Suicidal ideation in prisoners: risk factors and relevance to suicidal behaviour. A prospective case-control study.
OBJECTIVE
To investigate risk factors for suicidal ideation (SI) in prisoners, as well as the prediction of suicidal behaviour by SI.


METHODS
Participants were recruited from the all-male,adults', high security prison of Patras, Greece. Sixty-seven prisoners who expressed SI were evaluated using a structured interview, Hamilton's Rating Scale for Anxiety (HAMA) and the Montgomery-Asberg Rating Scale for Depression (MADRS). Sixty-seven control prisoners without SI, matched for age, nationality and penal status were evaluated using the same structured interview and rating scales. All participants were followed-up prospectively for 12 months after their initial assessment and any acts of self-destructive behaviour were recorded.


RESULTS
Independent significant risk factors for SI in prisoners were the family history of suicidal behaviour (OR = 56.34, 95% CI = 4.23-750.1, p < 0.002), history of psychiatric hospitalisation (OR = 7.18, 95% CI = 1.83-28.16, p < 0.005), and higher scores in the MADRS (p < 0.03) and HAMA (p < 0.03) scales. During the follow-up period, suicidal behaviour (suicide attempt or self-mutilation) was observed in 12 (17.9%) inmates with SI, as opposed to none of the controls (p < 0.0001).


CONCLUSIONS
A family history of suicidal behaviour, history of psychiatric hospitalisation and symptoms of anxiety or depression were independent risk factors for SI in prisoners. Inmates with SI had a higher risk for self-destructive acts at follow-up. Inmates with SI are a high-risk group for future self-destructive acts, so special precautions designed to reduce this risk are warranted.
Lekka
Nicoletta P
NP
Department of Psychiatry, University of Patras Medical School, 26500, Rion, Patras, Greece. nlekka@medscape.com
Argyriou
Andreas A
AA
Beratis
Stavroula
S
D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis / Q000235:genetics / Q000523:psychology; D016022:Case-Control Studies; D003866:Depressive Disorder / Q000175:diagnosis* / Q000235:genetics / Q000523:psychology; D006115:Greece; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010552:Personality Assessment; D011329:Prisoners / Q000523:psychology*; D011446:Prospective Studies; D012307:Risk Factors; D012652:Self Mutilation / Q000523:psychology; D013405:Suicide / Q000523:psychology; D013406:Suicide, Attempted / Q000523:psychology*; D000092864:Suicide Prevention