Comparison of Suicide Risk by Mental Illness: a Retrospective Review of 14-Year Electronic Medical Records

Song, Yoojin; Rhee, Sang Jin; Lee, Hyunju; Kim, Min Ji; Shin, Daun; Ahn, Yong Min

doi:10.3346/jkms.2020.35.e402

Cited by 14 publications

(8 citation statements)

References 34 publications

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“… 24 25 26 Older adults and individuals with serious preexisting mental illness may be vulnerable to suicide, self-harm and negative emotions through infrequent social interactions, requirements to stay home, increased risk of anxiety and aggravation of depression due to reduced social networks during the pandemic. 27 28 …”

Section: Discussionmentioning

confidence: 99%

Association of the COVID-19 Pandemic and Low-rescue Suicide Attempts in Patients Visiting the Emergency Department after Attempting Suicide

et al. 2021

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Background The coronavirus disease 2019 (COVID-19) pandemic may increase the total number of suicide attempts and the proportion of low-rescue attempts. We investigated the factors affecting low-rescue suicide attempts using the risk-rescue rating scale (RRRS) among patients who visited the emergency department (ED) after attempting suicide before or during the COVID-19 pandemic. Methods We retrospectively investigated suicide attempts made by patients who visited our ED from March 2019 to September 2020. Patients were classified into two groups based on whether they attempted suicide before or during the COVID-19 pandemic. Data on demographic variables, psychiatric factors, suicide risk factors and rescue factors were collected and compared. Results A total of 518 patients were included in the study, 275 (53.1%) of whom attempted suicide during the COVID-19 pandemic. The proportion of patients who made low-rescue suicide attempts differed before and during the COVID-19 pandemic (37.1% vs. 28.8%) ( P = 0.046). However, the proportions of patients who made high-risk suicide attempts and high-lethality suicide attempts did not significantly differ between the two periods. The independent risk factors for low-rescue suicide attempts were age and the COVID-19 pandemic (odds ratio [OR], 1.02; 95% confidence interval [CI], 1.00–1.03; P = 0.006) (OR, 1.52; 95% CI, 1.03–2.25; P = 0.034). Conclusion The COVID-19 pandemic was associated with low-rescue suicide attempts in patients visiting the ED after attempting suicide. Thus, we need to consider the implementation of measures to prevent low-rescue suicide attempts during similar infectious disease crises.

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Section: Discussionmentioning

confidence: 99%

Association of the COVID-19 Pandemic and Low-rescue Suicide Attempts in Patients Visiting the Emergency Department after Attempting Suicide

et al. 2021

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“…In this study, mental illness is the second risk factor for suicide attempts. Previous research had similar results that suffering from a mental illness, such as schizophrenia and anxiety/depressive disorders, increases the risk of suicide attempts35 36 because those with mental illness may have greater impulsivity and aggressive behaviours 37…”

Section: Discussionmentioning

confidence: 83%

Discordance between family report and clinical assessment of suicide attempts: a prospective study from the emergency department

2021

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BackgroundDeveloping accurate identification methods for individuals with suicide attempts and providing them with follow-up care and supports can be a vital component of all comprehensive suicide prevention strategies. However, because of the difficulties concerning one’s intentions behind injurious behaviour, identifying suicide attempts is a challenge for families and clinicians.AimsThe aim of this study was to investigate the differences between family report and clinical assessment for suicide attempts in the emergency department (ED).MethodsA total of 148 patients with suspected suicide attempts (SSAs) and 148 family caregivers in the ED were enrolled. The suicide risk module of the Chinese version of the MINI International Neuropsychiatric Interview and the self-report measure were used to assess those with SSA’s suicidal behaviours. The Family Adaptability and Cohesion Evaluation Scales and semi-structured interviews were used to investigate the characteristics of suicide risk and demographics of patients with SSA, as well as the rate and influencing factors of omitted suicide attempts reported by family caregivers.ResultsThe underreporting rate for family reported suicide attempts in the ED was 69.0%. The suicide attempts group indicated lower mean scores on perceptions of family resources, adaptability and cohesion. Patients' suicide risk rating (OR =−1.81, 95% CI: −3.87 to −0.33, p=0.036), family satisfaction (OR =−1.11, 95% CI: −2.29 to −0.06, p=0.048), and caregiver’s age (OR =−1.68, 95% CI: −3.10 to −0.48, p=0.010) might be associated with underreporting by families. If patients committed suicide attempts through a falling injury or medication overdose, their families may have misreported the suicide attempt.ConclusionsThe discordance of suicide attempt records between family report and clinical assessment reveals the limitations of family self-reports when identifying suicide attempts. Interviews and observations, together with information from certain diagnoses, should be combined to accurately identify suicide attempters in the ED.

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“…A recent study in South Korea, a country with one of the highest rates of suicide globally, found that of psychiatric patients admitted 3 or more times for psychiatric disturbance that only 1.4% died by suicide. 15 They analyzed the specific hazard ratios from different psychiatric diseases and found that those with psychosis had the highest hazard ratio of dying by suicide at 13.03 (11.23-15.03) when compared with the general population. That said, modern imaging modalities are excellent at detecting intracranial neoplasms; however, an insidious lymphoid neoplasm may be more difficult to see, as was the case with BNS.…”

Section: Discussionmentioning

confidence: 99%

Bing Neel Syndrome

Alexander

Jackson

Donahue

et al. 2023

Am J Forensic Med Pathol

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Suicide rapidly increased in the United States by 30% from 2000 to 2020, accounting for more than 800,000 deaths (Neurosci Res Program Bull. 1972; 10: 384-8). Studies have shown that there are a multitude of underlying issues, including mental illness, that elevate an individual's risk of dying by suicide (CDC WONDER: Underlying cause of death, 1999-2019. Atlanta, GA: US Department of Health and Human Services, CDC; 2020). Presented here is a case of Bing Neel syndrome (BNS) found in a 69-year-old man who died by suicide by jumping off a 135′ bridge. His medical history was significant for traumatic brain injury, Waldenstrom macroglobulinemia (WM), major depressive disorder, suicidal ideation, and anxiety. Bing Neel syndrome is a rare central nervous system complication of WM. His wife reported an abrupt mental deterioration starting 5 years before his death, characterized by paranoia, depression, and insomnia. He had been a high-functioning university professor. His decline culminated with the loss of independence in his activities of daily living. At autopsy, it was found that he experienced blunt force injuries related to the fall, causing his death. A neuropathologic examination revealed a brisk and fulminant clonal CD20 + /immunoglobulin M+ lymphocytic infiltrate, involving all sampled regions of his brain, consistent with WM. This workup was critical to obtaining an accurate pathologic diagnosis of BNS and understanding his full clinical status before death. Although BNS was not the proximate cause of death, this diagnosis aided the death investigation as a causal factor in his suicidality and was vital to providing his family closure.

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Comparison of Suicide Risk by Mental Illness: a Retrospective Review of 14-Year Electronic Medical Records

Cited by 14 publications

References 34 publications

Association of the COVID-19 Pandemic and Low-rescue Suicide Attempts in Patients Visiting the Emergency Department after Attempting Suicide

Association of the COVID-19 Pandemic and Low-rescue Suicide Attempts in Patients Visiting the Emergency Department after Attempting Suicide

Discordance between family report and clinical assessment of suicide attempts: a prospective study from the emergency department

Bing Neel Syndrome

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