title: Substance-induced suicidal admissions to an acute psychiatric service: characteristics and outcomes.
abstract: The degree of substance-induced syndrome (SIS) was evaluated in 5,116 acutely hospitalized suicidal psychiatric inpatients. Admission and discharge severity ratings were made by academic attendings using structured forms. Outcome variables analyzed include ratings of psychiatric symptom severity on admission and discharge, length of stay, severity of SIS, and severity of alcohol/drug problems. Suicidal inpatients rated with a high degree of SIS were more likely to be homeless, to be unemployed, to be uncooperative, to have shorter lengths of stay, and to show a more rapid improvement in symptoms. These patients represent a subgroup of the co-occurring disorders population having a high degree of addiction severity with temporary substance-induced suicidal syndromes and are subjected to the most expensive level of care in the mental health system. Implications of these findings include the fact that psychiatric inpatient services need to provide intensive addiction intervention treatment and that outpatient addiction services need improved capability and capacity to care for suicidal patients.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98104, USA. rries@u.washington.edu
authors.forename: Richard K
authors.initials: RK
authors.lastname: Ries
authors.forename: Christine
authors.initials: C
authors.lastname: Yuodelis-Flores
authors.forename: Katherine Anne
authors.initials: KA
authors.lastname: Comtois
authors.forename: Peter P
authors.initials: PP
authors.lastname: Roy-Byrne
authors.forename: Joan E
authors.initials: JE
authors.lastname: Russo
mesh_terms: D000328:Adult; D003710:Demography; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004637:Emergency Services, Psychiatric / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000534:rehabilitation*; D010343:Patient Admission / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D019966:Substance-Related Disorders / Q000453:epidemiology*; D013406:Suicide, Attempted / Q000706:statistics & numerical data*; D016896:Treatment Outcome