title: Psychiatric disorders and clinical correlates of suicidal patients admitted to a psychiatric hospital in Tokyo.
abstract: BACKGROUND
  Patients admitted to a psychiatric hospital with suicidal behavior (SB) are considered to be especially at high risk of suicide. However, the number of studies that have addressed this patient population remains insufficient compared to that of studies on suicidal patients in emergency or medical settings. The purpose of this study is to seek features of a sample of newly admitted suicidal psychiatric patients in a metropolitan area of Japan.
  
  
  METHODS
  155 suicidal patients consecutively admitted to a large psychiatric center during a 20-month period, admission styles of whom were mostly involuntary, were assessed using Structured Clinical Interviews for DSM-IV Axis I and II Disorders (SCID-I CV and SCID-II) and SB-related psychiatric measures. Associations of the psychiatric diagnoses and SB-related characteristics with gender and age were examined.
  
  
  RESULTS
  The common DSM-IV axis I diagnoses were affective disorders 62%, anxiety disorders 56% and substance-related disorders 38%. 56% of the subjects were diagnosed as having borderline PD, and 87% of them, at least one type of personality disorder (PD). SB methods used prior to admission were self-cutting 41%, overdosing 32%, self-strangulation 15%, jumping from a height 12% and attempting traffic death 10%, the first two of which were frequent among young females. The median (range) of the total number of SBs in the lifetime history was 7 (1-141). Severity of depressive symptomatology, suicidal intent and other symptoms, proportions of the subjects who reported SB-preceding life events and life problems, and childhood and adolescent abuse were comparable to those of the previous studies conducted in medical or emergency service settings. Gender and age-relevant life-problems and life events were identified.
  
  
  CONCLUSIONS
  Features of the studied sample were the high prevalence of affective disorders, anxiety disorders and borderline PD, a variety of SB methods used prior to admission and frequent SB repetition in the lifetime history. Gender and age appeared to have an influence on SB method selection and SB-preceding processes. The findings have important implications for assessment and treatment of psychiatric suicidal patients.
authors.affiliation: Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan. nhayashi55@nifty.com
authors.forename: Naoki
authors.initials: N
authors.lastname: Hayashi
authors.forename: Miyabi
authors.initials: M
authors.lastname: Igarashi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Imai
authors.forename: Yuka
authors.initials: Y
authors.lastname: Osawa
authors.forename: Kaori
authors.initials: K
authors.lastname: Utsumi
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Ishikawa
authors.forename: Taro
authors.initials: T
authors.lastname: Tokunaga
authors.forename: Kayo
authors.initials: K
authors.lastname: Ishimoto
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Harima
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Tatebayashi
authors.forename: Naoki
authors.initials: N
authors.lastname: Kumagai
authors.forename: Makoto
authors.initials: M
authors.lastname: Nozu
authors.forename: Hidetoki
authors.initials: H
authors.lastname: Ishii
authors.forename: Yuji
authors.initials: Y
authors.lastname: Okazaki
mesh_terms: D000328:Adult; D000367:Age Factors; D003134:Commitment of Persons with Psychiatric Disorders; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data*; D006801:Humans; D007564:Japan; D008016:Life Change Events; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D010343:Patient Admission / Q000706:statistics & numerical data; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012737:Sex Factors; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data*; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data; D014041:Tokyo / Q000453:epidemiology; D014505:Urban Population