Contact with the health care system prior to suicide: A nationwide population-based analysis using linkage national death certificates and national health insurance data

Park, Eun Jee; Ji, Nam Ju; Lee, Weon Young

doi:10.1016/j.jpsychires.2022.02.024

Cited by 5 publications

(2 citation statements)

References 31 publications

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“…In line with previous reports (1)(2)(3)(4)(6)(7)(8)21,22), the majority of individuals who died from suicide in our study consulted with primary care at least once in their final year. Our results also concur with earlier studies suggesting high suicide risk associated with frequent consultations with primary care (5-7).…”

Section: Comparison With Existing Literaturesupporting

confidence: 92%

Primary care consultation patterns before suicide: a nationally representative case–control study

Alothman,

Lewis,

Fogarty

et al. 2024

Br J Gen Pract

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Background: Consultation with primary health care may provide an opportunity to identify patients at higher suicide risk. Aims: To explore primary care consultation patterns in the 5 years before suicide to identify suicide high-risk groups and common reasons for consulting. Design: A case-control study in England from 2001 to 2019 using electronic health records. Method: Analysis of 14515 patients aged ≥15 who died by suicide and up to 40 matched live controls per case (N=594674). Results: Frequent consultations (>once per month in the final year) were associated with increased suicide risk (age and sex adjusted odds ratio (OR) 5.88; 95% CI: 5.47-6.32). The associated rise in suicide risk was seen across all sociodemographic groups as well as in those with and without psychiatric comorbidities. However, specific groups were more influenced by the effect of high-frequency consultation (>once per month in the final year) demonstrating higher suicide risk compared to their counterparts who consulted once: females (adjusted OR 9.50; 95% CI: 7.82-11.54); patients aged 15 to 45 (adjusted OR 8.08; 95% CI: 7.29-8.96); patients experiencing less socioeconomic deprivation (adjusted OR 6.56; 95% CI: 5.77-7.46); and those with psychiatric conditions (adjusted OR 4.57;95% CI: 4.12 to 5.06). Medication review, depression and pain were the commonest reasons for which suicide decedents consulted in the year before death. Conclusion: Escalating, or more than monthly consultations are associated with increased suicide risk regardless of patients’ sociodemographic characteristics and regardless of the presence (or absence) of known psychiatric illnesses.

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Section: Comparison With Existing Literaturesupporting

confidence: 92%

Primary care consultation patterns before suicide: a nationally representative case–control study

Alothman,

Lewis,

Fogarty

et al. 2024

Br J Gen Pract

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“…Notably, NO was not significantly associated with suicide hazards despite several previous results reporting increased contact with general practitioners and increased visits for physical symptoms before suicide ( 27 , 28 ). Another recent study using nationally representative Korean cohort data also reported that among those who completed suicide, utilization of non-psychiatric health care was more common than that of psychiatric health care prior to suicide ( 29 ). A study using a Swedish national cohort also reported that suicide among patients with drug use disorders was often preceded by NO ( 30 ), and a Danish study reported an increased frequency of encounters with general practitioners before suicide death ( 31 ).…”

Section: Discussionmentioning

confidence: 99%

Increased suicide risk of psychiatric patients following the recent utilization of health care services: results from a nationwide cohort study in South Korea

Lee

Lim

et al. 2023

Front. Public Health

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PurposeThis study aimed to examine whether and to what degree the suicide risk of psychiatric patients is associated with psychiatric and non-psychiatric health service utilization.MethodsWe selected incident psychiatric patients, including schizophrenia, bipolar disorders, borderline personality disorder, depressive disorders, other affective disorders, and post-traumatic stress disorder patients, in 2007–2010 and followed them up until 2017 based on the data linkage between the Korean National Health Insurance and National Death Registry. We analyzed the time-dependent association between suicide and four types of health service (psychiatric vs. non-psychiatric and outpatient vs. inpatient) utilization using a time-dependent Cox regression.ResultsThe suicide risk of psychiatric patients was significantly increased with recent psychiatric and non-psychiatric admission and psychiatric outpatient visits. The adjusted suicide hazard ratios for recent outpatient visits were similar to or even higher than those for recent psychiatric admission. The adjusted suicide hazard ratios of schizophrenia patients for psychiatric admission, psychiatric outpatient visits, and non-psychiatric admission within the recent 6 months were 2.34 (95% confidence interval [CI]: 2.12–2.58, p < 0.001), 2.96 (95% CI: 2.65–3.30, p < 0.001), and 1.55 (95% CI: 1.39–1.74, p < 0.001), respectively. Suicide risk was not associated with recent non-psychiatric outpatient visits in patients, except for the depressive disorders group showing a negative association.ConclusionOur results highlight the priority of suicide prevention for psychiatric patients in the clinical setting. Additionally, our results warrant the precaution against increased suicide risk of psychiatric patients after psychiatric and non-psychiatric discharge.

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Deep learning model with multi-feature fusion and label association for suicide detection

Cheng

Zhou

et al. 2023

Multimedia Systems

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Contact with the health care system prior to suicide: A nationwide population-based analysis using linkage national death certificates and national health insurance data

Cited by 5 publications

References 31 publications

Primary care consultation patterns before suicide: a nationally representative case–control study

Primary care consultation patterns before suicide: a nationally representative case–control study

Increased suicide risk of psychiatric patients following the recent utilization of health care services: results from a nationwide cohort study in South Korea

Deep learning model with multi-feature fusion and label association for suicide detection

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