Risk Estimates and Risk Factors Related to Psychiatric Inpatient Suicide—An Overview

Abstract

People with mental illness have an increased risk of suicide. The aim of this paper is to provide an overview of suicide risk estimates among psychiatric inpatients based on the body of evidence found in scientific peer-reviewed literature; primarily focusing on the relative risks, rates, time trends, and socio-demographic and clinical risk factors of suicide in psychiatric inpatients. Psychiatric inpatients have a very high risk of suicide relative to the background population, but it remains challenging for clinicians to identify those patients that are most likely to die from suicide during admission. Most studies are based on low power, thus compromising quality and generalisability. The few studies with sufficient statistical power mainly identified non-modifiable risk predictors such as male gender, diagnosis, or recent deliberate self-harm. Also, the predictive value of these predictors is low. It would be of great benefit if future studies would be based on large samples while focusing on modifiable predictors over the course of an admission, such as hopelessness, depressive symptoms, and family/social situations. This would improve our chances of developing better risk assessment tools.

Increased risk of depression in patients with cutaneous lupus erythematosus and systemic lupus erythematosus: a Danish nationwide cohort study

“…The suicide risk is increased in patients with depression . In our study, the number of attempts and completed suicides was low and was not increased in patients with LE compared with the general population.…”

“…26 The suicide risk is increased in patients with depression. 6 In our study, the number of attempts and completed suicides was low and was not increased in patients with LE compared with the general population. Previous studies have described that suicidal ideation is common in patients with SLE and that the IRs of completed suicides and attempts are also increased.…”

“Attenuating Anxieties”: A grounded theory study of mental health nurses’ responses to clients with suicidal behaviour

“…Among females, the rates per 100,000 of the population increased for those aged: (35-44) by 37% (3.5 to 4.8), (45)(46)(47)(48)(49)(50)(51)(52)(53)(54) reported that approximately 40% had some previous contact with the mental health services (Kielty et al, 2014). While rates of suicide in psychiatric hospitals vary across international studies, it is estimated that approximately 5% of all suicides occur among currently admitted service users (Madsen, Erlangsen, & Nordentoft, 2017;Walsh, Sara, Ryan, & Large, 2015). Suicide is one of five key A common approach in suicide prevention strategies and underpinned by WHO (2014) guidance is the importance of evidencebased interventions.…”

The effect of sex on suicide risk during and after psychiatric inpatient care in 12 countries—An ecological study

“…Thus, the increase of suicide rate in females could be hypothesized to be caused by this population being more severely affected by the stress of being admitted to/discharged from inpatient psychiatric care [25]. Furthermore, affective disorders, frequently associated with increased incidence of completed suicide, show higher rates of prevalence in females than in males, potentially contributing to an increased ratio of completed suicide in females currently receiving inpatient psychiatric care, when compared to the suicide rate of the total population [20,26,27].…”