Change in suicide rates for patients with schizophrenia in Denmark, 1981–97: Nested case-control study

Aarhus University, Aarhus, Central Jutland, Denmark
BMJ (online) (Impact Factor: 17.45). 08/2004; 329(7460):261. DOI: 10.1136/bmj.38133.622488.63
Source: PubMed


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.

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    • "Our data indicate that excess mortality, irrespective of whether it is due to diseases or to external causes, peaks during the first year after discharge. This has previously been documented for suicide in several studies [16], [30], [50], [51] Regarding deaths due to diseases and medical conditions, excess death following hospitalization due to a mental disorder not only indicates that a current mental disorder is a risk factor contributing to death from a physical disorder; it also indicates a systematic failure of the health system to prevent, identify and treat physical diseases during hospitalization for a mental disorder. This interpretation is supported by studies documenting that patients with psychiatric disorders receive less treatment for physical conditions than people without psychiatric disorders.[44], "
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    PLoS ONE 01/2013; 8(1):e55176. DOI:10.1371/journal.pone.0055176 · 3.23 Impact Factor
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    • "The lifetime suicide attempt rate in schizophrenia is lower than that in major depressive disorder [3], but attempts are more dangerous, resulting in physical harm significantly more often (44% vs 16%) [4]. Successful lifetime suicide rates in schizophrenia seem to vary considerably from country to country: they have been reported to be approx 20–30:100,000 in Denmark [5] versus 67:100,000 in China [6]. "
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    • "The first psychotic break down is usually seen in adolescence or early adulthood and has a serious impact on young peoples' lives through interference with their social lives and work. Furthermore, patients with psychosis often suffer from substance abuse, depression [2], suicide [3], and are often associated with high rates of violence and legal problems[4]. The direct cost of schizophrenia in European countries has been estimated to two percent of the national health expenditures[5], - a similar order of magnitude to cancer or ischaemic heart disease. "
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