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Suicide Risk Assessment and Risk of Suicide in Schizophrenia
Matthew M. Large, M.B.B.S., F.R.A.N.Z.C.P.; Christopher J. Ryan, M.B.B.S., F.R.A.N.Z.C.P.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201300545
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Dr. Large is with the Department of Mental Health Services, Prince of Wales Hospital, and with the School of Psychiatry, University of New South Wales, Sydney, Australia. Dr. Ryan is with the Discipline of Psychiatry and the Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, Australia.

Copyright © 2014 by the American Psychiatric Association


To the Editor: In the February issue, Pedersen and associates (1) reported that between 2005 and 2009, a steadily increasing proportion of patients with schizophrenia had received a suicide risk assessment at the point of discharge from Danish psychiatric hospitals. The authors also reported that 64 of 7,107 (.9%) discharged patients with schizophrenia died as a result of suicide during the following year. This second statistic suggests that patients with schizophrenia are approximately 80 times more likely to die by suicide than the general Danish population, for which the suicide rate is approximately 11.6 suicides per 100,000 per year (2). An understanding of the potential utility of risk assessment and the difference between absolute and relative risk suggests that the steady increase in risk assessment reported in Denmark represents the outcome of misguided policy.

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Pedersen  GC;  Wallenstein Jensen  SO;  Gradus  J  et al:  Systematic suicide risk assessment for patients with schizophrenia: a national population-based study.  Psychiatric Services 65:226–231, 2014
[CrossRef] | [PubMed]
Suicide rates (per 100,000), by gender, Denmark, 1950–2006.  Geneva,  World Health Organization, 2005. Available at www.who.int/mental_health/media/denm.pdf?ua=1
Large  M;  Sharma  S;  Cannon  E  et al:  Risk factors for suicide within a year of discharge from psychiatric hospital: a systematic meta-analysis.  Australian and New Zealand Journal of Psychiatry 45:619–628, 2011
[CrossRef] | [PubMed]
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