Ahti Johan, Haaki Willehard, Kieseppä Tuula, Suvisaari Jaana, Niemelä Solja, Suokas Kimmo, Torniainen-Holm Minna, Wegelius Asko, Kampman Olli, Lähteenvuo Markku, Paunio Tiina, Tiihonen Jari, Hietala Jarmo, Isometsä Erkki T
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Department of Psychiatry, https://ror.org/05vghhr25University of Turku, Turku, Finland.
Eur Psychiatry. 2025 Jul 17;68(1):e99. doi: 10.1192/j.eurpsy.2025.10066.
Psychotic disorders, including schizophrenia (SZ), schizoaffective disorder (SZA), bipolar disorder (BD), psychotic depression (PD), and other nonaffective psychoses (ONAP), are associated with increased risk of suicidal acts. Few studies have compared suicidal act prevalence across psychotic disorders using both self-report and register data. The impact of hospitalization duration on subsequent suicidal acts is unclear.
We used data from the SUPER-Finland study, involving 7067 participants with register-based ICD-10 diagnoses of psychotic disorders (SZ, SZA, BD, PD, ONAP). Lifetime suicidal acts were identified through self-report and register-based records of intentional self-harm events requiring medical treatment. Associations between diagnostic categories and suicidal acts were assessed using logistic regression, adjusted for sex, duration of illness, socioeconomic status, childhood abuse, and substance use. Survival analysis was used to examine the impact of hospital stay length on postdischarge self-harm.
Lifetime suicide attempts (39.1%) and register self-harm (19.3%) were prevalent. of those with self-reported suicide attempts, 40.5% also had register-based self-harm. Self-harm and suicide attempts were significantly more prevalent in SZA, BD, and PD compared to schizophrenia, with large differences between groups (24.1-46.4% for suicide attempts, 11.1-23.9% for self-harm). Adjusted odds of self-harm were higher for disorders with a mood component. Shorter hospitalizations were associated with an elevated hazard ratio for subsequent self-harm.
Prevalence of register-based self-harm and self-reported suicide attempts differ markedly. Suicidal acts are common in psychotic disorders, particularly in those with a mood component. Very short inpatient stays may not be adequate in these disorders.
包括精神分裂症（SZ）、分裂情感性障碍（SZA）、双相情感障碍（BD）、伴有精神病性症状的抑郁症（PD）以及其他非情感性精神病（ONAP）在内的精神病性障碍与自杀行为风险增加相关。很少有研究使用自我报告和登记数据来比较不同精神病性障碍的自杀行为患病率。住院时间对后续自杀行为的影响尚不清楚。
我们使用了来自芬兰超级研究的数据，该研究涉及7067名基于国际疾病分类第十版（ICD - 10）诊断为精神病性障碍（SZ、SZA、BD、PD、ONAP）的参与者。通过自我报告和基于登记的需要医疗救治的故意自伤事件记录来确定终生自杀行为。使用逻辑回归评估诊断类别与自杀行为之间的关联，并对性别、病程、社会经济地位、童年期虐待和物质使用情况进行了调整。生存分析用于检验住院时间长短对出院后自伤的影响。
终生自杀未遂（39.1%）和登记的自伤行为（19.3%）很普遍。在那些自我报告有自杀未遂的人中，40.5%也有基于登记的自伤行为。与精神分裂症相比，自伤和自杀未遂在SZA、BD和PD中更为普遍，组间差异很大（自杀未遂为24.1 - 46.4%，自伤为11.1 - 23.9%）。伴有情绪成分的障碍经调整后的自伤几率更高。较短的住院时间与后续自伤的风险比升高相关。
基于登记的自伤行为和自我报告的自杀未遂患病率有显著差异。自杀行为在精神病性障碍中很常见，尤其是在伴有情绪成分的障碍中。在这些障碍中，非常短的住院时间可能并不足够。
