Suicide after discharge from psychiatric inpatient care

Goldacre, Michael J; Seagroatt, Valerie; Hawton, Keith

doi:10.1016/0140-6736(93)91822-4

Cited by 352 publications

(240 citation statements)

References 19 publications

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“…Patients who are psychiatrically hospitalized for a suicide attempt or suicidal ideation (SI) are at very high risk for suicide following discharge [1][2][3], with rates of suicide shortly postdischarge more than 100 times greater than the rate in the general population [4]. Despite this high risk of suicide, there has been relatively limited study of formal interventions to reduce suicidality during or shortly after psychiatric admission.…”

Section: Introductionmentioning

confidence: 99%

Feasibility and utility of positive psychology exercises for suicidal inpatients

Huffman

DuBois

Healy

et al. 2014

General Hospital Psychiatry

155

107

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Objective: The objective was to assess the feasibility and acceptability of nine positive psychology exercises delivered to patients hospitalized for suicidal thoughts or behaviors, and to secondarily explore the relative impact of the exercises. Method: Participants admitted to a psychiatric unit for suicidal ideation or behavior completed daily positive psychology exercises while hospitalized. Likert-scale ratings of efficacy (optimism, hopelessness, perceived utility) and ease of completion were consolidated and compared across exercises using mixed models accounting for age, missing data and exercise order. Overall effects of exercise on efficacy and ease were also examined using mixed models. Results: Fifty-two (85.3%) of 61 participants completed at least one exercise, and 189/213 (88.7%) assigned exercises were completed. There were overall effects of exercise on efficacy (χ 2 =19.39; P=.013) but not ease of completion (χ 2 =11.64; P=.17), accounting for age, order and skipped exercises. Effect (Cohen's d) of exercise on both optimism and hopelessness was moderate for the majority of exercises. Exercises related to gratitude and personal strengths ranked highest. Both gratitude exercises had efficacy scores that were significantly (P=.001) greater than the lowest-ranked exercise (forgiveness). Conclusion: In this exploratory project, positive psychology exercises delivered to suicidal inpatients were feasible and associated with short-term gains in clinically relevant outcomes.

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Section: Introductionmentioning

confidence: 99%

Feasibility and utility of positive psychology exercises for suicidal inpatients

Huffman

DuBois

Healy

et al. 2014

General Hospital Psychiatry

155

107

View full text Add to dashboard Cite

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“…On average, results have shown that the overall mortality rate among patients with schizophrenia and related psychoses is twice as high as the rate for the general population, and that mortality due to suicide is 20 times higher 4,13,14 . Goldacre et al 9 (1993) studied suicide after discharge from psychiatric inpatient care in the UK, and found that for schizophrenic patients the SMR for the first 28 days after discharge was 46 for men and 92 for women, and after that period the risk was lower, with SMR's of 30 for both sexes. In the past these high rates were attributed to the poor living conditions found in the asylums, and now they seem to be associated with the process of transferring care to the community, where many patients lack adequate social support, such as housing, income and health care, and are more exposed to substance abuse 17 .…”

Section: Introductionmentioning

confidence: 99%

Mortality among patients with non-affective functional psychoses in a metropolitan area of South-Eastern Brazil

Menezes

Mann²

1996

Rev. Saúde Pública

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High mortality rates among those suffering from schizophrenia and related psychoses have been consistently described in developed societies. However, to date there is a lack of data on this matter in Brazil. In order to examine this issue, a prospective 2-year follow-up study was carried out in S. Paulo. The sample consisted of 120 consecutive admissions to psychiatric hospitals in a defined catchment area, aged 18 to 44 years old, with clinical diagnoses of nonaffective functional psychoses according to the ICD-9. After 2 years, 116 (96.7%) subjects were traced. During the study period there were 7 deaths (6.0% of those traced), 5 (4.3%) due to suicide. All but one of the suicides occurred in the first year after discharge from hospital. Age and sex Standardised Mortality Ratios (relative to rates for the population of the city of Sao Paulo) were 8.4 for overall mortality (95% confidence interval: 4.0-15.9) and 317.9 for deaths due to suicide (95% confidence interval: 125.2-668.3). These results are in agreement with previous studies, and show that in Brazil non-affective functional psychoses are life-threatening illnesses, which need adequate care, particularly when patients go back to live in the community after hospital discharge. Schizophrenia, mortality. Suicide, statistics. Resumo Estudos sobre mortalidade na esquizofrenia e outras psicoses não afetivas em diversos países industrializados têm consistentemente encontrado índices maio

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“…Ceci s'explique peutêtre par le fait que lorsque l'on examine les services utilisés au cours des six mois suivant le congé, tous ont obtenu un suivi médical mais seulement deux participants ont eu des rencontres avec d'autres professionnels de la santé (travailleur social en première ligne) ou dans des organismes communautaires pour répondre à leurs besoins exprimés en HDJ, de poursuivre la thérapie. Des études ont démontré qu'une absence ou un délai dans l'amorce d'un suivi en externe après une hospitalisation contribue à des rechutes et à des ré-hospitalisations (Prince, 2006), à une réduction de la qualité de vie (Boyer et al, 2000) et au suicide (Goldacre et al, 1993). Par ailleurs, Boyer et al (2000) et Olfson et al (1998) ont trouvé que la prise de contact avec la nouvelle équipe avant le congé, facilitait la transition selon certains participants.…”

Section: Discussionunclassified

Revisiter l’expérience en hôpital de jour six mois après le congé : parcours et perceptions des personnes utilisatrices

Larivière

Boyer

2011

smq

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Cet article présente une étude qualitative sur l’expérience d’un suivi en hôpital de jour psychiatrique six mois après la fin du séjour ; l’étude explore l’impact de cette expérience dans la vie de personnes adultes et âgées avec des troubles mentaux. Un devis qualitatif a utilisé des entrevues individuelles semi-dirigées complétées six mois après le congé, avec 18 participants. Les résultats indiquent que l’expérience à l’hôpital de jour a apporté une amélioration significative au niveau des symptômes et de la relation à soi. La thérapie a permis d’amorcer un processus de transformation personnelle qui s’est poursuivi dans le temps. La terminaison a créé un vide chez plusieurs participants. Les enjeux durant les premiers six mois après le congé étaient la continuité de soins, le soutien social et la mise en pratique des apprentissages.This article presents a qualitative study on the therapeutic experience in a psychiatric day hospital six months after discharge. The study explores the impact of this experience on the lives of people with mental disorders. A qualitative design using semi-structured individual interviews was completed with 18 participants six months after their discharge of a day hospital. Results showed that the day hospital experience was particularly helpful to improve symptoms and relationship with self. It activated a self-transformational process that continued afterwards. Termination created for many, an abrupt void. Issues at stake during the first six months were continuity of care, social support and maintaining skills and knowledge acquired.Este artículo presenta un estudio cualitativo sobre la experiencia de un seguimiento en el hospital psiquiátrico de día seis meses después de finalizada la estancia. El estudio explora el impacto de esta experiencia en la vida de personas adultas y ancianos con trastornos mentales. Se realizó un estudio cualitativo que utilizó entrevistas individuales simidirigidas, completadas seis meses después de la estancia en el hospital, con 18 participantes. Los resultados indican que la experiencia en el hospital de día aportó una mejora significativa al nivel de los síntomas y la relación consigo mismo. La terapia permitió iniciar un proceso de transformación personal que se continuó en el tiempo. El término de ésta creó un vacío en varios participantes. Los problemas durante los primeros meses después de salir del hospital fueron la continuidad de los cuidados, el apoyo social y la puesta en práctica de los aprendizajes.Este artigo apresenta um estudo qualitativo sobre a experiência de um acompanhamento em hospital psiquiátrico diurno seis meses após o fim da internação; o estudo explora o impacto desta experiência na vida de pessoas adultas e idosas que sofrem de transtornos mentais. Um diagnóstico qualitativo usou entrevistas individuais semi-dirigidas, realizadas seis meses após a alta, com 18 participantes. Os resultados indicam que a experiência no hospital diurno trouxe uma melhoria significativa dos sintomas e da relação consigo mesmo. A terapia perm...

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Suicide after discharge from psychiatric inpatient care

Cited by 352 publications

References 19 publications

Feasibility and utility of positive psychology exercises for suicidal inpatients

Feasibility and utility of positive psychology exercises for suicidal inpatients

Mortality among patients with non-affective functional psychoses in a metropolitan area of South-Eastern Brazil

Revisiter l’expérience en hôpital de jour six mois après le congé : parcours et perceptions des personnes utilisatrices

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