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Soc Psychiatry Psychiatr Epidemiol. 2013 Sep;48(9):1481-9. doi: 10.1007/s00127-013-0690-2. Epub 2013 Apr 23.

Deliberate self-harm before psychiatric admission and risk of suicide: survival in a Danish national cohort.

Author information

1
Psychiatric Center Copenhagen, Copenhagen University Hospital, Bispebjerg Bakke 23, Building 13A, 2400, Copenhagen, Denmark. trine.madsen@regionh.dk

Abstract

PURPOSE:

Psychiatric illness and deliberate self-harm (DSH) are major risk factors of suicide. In largely 15% of psychiatric admissions in Denmark, the patient had an episode of DSH within the last year before admission. This study examined the survival and predictors of suicide in a suicidal high-risk cohort consisting of hospitalized psychiatric patients with recent DSH.

METHODS:

This national prospective register-based study examined all hospitalized psychiatric patients who self-harmed within a year before admission. All admitted patients, in the time period 1998-2006, were followed and survival analyses techniques were used to identify predictors of suicide.

RESULTS:

The study population consisted of 17,257 patients; 520 (3%) died by suicide during follow-up; 50% of the suicides occurred within a year from the index admission. A rate of 1,645 suicides per 100,000 person-years in the first year after psychiatric admission was found. Adjusted analyses showed that a higher degree of education, having DSH within a month before psychiatric admission and contact with a private psychiatrist increased the risk of suicide.

CONCLUSIONS:

Psychiatric hospitalized patients with recent DSH revealed high suicide rates, even during hospitalization. When discharging psychiatric patients with recent DSH careful arrangement of follow-up treatment in the outpatient setting is recommendable.

PMID:
23609375
DOI:
10.1007/s00127-013-0690-2
[Indexed for MEDLINE]

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