Suicide rates among people with serious mental illness: a systematic review and meta-analysis

Abstract

Background People with serious mental illness are at great risk of suicide, but little is known about the suicide rates among this population. We aimed to quantify the suicide rates among people with serious mental illness (bipolar disorder, major depression, or schizophrenia). Methods PubMed and Web of Science were searched to identify studies published from 1 January 1975 to 10 December 2020. We assessed English-language studies for the suicide rates among people with serious mental illness. Random-effects meta-analysis was used. Changes in follow-up time and the suicide rates were presented by a locally weighted scatter-plot smoothing (LOESS) curve. Suicide rate ratio was estimated for assessments of difference in suicide rate by sex. Results Of 5014 identified studies, 41 were included in this analysis. The pooled suicide rate was 312.8 per 100 000 person-years (95% CI 230.3–406.8). Europe was reported to have the highest pooled suicide rate of 335.2 per 100 000 person-years (95% CI 261.5–417.6). Major depression had the highest suicide rate of 534.3 per 100 000 person-years (95% CI 30.4–1448.7). There is a downward trend in suicide rate estimates over follow-up time. Excess risk of suicide in males was found [1.90 (95% CI 1.60–2.25)]. The most common suicide method was poisoning [21.9 per 100 000 person-years (95% CI 3.7–50.4)]. Conclusions The suicide rates among people with serious mental illness were high, highlighting the requirements for increasing psychological assessment and monitoring. Further study should focus on region and age differences in suicide among this population.

Wird die Rolle von psychischen Erkrankungen beim Suizid überbewertet?

“…Eine umfassende Metaanalyse von Fu et al. [ 10 ] kommt auf der Basis von 41 Studien zu einer Suizidrate von Menschen mit schweren psychischen Erkrankungen von 313 pro 100.000 Personen. Dabei lag – basierend auf verschiedenen gepoolten Einzelstudien – die Suizidrate für Menschen, die an schwerer Depression leiden, bei 534 pro 100.000 Personen, die von Menschen mit Schizophrenie bei 352 und bei bipolarer Störung bei 237.…”

“…Deswegen weisen Fu et al. [ 10 ] und Nordentoft et al. [ 11 ] darauf hin, dass frühere Zahlen zum Zusammenhang zwischen Suizid und psychischer Erkrankung, die bis heute zitiert werden und von einer Suizidhäufigkeit von 25 % und mehr bei affektiven Erkrankungen ausgehen, zu hoch sind und als widerlegt gelten sollten, so z.…”

Risk of Suicidal Behaviors and Antidepressant Exposure Among Children and Adolescents: A Meta-Analysis of Observational Studies

“…Likewise, clinical guidelines covering the use of antidepressants in children and adolescents have taken the suicidal risk into consideration and recommended careful monitoring for suicidal behaviors after initiation of antidepressant treatment ( 4 ). Suicide is one of the major causes of death with a rate of 534.3 per 100,000 person-years in patients with major depression ( 5 ), and suicide clusters occur more frequently in young people than in adults, especially through social media ( 6 , 7 ); thus, it is of great importance to identify the suicidal risk of antidepressants.…”

Risk factors for suicide mortality and cancer‐specific mortality among patients with gastric adenocarcinoma: A SEER based study

“…1 Severe mental illnesses, especially major depression, schizophrenia, bipolar disorder alcohol dependence, and substance abuse, critically predispose to suicide. 3,4 Patients with diseases of bad prognosis as cancer have a high susceptibility to suffer depression and commit suicide, especially during the first year after diagnosis. [5][6][7][8][9] About 40% of cancer patients with major depression were reported to suffer from suicidal ideation.…”

“…Many medical, social, and cultural factors affect the incidence of suicide 1 . Severe mental illnesses, especially major depression, schizophrenia, bipolar disorder alcohol dependence, and substance abuse, critically predispose to suicide 3,4 . Patients with diseases of bad prognosis as cancer have a high susceptibility to suffer depression and commit suicide, especially during the first year after diagnosis 5‐9 .…”