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Title

Suicide in HIV-infected individuals and the general population in Switzerland, 1988-2008

Authors
Spoerri, Adrian
Brinkhof, Martin W. G.
Hasse, Barbara
Tissot, Frederic
Christen, Anna
Battegay, Manuel
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Published in American Journal of Psychiatry. 2010, vol. 167, no. 2, p. 143-150
Abstract OBJECTIVE: High rates of suicide have been described in HIV-infected patients, but it is unclear to what extent the introduction of highly active antiretroviral therapy (HAART) has affected suicide rates. The authors examined time trends and predictors of suicide in the pre-HAART (1988-1995) and HAART (1996-2008) eras in HIV-infected patients and the general population in Switzerland. METHOD: The authors analyzed data from the Swiss HIV Cohort Study and the Swiss National Cohort, a longitudinal study of mortality in the Swiss general population. The authors calculated standardized mortality ratios comparing HIV-infected patients with the general population and used Poisson regression to identify risk factors for suicide. RESULTS: From 1988 to 2008, 15,275 patients were followed in the Swiss HIV Cohort Study for a median duration of 4.7 years. Of these, 150 died by suicide (rate 158.4 per 100,000 person-years). In men, standardized mortality ratios declined from 13.7 (95% CI=11.0-17.0) in the pre-HAART era to 3.5 (95% CI=2.5-4.8) in the late HAART era. In women, ratios declined from 11.6 (95% CI=6.4-20.9) to 5.7 (95% CI=3.2-10.3). In both periods, suicide rates tended to be higher in older patients, in men, in injection drug users, and in patients with advanced clinical stage of HIV illness. An increase in CD4 cell counts was associated with a reduced risk of suicide. CONCLUSIONS: Suicide rates decreased significantly with the introduction of HAART, but they remain above the rate observed in the general population, and risk factors for suicide remain similar. HIV-infected patients remain an important target group for suicide prevention.
Keywords AdultAntiretroviral Therapy, Highly Active/psychologyCD4 Lymphocyte CountCohort StudiesFemaleHIV Infections/drug therapy/*psychologyHumansMaleMental Disorders/complications/psychologyPoisson DistributionRisk FactorsSuicide/psychology/*statistics & numerical dataSwitzerland/epidemiology
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PMID: 20008942
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KEISER, Olivia et al. Suicide in HIV-infected individuals and the general population in Switzerland, 1988-2008. In: American Journal of Psychiatry, 2010, vol. 167, n° 2, p. 143-150. https://archive-ouverte.unige.ch/unige:20493

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Deposited on : 2012-05-22

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