• suicide;
  • suicide attempt;
  • mental disorder;
  • psychiatry;
  • prospective study

Lundin A, Lundberg I, Allebeck P, Hemmingsson T. Psychiatric diagnosis in late adolescence and long-term risk of suicide and suicide attempt.

Objective:  To investigate the associations between psychiatric diagnosis in late adolescence in an unselected population and subsequent suicide attempt and suicide during 36-year follow-up.

Method:  A total of 49 321 Swedish men conscripted for compulsory military training in 1969/1970, born 1949–1951, were screened for psychiatric disorder and, if detected, diagnosed by a psychiatrist according to ICD-8. Data on suicides and suicide attempts 1971–2006 were collected in national registers.

Results:  At conscription examination, 11.7% of the cohort received a psychiatric diagnosis. Among those, increased risks of suicide 1971–2006 [HR = 2.7 (2.2–3.2), 624 cases] and suicide attempt 1973–2006 [HR = 3.5 (3.1–4.0), 1170 cases] were found. The increased relative risks persisted during the follow-up period 19–36 years after examination [1989–2006 suicide HR = 2.1 (1.6–2.7), 308 cases, and 1989–2006 suicide attempt HR = 2.6 (2.1–3.1), 484 cases]. The dominant diagnostic groups, neurosis and personality disorder, were significantly associated with suicide and suicide attempt in the early as well as the late follow-up period.

Conclusion:  Psychiatric diagnoses made in late adolescence predicted subsequent suicide and suicide attempt over a 36-year follow-up period. The increased relative risks were not limited to young adulthood but were also evident 18–36 years after conscription examination.