The study aimed at exploring prevalence and risk factors of attempted suicide and suicidal thoughts before hospital admission.

40.451 episodes of inpatient care from 1995 to 2004 were included. Last admission of each patient (n=20.543) was extracted to investigate attempted suicide and suicidal thoughts before admission, which were recorded by the German Basic Documentation System (BADO). Univariate analyses and multivariate logistic regression analyses were performed to explore predictors of suicidality before hospital admission.

3.643 (17.7%) of 20.543 inpatients attempted suicide or had suicidal thoughts before admission. 1.478 (7.2%) attempted suicide before admission. Most had diagnoses F43 (36.5%), F32/33 (19.2%) or F60/61 (8.8%). According to regression analysis risk of attempted suicide increases with life time suicide attempt, diagnosis F43, admission due to doctor´s recommendation, diagnosis F32/33, diagnosis F60/61 and period of onset of present episode less than one week. 2.165 (10.5%) had suicidal thoughts before admission without concomitant suicide attempt. Most frequent diagnoses were F43 (23.5%), F32/33 (22.7%) and F10 (11.7%). Risk of suicidal thoughts increases with diagnosis F43, diagnosis F32/33, life time suicide attempt, diagnosis F60/61, supportive psychotherapy before admission, period of onset of present episode less than one week, being younger and being not rehospitalized.

Basic rate of suicidality before admission of psychiatric inpatients is high. Therefore, risk of suicide should be carefully examined at admission but also during inpatient care. Especially, inpatients with adjustment disorder and depression seem to be a high risk groups regarding suicidality before admission and require special attention.