Table 3. Sensitivity analyses; age-adjusted within-individual associations between β-blockers and psychiatric and behavioural outcomes using alternative samples.
| HR (95% CI) | Number of events | ||
|---|---|---|---|
| Alternative samples | |||
| Excluding prevalent users (n = 550,944)† | |||
| Psychiatric hospitalisations | 0.94 (0.92–0.96) | 131,239 | <0.001 |
| Suicidal behaviour | 1.09 (0.99–1.18) | 10,377 | 0.057 |
| Violent crime | 0.88 (0.80–0.96) | 11,332 | 0.004 |
| Including those with only 1 dispense (n = 1,535,102) | |||
| Psychiatric hospitalisations | 0.94 (0.92–0.95) | 275,699 | <0.001 |
| Suicidal behaviour | 1.10 (1.04–1.17) | 21,113 | 0.001 |
| Violent crime | 0.88 (0.82–0.93) | 21,770 | <0.001 |
| Including those with PRN* instructions (n = 1,465,588) | |||
| Psychiatric hospitalisations | 0.92 (0.91–0.94) | 251,026 | <0.001 |
| Suicidal behaviour | 1.08 (1.02–1.15) | 18,621 | 0.012 |
| Violent crime | 0.87 (0.81–0.93) | 17,386 | <0.001 |
| Excluding individuals with antidepressants (n = 962,218) | |||
| Psychiatric hospitalisations | 0.85 (0.83–0.88) | 58,054 | <0.001 |
| Suicidal behaviour | 1.07 (0.84–1.37) | 2,065 | 0.576 |
| Violent crime | 0.91 (0.82–1.00) | 7,307 | 0.059 |
| Excluding individuals with antipsychotics (n = 1,299,030) | |||
| Psychiatric hospitalisations | 0.91 (0.89–0.93) | 127,216 | <0.001 |
| Suicidal behaviour | 1.08 (0.96–1.22) | 7,328 | 0.200 |
| Violent crime | 0.86 (0.80–0.93) | 12,010 | <0.001 |
| Excluding individuals with benzodiazepines (n = 785,607) | |||
| Psychiatric hospitalisations | 0.84 (0.81–0.87) | 42,562 | <0.001 |
| Suicidal behaviour | 0.85 (0.65–1.10) | 1,905 | 0.216 |
| Violent crime | 0.91 (0.82–1.02) | 6,440 | 0.112 |
| Excluding individuals with calcium channel blockers (n = 800,103) | |||
| Psychiatric hospitalisations | 0.91 (0.90–0.93) | 155,544 | <0.001 |
| Suicidal behaviour | 1.05 (0.98–1.13) | 12,627 | 0.162 |
| Violent crime | 0.88 (0.81–0.96) | 11,751 | 0.002 |
| Excluding individuals with renin-angiotensin system acting agents (n = 514,186) | |||
| Psychiatric hospitalisations | 0.92 (0.90–0.94) | 110,848 | <0.001 |
| Suicidal behaviour | 1.07 (0.98–1.15) | 10,531 | 0.116 |
| Violent crime | 0.85 (0.77–0.93) | 8,265 | <0.001 |
| Excluding individuals with statins (n = 702,971) | |||
| Psychiatric hospitalisations | 0.94 (0.92–0.95) | 140,800 | <0.001 |
| Suicidal behaviour | 1.08 (1.01–1.16) | 11,705 | 0.049 |
| Violent crime | 0.86 (0.79–0.94) | 10,973 | <0.001 |
| Excluding individuals with polypharmacy (n = 610,529) | |||
| Psychiatric hospitalisations | 0.84 (0.82–0.87) | 61,151 | <0.001 |
| Suicidal behaviour | 1.04 (0.89–1.21) | 4,101 | 0.619 |
| Violent crime | 0.83 (0.75–0.92) | 7,591 | 0.001 |
| By cardiac severity | |||
| Including only individuals hospitalised for cardiac disorders†† (n = 278,429) | |||
| Psychiatric hospitalisations | 1.14 (1.12–1.17) | 85,297 | <0.001 |
| Suicidal behaviour | 1.20 (1.05–1.36) | 4,219 | 0.006 |
| Violent crime | 0.85 (0.73–0.98) | 3,570 | 0.022 |
| Excluding individuals hospitalised for cardiac disorders†† (n = 1,122,337) | |||
| Psychiatric hospitalisations | 0.80 (0.79–0.82) | 160,160 | <0.001 |
| Suicidal behaviour | 1.05 (0.97–1.13) | 13,490 | 0.222 |
| Violent crime | 0.88 (0.81–0.95) | 13,255 | 0.001 |
| By previous history ††† | |||
| Including only individuals with a history of psychiatric disorders or suicidal behaviour (n = 92,619) | |||
| Psychiatric hospitalisations | 0.93 (0.92–0.95) | 137,081 | <0.001 |
| Suicidal behaviour | 1.11 (1.02–1.20) | 10,028 | 0.010 |
| Violent crime | 0.83 (0.76–0.91) | 7,502 | <0.001 |
| Excluding individuals with a history of psychiatric disorders or suicidal behaviour (n = 1,308,147) | |||
| Psychiatric hospitalisations | 0.90 (0.88–0.92) | 108,376 | <0.001 |
| Suicidal behaviour | 1.03 (0.93–1.15) | 7,681 | 0.566 |
| Violent crime | 0.92 (0.83–1.01) | 9,323 | 0.078 |
| Including only individuals with a history of violent crime (n = 6,902) | |||
| Violent crime | 0.82 (0.74–0.91) | 5,803 | <0.001 |
| Violent crime by age categories | |||
| Under 30 (n = 24,011) | 0.78 (0.59–1.03) | 1,688 | 0.077 |
| 30–49 (n = 161,083) | 0.76 (0.56–1.03) | 7,318 | 0.073 |
| 50–69 (n = 622,083) | 0.79 (0.72–0.88) | 7,114 | <0.001 |
| 70 and older (n = 593,164) | 0.86 (0.80–0.92) | 705 | <0.001 |
† Including only individuals who initiated β-blocker treatment from January 1, 2007 and onwards.
†† During the first year after medication initiation.
††† Before the start of the study period, i.e., January 1, 2006.
* PRN = Pro re nata, i.e., instructed to take medications “as required.”
CI, confidence interval; HR, hazard ratio.