Study of the outcome of suicide attempts: characteristics of hospitalization in a psychiatric ward group, critical care center group, and non-hospitalized group.
BACKGROUND
The allocation of outcome of suicide attempters is extremely important in emergency situations. Following categorization of suicidal attempters who visited the emergency room by outcome, we aimed to identify the characteristics and potential needs of each group.


METHODS
The outcomes of 1348 individuals who attempted suicide and visited the critical care center or the psychiatry emergency department of the hospital were categorized into 3 groups, "hospitalization in the critical care center (HICCC)", "hospitalization in the psychiatry ward (HIPW)", or "non-hospitalization (NH)", and the physical, mental, and social characteristics of these groups were compared. In addition, multiple logistic analysis was used to extract factors related to outcome.


RESULTS
The male-to-female ratio was 1:2. The hospitalized groups, particularly the HICCC group, were found to have biopsychosocially serious findings with regard to disturbance of consciousness (JCS), general health performance (GAS), psychiatric symptoms (BPRS), and life events (LCU), while most subjects in the NH group were women who tended to repeat suicide-related behaviors induced by relatively light stress. The HIPW group had the highest number of cases, and their symptoms were psychologically serious but physically mild. On multiple logistic analysis, outcome was found to be closely correlated with physical severity, risk factor of suicide, assessment of emergent medical intervention, and overall care.


CONCLUSIONS
There are different potential needs for each group. The HICCC group needs psychiatrists on a full-time basis and also social workers and clinical psychotherapists to immediately initiate comprehensive care by a medical team composed of multiple professionals. The HIPW group needs psychological education to prevent repetition of suicide attempts, and high-quality physical treatment and management skill of the staff in the psychiatric ward. The NH group subjects need a support system to convince them of the risks of attempting suicide and to take a problem-solving approach to specific issues.
Kudo
Kaoru
K
Department of Neuropsychiatry, School of Medicine, Iwate Medical University, Uchimaru, Morioka, Japan.
Otsuka
Kotaro
K
Endo
Jin
J
Yoshida
Tomoyuki
T
Isono
Hisayasu
H
Yambe
Takehito
T
Nakamura
Hikaru
H
Kawamura
Sachiyo
S
Koeda
Atsuhiko
A
Yagi
Junko
J
Kemuyama
Nobuo
N
Harada
Hisako
H
Chida
Fuminori
F
Endo
Shigeatsu
S
Sakai
Akio
A
D000328:Adult; D003156:Community Mental Health Services; D003191:Comprehensive Health Care; D003422:Critical Care / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006760:Hospitalization; D006778:Hospitals, Psychiatric; D006801:Humans; D007564:Japan; D008016:Life Change Events; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology*; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team; D011567:Psychiatric Department, Hospital / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012307:Risk Factors; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000517:prevention & control / Q000523:psychology* / Q000706:statistics & numerical data; D000092864:Suicide Prevention