The investigators' initial analysis showed that "the number of previous suicide attempts was the strongest predictor of another suicide attempt, and age was the strongest predictor of death and suicide."

After adjusting the data for the effect of other risk factors, the risk of completed suicide was lower in patients who were on an antidepressant compared with patients who were not on an antidepressant. There were no apparent differences by class of antidepressant used.

In contrast, the risk of a suicide attempt requiring hospitalization was greater in patients between 10 and 19 years old. The risk of an attempted, but not completed, suicide was increased further when selective serotonin reuptake inhibitors were used.

Patients on antidepressants less often attempted suicide using violent means, such as hanging or shooting.

In a secondary analysis, which examined cause of death other than suicide, the mortality risk from cardiovascular disease was significantly lower among antidepressant users versus non-users. This effect was greatest among patients taking selective serotonin reuptake inhibitors, particularly fluoxetine (Prozac).

Tiihonen and his associates conclude: "Antidepressant treatment may contribute to a substantial decrease in mortality among this patient population."

SOURCE: Archives of General Psychiatry, December 2006.

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Follow-up often lacking after gestational diabetes

Last Updated: 2006-12-04 15:50:23 -0400 (Reuters Health)

NEW YORK (Reuters Health) - The rates of postpartum blood sugar (glucose) testing after diabetes of pregnancy (gestational diabetes) are low, according to a review of the records of 344 women with gestational diabetes who received prenatal care in a maternal diabetes clinic in Rhode Island between 2001 and 2004.

According to a report in the current issue of the journal Obstetrics and Gynecology, only 45 percent women in the study group underwent postpartum glucose testing, which is recommended by the American Diabetes Association and the American College of Obstetricians and Gynecologists.

More than one third of those tested (36 percent) had persistent abnormal glucose levels, Dr. Michelle A. Russell, from the Department of Veterans Affairs Medical Center in White River Junction, Vermont, and colleagues report.

The only factor strongly associated with postpartum glucose testing was attending a postpartum doctor's appointment. The rate of testing was three-fold higher in those who had a postpartum visit compared with those who did not (54 percent versus 17 percent).

There were no demographic or clinical factors that predicted whether or not postpartum glucose testing was performed.

This study, the authors say, confirms that women with gestational diabetes are at increased risk of persistent glucose intolerance after delivery and shows that "many are not retested postpartum."

They conclude: "With the magnitude of the public health problem posed by the rising incidence of diabetes in the United States, further attention needs to be given to these high-risk women, including identifying and eliminating obstacles to postpartum care and glucose testing."

SOURCE: Obstetrics and Gynecology, December 2006.

Copyright © 2006 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.