Association between anxiolytic/hypnotic drugs and suicidal thoughts or behaviors in a population-based cohort of students

Psychiatry Res. 2020 Sep:291:113276. doi: 10.1016/j.psychres.2020.113276. Epub 2020 Jul 8.

Abstract

Aims: To investigate the association between the use of anxiolytic/hypnotic drugs and suicidal thoughts and/or behavior (STB) in students.

Methods: 12,112 participants who completed the baseline questionnaire in the i-Share cohort between April 2013 and March 2017 were included. STB were defined at inclusion as suicidal thoughts over the previous year and/or a lifetime suicide attempt. The use of prescribed anxiolytic/hypnotic drugs over the previous 3 months was measured at baseline and follow-up time points (in 2,919 students). Psychiatric disorders were assessed through validated scales. Multivariate logistic regression models were run using disease risk score.

Results: At inclusion, 25.2% of students had STB and 10.3% used anxiolytics/hypnotics. STB at baseline were associated with a more frequent use of anxiolytics/hypnotics in the previous 3 months, after adjustment for covariates including anxiety, depression, sleep, impulsivity, and substance use. The use of anxiolytics/hypnotics at baseline was not associated with the occurrence, persistence or remission of STB one year later. STB at baseline were associated with a new anxiolytic/hypnotic treatment one year later.

Conclusions: Anxiolytic/hypnotic drug use was associated with STB in students independently of many risk factors of suicide and most psychiatric disorders that require such treatment, which raises drug safety concerns.

Keywords: Anxiolytic; Hypnotic; Students; Suicide.

MeSH terms

  • Adolescent
  • Anti-Anxiety Agents / adverse effects
  • Anti-Anxiety Agents / therapeutic use*
  • Anxiety Disorders / drug therapy
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / psychology
  • Cohort Studies
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hypnotics and Sedatives / adverse effects
  • Hypnotics and Sedatives / therapeutic use*
  • Male
  • Population Surveillance*
  • Prospective Studies
  • Risk Factors
  • Students / psychology*
  • Suicidal Ideation*
  • Suicide, Attempted / psychology*
  • Suicide, Attempted / trends
  • Young Adult

Substances

  • Anti-Anxiety Agents
  • Hypnotics and Sedatives