Does peripheral vestibular disorder increase the risk of attempted suicide: A retrospective cohort study

This study aimed to investigate the risk of attempted suicide in the population of patients diagnosed with peripheral vestibular disorders (PVD).

We conducted a retrospective cohort study. We extracted data on patients diagnosed with PVD (72,569 study patients) and a 3:1 ratio of propensity-score matched comparison patients without PVD (217,707 patients) from Taiwan's Longitudinal Health Insurance Database 2010. The claims records of sampled patients were tracked for a one-year period from their index date to identify claims showing a diagnosis of suicide attempt. Cox proportional hazards regression analyses were performed to calculate the one-year hazard ratio (HR) of suicide attempt following the PVD diagnosis among PVD patients relative to comparison patients.

Of total 290,276 sampled patients, the rate of attempted suicide was 0.158 per 100 person-years, being 0.460 and 0.057, respectively, among PVD patients and comparison patients. Cox proportional hazard analysis showed that PVD patients had a high relative hazard of suicide attempt (adjusted HR = 7.622, 95 % CI = 6.196-9.376) during one-year follow-up relative to comparison patients. We also found that subcategories of PVD, showed similar adjusted hazard ratios as all PVDs: Meniere's disease (HR = 7.608, 95 % CI = 4.350-13.305), benign paroxysmal positional vertigo (HR = 8.201, 95 % CI = 4.716-14.260), and vestibular neuritis (HR = 9.399, 95 % CI = 5.036-17.544).

The incidence of suicide attempts could be underestimated in both the study group and comparison group, if the suicide attempt did not cause a medical emergency and the patient did not seek medical assistance.

We found a high magnitude of association between PVD and subsequent suicide attempt.