Suicide History and the Mortality from Cardiovascular Disease and Un-Nature Causes

Background: Previous research defined increased over-all mortality rate among suicide attempters. Yet specific cause has not been identified.

Method: We estimated the risk of all-cause, cardiovascular disease (CVD), and unnatural disease (including suicide and homicide). 6,293 nationally representative adults (17-39 years old), who participated the third National Health and Nutrition Examination Survey, 1988-1994, completed a mental disorder diagnostic interview, and were passively followed for mortality through December 31, 2006. Using participants with no suicidal history as a reference group, we used Cox proportional hazard regression to determine the hazard ratio (HR) of mortality from all causes and specific cause after adjustment for age, sex, race/ethnicity, education level, family income, smoking status, and health condition at baseline.

Result: A total of 345 suicide attempters were identified. There were 219 all-causes deaths, including 41 due to CVD, 26 to suicide/homicide. The suicide history at the baseline is associated with an increased risk for all-cause mortality [HR = 1.5 (95%CI=0.95-2.51)] at borderline significance. The hazards of death from CVD was increased by 168% [RR=2.68(95%CI= 1.01-2.51)] among people who attempted suicide. The HR of dying from suicide/homicide was as 3.99 (95%=1.28-12.4) among suicide attempters. The estimates remained unchanged in principle after adjustment for major depression disorder.

Conclusion: Cardiovascular death was significantly increased among suicide attempters. The individuals with a suicide history should be included as group at high cardiovascular risk for appropriate intervention. . Effective strategy warrants further exploration to prevent completed suicide and homicide among the group with a suicide history.