Menopausal Hormone Therapy and Suicide in a National Sample of Midlife and Older Women Veterans.

Autor:	Gibson CJ; San Francisco VA Health Care System.; Department of Psychiatry, University of California., Li Y; San Francisco VA Health Care System.; NCIRE-The Veterans Health Research Institute, San Francisco, CA., Jasuja GK; Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial VA Medical Center, Bedford.; Boston University School of Public Health, Boston, MA., Self KJ; San Francisco VA Health Care System.; Department of Psychiatry, University of California., Seal KH; San Francisco VA Health Care System.; Departments of Medicine and Psychiatry, University of California, San Francisco, CA., Byers AL; San Francisco VA Health Care System.; Department of Psychiatry, University of California.
Jazyk:	angličtina
Zdroj:	Medical care [Med Care] 2021 Feb 01; Vol. 59, pp. S70-S76.
DOI:	10.1097/MLR.0000000000001433
Abstrakt:	Background: Among midlife and older women, menopause symptoms and menopausal hormone therapy have been linked to mental health disorders and other comorbidities related to suicide. However, the role of hormone therapy as a prognostic factor of suicide risk is largely unknown. Objectives: To examine associations between menopausal hormone therapy, suicide attempts, and suicide among midlife and older women Veterans. Research Design: In this longitudinal analysis of national Veterans Health Administration data from women Veterans aged 50 years and above, we used Fine-Gray proportional hazards models to examine associations between menopausal hormone therapy (prescribed in 2012-2013) and incident suicide attempts and suicide (index date-2016). Measures: Menopausal hormone therapy and psychoactive medications from pharmacy records; suicide attempts and suicide from national suicide data repositories; demographic variables, medical and psychiatric diagnoses, and substance use disorders from electronic medical record data and International Classification Diagnoses-9-CM codes. Results: In this national sample of 291,709 women Veterans (mean age 60.47, SD 9.81), 6% were prescribed menopausal hormone therapy at baseline. Over an average of 4.5 years, 2673 had an incident suicide attempt (93%) or death by suicide (7%). Adjusting for age, race, and medical diagnoses, menopausal hormone therapy was associated with increased risk of suicide attempt (hazard ratio 1.41; 95% confidence interval, 1.22-1.64) and over 2-fold increased risk of death by suicide (hazard ratio 2.47; 95% confidence interval, 1.58-3.87). Associations with death by suicide remained significant after accounting for psychiatric comorbidity and psychoactive medications. Conclusions: Menopausal hormone therapy may be an important indicator of suicide risk among midlife and older women. Competing Interests: The authors declare no conflict of interest. (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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