Modelling suicide risk in affective disorders

Background. The lifetime risk of suicide in affective disorders is commonly quoted as 15%. This stems from hospital populations of affective disorders. Aims. To model the lifetime prevalence of suicide using data on completed suicides from one English Health District and community-based rates of prevalence of affective disorders. Methods. A secondary analysis of a primary data set based on 212 suicides in North Staffordshire was undertaken. The population rates of psychiatric morbidity were obtained from the National Comorbidity Survey. Results. The model suggests a lifetime prevalence rate of suicide for any affective disorder at 2.4%, with a rate for those uncomplicated by substance abuse, personality disorder or non-affective psychosis at 2.4%, and a rate for uncomplicated cases who had no mental health service contact at 1.1%. Conclusions. Lifetime prevalence rates of suicide in subgroups of affective disorders may be lower than the traditional rates cited for hospital depression. This has implications for primary care projects designed to investigate the occurrence of and the prevention of suicide. (C) 2001 Editions scientifiques et medicales Elsevier SAS.