The effect of income level on all-cause mortality and suicide among patients using antidepressants: A population-based cohort study
Background: To investigate whether household income levels are associated with all-cause mortality and suicide in patients using antidepressant agents.
Methods: We analyzed data from 75,782 patients using antidepressants, acquired from the Korean National Health Insurance claims database (2002-2013). Each patient was monitored until December 2013 or until death, whichever occurred sooner. Cox proportional hazard models were used to compare all-cause and suicide mortalities between different income groups after adjusting for possible confounding covariates and risk factors.
Results: The mid-low income group had a significantly higher suicide rate than the high-income group (hazard ratio [HR] 1.379; 95% confidence interval [CI] 1.102-1.762). Male patients in the low and mid-low income groups had a higher risk of suicide (HR 1.449; 95% CI, 1.006-2.087 and HR 1.410; 95% CI, 1.036-1.918, respectively), whereas there was no significant difference in suicide risk between income groups among female patients.
Conclusion: Promotion of targeted policies and priority health services for low-income patients on antidepressants may help reduce the risk of suicide in this high-risk group.