Suicide attempts at the time of first admission and during early course schizophrenia: A population based study

This article examined suicide attempt rates at first psychiatric hospitalization and risk factors for subsequent suicide attempts over the early course of schizophrenia in national population-based data. Data were extracted from the National Psychiatric Hospitalization Case Registry of the State of Israel that contains all first psychiatric admissions with schizophrenia 1989-1992 and were followed up to 1996 (N = 2293). Attempted suicide rates were: 8.5% (n = 196) at the time of first psychiatric hospitalization and 6.6% (n = 151) over the follow-up period of 4 to 7 years. 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). Risk profiles were derived using recursive partitioning to predict sub-groups at risk of a subsequent suicide attempt. Those characterized by an attempt at the time of first admission were college educated, female and not married (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. Suicide attempts at first admission and premorbid years of education have long-term prognostic utility and risk profiles are available.