Suicide and severe mental illnesses. Cohort study within the UK general practice research database.
We aimed to evaluate suicide risk across the life-course in severe mental illnesses (SMI) including schizophrenia. Using survival analysis, we compared suicide risk in cohorts of 46,136 people with SMI and 300,426 without. The overall unadjusted hazard ratio (HR) for suicide in SMI was 12.97 (95% CI: 9.75-17.25). The unadjusted HRs differed by age band: 18-30 years: 19.56 (9.76-39.17); 30-50 years: 13.14 (8.64-19.99); 50-70 years: 16.39 (9.15-29.37); 70+: 3.25 (1.33-7.94). In schizophrenia, risk was significantly higher when young but marked risk persisted until age 70. Greatest risk was associated with: increased consultation rates; antidepressant prescriptions and living in less deprived areas.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000175:diagnosis / Q000401:mortality* / Q000523:psychology; D015331:Cohort Studies; D005194:Family Practice; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D016016:Proportional Hazards Models; D011610:Psychosocial Deprivation; D011618:Psychotic Disorders / Q000175:diagnosis / Q000401:mortality* / Q000523:psychology; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012306:Risk; D012559:Schizophrenia / Q000175:diagnosis / Q000401:mortality*; D012565:Schizophrenic Psychology; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data*; D016019:Survival Analysis; D006113:United Kingdom; D014600:Utilization Review / Q000706:statistics & numerical data
D000928:Antidepressive Agents