Risk of suicide and all-cause death in patients with mental disorders: a nationwide cohort study

Mental disorders are associated with an increased risk of premature death, including suicide. This study aimed to examine the risk of suicide and all-cause death in patients with mental disorders after considering demographic, clinical, and lifestyle factors. Data from the National Health Insurance Sharing Service database and linked data from Statistics Korea were used. In total, 3,951,398 people aged ≥20 years were eligible for this study. Among the participants, 14 types of mental disorders were identified, and the subsequent incidences of suicide and all-cause death were monitored. The mean age of those with mental disorders and those without mental disorders was 56.5 (SD, 13.6) years and 46.6 (SD, 13.6) years, respectively. During an average follow-up period of 11.1 years (SD, 1.5), 249,830 participants died, of whom 12,290 died by suicide. Overall, the risk of suicide and all-cause death was higher in people with mental disorders than in controls. The risk of suicide was the highest among those with personality disorders, followed by those with bipolar disorder and schizophrenia spectrum disorder. The risk of all-cause death was the highest among those with intellectual disability, followed by those with schizophrenia spectrum disorder and alcohol use disorder. In conclusion, the risk of suicide and all-cause death increased among those with mental disorders, but there was substantial variation between the types of mental disorders for both suicide and all-cause death.