Clinical Features, Psychiatric Assessment, and Longitudinal Outcome of Suicide Attempters Admitted to a Tertiary Emergency Hospital

Arch Suicide Res. 2016;20(2):191-204. doi: 10.1080/13811118.2015.1004491. Epub 2015 May 11.

Abstract

The objective of this study was to characterize admissions to an emergency hospital due to suicide attempts and verify outcomes in 2 years. Data were collected from medical records and were analyzed using descriptive statistics and logistic regression. The sample consisted of 412 patients (58.7% women; mean age = 32.6 years old, SD = 14.3). Self-poisoning was the most frequent method (84.0%), and they were diagnosed mainly as depressive (40.3%) and borderline personality disorders (19.1%). Previous suicide attempts and current psychiatric treatment were reported by, respectively, 32.0% and 28.4%. Fifteen patients (3.6%, 9 males) died during hospitalization. At discharge, 79.3% were referred to community-based psychiatric services. Being male (OR = 2.11; 95% CI = 1.25-3.55), using violent methods (i.e., hanging, firearms, and knives) (OR = 1.96; 95% CI = 1.02-3.75) and psychiatric treatment history (OR = 2.58; 95% CI = 1.53-4.36) were predictors for psychiatric hospitalization. Of 258 patients followed for 2 years, 10 (3.9%) died (3 suicide), and 24 (9.3%) undertook new suicide attempts. Patients with a history of psychiatric treatment had higher risks of new suicide attempts (OR = 2.46, 95% CI = 1.07-5.65). Suicide attempters admitted to emergency hospitals exhibit severe psychiatric disorders, and despite interventions, they continue to present high risks for suicide attempts and death.

Keywords: emergency psychiatry; emergency room; suicide; suicide attempt.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Borderline Personality Disorder / epidemiology*
  • Brazil / epidemiology
  • Child
  • Community Mental Health Services
  • Depressive Disorder / epidemiology*
  • Emergency Service, Hospital
  • Female
  • Hospitalization
  • Humans
  • Logistic Models
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Poisoning / epidemiology*
  • Recurrence
  • Referral and Consultation
  • Retrospective Studies
  • Sex Factors
  • Suicide / statistics & numerical data
  • Suicide, Attempted / statistics & numerical data*
  • Tertiary Care Centers
  • Violence
  • Young Adult