Can post discharge suicide attempts of non psychotic inpatients be predicted?

Abstract

Predicting risk of suicidality is generally difficult. We studied whether it is possible to predict post discharge suicide attempts of non psychotic inpatients (n = 42) on the basis of the Hamilton Depression Rating Scale (HDRS) scored during the inpatient period. Twelve patients (29%) attempted suicide during a 3-year follow-up period. Total HDRS scores during the inpatient period did not predict suicide attempts. There were no differences in changes of total HDRS score during the first half of the inpatient period, but an unchanged total HDRS score during the second half of the inpatient period was associated with postdischarge suicide attempts. Predicting lack of suicidality succeeded well (83%) on the basis of HDRS item three on discharge. Two-thirds (63%) of those who attempted suicide during follow-up were assessed as suicidal on discharge. A structured clinical assessment like HDRS item three is reliable in predicting lack of suicidality and fairly good also in redicting suicidality.