The Real Risk for Suicide in Mental Disorders

In This Article

Abstract and Introduction

Abstract

New results suggest that the risk is lower than previously reported.

Introduction

Presence of a mental disorder increases the risk for suicide, but investigators typically have estimated risks in relatively brief, small studies, without adjusting for patients who are lost to follow-up or die of unclear causes. To avoid these limitations while ascertaining lifetime risks for suicide associated with specific disorders, researchers used Danish national registries to prospectively follow 176,347 people with a first psychiatric contact for a mental disorder after age 15 and 881,735 nonpsychiatric controls for up to 36 years (birth years, 1955–1991). Data included diagnoses of all treatment recipients; death from suicide or from other causes; emigration; and loss to follow-up.

Absolute risk (i.e., cumulative incidence) for suicide in nonpsychiatric controls was 0.72% in men and 0.26% in women. In patients with bipolar disorder, the risk was 7.77% in men and 4.78% in women; in those with unipolar depression, 6.67% and 3.77%; in those with schizophrenia, 6.55% and 4.91%; in those with "schizophrenia-like disorder," 5.90% and 4.07%; and in those with substance abuse treated in psychiatric settings, 4.71% and 3.34%. Suicide risk in women with anorexia nervosa was 2.62%. Independent of age at onset of the disorder, suicide risk increased the most in the early years after first psychiatric contact; cumulative incidence stabilized after 22 years. Lifetime suicide risk increased with comorbid substance abuse or unipolar depression and doubled with history of deliberate self-harm (e.g., overdose). Men with bipolar disorder and deliberate self-harm had the highest lifetime suicide risk (17.08%).

Commenting is limited to medical professionals. To comment please Log-in.

Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.