SUICIDE AS AN OUTCOME FOR MENTAL-DISORDERS - A METAANALYSIS

Background Mental disorders have a strong association with suicide. Th is metaanalysis, or statistical overview, of the literature gives an e stimate of the suicide risk of the common mental disorders. Method We searched the medical literature to find reports on the mortality of me ntal disorders. English language reports were located on MEDUNE (1966- 1993) with the search terms 'mental disorders','brain injury', 'eating disorders', 'epilepsy','suicide attempt','psychosurgery', with 'morta lity' and 'follow-up studies', and from the reference lists of these r eports. We abstracted 249 reports with two years or more follow-up and less than 10% loss of subjects, and compared observed numbers of suic ides with those expected. A standardised mortality ratio (SMR) was cal culated for each disorder. Results Of 44 disorders considered, 36 have a significantly raised SMR for suicide, live have a raised SMR which fails to reach significance, one SMR is not raised and for two entries the SMR could not be calculated. Conclusions If these results can be generalised then virtually all mental disorders have an increased risk of suicide excepting mental retardation and dementia. The suicide ris k is highest for functional and lowest for organic disorders with subs tance misuse disorders lying between. However, within these broad grou pings the suicide risk varies widely.