Repetition of Parasuicide: A Predictive Study

Suicide-related behavior (SRB), including suicide attempts and instrumental SRB, occurs far more often than completed suicide and exacts a toll on patients, their loved ones, and society. Nevertheless, few prospective studies of SRB have been conducted. In this study, 954 patients were interviewed in a psychiatric hospital and then followed for one year after discharge. During this one-year period, nearly one-quarter of patients (23%) engaged in SRB, with the rate of suicide attempts (18%) three times greater than the rate of instrumental SRB (5%). Risk factors for SRB were demographic (White ethnicity, female gender), clinical (past SRB, depression, impaired functioning), and contextual (unemployment, large social networks). In contrast with other studies, there was no "peak" in the risk of SRB shortly after hospital discharge. Instead, patients' rate of SRB was relatively constant over the one-year follow-up. Implications for risk assessment and management in acute inpatient settings are discussed.

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Comparison of cluster detection using patients and events of medically treated self-inflicted injuries in Alberta, Canada

Rosychuk

Colman

Rowe

2009

Health Serv Outcomes Res Method

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Geographic regions may be routinely evaluated for high rates of disease through statistical cluster detection tests. Areas with statistically higher rates can be targeted for further epidemiological study and possible interventions. Generally these tests are performed on incident or prevalent cases of a disease, and are not necessarily applicable to the health services context. We examine a new method appropriate for health services data and introduce this new method to health services researchers through a case study of selfinflicted injury presentations to emergency departments (EDs). We consider spatial clustering with two approaches. A case-based method uses only the number of patients whereas an event-based method uses the number of patients and the number of ED presentations. Analyses are adjusted by the age and gender distribution and restricted to a sub-group of the population. Several potential clusters are identified within each method. The case-based method identifies 10 geographic areas with statistically higher numbers of individuals seeking ED care and the event-based method identifies nine geographic areas with statistically higher numbers of ED presentations. These potential clusters are not likely to have occurred by chance alone, given the age and gender distribution. The two testing procedures illustrate different aspects of the data: individuals and presentations. The potential clusters based on individual cases suggest areas that may need special intervention programs and services. The clustering of presentations may represent areas that require increased provision of health services.

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Repetition of Parasuicide: A Predictive Study

Cited by 39 publications

References 38 publications

Repetition of Suicidal Behaviour

Repetition of Suicidal Behaviour

Suicide‐related behavior after psychiatric hospital discharge: implications for risk assessment and management

Comparison of cluster detection using patients and events of medically treated self-inflicted injuries in Alberta, Canada

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