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Published in: BMC Psychiatry 1/2018

Open Access 01-12-2018 | Research article

Patients admitted to hospital after suicide attempt with violent methods compared to patients with deliberate self-poisoning -a study of background variables, somatic and psychiatric health and suicidal behavior

Authors: Per Sverre Persett, Tine K. Grimholt, Oivind Ekeberg, Dag Jacobsen, Hilde Myhren

Published in: BMC Psychiatry | Issue 1/2018

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Abstract

Background

In Norway, there are about 550 suicides recorded each year. The number of suicide attempts is 10–15 times higher. Suicide attempt is a major risk factor for suicide, in particular when violent methods are used. Suicide attempts with violent methods have hardly been studied in Norway. This study describes demographic, psychiatric and somatic health in patients admitted to somatic hospitals in Norway after suicide attempt by violent methods compared with suicide attempters using deliberate self-poisoning (DSP).

Methods

Patients admitted to somatic hospital after suicide attempt aged > 18 years were included in a prospective cohort study, enrolled from December 2010 to April 2015.
Demographics (gender, age, marital and living condition, educational and employment status), previous somatic and psychological health were registered. Patients who had used violent methods were compared with patients admitted after suicide attempt by DSP.

Results

The study included 80 patients with violent methods and 81 patients with DSP (mean age both groups 42 yrs.). Violent methods used were cutting (34%), jumping from heights (32%), hanging (14%), others (10%), shooting (7%) and drowning (4%).
Patients with violent methods had more often psychosis than patients admitted with DSP (14% vs 4%, p <  0.05), less anxiety disorders (4% vs 19%, p <  0.01) and less affective disorders (21% vs. 36%, p <  0.05). There were no significant differences between the numbers of patients who received psychiatric treatment at the time of the suicide attempt (violent 55% versus DSP 48%) or reported previous suicide attempt, 58% in patients with violent methods and 47% in DSP. Patients with violent methods stayed longer in hospital (14.3 (mean 8.3–20.3) vs. 2.3 (mean 1.6–3.1) days, p <  0.001), stayed longer in intensive care unit (5 days vs. 0.5 days, p <  0.001) and were in need of longer mechanical ventilation (1.4 vs 0.1 days, p <  0.001).

Conclusions

Patients with violent methods had more often psychosis, less anxiety disorders and affective disorders than patients with DSP. Psychiatric treatment before the attempt and previous suicide attempt was not significantly different between the groups and about half of the patients in both groups were in psychiatric treatment at the time of the suicide attempt.
Literature
1.
go back to reference Titelman D, et al. Suicide mortality trends in the Nordic countries 1980-2009. Nord J Psychiatry. 2013;67(6):414–23.CrossRefPubMed Titelman D, et al. Suicide mortality trends in the Nordic countries 1980-2009. Nord J Psychiatry. 2013;67(6):414–23.CrossRefPubMed
2.
go back to reference Hawton K, Harriss L. How often does deliberate self-harm occur relative to each suicide? A study of variations by gender and age. Suicide Life Threat Behav. 2008;38(6):650–60.CrossRefPubMed Hawton K, Harriss L. How often does deliberate self-harm occur relative to each suicide? A study of variations by gender and age. Suicide Life Threat Behav. 2008;38(6):650–60.CrossRefPubMed
3.
go back to reference Nordentoft M. Prevention of suicide and attempted suicide in Denmark. Epidemiological studies of suicide and intervention studies in selected risk groups. Dan Med Bull. 2007;54(4):306–69.PubMed Nordentoft M. Prevention of suicide and attempted suicide in Denmark. Epidemiological studies of suicide and intervention studies in selected risk groups. Dan Med Bull. 2007;54(4):306–69.PubMed
4.
go back to reference Ostamo A, Lonnqvist J. Excess mortality of suicide attempters. Soc Psychiatry Psychiatr Epidemiol. 2001;36(1):29–35.CrossRefPubMed Ostamo A, Lonnqvist J. Excess mortality of suicide attempters. Soc Psychiatry Psychiatr Epidemiol. 2001;36(1):29–35.CrossRefPubMed
5.
go back to reference van Aalst JA, et al. Long-term follow-up of unsuccessful violent suicide attempts: risk factors for subsequent attempts. J Trauma. 1992;33(3):457–64.CrossRefPubMed van Aalst JA, et al. Long-term follow-up of unsuccessful violent suicide attempts: risk factors for subsequent attempts. J Trauma. 1992;33(3):457–64.CrossRefPubMed
6.
7.
go back to reference Hawton K, et al. General hospital presentations of non-fatal hanging over a 28-year period: case-control study. Br J Psychiatry. 2008;193(6):503–4.CrossRefPubMed Hawton K, et al. General hospital presentations of non-fatal hanging over a 28-year period: case-control study. Br J Psychiatry. 2008;193(6):503–4.CrossRefPubMed
8.
go back to reference Lindqvist P, et al. Are suicides by jumping off bridges preventable? An analysis of 50 cases from Sweden. Accid Anal Prev. 2004;36(4):691–4.CrossRefPubMed Lindqvist P, et al. Are suicides by jumping off bridges preventable? An analysis of 50 cases from Sweden. Accid Anal Prev. 2004;36(4):691–4.CrossRefPubMed
9.
go back to reference Beautrais AL. Subsequent mortality in medically serious suicide attempts: a 5 year follow-up. Aust N Z J Psychiatry. 2003;37(5):595–9.CrossRefPubMed Beautrais AL. Subsequent mortality in medically serious suicide attempts: a 5 year follow-up. Aust N Z J Psychiatry. 2003;37(5):595–9.CrossRefPubMed
10.
go back to reference Kuo CJ, et al. Suicide and non-suicide mortality after self-harm in Taipei City, Taiwan. Br J Psychiatry. 2012;200(5):405–11.CrossRefPubMed Kuo CJ, et al. Suicide and non-suicide mortality after self-harm in Taipei City, Taiwan. Br J Psychiatry. 2012;200(5):405–11.CrossRefPubMed
11.
go back to reference Bjornaas MA, et al. Mortality and causes of death after hospital-treated self-poisoning in Oslo: a 20-year follow-up. Clin Toxicol (Phila). 2009;47(2):116–23.CrossRef Bjornaas MA, et al. Mortality and causes of death after hospital-treated self-poisoning in Oslo: a 20-year follow-up. Clin Toxicol (Phila). 2009;47(2):116–23.CrossRef
12.
go back to reference Paykel ES, et al. Life events and depression. A controlled study. Arch Gen Psychiatry. 1969;21(6):753–60.CrossRefPubMed Paykel ES, et al. Life events and depression. A controlled study. Arch Gen Psychiatry. 1969;21(6):753–60.CrossRefPubMed
13.
go back to reference Osman A, et al. The suicidal behaviors questionnaire-revised (SBQ-R): validation with clinical and nonclinical samples. Assessment. 2001;8(4):443–54.CrossRefPubMed Osman A, et al. The suicidal behaviors questionnaire-revised (SBQ-R): validation with clinical and nonclinical samples. Assessment. 2001;8(4):443–54.CrossRefPubMed
14.
go back to reference Anslow WP Jr, Karnovsky DA, et al. The toxicity and pharmacological action of the nitrogen mustards and certain related compounds. J Pharmacol Exp Ther. 1947;91(3):224–35.PubMed Anslow WP Jr, Karnovsky DA, et al. The toxicity and pharmacological action of the nitrogen mustards and certain related compounds. J Pharmacol Exp Ther. 1947;91(3):224–35.PubMed
15.
go back to reference Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet. 1974;2(7872):81–4.CrossRefPubMed Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet. 1974;2(7872):81–4.CrossRefPubMed
16.
go back to reference Baker SP, et al. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma. 1974;14(3):187–96.CrossRefPubMed Baker SP, et al. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma. 1974;14(3):187–96.CrossRefPubMed
18.
go back to reference Le Gall JR, Lemeshow S, Saulnier F. A new simplified acute physiology score (SAPS II) based on a European/north American multicenter study. JAMA. 1993;270(24):2957–63.CrossRefPubMed Le Gall JR, Lemeshow S, Saulnier F. A new simplified acute physiology score (SAPS II) based on a European/north American multicenter study. JAMA. 1993;270(24):2957–63.CrossRefPubMed
20.
go back to reference Nielssen OB, Large MM. Untreated psychotic illness in the survivors of violent suicide attempts. Early Interv Psychiatry. 2009;3(2):116–22.CrossRefPubMed Nielssen OB, Large MM. Untreated psychotic illness in the survivors of violent suicide attempts. Early Interv Psychiatry. 2009;3(2):116–22.CrossRefPubMed
21.
go back to reference Heyerdahl F, et al. Repetition of acute poisoning in Oslo: 1-year prospective study. Br J Psychiatry. 2009;194(1):73–9.CrossRefPubMed Heyerdahl F, et al. Repetition of acute poisoning in Oslo: 1-year prospective study. Br J Psychiatry. 2009;194(1):73–9.CrossRefPubMed
22.
go back to reference Kapur N, et al. Hospital management of suicidal behaviour and subsequent mortality: a prospective cohort study. Lancet Psychiatry. 2015;2(9):809–16.CrossRefPubMed Kapur N, et al. Hospital management of suicidal behaviour and subsequent mortality: a prospective cohort study. Lancet Psychiatry. 2015;2(9):809–16.CrossRefPubMed
23.
go back to reference Ostamo A, Lahelma E, Lonnqvist J. Transitions of employment status among suicide attempters during a severe economic recession. Soc Sci Med. 2001;52(11):1741–50.CrossRefPubMed Ostamo A, Lahelma E, Lonnqvist J. Transitions of employment status among suicide attempters during a severe economic recession. Soc Sci Med. 2001;52(11):1741–50.CrossRefPubMed
24.
go back to reference Bjornaas MA, et al. Suicidal intention, psychosocial factors and referral to further treatment: a one-year cross-sectional study of self-poisoning. BMC Psychiatry. 2010;10:58.CrossRefPubMedPubMedCentral Bjornaas MA, et al. Suicidal intention, psychosocial factors and referral to further treatment: a one-year cross-sectional study of self-poisoning. BMC Psychiatry. 2010;10:58.CrossRefPubMedPubMedCentral
25.
go back to reference Borges G, et al. Twelve-month prevalence of and risk factors for suicide attempts in the World Health Organization world mental health surveys. J Clin Psychiatry. 2010;71(12):1617–28.CrossRefPubMedPubMedCentral Borges G, et al. Twelve-month prevalence of and risk factors for suicide attempts in the World Health Organization world mental health surveys. J Clin Psychiatry. 2010;71(12):1617–28.CrossRefPubMedPubMedCentral
27.
go back to reference Lund C, et al. A one-year observational study of all hospitalized acute poisonings in Oslo: complications, treatment and sequelae. Scand J Trauma Resusc Emerg Med. 2012;20:49.CrossRefPubMedPubMedCentral Lund C, et al. A one-year observational study of all hospitalized acute poisonings in Oslo: complications, treatment and sequelae. Scand J Trauma Resusc Emerg Med. 2012;20:49.CrossRefPubMedPubMedCentral
28.
go back to reference Toien K, et al. Psychological distress after severe trauma: a prospective 1-year follow-up study of a trauma intensive care unit population. J Trauma. 2010;69(6):1552–9.CrossRefPubMed Toien K, et al. Psychological distress after severe trauma: a prospective 1-year follow-up study of a trauma intensive care unit population. J Trauma. 2010;69(6):1552–9.CrossRefPubMed
31.
go back to reference Ajdacic-Gross V, et al. Methods of suicide: international suicide patterns derived from the WHO mortality database. Bull World Health Organ. 2008;86(9):726–32.CrossRefPubMedPubMedCentral Ajdacic-Gross V, et al. Methods of suicide: international suicide patterns derived from the WHO mortality database. Bull World Health Organ. 2008;86(9):726–32.CrossRefPubMedPubMedCentral
32.
go back to reference Park S. Brief report: sex differences in suicide rates and suicide methods among adolescents in South Korea, Japan, Finland, and the US. J Adolesc. 2015;40:74–7.CrossRefPubMed Park S. Brief report: sex differences in suicide rates and suicide methods among adolescents in South Korea, Japan, Finland, and the US. J Adolesc. 2015;40:74–7.CrossRefPubMed
33.
go back to reference Yip PS, Tan RC. Suicides in Hong-Kong and Singapore: a tale of two cities. Int J Soc Psychiatry. 1998;44(4):267–79.CrossRefPubMed Yip PS, Tan RC. Suicides in Hong-Kong and Singapore: a tale of two cities. Int J Soc Psychiatry. 1998;44(4):267–79.CrossRefPubMed
34.
go back to reference Grimholt TK, et al. Treatment received, satisfaction with health care services, and psychiatric symptoms 3 months after hospitalization for self-poisoning. Ann General Psychiatry. 2012;11:10.CrossRef Grimholt TK, et al. Treatment received, satisfaction with health care services, and psychiatric symptoms 3 months after hospitalization for self-poisoning. Ann General Psychiatry. 2012;11:10.CrossRef
35.
36.
go back to reference Gore-Jones V, O'Callaghan J. Suicide attempts by jumping from a height: a consultation liaison experience. Australas Psychiatry. 2012;20(4):309–12.CrossRefPubMed Gore-Jones V, O'Callaghan J. Suicide attempts by jumping from a height: a consultation liaison experience. Australas Psychiatry. 2012;20(4):309–12.CrossRefPubMed
37.
go back to reference Nielssen O, et al. Suicide attempts by jumping and psychotic illness. Aust N Z J Psychiatry. 2010;44(6):568–73.PubMed Nielssen O, et al. Suicide attempts by jumping and psychotic illness. Aust N Z J Psychiatry. 2010;44(6):568–73.PubMed
38.
go back to reference Cooper-Kazaz R. Psychiatric consultation of all suicide-attempt patients during a one year period in a tertiary hospital. Isr Med Assoc J. 2013;15(8):424–9.PubMed Cooper-Kazaz R. Psychiatric consultation of all suicide-attempt patients during a one year period in a tertiary hospital. Isr Med Assoc J. 2013;15(8):424–9.PubMed
39.
go back to reference Vallersnes OM, et al. Patients presenting with acute poisoning to an outpatient emergency clinic: a one-year observational study in Oslo, Norway. BMC Emerg Med. 2015;15:18.CrossRefPubMedPubMedCentral Vallersnes OM, et al. Patients presenting with acute poisoning to an outpatient emergency clinic: a one-year observational study in Oslo, Norway. BMC Emerg Med. 2015;15:18.CrossRefPubMedPubMedCentral
40.
go back to reference Lund C, et al. A one-year observational study of all hospitalized and fatal acute poisonings in Oslo: epidemiology, intention and follow-up. BMC Public Health. 2012;12:858.CrossRefPubMedPubMedCentral Lund C, et al. A one-year observational study of all hospitalized and fatal acute poisonings in Oslo: epidemiology, intention and follow-up. BMC Public Health. 2012;12:858.CrossRefPubMedPubMedCentral
41.
go back to reference Heyerdahl F, et al. Acute poisonings treated in hospitals in Oslo: a one-year prospective study (II): clinical outcome. Clin Toxicol (Phila). 2008;46(1):42–9.CrossRef Heyerdahl F, et al. Acute poisonings treated in hospitals in Oslo: a one-year prospective study (II): clinical outcome. Clin Toxicol (Phila). 2008;46(1):42–9.CrossRef
Metadata
Title
Patients admitted to hospital after suicide attempt with violent methods compared to patients with deliberate self-poisoning -a study of background variables, somatic and psychiatric health and suicidal behavior
Authors
Per Sverre Persett
Tine K. Grimholt
Oivind Ekeberg
Dag Jacobsen
Hilde Myhren
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2018
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-018-1602-5

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