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Suicide and attempted suicide among people of Caribbean origin with psychosis living in the UK

Department of Psychiatry and Behavioural Sciences, Royal Free and University College Medical School, London

J. VAN OS, MD, PhD

Department of Psychiatry and Neuropsychology, Maastricht University, The Netherlands

C. SAMELE, PhD

Department of Psychiatry, Institute of Psychiatry, London

E. VAN HORN, MRCPsych

The John Howard Centre, London

T. TATTAN, MRCPsych

Fromeside Clinic, Bristol

ROBIN MURRAY, MD, FRCPsych

Department of Psychiatry, Institute of Psychiatry, London

the UK700 GROUP

Correspondence: Dr Kwame McKenzie, Department of Psychiatry and Behavioural Sciences, Royal Free and University College Medical School, Royal Free Campus, Rowland Hill Street, London NW3 2PF,UK

Declaration of interest None.

Background A report from a 1980s cohort claimed that suicidal behaviour was four times less common in UK-resident people of Caribbean origin with psychosis than in British Whites. Since then, evidence has accumulated that the rate of suicide and suicidal ideation has been increasing.

Aims To compare rates of suicidal behaviour in people of Caribbean and British White origin in a large multi-centre sample of patients with psychosis.

Method A secondary analysis of 708 patients with psychosis followed up for 2 years. Outcome measures of reported suicide and attempted suicide were adjusted for socio-economic and clinical differences between groups at baseline.

Results People of Caribbean origin had a lower risk of suicidal behaviour than British Whites (odds ratio adjusted for age and gender 0.49, 95% CI 0.26–0.92). There was a strong negative interaction between ethnic group and age: suicidal acts were four times less likely in people of Caribbean origin aged over 35 years compared with British Whites, but there was no large or significant difference in those under 35.

Conclusions The previously reported lower relative risk of suicidal behaviour in people of Caribbean origin with psychosis is restricted to those over 35 years, suggesting that the protective effect of Caribbean origin is disappearing in younger generations.

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