Multiple factors linked to suicide risk in those hospitalized for a mental disorder
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Multiple factors, including geography, gender, income and previous diagnosis, are linked to suicide risk for those recently hospitalized for mental disorders, according to a study published in the Journal of Clinical Psychiatry.
“Although hospitalization is an important clinical intervention for managing acute suicide risk, there is a known increased risk of suicide among individuals recently discharged from hospitalization for mental disorders,” Jessica S. Enns, MD, of the department of psychiatry at the University of Manitoba in Winnipeg, and colleagues wrote.
Researchers sought to examine the incidence and predictors of suicide attempts and deaths in the year after psychiatric hospitalization in Manitoba.
The population-based study utilized information from the Manitoba Population Research Data Repository to include 26,975 participants aged 18 years and older who were admitted to the hospital with a mental disorder from April 2005 to December 2016. Among the diagnoses examined were mood and anxiety disorders, substance use disorders, psychotic disorders, personality disorders and suicide attempts.
Primary outcome for analysis was death by suicide, with secondary outcome the time to initial suicide attempt or death in the year following first hospitalization for mental health. Using Cox regression, hazard ratios (HRs) were calculated for each covariate among those who attempted and died by suicide in the year following hospitalization, while adjusting for confounders.
Results showed that 0.7% of the individuals died by suicide and 3.5% attempted suicide in the year after hospitalization for a mental disorder. Statistically significant risk factors for suicide in the year after discharge from psychiatric hospitalization included male sex (HR = 1.47; 95% CI, 1.10–1.97) and urban location (HR = 1.37; 95% CI, 1.02–1.85), female sex (HR = 0.63; 95% CI, 0.55–0.72), living rurally (HR = 0.66; 95% CI, 0.58–0.75), a previous mental disorder (HR = 1.63; 95% CI, 1.38–1.92), justice involvement (HR = 1.48; 95% CI, 1.28–1.70), and being on income assistance (HR = 1.17; 95% CI, 1.01–1.35).
Conversely, age (HR = 0.99; 95% CI, 0.99–0.99) was associated with a reduced rate of suicide attempts.
“Further research to expand our knowledge and develop interventions ... would be critical to better treat and manage this population,” Enns and colleagues wrote.