Persistent Depressive Disorder-Related Effect of Sleep Disorder on the Highest Risk of Suicide in Taiwan, 2000-2015

Int J Environ Res Public Health. 2022 Oct 13;19(20):13169. doi: 10.3390/ijerph192013169.

Abstract

Objective: to investigate whether persistent depressive disorder (PDD) affects sleep disorders (SDs) and increased suicide risk.

Methods: in this study, we used the National Health Insurance Research Database (NHIRD) to select 117,033 SD patients, of whom 137 died by suicide, and 468,132 non-SD patients, of whom 118 died by suicide, and analyzed gender, age, and co-existing diseases. Hazard ratios (HRs) and 95% confidence intervals (CI) were calculated using a multivariate Cox proportional hazards model.

Results: the hazard ratio of suicide in SD patients was 1.429 times that of non-SD patients. The hazard ratio of suicide in female patients was 1.297 times higher than in males. Compared with people without PDD, people with PDD had a 7.195 times higher hazard ratio for suicide than those without PDD. PDD patients with SDs had a 2.05 times higher hazard ratio for suicide than those with no SDs.

Conclusions: suicide risk was increased in SD patients, and the maximum suicide risk was greater in SD patients with PDD than in non-PDD patients. PDD affected SDs and increased suicide risk. Clinicians should be aware of the possibility that PDD affects patients with SDs and contributes to suicide risk.

Keywords: persistent depressive disorder (PDD); poor prognosis; sleep disorder (SD); suicide.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Depressive Disorder* / complications
  • Female
  • Humans
  • Male
  • Proportional Hazards Models
  • Risk Factors
  • Sleep Wake Disorders* / complications
  • Sleep Wake Disorders* / epidemiology
  • Suicide*
  • Taiwan / epidemiology

Grants and funding

This study was funded by the Tri-Service General Hospital, grant number TSGH-B-111018.