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Risk factors for suicide in patients with schizophrenia: Nested case–control study

Published online by Cambridge University Press:  03 January 2018

Charlotte Dahl Rossau  and
Preben Bo Mortensen
Charlotte Dahl Rossau*
Affiliation:
Institute for Basic Psychiatric Research, Aarhus, Denmark
Preben Bo Mortensen
Affiliation:
Institute for Basic Psychiatric Research, Aarhus, Denmark
*
Dr Rossau, Institute for Basic Psychiatric Research, Department of Psychiatric Demography, Psychiatric Hospital in Aarhus, University of Aarhus, Denmark
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Abstract

Background

Of 9156 patients admitted to psychiatric hospitals in Denmark between 1970 and 1987 and diagnosed for the first time as having schizophrenia, 508 committed suicide. The purpose of the study was to identify risk factors for suicide among patients with schizophrenia, particularly factors relating to hospitalisation.

Method

From the cohort of all 9156 patients, the 508 who had committed suicide were individually matched to 10 controls from the same cohort, and data were analysed using conditional logistic regression.

Results

Suicide risk was particularly high during the first 5 days after discharge, and increased risk was also associated with multiple admissions during the previous year, previous suicide attempts, previous diagnosis of depression, male gender, and previous admissions to general hospitals for physical disorders. After adjusting for these factors, no effect was found for age. There was some evidence of an excess of suicides during temporary leave from the psychiatric department.

Conclusions

The findings suggest that preventive measures could be focused on the first period after discharge, when closer monitoring and better social support may be needed. This may also apply to patients on temporary leave during a period of admission.

Type
Papers
Information
The British Journal of Psychiatry , Volume 171 , Issue 4 , October 1997 , pp. 355 - 359
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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References

Allebeck, P. (1989) Schizophrenia: a life-shortening disease. Schizophrenia Bulletin, 15, 81–89.Google Scholar
Appleby, L. (1992) Suicide in psychiatric patients: risk and prevention. British Journal of Psychiatry, 161, 749–758.Google Scholar
Bolin, R. K., Wright, R. E., Wilkinson, M. N., et al (1968) Survey of suicide among patients on home leave from a mental hospital. Psychiatric Quarterly, 42, 81–89.Google Scholar
Caldwell, C. B. & Gottesman, I. I. (1990) Schizophrenics kill themselves too: a review of risk factors for suicide. Schizophrenia Bulletin, 16, 571–589.Google Scholar
Clayton, D. & Hills, M. (1993) Statistical Models in Epidemiology. Oxford: Oxford University Press.Google Scholar
Copas, J. B. & Robin, A. (1982) Suicide in psychiatric inpatients. British Journal of Psychiatry, 141, 503–511.CrossRefGoogle Scholar
Epicenter Software (1993) Epilog Plus. Version 3. Procedures. Pasadena, CA: Epicenter Software.Google Scholar
Flanders, W. D. & Louv, W. C. (1986) The exposure odds ratio in nested case–control studies with competing risks. American Journal of Epidemiology, 124, 584–692.Google Scholar
Greenland, S. & Thomas, D. C. (1982) On the need for the rare disease assumption in case–control studies. American Journal of Epidemiology, 116, 547–553.Google Scholar
Hosmer, D. W. & Lemeshow, S. (1989) Applied Logistic Regression. New York: Wiley.Google Scholar
Miles, C. P. (1977) Conditions predisposing to suicide: a review. Journal of Nervous and Mental Disease, 164, 231–246.CrossRefGoogle ScholarPubMed
Mortensen, P. B. (1988) Ambidirectional studies – an extension of longitudinal studies in psychiatry. Psychiatric Developments, 6, 173–181.Google Scholar
Mortensen, P. B. (1995) Suicide among schizophrenic patients: occurrence and risk factors. Clinical Neuropharmacology, 18, 1–8.Google Scholar
Mortensen, P. B. & Juel, K. (1993) Mortality and causes of death in first admitted schizophrenic patients. British Journal of Psychiatry, 163, 183–189.CrossRefGoogle ScholarPubMed
Mortensen, P. B. & Eaton, W. W. (1994) Predictors for readmission risk in schizophrenia. Psychological Medicine, 24, 223–232.Google Scholar
Munk-Jørgensen, P. & Mortensen, P. B. (1992) Incidence and other aspects of the epidemiology of schizophrenia in Denmark, 1971–1987. British Journal of Psychiatry, 161, 489–495.CrossRefGoogle Scholar
Niskanen, P., Lønnquist, J. & Achte, K. (1974) Suicides in a Helsinki psychiatric hospital: 1964–1972. Psychiatria Fennica, 275–280.Google Scholar
Pokorny, A. D. (1960) Characteristics of 44 patients who subsequently committed suicide. Archives of General Psychiatry, 2, 1109–1116.CrossRefGoogle Scholar
Roy, A. (1982) Suicide in chronic schizophrenia. British Journal of Psychiatry, 141, 171–177.Google Scholar
Saugstad, L. F. & Odegard, O. (1979) Mortality in psychiatric hospitals in Norway 1950–1974. Acta Psychiatrica Scandinavica, 59, 431–447.Google Scholar
Simpson, J. C. (1988) Mortality studies in schizophrenia. In Handbook of Schizophrenia. Nosology, Epidemiology and Genetics of Schizophrenia (eds Tsuang, M. T. & Simpson, J. C.), pp. 245–274. Amsterdam: Elsevier.Google Scholar
Sletten, I., Brown, M. & Evenson, R. (1972) Suicide in mental hospital patients. Diseases of the Nervous System, 33, 328–334.Google Scholar
Sundhedsstyrelsen [The National Board of Health] (1993) Evaluering of Landspatientregisteret 1990 (Evaluation of the National Patient Register 1990). Copenhagen: The National Board of Health. Sygehgusstatistik 11, 57.Google Scholar
Stensman, R. & Sundqvist-Stensman, U. B. (1988) Physical disease and disability among 416 suicide cases in Sweden. Scandinavian Journal of Social Medicine, 16, 149–153.CrossRefGoogle ScholarPubMed
Temoche, A., Pug, T. F. & Macmahon, B. (1964) Suicide rates among current and former mental institution patients. Journal of Nervous and Mental Disease, 138, 124–130.Google Scholar
Virkkunen, M. (1974) Suicides in schizophrenia and paranoid psychoses. Acta Psychiatrica Sandinavica Supplementum, 250, 1–305.Google ScholarPubMed
World Health Organization (1967) Manual of the International Classification of Diseases (ICD–8). Geneva: World Health Organization.Google Scholar
Yarden, P. (1974) Observations on suicide in chronic schizophrenics. Comprehensive Psychiatry, 15, 325–333.Google Scholar
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