People with an interest in the absolute risk of suicide, and how suicide relates to other mental health conditions, will want to read more about this new Danish cohort study published in the Archives of General Psychiatry.

This prospective study involved 176,347 people who were followed up for as long as 36 years from the point at which they first came into contact with secondary mental health services as an adult (older than 15 years of age) until they died, emigrated, disappeared or until the end of 2006. The median follow up across this huge group of people was 18 years.

The main outcome measure in the study was the absolute risk of suicide in percentage of individuals up to 36 years after the first contact.

Here’s what the researchers found:

• For men, the absolute risk of suicide (95% confidence interval [CI]) was:
  • highest for bipolar disorder (7.77%; 6.01%-10.05%)
  • followed by unipolar affective disorder (major depression) (6.67%; 5.72%-7.78%)
  • and schizophrenia (6.55%; 5.85%-7.34%)
• For women, the highest risk was found among women with
  • schizophrenia (4.91%; 95% CI, 4.03%-5.98%)
  • followed by bipolar disorder (4.78%; 3.48%-6.56%)
• In the non-psychiatric population, the risk was:
  • 0.72% (95% CI, 0.61%-0.86%) for men
  • 0.26% (0.20%-0.35%) for women
• Comorbid substance abuse and comorbid unipolar affective disorder (major depression) significantly increased the risk
• The co-occurrence of deliberate self-harm increased the risk approximately 2-fold
• Men with bipolar disorder and deliberate self-harm had the highest risk (17.08%; 95% CI, 11.19%-26.07%)

The authors concluded:

This is the first analysis of the absolute risk of suicide in a total national cohort of individuals followed up from the first psychiatric contact, and it represents, to our knowledge, the hitherto largest sample with the longest and most complete follow-up. Our estimates are lower than those most often cited, but they are still substantial and indicate the continuous need for prevention of suicide among people with mental disorders.

Nordentoft M, Mortensen PB, Pedersen CB. Absolute risk of suicide after first hospital contact in mental disorder. Arch Gen Psychiatry. 2011 Oct;68(10):1058-64. [PubMed abstract]

If you need help

If you need help and support now and you live in the UK or the Republic of Ireland, please call the Samaritans on 116 123.

If you live elsewhere, we recommend finding a local Crisis Centre on the IASP website.

We also highly recommend that you visit the Connecting with People: Staying Safe resource.