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Visual Analysis of Regional Variations in Antidepressant Use and Suicide Rate
Korean J Clin Pharm 2018;28(4):308-319
Published online December 31, 2018
© 2018 Korean College of Clinical Pharmacy.

Ho-Jung Kim and Iyn-Hyang Lee*

College of Pharmacy, Yeungnam University, Gyeongsan 38541, Republic of Korea
Correspondence to: Iyn-Hyang Lee, College of Pharmacy, Yeungnam University, 280, Daehak-ro, Gyeongsan 38541, Republic of Korea Tel: +82-53-810-2829, Fax: +82-53-810-4654 E-mail: leeiynhyang@ynu.ac.kr
Received November 2, 2018; Revised December 13, 2018; Accepted December 17, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Some mental illnesses such as depression are known to be one of the risk factors of suicide and proper antidepressant therapy can reduce suicidal behavior.
Objectives: This study aimed to analyze regional variations in antidepressant consumption and adherence, suicide rate, prevalence of suicide related mental disorders, and access to relevant healthcare services.
Methods: Cross-sectional analyses were conducted using National Patients Sample data compiled by the Health Insurance Review and Assessment Service between 2014 and 2016. We included patients who had a diagnosis record of suicide related mental disorders during the study period. Cause of death statistics and National health and medical statistics were used to identify suicide rate and distribution of healthcare service. We conducted visual analyses, chi-squared tests, independent t-tests and correlation analyses to demonstrate regional variations. Results: Between 2014 and 2016, the average prevalence of suicide related mental disorders was 5.4 per cent. Suicide rate and prevalence of suicide related mental disorders were higher in Gangwon, Chungcheong, and Jeolla (p < 0.001), and lower in Seoul (p < 0.001) than the national average. Unexpectedly, regional variations in antidepressant consumption were seen in the limited area including Daejeon, Chungnam and Gyeongnam (p < 0.05). The number of mild patient-centered clinics was associated positively with antidepressant consumption (p < 0.01) and associated negatively with suicide rate (p < 0.01).
Conclusion: There were some regional variations in prevalence of suicide related mental disorders, antidepressant adherence and suicide rate. The higher level of antidepressant therapy and the lower level of suicide rates were seen in regions with easy access to mild patient-centered clinics.
Keywords : Antidepressants, suicide, mental disorders, spatial analysis, Geographic Information Systems


December 2018, 28 (4)
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