Skip to main content
NCBI home page
The BMJ logoLink to The BMJ
. 1995 Aug 5;311(7001):357–360. doi: 10.1136/bmj.311.7001.357

Period trends in rate of suicide in first 28 days after discharge from psychiatric hospital in Scotland, 1968-92.

J R Geddes 1, E Juszczak 1
PMCID: PMC2550428  PMID: 7640540

Abstract

OBJECTIVE--To examine period trends in the rate of suicide in the first 28 days after discharge from psychiatric hospital. DESIGN--Cohort study of patients discharged from psychiatric hospital. SETTING--Scotland. SUBJECTS--All patients aged 15-84 who were discharged from Scottish psychiatric hospitals during 1968 to 1992. OUTCOME MEASURE--The rate of suicide (classified as codes E950-9 and E980-9 according to the International Classification of Diseases, Ninth Revision) within 28 days of discharge per 100,000 person years at risk for five year periods during 1968 to 1992. Crude, within cohort rates and externally standardised rates were calculated. RESULTS--Overall, 196 male patients committed suicide in 20,520 person years at risk, and 171 female patients committed suicide in 24,114 person years at risk. A significant linear trend was seen in period effect on externally standardised mortality ratios in both sexes: a decrease in male patients (P = 0.008) and an increase in female patients (P = 0.0001). The adjusted standardised mortality ratio in 1988-92 compared with 1968-72 was 0.62 (95% confidence interval 0.39 to 0.98) in male patients and 2.73 (1.64 to 4.56) in female patients. CONCLUSION--The increase in the rate of suicide in the 28 days after discharge in female psychiatric patients makes this an increasingly important period to target. The rise has occurred against the background of a reduction of 60% in the number of psychiatric beds for adults.

Full text

PDF
357

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Allebeck P., Varla A., Kristjansson E., Wistedt B. Risk factors for suicide among patients with schizophrenia. Acta Psychiatr Scand. 1987 Oct;76(4):414–419. doi: 10.1111/j.1600-0447.1987.tb05626.x. [DOI] [PubMed] [Google Scholar]
  2. Appleby L. Suicide in psychiatric patients: risk and prevention. Br J Psychiatry. 1992 Dec;161:749–758. doi: 10.1192/bjp.161.6.749. [DOI] [PubMed] [Google Scholar]
  3. Diekstra R. F. The epidemiology of suicide and parasuicide. Acta Psychiatr Scand Suppl. 1993;371:9–20. doi: 10.1111/j.1600-0447.1993.tb05368.x. [DOI] [PubMed] [Google Scholar]
  4. Engberg M. Mortality and suicide rates of involuntarily committed patients. Acta Psychiatr Scand. 1994 Jan;89(1):35–40. doi: 10.1111/j.1600-0447.1994.tb01482.x. [DOI] [PubMed] [Google Scholar]
  5. Flood R. A., Seager C. P. A retrospective examination of psychiatric case records of patients who subsequently committed suicide. Br J Psychiatry. 1968 Apr;114(509):443–450. doi: 10.1192/bjp.114.509.443. [DOI] [PubMed] [Google Scholar]
  6. Goldacre M., Seagroatt V., Hawton K. Suicide after discharge from psychiatric inpatient care. Lancet. 1993 Jul 31;342(8866):283–286. doi: 10.1016/0140-6736(93)91822-4. [DOI] [PubMed] [Google Scholar]
  7. Gunnell D., Frankel S. Prevention of suicide: aspirations and evidence. BMJ. 1994 May 7;308(6938):1227–1233. doi: 10.1136/bmj.308.6938.1227. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Isometsä E., Henriksson M., Heikkinen M., Lönnqvist J. Suicide after discharge from psychiatric inpatient care. Lancet. 1993 Oct 23;342(8878):1055–1056. doi: 10.1016/0140-6736(93)92913-e. [DOI] [PubMed] [Google Scholar]
  9. Kendrick S., Clarke J. The Scottish Record Linkage System. Health Bull (Edinb) 1993 Mar;51(2):72–79. [PubMed] [Google Scholar]
  10. King E. A., Barraclough B. M. Suicide. Lancet. 1993 Sep 18;342(8873):744–745. [PubMed] [Google Scholar]
  11. King E. Suicide in the mentally ill. An epidemiological sample and implications for clinicians. Br J Psychiatry. 1994 Nov;165(5):658–663. doi: 10.1192/bjp.165.5.658. [DOI] [PubMed] [Google Scholar]
  12. McGonigal G., McQuade C., Thomas B. Accuracy and completeness of Scottish mental hospital in-patient data. Health Bull (Edinb) 1992 Jul;50(4):309–314. [PubMed] [Google Scholar]
  13. Morgan H. G. Suicide prevention. Hazards on the fast lane to community care. Br J Psychiatry. 1992 Feb;160:149–153. doi: 10.1192/bjp.160.2.149. [DOI] [PubMed] [Google Scholar]
  14. Pullen I. Hunting the gowk?--Psychiatric community care in Scotland. BMJ. 1993 Mar 13;306(6879):710–712. doi: 10.1136/bmj.306.6879.710. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Vassilas C. A., Morgan H. G. General practitioners' contact with victims of suicide. BMJ. 1993 Jul 31;307(6899):300–301. doi: 10.1136/bmj.307.6899.300. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from BMJ : British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES