Fourth, while we were careful to include nearly every psychiatric prescription medication within our propensity score along with measures of mental health resource use, NHANES does not provide data on whether participants met criteria for DSM-validated anxiety and depressive disorders, which are often treated with benzodiazepines and have been found to correlate with increased suicide risk. Countering this information, use of an active comparator reduces between-group differences in depression and anxiety that could not be addressed using measured covariates.