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Review: long term lithium treatment lowers suicide risk in major affective disorder
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 QUESTION: In patients with a major affective disorder, is long term lithium treatment associated with a lower suicide risk?

Data sources

Studies were identified by searching Current Contents, Medline, PsycLIT, and PubMed from the 1960s. Pertinent publications (since 1949) were also searched, and experts were contacted.

Study selection

Studies were selected if they examined lithium treatment in patients with bipolar manic depressive disorder, major affective disorder (including recurrent major depression), or schizoaffective disorder, and included data for estimating suicide rates.

Data extraction

Data were extracted on patient diagnoses, study design, number of suicides, total number of patients at risk for suicide, at-risk exposure times, and study quality. Study quality was assessed by using a quality scoring scale (maximum score 7, which referred to the highest quality score) and expressed as a percentage of the maximum.

Main results

22 studies (5647 patients, 33 473 patient y …

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