Mortality and Suicide Risk in Treatment-Resistant Depression: An Observational Study of the Long-Term Impact of Intervention

Bryan Olin, Amara K. Jayewardene, Mark Bunker, Francisco Moreno

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Major depressive disorder is a common global disease that causes a significant societal burden. Most interventional studies of depression provide a limited assessment of the interventions on mortality and suicide risks. This study utilizes data from an observational registry of patients with major depressive disorder to determine the impact of intervention (vagus nerve stimulation or standard pharmacological/non-pharmacological therapy) and a latent factor, patient trajectory toward response, on mortality, suicide and suicidal ideation. A total of 636 patients were available for an intent-to-treat analysis of all-cause mortality, suicide and suicidal ideation. Patients treated with vagus nerve stimulation in addition to standard therapies experienced lower, but not statistically significant, all-cause mortality (vagus nerve stimulation 4.93 per 1,000 person-years vs. 10.02 per 1,000 patient years for treatment as usual) and suicide rates (vagus nerve stimulation 0.88 per 1,000 person-years vs. 1.61 per 1,000 patient years for treatment as usual). Treatment with vagus nerve stimulation produced a statistically lower relative risk of suicidal ideation 0.80, 95% confidence interval (0.68,0.95). Further, patients that responded to either treatment saw a 51% reduction in relative risk of suicidal behavior; relative risk and 95% confidence interval of 0.49 (0.41,0.58). In summary, we find that treatment with adjunctive vagus nerve stimulation can potentially lower the risk of all-cause mortality, suicide and suicide attempts.

Original languageEnglish (US)
Article numbere48002
JournalPLoS One
Volume7
Issue number10
DOIs
StatePublished - Oct 25 2012

Fingerprint

Treatment-Resistant Depressive Disorder
suicide
vagus nerve
Vagus Nerve Stimulation
observational studies
Suicide
Observational Studies
Mortality
Suicidal Ideation
relative risk
Major Depressive Disorder
Therapeutics
confidence interval
Confidence Intervals
risk behavior
therapeutics
Trajectories
Risk-Taking
trajectories
Registries

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Mortality and Suicide Risk in Treatment-Resistant Depression : An Observational Study of the Long-Term Impact of Intervention. / Olin, Bryan; Jayewardene, Amara K.; Bunker, Mark; Moreno, Francisco.

In: PLoS One, Vol. 7, No. 10, e48002, 25.10.2012.

Research output: Contribution to journalArticle

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