Suicide accounts for approximately 29,000 deaths each year in the United States. Two different methods of analysis both suggest that at least 5,000 of the individuals who commit suicide have schizophrenia or bipolar disorder at the time of their suicide.

BACKGROUNDER
Updated March 2011

SUMMARY: Suicide accounts for approximately 29,000 deaths each year in the United States. Studies suggest that at least 5,000 of the individuals who commit suicide have schizophrenia or bipolar disorder at the time of their suicide. Other studies indicate that most of these individuals were not receiving adequate psychiatric treatment at the time of their death. Adequate psychiatric treatment could save up to 5,000 lives per year.

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• Estimates of the completed suicide rate for individuals with schizophrenia range from 10 to 13 percent, and for individuals with bipolar disorder the rate is about 15 percent. This rate is at least four times higher than similar studies from the period from 1913 to 1940, suggesting that the suicide rate has risen markedly since deinstitutionalization began.

Caldwell C, Gottesman I. Schizophrenics kill themselves too: a review of risk factors for suicide. Schizophrenia Bulletin 1990;16:571–-589.

Goodwin FK, Jamison KR. Manic-Depressive Illness (New York: Oxford University Press, 1990), p. 230.

Stephens J, Richard P, McHugh PR. Suicide in patients hospitalized for schizophrenia: 1913-1940. Journal of Nervous and Mental Disease 1999;187:10–14.

• One study examined the psychiatric histories in 134 individuals who committed suicide. It reported that 19 percent of these individuals had had symptoms of psychosis (e.g., delusions) in the month preceding their suicide. If this study is representative, then it means that almost one-fifth of all suicides are related to psychoses. Since there are about 29,000 suicides a year in the US, then at least 5,000 of them are psychosis-related.

Robins E. Psychosis and suicide. Biological Psychiatry 1986;21:665–672.

• Several studies have reported that suicide among individuals with serious mental illnesses occur most commonly in individuals who are not taking their medication. For example, a study in Kentucky found that only 2 of 28 individuals with schizophrenia who committed suicide had evidence in their blood of having taken antipsychotic medication. Thus, 93 percent of them were not being treated.

Shields LBE, Hunsaker DM, Hunsaker JC III. Schizophrenia and suicide: a 10-year review of Kentucky Medical Examiner cases. Journal of Forensic Sciences 2007;52:930–937.

• A study of 187 individuals with schizophrenia who attempted or committed suicide reported that "two positive symptoms (suspiciousness and delusions) were more severe among successful suicides," suggesting inadequate treatment.

Fenton W, McGlashan TH, Victor BJ et al. Symptoms, subtype, and suicidality in patients with schizophrenia spectrum disorders. American Journal of Psychiatry 1997;154:199–204.

• Multiple European studies have also reported that the failure to adequately treat individuals with serious mental illnesses increases the risk for suicide.

Gaertner I, Gilot C, Heidrich P et al. A case control study on psychopharmacotherapy before suicide committed by 61 psychiatric inpatients. Pharmacopsychiatry 2002;35: 37–43.

Angst F, Stassen HH, Clayton PJ et al. Mortality of patients with mood disorders: follow-up over 34-38 years. Journal of Affective Disorders 2002;68:167–181.

De Hert M, McKenzie K, Peuskens J. Risk factors for suicide in young people suffering from schizophrenia: a long-term follow-up study. Schizophrenia Research 2001;47:127–134.

Appleby L, Dennehy JA, Thomas CS et al. Aftercare and clinical characteristics of people with mental illness who commit suicide: a case-control study. Lancet 1999;353:1397–1400.

Heilä H, Isometsä ET, Henriksson MM et al. Suicide and schizophrenia: a nationwide psychological autopsy study on age- and sex-specific clinical characteristics of 92 suicide victims with schizophrenia. American Journal of Psychiatry 1997;154:1235–1242.

Nieto E, Vieta E, Gastó C et al. Suicide attempts of high medical seriousness in schizophrenic patients. Comprehensive Psychiatry 1992; 33:384–387.

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