Suicidality related to first-time admissions to psychiatric hospital

Abstract

BackgroundThe epidemiology of suicidality shows considerable variation across sites. However, one of the strongest predictors of suicide is a suicidal attempt. Knowledge of the epidemiology of suicidal ideas and attempts in the general population as well as in the health care system is of importance for designing preventive strategies. In this study, we will explore the role of the psychiatric hospital in suicide prevention by investigating treated incidence of suicidal ideation and attempt, and further, discern whether sociodemographic, clinical and service utilization factors differ between these two groups at admission.MethodsThe study was a prospective cohort study on treated incidence in a 1-year period and 12-month follow-up. The two psychiatric hospitals in northern Norway, serving a population of about 500,000 people, participated in the study. A total of 676 first-time admissions were retrospectively checked for suicidality at the time of admission. A study sample of 168 patients was found eligible for logistic regression analysis to elucidate the risk profiles of suicidal ideators versus suicidal attempters. GAF, HoNOS and SCL-90-R were used to assess symptomatology at baseline.Results52.2% of all patients admitted had suicidal ideas at admission and 19.7% had attempted suicide. In the study sample, there were no differences in risk profile between the two groups with regard to sociodemographic and clinical factors. Males who had made a suicide attempt were less likely to have been in contact with an out-patient clinic before the attempt. The rating scales not measuring suicidality directly showed no differences in symptomatology.ConclusionThe findings provide evidence for the importance of the psychiatric hospital in suicide prevention. About half of the admissions were related to suicidality and the similar risk profiles found in suicidal ideators and suicidal attempters indicate that it is the ideators who mostly need treatment that get admitted to the hospital, and should be evaluated and treated with equal concern as those who have attempted suicide.

Suicide Risk and Acute Psychiatric Readmissions: A Prospective Cohort Study

“…Another study on first-time admitted patients found that about 50% of the patients presented with suicidal ideation (56). Moreover, suicide risk was the reason for 29% of index admissions in a random sample of acute psychiatric admissions (54), and in a study of patients admitted to an open PAU, it accounted for 66% of the total consecutive admissions, which included readmissions, over a 1-year study period (57).…”

“…The most frequently used source of research findings on suicide risk-or self-harm-related psychiatric admissions has been retrospective chart reviews (50,(54)(55)(56)(57)(58). However, the definitions of self-harm and suicide attempt, when presenting as reasons for admission, are often missing.…”

“…In addition, a study of first-time psychiatric admissions in northern Norway found that suicide risk was the reason for 52% of admissions (56) …”

Former suicidal inpatients’ experiences of treatment and care in psychiatric wards in Norway

“…For instance, a Norwegian study found that about 52% of first-time admissions to psychiatric hospitals were related to suicidality (Øiesvold, Bakkejord, Hansen, Nivison, & Sørgaard, 2012). Mental health workers face the task of helping these patients through their suicidal crisis and preventing suicide attempts and suicide.…”

Prevalence and characteristics of suicide attempters and ideators among acutely admitted psychiatric hospital patients in northwest Russia and northern Norway

“…From a clinical perspective, it is particularly important to identify predictors of suicidal ideation and attempt among patients acutely admitted to psychiatric hospitals as their suicide risk is particularly high. A recent comparative study of 168 first-time hospital admitted psychiatric patients in northern Norway found no sociodemographic or clinical differences in risk profiles for suicidal ideation (reported by half the patients) and attempt (reported by one fifth of patients) [ 21 ]. However, first-time admissions constitute only a limited proportion of admissions to acute psychiatric wards and more knowledge regarding the risk profiles of all acutely admitted psychiatric patients is needed.…”