Highlights
- •Many suicide attempters do not receive emergency psychiatric consultations.
- •Suicide attempters with emergency psychiatric consultation die less on subsequent retries.
- •Lower mortality is made because they choose less lethal methods.
Abstract
Background
The emergency department (ED) is one of the first gateways when suicide attempt patients
seek health care services. The purpose of this study was to analyze the hypothesis
that people who received emergency psychiatric services in previous suicide attempts
will have a lower mortality rate in current ED visits owing to subsequent suicide
attempts.
Method
This retrospective study included patients who visited six EDs, and participated in
the injury surveillance and in-depth suicide surveillance for 10 years, from January
2008 to December 2017. The study subjects were adult patients 18 years or older who
visited EDs due to suicide attempts. The main explanatory variable is whether psychiatric
treatment was provided in previous suicide attempts. The main outcome variable was
suicide related mortality.
Results
The study included 2144 suicide attempt patients with a previous history of suicide
attempts. Among these, 1335 patients (62.2%) had received psychiatric treatment in
previous suicide attempts. Mortality was significantly different between the psychiatric
consultation group (n = 33, 2.5%) and non-consultation group (n = 47, 5.8%) (P < 0.01). In multivariate logistic regression analysis, previous psychiatric consultation
showed a significant association with low mortality (adjusted OR 0.41; 95% CI [0.23–0.72])
and selecting non-fatal suicide methods (adjusted OR 0.47; 95% CI [0.36–0.61]).
Conclusion
Patients who received psychiatric consultation in previous suicide attempts had a
lower suicide-related mortality in current ED visits as compared to patients who did
not, and this may have been related to choosing non-fatal suicide methods.
Keywords
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Article Info
Publication History
Published online: May 15, 2020
Accepted:
May 10,
2020
Received in revised form:
May 7,
2020
Received:
March 2,
2020
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
