Leo Sher, M.D.

A research work, “Suicide methods and severe mental illness” has been published in Acta Psychiatrica Scandinavica online ahead of print (1). The aim of this systematic review was to pool the odds of people with severe mental illness (SMI) who die by suicide versus those with no SMI, stratified by suicide method.

The authors conducted searches in December 2023 using PubMed, PsycInfo, CINAHL, and Embase. Eligible studies were those that reported suicide deaths stratified by SMI and suicide methods. After screening, 12 studies were included (n = 380,523).

Among people with all diagnoses of SMI, dying by firearms was the most prevalent (16.24%), followed by drug overdose (15.51%), and hanging (15.14%). Among people with schizophrenia, dying by drug overdose was the most prevalent (16.86%), followed by poisoning (16.71%), and firearms (16.13%). Among people with bipolar disorder, dying by shooting was the most prevalent (17.63%), followed by poisoning (17.46%), and hanging (17.29%). Among people with major depressive disorder, dying by gaseous poisoning was the most prevalent (21.07%), followed by hanging (16.23%), and firearms (16.18%).

Compared with those with no SMI, people with schizophrenia had 3.38 times higher odds of jumping from heights and 1.93 times higher odds of drowning. People with bipolar disorder had 3.2 times higher odds of jumping from heights. People with major depression had 3.11 times higher odds of drug overdose and 2.11 times higher odds of jumping from heights, However, individuals with major depression had 2.33 times lower odds of dying by firearms in comparison with people without SMI.

This study shows that the prevalence of suicide methods differs by diagnosis of severe mental illness, The results of this study suggest that individual, clinical, community and public health interventions for people with SMI should prioritize means restriction including access to guns, heights, or drugs to overdose.

Reference

1. Trott M, Suetani S, Arnautovska U, Kisely S, Kar Ray M, Theodoros T, Le V, Leske S, Lu M, Soole R, Warren N, Siskind D. Suicide methods and severe mental illness: A systematic review and meta-analysis. Acta Psychiatr Scand. 2024 Oct 1. doi: 10.1111/acps.13759. Epub ahead of print.