The DOI matches its Crossref record; 78 of the 79 references it cites were found in a registry or an index.
The Lifetime Risk of Suicide in Schizophrenia: A Reexamination
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.
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“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
In the citing paper
“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
Citations
Cites
Everitt, B. S. (2001) · Psychology Press eBooks · doi:10.4324/9781410605542-11 · Cited by 6,877
Diagnostic criteria for use in psychiatric research.
Feighner, J. P., Robins, E., Guze, S. B., Woodruff, R. A., Winokur, G., & Munoz, R. A. (1972) · Archives of General Psychiatry · doi:10.1001/archpsyc.1972.01750190059011 · Cited by 5,491
Dementia Praecox or the Group of Schizophrenias
(1951) · Journal of the American Medical Association · doi:10.1001/jama.1951.02920270079043 · Cited by 4,407
Everitt, B. (1998) · British Journal of Psychiatry · doi:10.1192/bjp.172.1.7 · Cited by 4,331
Suicide as an outcome for mental disorders: A meta-analysis
Harris, E. C., & Barraclough, B. (1997) · British Journal of Psychiatry · doi:10.1192/bjp.170.3.205 · Cited by 2,589
International Classification of Diseases, Ninth Revision
National Cancer Institute (2020) · Definitions · doi:10.32388/bd1nux · Cited by 891
Affective disorders and suicide risk: a reexamination
Bostwick, J. M., & Pankratz, V. S. (2000) · American Journal of Psychiatry · doi:10.1176/appi.ajp.157.12.1925 · Cited by 878
Self-citationExcess mortality of schizophrenia: A meta-analysis
Brown, S. (1997) · British Journal of Psychiatry · doi:10.1192/bjp.171.6.502 · Cited by 869
Prediction of Suicide in Psychiatric Patients
Pokorny, A. D. (1983) · Archives of General Psychiatry · doi:10.1001/archpsyc.1983.01790030019002 · Cited by 749
Mortality and causes of death in schizophrenia in Stockholm County, Sweden
Ösby, U., Correia, N., Brandt, L., Ekbom, A., & Sparén, P. (2000) · Schizophrenia Research · doi:10.1016/s0920-9964(99)00191-7 · Cited by 679
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1 of the 79 references couldn’t be matched to a known paper.
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The interpersonal theory of suicide.
Van Orden, K. A., Witte, T. K., Cukrowicz, K. C., Braithwaite, S. R., Selby, E. A., & Joiner, T. E. (2010) · Psychological Review · doi:10.1037/a0018697 · Cited by 5,292
“, 2003); however, the vast majority of those with mental disorders, including disorders with the highest suicide rates, will not attempt or die by suicide, though many will think about suicide (Bostwick & Pankratz, 2000; Hawton, Sutton, Haw, Sinclair, & Harriss, 2005; Herzog et al., 2000; Palmer et al., 2005).”
BackgroundSchizophrenia: A Concise Overview of Incidence, Prevalence, and Mortality
McGrath, J., Saha, S., Chant, D., & Welham, J. (2008) · Epidemiologic Reviews · doi:10.1093/epirev/mxn001 · Cited by 2,280
Saha, S., Chant, D., & McGrath, J. (2007) · Archives of General Psychiatry · doi:10.1001/archpsyc.64.10.1123 · Cited by 2,065
(2009) · Cited by 2,013
Hawton, K., & van Heeringen, K. (2009) · The Lancet · doi:10.1016/s0140-6736(09)60372-x · Cited by 1,671
Metadata
- Authors
- Palmer, B. A., Pankratz, V. S., & Bostwick, J. M.
- Affiliations
- Mayo Clinic (US)
- 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)
- 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
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