Risk factors for suicide in patients with schizophrenia: nested case-control study

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.