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.

Automated summary

This study found that the mid-low income group had a significantly higher suicide rate compared to the high-income group among patients using antidepressants, particularly in male patients. Therefore, implementing targeted policies and priority health services for low-income patients using antidepressants may help reduce the risk of suicide in this high-risk group.