Incidence of suicide within two years of a first diagnosis of depression, anxiety, or mixed anxiety and depression: an exploratory cohort study in primary care using the Clinical Practice Research Datalink

作者：J.p.m. Bailey, Patricia Schartau, Seena Fazel, Irwin Nazareth, Irene Petersen · 发表于：EClinicalMedicine · 年份：2025 · DOI：10.1016/j.eclinm.2025.103441 · 被引用次数：3 · 研究领域：Suicide and Self-Harm Studies、Mental Health Treatment and Access、Mental Health via Writing

Background: The risk of suicide following first diagnosis of depression or anxiety in primary care is uncertain. We investigated suicide incidence within two years of a first diagnosis of depression, anxiety, or mixed anxiety and depression in primary care, analysing variation by diagnosis, age, sex, and social deprivation at lower layer Super Output Area level. Methods: We conducted a cohort study using the Clinical Practice Research Datalink, a large primary care electronic health records database, linked to mortality records. Adults with their first diagnosis of depression, anxiety, or mixed anxiety and depression between 1 January 1999 and 31 December 2018 were included. The outcome was suicides per 100,000 person-years at risk (PYAR) within two years of diagnosis. Adjusted incidence rate ratios (aIRR) were calculated using Poisson regression. Findings: Among 1,454,102 individuals diagnosed there were 1439 suicides within two years of diagnosis. Rates were higher in men across all cohorts. The highest rate for men was after depression diagnosis: 115·85 per 100,000 PYAR (95% confidence interval [CI] 107·60-124·58), five times higher than women: aIRR 4·99 (95% CI 4·29-5·79). For women the highest rate was after a mixed diagnosis: 27·73 per 100,000 PYAR (95% CI 21·70-34·92). The highest rate across all groups was seen in men aged 70+ after a mixed diagnosis: 156·43 per 100,000 PYAR (95% CI 89·41-254·03). There was no association between rate and deprivation. Interpretation: ...