Characteristics of the Early Post-suicidal Period after Repeat Suicide Attempts in Patients with Mental Disorders

Study Objective: To study characteristics of the early post-suicidal period after suicide attempts in patients with mental disorders. Study Design: This was a retrospective clinical study. Materials and Methods: The study looked at the characteristics of the early post-suicidal period after suicide attempts in a group of 260 subjects with mental disorders (schizophrenia-spectrum disorders, organic, affective, neurotic, addictive, or personality disorders, or intellectual disability). The mean age of patients who attempted suicide was 43.5 ± 17.7 years. The numbers of men and women were almost equal: 134 (51.5%) and 126 (48.5%), respectively (p>0.05). The mean duration of hospitalization was 42.7 ± 43.2 bed-days. The study methods included clinical examinations, psychopathological assessments, psychometrics, and statistical-mathematical methods. Study Results: The authors identified the following main types of early post-suicidal period: the critical type (n = 73, 28.1%) and denial of a suicide attempt (n = 55, 21.2%) were the most common and the analytical type (n = 23, 8.8%) was the least common. The study determined that 77 (29.6%) psychiatric inpatients with a history of attempting suicide made another attempt. The most common methods of attempted suicide in this group of patients included poisoning with medications (n = 41, 53.2%) and self-cutting (n = 26, 33.8%), and 40.3% were under the influence of alcohol at the time of the repeat suicide attempt. Among the patients who made a repeat suicide attempt, manipulative and suicide-fixated types of post-suicidal period were observed significantly more often. Patients with mental disorders who made repeat suicide attempts showed poor social adjustment in their professional life and overall attitude toward life. Conclusion: The characteristics of the post-suicidal period identified in patients with mental disorders who have made a repeat suicide attempt should be taken into consideration when planning and providing secondary preventive mental healthcare services. Further investigation of these characteristics in various groups of patients, combined with a search for predictive factors for repeat suicide attempts, as well as evaluation of the effectiveness of previously provided preventive mental health care, will make it possible to better tailor these services and reduce the overall risk of suicidal behavior in people with mental disorders. Keywords: suicide, repeat suicide attempt, type of post-suicidal period, mental disorder, social adjustment.

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Long-term economic and social outcomes of youth suicide attempts

The British Journal of Psychiatry ◽

10.1192/bjp.2021.133 ◽

2021 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Massimiliano Orri ◽

Francis Vergunst ◽

Gustavo Turecki ◽

Cédric Galera ◽

Eric Latimer ◽

...

Keyword(s):

At Risk ◽

Mental Disorders ◽

Suicide Attempt ◽

Attempted Suicide ◽

Suicide Attempts ◽

Social Outcomes ◽

Retirement Savings ◽

Youth Suicide ◽

Socioeconomic Outcomes

Background Youth who attempt suicide are more at risk for later mental disorders and suicide. However, little is known about their long-term socioeconomic outcomes. Aims We investigated associations between youth suicide attempts and adult economic and social outcomes. Method Participants were drawn from the Quebec Longitudinal Study of Kindergarten Children (n = 2140) and followed up from ages 6 to 37 years. Lifetime suicide attempt was assessed at 15 and 22 years. Economic (employment earnings, retirement savings, welfare support, bankruptcy) and social (romantic partnership, separation/divorce, number of children) outcomes were assessed through data linkage with government tax return records obtained from age 22 to 37 years (2002–2017). Generalised linear models were used to test the association between youth suicide attempt and outcomes adjusting for background characteristics, parental mental disorders and suicide, and youth concurrent mental disorders. Results By age 22, 210 youths (9.8%) had attempted suicide. In fully adjusted models, youth who attempted suicide had lower annual earnings (average last 5 years, US$ −4134, 95% CI −7950 to −317), retirement savings (average last 5 years, US$ −1387, 95% CI −2982 to 209), greater risk of receiving welfare support (risk ratio (RR) = 2.05, 95% CI 1.39 to 3.04) and were less likely to be married/cohabiting (RR = 0.82, 95% CI 0.73 to 0.93), compared with those who did not attempt suicide. Over a 40-year working career, the loss of individual earnings attributable to suicide attempts was estimated at US$98 384. Conclusions Youth who attempt suicide are at risk of poor adult socioeconomic outcomes. Findings underscore the importance of psychosocial interventions for young people who have attempted suicide to prevent long-term social and economic disadvantage.

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Predictive factors for the medical hospitalisation of patients who visited the emergency department with suicide attempt

10.21203/rs.3.rs-51267/v3 ◽

2021 ◽

Author(s):

Hye Jin Kim ◽

Duk Hee Lee

Keyword(s):

Emergency Department ◽

Suicide Attempt ◽

Attempted Suicide ◽

Suicide Attempts ◽

Area Under The Curve ◽

Public Health Problem ◽

Teaching Hospitals ◽

Operating Characteristics ◽

Tertiary Teaching ◽

The Mean

Abstract Background Suicide is a significant public health problem. Individuals are estimated to make up to 20 suicide attempts before suicide. The emergency department (ED) is the first location where individuals are brought after a suicide attempt. This study investigated the factors related to delays in the medical hospitalisation of patients who attempted suicide and aimed to provide criteria for hospitalisation decisions by physicians. Methods This study included patients who had deliberately self-harmed (age ≥19 years) and presented at the EDs of two tertiary teaching hospitals between March 2017 and April 2020. Those for whom relevant demographic and clinical information were unavailable and those admitted to the psychiatric wards were excluded. Results This study included 414 patients in the hospitalisation group and 1,346 in the discharged group. The mean patient age was 50.3 ± 20.0 years and 40.7 ± 17.0 years in the hospitalised and discharged groups (p <0.001), respectively. The mean ED length of stay (LOS) was 4.2 ± 12.3 and 11.4 ± 18.8 h in the hospitalised and discharged groups, respectively. In the hospitalised group, the odds ratio and confidence interval for aged 35~64 (2.222, 1.343–3.678), aged over 65 (2.788, 1.416-5.492), sex -male (2.041, 1.302–3.119), and consciousness (1.840, 1.253–2.466). The Risk-Rescue Ratio Scale (RRRS) was (1.298, 1.255–1.343). A receiver operating characteristics analysis of RRRS for the decision to hospitalise patients who attempted suicide showed a cut-off value of 42, with sensitivity, specificity, and area under the curve being 85.7%, 85.5%, and 0.924, respectively.Conclusion The level of consciousness and the RRRS of patients who attempted suicide can be the factors to decide medical hospitalisation and reduce ED LOS and crowding.

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VARTOJANČIŲJŲ PSICHOAKTYVIAS MEDŽIAGAS MĖGINIMŲ NUSIŽUDYTI TIPAI

Psichologija ◽

10.15388/psichol.2012.45.4 ◽

2012 ◽

Vol 45 ◽

pp. 55-69

Author(s):

Jurgita Rimkevičienė ◽

Danutė Gailienė

Keyword(s):

Substance Use ◽

Suicide Attempt ◽

Risk Evaluation ◽

Suicide Risk ◽

Attempted Suicide ◽

Suicide Attempts ◽

Psychoactive Substance ◽

Substance Users ◽

Study Results ◽

Suicidal Crisis

Suicidologijoje stokojama duomenų apie psichoaktyvių medžiagų vartojimo vaidmenį savižudybės procese bei impulsyvių ir neimpulsyvių mėginimų nusižudyti skirtumus. Šiame tyrime atlikta 15 vartojančių alkoholį arba narkotikus asmenų, per paskutinius metus mėginusių nusižudyti, kokybinių interviu teminė analizė. Tyrimas leido išskirti ne du, kaip aprašoma literatūroje, o tris mėginimų nusižudyti tipus, būdingus vartojantiems psichoaktyvias medžiagas: planuoti, neplanuoti ir mėginimai nusižudyti „aptemus sąmonei“, ir aprašyti visiems jiems būdingus bruožus. Nepaisant kai kurių ribotumų, šis tyrimas gali pasiūlyti vertingų įžvalgų vertinant vartojančių psichoaktyvias medžiagas asmenų suicidinę riziką.Pagrindiniai žodžiai: mėginimas nusižudyti, savižudybės procesas, psichoaktyvios medžiagos, alkoholis, narkotikai.THE TYPES OF SUICIDE PROCESS AMONG PSYCHOACTIVE SUBSTANCE USERS Jurgita Rimkevičienė, Danutė Gailienė Summary Research regarding the role of psychoactive substance use in the process of suicide is lacking in current suicidology. In addition to this, evidence shows that impulsive suicide attempts are common among substance users. However there is no clear understanding of the impulsive suicide process. That makes it difficult to combine results of different studies and create clear guidelines for impulsive suicide risk evaluation. The purpose of this research is to depict the impulsive and non-impulsive process of suicide among psychoactive substance users. The participants of the study were 15 psychoactive substance (10 – alcohol, 5 – drug) users, who had attempted suicide during the last year. 8 of them attempted once, 4 – two or three times, other 3 – more than 5 times. All participants – 4 women and 11 men were patients from Vilnius Centre for Addictive Disorders and Vilnius Mental Health Centre. Qualitative interviews based on Suicide Intent Scale were conducted about the suicide attempt or attempts. A thematic analysis of the interviews was used to depict the process of suicide. This study led to distinguishing 3 different types of attempted suicide – planned, unplanned and suicide attempts during a “blackout” – which are typical for psychoactive substance users. Both unplanned suicide attempts and suicide attempts during a “blackout” can be called impulsive, though the latter diverged by their hastiness, aggressiveness, inability to control one’s behaviour, intensive feeling of anger, serious danger caused to health and wellbeing, as well as a following amnesia of a major part of the suicide attempt. Intensive emotions, especially anger and stressors in interpersonal relationships, had a major impact for the respondents in the process of suicide. According to the participants of the survey, substance use had intensified their suicidal crisis having a clear effect on their emotional, relationship and other difficulties. In addition, alcohol and drug use was considered as one of the suicide methods. Despite several restrictions of the research, the study results provide some valuable insight in the suicide risk evaluation among psychoactive substance users. Key words: suicide attempt, suicide process, psychoactive substances, alcohol, drugs.

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Predictive factors for the medical hospitalization of patients who visited to emergency department with suicide attempt

10.21203/rs.3.rs-51267/v2 ◽

2020 ◽

Author(s):

Hye Jin Kim ◽

Duk Hee Lee

Keyword(s):

Emergency Department ◽

Suicide Attempt ◽

Attempted Suicide ◽

Suicide Attempts ◽

Area Under The Curve ◽

Public Health Problem ◽

Teaching Hospitals ◽

Operating Characteristics ◽

Tertiary Teaching ◽

The Mean

Abstract Background Suicide is a significant public health problem. Individuals are estimated to make up to 20 suicide attempts before suicide. The emergency department (ED) is the first location where individuals are brought after a suicide attempt. This study investigated the factors related to delays in the medical hospitalization of patients who attempted suicide and aimed to provide criteria for hospitalization decisions for physicians. Methods This study included who had deliberately self-harmed (age ≥19 years) and who presented at the EDs of two tertiary teaching hospitals between March 2017 and April 2020. Those for whom relevant demographic and clinical information were unavailable and those who were admitted to the psychiatric wards were excluded. Results This study included 414 patients in the hospitalization group and 1,346 in the discharged group. The mean patient age was 50.3 ± 20.0 years and 40.7 ± 17.0 years in the hospitalized and discharged groups ( p <0.001), respectively. The mean ED length of stay (LOS) was 4.2 ± 12.3 and 11.4 ± 18.8 h in the hospitalized and discharged groups, respectively . In the hospitalized group, the odds ratio and confidence interval for aged 35~64 (2.222, 1.343–3.678), aged over 65 (2.788, 1.416-5.492), sex -male (2.041, 1.302–3.119), and consciousness (1.840, 1.253–2.466). The Risk-Rescue Ratio Scale (RRRS) was (1.298, 1.255–1.343). A receiver operating characteristics analysis of RRRS for the decision to hospitalize patients who attempted suicide showed a cut-off value of 42, with sensitivity, specificity, and area under the curve being 85.7%, 85.5%, and 0.924, respectively. Conclusion The level of consciousness and the RRRS of patients who attempted suicide can be the factors to decide medical hospitalization and reduce ED LOS and crowding.

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Family, Health, and Poverty Factors Impacting Suicide Attempts in Cambodian Women

Crisis ◽

10.1027/0227-5910/a000548 ◽

2019 ◽

Vol 40 (2) ◽

pp. 141-145

Author(s):

Desiree M. Seponski ◽

Charity M. Somo ◽

Sovandara Kao ◽

Cindy J. Lahar ◽

Sareth Khann ◽

...

Keyword(s):

Data Collection ◽

Suicide Attempt ◽

Suicide Prevention ◽

Emotional Distress ◽

Family Conflict ◽

Attempted Suicide ◽

Suicide Attempts ◽

Family Health ◽

Life Saving ◽

Study Results

Abstract. Background: Our recent report demonstrates that 5.5% of Cambodian women have previously attempted suicide. Despite these high rates and critical need for intervention, research on suicide attempts in Cambodia is lacking, and life-saving information on suicide prevention is therefore unknown. Aims: This study explores factors impacting Cambodian women suicide attempts. Method: A total of 1,801 women participated in the large national survey during which 100 of these women (5.5%) reported at least one suicide attempt. Of the 100 participants 76 provided qualitative reasons for the suicide attempts. Only the 76 who provided the reasons for suicide attempt were included for analysis in this study. Results: Four major themes emerged: (1) family conflict, (2) emotional distress, (3) poverty, and (4) illness. Family conflict, emotional distress, poverty, and illness were all interrelated with each other; for example, women without money were unable to pay for treatment of otherwise treatable illnesses. Limitations: Owing to the nature of the data collection, member checking could not be conducted. Conclusion: Cumulative and intertwined personal, interpersonal, and contextual-level factors impacting suicide attempts included emotional distress, illness, family conflict, and poverty. Findings highlight points of intervention at individual, familial, and contextual levels to prevent suicide.

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Predictive factors for the medical hospitalisation of patients who visited the emergency department with suicide attempt

BMC Psychiatry ◽

10.1186/s12888-021-03089-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hye Jin Kim ◽

Duk Hee Lee

Keyword(s):

Emergency Department ◽

Suicide Attempt ◽

Attempted Suicide ◽

Suicide Attempts ◽

Area Under The Curve ◽

Public Health Problem ◽

Teaching Hospitals ◽

Operating Characteristics ◽

Tertiary Teaching ◽

The Mean

Abstract Background Suicide is a significant public health problem. Individuals are estimated to make up to 20 suicide attempts before suicide. The emergency department (ED) is the first location where individuals are brought after a suicide attempt. This study investigated the factors related to delays in the medical hospitalisation of patients who attempted suicide and aimed to provide criteria for hospitalisation decisions by physicians. Methods This study included patients who had deliberately self-harmed (age ≥ 19 years) and presented at the EDs of two tertiary teaching hospitals between March 2017 and April 2020. Those for whom relevant demographic and clinical information were unavailable and those admitted to the psychiatric wards were excluded. Results This study included 414 patients in the hospitalisation group and 1346 in the discharged group. The mean patient age was 50.3 ± 20.0 years and 40.7 ± 17.0 years in the hospitalised and discharged groups (p < 0.001), respectively. The mean ED length of stay (LOS) was 4.2 ± 12.3 and 11.4 ± 18.8 h in the hospitalised and discharged groups, respectively. In the hospitalised group, the odds ratio and confidence interval for aged 35 ~ 64 (2.222, 1.343–3.678), aged over 65 (2.788, 1.416–5.492), sex -male (2.041, 1.302–3.119), and consciousness (1.840, 1.253–2.466). The Risk-Rescue Ratio Scale (RRRS) was (1.298, 1.255–1.343). A receiver operating characteristics analysis of RRRS for the decision to hospitalise patients who attempted suicide showed a cut-off value of 42, with sensitivity, specificity, and area under the curve being 85.7, 85.5%, and 0.924, respectively. Conclusion The level of consciousness and the RRRS of patients who attempted suicide can be the factors to decide medical hospitalisation and reduce ED LOS and crowding.

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Family, Health, and Poverty Factors Impacting Suicide Attempts in Cambodian Women

Crisis ◽

10.1027/0227-5910/a001548 ◽

2018 ◽

pp. 1-5

Author(s):

Desiree M. Seponski ◽

Charity M. Somo ◽

Sovandara Kao ◽

Cindy J. Lahar ◽

Sareth Khann ◽

...

Keyword(s):

Data Collection ◽

Suicide Attempt ◽

Suicide Prevention ◽

Emotional Distress ◽

Family Conflict ◽

Attempted Suicide ◽

Suicide Attempts ◽

Family Health ◽

Life Saving ◽

Study Results

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Attempted suicide attention at an emergency room: A hospital-based descriptive approach

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.2252 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S603-S603

Author(s):

D. Torres ◽

G. Martinez-Ales ◽

M. Quintana ◽

V. Pastor ◽

M.F. Bravo

Keyword(s):

Emergency Room ◽

Attempted Suicide ◽

Suicide Attempts ◽

Psychiatric Hospitalization ◽

Study Results ◽

History Of ◽

Competing Interest ◽

Reported Data ◽

Medium Cost ◽

Rule Out

IntroductionSuicide causes 1.4% of deaths worldwide. Twenty times more frequent, suicide attempts entail an important source of disability and of psychosocial and medical resources use.ObjectiveTo describe main socio-demographical and psychiatric risk factors of suicide attempters treated in a general hospital's emergency room basis.AimsTo identify individual features potentially useful to improve both emergency treatments and resource investment.MethodsA descriptive study including data from 2894 patients treated in a general hospital's emergency room after a suicidal attempt between years 2006 and 2014.ResultsSixty-nine percent of the population treated after an attempted suicide were women. Mean age was 38 years old. Sixty-six percent had familiar support; 48.5% had previously attempted a suicide (13% did not answer this point); 72.6% showed a personal history of psychiatric illness. Drug use was present in 38.3% of the patients (20.3% did not answer this question); 23.5% were admitted to an inpatient psychiatric unit. Medium cost of a psychiatric hospitalization was found to be 4900 euros.ConclusionThis study results agree with previously reported data. Further observational studies are needed in order to bear out these findings, rule out potential confounders and thus infer and quantify causality related to each risk factor.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Risk of suicide after attempted suicide in the population of Slovenia from 1970 to 1996

European Psychiatry ◽

10.1016/j.eurpsy.2005.04.006 ◽

2006 ◽

Vol 21 (6) ◽

pp. 396-400 ◽

Cited By ~ 11

Author(s):

Slavko Ziherl ◽

Bojan Zalar

Keyword(s):

Suicide Attempt ◽

Attempted Suicide ◽

Suicide Attempts ◽

Categorical Variables ◽

Frequency Table ◽

Completed Suicide ◽

The Republic ◽

And Gender ◽

Log Linear ◽

Commit Suicide

AbstractObjective:All suicide attempts cannot predict suicide, therefore we examined those characteristics of suicide attempt which could most accurately predict completed suicide.Subject and methods:Subjects were all individuals registered as committed suicides (N = 16,522) or attempted suicides (N = 15,057) in the register of suicides of the Republic of Slovenia between 1970 and 1996. Log linear analysis of a frequency table was used to uncover relationship between categorical variables.Results:The model we found fit between variables: mode, number of repetitions and type, then between number of repetitions, type and gender, and between mode, type and gender.Discussion:The risk of suicide in those who previously attempted suicide is approximately 773 times higher than the risk of suicide without a previous suicide attempt. Those who attempt suicide by hanging (hanging being in Slovenia the most frequent mode of completed suicide) are at even greater risk to commit suicide.Conclusion:Our data suggests that clinicians should heighten their awareness that any suicide attempt can in some 20% predict suicide. Someone who has attempted suicide by hanging is at the highest risk of suicide.

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Increased risk of attempted suicide in Australian veterans is associated with total and permanent incapacitation, unemployment and posttraumatic stress disorder severity

Australian & New Zealand Journal of Psychiatry ◽

10.1177/0004867417718945 ◽

2017 ◽

Vol 52 (6) ◽

pp. 552-560 ◽

Cited By ~ 1

Author(s):

Katelyn Kerr ◽

Madeline Romaniuk ◽

Sarah McLeay ◽

Andrew Khoo ◽

Michael T Dent ◽

...

Keyword(s):

Posttraumatic Stress Disorder ◽

Suicide Attempt ◽

Posttraumatic Stress ◽

Attempted Suicide ◽

Suicide Attempts ◽

Stress Disorder ◽

Self Report ◽

Depression Symptoms ◽

Increased Risk ◽

History Of

Background: Military veterans have higher rates of suicidality and completed suicides compared to the general population. Previous research has demonstrated suicidal behaviour is higher in US combat veterans who are younger, suffer from posttraumatic stress disorder, depression and anxiety and score lower on measures of health. However, research on predictors of suicide for Australian veterans is limited. The aim of this study was to identify significant demographic and psychological differences between veterans with posttraumatic stress disorder who had attempted suicide and those with posttraumatic stress disorder who had not, as well as determine predictors of suicide attempts within an Australian cohort. Methods: A retrospective analysis was conducted on 229 ex-service personnel diagnosed with posttraumatic stress disorder who had attended a Military Service Trauma Recovery Day Program as outpatients at Toowong Private Hospital from 2007 to 2014. Patients completed a battery of mental health self-report questionnaires assessing symptoms of posttraumatic stress disorder, alcohol use, anger, depression, anxiety and quality of life. Demographic information and self-reported history of suicide attempts were also recorded. Results: Results indicated the average age was significantly lower, and the rates of posttraumatic stress disorder, anger, anxiety and depression symptoms were significantly higher in those veterans with history of a suicide attempt. Multivariate logistic regression analyses indicated posttraumatic stress disorder symptom severity, unemployment or total and permanent incapacity pension status significantly predicted suicide attempt history. Conclusion: Among a cohort of Australian veterans with posttraumatic stress disorder, psychopathology severity, unemployment and total and permanent incapacity status are significantly associated with suicidality. This study highlights the importance of early identification of posttraumatic stress disorder and psychopathology, therapeutic and social engagement, and prioritisation of tangible employment options or meaningful and goal-directed activities for veterans deemed unable to work.

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