Suicide following an inpatient hospitalization for a suicide attempt: a Canadian follow-up study

Abstract

This study contributes a Canadian perspective to a growing body of international studies examining suicide among cohorts of suicide attempters, and a much more limited literature on the epidemiology of suicide in Canada. We evaluated the 13-year mortality experience of a regional cohort of 876 first-ever inpatient hospital admissions for a suicide attempt admitted between 1979 and 1981. Compared to the general population, study subjects were 4 times more likely to die of any cause, but 25 times more likely to commit suicide and 15 times more likely to die of accidental or adverse causes. Ten years after then first hospitalization for attempted suicide, 5.9% of study subjects had committed suicide. Baseline age appeared to be a risk factor for women, but not for men. Women under 60 years had the best 10-year survival (3.6% had committed suicide) and women over 60 years had the poorest (17.5%). A total of 8.7% of men under 60 years and 10% of those over 60 years committed suicide within 10 years. The remainder of the analysis focused on those under 60 years of age at the time of their index inpatient hospitalization. Three factors were prognostic for suicide: being male, which had a relative risk (RR) of 5.0, living in a lower income area (RR = 3.2), and having used a violent method during the index attempt (RR = 2.5). The periods of greatest risk for suicide were within the 1st and 4th years following first-ever inpatient hospitalization, with the 4th year representing the time of highest risk. The identification of time periods subsequent to first-ever hospitalization when patients are at greatest risk of suicide can be used to guide the timing and duration of clinical interventions and aftercare to ensure that patients are appropriately supported during periods of highest risk.

All-cause mortality after non-fatal self-poisoning: a cohort study

“…Similar results were found more recently in follow-up studies conducted in Austria, Australia and Finland among patients who had attended hospital because of self-poisoning or attempted suicide; in each case there were clear excesses of deaths due to natural and unnatural causes [1,2,22]. On the other hand, a Canadian study found that patients admitted to inpatient psychiatric care following a suicide attempt were significantly less likely than the population in general to die of natural causes [17].…”

Non-fatal suicidal behaviour at the Johannesburg General Hospital

“…8,14 The results of the current study indicate that NFSB is more common in the younger age group. Pillay et al 22 and Schlebusch 23 in South Africa obtained similar results.…”

“…7,8,9 Another strong risk factor for NFSB is a history of psychiatric disorder. 10,11,12,13 Increasing age 8,14 , living alone 15 or in a low-income area 8 , mental illness 14 , somatic illness 7,16 and the abuse of alcohol and drugs 15 have also been identified as risk factors. Some medical illnesses, such as spinal cord injuries and multiple sclerosis 17 , are associated with increased rates of NFSB, but the evidence of this association is very limited.…”

Last Suicide Attempt before Completed Suicide in Severe Depression: An Extended Suicidal Process May Be Found in Men Rather Than Women

“…Suicide risk has appeared to be highest during the first two or three years after an index suicide attempt for patients with mixed diagnoses according to several investigators (Hawton & Fagg 1988, Nielsen, Wang & Bille-Brahe 1990, Ekeberg, Ellingsen & Jacobsen 1991, Nordentoft et al 1993, Johnsson-Fridell, Öjehagen A & Träskman-Bendz 1996, Tejedor 1999, Suokas et al 2001 or for patients with unipolar depression and bipolar disorder (Tidemalm et al 2008). A highest peak after a first-ever hospitalization for a suicide attempt was found in the fourth year (Holley, Fick & Love 1998).…”