BMJ, doi: 10.1136/bmj.38133.622488.63, (Published 22 June 2004)

PAPERS

Change in suicide rates for patients with schizophrenia in Denmark, 1981-97: nested case-control study

Merete Nordentoft ¹, Thomas Munk Laursen ², Esben Agerbo ², Ping Qin ², Eyd Hansen Høyer ², Preben Bo Mortensen ²

¹ Bispebjerg Hospital, Department of Psychiatry, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark
² National Center for Register-based Research, University of Aarhus, Taasingegade 1, DK-8200 Aarhus N, Denmark

Objective To study the change in risk of suicide among patients with schizophrenia and related disorders.

Design Nested case-control design with linked data.

Setting 4 longitudinal Danish registers.

Participants 18 744 people aged up to 75 years who committed suicide in 1981-97 individually matched with 20 controls.

Results Over the time studied the reduction in suicide rate among patients with schizophrenia and schizophrenia spectrum disorder was similar to that seen in the general population (incidence rate ratio 1.00, 95% confidence interval 0.98 to 1.03). The reduction among patients with other psychosis in the schizophrenia spectrum was faster than the reduction seen in the general population. Among people admitted to hospital with schizophrenia the risk of suicide was highest in the first year after first admission, and the excess risk was largest in the younger age groups--that is, the risk decreased per year for every additional year of age.

Conclusion The suicide rate among patients with a diagnosis of schizophrenia and related disorders has fallen. This may be due to by better psychiatric treatment, reduced access to means of suicide, or improvements in treatment after suicide attempts.

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(Accepted 6 May 2004)
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