Non-disclosure of suicidal ideation in psychiatric inpatients: Rates and correlates

Abstract

The study explored how common non-disclosure of suicidal ideation is in a sample of adult psychiatric inpatients (N ¼ 171) plus associated patient characteristics. A large percentage (51.5%) withheld some information on suicidal ideation during admission. In multivariable analyses, correlates of non-disclosure included a diagnosis of emotionally unstable personality disorder, low satisfaction with stay, and symptoms of the suicide crisis syndrome. In univariate analyses, therapists' emotional response to the patient was also a correlate. Findings indicate that among acute psychiatric inpatients, non-disclosure of suicidal ideation is quite common, requiring awareness from clinicians relying on this parameter in suicide risk assessments.

Who are the patients who deny suicidal intent? Exploring patients' characteristics associated with self‐disclosure and denial of suicidal intent

“…37 A recent study on disclosure among inpatients found that patients with "emotionally unstable personality disorders," affective and cognitive dysregulation (as described in the proposed DSM "Suicide Crisis Syndrome" 38,39 ), and low satisfaction with treatment predicted lower SI disclosure at discharge. 40 Among adolescents, the current SI and recent suicidal behaviors, together with depression and anxiety severity were found to increase the likelihood of concealment among Israeli adolescents. 20 Psychological distress severity was also found to predict non-disclosure, together with age, poor health, frequent SI, and social isolation, in a Dutch sample, 29 and together with low well-being, low social support, and high perceptions of social stigma among Australian first responders.…”

“…20 Psychological distress severity was also found to predict non-disclosure, together with age, poor health, frequent SI, and social isolation, in a Dutch sample, 29 and together with low well-being, low social support, and high perceptions of social stigma among Australian first responders. 41 These studies examining the association between the patients' characteristics and disclosure primarily focused on specific populations (adolescents 20 ; inpatients 40 ; Chinese decedents 37 ; Dutch adults 29 ; Australian first responders 41 ). Furthermore, most studies assessed the Keypoints • Patients were found to be more likely to disclose suicidal intents to research assistants, in the context of a research study, than to their clinicians in an outpatient clinic.…”

Az öngyilkossági rizikó becslése a klinikai gyakorlatban.

“…A praeszuicidális pszichopatológiai eltérések (mint például érzelmi és kognitív beszűkültség, tagadás stb.) miatt nem könnyű releváns információkat szerezni és megbízhatóan felmérni a páciens aktuális lelkiállapotát [58]. Ezeknek a skáláknak a kitöltése sokszor bonyolult, körülményes és időigényes, ráadásul gyakran nem rendelkeznek a megfelelő szenzitivitással vagy specificitással.…”

“…Napjainkban még mindig kevés empirikus kutatás vizsgálta ezen rizikóbecslő skálák alkalmasságát és gyakorlati felhasználásuk lehetőségeit. Az akut pszichiátriai pácienseknél a szuicid gondolatok gyakran nem kerülnek felismerésre, ezért egyre nagyobb szükség van a klinikusok számára is könnyen használható mérőeszközökre [58]. Éppen ezért kutatócsoportunk célul tűzte ki ezen kérdőívek magyar változatának elkészítését és a korábban használt rizikóbecslő skálákkal való összehasonlítását.…”

Past Levels of Mental Health Intervention and Current Nondisclosure of Suicide Risk Among Men Older Than Age 50

“…Such inpatient experiences may contribute to a person’s future likelihood to nondisclose suicide risk to a health care professional, especially if the anticipated reaction is that they will simply be rehospitalized. To this point, Høyen et al (2021) found that 51% of psychiatric inpatients at discharge reported that they withheld suicide risk information from clinical staff, and that poor satisfaction of stay was significantly associated with likelihood for nondisclosure. Furthermore, Busch et al (2003) found that 78% of current or recently discharged hospital inpatients who died by suicide had explicitly denied suicide risk to a health care professional during the final communications before their deaths.…”