PREVALENCE AND COMORBIDITY OF MENTAL-DISORDERS IN PERSONS MAKING SERIOUS SUICIDE ATTEMPTS - A CASE-CONTROL STUDY

Objective: The aim of this study was to compare the prevalence and com orbidity patterns of psychiatric disorders in subjects making medicall y serious suicide attempts and in comparison subjects. Method: The ass ociation between mental disorders and the risk of a suicide attempt wa s examined in 302 consecutive individuals who made serious suicide att empts and 1,028 randomly selected comparison subjects. Each subject co mpleted a semistructured interview, and a significant other underwent a parallel interview; best-estimate DSM-III-R diagnoses were then gene rated. Results: Of those who made serious suicide attempts, 90.1% had a mental disorder at the time of the attempt. Multiple logistic regres sion showed that those who mane suicide attempts had high rates of moo d disorders (odds ratio=33.4, 95% confidence interval=21.9-51.2); subs tance use disorders (odds ratio=2.6, 95% confidence interval=1.6-4.3); conduct disorder or antisocial personality disorder (odds ratio=3.7, 95% confidence interval=2.1-6.5); and nonaffective psychosis (odds rat io=16.8, 95% confidence interval=2.7-105.8). The relationship between psychiatric morbidity and suicide risk varied with age and gender. The incidence of comorbidity was high: 56.6% of those who made serious su icide attempts had two or more disorders. The risk of a suicide attemp t increased with increasing psychiatric morbidity: subjects with two o r more disorders had odds of serious suicide attempts that were 89.7 t imes the odds of those with no psychiatric disorder. Conclusions: Indi viduals who made serious suicide attempts had high rates of mental dis orders and of comorbid disorders. Subjects with high levels of psychia tric comorbidity had markedly high risks of serious suicide attempts.