Suicide rates in a general psychiatric care system

Reduction of the elevated suicide rates in psychiatric patients remains an important aim of psychiatric treatment. There has been an ongoing discussion on the question of whether the increased tendency to transfer long-term psychiatric patients from inpatient care to community psychiatric care might go along with increased suicide rates. In our community care system we found an age- and sex-adjusted suicide rate 40 times as high as in the general population in the period between 1973 and 1993. Within the first 4 years suicide rates were significantly elevated. All suicides had the diagnosis of chronic schizophrenia or schizoaffective psychosis. In the non-schizophrenic group no suicide occurred during treatment. Our study shows that in community psychiatric care suicide rates in schizophrenic patients are significantly increased whereas suicide rates in non-schizophrenic patients may be decreased.