Objective: Over two decades ago a study reported that a percentage as high as 11% of the patients with a psychotic disorder in the northern Netherlands died by committing suicide. The primary objective of the current study was to replicate these findings in the same geographical area. A secondary objective was to investigate potential predictors of suicide.
Design: Retrospective cohort study.
Method: From patient files we identified the current status of all patients who experienced their first episode of psychosis and participated in the Psychosis Recent Onset Groningen-Survey (PROGR-S) between 2000 and 2009. The PROGR-S is a diagnostic protocol for persons with suspected first psychosis. Kaplan-Meier survival analysis was used to identify the current suicide risk in this group and this was compared with the 1973-1988 patients using a log rank test. We also determined the standardized mortality rate in relation to the general population. Cox regression analysis was used to assess significant predictors of suicide.
Results: The suicide risk dropped drastically over the course of two decades from 11% to 2.4%. Older age was the strongest predictor of suicide. The standardized mortality rate was 41.6.
Conclusion: Despite the significant decline in suicide after a first episode of psychosis, the risk of suicide should be given the highest priority in psychiatric psychosis care, as it is very high at 4162% compared with the suicide risk in general population.