Long-term risk factors for suicide in suicide attempters examined at a medical emergency in patient unit : results from a 32-year follow-up study
(2020) In BMJ Open 10(10).- Abstract
OBJECTIVES: The overall aim of this study is to gain greater knowledge about the risk of suicide among suicide attempters in a very long-term perspective. Specifically, to investigate possible differences in clinical risk factors at short (≤5 years) versus long term (>5 years), with the hypothesis that risk factors differ in the shorter and longer perspective. DESIGN: Prospective study with register-based follow-up for 21-32 years. SETTING: Medical emergency inpatient unit in the south of Sweden. PARTICIPANTS: 1044 individuals assessed by psychiatric consultation when admitted to medical inpatient care for attempted suicide during 1987-1998. OUTCOME MEASURES: Suicide and all-cause mortality. RESULTS: At follow-up, 37.6% of the... (More)
OBJECTIVES: The overall aim of this study is to gain greater knowledge about the risk of suicide among suicide attempters in a very long-term perspective. Specifically, to investigate possible differences in clinical risk factors at short (≤5 years) versus long term (>5 years), with the hypothesis that risk factors differ in the shorter and longer perspective. DESIGN: Prospective study with register-based follow-up for 21-32 years. SETTING: Medical emergency inpatient unit in the south of Sweden. PARTICIPANTS: 1044 individuals assessed by psychiatric consultation when admitted to medical inpatient care for attempted suicide during 1987-1998. OUTCOME MEASURES: Suicide and all-cause mortality. RESULTS: At follow-up, 37.6% of the participants had died, 7.2% by suicide and 53% of these within 5 years of the suicide attempt. A diagnosis of psychosis at baseline represented the risk factor with the highest HR at long-term follow-up, that is, >5 years, followed by major depression and a history of attempted suicide before the index attempt. The severity of a suicide attempt as measured by SIS (Suicide Intent Scale) showed a non-proportional association with the hazard for suicide over time and was a relevant risk factor for suicide only within the first 5 years after an attempted suicide. CONCLUSIONS: The risk of suicide after a suicide attempt persists for up to 32 years after the index attempt. A baseline diagnosis of psychosis or major depression or earlier suicide attempts continued to be relevant risk factors in the very long term. The SIS score is a better predictor of suicide risk at short term, that is, within 5 years than at long term. This should be considered in the assessment of suicide risk and the implementation of care for these individuals.
(Less)
- author
- Probert-Lindström, Sara LU ; Berge, Jonas LU ; Westrin, Åsa LU ; Öjehagen, Agneta LU and Skogman Pavulans, Katarina LU
- organization
- publishing date
- 2020
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- depression & mood disorders, psychiatry, schizophrenia & psychotic disorders, suicide & self-harm
- in
- BMJ Open
- volume
- 10
- issue
- 10
- article number
- e038794
- publisher
- BMJ Publishing Group
- external identifiers
-
- pmid:33130567
- scopus:85095391935
- ISSN
- 2044-6055
- DOI
- 10.1136/bmjopen-2020-038794
- language
- English
- LU publication?
- yes
- id
- 77ec2f6c-1407-43f7-8300-6c78214fa1d2
- date added to LUP
- 2020-11-16 10:29:42
- date last changed
- 2024-07-11 01:31:15
@article{77ec2f6c-1407-43f7-8300-6c78214fa1d2, abstract = {{<p>OBJECTIVES: The overall aim of this study is to gain greater knowledge about the risk of suicide among suicide attempters in a very long-term perspective. Specifically, to investigate possible differences in clinical risk factors at short (≤5 years) versus long term (>5 years), with the hypothesis that risk factors differ in the shorter and longer perspective. DESIGN: Prospective study with register-based follow-up for 21-32 years. SETTING: Medical emergency inpatient unit in the south of Sweden. PARTICIPANTS: 1044 individuals assessed by psychiatric consultation when admitted to medical inpatient care for attempted suicide during 1987-1998. OUTCOME MEASURES: Suicide and all-cause mortality. RESULTS: At follow-up, 37.6% of the participants had died, 7.2% by suicide and 53% of these within 5 years of the suicide attempt. A diagnosis of psychosis at baseline represented the risk factor with the highest HR at long-term follow-up, that is, >5 years, followed by major depression and a history of attempted suicide before the index attempt. The severity of a suicide attempt as measured by SIS (Suicide Intent Scale) showed a non-proportional association with the hazard for suicide over time and was a relevant risk factor for suicide only within the first 5 years after an attempted suicide. CONCLUSIONS: The risk of suicide after a suicide attempt persists for up to 32 years after the index attempt. A baseline diagnosis of psychosis or major depression or earlier suicide attempts continued to be relevant risk factors in the very long term. The SIS score is a better predictor of suicide risk at short term, that is, within 5 years than at long term. This should be considered in the assessment of suicide risk and the implementation of care for these individuals.</p>}}, author = {{Probert-Lindström, Sara and Berge, Jonas and Westrin, Åsa and Öjehagen, Agneta and Skogman Pavulans, Katarina}}, issn = {{2044-6055}}, keywords = {{depression & mood disorders; psychiatry; schizophrenia & psychotic disorders; suicide & self-harm}}, language = {{eng}}, number = {{10}}, publisher = {{BMJ Publishing Group}}, series = {{BMJ Open}}, title = {{Long-term risk factors for suicide in suicide attempters examined at a medical emergency in patient unit : results from a 32-year follow-up study}}, url = {{http://dx.doi.org/10.1136/bmjopen-2020-038794}}, doi = {{10.1136/bmjopen-2020-038794}}, volume = {{10}}, year = {{2020}}, }