TY  - JOUR
T1  - ABsolute risk of suicide after first hospital contact in mental disorder
AU  - Nordentoft M, Mortensen P, Pedersen C
Y1  - 2011/10/01
N1  - 10.1001/archgenpsychiatry.2011.113
JO  - Archives of General Psychiatry
SP  - 1058
EP  - 1064
VL  - 68
IS  - 10
N2  - Context 
                  Estimates of lifetime risk of suicide in mental disorders were based on selected samples with incomplete follow-up.Objective 
                  To estimate, in a national cohort, the absolute risk of suicide within 36 years after the first psychiatric contact.Design 
                  Prospective study of incident cases followed up for as long as 36 years. Median follow-up was 18 years.Setting 
                  Individual data drawn from Danish longitudinal registers.Participants 
                  A total of 176 347 persons born from January 1, 1955, through December 31, 1991, were followed up from their first contact with secondary mental health services after 15 years of age until death, emigration, disappearance, or the end of 2006. For each participant, 5 matched control individuals were included.Main Outcome Measures 
                  Absolute risk of suicide in percentage of individuals up to 36 years after the first contact.Results 
                  Among 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 (6.67%; 5.72%-7.78%) and schizophrenia (6.55%; 5.85%-7.34%). Among 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 nonpsychiatric population, the risk was 0.72% (95% CI, 0.61%-0.86%) for men and 0.26% (0.20%-0.35%) for women. Comorbid substance abuse and comorbid unipolar affective disorder 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%).Conclusions 
                  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.
SN  - 0003-990X
M3  - doi: 10.1001/archgenpsychiatry.2011.113
UR  - http://dx.doi.org/10.1001/archgenpsychiatry.2011.113
ER  -