthcare services. Methods: Cross-sectional analyses were conducted using National Patients Sample data compiled by the Health Insurance Review and Assessment Service between 2014 and 2016. We included patients who had a diagnosis record of suicide related mental disorders during the study period. Cause of death statistics and National health and medical statistics were used to identify suicide rate and distribution of healthcare service. We conducted visual analyses, chi-squared tests, independent t-tests and correlation analyses to demonstrate regional variations. Results: Between 2014 and 2016, the average prevalence of suicide related mental disorders was 5.4 per cent. Suicide rate and prevalence of suicide related mental disorders were higher in Gangwon, Chungcheong, and Jeolla (p < 0.001), and lower in Seoul (p < 0.001) than the national average. Unexpectedly, regional variations in antidepressant consumption were seen in the limited area including Daejeon, Chungnam and Gyeongnam (p < 0.05). The number of mild patient-centered clinics was associated positively with antidepressant consumption (p < 0.01) and associated negatively with suicide rate (p < 0.01). Conclusion: There were some regional variations in prevalence of suicide related mental disorders, antidepressant adherence and suicide rate. The higher level of antidepressant therapy and the lower level of suicide rates were seen in regions with easy access to mild patient-centered clinics.
Keywords
Antidepressants; suicide; mental disorders; spatial analysis; Geographic Information Systems;
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1 Keyloun KR, Hansen RN, Hepp Z, et al. Adherence and persistence across antidepressant therapeutic classes: A retrospective claims analysis among insured us patients with major depressive disorder (mdd). CNS Drugs 2017;31(5):421-32.   DOI
2 Henein F, Prabhakar D, Peterson EL, et al. A prospective study of antidepressant adherence and suicidal ideation among adults. The primary care companion for CNS disorders 2016;18(6).
3 Ruengorn C, Sanichwankul K, Niwatananun W, et al. Factors related to suicide attempts among individuals with major depressive disorder. Int J Gen Med 2012;5:323-30.
4 Park J. Socioeconomic inequalities in health at the regional level in Korea. Korea Institute for Health and Social Affairs 2018;1-18.
5 Kim Y-M, Kang S-H. Changes and determinants affecting on geographic variations in health behavior, prevalence of hypertension and diabetes in Korean. Journal of Digital Convergence 2015;13(11):241-54.   DOI
6 Kim M, Park E. The prevalence and the related factors of metabolic syndrome in urban and rural community. Korean J Adult Nurs 2014;26(1):67-77.   DOI
7 Jeong H-E, Cho P-K. A study about the prevalence and the related factors of metabolic syndrome and fatty liver comparing the urban area to the industrial area. J Korean Soc Radiol 2016;39:361-68.
8 Kessing LV. Severity of depressive episodes according to icd-10: Prediction of risk of relapse and suicide. Br J Psychiatry 2004;184:153-6.   DOI
9 Kim N, Kim K, Lee S, et al. Status and quality of medical use of depression patients. Health Insurance Review & Assessment Service; 2008;1-215.
10 Heo D, Lee S, Ahn J, et al. Current situation of burden and treatment of diseases of domestic depression. National Evidence-based Healthcare Collaborating Agency 2011;1-98.
11 Choi H, Kim H. Analysis of the relationship between community characteristics and depression using geographically weighted regression. Epidemiology and health 2017;39.
12 Ahn J, Han C, Woo J, et al. Understanding the current state of research on mental illness in Korea and research on suicide by depression. National Evidence-based Healthcare Collaborationg Agency 2012;1-485.
13 Lee S, Baek J, Yoon Y, et al. Analysis of socioeconomic impact of mental health problems and research on management strategies -focusing on depression-. National Health Insurance Service 2013;1-270.
14 World Health Organization. Definition and general considerations 2017. Available from https://www.whocc.no/ddd/definition_and_general_considera/. Accessed Oct 17, 2017.
15 Kang H-Y, Kwon J-W, Bae S-J, et al. Administrative and managerial pharmacy. Korean Assosiation of Pharmacy Education 2013; 204.
16 Korean Statistical Information Service. Cause of death. Available from http://kosis.kr/statHtml/statHtml.do?orgId=101&tblId=DT_1B34E13&conn_path=I2. Accessed Aug 25, 2018.
17 Ministry for Health and Welfare, Health Insuracne Review & Assessment Services. Pharmaceutical consumption and sales statistics for 2016. Ministry for Health and Welfare, Health Insurance Review & Assessment Services 2017;1-177.
18 Ministry of Health and Welfare. National health and medical statistics 2017;1-622.
19 Park H. Difference of depression prevalence by demographic characteristic, urban-rural and type of health insurance using HIRA-NPS data. M.S. Thesis for Sungkyunkwan University, 2017.
20 Cheong KS, Choi MH, Cho BM, et al. Suicide rate differences by sex, age, and urbanicity, and related regional factors in Korea. Journal of preventive medicine and public health=Yebang Uihakhoe chi 2012;45(2):70-7.   DOI
21 Park C, Nam BW. Prevalence of depressive disorder among the elderly attending community health center in a small city. Int Psycogeriatr 2013;25(6):S126-S27.
22 Park E. A Comparison of community health status by region and an investigation of related factors using community health indicators. J Korean Acad Community Health Nurs 2012;23(1):31-39.   DOI
23 Lee MS, Lee HY, Kang SG, et al. Variables influencing antidepressant medication adherence for treating outpatients with depressive disorders. J Affect Disord 2010;123(1-3):216-21.   DOI
24 Ahn J. Depression, suicide, and Korean society. J Korean Med Assoc 2012;55(4):320-21.   DOI
25 Jun JA. Gender differences in mental health of Korean adults: Focusing on depression. Health Welf Policy Forum 2014:17-26.
26 Cho SJ, Oh DH, Lee JA, et al. Prevalence of main psychiatric disorders in relation to urbanization in Gyeonggi province by using the Korean version of the mini-international neuropsychiatric interview. J Korean Neuropsychiatr Assoc 2011;50(4):288-96.
27 Jung S-J, Lee S-S, Lee KE, et al. Perception and attitude towards antidepressants in Koreans. Korean J Clin Pharm 2012;22(1):65-72.
28 Ministry for Health Welfare and Family Affairs. Suicide prevention comprehensive measures (2nd edition). Ministry for Health Welfare and Family Affairs 2008; 1-86.
29 Organisation for Economic Co-operation and Development. Paris: Health at a glance 2015; 2015 Oct. Available from https://doi.org/10.1787/19991312. Accessed Mar 17, 2017.
30 Lee H, Myung W, Lee C, et al. Clinical epidemiology of long-term suicide risk in a nationwide population-based cohort study in South Korea. J. Psychiatr Res 2018;100:47-55.   DOI
31 Thomson W. Long term follow up of suicide in a clinically depressed community sample. Journal of Affective Disorders 2012;139(1):52-55.   DOI
32 Indu PS, Anilkumar TV, Pisharody R, et al. Prevalence of depression and past suicide attempt in primary care. Asian J Psychiatr 2017;27:48-52.   DOI
33 Hawton K, Casanas ICC, Haw C, et al. Risk factors for suicide in individuals with depression: A systematic review. J Affect Disord 2013;147(1-3):17-28.   DOI
34 Zhou X, Michael KD, Liu Y, et al. Systematic review of management for treatment-resistant depression in adolescents. BMC psychiatry 2014;14:340.   DOI
35 Vander Stoep A, Adrian M, McCauley E, et al. Risk for suicidal ideation and suicide attempts associated with co-occurring depression and conduct problems in early adolescence. Suicide Life Threat Behav 2011;41(3):316-29.   DOI
36 Nrugham L, Holen A, Sund AM. Suicide attempters and repeaters: Depression and coping: A prospective study of early adolescents followed up as young adults. J Nerv Ment Dis 2012;200(3):197-203.   DOI
37 Hirschfeld RM. The epidemiology of depression and the evolution of treatment. J Clin Psychiatry 2012;73(1):5-9.
38 Yau WY, Chan MC, Wing YK, et al. Noncontinuous use of antidepressant in adults with major depressive disorders -a retrospective cohort study. Brain Behav 2014;4(3):390-7.   DOI
39 Castelpietra G, Gobbato M, Valent F, et al. Antidepressant use in suicides: A case-control study from the Friuli Venezia Giulia Region, Italy, 2005-2014. Eur J Clin Pharmacol 2017;73(7):883-90.   DOI
40 Sawada N, Uchida H, Suzuki T, et al. Persistence and compliance to antidepressant treatment in patients with depression: A chart review. BMC psychiatry 2009;9:38.   DOI
41 Bushnell GA, Sturmer T, White A, et al. Predicting persistence to antidepressant treatment in administrative claims data: Considering the influence of refill delays and prior persistence on other medications. J Affect Disord 2016;196:138-47.   DOI
42 Ho SC, Chong HY, Chaiyakunapruk N, et al. Clinical and economic impact of non-adherence to antidepressants in major depressive disorder: A systematic review. J Affect Disord 2016;193:1-10.   DOI