REVIEW OF: Perlis RH et al, JAMA Network Open 2022;5(3):e223245

STUDY TYPE: Cross-sectional online survey 

We know that the likelihood of suicide is several times higher among people who own a gun, and the CDC reports firearms are used in more than 50% of suicide deaths (Studder DM et al, N Engl J Med 2020;382(23):2220–2229; www.cdc.gov/suicide/suicide-data-statistics.html). But are depressed individuals more likely to purchase firearms when compared to non-depressed ­individuals? 

Researchers used data from the COVID States Project, an internet survey that included questions about gun ownership and gun-purchasing plans as well as the Patient Health Questionnaire (PHQ-9). 

The survey included participants from all 50 states and the District of Columbia (n=24,770). They were on average 46 years old, female (65%), and White (74.0%). More than half of the sample was currently employed (57%) and living in a suburban area (58%). Of these, 28% reported at least moderate depressive symptoms as defined by a PHQ-9 score of 10 or greater. 

Rates of gun ownership were comparable among depressed individuals (31%) and non-depressed individuals (32%), but among individuals with depressive symptoms, 36% reported they made their first gun purchase during the COVID-19 pandemic, compared to 19% of non-depressed individuals. Depressive symptoms were significantly associated with first-time purchase of a gun (odds ratio [OR] 1.8) and thoughts about purchasing a gun in the future (OR 1.5). Depressed individuals were more likely than non-depressed individuals to purchase a gun from concerns related to the COVID-19 pandemic (p<0.001) or to protect themselves against someone they knew (p=0.001).

CARLAT TAKE 

Gun ownership is common in individuals with depression in the United States, especially since the COVID-19 pandemic. Be sure to ask your depressed patients if they own or plan to purchase firearms, as the risk of suicide is several times higher among people who own guns.