Incidence rate of suicidal behavior stratified by diagnosis among high-risk patients

Abstract

BackgroundPsychiatric diagnoses are known to increase suicide risk, but whether this risk varies across specific disorders remains unclear. Previous studies have often relied on retrospective designs or population-based databases, limiting comparability due to heterogeneous methodologies and follow-up periods. AimsThis study aimed to compare the incidence rates of unfavorable events (suicide or suicide attempts) among high-risk patients with Major Depressive Disorder (MDD), Bipolar Disorder (BD), and Schizophrenia over a 24-month follow-up period. MethodsThis secondary analysis was conducted as part of a multicenter prospective cohort study involving 324 patients admitted to emergency departments for suicidal ideation or a recent suicide attempt. Clinical evaluations were performed at baseline and every six months to assess for unfavorable events. Additionally, Kaplan-Meier curves were estimated for each diagnosis, and Cox regression models were used to evaluate whether the diagnosis is associated with unfavorable events, adjusted for covariates such as age, history of childhood sexual abuse, and number of previous suicide attempts. ResultsThe incidence rates of suicide attempts were 27,000, 20,400, and 21,100 per 100,000 person-years for patients with MDD, BD, and Schizophrenia, respectively, while suicide rates were 1,600 per 100,000 person-years across all groups. No statistically significant differences were found in the risk of unfavorable events among diagnostic groups (p = 0.653), as confirmed by Kaplan-Meier survival analysis and Cox regression models. ConclusionsOver a 2-year follow-up, psychiatric diagnosis alone did not predict significant differences in unfavorable events rates. Comprehensive suicide risk assessments should prioritize individual risk profiles over diagnostic categories. These findings underscore the importance of integrating biopsychosocial factors in suicide prevention strategies for high-risk psychiatric populations.