title: Suicides following inpatient psychiatric hospitalization: A nationwide case control study.
abstract: BACKGROUND
  Research shows the elevated risk of suicide associated with current or recent inpatient psychiatric hospitalization. However, it is unclear whether this applies in the area of post-communist Central and Eastern Europe where mental health care has not been deinstitutionalized yet. The present study aims to examine the rates of suicides among psychiatric patients during and shortly after discharge from inpatient hospitalization in the Czech Republic.
  
  
  METHODS
  All inpatient psychiatric hospitalizations and all suicides committed between 2008 and 2012 have been merged on an individual data basis. The time horizon between the admission and two months after the discharge from inpatient psychiatric facility was utilized and multiple logistic regression was performed to calculate the odds of committing suicide.
  
  
  RESULTS
  A total of 137,290 inpatients were hospitalized in Czech psychiatric facilities between 2008 and 2012, and 402 of the inpatients committed suicide during the hospitalization or within the 2 months after the discharge. Highly elevated risks of suicides were found to be associated with being a male, having a history of multiple hospitalizations, and having a diagnosis of affective, anxiety, or personality disorder.
  
  
  CONCLUSIONS
  Limitations are related to the design of the study, and its reliance on routinely collected data. Also, it was not possible to assess the odds of suicide associated with inpatient psychiatric hospitalization against the odds of suicide in general population.
  
  
  CONCLUSIONS
  During psychiatric treatment and recovery, suicial behavior and idealiation is increased. In psychiatry, hospitalization may be a risky period for suicide behavior. Suicide rates during and soon after the psychiatric hospitalization identified in this study from Central and Eastern Europe are similar to the findings from Western Europe. Preventive strategies should be tailored accordingly.
authors.affiliation: Department of Social Psychiatry, National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, United Kingdom. Electronic address: petr.winkler@nudz.cz.
authors.forename: Petr
authors.initials: P
authors.lastname: Winkler
authors.affiliation: Department of Social Psychiatry, National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic.
authors.forename: Karolína
authors.initials: K
authors.lastname: Mladá
authors.affiliation: Department of Social Psychiatry, National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic.
authors.forename: Ladislav
authors.initials: L
authors.lastname: Csémy
authors.affiliation: Department of Social Psychiatry, National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic; Institute of Health Information and Statistics, Palackého nám. 4 , P.O. BOX 60, Praha 2 - Nové Město 128 01, Czech Republic.
authors.forename: Blanka
authors.initials: B
authors.lastname: Nechanská
authors.affiliation: Department of Social Psychiatry, National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic.
authors.forename: Cyril
authors.initials: C
authors.lastname: Höschl
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000401:mortality; D016022:Case-Control Studies; D018153:Czech Republic / Q000453:epidemiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006778:Hospitals, Psychiatric; D006801:Humans; D007297:Inpatients; D008297:Male; D001523:Mental Disorders / Q000401:mortality*; D008875:Middle Aged; D019964:Mood Disorders / Q000401:mortality; D010351:Patient Discharge; D010554:Personality Disorders / Q000401:mortality; D011567:Psychiatric Department, Hospital; D012737:Sex Factors; D012959:Socioeconomic Factors; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Case control study; Central and Eastern Europe; Psychiatric hospitalization; Suicide