Over a 5-year period, more than one in 10 suicides in Ontario, Canada, were attributable to individuals with schizophrenia spectrum disorder, research findings revealed.
According to the study, those with schizophrenia who died by suicide tended to be younger, poorer, live in urban areas and have higher rates of mental health service utilization prior to death.
“Individuals with [schizophrenia spectrum disorder] may differ from the general population with respect to suicide risk factors and may require different types of suicide interventions,” Juveria Zaheer, MD, from the Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, and the department of psychiatry, University of Toronto, and colleagues wrote. “There are few studies that systematically compare those who die by suicide in [schizophrenia spectrum disorder] vs. other psychiatric diagnoses.”
The authors compared people with and without schizophrenia, schizoaffective disorder or psychotic disorder not otherwise specified who died by suicide in Ontario, Canada between Jan. 1, 2008 and Dec. 31, 2012 in a retrospective case control study.
Researchers compared demographics, clinical characteristics and health service utilization before suicide among cases and controls. They also performed a secondary analysis to compare the characteristics of those with schizophrenia and those with severe mental illness, defined as those without schizophrenia who were hospitalized at a psychiatric hospital within the 5 years prior to suicide.
Of 5,650 suicides reported between 2008 and 2012, 663 were by people with schizophrenia spectrum disorder. Zaheer and colleagues found that those with schizophrenia spectrum disorder diagnoses comprised 11.7% of all suicide deaths compared to a population prevalence of about 1%.
Suicides committed by people with schizophrenia spectrum disorder accounted for 10.3% of suicides in men and 15.7% of suicides among women, according to the results. Schizophrenia suicides were significantly more likely to occur between the ages of 25 and 34 years. Those in the schizophrenia suicide group were significantly younger, less likely to live in rural areas and more likely to live in low-income areas. These decedents were also significantly more likely to have comorbid mood and personality disorders.
Furthermore, individuals with schizophrenia spectrum disorders were significantly more likely to utilize health services than those without schizophrenia and those who had a history of mental health hospitalization. Specifically, the results showed that they were more likely to have mental health system contact in the 30 days before suicide, visit a primary care provider for mental health reasons or a psychiatrist as an outpatient, go to an ED for mental health reasons and be admitted to hospital for mental health reasons.
“The results indicate that clinicians need to be vigilant about suicide risk in young individuals with schizophrenia spectrum disorder, particularly in major urban areas,” the researchers wrote. “Our results also suggest that there may be opportunities to intervene because many individuals with schizophrenia spectrum disorders who die by suicide have had contact with the health care system, and most frequently with mental health care providers.” – by Savannah Demko
Healio Psychiatry was unable to confirm any relevant financial disclosures at the time of publication.