title: Predictors of suicide in the patient population admitted to a locked-door psychiatric acute ward.
abstract: OBJECTIVE
  No prior study appears to have focused on predictors of suicide in the general patient population admitted to psychiatric acute wards. We used a case-control design to investigate the association between suicide risk factors assessed systematically at admission to a locked-door psychiatric acute ward in Norway and subsequent death by suicide.
  
  
  METHODS
  From 2008 to 2013, patients were routinely assessed for suicide risk upon admission to the acute ward with a 17-item check list based on recommendations from the Norwegian Directorate of Health and Social Affairs. Among 1976 patients admitted to the ward, 40 patients, 22 men and 18 women, completed suicide within December 2014.
  
  
  RESULTS
  Compared to a matched control group (n = 120), after correction for multiple tests, suicide completers scored significantly higher on two items on the check list: presence of suicidal thoughts and wishing to be dead. An additional four items were significant in non-corrected tests: previous suicide attempts, continuity of suicidal thoughts, having a suicide plan, and feelings of hopelessness, indifference, and/or aggression. A brief scale based on these six items was the only variable associated with suicide in multivariate regression analysis, but its predictive value was poor.
  
  
  CONCLUSIONS
  Suicide specific ideations may be the most central risk markers for suicide in the general patient population admitted to psychiatric acute wards. However, a low predictive value may question the utility of assessing suicide risk.
authors.affiliation: Department of research and development, Division of mental health and addiction, Vestre Viken hospital trust, Lier, Norway.
authors.forename: Roar
authors.initials: R
authors.lastname: Fosse
authors.affiliation: Department of research and development, Division of mental health and addiction, Vestre Viken hospital trust, Lier, Norway.
authors.forename: Wenche
authors.initials: W
authors.lastname: Ryberg
authors.affiliation: Department of research and development, Division of mental health and addiction, Vestre Viken hospital trust, Lier, Norway.
authors.forename: Merete Kvalsvik
authors.initials: MK
authors.lastname: Carlsson
authors.affiliation: Department of research and development, Division of mental health and addiction, Vestre Viken hospital trust, Lier, Norway.
authors.forename: Jan
authors.initials: J
authors.lastname: Hammer
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D013405:Suicide