Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-23T00:59:07.410Z Has data issue: false hasContentIssue false

Risk factors of suicide in inpatients and recently discharged patients with affective disorders. A case-control study

Published online by Cambridge University Press:  16 April 2020

E.H. Høyer*
Affiliation:
Psychiatric hospital in Aarhus, University of Aarhus, Skovagervej 2, DK-8240Risskov, Denmark
R.W. Licht
Affiliation:
Mood Disorders Research Unit, Psychiatric Hospital in Aarhus, University of Aarhus, Skovagervej 2, DK-8240Risskov, Denmark
P.B. Mortensen
Affiliation:
National Centre for Register-based Research, University of Aarhus, Taasingegade 1, DK-8000Aarhus C, Denmark
*
*Corresponding author. Gerontopsyciatric Department, University Hospital in Risskov, Skovagervej 2, 8240 Risskov, Denmark. E-mail address: [email protected]
Get access

Abstract

Objective

Patients with affective disorders are at high risk of suicide, especially during inpatient treatment and during the first year after discharge.

Methods

A blinded case-control design was used. The study included a total national sample of patients with affective disorder admitted during the period from January 1, 1994 to December 31, 1995, who died because of suicide, either during admission or shortly after discharge.

Results

A history of suicide attempt was a significant risk factor (IRR 4.9; 95% CI 2.1–11.6). Loss of job during the year prior to the index admission was associated with an increase in suicide risk (IRR: 2.9; 95% CI 1.2–7.5). Clinical improvement during the index admission (IRR: 0.3; 95% CI 0.1–0.7), and treatment with antidepressant drugs at the censoring date (IRR: 0.3; 95% CI 0.1–0.7) were associated with a decrease in suicide risk.

Conclusion

Improved treatment may be a key factor in suicide prevention in patients during, and shortly after hospitalisation with affective disorders. Also, there is a need to be especially aware of suicide risk in patients with little or no improvement at discharge.

Type
Original article
Copyright
Copyright © Elsevier Masson SAS 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andersen, U.A., Andersen, M., Rosholm, J.U., Gram, L.F.Psychopharmacological treatment and psychiatric morbidity in 390 cases of suicide with special focus on affective disorders. Acta Psychiatr Scand 2001;104(6):458465.CrossRefGoogle ScholarPubMed
Appleby, L., Shaw, J., Amos, T., McDonnell, R., Harris, C., McCann, K.et al.Suicide within 12 months of contact with mental health services: national clinical survey [see comments] BMJ 1999;318(7193):12351239.CrossRefGoogle ScholarPubMed
Barraclough, B., Bunch, J., Nelson, B., Sainsbury, P.A hundred cases of suicide: clinical aspects. Br J Psychiatry 1974;125:355373.CrossRefGoogle ScholarPubMed
Coryell, W., Haley, J., Endicott, J., Solomon, D., Leon, A.C., Keller, M.et al.The prospectively observed course of illness among depressed patients who commit suicide. Acta Psychiatr Scand 2002;105(3):218223.CrossRefGoogle ScholarPubMed
Dennehy, J.A., Appleby, L., Thomas, C.S., Faragher, E.B.Case-control study of suicide by discharged psychiatric patients. BMJ 1996;312(7046):1580CrossRefGoogle ScholarPubMed
Goldacre, M., Seagroatt, V., Hawton, K.Suicide after discharge from psychiatric inpatient care. Lancet 1993;342(8866):283286.CrossRefGoogle ScholarPubMed
Hoyer, E.H., Olesen, A.V., Mortensen, P.B.Suicide risk in patients hospitalised because of affective disorder. A follow study, 1973–1993. J Affect Disord 2004;78(3):209217.CrossRefGoogle ScholarPubMed
Isometsa, E.T., Henriksson, M.M., Aro, H.M., Heikkinen, M.E., Kuoppasalmi, K.I., Lonnqvist, J.K.Suicide in major depression. Am J Psychiatry 1994;151(4):530536.Google ScholarPubMed
Isometsa, E.T., Lonnqvist, J.Suicide in major depressionBotsis, J.A., Soldatos, C.R., Stefanis, C.N.Suicide: Biopsychosocial approaches Amsterdam: Elsevier; 1997. 3347.Google Scholar
Kessing, L.V.Validity of diagnoses and other clinical register data in patients with affective disorder. Eur Psychiatry 1998;13:392398.CrossRefGoogle ScholarPubMed
Kessing, L.V., Agerbo, E., Mortensen, P.B.Does the impact of major stressful life events on the risk of developing depression change throughout life?. Psychol Med 2003;33(7):11771184.CrossRefGoogle ScholarPubMed
King, E.A., Baldwin, D.S., Sinclair, J.M., Baker, N.G., Campbell, M.J., Thompson, C.The Wessex Recent In-Patient Suicide Study, 1. Case-control study of 234 recently discharged psychiatric patient suicides. Br J Psychiatry 2001;178:531536.CrossRefGoogle ScholarPubMed
King, E.A., Baldwin, D.S., Sinclair, J.M., Campbell, M.J.The Wessex Recent In-Patient Suicide Study, 2. Case-control study of 59 inpatient suicides. Br J Psychiatry 2001;178:537542.CrossRefGoogle Scholar
McGuffin, P., Farmer, A., Harvey, I.A polydiagnostic application of operational criteria in studies of psychotic illness. Development and reliability of the OPCRIT system [news] Arch Gen Psychiatry 1991;48(8):764770.CrossRefGoogle ScholarPubMed
Moller, H.J.Suicide, suicidality and suicide prevention in affective disorders. Acta Psychiatr Scand Suppl 2003;418:7380.CrossRefGoogle Scholar
Mortensen, P.B., Agerbo, E., Erikson, T., Qin, P., Westergaard-Nielsen, N.Psychiatric illness and risk factors for suicide in Denmark. Lancet 2000;355(9197):912.CrossRefGoogle ScholarPubMed
Munk-Jorgensen, P., Mortensen, P.B.The Danish Psychiatric Central Register. Dan Med Bull 1997;44(1):8284.Google ScholarPubMed
Nordentoft, M., Breum, L., Munck, L.K., Nordestgaard, A.G., Hunding, A., Laursen Bjaeldager, P.A.High mortality by natural and unnatural causes: a 10-year follow up study of patients admitted to a poisoning treatment centre after suicide attempts [see comments] BMJ 1993;306(6893):16371641.CrossRefGoogle ScholarPubMed
Powell, J., Geddes, J., Deeks, J., Goldacre, M., Hawton, K.Suicide in psychiatric hospital inpatients. Risk factors and their predictive power. Br J Psychiatry 2000;176:266272.CrossRefGoogle ScholarPubMed
Qin, P., Agerbo, E., Mortensen, P.B.Suicide risk in relation to socioeconomic, demographic, psychiatric, and familial factors: A National Register-Based Study of All Suicides in Denmark, 1981–1997. Am J Psychiatry 2003;160(4):765CrossRefGoogle Scholar
Romanov, K., Varjonen, J., Kaprio, J., Koskenvuo, M.Life events and depressiveness – the effect of adjustment for psychosocial factors, somatic health and genetic liability. Acta Psychiatr Scand 2003;107(1):2533.CrossRefGoogle ScholarPubMed
Rothmann, K.J., Greenland, S.Modern epidemiology Philadelphia: Lippincott-Raven; 1998.Google Scholar
Sinclair, J.M., Harriss, L., Baldwin, D.S., King, E.A.Suicide in depressive disorders: a retrospective case-control study of 127 suicides. J Affect Disord 2005;87(1):107113.CrossRefGoogle ScholarPubMed
STATA Corporation STATA. Release 6 College Station, TX: STATA Press; 1998.Google Scholar
World Health Organisation International Classification of Diseases, 10th version World Health Organisation; 1992.Google Scholar
Submit a response

Comments

No Comments have been published for this article.