School of Medicine, Nantong University, Nantong, Jiangsu, 226001 PR China.
Affiliated Hospital of Nantong University, Nantong, Jiangsu, 226001 PR China.
Psychol Med. 2023 Jan;53(2):351-361. doi: 10.1017/S0033291721001549. Epub 2021 May 6.
People with serious mental illness are at great risk of suicide, but little is known about the suicide rates among this population. We aimed to quantify the suicide rates among people with serious mental illness (bipolar disorder, major depression, or schizophrenia).
PubMed and Web of Science were searched to identify studies published from 1 January 1975 to 10 December 2020. We assessed English-language studies for the suicide rates among people with serious mental illness. Random-effects meta-analysis was used. Changes in follow-up time and the suicide rates were presented by a locally weighted scatter-plot smoothing (LOESS) curve. Suicide rate ratio was estimated for assessments of difference in suicide rate by sex.
Of 5014 identified studies, 41 were included in this analysis. The pooled suicide rate was 312.8 per 100 000 person-years (95% CI 230.3-406.8). Europe was reported to have the highest pooled suicide rate of 335.2 per 100 000 person-years (95% CI 261.5-417.6). Major depression had the highest suicide rate of 534.3 per 100 000 person-years (95% CI 30.4-1448.7). There is a downward trend in suicide rate estimates over follow-up time. Excess risk of suicide in males was found [1.90 (95% CI 1.60-2.25)]. The most common suicide method was poisoning [21.9 per 100 000 person-years (95% CI 3.7-50.4)].
The suicide rates among people with serious mental illness were high, highlighting the requirements for increasing psychological assessment and monitoring. Further study should focus on region and age differences in suicide among this population.
患有严重精神疾病的人自杀风险极高，但人们对该人群的自杀率知之甚少。本研究旨在量化患有严重精神疾病（双相情感障碍、重度抑郁症或精神分裂症）人群的自杀率。
检索 PubMed 和 Web of Science，以确定 1975 年 1 月 1 日至 2020 年 12 月 10 日期间发表的英语研究。我们评估了严重精神疾病人群自杀率的英文研究。采用随机效应荟萃分析。通过局部加权散点平滑（LOESS）曲线呈现随访时间和自杀率的变化。采用自杀率比值评估不同性别间自杀率的差异。
在 5014 项已识别的研究中，有 41 项被纳入本分析。汇总的自杀率为每 10 万人年 312.8 例（95%CI 230.3-406.8）。据报道，欧洲的汇总自杀率最高，为每 10 万人年 335.2 例（95%CI 261.5-417.6）。重度抑郁症的自杀率最高，为每 10 万人年 534.3 例（95%CI 30.4-1448.7）。随着随访时间的推移，自杀率的估计值呈下降趋势。男性自杀风险增加[1.90（95%CI 1.60-2.25）]。最常见的自杀方法是中毒[每 10 万人年 21.9 例（95%CI 3.7-50.4）]。
患有严重精神疾病的人群的自杀率较高，这突出了加强心理评估和监测的必要性。进一步的研究应侧重于该人群中不同地区和年龄的自杀差异。
