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Menopausal Hormone Therapy and Suicide in a National Sample of Midlife and Older Women Veterans
- Source :
- Med Care
- Publication Year :
- 2021
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2021.
-
Abstract
- 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.
- Subjects :
- Research design
medicine.medical_specialty
Hormone Replacement Therapy
medicine.medical_treatment
Veterans Health
Suicide, Attempted
Centers for Medicare and Medicaid Services, U.S
Article
03 medical and health sciences
0302 clinical medicine
Risk Factors
Suicide, Completed
medicine
Humans
Longitudinal Studies
030212 general & internal medicine
Psychiatry
Aged
Proportional Hazards Models
Veterans
Suicide attempt
Proportional hazards model
business.industry
Incidence
030503 health policy & services
Hazard ratio
Public Health, Environmental and Occupational Health
Middle Aged
medicine.disease
Mental health
United States
Confidence interval
Menopause
United States Department of Veterans Affairs
Female
Hormone therapy
0305 other medical science
business
Subjects
Details
- ISSN :
- 00257079
- Volume :
- 59
- Database :
- OpenAIRE
- Journal :
- Medical Care
- Accession number :
- edsair.doi.dedup.....8a8fceeb7b88c1705af4d5d6cc737c80