Dataset Information

Profile of suicide attempts and risk factors among psychiatric patients: A case-control study.

ABSTRACT:

Background

Suicidal behaviour remains challenging for clinicians to predict, with few established risk factors and warning signs among psychiatric patients.

Aim

We aimed to describe characteristics and identify risk factors for suicide attempts among patients with psychiatric disorders.

Methods

Multivariable logistic regression analysis, adjusted for clinically important confounders, was employed to determine risk factors for suicide attempts within a psychiatric patient population.

Results

The case (n = 146) and control groups (n = 104) did not differ significantly with regards to sociodemographic characteristics. The majority of the participants who had attempted suicide did so with high intent to die, and expected to die without medical intervention. The primary method of attempt was pharmaceutical overdose among the case participants (73.3%). Results showed impulsivity (odds ratio [OR] = 1.15, 95% confidence interval [CI] = 1.03-1.30) and borderline personality symptoms (OR = 1.07, 95% CI = 1.01-1.13) were significantly associated with attempted suicide.

Conclusions

Our findings indicate that known sociodemographic risk factors for suicide may not apply within psychiatric populations. Prevention strategies for suicidal behaviour in psychiatric patients may be effective, including limited access to means for suicide attempts (i.e. excess pharmaceutical drugs) and target screening for high-risk personality and impulsivity traits.

SUBMITTER: Bhatt M

PROVIDER: S-EPMC5823369 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Publications

Profile of suicide attempts and risk factors among psychiatric patients: A case-control study.

Bhatt Meha M Perera Stefan S Zielinski Laura L Eisen Rebecca B RB Yeung Sharon S El-Sheikh Wala W DeJesus Jane J Rangarajan Sumathy S Sholer Heather H Iordan Elizabeth E Mackie Pam P Islam Shofiqul S Dehghan Mahshid M Thabane Lehana L Samaan Zainab Z

PloS one 20180222 2

<h4>Background</h4>Suicidal behaviour remains challenging for clinicians to predict, with few established risk factors and warning signs among psychiatric patients.<h4>Aim</h4>We aimed to describe characteristics and identify risk factors for suicide attempts among patients with psychiatric disorders.<h4>Methods</h4>Multivariable logistic regression analysis, adjusted for clinically important confounders, was employed to determine risk factors for suicide attempts within a psychiatric patient po ...[more]

PMID: 29470514

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Project description:IntroductionSuicide attempts represent an important public health burden. Centralised electronic health record (EHR) systems have high potential to provide suicide attempt surveillance, to inform public health action aimed at reducing risk for suicide attempt in the population, and to provide data-driven clinical decision support for suicide risk assessment across healthcare settings. To exploit this potential, we designed the Catalonia Suicide Risk Code Epidemiology (CSRC-Epi) study. Using centralised EHR data from the entire public healthcare system of Catalonia, Spain, the CSRC-Epi study aims to estimate reliable suicide attempt incidence rates, identify suicide attempt risk factors and develop validated suicide attempt risk prediction tools.Methods and analysisThe CSRC-Epi study is registry-based study, specifically, a two-stage exposure-enriched nested case-control study of suicide attempts during the period 2014-2019 in Catalonia, Spain. The primary study outcome consists of first and repeat attempts during the observation period. Cases will come from a case register linked to a suicide attempt surveillance programme, which offers in-depth psychiatric evaluations to all Catalan residents who present to clinical care with any suspected risk for suicide. Predictor variables will come from centralised EHR systems representing all relevant healthcare settings. The study's sampling frame will be constructed using population-representative administrative lists of Catalan residents. Inverse probability weights will restore representativeness of the original population. Analysis will include the calculation of age-standardised and sex-standardised suicide attempt incidence rates. Logistic regression will identify suicide attempt risk factors on the individual level (ie, relative risk) and the population level (ie, population attributable risk proportions). Machine learning techniques will be used to develop suicide attempt risk prediction tools.Ethics and disseminationThis protocol is approved by the Parc de Salut Mar Clinical Research Ethics Committee (2017/7431/I). Dissemination will include peer-reviewed scientific publications, scientific reports for hospital and government authorities, and updated clinical guidelines.Trial registration numberNCT04235127.

Project description:ImportancePeripartum suicide attempt is a major psychiatric complication associated with pregnancy, but the risk factors remain largely uncertain.ObjectiveTo identify the demographic characteristics and predisposing risks for peripartum suicide attempts and postpartum depression.Design, setting, and participantsThis cohort study used retrospective data on pregnant women who delivered children between April 1, 2016, and March 31, 2021, at 712 hospitals in Japan. The nationwide Diagnosis Procedure Combination database was used.ExposuresPsychiatric and nonpsychiatric medical history, age, alcohol and tobacco use, and obstetric complications and procedures.Main outcomes and measuresData on admissions for prepartum suicide attempt and delivery during the same hospital stay and readmissions for depression or suicide attempt within 1 year post partum were collected. Comparisons of prevalence of each study variable were performed, and multivariable logistic regression analyses were used to determine risk factors.ResultsFrom a total of 39 908 649 hospitalization episodes, 804 617 cumulative pregnant women (median [IQR] age at childbirth, 33 [29-36] years) who delivered at the enrolled hospitals were identified, including 1202 who were admitted for suicide attempt and delivery during the same hospital stay and 111 readmitted for suicide attempt within 1 year post partum. Risk factors associated with prepartum suicide attempts included younger age (adjusted odds ratio [aOR], 0.99; 95% CI, 0.98-1.00) and histories of personality disorder (aOR, 10.81; 95% CI, 5.70-20.49), depression (aOR, 3.97; 95% CI, 2.35-6.70), schizophrenia (aOR, 2.89; 95% CI, 1.52-5.50), and adjustment disorder (aOR, 2.66; 95% CI, 1.07-6.58). Risk factors associated with postpartum suicide attempts included younger age (aOR, 0.96; 95% CI, 0.93-1.00), heavy tobacco use (aOR, 23.09; 95% CI, 5.46-97.62), and histories of alcohol use disorder (aOR, 163.54; 95% CI, 28.30-944.95), personality disorder (aOR, 10.28; 95% CI, 3.29-32.10), anxiety disorders (aOR, 8.13; 95% CI, 2.88-22.98), depression (aOR, 7.27; 95% CI, 2.95-17.91), schizophrenia (aOR, 5.77; 95% CI, 2.17-15.38), bipolar disorder (aOR, 3.98; 95% CI, 1.36-11.67), and insomnia (aOR, 3.17; 95% CI, 1.30-7.78). On sensitivity analysis, risk factors associated with postpartum depression after excluding those with prenatal depression included histories of personality disorder, adjustment disorder, bipolar disorder, insomnia, and anxiety disorders.Conclusions and relevanceThe findings of this cohort study suggest that histories of smoking and prenatal psychiatric disorders are potential risk factors for peripartum suicide attempts and may require additional treatment and prevention interventions.

Project description:BackgroundWhile there are many studies on adolescents' suicide attempts in the western countries, studies on adolescent suicide in South Korea are relatively scarce. We compared demographical and clinical variables between the first and multiple suicide attempters and examined potential risk factors predicting multiple suicide attempts.MethodsTwo hundred forty-eight suicide attempters aged from 11 to 19 years old who visited emergency department of Uijeongbu St. Mary's Hospital, South Korea were recruited and divided into two groups: first attempter (n = 139, 56%) and multiple attempter (n = 109, 44%). A psychiatric interview with the Brief Emergency Room Suicide Risk Assessment were administered to all participants, and univariate analyses to compare characteristics of the two group and a multivariable logistic regression analysis to predict multiple suicidal attempts were performed.ResultsOur results showed multiple suicide attempters were mostly female (78%), more severe in psychopathology (e.g., higher rate of psychiatric family history, diagnosis of axis I history, history of major depressive disorder, higher feeling of hopelessness/helplessness) and suicidality (e.g., repetitive/severe/continuous suicide ideation, lower regret for suicide attempt). Moreover, multiple suicide attempters were lower in psychiatric resources, such as lower personal achievement, lower ability to control emotion, and less insight. Multivariate logistic regression analysis showed that suicide ideation severity (odds ratio [OR], 2.30; P = 0.004), past history of axis I diagnosis (especially major depressive disorder; OR, 2.55; P = 0.002), and the use of "cutting" (OR, 2.85; P = 0.001) predicted multiple suicide attempts.ConclusionThe present study suggests that multiple suicide attempters tend to have more severe clinical profiles than the first suicide attempters. Intervention for depression and self-mutilation behavior of suicide attempters may be important in preventing multiple suicide attempts of adolescents.

Dataset Information

Profile of suicide attempts and risk factors among psychiatric patients: A case-control study.

Background

Aim

Methods

Results

Conclusions

Publications

Profile of suicide attempts and risk factors among psychiatric patients: A case-control study.

Similar Datasets

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