Post-hospitalization course and predictive signs of suicidal behavior of suicidal patients admitted to a psychiatric hospital: a 2-year prospective follow-up study

Abstract

BackgroundSuicidal patients admitted to a psychiatric hospital are considered to be at risk of suicidal behavior (SB) and suicide. The present study aimed to seek predictors of SB recurrence of the high-risk patients by examining their post-hospitalization course.MethodThe design was 2-year prospective follow-up study of patients consecutively admitted with SB to a psychiatric center in Tokyo. The DSM-IV diagnoses and SB-related features of subjects were determined in structured interviews. Subsequently, the subjects underwent a series of follow-up assessments at 6-month intervals. The assessment included inquiries into SB recurrence, its accompanying suicidal intent (SI) and SF-8 health survey. Analyses of serial change over time in the follow-up data and Cox proportional hazards regression analyses of SB recurrence were performed.Results106 patients participated in this study. The dropout rate during the follow-up was 9%. Within 2 years, incidences of SB as a whole, SB with certain SI (suicide attempt) and suicide were 67% (95% CI 58 - 75%), 38% (95% CI 29 - 47%) and 6% (95% CI 3 - 12%), respectively. Younger age, number of lifetime SBs and maltreatment in the developmental period were predictive of SB as a whole, and younger age and hopelessness prior to index admission were predictive of suicide attempt. Regarding diagnostic variables, anxiety disorders and personality disorders appeared to have predictive value for SB. Additionally, poor physical health assessed during the follow-up was indicated as a possible short-term predictor of SB recurrence.ConclusionsThis study demonstrated a high incidence of SB and suicide and possible predictors of SB recurrence in the post-hospitalization period of psychiatric suicidal patients. Specialized interventions should be developed to reduce the suicide risk of this patient population.

Determinants of suicidal ideation among patients with mental disorders visiting psychiatry outpatient unit in Mekelle town, psychiatric clinics, Tigray, Northern Ethiopia: a case–control study

“…Also, in this study, having a family mental illness history is a significant predictor of suicidal ideation. This finding was consistent with studies done in Eastern Nepal and Ethiopia, Jimma [13,18]. This study also revealed that a previous suicide attempt history was significant for suicidal ideation.…”

“…A study conducted in Japan showed that moderate (AOR = 3.98, 95% CI 1.63-9.72, P < 0.01) or more severe depression (AOR = 59.62, 95% CI 8.14-436.80, P < 0.01) was associated with current suicidal ideation [12], whereas another study in that country, Tokyo reported that panic disorder with agoraphobia (AOR = 2.405, 95% CI 1.269-3.492, P = 0.004); obsessive compulsive disorder, OCD (AOR = 2.912, 95% CI 1.511-5.612, P = 0.001); PTSD (AOR = 2.048, 95% CI 1.153-3.637, P = 0.014) and specific phobia (AOR = 2.038, 95% CI 1.037-4.005, P = 0.039), and borderline personality disorder (AOR = 2.523, 95% CI 1.186-5.366, P = 0.016) were predictive of suicide behavior (SB) as a whole and appeared to have predictive value for SB, respectively [13].…”

Pathways from life‐historical events and borderline personality disorder to symptomatic disorders among suicidal psychiatric patients: A study of structural equation modeling

“…It portrayed the sequentially influencing pathways from life‐historical events to psychiatric disorders and the mediating role of BPD among SB‐related factors. The studied suicidal patients were at quite high risk of SB repetition and suicide while usual treatment was seemingly hardly effective for SB and suicide prevention . The points the model of this study has highlighted are usable for developing effective treatments for suicidal patients.…”

Getting back to school : understanding adolescents' experience of reentry into school after psychiatric hospitalization

“…Their continued struggle with symptoms, as a finding, supports previous research about adolescents and their mental health trajectories following psychiatric hospitalization. Post-hospitalization, students' continued struggles warrants intervention, with high rates of suicidal ideation and suicide attempts both requiring re-hospitalization (Czyz et al, 2012;Hayashi et al, 2012;James et al, 2010;Reid, 2009). Participants from this research reported their worry about the social and academic issues they would face after return, which were present while in treatment, and findings showed that these concerns proved warranted.…”

“…While students return from hospitals, their issues are varied, ranging from anxiety or depression to other major medical or mental issues, self-harm, substance abuse, or suicidality (White & Houle, 2016). Overall, the risks for this population are quite high, with 67% with suicidal behavior (ideation), and 38% making attempts within two years after having been hospitalized (Hayashi et al, 2012).…”