TY - JOUR
T1 - A nested case-control study of the risk of suicide attempts after discharge from psychiatric care
T2 - The role of co-morbid substance use disorder
AU - Christiansen, Erik
AU - Jensen, Børge
PY - 2008/11/20
Y1 - 2008/11/20
N2 - The literature suggests that the risk of suicide is high within the first weeks after discharge from psychiatric care, but practically no studies have estimated the risk of suicide attempt after discharge from psychiatric care. The aim of this study was to examine the risk level for suicide attempt after discharge from psychiatric care, and to control for effects from psychiatric diagnoses, number and length of previous admission. An analysis of the role of co-morbid substance use disorder in suicide attempts risk was completed. The study is a Danish register-based nested case-control study; 3037 cases were identified from Register for Suicide Attempts, and 60,295 individuals, matched by gender and age, were identified for comparison. Retrospective personal data on psychiatric care was obtained from the Danish Psychiatric Central Register. Risk of suicide attempts was estimated by the use of conditional logistic regression. We found a significant high peak in risk of suicide attempts in the first weeks after discharge from psychiatric care. The risk was lowered as time passed by. Suicide attempt risk was not equally distributed across various psychiatric diagnoses, and co-morbidity of substance abuse with mental illness raised risk in an additive way. We found only small gender differences in risk. In order to lower the risk of suicide attempts, we need to improve after-care when discharging from psychiatric care. A differentiation between the possibilities of after-care for different mental illnesses is needed.
AB - The literature suggests that the risk of suicide is high within the first weeks after discharge from psychiatric care, but practically no studies have estimated the risk of suicide attempt after discharge from psychiatric care. The aim of this study was to examine the risk level for suicide attempt after discharge from psychiatric care, and to control for effects from psychiatric diagnoses, number and length of previous admission. An analysis of the role of co-morbid substance use disorder in suicide attempts risk was completed. The study is a Danish register-based nested case-control study; 3037 cases were identified from Register for Suicide Attempts, and 60,295 individuals, matched by gender and age, were identified for comparison. Retrospective personal data on psychiatric care was obtained from the Danish Psychiatric Central Register. Risk of suicide attempts was estimated by the use of conditional logistic regression. We found a significant high peak in risk of suicide attempts in the first weeks after discharge from psychiatric care. The risk was lowered as time passed by. Suicide attempt risk was not equally distributed across various psychiatric diagnoses, and co-morbidity of substance abuse with mental illness raised risk in an additive way. We found only small gender differences in risk. In order to lower the risk of suicide attempts, we need to improve after-care when discharging from psychiatric care. A differentiation between the possibilities of after-care for different mental illnesses is needed.
U2 - 10.1080/08039480802422677
DO - 10.1080/08039480802422677
M3 - Journal article
C2 - 19031150
SN - 0803-9488
SP - 1
EP - 8
JO - Nordic Journal of Psychiatry
JF - Nordic Journal of Psychiatry
ER -