Suicide among psychiatric patients of a district general hospital

Abstract

SynopsisTwenty-two psychiatric patients who committed suicide while receiving hospital treatment or within 3 months of discharge from psychiatric care were studied using general population statistics, a random sample of 100 psychiatric patients and a control group matched individually with the hospital suicides. The rate of suicide among psychiatric in-patients was over 50 times that in the general population. A higher vulnerability to suicide was detected among in-patients (v. other patient groups), men (v. women) and middle-aged patients (v. older and younger patients). Suicides were differentiated from controls in having suffered more losses (P < 0·05), being psychiatrically ill for the first time (P < 0·05), having a past history of deliberate self-harm (P < 0·05), and not receiving a schizophrenic diagnosis (P < 0·02). People with mid-life crises, patients who swing rapidly into depression while receiving treatment, and individuals who are judged to be depressed because of personal problems may carry a particularly high suicide risk during psychiatric treatment.

Review of predictors of suicide within 1 year of discharge from a psychiatric hospital

“…Results showed that patients in the early suicide group had more previous DSH incidents than the late and control groups. Fernando and Storm [11] also examined patients who died by suicide within 3 months of discharge. Their results matched those of McKenzie and Wurr [8], with more DSH histories found in individuals who died by suicide [11].…”

“…Several studies comparing suicides within 1 year of discharge with those who did not die by suicide postdischarge found suicide ideation/attempt before admission to be a predictor of completed suicide [1,3,10,11]. Results also revealed that a self-harm/suicide attempt during admission was a significant predictor of suicide [1,8,11]. Results for these variables are summarized in Table 1.…”

“…Other studies grouped certain demographic variables into one larger variable. Fernando and Storm [11] took this approach to studying these variables by grouping them into one category called "losses." Losses included divorce or separation; illness or death of a first-degree relative or close friend; or job loss through redundancy, retirement, or dismissal within the previous year.…”

Psychogeriatric Inpatient Suicides in Australia

“…Moreover, suicide rates appear to increase with age (Surtees and Duy, 1989), although in some studies suicide rates in women peak at menopause and decline thereafter (Woodbury et al, 1988). Suicide rates among psychiatric inpatients are higher than in the general population (Farberow et al, 1971;Fernando and Storm, 1984;Modestin and Homan, 1989) and may have increased in recent years (Beskow, 1987;Wolfersdorf et al, 1988). These factors suggest that suicide rates among psychogeriatric inpatients may be high.…”

Le suicide chez les patients hospitalisés

“…Le taux de suicide d'anciens combattants hospitalisés en milieu médico-chirurgical et neuro-psychiatrique est respectivement 3,5 et 30 fois plus élevé que celui de la population générale (Farberow, 1981). Par rapport à la population générale, on a rapporté en ex-Allemagne fédérale dix fois plus de suicide de patients hospitalisés (WoIfersdorf et al, 1991) et 50 fois plus parmi la clientèle psychiatrique d'un hôpital londonien (Fernando et Storm, 1984).…”