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Suicide and severe mental illnesses. Cohort study within the UK general practice research database
David Osborn1, Gus Levy, Irwin Nazareth
1Department of Mental Health Sciences, (Hampstead Campus), Royal Free and University College Medical School, Rowland Hill Street, London, NW3 2PF, UK. d.osborn@medsch.ucl.ac.uk
Schizophrenia Research
|December 25, 2007
Summary
Individuals with severe mental illnesses (SMI) face a significantly elevated suicide risk across their lifespan. This risk is particularly high in younger adults but remains substantial until age 70.
Area of Science:
- Psychiatry
- Epidemiology
- Public Health
Background:
- Severe mental illnesses (SMI) are associated with increased mortality, particularly suicide.
- Understanding suicide risk across the life-course in SMI is crucial for targeted interventions.
Purpose of the Study:
- To evaluate suicide risk throughout the lifespan in individuals with severe mental illnesses (SMI), including schizophrenia.
- To compare suicide risk between individuals with and without SMI.
Main Methods:
- Survival analysis was employed to compare suicide risk.
- Cohorts included 46,136 individuals with SMI and 300,426 individuals without SMI.
- Analysis examined risk across different age bands.
Main Results:
- The overall unadjusted hazard ratio (HR) for suicide in SMI was 12.97.
- Unadjusted HRs varied by age: 19.56 (18-30 years), 13.14 (30-50 years), 16.39 (50-70 years), and 3.25 (70+ years).
- In schizophrenia, risk was highest in young adults, persisting significantly until age 70. Increased consultation rates, antidepressant prescriptions, and living in less deprived areas were associated with greatest risk.
Conclusions:
- Severe mental illness confers a substantially elevated and persistent suicide risk across the life-course.
- Targeted suicide prevention strategies are essential for individuals with SMI, particularly during younger adulthood and middle age.
- Factors such as healthcare utilization and socioeconomic status may modify suicide risk within SMI populations.
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