This work may not be copied, distributed, displayed, published, reproduced, transmitted, modified, posted, sold, licensed, or used for commercial purposes. By downloading this file, you are agreeing to the publisher’s Terms & Conditions.

Article

Repeated Suicide Attempts and Suicide Among Individuals With a First Emergency Department Contact for Attempted Suicide: A Prospective, Nationwide, Danish Register-Based Study

Izabela E. Fedyszyn, PhD; Annette Erlangsen, PhD; Carsten Hjorthøj, PhD; Trine Madsen, PhD; and Merete Nordentoft, PhD

Published: June 22, 2016

Article Abstract

Objective: Emergency departments are important, albeit underutilized, sites for suicide prevention. Preventive strategies and interventions could benefit from a greater understanding of factors influencing the course of suicide risk after emergency department contact due to attempted suicide. The aim of our study was 2-fold: to identify predictors of repeated suicide attempts and suicide and to investigate the timing of these events.

Methods: Data from Danish nationwide, longitudinal registers were used in this prospective, population-based study of all individuals first presenting to an emergency department after attempted suicide (index attempt) between January 1, 1996, and December 31, 2011 (N = 11,802). Cox regression analysis identified predictors, and Kaplan-Meier survival analysis modeled the time to repeated suicide attempts and suicide.

Results: Sixteen percent of the sample repeated suicide attempt, and 1.4% died by suicide. Repetition was less likely among men than women (adjusted hazard ratio [AHR] = 0.70; 95% CI, 0.63-0.79), whereas those most prone to repeated attempts were individuals with recent psychiatric treatment (AHR = 2.19; 95% CI, 1.97-2.43) and those with recent psychiatric treatment (AHR = 2.19; 95% CI, 1.97-2.43). Predictors of suicide included age over 35 years (AHR = 5.56; 95% CI, 2.89-10.69); hanging, strangling, or suffocation as the method of the index attempt (AHR = 2.55; 95% CI, 1.29-5.01); and receiving psychiatric hospitalization for the index attempt (AHR = 1.74; 95% CI, 1.22-2.49). The cumulative rates of repeated attempts and suicide deaths in the total sample were particularly high within the first week of the index attempt, reaching 3.6% and 0.1%, respectively.

Conclusions: Preventive efforts need to target the period close to discharge from emergency departments.

Volume: 77

Quick Links: Depression (MDD) , Suicide

Continue Reading…

Subscribe to read the entire article

$40.00

Buy this Article as a PDF