우울증 환자에서 항우울제 단독요법과 항정신병제와 항우울제의 병용요법의 자살위험비교

Suicidal Risk in Depressed Patients with the Treatment by Antipsychotics and Antidepressant Compared to Antidepressant Monotherapy: A Pilot Study Using Psychiatric Common Data Model

Objectives This study examined the effects of reducing suicide attempts when taking antipsychotics in combination with antidepressants in depressive patients. Methods Using a common data model of electronic medical records at a university medical center in South Korea, the study populations were extracted if the depressive patients were treated either with antidepressants only or along with antipsychotics. The suicidal risks were compared with the Kaplan-Meier plot and log-rank test, and the risk factors were accessed using the Cox proportional hazard model. Results All demographic characteristics were similar in the monotherapy group taking only antidepressants and the combination therapy group taking antipsychotics with antidepressants, except for the smoking characteristic (p=0.023). The combination therapy group showed a lower suicidal risk [hazard ratio=0.58, 95% confidence interval (CI)=0.282-1.190] compared to the monotherapy group, which was not significant (p=0.138). Conclusion The combination therapy had no beneficial effects on reducing the suicidal risk in patients with depressive symptoms. This study is meaningful in that it is the first attempt to explore a psychiatric behavior/symptom using real-world data based on a common data model of general electronic medical records as well as narrative textual data.