Note that in this study, the association was greater for patients taking finasteride for male pattern baldness:
Finasteride and mental health - Advanced Prostate...
Finasteride and mental health
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Baldness at young age can make many men depressed...Seems like one of those planted studies to defame cheap, generic drugs to promote branded expensive ones. Another marketing gimmick...seen this before for other meds. As soon as a drug goes generic.. all the bad things about it start appearing. Is it coincidence ?
I don't think one has to propose nefarious intent to see that teasing out the differences in groups is difficult and makes the implications of this study difficult to interpret. In fact, your objection is specifically noted in the article, that "men seeking treatment for alopecia have a higher prevalence of depression and sexual dysfunction than the general population". Furthermore, "Indeed, one meta-analysis of the quantitative risk of depression in patients using 5-ARI for BPH reported a pooled overall hazard ratio of 1.23 (95% confidence interval [CI] 0.99-1.54) and a pooled overall OR of 1.19 (95% CI 0.95–1.49) in random effects models."--so non-significant at the 95% confidence level.
The first generic approval for finasteride in male pattern baldness was in 2006; the warning re: depression cam in 2011, so--the warning was not immediate.
My point in posting this was that while a relationship between finasteride and depression and suicidality cannot be discounted, very often in these papers there's less there than meets the eye.