Social Psychiatry and Psychiatric Epidemiology

, Volume 44, Issue 12, pp 1107–1110 | Cite as

Suicide rate in schizophrenia in the Northern Finland 1966 Birth Cohort

  • Antti AlaräisänenEmail author
  • Jouko Miettunen
  • Pirkko Räsänen
  • Wayne Fenton
  • Heli-Tuulie Jeannette Koivumaa-Honkanen
  • Matti Isohanni
Original Paper



Suicide rate among schizophrenia patients may vary for several reasons, one of the most important being the time point of the suicide during the illness process. However, prospective studies on suicide risk in population-based cohort of individuals with new-onset schizophrenia have been lacking.


The data were collected for 10,934 individuals alive in Finland at the age of 16 from the genetically homogenous, population-based Northern Finland 1966 Birth Cohort ascertained already during mid-pregnancy. The Finnish Hospital Discharge Register was used until the end of 1997 (age 31) to identify cases with mental disorder. Case records were scrutinized and diagnoses were re-checked for DSM-III-R criteria. One hundred subjects met the DSM-III-R criteria for schizophrenia. Deaths by the end of year 2005 (age 39) were ascertained from death certificates.


Suicides (n = 7) accounted for 50% of all the deaths at age from 16 to 39. Seven (7.0%) subjects with schizophrenia had committed suicide; suicide rate being 2.9% (1/35) for women and 9.2% (6/65) for men. Furthermore, 71% of suicides in schizophrenia occurred during the first 3 years after onset of illness.


The suicide rate for patients with new-onset schizophrenia followed until the age of 39 was high and accounted for half of the deaths. Great majority of the suicides took place during the first years of the illness.


Schizophrenia Suicide Mortality Cohort studies 



This work was supported by unrestricted grants from the Academy of Finland, the Sigrid Juselius Foundation, the Stanley Medical Research Institute, the Duodecim Association, Jalmari and Rauha Ahokas Foundation, Lundbeck Foundation, Finnish Cultural Foundation and Orion Research Foundation.


  1. 1.
    Arajarvi R, Suvisaari J, Suokas J, Schreck M, Haukka J, Hintikka J et al (2005) Prevalence and diagnosis of schizophrenia based on register, case record and interview data in an isolated Finnish birth cohort born 1940–1969. Soc Psychiatry Psychiatr Epidemiol 40:808–816CrossRefPubMedGoogle Scholar
  2. 2.
    Caldwell CB, Gottesman II (1990) Schizophrenics kill themselves too: a review of risk factors for suicide. Schizophr Bull 16:571–588PubMedGoogle Scholar
  3. 3.
    Cannon M, Kendell R, Susser E, Jones P (2003) Pre- and perinatal risk factors for schizophrenia. In: Murray R, Jones P, Susser E, van Os, Cannon M (eds) The epidemiology of schizophrenia. Cambridge university press, Cambridge, pp 74–99Google Scholar
  4. 4.
    Dong J, Ho T, Kan C (2005) A case-control study of 92 cases of in-patient suicides. J Affect Disord 87:91–99CrossRefPubMedGoogle Scholar
  5. 5.
    Hawton K, Sutton L, Haw C, Sinclair J, Deeks JJ (2005) Schizophrenia and suicide: systematic review of risk factors. Br J Psychiatry 187:9–20CrossRefPubMedGoogle Scholar
  6. 6.
    Healy D, Harris M, Tranter R, Gutting P, Austin R, Jones-Edwards G, Roberts AP (2006) Lifetime suicide rates in treated schizophrenia: 1875–1924 and 1994–1998 cohorts compared. Br J Psychiatry 188:223–228CrossRefPubMedGoogle Scholar
  7. 7.
    Heila H, Isometsa ET, Henriksson MM, Heikkinen ME, Marttunen MJ, Lonnqvist JK (1997) Suicide and schizophrenia: a nationwide psychological autopsy study on age- and sex-specific clinical characteristics of 92 suicide victims with schizophrenia. Am J Psychiatry 154:1235–1242PubMedGoogle Scholar
  8. 8.
    Heila H, Lonnqvist J (2003) The clinical epidemiology of suicide in schizophrenia. In: Murray R, Jones P, Susser E, van Os, Cannon M (eds) The epidemiology of schizophrenia. Cambridge university press, Cambridge, pp 288–316Google Scholar
  9. 9.
    Isohanni M, Makikyro T, Moring J, Rasanen P, Hakko H, Partanen U et al (1997) A comparison of clinical and research DSM-III-R diagnoses of schizophrenia in a Finnish national birth cohort. Clinical and research diagnoses of schizophrenia. Soc Psychiatry Psychiatr Epidemiol 32:303–308CrossRefPubMedGoogle Scholar
  10. 10.
    Kua J, Wong KE, Kua EH, Tsoi WF (2003) A 20-year follow-up study on schizophrenia in Singapore. Acta Psychiatr Scand 108:118–125CrossRefPubMedGoogle Scholar
  11. 11.
    Kuo CJ, Tsai SY, Lo CH, Wang YP, Chen CC (2005) Risk factors for completed suicide in schizophrenia. J Clin Psychiatry 66:579–585PubMedCrossRefGoogle Scholar
  12. 12.
    Lewis L (2004) Mourning, insight, and reduction of suicide risk in schizophrenia. Bull Menninger Clin 68:231–244CrossRefPubMedGoogle Scholar
  13. 13.
    Moilanen K, Veijola J, Laksy K, Makikyro T, Miettunen J, Kantojarvi L et al (2003) Reason for diagnostic discordance between clinicians and researches in schizophrenia in the Northern Finland 1966 cohort. Soc Psychiatry Psychiatr Epidemiol 38:305–310PubMedGoogle Scholar
  14. 14.
    Palmer BA, Pankratz VS, Bostwick JM (2005) The lifetime risk for suicide in schizophrenia. Arch Gen Psychiatry 62:247–253CrossRefPubMedGoogle Scholar
  15. 15.
    Pirkola S, Sohlman B, Heila H, Wahlbeck K (2007) Reductions in postdischarge suicide after deinstitutionalization and decentralization: a Nationwide Register Study in Finland. Psychiatr Serv 58:221–226CrossRefPubMedGoogle Scholar
  16. 16.
    Pompili M, Mancinelli I, Ruberto A, Kotzalidis GD, Girardi P, Tatarelli R (2005) Where schizophrenic patients commit suicide: a review of suicide among inpatients and former inpatients. Int J Psychiatry Med 35:171–190CrossRefPubMedGoogle Scholar
  17. 17.
    Rantanen H, Koivisto AM, Salokangas RK, Helminen M, Oja H, Pirkola S, Wahlbeck K, Joukamaa M (2009) Five-year mortality of Finnish schizophrenia patients in the era of deinstitutionalization. Soc Psychiatry Psychiatr Epidemiol 44:135–142CrossRefPubMedGoogle Scholar
  18. 18.
    Rasanen P, Tiihonen J, Isohanni M, Moring J, Koiranen M (1998) Juvenile mortality, mental disturbances and criminality: a prospective study of the Northern Finland 1966 Birth Cohort. Acta Psychiatr Scand 97:5–9CrossRefPubMedGoogle Scholar
  19. 19.
    Stenager K, Qin P (2008) Individual and parental psychiatric history and risk for suicide among adolescents and young adults in Denmark: a population-based study. Soc Psychiatry Psychiatr Epidemiol 43:920–926CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Antti Alaräisänen
    • 1
    Email author
  • Jouko Miettunen
    • 1
  • Pirkko Räsänen
    • 1
  • Wayne Fenton
    • 2
  • Heli-Tuulie Jeannette Koivumaa-Honkanen
    • 1
    • 3
    • 4
  • Matti Isohanni
    • 1
  1. 1.Department of Psychiatry, Institute of Clinical MedicineUniversity of OuluOuluFinland
  2. 2.National Institute of Mental HealthBethesdaUSA
  3. 3.Department of PsychiatryLapland Hospital DistrictMuurolaFinland
  4. 4.Department of PsychiatryKuopio University HospitalKuopioFinland

Personalised recommendations