Cause-specific excess mortality in suicidal patients: gender differences in mortality patterns

ObjectiveFew studies have investigated gender-specific excess mortality in suicidal patients. The objective of this study was to examine the risk of dying from all causes of death in male and female suicidal patients.MethodThis study included 4140 patients who received psychiatric treatment in two Austrian hospitals after non-fatal suicidal behavior between 1989 and 2001. Mortality was prospectively assessed for a maximum follow-up period of 17 years (1989–2005). Gender-specific standardized mortality ratios were calculated for all causes of death. Rate ratios were used to assess gender differences.ResultsMales but not females had an elevated risk to die from “natural” causes of death. Mortality from “unnatural” causes of death, particularly suicide, was elevated in both genders. The female suicide risk markedly exceeded the risk for males. In both genders, mortality caused by substance use disorders was considerably elevated.ConclusionSignificant gender differences in the excess mortality of suicidal patients underline the need for gender-specific research in psychiatry.