Mental Health Conditions with Highest Suicide Rates
Bipolar disorder and major depressive disorder carry nearly identical and extraordinarily high suicide risks, with patients facing approximately 8-9 times greater odds of death by suicide compared to the general population, while schizophrenia spectrum disorder demonstrates the single highest risk at 15-fold increased odds. 1, 2
Highest Risk Conditions (Ranked by Suicide Mortality)
Schizophrenia Spectrum Disorder
- Carries the highest adjusted odds ratio of 15.0 for suicide death compared to the general population 2
- Represents the most severe suicide risk among all psychiatric diagnoses in population-based studies 2
Bipolar Disorder
- Demonstrates an 8.66-fold increased risk of death by suicide compared to the general population based on registry data 1
- Alternative U.S. data shows adjusted odds ratios of 13.2 for suicide mortality 2
- Lifetime prevalence of suicide attempts reaches 29.2%, substantially higher than other mood disorders 1, 3
- Women with bipolar disorder face particularly elevated risk with odds ratios of 22.87 compared to 12.60 in men 1
Major Depressive Disorder
- Carries an 8.62-fold increased risk of death by suicide compared to the general population 1, 4
- Alternative estimates show adjusted odds ratios of 7.2 for suicide mortality 2
- The highest risk period occurs within the first year following diagnosis or hospital discharge, requiring intensive monitoring 4, 5
- Women face 9.40-10.9 times higher odds of suicide death compared to the general population 4, 5
Borderline Personality Disorder
- Represents 6.3% of all suicides in population-based coroner investigations, with an additional 2.5% of suspected undiagnosed cases 6
- 99% of BPD patients who died by suicide had contact with emergency/mental health services within 12 months of death, and 88% sought help within 6 weeks 6
- Belongs in the same high-risk category as schizophrenia, bipolar disorder, and major depression for suicide representation 6
Additional High-Risk Conditions
Post-Traumatic Stress Disorder
- Significantly predicts progression from suicidal ideation to actual suicide attempts (OR 2.7-6.7 in bivariate analyses) 1, 7
- Characterized by severe anxiety/agitation that drives transition from thoughts to action 7
Substance Use Disorders
- Predict which suicide ideators progress to making plans or attempts through mechanisms of poor impulse control 1, 7
- More strongly linked to suicidality in bipolar disorder than in major depression 1
Anxiety Disorders
- Adjusted odds ratio of 5.8 for suicide mortality 2
- More prevalent and strongly linked to suicidality in major depression than bipolar disorder 1
Critical Clinical Considerations
Comorbidity Amplifies Risk
- Approximately 87% of patients who die by suicide meet criteria for one or more mental health disorders 1
- Diagnostic complexity is significantly higher in those who complete suicide, particularly with borderline personality disorder 6
Gender-Specific Patterns
- Women attempt suicide more frequently, but when comparing suicide deaths to the general population, women with mood disorders show higher relative risk than men 1
- Men with serious mental illness still have higher absolute suicide rates but lower relative increases compared to their baseline population risk 1
Common Pitfall
- Depression predicts suicide ideation but does NOT independently predict progression from ideation to attempts 7
- Instead, disorders with severe anxiety/agitation (PTSD) and poor impulse control (conduct disorder, substance use) drive the transition from thoughts to action 7
- This means screening for depression alone is insufficient—you must assess for comorbid anxiety, trauma, and substance use disorders 7