The aim of this study was to identify risk factors for suicide related to the course of treatment.
Methods: All persons in Denmark hospitalised for the first time because of an affective disorder during the period 1973-1993 were included.
Results: In 53466 patients, suicide was the cause of death in 3141 (6%) cases. The risk of suicide was high both immediately after admission and immediately following discharge. Increased risk was also associated with short duration of affective disorder, a history of multiple admissions, male gender, and increasing age.
Limitations: We were not able to distinguish with certainty between manic and depressive episodes in bipolar disorder. Prior suicide attempts could not be included in the analyses. Lack of operationalised diagnostic criteria.
Conclusions: Patients hospitalised because of an affective disorder are a highly relevant target group for suicide prevention. There is a need for improvement of preventive measures during admission and at discharge. Likewise, there is a need for preventive measures which can minimize the risk of relapse in affective disorders.