CoChat
Sign Up
Cited by 1,026Suicide and Self-Harm StudiesSchizophrenia research and treatmentMental Health and Psychiatry

The Lifetime Risk of Suicide in Schizophrenia: A Reexamination

Palmer, Brian A., Pankratz, V. Shane, Bostwick, John Michael·2005·Archives of General Psychiatry
DOI 10.1001/archpsyc.62.3.247
Open this paper in CoChat — free account

Abstract

BACKGROUND: The psychiatry literature routinely quotes a lifetime schizophrenia suicide prevalence of 10% based on 1 meta-analysis and 2 studies of chronic schizophrenics. OBJECTIVES: To build a methodology for extrapolating lifetime suicide prevalence estimates from published cohorts and to apply this approach to studies that meet inclusion criteria. DATA SOURCES: We began with a MEDLINE search (1966-present) for articles that observed cohorts of schizophrenic patients. Exhaustive bibliography searching of each identified article brought the total number of articles reviewed to 632. STUDY SELECTION: Studies included in the meta-analysis observed a cohort of schizophrenic patients for at least 2 years, with at least 90% follow-up, and reported suicides. Articles are excluded for systematic age bias (ie, adolescents). DATA EXTRACTION: Extracted data included sample size, number of deaths, number of suicides, percentage of follow-up, and diagnostic system used. Data were extracted independently by 2 of us, and differences were resolved by consensus after re-review. DATA SYNTHESIS: Studies were divided into 2 groups: 32 studies of schizophrenics enrolled at various illness points (25 578 subjects) and 29 studies of schizophrenics identified at either illness onset or first admission (22 598 subjects). Regression models of the intersection of proportionate mortality (the percentage of the dead who died by suicide) and case fatality (the percentage of the total sample who died by suicide) were used to calculate suicide risk in each group. The estimate of lifetime suicide prevalence in those observed from first admission or illness onset was 5.6% (95% confidence interval, 3.7%-8.5%). Mixed samples showed a rate of 1.8% (95% confidence interval, 1.4%-2.3%). Case fatality rates showed no significant differences when studies of patients diagnosed with the use of newer systems were compared with studies of patients diagnosed under older criteria. CONCLUSION: This study estimates that 4.9% of schizophrenics will commit suicide during their lifetimes, usually near illness onset.

Integrity signals

Registry

Crossref · 10.1001/archpsyc.62.3.247

Cites

78 of 78 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

We couldn’t retrieve this paper’s full text, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Meta-analyses that were based on more sophisticated statistical methods and included large long-term follow-up studies found lower figures.

    “Meta-analyses that were based on more sophisticated statistical methods and included large long-term follow-up studies found lower figures (Bostwick & Pankratz 2000, Inskip et al. 1998, Palmer et al. 2005).”

    From Excess early mortality in schizophrenia. (2014) · cites this paper as Palmer et al. 2005

  • Palmer and colleagues (2005) estimated the lifetime risk to be 5.6% for schizophrenia.

    “Inskip et al. (1998) estimated the lifetime risk to be 6% for affective disorder, 7% for alcohol dependence, and 4% for schizophrenia, whereas Palmer and colleagues (2005) estimated the lifetime risk to be 5.6% for schizophrenia.”

    From Excess early mortality in schizophrenia. (2014) · cites this paper as Palmer et al. 2005

Cites

Flagged first, then by citations

1 of the 79 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Related

Authors
Palmer, B. A., Pankratz, V. S., & Bostwick, J. M.
Affiliations
Mayo Clinic (US)
ORCID
Venue
Archives of General Psychiatry
Publisher
American Medical Association (AMA)
Published
2005-03-01
Volume
62
Issue
3
Pages
247
ISSN
0003-990X (ISSN-L)
DOI
10.1001/archpsyc.62.3.247
OpenAlex
W1989405621
Cited by
1,026
References
79
Citations by year
2026: 35 · 2025: 39 · 2024: 30 · 2023: 31 · 2022: 39 · 2021: 66 · 2020: 71 · 2019: 54 · 2018: 57 · 2017: 57 · 2016: 56 · 2015: 52 · 2014: 54 · 2013: 52 · 2012: 61
FWCI
36.65
Type
journal article
Language
en
Open access
closed
Locations
  • Archives of General Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
Keywords
schizophrenia, suicide, suicide prevalence, case fatality, disease onset, diagnostic criteria
MeSH terms
Cause of Death, Cross-Cultural Comparison, Follow-Up Studies, Hospitalization, Humans, Regression Analysis, Risk Factors, Schizophrenia, Schizophrenic Psychology, Suicide, Cohort Studies, Prevalence, Confidence Intervals, Odds Ratio, Hospital Mortality, Age of Onset, Nonlinear Dynamics

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review