Method of Suicide Attempt and Reaction to Survival as Predictors of Repeat Suicide Attempts

Bhaskaran, Joanna; Wang, Yunqiao; Roos, Leslie E.; Sareen, Jitender; Skakum, Kurt; Bolton, James M.

doi:10.4088/jcp.13m08879

Cited by 14 publications

(10 citation statements)

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“…Given known difficulties with help-seeking among suicidal individuals (Downs & Eisenberg, 2012;Hawton, Saunders & O'Connor, 2012), any research that demonstrates the effectiveness of a therapeutic intervention may be beneficial to the client, to those in their immediate support network and to the therapist. For the client, research has demonstrated the high degree of ambivalence among those with suicidal ideation (Bhaskaran et al, 2014;O'Connor et al, 2012). Any potential hope instilled by evidence of recovery and of an increased positive and decreased negative outlook, therefore, may be the impetus necessary to engage in therapy.…”

Section: Discussionmentioning

confidence: 99%

Promoting recovery from suicidal ideation through the development of protective factors

Surgenor

2015

Couns and Psychother Res

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BackgroundThe important message of engendering hope in clients with suicidal ideation has frequently been obscured by the prevalence of a negative risk factors perspective and by a general lack of empirical support for intervention models based on developing protective factors.AimThis research aimed to explore recovery from suicidal ideation in the six months following engagement in a protective factors‐based therapeutic intervention.MethodRecovery was ascertained by the change in levels of positive and negative outlook, as measured by the PHQ‐9, the single‐item self‐esteem indicator, and the positive and negative suicide ideation inventory. This involved administering a questionnaire to clients pre‐therapy (n = 376) and again to the same clients one month (n = 147), three months (n = 130) and six months (n = 107) post‐therapy. All participants were over 18 years old and presented to a suicide intervention charity for therapy due to suicidal ideation.FindingsResults showed an overall significant effect for engaging in therapy. Comparisons revealed statistically significant decreases in levels of negative outlook and increases in positive outlook, with the largest differences observed in pre‐therapy and six‐month post‐therapy comparisons.ImplicationsResults provide support for the efficacy of intervention models that develop a client's protective factors and for the ability of a client to recover from suicidal ideation. Findings may also encourage therapists to reconsider reliance on the traditional negative model of suicide intervention and to explore intervention methods that enhance clients’ protective factors in line with the positive psychology perspective.

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Section: Discussionmentioning

confidence: 99%

Promoting recovery from suicidal ideation through the development of protective factors

Surgenor

2015

Couns and Psychother Res

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“…Finally, the lifetime prevalence and type (cutting vs. other) of non-suicidal self-injuries was considered. [35][36][37] -Previous SA characteristics: the lifetime prevalence of SA (including the SA that motivated the present emergency visit) and the method used in the most recent SA were classified according to the literature as drug overdose, defenestration, hanging, suffocation, poisoning and phlebotomy, 12,23 after aggregation into the categories drug overdose and other. -Prior psychiatric treatment and use of psychiatric services in the past 5 years 10 included psychiatric consultations, hospital admissions (number of episodes: 0, 1, 2, X 3), time since the last episode (o 1 year or X 1 year), and visits to the psychiatric ER (0, 1, 2 or X 3, excluding the present emergency visit).…”

Section: Variablesmentioning

confidence: 99%

“… 22 The repeated SA rate seems to be especially high during the first 6 months after a SA 8 : this is considered the highest risk period for repeated SA, with rates of up to 9%. 23 However, SA rates can reach 60% within 1-2 years. 24 Comparatively, the completed suicide rate is approximately 3% in 1-4 years of follow-up.…”

Section: Introductionmentioning

confidence: 99%

Suicide and suicide attempts in adults: exploring suicide risk 24 months after a psychiatric emergency room visit

Taron

Nunes

Maia

2020

Braz. J. Psychiatry

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Objective: Suicide risk (including attempted and completed suicide) should be measured over short periods of time after contacting health services. The objective of this study was to identify the patterns of attempted and completed suicides within 24-months of a psychiatric emergency department visit, as well as to investigate predictive risk factors, including sociodemographic and clinical variables, previous suicidal behavior, and service utilization. Method: A convenience sample (n=147), recruited at a general hospital's psychiatric emergency room, included patients with suicidal ideation, suicidal plans or previous suicide attempts. These patients were followed for 24 months, focusing on two main outcomes: attempted and completed suicides. Results: After six months there were no completed suicides and 36 suicide attempts, while after 24 months there were seven completed suicides and 69 suicide attempts. A final logistic regression model for suicide attempts at 24 months identified somatic pathology and the number of previous psychiatric hospitalizations as predictive factors, with a good area under the receiver operating characteristic curve. Conclusions: The findings showed distinct patterns of attempted and completed suicides over time, indicating the importance of a systematic multidisciplinary suicide risk evaluation in psychiatric emergency rooms.

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“…33,34,[70][71][72] This study has several potential limitations. First, data were not available concerning several clinically important factors, such as patients' reactions to surviving self-harm, 73 self-harm intent, 23 Without more detailed information on whether the self-harm occurred with or without a suicidal intent, it is impossible to exclude the possibility that some discharged patients were at relatively low risk, although deliberate self-harm is a main risk factor for fatal and nonfatal suicide attempts, 2,3 particularly among older adults. 10 Second, concerns exist over the validity and completeness of ICD codes to measure self-harm.…”

Section: Outpatient Mental Health Carementioning

confidence: 99%

“…Prior US research shows that roughly 50% of younger ED patients discharged to the community following self-harm proceed to followup on referrals to outpatient mental health services 26,28,62. First, data were not available concerning several clinically important factors, such as patients' reactions to surviving self-harm,73 self-harm intent,23 or the extent to which patients were offered referrals for outpatient mental health care, all of which may influence hospital admission, recognition of mental disorders, or use of follow-up outpatient mental health care. Moreover, the only variable associated with lower likelihood of follow-up mental health care was male gender (ARR = 0.82, 99% CI = 0.71-0.94), which is consistent with research demonstrating lower help-seeking behavior in men 66,67.…”

mentioning

confidence: 99%

Deliberate self‐harm in older adults: A national analysis of US emergency department visits and follow‐up care

Schmutte

Olfson

Xie

et al. 2019

Int J Geriat Psychiatry

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Objective To examine mental health care received by older adults following emergency department (ED) visits for deliberate self‐harm. Methods This retrospective cohort analysis examined 2015 Medicare claims for adults ≥65 years of age with ED visits for deliberate self‐harm (N = 16 495). We estimated adjusted risk ratios (ARR) for discharge disposition, ED coding of mental disorder, and 30‐day follow‐up mental health outpatient care. Results Most patients (76.9%) were hospitalized with lower likelihoods observed for African American patients (ARR = 0.86, 99% CI = 0.79‐0.94) and patients with either one medical comorbidity (ARR = 0.91, 99% CI = 0.83‐0.99) or two to three comorbidities (ARR = 0.93, 99% CI = 0.88‐0.99). Hospitalization was associated with recent depression (ARR = 1.09, 99% CI = 1.03‐1.16) and recent psychiatric inpatient care (ARR = 1.13, 99% CI = 1.04‐1.22). Among patients discharged to the community (n = 3818), 56.4% received an ED mental disorder diagnosis. Predictors of an ED mental disorder diagnosis included younger age (65‐69 years; ARR = 1.53, 99% CI = 1.31‐1.78), recent mental health care in ED (ARR = 1.50, 99% CI = 1.29‐1.74) or outpatient (ARR = 1.62, 99% CI = 1.44‐1.82) settings, recent diagnosis of mental disorder (ARR = 1.61, 99% CI = 1.43‐1.80), and other/unknown lethality methods of self‐harm (ARR = 1.24, 99% CI = 1.01‐1.52). Among community discharged patients, 39.0% received 30‐day follow‐up outpatient mental health care, which was most strongly predicted by an ED diagnosis of mental disorder (ARR = 2.65, 99% CI = 2.25‐3.12) and prior outpatient mental health care (ARR = 2.62, 99% CI = 2.28‐3.00). Conclusion Most older adult Medicare beneficiaries who present to EDs with self‐harm are hospitalized. Of those who are discharged to the community, many are not diagnosed with mental disorder in the ED or receive timely follow‐up mental health care.

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Method of Suicide Attempt and Reaction to Survival as Predictors of Repeat Suicide Attempts

Abstract: Assessment of the patient's reaction to survival, regardless of method of attempt, is important to identify risk of repeat attempts.

Cited by 14 publications

References 0 publications

Promoting recovery from suicidal ideation through the development of protective factors

Promoting recovery from suicidal ideation through the development of protective factors

Suicide and suicide attempts in adults: exploring suicide risk 24 months after a psychiatric emergency room visit

Deliberate self‐harm in older adults: A national analysis of US emergency department visits and follow‐up care

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