Change in suicide rates for patients with schizophrenia in Denmark, 1981-97: nested case-control study
ABSTRACT To study the change in risk of suicide among patients with schizophrenia and related disorders.
Nested case-control design with linked data.
4 longitudinal Danish registers.
18,744 people aged up to 75 years who committed suicide in 1981-97 individually matched with 20 controls.
Over the time studied the reduction in suicide rate among patients with schizophrenia and schizophrenia spectrum disorder was similar to that seen in the general population (incidence rate ratio 1.00, 95% confidence interval 0.98 to 1.03). The reduction among patients with other psychosis in the schizophrenia spectrum was faster than the reduction seen in the general population. Among people admitted to hospital with schizophrenia the risk of suicide was highest in the first year after first admission, and the excess risk was largest in the younger age groups-that is, the risk decreased per year for every additional year of age.
The suicide rate among patients with a diagnosis of schizophrenia and related disorders has fallen. This may be due to better psychiatric treatment, reduced access to means of suicide, or improvements in treatment after suicide attempts.
Full-textDOI: · Available from: Merete Nordentoft, Jul 07, 2015
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ABSTRACT: The risk of suicide is a major factor in the morbidity and mortality of schizophrenia and schizoaffective disorder, accounting for at least 5% of deaths. The use of antipsychotic, antidepressant, anxiolytic, and mood stabilizing drugs to reduce the risk of suicide in schizophrenia is reviewed. Typical antipsychotic drugs, e.g. haloperidol, have not been reliably shown to reduce the risk of suicide. There is significant evidence from both mirror image, registry, and one controlled trial, the International Suicide Prevention Trial (InterSePT), which indicate that clozapine can greatly reduce the risk of a suicide attempt, and most likely completed suicide, in patients with schizophrenia or schizoaffective disor-der. Evidence that other atypical antipsychotic drugs reduce the risk for suicide in schizophrenia and schizoaffective disorder is limited. As the major clinically evident risk factors for suicide in schizophrenia have been identified, e.g. prior serious suicide attempts, substance abuse, male sex, first decade of illness, social isolation, depression, and feel-ings of hopelessness, it is possible to use this information to guide pharmacologic treatment which may reduce the risk of suicide attempts and completed suicide.