Abstract
BackgroundResearch is required to identify those psychiatric interventions with a protective effect against suicide. The overarching aim of the current study was to examine whether completed suicide in psychiatric patients in a Swedish population was associated with the quantity and nature of previous medical and psychosocial treatment interventions.MethodsThis retrospective case-control study (n = 308) compared a group of deceased psychiatric patients with matched controls. For every case of suicide, a control was found within psychiatry that matched according to sex, age, and primary psychiatric diagnosis. A stepwise forward logistic regression model with suicide as the dependent outcome variable was used.ResultsReceiving pharmacotherapy combined with psychotherapy [OR: 0.44 (95% CI: 0.226–0.876), p = 0.019] and a higher number of outpatient visits in psychiatry [OR: 0.99 (95% CI: 0.982–0.999), p = 0.028] were negatively associated with suicide. These associations were still significant after controlling for previous serious suicide attempts and somatic comorbidity.ConclusionsFrequent visits and pharmacotherapy combined with psychotherapy seem to be important for preventing suicide in psychiatric patients. The reasons for not receiving such therapy are important issues for further study.
Highlights
Research is required to identify those psychiatric interventions with a protective effect against suicide
During the 2 years before the suicide, outpatient psychiatric care was received by 305 patients (305/308, 99%) in the total cohort, and inpatient care was received by 155 patients (155/308, 50.3%) in psychiatric specialist units
Similar proportions of the occurrence of outpatient care were observed in the suicide case and control groups; during the 2 years before death, suicide cases made a significantly lower number of visits to outpatient psychiatry than controls
Summary
Research is required to identify those psychiatric interventions with a protective effect against suicide. The overarching aim of the current study was to examine whether completed suicide in psychiatric patients in a Swedish population was associated with the quantity and nature of previous medical and psychosocial treatment interventions. Ever since the adoption of a national suicide prevention strategy in 2008, [2] the suicide rate among males in Sweden has declined further [3]. Research suggests that repeated suicide attempts can be significantly reduced or prevented by rather short psychotherapeutic interventions [23]. More studies are needed on treatments that combine psychotropic medication and psychotherapy to refine treatment recommendations for suicidal behavior [26]. The necessary requirements for successful interventions for patients with suicidal behavior or suicidal ideation are not yet fully understood [27]
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