title: Suicide in custody: case-control study.
abstract: BACKGROUND
  Few risk factors and indicators of vulnerability for suicide in custody are known so far.
  
  
  OBJECTIVE
  A case-control study was conducted to investigate the relevance of criminal history, psychiatric morbidity and social integration to suicide in prison.
  
  
  METHODS
  For every suicide that occurred in an Austrian correctional institution between 1975 and 1999, two controls matched for correctional institution, gender, nationality, age, custodial status and time of admission were selected. Psychiatric characteristics, previous suicidal behaviour, criminal history and indicators of social integration were compared.
  
  
  RESULTS
  Of 250 recorded suicides, 220 personal files were available and matched to 440 controls. The most important predictors for suicide in custody were a history of suicidality (status following attempted suicide and suicide threat), psychiatric diagnosis, psychotropic medication, a highly violent index offence and single- cell accommodation.
  
  
  CONCLUSIONS
  A significant finding is the importance of suicidal behaviour as an indicator of risk of suicide in correctional institutions, which until now has been a matter of debate. This study demonstrates the need for staff to take suicidal behaviour as seriously in custodial settings as in any other circumstances.
authors.affiliation: Division of Social Psychiatry, Department of Psychiatry, Medical University of Vienna, Austria. psd.fruehwald@stpoelten.caritas.at
authors.forename: Stefan
authors.initials: S
authors.lastname: Fruehwald
authors.forename: Teresa
authors.initials: T
authors.lastname: Matschnig
authors.forename: Franz
authors.initials: F
authors.lastname: Koenig
authors.forename: Peter
authors.initials: P
authors.lastname: Bauer
authors.forename: Patrick
authors.initials: P
authors.lastname: Frottier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001317:Austria / Q000453:epidemiology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D011329:Prisoners / Q000706:statistics & numerical data*; D012044:Regression Analysis; D012307:Risk Factors; D013405:Suicide / Q000706:statistics & numerical data*