Study of the outcome of suicide attempts: characteristics of hospitalization in a psychiatric ward group, critical care center group, and non-hospitalized group

Abstract

BackgroundThe allocation of outcome of suicide attempters is extremely important in emergency situations. Following categorization of suicidal attempters who visited the emergency room by outcome, we aimed to identify the characteristics and potential needs of each group.MethodsThe outcomes of 1348 individuals who attempted suicide and visited the critical care center or the psychiatry emergency department of the hospital were categorized into 3 groups, "hospitalization in the critical care center (HICCC)", "hospitalization in the psychiatry ward (HIPW)", or "non-hospitalization (NH)", and the physical, mental, and social characteristics of these groups were compared. In addition, multiple logistic analysis was used to extract factors related to outcome.ResultsThe male-to-female ratio was 1:2. The hospitalized groups, particularly the HICCC group, were found to have biopsychosocially serious findings with regard to disturbance of consciousness (JCS), general health performance (GAS), psychiatric symptoms (BPRS), and life events (LCU), while most subjects in the NH group were women who tended to repeat suicide-related behaviors induced by relatively light stress. The HIPW group had the highest number of cases, and their symptoms were psychologically serious but physically mild. On multiple logistic analysis, outcome was found to be closely correlated with physical severity, risk factor of suicide, assessment of emergent medical intervention, and overall care.ConclusionThere are different potential needs for each group. The HICCC group needs psychiatrists on a full-time basis and also social workers and clinical psychotherapists to immediately initiate comprehensive care by a medical team composed of multiple professionals. The HIPW group needs psychological education to prevent repetition of suicide attempts, and high-quality physical treatment and management skill of the staff in the psychiatric ward. The NH group subjects need a support system to convince them of the risks of attempting suicide and to take a problem-solving approach to specific issues.

Effect of telephone follow-up on repeated suicide attempt in patients discharged from an emergency psychiatry department: a controlled study

“…Similarly, characteristics of the study population, such as suicide attempt without hospitalization, could also play a role [25]. This may reflect a hidden selection bias that favors inclusion.…”

Características de la conducta suicida y factores asociados a su mortalidad en el ámbito hospitalario

“…De esta forma los pacientes con ingreso en cuidados intensivos tendrían un perfil y unas necesidades muy distanciadas de aquellos otros habitualmente no hospitalizados con conductas repetitivas de carácter parasuicida 18 .…”

Assistência hospitalar na tentativa de suicídio

“…O grupo HIPW necessita de educação psicológica para evitar a repetição de tentativas de suicídio, de equipe qualificada para realização do tratamento físico e ainda, equipe com habilidade de gestão na ala psiquiátrica. Já os pacientes do grupo NH precisam de um sistema de apoio para convencê-los sobre os riscos de tentativa de suicídio e levar a resolução de problemas com abordagem de questões específicas (Kudo et al, 2010).…”