People with psychotic disorders, such as schizophrenia or bipolar disorder, are 12 times more likely to commit suicide than average, according to research released today by King's Health Partners.
The research found that the rate of suicide was highest in the first year following diagnosis (12 times national average) and that high risk persisted – remaining four times greater than the general population ten years after diagnosis, a time when there may be less intense clinical monitoring of risk.
Neither the risk of suicide nor the long-term risk of suicide, as compared to the general population, have been studied and measured in this way before. And the findings show that doctors must always remain vigilant when assessing a patient's risk of suicide regardless of time since first diagnosis.
A key aim of the study was to challenge the widely held view that "10-15% of people suffering psychotic disorders are likely to commit suicide"¹. This study shows that these figures, largely derived from research in the 1970s, are misleading as they use crude measurement techniques² and do not accurately measure risk over a lifetime. Today's findings indicate a lower overall risk, but more persistent danger of suicide among this patient group over a lifetime.
Dr Rina Dutta, MRC Research Fellow and Honorary Consultant Psychiatrist, King's Health Partners, said: "It's well known that people who commit suicide often suffer serious mental health problems, but it's surprising that the risk they face remains so high ten years or more after first diagnosis. Putting a figure on it like this helps doctors to understand the extent of risk some of their patients face."
The research studied a group of almost 3,000 patients in the UK (London, Nottingham and Dumfries and Galloway) who suffered their first psychotic illness between 1965 and 2004. The patients were traced after an average follow-up time of 11.5 years and their death certificates were analysed.
People with psychotic disorders experience disturbed thoughts, feelings, mood and behaviours. Psychotic conditions tend to strike when people are young and affect one in 50 of the UK population.
King's Health Partners (KHP) is a major collaboration between three of the country's most successful NHS Foundation Trusts - Guy's and St Thomas', King's College Hospital and South London and Maudsley, and one of the world's leading research universities, King's College London.
KHP is one of only five Academic Health Science Centres (AHSC) in the UK. The objective of AHSCs is to break down barriers so that world-class research finds its way more swiftly, effectively and systematically to improve healthcare services for patients. Currently, research findings tend to take a long time to trickle down to benefit patients.
Reassessing the Long-term Risk of Suicide after a First Episode of Psychosis is published in the US journal Archives of General Psychiatry on Monday 6 December 2010.
This study was funded by the Medical Research Council, London, UK, as well as by grants from the British Medical Association, Psychiatry Research Trust, London, UK and the Chief Scientist Office, Scottish Government.
Archives of General Psychiatry