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Utilization of psychiatric services prior to suicide- a retrospective comparison of users with and without previous suicide attempts

Probert-Lindström, Sara LU orcid ; Vaez, Marjan ; Fröding, Elin ; Ehnvall, Anna LU ; Sellin, Tabita ; Ambrus, Livia LU ; Bergqvist, Erik LU orcid ; Palmqvist-Öberg, Nina LU ; Waern, Margda and Westrin, Åsa LU (2023) In Archives of Suicide Research 27(2). p.401-414
Abstract

INTRODUCTION: The aim was to investigate psychiatric health care utilization two years before death by suicide among individuals with previous suicide attempts (PSA) compared with those without (NSA).

METHOD: A retrospective population-based cohort study was conducted including 484 individuals who died by suicide in Sweden in 2015 and were in contact with psychiatric services within the two years preceding death, identified through the Cause of Death register. Data on psychiatric health care two years before death, including suicide attempts according to notes in the medical record was used. Associations between having at least one PSA vs. NSA and health care utilization were estimated as odds ratios (OR) with 95% confidence... (More)

INTRODUCTION: The aim was to investigate psychiatric health care utilization two years before death by suicide among individuals with previous suicide attempts (PSA) compared with those without (NSA).

METHOD: A retrospective population-based cohort study was conducted including 484 individuals who died by suicide in Sweden in 2015 and were in contact with psychiatric services within the two years preceding death, identified through the Cause of Death register. Data on psychiatric health care two years before death, including suicide attempts according to notes in the medical record was used. Associations between having at least one PSA vs. NSA and health care utilization were estimated as odds ratios (OR) with 95% confidence intervals (CI) by logistic regression analyses.

RESULTS: Of the 484 individuals included, 51% had PSA. Those with PSA were more likely than NSA to have received a psychiatric diagnosis [OR 1.96 (CI 95% 1.17-3.30)], to have ongoing psychotropic medication [OR 1.96 (CI 95% 1.15-3.36)] and to have been absent from appointments during the last three months [1.97 (1.25-3.13)]. In addition, elevated suicide risk was more often noted in the psychiatric case records of those with a PSA than those without [OR 2.17 (CI 95% 1.24-3.79)].

CONCLUSION: The results underline the importance of improved suicide risk assessment as well as thorough diagnostic assessment and when indicated, psychiatric treatment as suicide preventive interventions regardless of PSA. Furthermore, the larger proportion of absence from appointments in individuals with PSA may indicate a need of improved alliance between psychiatric care providers and individuals with PSA.HIGHLIGHTSBeing assessed with elevated suicide risk was more common among those with previous attempt/s (PSA).One-fifth of all with no previous attempt (NSA) had no psychiatric diagnosis, compared to one in ten in those with PSA.Receiving psychotropic medication was more common among those with PSA.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Archives of Suicide Research
volume
27
issue
2
pages
401 - 414
publisher
Routledge
external identifiers
  • pmid:34821208
  • scopus:85120822238
ISSN
1543-6136
DOI
10.1080/13811118.2021.2006101
language
English
LU publication?
yes
id
b5a82bf5-eee9-4f26-b679-0697549eefb0
date added to LUP
2021-12-02 15:13:22
date last changed
2024-04-18 04:59:16
@article{b5a82bf5-eee9-4f26-b679-0697549eefb0,
  abstract     = {{<p>INTRODUCTION: The aim was to investigate psychiatric health care utilization two years before death by suicide among individuals with previous suicide attempts (PSA) compared with those without (NSA).</p><p>METHOD: A retrospective population-based cohort study was conducted including 484 individuals who died by suicide in Sweden in 2015 and were in contact with psychiatric services within the two years preceding death, identified through the Cause of Death register. Data on psychiatric health care two years before death, including suicide attempts according to notes in the medical record was used. Associations between having at least one PSA vs. NSA and health care utilization were estimated as odds ratios (OR) with 95% confidence intervals (CI) by logistic regression analyses.</p><p>RESULTS: Of the 484 individuals included, 51% had PSA. Those with PSA were more likely than NSA to have received a psychiatric diagnosis [OR 1.96 (CI 95% 1.17-3.30)], to have ongoing psychotropic medication [OR 1.96 (CI 95% 1.15-3.36)] and to have been absent from appointments during the last three months [1.97 (1.25-3.13)]. In addition, elevated suicide risk was more often noted in the psychiatric case records of those with a PSA than those without [OR 2.17 (CI 95% 1.24-3.79)].</p><p>CONCLUSION: The results underline the importance of improved suicide risk assessment as well as thorough diagnostic assessment and when indicated, psychiatric treatment as suicide preventive interventions regardless of PSA. Furthermore, the larger proportion of absence from appointments in individuals with PSA may indicate a need of improved alliance between psychiatric care providers and individuals with PSA.HIGHLIGHTSBeing assessed with elevated suicide risk was more common among those with previous attempt/s (PSA).One-fifth of all with no previous attempt (NSA) had no psychiatric diagnosis, compared to one in ten in those with PSA.Receiving psychotropic medication was more common among those with PSA.</p>}},
  author       = {{Probert-Lindström, Sara and Vaez, Marjan and Fröding, Elin and Ehnvall, Anna and Sellin, Tabita and Ambrus, Livia and Bergqvist, Erik and Palmqvist-Öberg, Nina and Waern, Margda and Westrin, Åsa}},
  issn         = {{1543-6136}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{401--414}},
  publisher    = {{Routledge}},
  series       = {{Archives of Suicide Research}},
  title        = {{Utilization of psychiatric services prior to suicide- a retrospective comparison of users with and without previous suicide attempts}},
  url          = {{http://dx.doi.org/10.1080/13811118.2021.2006101}},
  doi          = {{10.1080/13811118.2021.2006101}},
  volume       = {{27}},
  year         = {{2023}},
}