(Vienna, 03-09-2024) Previous studies have shown that patients immediately following and up to one year after discharge from in-patient psychiatric treatment have an increased risk of suicide. A MedUni Vienna research team has now analyzed the data of 18,425 patients treated at MedUni Vienna's Department of Psychiatry and Psychotherapy and Vienna General Hospital over 15 years. The results, recently published in the "Journal of Affective Disorders", emphasize that although intensive follow-up care at the clinic has led to a reduction in the suicide rate, the need for targeted prevention remains high.
The study confirms that male patients have a significantly higher risk of suicide after discharge from in-patient psychiatric care. "One reason for this could be that men are still less willing to seek help," says first author Daniel König-Castillo (Department of Psychiatry and Psychotherapy, Division of Social Psychiatry). When analyzing the data, no correlation was found between the age of the patients and the risk of suicide, indicating that this increased risk persists for men regardless of their age.
What was particularly striking in the study was the marked and significantly increased risk of suicide in patients with affective disorders such as depression and bipolar affective disorders (formerly known as "manic-depressive") or neurotic and somatoform disorders (anxiety and obsessive-compulsive disorders as well as pain disorders, for example). While the risk was also increased in people with schizophrenia spectrum disorders, personality disorders, and body-related disorders, this increase was not significantly different from the increased risk of the group of patients with substance use disorders. These results underline the importance of specific psychiatric disorders for the assessment of suicide risk after discharge from in-patient treatment and highlight the need to pay particular attention to signs of suicidal behavior in these patients.
Duration of hospitalization not decisive
In contrast to various previous studies, the MedUni Vienna research team did not find any correlation between the length of hospitalization and the risk of suicide after discharge in their comprehensive study. This suggests that other factors, such as the severity of the illness or the lack of social support after discharge, may play a more important role.
The results also show that the suicide rate among patients following discharge from in-patient treatment at MedUni Vienna's Department of Psychiatry and Psychotherapy decreased from year to year during the period analyzed. "This may suggest that care structures have become increasingly efficient at recognizing suicidal risk and preventing suicides through comprehensive follow-up care in recent years," says Daniel König-Castillo. Despite this decline, the risk of suicide in this group remains significantly higher than in the general population. Therefore, the need to further minimize this risk through targeted prevention strategies to ensure the survival of patients remains high. These efforts include intensive follow-up care that begins immediately after discharge and developing special screening tools that can help identify at-risk patients.
Publication: Journal of Affective Disorders
Suicide risk after discharge from in-patient psychiatric care: A 15-year retrospective cohort study of individual patient data.
Daniel König , Andreas Gleiss, Benjamin Vyssoki, Christine Harrer, Armin Trojer , Magdalena Groemer, Sabine Weber, Alexander Glahn, Lea Sommer, Stephan Listabarth, Andreas Wippel.
DOI: https://doi.org/10.1016/j.jad.2024.03.046