Perceived Coercion During Admission Into Psychiatric Hospitalization Increases Risk of Suicide Attempts After Discharge

2019 ◽  
Vol 50 (1) ◽  
pp. 180-188 ◽  
Author(s):  
Joshua T. Jordan ◽  
Dale E. McNiel
Keyword(s):  
Suicide Attempts ◽  
Psychiatric Hospitalization ◽  
Perceived Coercion

Attempted suicide attention at an emergency room: A hospital-based descriptive approach

2016 ◽  
Vol 33 (S1) ◽  
pp. S603-S603
Author(s):  
D. Torres ◽  
G. Martinez-Ales ◽  
M. Quintana ◽  
V. Pastor ◽  
M.F. Bravo
Keyword(s):  
Emergency Room ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Psychiatric Hospitalization ◽  
Study Results ◽  
History Of ◽  
Competing Interest ◽  
Reported Data ◽  
Medium Cost ◽  
Rule Out

IntroductionSuicide causes 1.4% of deaths worldwide. Twenty times more frequent, suicide attempts entail an important source of disability and of psychosocial and medical resources use.ObjectiveTo describe main socio-demographical and psychiatric risk factors of suicide attempters treated in a general hospital's emergency room basis.AimsTo identify individual features potentially useful to improve both emergency treatments and resource investment.MethodsA descriptive study including data from 2894 patients treated in a general hospital's emergency room after a suicidal attempt between years 2006 and 2014.ResultsSixty-nine percent of the population treated after an attempted suicide were women. Mean age was 38 years old. Sixty-six percent had familiar support; 48.5% had previously attempted a suicide (13% did not answer this point); 72.6% showed a personal history of psychiatric illness. Drug use was present in 38.3% of the patients (20.3% did not answer this question); 23.5% were admitted to an inpatient psychiatric unit. Medium cost of a psychiatric hospitalization was found to be 4900 euros.ConclusionThis study results agree with previously reported data. Further observational studies are needed in order to bear out these findings, rule out potential confounders and thus infer and quantify causality related to each risk factor.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Comparison of suicide risk and other outcomes among boys and girls who self-harm

2020 ◽  
Vol 29 (12) ◽  
pp. 1741-1746 ◽  
Author(s):  
Anna Ohlis ◽  
Johan Bjureberg ◽  
Paul Lichtenstein ◽  
Brian M. D’Onofrio ◽  
Alan E. Fruzzetti ◽  
...  
Keyword(s):  
Sex Differences ◽  
Suicide Attempts ◽  
Psychiatric Hospitalization ◽  
Economic Status ◽  
Adverse Outcomes ◽  
Hazard Ratios ◽  
Self Harm ◽  
Males And Females ◽  
Drug Use Disorder

Abstract Little is known about sex differences in outcomes of self-harm, and there are inconclusive results concerning the association between sex, self-harm, and suicide attempts. The aim of this study was to explore sex differences in outcomes of self-harm in adolescence. In this cohort study, all individuals (0–17 years) enrolled at the child- and adolescent mental health services (CAMHS) in Stockholm between 2001 and 2015 (N = 110,072) were followed in national registers from their last contact with the CAMHS, until end of 2015. Exposure was self-harm as reason for contact, outcome measures were: alcohol-/substance use disorder, psychiatric hospitalization, non-violent or violent crime, and suicide. Differences in outcomes rates between exposed versus unexposed males, and exposed versus unexposed females, were examined using Cox regressions, expressed as hazard ratios (HR) with 95% confidence intervals (CI). Median follow-up time was 5.8 years (Q1: 2.3 years; Q3: 9.7 years). Self-harm was documented in 2.2% (N = 1241) males and 8.7% (4716) females. Exposed individuals had higher HR for all outcomes as compared with unexposed individuals of their own sex. Exposed females had more pronounced risk for drug use disorder (HR 11.2; 95% CI 9.9–12.7) compared with exposed males (HR 6.5, 95% 5.2–8.0). Both males and females who had engaged in self-harm had elevated risks for future suicide. Adjusting for socio-economic status and age at start of follow-up only marginally affected the associations. Females and males with self-harm had similarly elevated risk for suicide, and self-harm was also an important risk marker for other adverse outcomes within both sexes.

scholarly journals Predictors of Psychiatric Aftercare among Formerly Hospitalized Adolescents

2012 ◽  
Vol 57 (11) ◽  
pp. 666-676 ◽  
Author(s):  
Corine E Carlisle ◽  
Muhammad Mamdani ◽  
Russell Schachar ◽  
Teresa To
Keyword(s):  
Rural Areas ◽  
Psychotic Disorders ◽  
Suicide Attempts ◽  
Psychiatric Hospitalization ◽  
Psychiatric Treatment ◽  
Population Based ◽  
Care Physician ◽  
Administrative Databases ◽  
Timely Access ◽  
Self Harm

Objective: Timely aftercare can be viewed as a patient safety imperative. In the context of decreasing inpatient length of stay (LOS) and known child psychiatry human resource challenges, we investigated time to aftercare for adolescents following psychiatric hospitalization. Method: We conducted a population-based cohort study of adolescents aged 15 to 19 years with psychiatric discharge between April 1, 2002, and March 1, 2004, in Ontario, using encrypted identifiers across health administrative databases to determine time to first psychiatric aftercare with a primary care physician (PCP) or a psychiatrist within 395 days of discharge. Results: Among the 7111 adolescents discharged in the study period, 24% had aftercare with a PCP or a psychiatrist within 7 days and 49% within 30 days. High socioeconomic status (adjusted hazard ratio [AHR] 1.31; 95% CI 1.21 to 1.43, P < 0.001) and psychotic disorders (AHR 1.24; 95% CI 1.12 to 1.36, P < 0.001) were associated with greater likelihood of aftercare. Youth in the northern part of the province (AHR 0.48; 95% CI 0.32 to 0.71, P < 0.001), rural areas (AHR 0.82; 95% CI 0.76 to 0.89, P < 0.001), and with self-harm or suicide attempts (AHR 0.58; 95% CI 0.53 to 0.64, P < 0.001) and substance use disorders (AHR 0.50; 95% CI 0.44 to 0.56, P < 0.001) were less likely to receive aftercare. Conclusions: Hospitalization is our most intensive, intrusive, and expensive psychiatric treatment setting, yet in our cohort of formerly hospitalized adolescents fewer than 50% received psychiatry-related aftercare in the month postdischarge. Innovations are necessary to address geographic inequities and improve timely access to mental health aftercare for all youth.

scholarly journals Identification of risk factors for involuntary psychiatric hospitalization: Using environmental socioeconomic data and methods of machine learning to improve prediction

2020 ◽  
Author(s):  
Olaf Karasch ◽  
Mario Schmitz-Buhl ◽  
R Roman Mennicken ◽  
Jürgen Zielasek ◽  
Euphrosyne Gouzoulis-Mayfrank
Keyword(s):  
Mental Health ◽  
Machine Learning ◽  
Risk Factors ◽  
Prediction Model ◽  
Suicide Attempts ◽  
Psychiatric Hospitalization ◽  
Previous Analysis ◽  
Data Set ◽  
Interaction Detection ◽  
Socioeconomic Data

Abstract Background: The purpose of this study was to identify factors associated with a high risk of involuntary psychiatric in-patient hospitalization both on the individual level and on the level of mental health services and the socioeconomic environment that patients live in. Methods: The present study expands on a previous analysis of the health records of 5764 cases admitted as in-patients in the four psy­chiat­ric hospitals of the Metropolitan City of Cologne, Germany, in the year 2011 (1773 cases treated under the Mental Health Act and 3991 cases trea­ted voluntarily). Our previous analysis had included medical, socio­demographic and socioeconomic data of every case and used a machine learning-based prediction model employing chi-squared automatic interaction detection (CHAID). Our current analysis attempts to improve the previous one through (1) optimizing the machine learning procedures (use of a different type of decision-tree prediction model (CART) and application of hyperparameter tuning), and (2) the addition of socioeconomic data on the patients’ environment to the data set. Results: Compared to our previous analysis, model fit was improved. Main diagnoses of an organic mental or a psychotic disorder (ICD-10 groups F0 and F2), suicidal behavior upon admission, admission outside of regular service hours and absence of outpatient treatment prior to admission were confirmed as powerful predictors of detention. Particularly high risks were shown for (1) patients with an organic mental disorder, specifically if they were retired, admitted outside of regular service hours and lived in assisted housing, (2) patients with suicidal tendencies upon admission who did not suffer from an affective disorder, specifically if it was unclear whether there had been previous suicide attempts, or if the affected person lived in areas with high unemployment rates, and (3) patients with psychosis, specifically those who lived in densely built areas with a large proportion of small or one-person households. Conclusions: Certain psychiatric diagnoses and suicidal tendencies are major risk factors for involuntary psychiatric hospitalization. In addition, service-related and environmental socioeconomic factors contribute to the risk for detention. Identifying modifiable risk factors and particularly vulnerable risk groups should help to develop suitable preventive measures.

Understanding the Risks of Recent Discharge

Crisis ◽  
2012 ◽  
Vol 33 (1) ◽  
pp. 21-29 ◽  
Author(s):  
John R. Cutcliffe ◽  
Paul S. Links ◽  
Henry G. Harder ◽  
Ken Balderson ◽  
Yvonne Bergmans ◽  
...  
Keyword(s):  
Inpatient Care ◽  
Suicide Attempts ◽  
Mental Health Problems ◽  
Psychiatric Hospitalization ◽  
Psychiatric Service ◽  
Mixed Methods Study ◽  
Federally Funded ◽  
Increased Risk ◽  
Early Exploration ◽  
Purposive Sample

Background: Evidence indicates that people whose mental health problems lead them to require psychiatric hospitalization are at a significantly increased risk of suicide, and that the time immediately following discharge after such hospitalizations is a particularly high-risk time. Aims: This paper reports on phenomenological findings from a federally funded, mixed-methods study that sought to better understand the observed increased risk for suicide following discharge from an inpatient psychiatric service. Methods: A purposive sample of 20 recently discharged former suicidal inpatients was obtained. Data were collected in hermeneutic interviews lasting between 1 h and 2 h and analyzed according to van Manen’s (1997 ) interpretation of hermeneutic phenomenology. Results: Two key themes, “existential angst at the prospect of discharge” and “trying to survive while living under the proverbial ‘sword of Damocles’” were induced. Each of these was comprised of five themes with the first key theme (which is the focus of this paper) encompassing the following: “Feeling scared, anxious, fearful and/or stressed,” “Preparedness,” “Leaving the place of safety,” “Duality and ambivalence,” and “Feel like a burden.” Conclusions: Early exploration of and reconciling of patients’ expectations regarding inpatient care for their suicidality would be empirically based interventions that could diminish the postdischarge risk for further suicide attempts.

Autolytic behavior in acute psychiatric hospitalization

2016 ◽  
Vol 33 (S1) ◽  
pp. S602-S602
Author(s):  
P. Hervías Higueras ◽  
L. Maroto Martín ◽  
S. Raffo Moncloa ◽  
P. Jiménez de los Galanes Marchán
Keyword(s):  
Alcohol Use ◽  
Personality Disorders ◽  
Depressed Mood ◽  
Depressive Episode ◽  
Suicide Attempts ◽  
Psychiatric Hospitalization ◽  
Alcohol Use Disorders ◽  
Bipolar Disorders ◽  
Adjustment Disorders ◽  
Obsessive Compulsive

The aim of the study was to identify inpatients due to autolytic behavior in the acute psychiatric hospitalization of Dr. R. Lafora Hospital. It is an observational, descriptive and retrospective study. We collected information about patients aged 18 to 64 who were hospitalized during the month of January of 2015 in the acute psychiatric hospitalization by Selene software. The results were analyzed by SPSS software; 53.3% of patients diagnosed with schizophrenia spectrum and other psychotic disorders were hospitalized for acute exacerbation of paranoid schizophrenia; 57.1% of personality disorders for suicide attempts, 28.6% autolytic ideation; 28.6% of bipolar disorders due to mania, 28.6% depression, 28.6% mixed clinical and 14.29% suicide attempts; 60% of alcohol use disorders for autolytic ideation, 20% intoxication; 100% of substance-related and addictive disorders due to autolytic ideation; 100% of feeding and eating disorders for autolytic ideation; 50% of obsessive-compulsive and related disorders due to autolytic ideation; 100% of adjustment disorders with depressed mood due to drug over-eating; 100% of adjustment disorders with mixed anxiety and depressed mood for mixed clinic; 16.7% of depressive disorders due to dysthymia, 16.7% due to major depressive episode, 16.7% for moderate depressive episode, 16.7% for mild depressive episode with mixed nature, 16.7% for drug over-eating, 16.7% for autolytic ideation. It would be important to focus on patients with a diagnosis of adjustment disorders, personality disorders, alcohol use disorders, obsessive-compulsive and related disorders and bipolar disorders, providing community care and avoiding the risks associated psychiatric hospitalization.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Prevention of suicide following psychiatric hospitalization

2021 ◽  
pp. 511-520
Author(s):  
Natalie B. Riblet ◽  
Brian Shiner
Keyword(s):  
High Risk ◽  
Clinical Outcome ◽  
Suicide Attempts ◽  
Psychiatric Hospitalization ◽  
World Health ◽  
Effective Strategies ◽  
Risk Period ◽  
The World ◽  
Cognitive Therapies ◽  
Health Organization

The period following a psychiatric hospitalization is a high-risk period for suicide and several factors may contribute such as problems with patient engagement. It is vital that researchers identify effective strategies to prevent suicide in the period following hospitalization. Yet, researchers face many challenges in conducting suicide research. Importantly, because the clinical outcome of greatest interest, death by suicide, is rare, researchers must rely heavily on proxy measures of suicide. Furthermore, while there have been over 30 trials of various strategies to mitigate suicide risk following hospital or emergency room discharge, there is mixed evidence regarding the efficacy of these interventions. While some studies have shown significant reduction in suicide attempts, other studies have found no difference. Few studies have demonstrated a significant effect on death by suicide. The most promising interventions include cognitive therapies for suicide prevention, the World Health Organization Brief Intervention and Contact programme.

scholarly journals A Worldwide Assessment of the Frequency of Suicide, Suicide Attempts, or Psychiatric Hospitalization after Predictive Testing for Huntington Disease

1999 ◽  
Vol 64 (5) ◽  
pp. 1293-1304 ◽  
Author(s):  
Elisabeth W. Almqvist ◽  
Maurice Bloch ◽  
Ryan Brinkman ◽  
David Craufurd ◽  
Michael R. Hayden
Keyword(s):  
Huntington Disease ◽  
Suicide Attempts ◽  
Psychiatric Hospitalization ◽  
Predictive Testing

Heavy daily smoking among under 18-year-old psychiatric inpatients is associated with increased risk for suicide attempts

2007 ◽  
Vol 22 (4) ◽  
pp. 219-222 ◽  
Author(s):  
Kaisa Riala ◽  
Kaisa Viilo ◽  
Helinä Hakko ◽  
Pirkko Räsänen
Keyword(s):  
Suicide Attempts ◽  
Psychiatric Hospitalization ◽  
Psychiatric Inpatients ◽  
Smoking Behaviour ◽  
Daily Smoking ◽  
Psychiatric Evaluation ◽  
Psychiatric Illnesses ◽  
Increased Risk ◽  
Waking Up ◽  
The Relationship

AbstractPurposeTo investigate the relationship between heavy daily smoking and suicidality among adolescent psychiatric inpatients in Finland.MethodsData were collected from 411 patients (age 12–17 years) admitted to inpatient psychiatric hospitalization between April 2001 and July 2005. The number of daily cigarettes (>15) and the time of first cigarette after waking up (within 30 min) were used as indicators of heavy daily smoking.ResultsAfter adjusting for psychiatric diagnoses an over twofold risk for suicide attempts was found among adolescents who smoked over 15 cigarettes a day. Additionally, if an adolescent also smoked the first cigarette immediately after waking up the risk was over threefold. Suicidal ideation was not associated with smoking behaviour.Discussion and conclusionsAmong adolescents with severe psychiatric illnesses, heavy daily smoking may increase the risk of suicidal behaviour independently of current psychiatric diagnosis. The degree of nicotine dependence of an adolescent should therefore be carefully assessed as part of psychiatric evaluation.

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