Fewer Typical Suicide Factors Observed After Recent Schizophrenia Diagnosis

Individuals who died by suicide after recent schizophrenia diagnosis have fewer social and behavioral factors typically associated with suicide, according to results of a study published in Schizophrenia Bulletin.

Around 10% of individuals diagnosed with schizophrenia or other primary psychotic disorders attempt suicide within a year of their diagnosis.

Investigators from the University of Manchester conducted this observational post hoc analysis using data from the National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH). Decedents (n=2828) with schizophrenia who died by suicide between 2008 and 2021 and had contact with mental health services in the year before their death were evaluated for sociodemographic and clinical characteristics. Trends were compared between individuals diagnosed with schizophrenia within a year of their death (n=288) and those diagnosed more than a year before their death (n=2475).

The decedents diagnosed within a year or more than a year before their death were aged median 37 (range, 15-88) and 43 (range, 16-91) years and 19% and 17% were an ethnic minority, respectively. Both groups were made up of 75% men or boys.

In the univariate analysis, a recent diagnosis of schizophrenia was more common among younger individuals, those with comorbid affective disorder, an inpatient discharge in the last 3 months, under Crisis Resolution/Home Treatment (CRHT) services, in contact with services within 7 days of death, and those who died by hanging.

A recent diagnosis was less common among individuals aged 45 to 54 years, who were unemployed, on long-term sick leave, unmarried, living alone, with a history of self-harm, history of violence, history of alcohol misuse, and who died by self-poisoning (all P £.001).

In the multivariate analysis, decedents with a recent diagnosis of schizophrenia were more likely to be under CRHT services (adjusted odds ratio [aOR], 2.57; 95% CI, 1.69-3.90; P <.001) and discharged from inpatient care within 3 months of death (aOR, 2.16; 95% CI, 1.48-3.14; P <.001) but less likely to be aged 45 to 64 years (aOR, 0.63; 95% CI, 0.21-0.62; P <.001), have a history of self-harm (aOR, 0.55; 95% CI, 0.40-0.77; P <.001), to live alone (aOR, 0.51; 95% CI, 0.35-0.73; P <.001), to be unemployed (aOR, 0.34; 95% CI, 0.21-0.50; P <.001), and to be on long-term sick leave (aOR, 0.23; 95% CI, 0.013-0.43; P <.001) than decedents without a recent diagnosis.

The study authors concluded, “This study highlights how common established characteristics of suicide can vary at different stages of illness and…direct clinical focus to where care and suicide prevention efforts can be improved.”

This study was limited by only having categorical information about schizophrenia diagnosis timing and the fact that clinical information about suicide was retrospectively collected.

Disclosure: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

This article originally appeared on Psychiatry Advisor