Suicide risk in the general hospital

Abstract

This paper reviews the relationship between physical illness and suicide, reviews the studies of attempters and completers of suicide in general hospitals, and discusses those studies which have investigated the characteristics of patients in the medical setting with suicidal ideation. Study of suicidal ideation in a general hospital setting aimed at characterizing patients' suicidality may allow psychiatrists to better discriminate those patients at greater risk for completed suicide. Comparison of medical patients with suicidal ideation with those who had attempted or completed suicide, and recommendations to reduce suicidal impulses and treat these patients are discussed.

A Comparison of Japanese and American Psychiatrists’ Attitudes towards Patients Wishing to Die in the General Hospital

“…This is thought to be due to the desire to maintain the image of the physician as protector of life and that there is the danger of abuse in legalizing these procedures [10], Studies of suicide victims in both the west and in Japan have consistently found high rates of preexisting mental disorders, and psychiatrists will need to determine when depression in the terminally ill may affect one's decision to forgo life-sustaining medical treatment [11][12][13][14][15]. Ganzini et al [13] found that remission of major depression with hopelessness in psychiatric patients increased the preferences of these patients for life-saving treatment, while Chochinov et al [ 15] and Berger [16,17] found the desire for death in med-surg or terminal patients to be associated with clinical depression: this desire for death was often transient, and improvement in family support and treatment of pain could diminish desire for death.…”