Suicide Risk Increased for All Psychiatric Disorders

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Clinical Context

All mental disorders are associated with an increased risk for death from suicide. This risk is often expressed as the odds ratio for suicide in those who have contact with mental health services. No studies have actually conducted lifetime follow-up after psychiatric contact, but lifetime risk is mentioned in many reports. Estimates range from 4% for schizophrenia to 15% for unipolar disorder.

This is a population-based cohort study of the Danish population to examine the lifetime risk for death from suicide among men and women with psychiatric contact and the general population.

Study Synopsis and Perspective

Patients with any major psychiatric disorder are at significant risk for suicide after their first hospital visit, according to new research.

In a Danish registry study of more than 175,000 individuals who were followed-up for up to 36 years, investigators found that among men, those with bipolar disorder or unipolar affective disorder had the highest absolute risk for suicide. Schizophrenia, followed closely by bipolar disorder, represented the highest risks for women.

Comorbidities were also significant risk factors for both sexes, and the cooccurrence of deliberate self-harm increased the risk by 2-fold.

“The steepest increase in suicide incidence occurs during the first years after first contact,” write lead author Merete Nordentoft, MD, from the Psychiatric Center Copenhagen and Copenhagen University in Denmark, and colleagues.

The investigators note that the absolute risk for suicide varied between 2% and 8% for the different psychiatric disorders studied.

“Our estimates are lower than those most often cited, but they are still substantial and indicate the continuous need for prevention of suicide among people with mental disorders,” the authors write.

The study appears in the October issue of the Archives of General Psychiatry….

By Deborah Brauser and Désirée Lie, MD, MSEd

Medscape

http://www.medscape.org/viewarticle/751701

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