Inverse association of anti-inflammatory prescription fills and suicide-related mortality in young adults : Evidence from a nationwide study of Swedish regions, 2006–2021
(2023) In Brain, Behavior, and Immunity - Health 31.- Abstract
Background: This cross-sectional study examined nationwide real-world associations between anti-inflammatory agent fills and suicide-related death rates in 20–24-year-olds across the 21 Swedish regions during 2006–2021. Methods: Nationwide Swedish registers were used to compare regional year-wise suicide-related mortality (SRM) and dispensations for anti-inflammatory agents (ATC-code: M01) in 20–24-year-olds. Dispensations for paracetamol (ATC-code: N02BE01) was applied as a control variable. Associations between regional year-wise SRM and dispensation rates were analyzed by sex-stratified zero-inflated generalized linear mixed effect models (GLMM). Dispensation rates of paracetamol and inflammatory agents were designated as independent... (More)
Background: This cross-sectional study examined nationwide real-world associations between anti-inflammatory agent fills and suicide-related death rates in 20–24-year-olds across the 21 Swedish regions during 2006–2021. Methods: Nationwide Swedish registers were used to compare regional year-wise suicide-related mortality (SRM) and dispensations for anti-inflammatory agents (ATC-code: M01) in 20–24-year-olds. Dispensations for paracetamol (ATC-code: N02BE01) was applied as a control variable. Associations between regional year-wise SRM and dispensation rates were analyzed by sex-stratified zero-inflated generalized linear mixed effect models (GLMM). Dispensation rates of paracetamol and inflammatory agents were designated as independent fixed effects variables, and year and region constituted random-intercept effects. Results: Acetic acid derivatives and related substances (M01AB) and propionic acid derivates (M01A3) accounted for ∼71% of measured dispensation fills for anti-inflammatory agents. Diclofenac fills constituted ∼98% of the former category, whereas dispensations for Ibuprofen (∼21%), Naproxen (∼62%) and Ketoprofen (∼13%) constituted the most prescribed agents in the latter category. Regional yearly dispensation rates of anti-inflammatory agents in 20–24-year-old females were inversely associated with female SRM (β = −0.095, p = 0.0393, 95% CI -0.186, −0.005) – independent of paracetamol rates, which were unassociated to SRM (p = 0.2094). Results were confirmed in validation analyses for anti-inflammatory agents (OR = 0.7232, p = 0.0354, 95% CI [OR] 0.5347, 0.9781). No association was demonstrated in males (p = 0.833). Conclusion: Anti-inflammatory agent dispensation rates were independently associated to lower suicide-related death rates in female 20-24-year-olds. This adds to growing evidence implicating inflammatory processes in mental disorders, warranting trials focusing on the suicide preventative potential of anti-inflammatories in young adults.
(Less)
- author
- Andersson, Peter ; Lundberg, Johan ; Jarbin, Håkan LU ; Jokinen, Jussi and Desai Boström, Adrian E.
- organization
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Brain, Behavior, and Immunity - Health
- volume
- 31
- article number
- 100665
- publisher
- Elsevier
- external identifiers
-
- pmid:37425134
- scopus:85163971630
- ISSN
- 2666-3546
- DOI
- 10.1016/j.bbih.2023.100665
- language
- English
- LU publication?
- yes
- id
- 75be032b-7b41-4a46-8369-452caf35746a
- date added to LUP
- 2023-09-11 13:57:05
- date last changed
- 2024-04-20 03:03:01
@article{75be032b-7b41-4a46-8369-452caf35746a,
abstract = {{<p>Background: This cross-sectional study examined nationwide real-world associations between anti-inflammatory agent fills and suicide-related death rates in 20–24-year-olds across the 21 Swedish regions during 2006–2021. Methods: Nationwide Swedish registers were used to compare regional year-wise suicide-related mortality (SRM) and dispensations for anti-inflammatory agents (ATC-code: M01) in 20–24-year-olds. Dispensations for paracetamol (ATC-code: N02BE01) was applied as a control variable. Associations between regional year-wise SRM and dispensation rates were analyzed by sex-stratified zero-inflated generalized linear mixed effect models (GLMM). Dispensation rates of paracetamol and inflammatory agents were designated as independent fixed effects variables, and year and region constituted random-intercept effects. Results: Acetic acid derivatives and related substances (M01AB) and propionic acid derivates (M01A3) accounted for ∼71% of measured dispensation fills for anti-inflammatory agents. Diclofenac fills constituted ∼98% of the former category, whereas dispensations for Ibuprofen (∼21%), Naproxen (∼62%) and Ketoprofen (∼13%) constituted the most prescribed agents in the latter category. Regional yearly dispensation rates of anti-inflammatory agents in 20–24-year-old females were inversely associated with female SRM (β = −0.095, p = 0.0393, 95% CI -0.186, −0.005) – independent of paracetamol rates, which were unassociated to SRM (p = 0.2094). Results were confirmed in validation analyses for anti-inflammatory agents (OR = 0.7232, p = 0.0354, 95% CI [OR] 0.5347, 0.9781). No association was demonstrated in males (p = 0.833). Conclusion: Anti-inflammatory agent dispensation rates were independently associated to lower suicide-related death rates in female 20-24-year-olds. This adds to growing evidence implicating inflammatory processes in mental disorders, warranting trials focusing on the suicide preventative potential of anti-inflammatories in young adults.</p>}},
author = {{Andersson, Peter and Lundberg, Johan and Jarbin, Håkan and Jokinen, Jussi and Desai Boström, Adrian E.}},
issn = {{2666-3546}},
language = {{eng}},
publisher = {{Elsevier}},
series = {{Brain, Behavior, and Immunity - Health}},
title = {{Inverse association of anti-inflammatory prescription fills and suicide-related mortality in young adults : Evidence from a nationwide study of Swedish regions, 2006–2021}},
url = {{http://dx.doi.org/10.1016/j.bbih.2023.100665}},
doi = {{10.1016/j.bbih.2023.100665}},
volume = {{31}},
year = {{2023}},
}