The suicide rate among people with schizophrenia spectrum disorders is 170 times higher than in the general population, according to a study published online in the journal Schizophrenia Research. Researchers described the figure as “tragically high.”
“In the past, clinicians have focused on treating the psychosis itself when it first appears,” said senior author Paul Kurdyak, MD, PhD, of the Centre for Addiction and Mental Health in Toronto, Canada. “This study shows that treatment has to include suicide prevention safety planning as well from the very beginning.”
The study included nearly 76,000 people who received a first diagnosis of a schizophrenia spectrum disorder — schizophrenia, schizoaffective disorder, or psychotic disorder not otherwise specified. Participants were followed, on average, for approximately a decade. During that time, 1.71% of the study population died by suicide, after an average 4.32 years, researchers found.
The study identified several predictors of suicide in people with schizophrenia spectrum disorders, including male sex, diagnosis of the schizophrenia spectrum disorder at a later age, and a mood disorder diagnosis, drug use disorder, suicide attempt, or mental health hospitalization 2 years prior to schizophrenia spectrum disorder diagnosis.
“What this study teaches us is that although people with schizophrenia spectrum disorders are at higher risk for suicide, we can target those at the highest risk with changes in policy and treatment,” said lead author Juveria Zaheer, MD, of the Centre for Addiction and Mental Health.
Overall, 1 out of every 58 participants died by suicide after a schizophrenia spectrum disorder diagnosis, according to the study.
“Psychiatric hospitalizations, mood disorder diagnoses, suicide attempts prior to schizophrenia spectrum disorder 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,” researchers concluded.
Zaheer J, Olfson M, Mallia E, et al. Predictors of suicide at time of diagnosis in schizophrenia spectrum disorder: a 20-year total population study in Ontario, Canada. Schizophrenia Research. 2020 June 2;[Epub ahead of print].