Suicide in Psychiatric Patients: Case–Control Study in Singapore

Thong, Jiunn Yew; Su, Alex; Chan, Yiong Huak; Chia, Boon Hock

doi:10.1080/00048670802050553

Cited by 38 publications

(34 citation statements)

References 21 publications

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“…A study from Singapore reported that a considerable percentage of individuals with mental illness committed suicide soon after discharge from a psychiatric hospital, with 15% committing suicide within the first week, 21% within two weeks, 26% within four weeks, and an alarming 63% within one year 45 . These high figures reflect the population studied, of individuals with psychiatric disorders severe enough to require hospital admission.…”

Section: Factors Contributing To Suicidementioning

confidence: 99%

Suicide in forensic practice – an Australian perspective

Byard¹,

Austin²,

Heuval³

2011

Australian Journal of Forensic Sciences

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Section: Factors Contributing To Suicidementioning

confidence: 99%

Suicide in forensic practice – an Australian perspective

Byard¹,

Austin²,

Heuval³

2011

Australian Journal of Forensic Sciences

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“…This is similarly noted among suicide studies from Asia (Cheng et al, 1995;Phillips et al, 2002;Thong et al, 2008). The associated physical illnesses are generally chronic, debilitating, deteriorating, painful and stigmatizing; such as HIV or AIDS, cancers and chronic renal failure (Harris & Barraclough, 1994).…”

Section: Risk Factors In Asiamentioning

confidence: 63%

“…In a Singapore case-control study of suicide in psychiatric patients, psychotic symptoms in the form of auditory hallucinations and delusions were associated with significantly increased risk of suicide (Thong, Su, Chan & Chia, 2008). Alcohol abuse or dependence was present in 44% and 34% of suicide completers in Taiwan (Cheng et al, 1995) and India (Vijayakumar & Rajkumar, 1999) respectively.…”

Section: Risk Factors In Asiamentioning

confidence: 98%

“…The associated physical illnesses are generally chronic, debilitating, deteriorating, painful and stigmatizing; such as HIV or AIDS, cancers and chronic renal failure (Harris & Barraclough, 1994). Interestingly, in the Singaporean study of suicide in psychiatric patients, many of those who have died from suicide had physical illnesses that were not given definite formal diagnoses, but instead were recorded as complaining of distressing pain or weakness (Thong et al, 2008). In China, the psychological case-control study by Phillips placed the presence of physical illness within the context of its effects on family members in the month before death.…”

Section: Risk Factors In Asiamentioning

confidence: 98%

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Suicide in Asia

Wei

Chua

2008

International Review of Psychiatry

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Suicide is a major problem worldwide, and suicides in Asian countries account for as much as 60% of all suicides in the world. There are many unique features in suicides within this ethnically-diverse continent, from the methods used, to the putative risk factors. Much research still needs to be done to guide efficacious and culturally relevant interventions in suicide prevention; existing literature suggests a strong focus for programmes that address restricting access to pesticides, increasing crisis counseling activities, improving the accessibility and delivery of mental health services, and promoting responsible media reporting of suicide and related issues. There is a need for coordinated national suicide plans to be developed that are sensitive to the socioeconomic and cultural factors in the local context.

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“…[159][160][161][162][163] An analysis of HES data for England carried out in the early stages of this research programme showed that the risk of non-fatal self-harm is similarly elevated in the period after hospital discharge. 164 In total, > 6% of patients discharged from psychiatric inpatient care were admitted to a general hospital bed as a result of self-harm in the subsequent 12 months.…”

Section: Introductionmentioning

confidence: 99%

A multicentre programme of clinical and public health research in support of the National Suicide Prevention Strategy for England

Gunnell

Hawton

Bennewith

et al. 2013

Programme Grants for Applied Research

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ObjectivesTo carry out a programme of linked research studies aimed at improving the management of self-harm, reducing the incidence of suicide and providing reliable data to evaluate the impact of theNational Suicide Prevention Strategy for England(2002).MethodsThere were four research streams: (1) we studied inquest records from 12 coroners and Ministry of Justice data to assess the accuracy of official suicide statistics; (2) we used Office for National Statistics mortality statistics, data from the Multicentre Study of Self-harm in England, national liver unit data, prescription data and patient interviews to assess (a) the impact of paracetamol (acetaminophen) pack size restrictions (1998), (b) the impact of withdrawal of co-proxamol in 2007 and (c) the relative toxicity in overdose of commonly used antidepressants; (3) we carried out 3-month audits of self-harm management in 32 hospitals to investigate variations between hospitals and the impact of management on repeat self-harm; and (4) we developed and piloted letter-based contact interventions aimed at reducing self-harm.Key findings(1) Between 1990 and 2005, the proportion of researcher-defined suicides given a verdict of suicide by the 12 coroners studied decreased by almost 7%, largely because of the increased use of misadventure/accident verdicts for deaths thought, on clinical review, to be suicides. Use of narrative verdicts increased markedly. Coroners who gave more narrative verdicts also gave fewer suicide verdicts, and geographical variations in the use of narrative verdicts appeared to distort reliable assessment of small-area differences in suicide rates. 2(a) UK legislation to reduce pack sizes of paracetamol was followed by a 43% reduction in number of deaths and a 61% reduction in registrations for liver transplantation over the next 11 years. Paracetamol overdoses were often impulsive and some were influenced by media (including the internet); sales outlets appeared mostly to be adhering to sales guidance. Smaller pack sizes of paracetamol for sale in Ireland compared with England did not result in a smaller number of tablets being taken in overdose. There was no clear evidence of an effect of the legislation on prescribing of non-steroidal anti-inflammatory drugs, nor on resulting gastrointestinal bleeds. 2(b) Withdrawal of co-proxamol from use in the UK resulted in approximately 600 fewer deaths than predicted between 2005 and 2010 based on previous trends, with no evidence of substitution by poisoning with other analgesics. 2(c) Of the tricyclic antidepressants, dosulepin and doxepin had the greatest toxicity. Citalopram was more toxic than other selective serotonin reuptake inhibitors. (3) There was marked variation between hospitals in the management of self-harm; effects of this variation on patient outcomes were unclear, although psychosocial assessment may have been associated with reduced repetition. Levels of specialist assessment remained static between 2001–2 and 2010–11, but service quality appeared to improve. (4) Findings of two pilot randomised controlled trials suggested that, although it would be feasible to scale up these interventions to full trials, these interventions might have low generalisability and be of limited benefit to patients.ConclusionWithin the context of the strengths and limitations of the individual studies, this research programme has made significant additions to the evidence base related to suicide and self-harm prevention in the UK.Study registrationA pilot study of a contact and information based intervention to reduce repeat self-harm; ISRCTN65171515.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.

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Suicide in Psychiatric Patients: Case–Control Study in Singapore

Cited by 38 publications

References 21 publications

Suicide in forensic practice – an Australian perspective

Suicide in forensic practice – an Australian perspective

Suicide in Asia

A multicentre programme of clinical and public health research in support of the National Suicide Prevention Strategy for England

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