Mental Disorders and Long – Term Suicide Risk

A Swedish study found that people without mental disorders had a very low long-term risk of suicide (0.3 percent) compared to people with one or more mental disorders, whose long-term risk of suicide is 3.4 percent. The presence of more than one mental disorder increased the long-term risk of suicide to 6.2 percent even if the diagnoses of the disorders were separated by a long period of time. Among people who died by suicide and had two or more disorders, the average time between diagnoses was ten years. The authors reported that since their study followed samples for 50 years, and the average age of suicide was fairly high (55-60 years for those with a disorder; 69 for those without) this long-term risk probably approaches lifetime risk.

The disorders with the highest long-term risk of suicide were depression (6.0 percent), alcohol use disorder (4.7 percent), and psychosis (3.1 percent). The presence of a second disorder raised the risk to 6.6 percent, 9.4 percent, and 10.4 percent, respectively. A combination of alcohol use disorder and depression in men produced a long-term suicide risk of 16.2 percent. Depression also raised the risk of women, although suicide risk was much higher among depressed men than depressed women.

It was not possible to estimate the combined risk of depression and alcohol abuse disorder on women because the sample included a very small number of women with alcohol abuse disorder who died by suicide. Neither was it possible to determine if people with three disorders were more at risk for suicide than people with two disorders, given the small number of people with more than two diagnoses.

This summary is based on: Holmstrand, C., Bogren, M., Mattisson, C., & Bradvik, L. (2015). Long-term suicide risk in no, one, or more mental disorders: the Lundby Study 1947-1997. Acta Psychiatrica Scandinavica, 132, 459-469.