Case register study of suicide risk in mental disorders.
BACKGROUND
There have been few large-scale studies of long-term suicide risk in mental disorders in the UK.


OBJECTIVE
To estimate the long-term risk of suicide in psychiatric patients.


METHODS
A sample of 7921 individuals was identified from the Salford Psychiatric Case Register. Mortality by suicide or undetermined external cause during a follow-up period of up to 18 years was determined using the NHS Central Register; suicide risks were estimated as rate ratios.


RESULTS
Suicide risk was increased more than ten-fold in both genders: the rate ratio for males was 11.4; for females it was 13.7. The risk was highest in young patients, but high risk continued into late life. The diagnoses with the highest risk were schizophrenia, affective disorders, personality disorder and (in males) substance dependence. Risk was also associated with recent initial contact and number of admissions but not comorbidity.


CONCLUSIONS
The suicide risks estimated in this study are generally higher than those previously reported, notably in schizophrenia and personality disorder, and in previous in-patients. Patients with these high-risk diagnoses, an onset of illness within the previous 1-3 years, or more than one previous admission should be regarded as priority groups for suicide prevention by mental health services.
Baxter
D
D
Appleby
L
L
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003644:Death Certificates; D004739:England / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D001523:Mental Disorders / Q000401:mortality* / Q000523:psychology; D008875:Middle Aged; D012042:Registries; D012307:Risk Factors; D017678:Sex Distribution; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data*; D013997:Time Factors