Suicide in custody: case-control study.
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.
Fruehwald
Stefan
S
Division of Social Psychiatry, Department of Psychiatry, Medical University of Vienna, Austria. psd.fruehwald@stpoelten.caritas.at
Matschnig
Teresa
T
Koenig
Franz
F
Bauer
Peter
P
Frottier
Patrick
P
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*