New study of suicide rates reveals: the emperor has no clothes

A bewildered tone seemed to permeate the news reports this week that suicide rates among middle-aged Americans rose sharply from 1999 to 2005. Even the authors of the new analysis in the American Journal of Preventive Medicine said they had no idea why the suicide rate climbed 19 percent among white women ages 40 to 64 and 16 percent among white men of the same age during those six years. As Susan Baker, an epidemiologist at Johns Hopkins School of Public Health said in The Boston Globe yesterday, “I have no idea what’s going on with this age group.”

Could it be that some of the confusion stems from the fact that this new data puts the lie to the drug industry’s long-held contention that antidepressants known as selective serotonin reuptake inhibitors (SSRIs) lead to fewer suicides? After all, during roughly the same time period, antidepressant prescriptions in the United States rose 10 percent, according to a survey by the federal Agency for Healthcare Research and Quality. In a statistical brief published in June 2008, the AHRQ noted that the number of antidepressants purchased in the U.S. rose from 154 million in 2002 to 170 million in 2005. So if antidepressant prescriptions and suicide rates among middle-aged adults were both rising during the first five years of the 21st century, drugs like Prozac, Paxil, Zoloft and Celexa are obviously not stemming the tide.

So what does explain the sharp rise in suicide rates among folks that (unlike teenagers and the elderly) are not known for having a high risk of self-in jury? One explanation could be the economy. Research has shown that suicide rates tend to rise during periods of economic hard times and decline during good times. And as we all know, with the burst of the dot com bubble in 2000, the American economy slid into a recession for the next three or four years.

That correlation has prompted some observers to voice concerns about what might happen with the current financial meltdown. Newsday quoted Alan Berman, executive director of the American Association of Suicidology (AAS), saying he feared the struggling economy could accelerate the trend. “We know that unemployment affects suicide rates and that when people feel a severe economic strain, suicide rates tend to increase among people experiencing this trend,” Berman said.

I find it interesting that neither Berman nor any of the experts quoted in the news raised the issue of antidepressants and what role they may (or may not) play in the rising suicide rates. No one, it seems, least of all organizations like the AAS, which derives a lot of its funding from drug companies, are eager to call attention to the likelihood that the Emperor has no clothes.

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