Possible factors influencing the duration of hospital stay in patients with psychiatric disorders attempting suicide by jumping

Abstract

BackgroundPatients with psychiatric disorders have a high rate of suicide. The present study investigated factors influencing hospital stays for Japanese patients with psychiatric disorders attempting suicide by jumping.MethodsWe diagnosed all suicide attempts (n = 113) by jumping based on the International Classification of Diseases 10th Revision (ICD-10) and investigated the mean hospital stays of patients with each diagnosis based on the ICD-10 code. We then analyzed differences in the demographic and clinical characteristics between the diagnostic groups to identify factors influencing the duration of hospital stay.ResultsPatients diagnosed with schizophrenia (F2 code) were the most frequent (32.7%) of all diagnoses; therefore, we divided the diagnostic groups into schizophrenia group (n = 37) and other psychiatric diagnoses group (n = 76). The patients with schizophrenia showed a significantly longer hospital stay (125.7 ± 63.9 days) compared with the patients with other psychiatric diagnoses (83.6 ± 63.2) (β ± SE = 42.1 ± 12.7, p = 0.0013), whereas there was no difference in the jump height between the two groups (the average was the 3rd to 4th floor; p > 0.05). The number of injured parts, particularly lower-limb fractures, was significantly higher (p = 0.017) in patients with schizophrenia than in patients with other psychiatric diagnoses. The duration of psychiatric treatment in patients with schizophrenia were significantly longer (z = 3.4, p = 0.001) than in patients with other psychiatric diagnoses.ConclusionOur findings indicate that the number of injuries and the body parts injured in patients with schizophrenia are associated with a longer duration of hospital stay following a suicide attempt by jumping. The current use of antipsychotics and a longer duration of taking antipsychotics might contribute to the risk of bone fracture via hyperprolactinemia. Further cognitive impairment in patients with schizophrenia might prevent rehabilitation for the management of lower-limb fractures. From these results, we suggest that clinicians should monitor the level of prolactin and cognitive function in patients with schizophrenia in future studies on managing of lower-limb fractures.

Suicide attempts by jumping and length of stay in general hospital: A retrospective study of 225 patients

“…However, little is known about socio-demographic and clinical factors associated with LOS in general hospital after violent suicide attempts. Only one recent study investigated these factors among 113 patients having attempted suicide by jumping [20]. The authors reported that LOS was significantly associated with schizophrenia, height of the fall and the number of injuries.…”

Length of stay of hospitalized patients at tertiary psychiatry facilities in Uganda: the role of caregiver’s presence

“…Having a diagnosis of schizophrenia, especially among patients without caregivers, was associated with increased LoS. A diagnosis of schizophrenia has consistently been associated with the longest LoS among patients with mental illness [10,12,14,20,38,39]. This is mainly attributed to the severity of the illness and its impact on the perception that hinders individual's functionality outside institutions, such as an increase in criminality [38,40].…”

“…This is mainly attributed to the severity of the illness and its impact on the perception that hinders individual's functionality outside institutions, such as an increase in criminality [38,40]. Schizophrenia has also been associated with multiple complications such as fractures, malnutrition, and other co-infections (39), all of which may take longer to recover, hence increasing the LoS. The longer LoS among patients with schizophrenia may also be linked to the severe neurocognitive function impairment among patients with schizophrenia that deems them unfunctional outside the hospital environment.…”

“…The longer LoS among patients with schizophrenia may also be linked to the severe neurocognitive function impairment among patients with schizophrenia that deems them unfunctional outside the hospital environment. Moreover, cognitive impairment-a common feature in schizophrenia, might hinder the treatment of comorbidities such as fractures, diabetes, hypertension, HIV, among others, due to the inability to follow instructions [35,39]. The cognitive deficit is worsened by antipsychotics, which are the main treatment for schizophrenia, thus worsening decision-making and prolonging recovery.…”

Characteristics of Dimensional Psychopathology in Suicidal Patients With Major Psychiatric Disorders and Its Association With the Length of Hospital Stay: Algorithm Validation Study

“…The World Health Organization states that nearly 800,000 people die each year from suicide, one every 40 seconds [ 1 ]. Most patients who committed suicide had psychiatric disorders [ 2 ]. Among psychiatric disorders, schizophrenia and affective disorders demonstrate the highest risk for suicide [ 3 ], but few studies have examined the differences in the suicide-related features of psychiatric disorders [ 4 ].…”