Suicide in Psychiatric Patients: Age Distribution

Morrison, James

doi:10.1111/j.1943-278x.1984.tb00336.x

Cited by 7 publications

(6 citation statements)

References 8 publications

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“…The subjects of the PCI group were also somewhat younger than both the PCO subjects and those suicides who had never received psychiatric care. This is in accordance with earlier findings (1, 11,12) and is an important observation since one statistical risk factor for suicides in general is claimed "to be a man of more than 45 years". This is thus not true for the inpatients.…”

Section: Discussionsupporting

confidence: 93%

Suicides in close connection with psychiatric care: An analysis of 57 cases in a Swedish county

Sundqvist-Stensman

1987

Acta Psychiatr Scand

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Among 523 suicides committed in 1977-1984, 10 took place in a psychiatric hospital ward, 17 after the patient had left the ward without permission, 21 while the patient was on leave and nine 0-7 days after discharge. These 57 subjects were compared with 271 suicides committed more than 7 days after discharge or during outpatient care only (PCO). The male:female ratio was 1.0 in the former (PCI) group and 2.0 in the PCO group. The median age of the PCI subjects was 38 years. The suicide method was hanging in all 10 suicides (2 males, 8 females) committed in the psychiatric hospital ward. Depressive syndromes and, particularly schizophrenic and paranoid psychoses were more frequent among the PCI than among the PCO subjects. The extent of psychiatric care, as assessed by the number of admissions, was much greater in the PCI than in the PCO subjects. Environmental factors that might have been of causative importance for the suicidal act were of various kinds and differed to some extent between the two groups. Among the PCI subjects women seemed to have experienced family troubles more often than men, and situations of stressful psychiatric rehabilitation were more common among men.

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Section: Discussionsupporting

confidence: 93%

Suicides in close connection with psychiatric care: An analysis of 57 cases in a Swedish county

Sundqvist-Stensman

1987

Acta Psychiatr Scand

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“…The lower age for patients with schizophrenia is similar to that in other large suicide caseloads (37,38). The high proportion with schizophrenia is similar to the previously reported 20.5 and 29.0% (17,37). The proportion ofinpatient suicides with schizophrenia is also similar to the 35% previously reported (19,36), and lower than the 75.7% at another Canadian facility (18), but much higher than that at a third single Canadian facility (20).…”

Section: Methodssupporting

confidence: 88%

“…The annual rates (in studies lasting 8 to 20 years) ranged from 49.6 to 208 per 100 000 patients. For schizophrenia alone, rates of 167, 411, and 456 per 100 000 patients have been reported (15)(16)(17). In several studies, these high rates are extrapolations from small numbers of actual suicide cases.…”

mentioning

confidence: 99%

The Clarke Institute Experience with Completed Suicide: 1966 to 1997

Martin

2000

Can J Psychiatry

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Suicide as a cause ofdeath is one ofthe eventual outcomes ofmental illness, and the estimated risk ofsuicide for specific disorders is substantial, ranging from 4% to 10% for schizophrenia and up to 15% for severe affective disorders (1-6). The prevalence ofmental disorder in cases ofsuicide is 80% to 90% or higher (7-11). As a generalization, almost every substance abuse and severe mental disorder carries an increased risk of suicide (12,13). It will, therefore, inevitably be a cause of death in the caseload of every facility involved in the care of patients with serious mental illness.Not unexpectedly, then, the reported suicide rates for psychiatric caseloads are higher than those for general populations. An overview of the literature presents rates for both individual hospitals and groups ofhospitals over different time periods from the 19th century to 1985 (14). The more contemporary studies from 1950 on indicate a wide range in suicide rates. The cumulative rates for studies lasting from 3 to 21 years range from 79 to 684 per 100 000 patients treated or admitted; the rates for 5-year periods ranged from 35 to 629. The annual rates (in studies lasting 8 to 20 years) ranged from 49.6 to 208 per 100 000 patients. For schizophrenia alone, rates of 167, 411, and 456 per 100 000 patients have been reported (15)(16)(17). In several studies, these high rates are extrapolations from small numbers of actual suicide cases. Recent reports of inpatient suicide at Canadian hospitals do not cite the rates for registered patients at risk (18)(19)(20).Although inevitable and not uncommon within hospital caseloads, the occurrence of a suicide is generally very distressing to staff-often more so than a death from natural causes. To address both staffconcerns and more general quality assurance issues, many facilities conduct mandatory reviews ofall suicides in their caseloads. Such audits, including those conducted at the Clarke Institute, may address more than do traditional psychological autopsies, answering why the person died, what was the cause of death, and whether it was a suicide (21).The primary purpose of this report is to describe the experience with suicide in over 100 000 patients at a single psychiatric facility over a period ofmore than 30 years. The secondary purpose is to present an overview ofrecommendations made pursuant to audits of the documentation, management, and post-suicide response for each case. Although data on part of this caseload have been published previously (22,23), this is the first report of the entire cumulative experience with

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“…In a San Diego County study of private psychiatric patients (Morrison, 19841, the rate for psychiatric patients peaked in the 25 to 34 age group. The author attributed the finding to the characteristic early onset of schizophrenia and bipolar affective disorder, the two psychiatric disorders he had previously found to carry the greatest potential for suicide in his psychiatric population (Morrison, 1982). He also pointed to the predominance of unipolar depression among older patients, a disorder associated with a lower than average suicide rate (Morrison, 1982) and for which there are effective biological treatments.…”

mentioning

confidence: 98%

Schizophrenia—A High‐Risk Factor for Suicide: Clues to Risk Reduction

Caldwell,

Gottesman

1992

Suicide & Life Threat Behav

138

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Suicide is the chief cause of premature death among schizophrenic persons. The lifetime incidence of suicide for patients with schizophrenia is 10% to 13% compared to a general population estimate of about 1%, and is quite close to that observed among those with major affective disorder. The magnitude of increased risk for suicide among schizophrenics peaks before middle age and declines thereafter, although schizophrenic persons tend to be at increased risk throughout the life span. Among psychiatric patients, schizophrenics are overrepresented among suicides, and often schizophrenics constitute the majority of inpatient suicides. It is important in evaluating suicide risk among schizophrenic persons to assess depression and suicidal ideation especially during index admission and during acute phases of the illness. It is noteworthy that schizophrenic persons often commit suicide as the overall level of psychopathology decreases during a nonpsychotic phase. Research has yielded salient risk factors for suicide in schizophrenic persons and “types” of especially vulnerable patients, even though statistical prediction of individual suicides has not proven effective.

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Suicide in Psychiatric Patients: Age Distribution

Cited by 7 publications

References 8 publications

Suicides in close connection with psychiatric care: An analysis of 57 cases in a Swedish county

Suicides in close connection with psychiatric care: An analysis of 57 cases in a Swedish county

The Clarke Institute Experience with Completed Suicide: 1966 to 1997

Schizophrenia—A High‐Risk Factor for Suicide: Clues to Risk Reduction

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