Possible factors influencing the duration of hospital stay in patients with psychiatric disorders attempting suicide by jumping.
Patients with psychiatric disorders have a high rate of suicide. The present study investigated factors influencing hospital stays for Japanese patients with psychiatric disorders attempting suicide by jumping.



We diagnosed all suicide attempts (n = 113) by jumping based on the International Classification of Diseases 10th Revision (ICD-10) and investigated the mean hospital stays of patients with each diagnosis based on the ICD-10 code. We then analyzed differences in the demographic and clinical characteristics between the diagnostic groups to identify factors influencing the duration of hospital stay.



Patients diagnosed with schizophrenia (F2 code) were the most frequent (32.7%) of all diagnoses; therefore, we divided the diagnostic groups into schizophrenia group (n = 37) and other psychiatric diagnoses group (n = 76). The patients with schizophrenia showed a significantly longer hospital stay (125.7 ± 63.9 days) compared with the patients with other psychiatric diagnoses (83.6 ± 63.2) (β ± SE = 42.1 ± 12.7, p = 0.0013), whereas there was no difference in the jump height between the two groups (the average was the 3rd to 4th floor; p > 0.05). The number of injured parts, particularly lower-limb fractures, was significantly higher (p = 0.017) in patients with schizophrenia than in patients with other psychiatric diagnoses. The duration of psychiatric treatment in patients with schizophrenia were significantly longer (z = 3.4, p = 0.001) than in patients with other psychiatric diagnoses.



Our findings indicate that the number of injuries and the body parts injured in patients with schizophrenia are associated with a longer duration of hospital stay following a suicide attempt by jumping. The current use of antipsychotics and a longer duration of taking antipsychotics might contribute to the risk of bone fracture via hyperprolactinemia. Further cognitive impairment in patients with schizophrenia might prevent rehabilitation for the management of lower-limb fractures. From these results, we suggest that clinicians should monitor the level of prolactin and cognitive function in patients with schizophrenia in future studies on managing of lower-limb fractures.
Department of Psychiatry, Osaka General Medical Center, Osaka, Japan. omi@gh.opho.jp.
Tsubasa
T
Omi
Department of Emergency Medicine, Osaka General Medical Center, Osaka, Japan.
Hiroshi
H
Ito
Department of Psychiatry, Osaka General Medical Center, Osaka, Japan.
Keisen
K
Riku
Department of Psychiatry, Osaka General Medical Center, Osaka, Japan.
Koji
K
Kanai
Department of Psychiatry, Osaka General Medical Center, Osaka, Japan.
Hiromune
H
Takada
Department of Emergency Medicine, Osaka General Medical Center, Osaka, Japan.
Satoshi
S
Fujimi
Department of Psychiatry, Osaka General Medical Center, Osaka, Japan.
Hidenori
H
Matsunaga
Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan. ohi@kanazawa-med.ac.jp.
Kazutaka
K
Ohi
D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D050723:Fractures, Bone / Q000139:chemically induced; D006801:Humans; D006966:Hyperprolactinemia / Q000139:chemically induced; D007564:Japan; D007869:Leg Injuries / Q000139:chemically induced; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology*; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012559:Schizophrenia / Q000188:drug therapy / Q000453:epidemiology*; D012565:Schizophrenic Psychology; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000453:epidemiology / Q000523:psychology; D055815:Young Adult
D014150:Antipsychotic Agents
Antipsychotics; Hospital stay; Lower-limb fracture; Schizophrenia; Suicide attempts by jumping