Background: Early schizophrenia is a period of increased suicide
risk, yet past research does not use national population based data
to examine the extent of suicide attempts in first admission
schizophrenia and risk factors associated with subsequent suicide
attempts. This study aims to examine suicide attempt rates at time
of first admission and risk factors for subsequent suicide attempts
over the early course of illness in national population-based data.
Methods: All first admissions for schizophrenia in a national
population based Israeli cohort from 1989 to 1992 were followed
through 1996 (n= 2293). The data were from the National
Psychiatric Hospitalization Case Registry of the State of Israel, a
complete national registry of psychiatric admissions that includes
suicide attempt data prior to admission.
Results: Attempted suicide rates were: 8.5% (n= 196) at the time of
first admission and 6.6% (n= 151) over the follow-up period. Of
those with a suicide attempt at first admission, 31.6% (n= 62) made
a subsequent suicide attempt during the follow-up period
(OR= 10.44, 95% CIs= 7.22 to 15.09). Binary logistic regression
modeling showed that protective factors of subsequent attempts
included being female, aged 36 to 40 at time of first hospitalization,
completion of more formal education, whereas a suicide attempt at
first hospitalization increased risk ten-fold. Risk profiles from
recursive partitioning were derived to predict sub-groups of
patients at risk of a subsequent suicide attempt. For example, those
characterized by an attempt at time of first admission, college
educated, female and not married were at salient risk (45.9% (17/
37), OR= 13.46, 95% CIs= 6.89 to 26.3). The risk profiles together
correctly classified 90.7% (137/151) of subsequent suicide attempts.
Discussion: Suicide attempts at time of first admission and
premorbid years of education have long-term prognostic utility
and risk profiles are available.
|Conference||Abstracts of the 2nd Biennial Schizophrenia International|
|Period||10/04/10 → 14/04/10|