Georgios D Makris1, Johan Reutfors2, Rolf Larsson3, Göran Isacsson4, Urban Ösby4, Anders Ekbom2, Lisa Ekselius5, Fotios C Papadopoulos5. 1. Department of Neuroscience, Psychiatry, Uppsala University Hospital, Uppsala University, Uppsala SE-751 85, Sweden. Electronic address: makrisgeorge2@gmail.com. 2. Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden. 3. Department of Mathematics, Uppsala University, Uppsala, Sweden. 4. Department of Molecular Medicine and Surgery, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Psychiatry, Tiohundra AB, Norrtälje, Sweden. 5. Department of Neuroscience, Psychiatry, Uppsala University Hospital, Uppsala University, Uppsala SE-751 85, Sweden.
Abstract
BACKGROUND: An association between suicide and sunshine has been reported. The effect of sunshine on hormones and neurotransmitters such as serotonin has been hypothesized to exert a possible triggering effect on susceptible individuals. The aim of this study is to examine if there is an association between sunshine and suicide, adjusting for season, and if such an association differs between individuals on different antidepressants. METHODS: By using Swedish Registers and the Swedish Meteorological and Hydrological Institute we obtained information, including forensic data on antidepressive medication for 12,448 suicides and data on monthly sunshine duration. The association between monthly suicide and sunshine hours was examined with Poisson regression analyses while stratifying for sex and age and controlling for time trend and season. These analyses were repeated in different groups of antidepressant treatment. RESULTS: We found a significantly increased suicide risk with increasing sunshine in both men and women. This finding disappeared when we adjusted for season. Among both men and women treated with selective serotonin reuptake inhibitors (SSRIs) there was a positive association between sunshine and suicide even after adjustment for season and time trend for suicide. Pair comparisons showed that the sunshine-suicide association was stronger among men treated with SSRIs compared to other antidepressant medications or no medication at all. LIMITATIONS: Other meteorological factors were not controlled (i.e. temperature) for in the analyses. CONCLUSIONS: There is an enhanced association between sunshine and suicide among those with SSRI medication, even after adjusting for season. This may have interesting theoretical and clinical implications.
BACKGROUND: An association between suicide and sunshine has been reported. The effect of sunshine on hormones and neurotransmitters such as serotonin has been hypothesized to exert a possible triggering effect on susceptible individuals. The aim of this study is to examine if there is an association between sunshine and suicide, adjusting for season, and if such an association differs between individuals on different antidepressants. METHODS: By using Swedish Registers and the Swedish Meteorological and Hydrological Institute we obtained information, including forensic data on antidepressive medication for 12,448 suicides and data on monthly sunshine duration. The association between monthly suicide and sunshine hours was examined with Poisson regression analyses while stratifying for sex and age and controlling for time trend and season. These analyses were repeated in different groups of antidepressant treatment. RESULTS: We found a significantly increased suicide risk with increasing sunshine in both men and women. This finding disappeared when we adjusted for season. Among both men and women treated with selective serotonin reuptake inhibitors (SSRIs) there was a positive association between sunshine and suicide even after adjustment for season and time trend for suicide. Pair comparisons showed that the sunshine-suicide association was stronger among men treated with SSRIs compared to other antidepressant medications or no medication at all. LIMITATIONS: Other meteorological factors were not controlled (i.e. temperature) for in the analyses. CONCLUSIONS: There is an enhanced association between sunshine and suicide among those with SSRI medication, even after adjusting for season. This may have interesting theoretical and clinical implications.
Authors: Andrew S Tubbs; Michael L Perlis; Mathias Basner; Subhajit Chakravorty; Waliuddin Khader; Fabian Fernandez; Michael A Grandner Journal: J Clin Psychiatry Date: 2020-02-25 Impact factor: 4.384
Authors: Georgios D Makris; Richard A White; Johan Reutfors; Lisa Ekselius; Morten Andersen; Fotios C Papadopoulos Journal: Sci Rep Date: 2021-05-13 Impact factor: 4.379
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