When to discharge and when to voluntary or compulsory hospitalize? Factors associated with treatment decision after self-harm

Michaud, Laurent; Berva, Sébastien; Ostertag, Louise; Costanza, Alessandra; Vaeren, Bénédicte Van der; Dorogi, Yves; Saillant, Stéphane; Golay, Philippe; Morandi, Stéphane

doi:10.1016/j.psychres.2022.114810

Cited by 5 publications

(5 citation statements)

References 40 publications

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“…Unsurprisingly, lack of distance to suicidal intentions and missing information on this item increased the probability of IPA significantly as the consequence of not admitting patients with acute suicidal intentions may undeniably be fatal. Similarly to Michaud et al’s findings, the level of suicidal intent significantly correlated with the risk of IPA [ 48 ]. The same applies for the preliminary stage, namely suicidal ideation: Even though the presence of suicidal ideation present a smaller risk of suicide than suicidal intent, it may still lead to suicide if not addressed adequately [ 49 ].…”

Section: Discussionsupporting

confidence: 69%

“…Since the confidence intervals of the different methods of SAs are especially wide (Table 5 ), the strength of this predictors cannot be evaluated appropriately, but the existence of an influence seems apparent. However, Michaud et al’s found serious SAs, “defined by the fact that [they] required hospitalization for more than 24 h and met one of the following criteria: management in a specialized unit (e.g., intensive care), surgery under anaesthesia, or prescription of major medications” [ 48 ] to be independent predictors of IPA [ 48 ]. It is likely that a majority of patients who meet these criteria were not included in this study, since they were not treated primarily by the psychiatrist on call but e.g., by surgical disciplines.…”

Section: Discussionmentioning

confidence: 99%

“…Many aspects, such as the distribution of the main diagnoses (see above), demographics (e.g., gender, age, work status [ 39 ]) and admission rates [ 48 ], may be subject to regional differences. Therefore, a precise analysis of specific aspects of PPA using a well-established assessment system such as AMDP as performed in the present study may be helpful to determine more objective risk factors for subsequent IPA.…”

Section: Conclusion and Clinical Implicationmentioning

confidence: 99%

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Clinical and sociodemographic predictors of inpatient admission after presentation in a psychiatric emergency room: an observational study

Gisy,

Toto,

Bleich

et al. 2023

Int J Ment Health Syst

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Background The admission decision after presentation in the psychiatric emergency room (PER) has potentially far-reaching consequences for the patient and the community. In a short amount of time, information must be collected and evaluated for a well-founded admission decision. The present study aimed to identify risk factors associated with inpatient psychiatric admission (IPA) after previous emergency presentation to the PER. Methods Electronic patient records for all patients presenting in the PER of Hannover Medical School (MHH) in the year 2022 were retrospectively examined (n = 2580). Out of these, 2387 were included in this study. Two multivariate binary logistic regression analyses were performed to identify risk factors for IPA within sociodemographic, circumstantial and clinical variables. Results 1300 (54.5%) consultations resulted in IPA. The most significant sociodemographic and circumstantial risk factors for IPA were found to be suicide attempt (depending on method: OR 9.1–17.4), aggressive behavior towards people prior to presentation (OR 2.9, 95% CI 1.7–4.8), previous psychiatric treatment (OR 1.8, 95% CI 1.4–2.3) and transfer from another hospital or medical discipline of MHH as means of presentation (OR 6.3, 95% CI 3.0–13.0). Among psychopathological aspects, suicidal ideation (OR 3.8, 95% CI 2.9–4.9), suicidal intent (OR 116.0, 95% CI 15.9–844.8), disturbance of orientation (OR 3.7, 95% CI 2.5–5.3), delusions (OR 2.3, 95% CI 1.6–3.1), visual hallucinations (OR 2.9, 95% CI 1.6–5.1), hopelessness/despair (OR 2.4, 95% CI 1.7–3.2) and inhibition of drive (OR 1.6, 95% CI 1.3–2.1) were significantly associated with IPA. Conclusions The admission decision is a complex process influenced by a multitude of sociodemographic, circumstantial and clinical factors. A deeper understanding of the decision-making process can be used to improve patient care and facilitate the evaluation process in the PER.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Section: Conclusion and Clinical Implicationmentioning

confidence: 99%

See 1 more Smart Citation

Clinical and sociodemographic predictors of inpatient admission after presentation in a psychiatric emergency room: an observational study

Gisy,

Toto,

Bleich

et al. 2023

Int J Ment Health Syst

View full text Add to dashboard Cite

show abstract

“…These factors have been emphasized in other studies as important indicators for identifying suicide risk. [24,[44][45][46][47] In terms of anxiety-depression, Guo et al noted that psychiatric patients frequently experience feelings of anxiety and distress about their current and future circumstances, often accompanied by emotions such as sadness, frustration, and helplessness. These negative emotions can hinder their willingness to seek mental health services.…”

Section: Discussionmentioning

confidence: 99%

“…[44] Michaud et al reported that the severity of suicidal ideation and behavior was independently associated with involuntary hospitalization. [45] Levola et al found that depression and involuntary psychiatric hospitalization were significantly linked to an increased risk of suicide by 132% and 40%, respectively. [46][47] Consequently, healthcare professionals should actively and meticulously pay attention to LLD patients displaying anxiety, depression symptoms, and resistance to hospitalization, as these individuals have an increased risk of suicide.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with a high level of suicide risk among patients with late-life depression: a cross-sectional study from a tertiary psychiatric hospital in Guangzhou China

Liu,

Ye,

Wei

et al. 2024

Preprint

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Background As global aging accelerates, depression in the elderly becomes more common. Research had revealed that patients with late-life depression face an increased risk of suicide compared to those in other age groups with similar disorders, with the pathway to suicide being multifaceted. Thus, investigating the various factors linked to the elevated risk of suicide in elderly individuals with depression is critical. Objective To investigate the factors associated with a high level of suicide risk among patients with late-life depression (LLD). Methods A total of 108 patients with LLD were recruited for this study. From October 2022 to November 2023, a cross-sectional study was conducted on patients with LLD from the Affiliated Brain Hospital of Guangzhou Medical University. Suicide risk was evaluated using the Chinese version of the Nurses' Global Assessment of Suicide Risk Scale (NGASR). Potential influencing factors were included and analyzed through multivariate linear regression to identify the factors associated with high level of suicide risk among patients with LLD. Results The average score of NGASR in patients with LLD was 7.30±4.34 (range: 0~19). Multiple linear regression analyses revealed that depression-anxiety of BPRS (β=0.31, 95%CI=0.13, 0.45, P＜0.001), activation of BPRS (β=-0.29, 95%CI=-1.22, -0.35, P＜0.001), normal cognitive function of MMSE (β=0.21, 95%CI=0.50, 3.48, P＜0.05), involuntary admission (β=0.20, 95%CI=0.44, 3.43, P＜0.05), and objective support of SSRS (β=0.21, 95%CI=0.08, 0.66, P＜0.05) were statistically associated with the a high level of suicide risk in patients with LLD (P<0.05). Conclusion This study found that LLD patients with severe depression-anxiety, low activation, normal cognitive function, involuntary admission, and strong objective support exhibited a high level of suicide risk. These patients should receive intensified monitoring and comprehensive measures should be implemented to prevent the occurrence of suicidal behaviors during hospitalization.

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Comparison between aborted/interrupted and actual suicide attempt: An observational study on clinical and sociodemographic characteristics

Alberto,

Massimiliano,

Philippe

et al. 2024

Journal of Affective Disorders

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When to discharge and when to voluntary or compulsory hospitalize? Factors associated with treatment decision after self-harm

Cited by 5 publications

References 40 publications

Clinical and sociodemographic predictors of inpatient admission after presentation in a psychiatric emergency room: an observational study

Clinical and sociodemographic predictors of inpatient admission after presentation in a psychiatric emergency room: an observational study

Factors associated with a high level of suicide risk among patients with late-life depression: a cross-sectional study from a tertiary psychiatric hospital in Guangzhou China

Comparison between aborted/interrupted and actual suicide attempt: An observational study on clinical and sociodemographic characteristics

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