The association between mental disorders and suicide: A systematic review and meta-analysis of record linkage studies

Too, Lay San; Spittal, Matthew J; Bugeja, Lyndal; Reifels, Lennart; Butterworth, Peter; Pirkis, Jane

doi:10.1016/j.jad.2019.08.054

Cited by 234 publications

(144 citation statements)

References 32 publications

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“…Mental illness is associated with an increased risk for suicide (1)(2)(3)(4). Psychiatric patients requiring admission to hospital treatment constitute a particularly vulnerable population given that they suffer the most severe subjective burden of disease.…”

Section: Introductionmentioning

confidence: 99%

Suicide in Psychiatric Inpatients— A Case–Control Study

et al. 2020

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Objective: Psychiatric inpatients constitute a population at considerably increased risk for suicide. Identifying those at imminent risk is still a challenging task for hospital staff. This retrospective case–control study focused on clinical risk factors related to the course of the hospital stay.Method: Inpatient suicide cases were identified by linking the Tyrol Suicide Register with the registers of three psychiatric hospitals in the state. Control subjects were patients who had also been hospitalized in the respective psychiatric unit but had not died by suicide. Matching variables included sex, age, hospital, diagnosis, and admission date. The study period comprised 7 years. Data were analyzed by the appropriate two-sample tests and by logistic regression.Results: A total of 30 inpatient suicide cases and 54 control patients were included. A number of factors differentiated cases from controls; after correction for multiple testing, the following retained significance: history of aborted suicide, history of attempted suicide, history of any suicidal behavior/threats, suicidal ideation continuing during hospitalization, no development of prospective plans, no improvement of mood during the hospital stay, and leaving ward without giving notice. Logistic regression identified the latter three variables and history of attempted suicide as highly significant predictors of inpatient suicide.Conclusions: Preventive measures during hospitalization include thorough assessment of suicidal features, an emphasis on the development of future perspectives, and a review of hospital regulations for patients who want to leave the ward.

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Section: Introductionmentioning

confidence: 99%

Suicide in Psychiatric Inpatients— A Case–Control Study

et al. 2020

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“…The primary objectives of the study are to evaluate the impact of the Aftercare intervention on the likelihood of a re-presentation to an emergency department as a result of a suicide attempt or because of high risk for suicide, the rates of re-presentation to emergency departments as a result of one or more repeat suicide attempt(s) or because of high risk for suicide, and the number of deaths by any cause. The secondary objectives of the study are to evaluate the impact of the Aftercare intervention on factors associated with increased risk of suicide, namely, mood [64], hopelessness [65, 66], belongingness, burdensomeness [66], and psychological distress [67, 68].…”

Section: Methodsmentioning

confidence: 99%

“…Secondary outcome measures were chosen as they assess factors associated with increased risk for suicide [64–68]. The measures will be collected from the participants of the Aftercare intervention (pre- and post-) using the following measures.…”

Section: Methodsmentioning

confidence: 99%

Community-based aftercare following an emergency department presentation for attempted suicide or high risk for suicide: study protocol for a non-randomised controlled trial

et al. 2019

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BackgroundSuicide is a major public health issue worldwide. Those who have made a recent suicide attempt are at high risk for dying by suicide in the future, particularly during the period immediately following departure from a hospital emergency department. As such the transition from hospital-based care to the community is an important area of focus in the attempt to reduce suicide rates. There is a need for evaluation studies to test the effectiveness of interventions directed to this stage (termed ‘aftercare’ interventions).MethodsA controlled non-randomised two group (intervention vs treatment-as-usual control) design, using an intention-to-treat model, will evaluate the effectiveness of a suicide prevention aftercare intervention providing follow-up after presentations to a hospital emergency department as a result of a suicide attempt or high risk for suicide. The intervention is a community-based service, utilising two meetings with a mental health clinician and follow-up contacts by peer workers via a combination of face-to-face and telephone for four weeks, with the option of extension to 12 weeks. Seventy-five participants of the intervention service will be recruited to the study and compared to 1265 treatment-as-usual controls. The primary hypotheses are that over 12 months, those who participate in the aftercare follow-up intervention are less likely than controls to present to a hospital emergency department for a repeat suicide attempt or because of high risk for suicide, will have fewer re-presentations during this period and will have lower all-cause mortality. As a secondary aim, the impact of the intervention on suicide risk factors for those who participate in the service will be evaluated using pre- and post-intervention repeated measures of depression, anxiety, stress, hopelessness, belongingness, burdensomeness, and psychological distress. Enrolments into the study commenced on 1 November 2017 and are anticipated to cease in November 2019.DiscussionThe study aims to contribute to the understanding of effective interventions for individuals who have presented to a hospital emergency department as a result of a suicide attempt or at high risk for suicide and provide evidence in relation to interventions that incorporate peer-workers.Trial registrationACTRN12618001701213. Registered on 16 October 2018. Retrospectively registered.

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“…Finally, mental health symptoms and diagnoses are wellestablished risk factors for suicide, 45 and there is the potential for onset or exacerbation of mental health symptoms during the COVID-19 pandemic-whether due to fear and anxiety regarding infection, or the prolonged physical distancing, disruptions, and uncertainty created by this unprecedented and potentially lethal pandemic. [46][47][48][49] This may disproportionately affect individuals in rural communities, who already experience increased stigma regarding mental health, suicide, and help-seeking.…”

Section: Mental Health and Access To Carementioning

confidence: 99%

Preventing Suicide in Rural Communities During the COVID‐19 Pandemic

Monteith

Holliday

Brown

et al. 2020

The Journal of Rural Health

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COVID-19, mental health, psychology, social determinants of health, utilization of health services. Individuals in rural communities are at increased risk for suicide. 1,2 While the impact of Coronavirus Disease 2019 (COVID-19) continues to unfold, 3 it is likely that suicide risk factors among individuals residing in rural areas will be exacerbated and suicide rates may subsequently increase. 4 Awareness of these factors is essential to ensure that appropriate steps are taken to prevent suicide in rural communities, both during and in the aftermath of this pandemic. In this commentary, we delineate key considerations for doing so, with potential solutions summarized in Table 1.

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The association between mental disorders and suicide: A systematic review and meta-analysis of record linkage studies

Cited by 234 publications

References 32 publications

Suicide in Psychiatric Inpatients— A Case–Control Study

Suicide in Psychiatric Inpatients— A Case–Control Study

Community-based aftercare following an emergency department presentation for attempted suicide or high risk for suicide: study protocol for a non-randomised controlled trial

Preventing Suicide in Rural Communities During the COVID‐19 Pandemic

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