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To test the hypothesis that lithium is associated with reduced rates of self-harm, unintentional injury, and suicide in patients with bipolar disorder, researchers studied electronic health records collected from a representative sample of 6671 British patients from 1995 through 2013. The patients had a diagnosis of bipolar disorder and received maintenance medication in primary care practices (the standard in the U.K. after diagnosis by a psychiatrist) with lithium, valproate, olanzapine, or quetiapine.
Analyses were performed with and without adjustment for various features thought to influence the propensity to prescribe one or another medication (e.g., demographic factors, medical comorbidity, previous treatment, anxiety, depression, ins…