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Population-Attributable Risk of Suicide Conferred by Axis I Psychiatric Diagnoses in a Hong Kong Chinese Population

Dr. Sandra Chan and Dr. Chiu are affiliated with the Department of Psychiatry, Chinese University of Hong Kong, Ground Floor, Multicentre, Tai Po Hospital, 9 Chuen On Rd., Tai Po, N.T., Hong Kong (e-mail: schan{at}cuhk.edu.hk). Dr. Chen, Ms. Wincy Chan, Dr. Wong, Dr. Cecelia Chan, Ms. Law, and Dr. Yip are with the Hong Kong Jockey Club Centre for Suicide Research and Prevention, University of Hong Kong. Ms.Wincy Chan is also with the Centre for the Advancement of University Teaching, University of Hong Kong.

OBJECTIVE: This study was conducted to determine the population-attributable risk (PAR) of completed suicide among Hong Kong Chinese with axis I psychiatric diagnoses. METHODS: With a case-control psychological autopsy method, 150 suicide decedents aged 15–59 were compared for axis I psychiatric diagnoses and psychosocial variables with 150 randomly selected age- and gender-matched persons living in the community. RESULTS: In the presence of other, non-disease-related social risk factors (unemployment and unmanageable debt), past suicide attempt independently accounted for 44% of the PAR of suicide, followed by current major depressive disorder (27%), schizophrenia spectrum disorders (22%), and substance use disorder or pathological gambling (16%). Other diagnoses (such as anxiety and phobic disorders, dysthymia, adjustment disorders, and past major depressive episode) accounted for 24% of PAR. CONCLUSIONS: Psychiatric morbidity remains the major risk factor for suicide in Hong Kong despite well-developed psychiatric services. Mental health policy should be refined to target clinical groups at high risk of suicide.

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