DEPRESSION MED: Suicide Attempt: Story on The Gap: Australia

Paragraph 11 reads: “Years later, Mr Ritchie encouraged a ‘‘nervous and confused’’ woman, sitting on a ledge, shoes by her side, to follow him home. Over tea and toast, she revealed she was unhappy with medication she had been prescribed for depression. Mr Ritchie’s wife suggested she seek a second opinion. ‘‘A couple of months later she came up the path with a bottle of French champagne. We later got a Christmas card from her, and a postcard. It said ‘I’ll never forget your important intervention in my life. I am well’.’’

http://www.smh.com.au/national/an-angel-walking-among-us-at-the-gap-20090731-e4f2.html

An angel walking among us at The Gap

’’People will always come here. I don’t think it will ever stop’’ … Don Ritchie. Photo: Marco del Grande

Kate Benson Medical Reporter
August 1, 2009

HE IS the watchman of The Gap. A former life insurance salesman who in 45 years has officially rescued about 160 people intent on jumping from the cliffs at Watsons Bay, mostly from Gap Park, opposite his home high on Old South Head Road. Unofficially, that figure is closer to 400.

Some, at his urging, quietly gathered their shoes and wallets, neatly laid out on the rocks, and followed him home for breakfast. Others, tragically, struggled as he grabbed at their clothes before they slipped over the edge.

Still others later sent tokens of thanks, a magnum of champagne or an anonymous drawing slipped into his letter box, labelling him ‘‘an angel walking among us’’.

Don Ritchie, 82, spends much of his time reading newspapers, books and scanning the glistening expanse of ocean laid out before him. His days of climbing fences are gone and he admits some relief that most visitors now carry mobile phones and are quick to contact the police if they see a lone figure standing too close to the edge, too deep in contemplation.

For its part, Woollahra Council has been campaigning for $2.5 million to install higher fences, motion-sensitive lights, emergency phones and closed-circuit television cameras, but Mr Ritchie is ambivalent.

‘‘People will always come here. I don’t think it will ever stop,’’ he says, with a shrug.

Some deaths have been recorded in his diary, others are eternally etched in his mind.

One summer evening he spotted a young man perched on a thin ledge, beyond the fence.

‘‘I went over and I tried to talk to him, asking him questions about where he was from. He wouldn’t talk much, just kept looking straight ahead. I was talking to him for about half an hour … thinking I was making headway. I said ‘why don’t you come over for a cup of tea, or a

beer, if you’d like one?’ He said ‘no’ and stepped straight off the side … his hat blew up and I caught it in my hand.’’ Later, Mr Ritchie discovered the 19-year-old had grown up next door, playing with his grandchildren.

Years later, Mr Ritchie encouraged a ‘‘nervous and confused’’ woman, sitting on a ledge, shoes by her side, to follow him home. Over tea and toast, she revealed she was unhappy with medication she had been prescribed for depression. Mr Ritchie’s wife suggested she seek a second opinion. ‘‘A couple of months later she came up the path with a bottle of French champagne. We later got a Christmas card from her, and a postcard. It said ‘I’ll never forget your important intervention in my life. I am well’.’’

Despite his bravery and compassion, Mr Ritchie has steered clear of the limelight. He was awarded a Medal of the Order of Australia in 2006 for his services to suicide prevention but is all too aware that any publicity attracts more depressed and disturbed people.

In the weeks after the Channel 10 newsreader Charmaine Dragun jumped to her death outside his house in November 2007, Mr Ritchie’s wife is adamant six more followed.

‘‘But what do you do? Not talk about it?’’ he asks. ‘‘It’s the truth. It’s what goes on here.’’

It has long been a haunting dichotomy for rescuers, families and media. To speak out in a bid to have the area made safer, risking more people becoming aware of it, or to keep quiet, letting the deaths go on.

But for an anti-suicide campaigner, Dianne Gaddin, whose daughter Tracy jumped from The Gap in 2005, the answer is easy. If the issue is not aired, the problem will never be solved.

She has written four letters in the past month to the Prime Minister, Kevin Rudd, urging him to act. While her pleas go unanswered, her desperation balloons. She knows Mr Ritchie will not be standing guard forever.

‘‘Sometimes just a smile and a greeting is all it takes to change the mind of the would-be suicider. I don’t believe people want to die, but living is just too hard. To me, Don is a guardian angel.’’

Lifeline: 131 114; Salvo Crisis Line 93312000; Beyond Blue 1300224 636.

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ANTIDEPRESSANT & ALCOHOL: In Pink Pajamas Woman Slashes Neighbor’s Tires: UK

Third paragraph from the end reads: “Stephen Constantine, defending, said: ‘Ms Fergus suffers from depression and this offending was a result of combining drink with her prescribed medication’.”

http://www.sunderlandecho.com/news/Easington-tyreslasher-wore-pink-pyjamas.5509772.jp

Easington tyre-slasher wore pink pyjamas
Published Date:
30 July 2009
By Rob Freeth

A drunken woman dressed herself in pink pyjamas before going out at the dead of night to slash car tyres.

Joanne Fergus did not know the owners of the vehicles she damaged, Durham Crown Court heard.

Fergus, 25, of Glenhurst Road, Easington Village, admitted three charges of criminal damage on January 23 this year.

She has no previous convictions, but has police caustions for a public order offence and possessing a small quantity of amphetamine, and she received a penalty notice for being drunk and disorderly.

Judge Esmond Faulks sentenced Fergus to a nine-month supervision order, and ordered her to pay £282 compensation.

“You slashed the tyres of cars belonging to neighbours who had done nothing to you,” the judge told Fergus.

“It was a disgraceful thing to do and I hope you are ashamed of yourself.”

“A neighbour in Easington saw a figure crouched down beside a Jaguar car,” said David Wilkinson, prosecuting.

“He then saw a flash of metal, which was later confirmed to be a kitchen knife.

“The neighbour was able to tell police the person with the knife was a woman dressed in pink pyjamas.

“Officers cruised around the immediate area and the only house with a downstairs light on belonged to Fergus.

“She was wearing the pink pyjamas when she answered the door.”

The court heard Fergus admitted she had been out slashing tyres, but could not say why she had done it.

“She had been drinking and was upset due to an argument with her boyfriend,” added Mr Wilkinson.

“One tyre on the Jaguar was found to be slashed, as well as two tyres on a Peugeot, and another two tyres on a Vauxhall Astra.”

Stephen Constantine, defending, said: “Ms Fergus suffers from depression and this offending was a result of combining drink with her prescribed medication.

“The incident was also borne out of a domestic argument with her boyfriend at the time.

“She can pay compensation, although her income from benefits is £120 a week, from which she has to look after herself and her young daughter.”

* Last Updated: 30 July 2009 12:44 PM
* Source: n/a
* Location: Sunderland

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ANTIDEPESSANTS: Death: 21 Year Old: Florida

Paragraph 20 reads: “Mr. Mott was discharged July 14. He went home with three prescriptions to treat depression, his family said ­ and a companion.”

Paragraphs 27 through 29 read: “In the wake of his death, his family searches for answers. Kathy Mott said she does not believe her son relapsed. She wonders if the antidepressants played a role in his death.”

“Now she wants others to be careful.”

“‘Just because it’s prescription drugs, doesn’t mean you can’t OD,’ she said.”

http://www.tampabay.com/news/obituaries/article1023489.ece

Track star Matthew Mott had started rehab
By Andrew Meacham, Times Staff Writer
In Print: Friday, July 31, 2009
[LARA CERRI | Times]

ST. PETERSBURG ­ At a gathering held in his honor Wednesday at Northeast High School, Matthew Mott’s family and peers recalled the good times.

A former teammate showed off a large pink stuffed bunny rabbit, the unofficial mascot of the Northeast High track team, led by Mr. Mott and his twin brother, Jonathan. Others reminisced about late-night scavenger hunts and mud-wrestling in Mr. Mott’s back yard.

But it wasn’t good times that brought more than 140 people to Northeast’s cafeteria Wednesday ­ it was an unexpected death. Mr. Mott died of unknown causes early July 23, nine days after leaving an addiction treatment center. He was 22.

Mr. Mott literally ran through most of his life, competing with and against his brother. The brothers anchored a previously unremarkable Northeast track team, each earning second-team all-county honors in 2005. The next year, they helped take Northeast to its first state finals in more than two decades.

They trained together, worked out together. Jonathan won many races just a second or so ahead of Matthew, though sometimes it was the other way around.

“I don’t think they were competing against anybody else,” said Patty Parker, the boys’ aunt. “The competition was between those two.”

The boys took separate paths after their graduation in 2006. Jonathan Mott got a full track scholarship to Webber International University, where he remains.

Matthew Mott did not get the same offer. He enrolled in the Orlando Culinary Academy.

In the fall of 2006, after less than two weeks at the school, he called his aunt.

“He called in a panic,” said Parker, 40. He didn’t like it there, she said. Parker and her husband drove Mr. Mott back to St. Petersburg.

It is around this same time that friends began noticing changes in Mr. Mott’s behavior. Suddenly, the happy-go-lucky man with bleached blond locks had grown quieter, more reserved.

“He was the most upbeat, happy person,” said Ian Upson, 21. “He was always saying, ‘Let’s do this’ or ‘Let’s do that.’ Afterward, he just wanted to sit back and do nothing.”

Some of his friends and family members knew that Mr. Mott was taking the painkiller OxyContin. But they, like everyone else, were powerless to stop him.

“If you were around him, you knew,” said older brother Sam Mott.

Mr. Mott got a series of cooking jobs at places like the Don CeSar, the TradeWinds, Bascom’s Chop House and Derby Lane, his family said.

“He lost all of those jobs due to his addiction,” said his mother, Kathy Mott, 53.

With less money to buy OxyContin illegally, Mr. Mott resorted to Coricidin Cough and Cold medicine ­ or “Triple C” ­ an over-the-counter antihistamine that can be used as an intoxicant.

In June, Mr. Mott told his family he had had enough. His mother entered him in Fairwinds Treatment Center in Clearwater.

During a family visit to the facility, Mr. Mott seemed to have improved. He had gained weight. He was his old, animated self.

Mr. Mott was discharged July 14. He went home with three prescriptions to treat depression, his family said  and a companion.

Mr. Mott had met Genny Perry in treatment, and the two had formed an attraction. Perry and Mr. Mott lived with Kathy Mott. The two went to 12-step meetings together and separately.

Mr. Mott had gone to an AA meeting the night of July 22, then talked to his AA sponsor, his mother said. They stayed close to home the rest of the evening, Perry said, and fell asleep together at 3:30 a.m.

She awoke at 4 a.m. sensing something was wrong.

“He felt sweaty,” said Perry, 32.

Mr. Mott was snoring ­something he did not normally do, his mother said. Foam bubbled around his lips, his mother and Perry said.

Paramedics were unable to revive him, and he died at 4:40 a.m.

In the wake of his death, his family searches for answers. Kathy Mott said she does not believe her son relapsed. She wonders if the antidepressants played a role in his death.

Now she wants others to be careful.

“Just because it’s prescription drugs, doesn’t mean you can’t OD,” she said.

Learning the cause of death could take months, as the Pinellas County medical examiner awaits toxicology results.

At his celebration service Wednesday, family and friends spoke of Mr. Mott’s zest for life. A friend strummed a ukulele and sang a song. A priest extolled the value of Mr. Mott’s life and called it complete.

The audience listened in respectful silence.

Andrew Meacham can be reached at (727) 892-2248 or ameacham@sptimes.com.

.Biography

Matthew

David Mott

Born: Feb. 20, 1987.

Died: July 23, 2009.

Survivors: brothers, Jonathan and Sam; parents, Kathy and Sam; aunts, Patty Parker and Barbara DuFault; extended family.

[Last modified: Jul 30, 2009 10:29 PM]

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PROZAC: Man Hallucinates for Two Weeks: U.S.A.

Paragraphs 2 and 3 read: “I had a bout of hallucinations about 10 years ago. I was suffering quite badly with depression and had been on anti-depressants for years. Then came along Prozac®. The doc thought they would be good so off I went!

The three stages of my hallucinations always happened at night and in bed. I had always been asleep for a while and was awakened by the goings on. They happened in quite quick succession, perhaps over the space of two weeks, then stopped.

http://www.clusterflock.org/2009/08/dear-clusterflock-have-you-ever-hallucinated.html

August 1, 2009

Dear Clusterflock: Have you ever hallucinated?

I had a bout of hallucinations about 10 years ago. I was suffering quite badly with depression and had been on anti-depressants for years. Then came along Prozac®. The doc thought they would be good so off I went!

The three stages of my hallucinations always happened at night and in bed. I had always been asleep for a while and was awakened by the goings on. They happened in quite quick succession, perhaps over the space of two weeks, then stopped.

1. I woke violently as a tiger jumped from sitting above the bedroom door, onto my pillow and then jumped up onto a shelf (which didn’t exist in reality) above the bed. I woke my wife, quite calmly pointed out said tiger, but was told to return to sleep as there wasn’t one. He only appeared once.

2. I woke to see a man standing in the doorway of the bedroom — that would have been about 4 feet from me. He didn’t scare me. I came around slowly to see him standing there. I don’t remember colour — I do remember him being an Abe Lincoln type ­ stovepipe hat, and a beard. He wasn’t moving. I woke my wife and asked her quite calmly if she could see the man stood in the corner ­ she could not. I lay there for a while looking at him, closing my eyes and opening them. He stayed for a while and then left.

He returned for quite a few nights. He was always in the same place, always in monochrome and he never spoke. Unfortunately, I never spoke to him.

3. I woke one night. I was lying on my back, and as I looked up at the ceiling it was alive with a sea of frogs ­ all moving as one. I again woke my wife ­ just for the reality check. They stayed until I closed my eyes, say 20 minutes, then disappeared.

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ANTIDEPRESSANT: Man Threatens to Shoot Self: In Stand-Off with Police: …

Paragraph three reads: “She said he is taking medication to combat depression and that he had been drinking. The unnamed man allegedly told his wife he would resist if police responded, according to a news release.”

SSRI Stories Note: The Physicians Desk Reference states that antidepressants can cause a craving for alcohol and alcohol abuse. Also, the liver cannot metabolize the antidepressant and the alcohol simultaneously, thus leading to higher levels of both alcohol and the antidepressant in the human body.

http://www.lehighvalleylive.com/hunterdon-county/express-times/index.ssf/2009/08/armed_raritan_township_man_thr.html

Armed Raritan Township man threatens to shoot himself, engages in hour-long standoff with police

by Express-Times staff
Monday August 03, 2009, 6:55 AM
Officials in Raritan Township spent more than an hour Sunday urging an apparently suicidal man to put down his weapons and surrender peacefully.

Raritan Township police were called to a single-family home in the township about 3:30 p.m. after a woman reported her husband had locked himself in the bedroom and was threatening to shoot himself. The woman told police her husband had several guns in the house and that at least two — a pistol and a rifle — were in the bedroom with him.

She said he is taking medication to combat depression and that he had been drinking. The unnamed man allegedly told his wife he would resist if police responded, according to a news release.

Police set up a safe perimeter around the house, evacuated neighboring homes and blocked off the road. Officers called the man, with the assistance of his brother. After an hour on the phone with him, he agreed to surrender. Police recovered two handguns and a rifle from the home.

The man was taken to Hunterdon County Medical Center for an evaluation. Charges against him are pending.

The Hunterdon County Prosecutor’s Office, Flemington-Raritan First Aid and Rescue Squad and Raritan Township Department of Public Works assisted township police.

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DEPRESSION MED: Violence: Man Beats Up Frail Neighbor: England

Fourth paragraph from the end reads: “Rod Hunt, in mitigation, said his client had been mixing alcohol with anti-depressant tablets, which had made him turn violent.”

Paragraphs four & five read: “In a letter to the court, Mr Hodgson described Summersgill as a decent man and said the brutal assault was out-of-character.”

“The pair were friends at the time, and Summersgill and his partner, Heather Barnett, acted as carers for their neighbour.”

Paragraphs seven & eight read: “Paul Newcombe, prosecuting, said that without warning, Summersgill turned to his housebound friend and said he would kill him.”

“He then grabbed him by the throat and squeezed tightly as he pushed him onto a bed in his front room.”

SSRI Stories Note: The Physicians Desk Reference states that antidepressants can cause a craving for alcohol and alcohol abuse. Also, the liver cannot metabolize the antidepressant and the alcohol simultaneously, thus leading to higher levels of both alcohol and the antidepressant in the human body.

http://www.thenorthernecho.co.uk/news/4515923.Man_jailed_for_threats_to_kill_frail_neighbour/

Man jailed for threats to kill frail neighbour
1:06pm Tuesday 28th July 2009

By Neil Hunter »

A DRUNK who throttled a wheelchair- bound neighbour after threatening to kill him was yesterday jailed for four years.

Paul Summersgill left the frail pensioner on the floor of his home and stole his mobile phone and spectacles before fleeing.

Teesside Crown Court heard that Bernard Hodgson, 65, blacked out during the attack, which left him covered in wounds and bruises.

In a letter to the court, Mr Hodgson described Summersgill as a decent man and said the brutal assault was out-of-character.

The pair were friends at the time, and Summersgill and his partner, Heather Barnett, acted as carers for their neighbour.

On the day of the attack, April 9, Summersgill had been at Mr Hodgson’s home watching television and drinking his beer.

Paul Newcombe, prosecuting, said that without warning, Summersgill turned to his housebound friend and said he would kill him.

He then grabbed him by the throat and squeezed tightly as he pushed him onto a bed in his front room.

On the brink of consciousness, Mr Hodgson then had his face pushed into a pillow.

Summersgill then loosened his grip and took the phone and glasses.

After a short time, Summersgill threw a chair at Mr Hodgson, knocking him to the floor.

Mr Newcombe said: “He then straddled him, using his knees on the victim’s shoulders to pin him to the floor. He again put his hands around the victim’s throat, strangling him and striking him repeatedly across the face.”

Rod Hunt, in mitigation, said his client had been mixing alcohol with anti-depressant tablets, which had made him turn violent.

Summersgill, 34, of The Bungalows, Grangetown, Middlesbrough, admitted wounding with intent to cause grievous bodily harm.

The court heard that last year he throttled his girlfriend, now pregnant, until she lost consciousness.

Judge Tony Briggs, who described Mr Hodgson’s supportive letter as “unusual and extremely generous”, said: “It was a nasty, vicious attack and custody is inevitable.”

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DEPRESSION MED: Suicide: 14 year old girl: Ohio

Paragraphs 13 and 14 read: “After his daughter’s death, Weidlich went through a long bewildering search into why it happened.”

“She’d been on medication and in therapy for depression, but seemed to be responding.”

http://www.mansfieldnewsjournal.com/article/20090729/NEWS01/907290321/1002/NEWS01

Speaker confronts teen suicide, depression
By LINDA MARTZ • News Journal • July 29, 2009

MANSFIELD — James Weidlich is finally comfortable telling strangers about his daughter’s suicide.Advertisement

The family discovered 14-year-old Savannah after she hung herself at home July 15, 2004, after battles with depression.

Weidlich, who once ran a landscaping and contracting business, says this year he committed to a full-time mission to open up public discussion of suicide.

It’s a topic many people find difficult to address, but Weidlich argues people should talk about it. “The cost of promoting the human comfort level is that people are dying,” he said.

“There is a huge amount of secrecy and denial. We have done a really good job of scaring people out of talking about their own mental health,” he said.

Weidlich, of Cambridge, brought his Families on Fire Mental Health Reality Crusade to Citichurch last week.

This Friday, Saturday and Sunday, he’ll offer free public talks at the Quality Inn on Ohio 97, near Bellville.

Weidlich described his daughter as a good kid and an athlete. “My daughter had a very inspiring personality and a sense of humor. Yet she had an illness that took her life.”

Young people come under tremendous pressure, he said. “It is a war zone for children, in our schools, on our playgrounds, in our streets.”

Weidlich believes adults must take responsibility for spotting the signs a young person is contemplating suicide. He also believes adults must take action.

“I never want a parent to say, ‘Just get over it’ or ‘I went through the same thing you’re going through, and I got over it. Just toughen up,’ ” he said.

Severe depression is a physical illness, like diabetes or heart disease, he said. It should be discussed openly and swiftly treated.

After his daughter’s death, Weidlich went through a long bewildering search into why it happened.

She’d been on medication and in therapy for depression, but seemed to be responding.

Weidlich, a single father, eventually found clues that indicated Savannah hadn’t been doing as well as he thought. He doesn’t want others to miss signs or ignore reality.

“That moment, on that night, in our house, is something that you do not want to experience,” he said.

Now, from a “Families on Fire” camper, he spreads his message. He strikes up conversations about suicide in coffee shops and churches statewide. Making ends meet is difficult given his mission, but he’s sticking to it.

“Depression-related suicide is the number one killer of our children. You absolutely have no excuse not to come and learn something.”

lmartz@nncogannett.com

419-521-7729

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ANTIDEPRESSANTS: Mother Kills Daughter’s Rapist: Spain

First paragraph reads: “A MUM who killed her daughter’s rapist by throwing petrol over him and setting him alight has been jailed for nine years. Maria del Carmen Garcia Espinosa’s daughter Veronica was raped by a man from their home town, Benejuzar, in 1998 when she was just 13. Veronica’s mother has been in counselling and on anti-depressants ever since. But in June 2005, the rapist was on weekend leave from prison, where he was serving a nine-year sentence, and Maria del Carmen saw him in the family’s local bar.”

http://www.euroweeklynews.com/2009073061426/news/costa-blanca/jail-for-mum-who-killed-her-daughters-rapist.html

Thu, 30 July 16:33 2009

Jail for mum who killed her daughter’s rapist

BENEJUZAR

The deceased ‘provoked and intimidated’ the mother, who had been depressed since the rape

A MUM who killed her daughter’s rapist by throwing petrol over him and setting him alight has been jailed for nine years. Maria del Carmen Garcia Espinosa’s daughter Veronica was raped by a man from their home town, Benejuzar, in 1998 when she was just 13. Veronica’s mother has been in counselling and on anti-depressants ever since. But in June 2005, the rapist was on weekend leave from prison, where he was serving a nine-year sentence, and Maria del Carmen saw him in the family’s local bar.

The bar was next to the stop where Veronica caught her bus every day, leading her mother to believe his presence in the area was aimed at provoking and intimidating the family. Antonio Velasco is said to have approached Maria del Carmen and asked her how her daughter was in order to scare her. A distraught Maria del Carmen returned home and fetched a vat of petrol, a court heard. She then went back to the bar where she doused her daughter’s rapist in fuel and set him alight.

The woman was then found hours later in Alicante ‘in a disoriented state’, police say. Meanwhile, the man died in Valencia’s La Fe hospital from third-degree burns affecting 60 per cent of his body. Family members of the arrested woman say the deceased’s relatives had sold their assets to avoid having to pay compensation owed to Veronica, now 24. But Veronica’s mother has now been ordered to pay them 140,000 euros. She has also been sentenced to nine years in prison.

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ANTIDEPRESSANTS: Police Officer Dead: Shooter Dies Also: shooter was o…

Headline reads:
Coroner: “Shooter was prescribed antidepressants.”
Paragraph four reads: “The shooting left Sgt. David Kinterknecht dead, along with the suspect, Dennis Gurney, who lived at the home.”

http://www.montrosepress.com/articles/2009/07/30/news/doc4a71057ebf681398337489.txt

Injured officers face lengthy recovery

Coroner: Shooter was prescribed antidepressants

Print this story Post a Comment ShareThis

By Katharhynn Heidelberg
Daily Press Senior Writer
Published/Last Modified on Thursday, July 30, 2009 4:11 AM MDT

MONTROSE ­ Two officers shot Saturday can expect an extensive recovery process, the chief of police said.

Montrose Police officers Larry Witte and Rodney Ragsdale were hit in the legs with shotgun blasts while responding to a domestic violence call in the Cobble Creek area.

“I think it’s going to be weeks to months before we see them back to work,” Police Chief Tom Chinn said.

The shooting left Sgt. David Kinterknecht dead, along with the suspect, Dennis Gurney, who lived at the home.

Witte was released from Montrose Memorial Hospital Tuesday, to a hero’s welcome from other officers. Ragsdale’s release from St. Mary’s Hospital in Grand Junction was expected today, Chinn said.

He said both men will need extensive rehab.

­­­

The above is an excerpt from the story that appeared in today’s print edition. The excerpts, usually the first few paragraphs, may not reflect all relevant information that was reported. We encourage readers to obtain the full story by reading the print edition or our e-edition, To subscribe, call (970) 252-7081 or click on the subscription link on the main page.

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ANTIDEPRESSANTS: 52% of Women Who Committed Suicide in 2006 Were taking a…

Paragraph three reads: “We first looked at antidepressant prescriptions. Of the 776 Scandinavian men in the sample, 259 (32%) (age-adjusted 95% confidence interval [CI]=28.5–35.2) filled a prescription for antidepressants in the 180 days before death. The corresponding figures were 176 of the 333 Scandinavian women in the sample (52%) (CI=46.7–57.5), 32 of the 102 foreign-born men (31%) (CI=21.6–39.5), and 21 of the 44 foreign-born women (43%) (CI=28.7–58.1).”

http://ps.psychiatryonline.org/cgi/content/full/59/1/116-a

Psychiatr Serv 59:116-a-117, January 2008
doi: 10.1176/appi.ps.59.1.116-a
© 2008 American Psychiatric Association

Letter

Ethnic Differences in Antidepressant Treatment Preceding Suicide in Sweden
To the Editor: In the October 2007 issue Ray and colleagues (1) observed that the odds of receiving treatments for mood disorders in the year preceding suicide were lower for African Americans. The study of racial-ethnic differences in drug utilization among individuals with severe mood disorders is important. We analyzed whether similar undertreatment is present in Sweden, a country of nine million inhabitants. However, because Sweden has a different racial-ethnic composition than the United States, we analyzed country of birth instead of race.

We analyzed all suicides and deaths from undetermined intent among persons aged 18 to 84 in 2006 (N=1,255, or about 95% of all suicides). We examined use of prescription drugs in the 180 days before death. Persons born in Sweden, Denmark, and Norway, representing the Scandinavian countries, were compared with persons born in all other countries.

We first looked at antidepressant prescriptions. Of the 776 Scandinavian men in the sample, 259 (32%) (age-adjusted 95% confidence interval [CI]=28.5–35.2) filled a prescription for antidepressants in the 180 days before death. The corresponding figures were 176 of the 333 Scandinavian women in the sample (52%) (CI=46.7–57.5), 32 of the 102 foreign-born men (31%) (CI=21.6–39.5), and 21 of the 44 foreign-born women (43%) (CI=28.7–58.1).

We also examined use of antipsychotic drugs. Among Scandinavian men, 100 (13%) (CI=10.1–14.5) filled a prescription for an antipsychotic in the 180 days before death. The corresponding figures were 81 of the Scandinavian women (24%) (CI=19.5–28.9), 19 of the foreign-born men (18%) (10.7–25.4), and 16 of the foreign-born women (32%) (CI=19.8–44.6). Use of lithium was 2% or less in all groups.

As a comparison we analyzed use of these drugs among persons aged 18 to 84 years in the Swedish population in 2006 by country of birth. Among Scandinavian men, 6.1% (CI=6.05–6.10) had at least one filled prescription for an antidepressant. The corresponding figure for foreign-born men was 6.5% (CI=6.43–6.59). Among Scandinavian women the figure was 11.7% (CI=11.68–11.76), compared with 11.1% (CI=11.02–11.20) for foreign-born women. We did not analyze differences in inpatient or outpatient admission before suicide, although we have previously commented on postdischarge suicides in Sweden (2).

We have some minor concerns about the study by Ray and colleagues (1). Data used in that study represented suicides in different periods­1986 to 2004. Over those years, at least in Sweden, policies in regard to inpatient care changed. We also suspect that use of antidepressants increased substantially in the United States since the early 1990s as a result of the introduction of selective serotonin reuptake inhibitors (SSRIs). The increase in use of SSRIs in Sweden was sixfold between 1990 and 2004. In the study by Ray and colleagues, the mean age of African Americans who committed suicide was also nearly ten years lower than that of whites, which may indicate socioeconomic or other differences in the underlying white and African-American populations from which the samples were drawn.

Although one might suspect relative undertreatment of psychiatric disorders in the non-Scandinavian population in Sweden, it could not be verified by our analyses because we studied only drug utilization without knowledge of the underlying disease prevalence. However, the rates of prescription were similar for Scandinavians and foreign-born persons in our sample who filled a prescription for an antidepressant in the months before they committed suicide­and who therefore could be said to have been suffering from a severe mood disorder. This, together with the observed similar rates of prescription in the general population, could indicate equal access to drug treatment. The study by Ray and colleagues highlights an important issue in research on socioeconomic inequalities in care. Racial-ethnic differences in the use of medications may result from differences in religious and cultural beliefs that can affect both health-seeking behavior and attitudes toward suicide.

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