AUTHOR=Deisenhammer Eberhard A. , Behrndt-Bauer Elisa-Marie , Kemmler Georg , Haring Christian , Miller Carl 

TITLE=Suicide in Psychiatric Inpatients— A Case–Control Study

JOURNAL=Frontiers in Psychiatry

VOLUME=Volume 11 - 2020

YEAR=2020

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2020.591460

DOI=10.3389/fpsyt.2020.591460

ISSN=1664-0640

ABSTRACT=Objective: Psychiatric in-patients constitute a population of considerably increased risk for suicide. Identifying those at imminent risk is still a challenging task for hospital staff. This retrospective case-control study focused on clinical risk factors related to the course of the hospital stay. 
Method: In-patient suicide cases were identified by linking the Tyrol Suicide Register with the registers of three psychiatric hospitals in the state. Control subjects were patients who had also been hospitalized in the respective psychiatric unit but had not died by suicide. Matching variables included sex, age, hospital, diagnosis and admission date. The study period comprised seven years. Data were analyzed by the appropriate two-sample tests and by logistic regression. 
Results: A total of 30 in-patient suicide cases and 54 control patients were included. A number of factors differentiated cases from controls, after correction for multiple testing the following retained significance: history of aborted suicide, history of attempted suicide, history of any suicidal behavior/threats, suicidal ideation continuing during hospitalization, no development of prospective plans, no improvement of mood during the hospital stay, and leaving ward without giving notice. Logistic regression identified the latter three variables and history of attempted suicide as highly significant predictors of in-patient suicide. 
Conclusions: Preventive measures during hospitalization include thorough assessment of suicidal features, an emphasis on the development of future perspectives and to review hospital regulations for patients who want to leave the ward.