Psychiatric inpatients are at increased risk for suicide after discharge, but it is not known whether the risk varies across psychiatric diagnoses. Olfson and colleagues studied a large longitudinal cohort of inpatients in the Medicaid program. Suicide rates during the first 90 days after hospital discharge were highest for patients with depression and bipolar disorder, followed by patients with schizophrenia and substance use disorder. In an editorial, Nordentoft and colleagues discuss the clinical challenge of reducing the risk of postdischarge suicide.
Editorial
The 40-Hz auditory steady-state response has been suggested as a potential biomarker for circuit dysfunction in schizophrenia. Thuné and colleagues carried out a meta-analysis of 20 articles reporting 40-Hz auditory steady-state response data in schizophrenic patients compared with healthy control participants in electroencephalographic and magnetoencephalographic recordings and found significantly reduced spectral power and/or phase-locking in schizophrenia, regardless of stage of illness, stimulus characteristics, and analysis methods. The 40-Hz auditory steady-state response deficits could be useful probes for understanding the neurobiology of schizophrenia.
The relationship between use of hormonal contraception and depression in women is not well understood. In a population-based sample that included more than 1 million women in Denmark, Skovlund and colleagues found a significantly elevated risk of first use of antidepressants and a first diagnosis of depression for users of multiple kinds of hormonal contraceptives, with the highest risk among adolescent women. These findings suggest that users of hormonal contraception are at an increased risk of receiving treatment for depression.
Continuing Medical Education
Selective serotonin reuptake inhibitors are used by 4% to 10% of women during pregnancy. Brown and colleagues studied offspring of mothers who purchased at least 2 selective serotonin reuptake inhibitor prescriptions during pregnancy. They found a 37% increased risk for speech/language disorders compared with offspring of mothers with psychiatric disorders but no antidepressant use during pregnancy. The risk for scholastic and motor disorders was not increased. In an Invited Commentary, Cohen and Nonacs discuss the importance of the study.
Invited Commentary
Cannabis use after first-episode psychosis is associated with poor outcomes. Schoeler and colleagues followed up 220 patients after onset of psychosis for at least 2 years to study the association of cannabis use and risk of relapse of psychosis. The odds of experiencing psychosis were increased, in a dose-dependent way, during periods of cannabis use. Additional analysis revealed an effect of cannabis on subsequent risk of relapse rather than an effect of relapse on subsequent cannabis use.