Suicidal and violent ideation in acute psychiatric inpatients: prevalence, co‐occurrence, and associated characteristics

Abstract

Objective We studied the point prevalence of suicidal and violent ideation, as well as their co‐occurrence and associated characteristics in inpatients with mental health disorders. Methods Data on suicidal and violent ideation, and sociodemographic and clinical information, were gathered from 1,737 patients when admitted to the acute psychiatric ward. Results The point prevalence was 51.9% for suicidal ideation and 19.8% for violent ideation. The point prevalence of co‐occurring suicidal and violent ideation was 12.3%, which was significantly greater than expected by chance. Logistic regression analyses indicated that both suicidal and violent ideation were associated with young age and the absence of diagnoses of psychotic disorders; in addition, suicidal ideation was associated with female gender, violent ideation, and diagnoses of mood‐ neurotic and personality disorders, whereas violent ideation was associated with male gender, suicidal ideation, and diagnoses of mood and neurotic disorders. Conclusions Overall, the findings highlight the need for further research on suicidal and violent ideation in people with mental health problems including, but not limited to, their association with adverse behavioral outcomes, as well as the need to routinely assess both suicidal and violent ideation in clinical practice.

Suicidal ideation in patients with mental illness and concurrent substance use: analyses of national census data in Norway

“…The most directly comparable research to the present one regarding SI risk associated with diverse mental disorders have been studies conducted among unselected psychiatric samples using similar methodologies with the current study in measuring SI. Our findings of particularly elevated rates of SI associated with depression and personality disorders agree with those previous studies [ 10 , 12 , 13 ]. Moreover, this finding is unsurprising given the higher risk of suicide associated with SUD in these diagnostic groups [ 30 , 31 ].…”

“…Adverse psychosocial factors remained independently associated with SI in the multivariate model, which supports this latter assumption. The current findings of an increased SI risk associated with adverse sociodemographic factors align with previous findings from mental health treatment samples [ 10 , 12 , 13 , 18 , 19 ]. Our study contributes to existing knowledge by suggesting that among patients with concurrent substance, those with younger age, single marital status and poor social relationships may have a further elevated SI risk.…”

“…A comprehensive literature review and meta-analysis that included both clinical and general samples suggested that among the anxiety disorders, PTSD was significantly associated with both SI and attempts at suicide [ 14 ]. Thus, the risk of suicidality associated with PTSD might have been undetected in previous mental health treatment studies that analyzed the broader ICD-10 category of anxiety disorders [ 11 – 13 ]. Previous research suggested that patients with both SUD and PTSD exhibit more severe substance use [ 32 ] and adverse treatment outcomes [ 33 ].…”

“…Mental disorders are strongly associated with suicidal behaviors [ 6 – 8 ]. Clinical studies have repeatedly reported an increased risk of suicidality associated with mood disorders [ 9 – 13 ], personality disorders [ 10 , 12 , 13 ] and anxiety disorders [ 13 , 14 ]. In patients with mental illness, concurrent alcohol or drug use may pose an elevated risk of suicidality [ 10 , 15 , 16 ].…”

“…While there are some studies on risk factors for SI among samples of psychiatric patients with diverse mental disorders [ 10 – 13 , 16 ], we are aware of only two studies that examined the prevalence of SI in mentally ill patients with concurrent substance use. Both these studies were carried out among patients in acute psychiatric wards, and indicated an increased risk of suicidality associated with concurrent alcohol and drug use [ 10 , 16 ].…”