Predictors of suicide at time of diagnosis in schizophrenia spectrum disorder: A 20-year total population study in Ontario, Canada.

Autor: Zaheer J; Health Outcomes and Performance Evaluation (HOPE) Research Unit, Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Centre for Addiction and Mental Health, Canada. Electronic address: juveria.zaheer@camh.ca., Olfson M; New York State Psychiatric Institute, United States; Columbia University, New York, NY, United States., Mallia E; Health Outcomes and Performance Evaluation (HOPE) Research Unit, Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Canada; Centre for Addiction and Mental Health, Canada; Mental Health and Addictions Research Program, Institute for Clinical Evaluative Sciences (ICES), Canada., Lam JSH; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Centre for Addiction and Mental Health, Canada., de Oliveira C; Health Outcomes and Performance Evaluation (HOPE) Research Unit, Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Canada; ICES, Toronto, Ontario, Canada; Institute for Health Policy, Management and Evaluation (IHPME), University of Toronto, Canada; Centre for Health Economics, University of York, York, England., Rudoler D; ICES, Toronto, Ontario, Canada; Institute for Health Policy, Management and Evaluation (IHPME), University of Toronto, Canada; University of Ontario Institute of Technology, Ontario, Canada; Centre for Addiction and Mental Health, Canada., Carvalho AF; Centre for Addiction and Mental Health, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada., Jacob BJ; University Health Network, Toronto, Ontario, Canada., Juda A; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada., Kurdyak P; Health Outcomes and Performance Evaluation (HOPE) Research Unit, Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Institute for Health Policy, Management and Evaluation (IHPME), University of Toronto, Canada; Mental Health and Addictions Research Program, Institute for Clinical Evaluative Sciences (ICES), Canada.
Jazyk: angličtina
Zdroj: Schizophrenia research [Schizophr Res] 2020 Aug; Vol. 222, pp. 382-388. Date of Electronic Publication: 2020 Jun 02.
DOI: 10.1016/j.schres.2020.04.025
Abstrakt: Background: Suicide is a major cause of mortality for individuals with schizophrenia spectrum disorders (SSD). Understanding the risk factors for suicide at time of diagnosis can aid clinicians in identifying people at risk.
Methods: Records from linked administrative health databases in Ontario, Canada were used to identify individuals aged 16 through 45 years who received a first lifetime diagnosis of SSD (schizophrenia, schizoaffective disorder, psychotic disorder not otherwise specified (NOS)) using a validated algorithm between 01/01/1993 and 12/31/2010. The main outcome was death by suicide following cohort entry until 12/31/2012.
Outcomes: 75,989 individuals with a first SSD diagnosis (60.1% male, 39.9% female) were followed for an average of 9.56 years. During this period, 1.71% of the total sample (72.1% male, 27.9% female) died by suicide, after an average of 4.32 years. Predictors of suicide death included male sex (HR 2.00, 95% CI 1.76-2.27), age at diagnosis between 26 and 35 (HR 1.27, 95% CI 1.10-1.45) or 36-45 (HR 1.34, 95% CI 1.16-1.54), relative to 16-25, and suicide attempt (HR 2.23, 95% CI 1.86-2.66), drug use disorder (HR 1.21, 95% CI 1.04-1.41), mood disorder diagnosis (HR 1.32, 95% CI 1.17-1.50), or mental health hospitalization (HR 1.30 95% CI 1.13-1.49) in the 2 years prior to SSD diagnosis.
Interpretation: Death by suicide occurs in 1 out of every 58 individuals and occurred early following first diagnosis of SSD. Psychiatric hospitalizations, mood disorder diagnoses, suicide attempts prior to SSD diagnosis, as well as a later age at first diagnosis, are all predictors of suicide and should be integrated into clinical assessment of suicide risk in this population.
Competing Interests: Declaration of competing interest The authors do not have any conflicts of interest to declare.
(Copyright © 2020 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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