Abstract
BackgroundIn Norway, there are about 550 suicides recorded each year. The number of suicide attempts is 10–15 times higher. Suicide attempt is a major risk factor for suicide, in particular when violent methods are used. Suicide attempts with violent methods have hardly been studied in Norway. This study describes demographic, psychiatric and somatic health in patients admitted to somatic hospitals in Norway after suicide attempt by violent methods compared with suicide attempters using deliberate self-poisoning (DSP).MethodsPatients admitted to somatic hospital after suicide attempt aged > 18 years were included in a prospective cohort study, enrolled from December 2010 to April 2015.Demographics (gender, age, marital and living condition, educational and employment status), previous somatic and psychological health were registered. Patients who had used violent methods were compared with patients admitted after suicide attempt by DSP.ResultsThe study included 80 patients with violent methods and 81 patients with DSP (mean age both groups 42 yrs.). Violent methods used were cutting (34%), jumping from heights (32%), hanging (14%), others (10%), shooting (7%) and drowning (4%).Patients with violent methods had more often psychosis than patients admitted with DSP (14% vs 4%, p < 0.05), less anxiety disorders (4% vs 19%, p < 0.01) and less affective disorders (21% vs. 36%, p < 0.05). There were no significant differences between the numbers of patients who received psychiatric treatment at the time of the suicide attempt (violent 55% versus DSP 48%) or reported previous suicide attempt, 58% in patients with violent methods and 47% in DSP. Patients with violent methods stayed longer in hospital (14.3 (mean 8.3–20.3) vs. 2.3 (mean 1.6–3.1) days, p < 0.001), stayed longer in intensive care unit (5 days vs. 0.5 days, p < 0.001) and were in need of longer mechanical ventilation (1.4 vs 0.1 days, p < 0.001).ConclusionsPatients with violent methods had more often psychosis, less anxiety disorders and affective disorders than patients with DSP. Psychiatric treatment before the attempt and previous suicide attempt was not significantly different between the groups and about half of the patients in both groups were in psychiatric treatment at the time of the suicide attempt.
Highlights
In Norway, there are about 550 suicides recorded each year
A British study showed that patients who had made suicide attempts by hanging had higher suicide intent and fewer used alcohol compared with patients who had used deliberate self-poisoning (DSP) [7]
In the DSP group, more patients had an episode of selfharm the last month (40% vs 24%, p > 0.05 (Table 2) and a suicide attempt less than a week before this attempt (27% vs 15%, p < 0.05)
Summary
In Norway, there are about 550 suicides recorded each year. The number of suicide attempts is 10–15 times higher. This study describes demographic, psychiatric and somatic health in patients admitted to somatic hospitals in Norway after suicide attempt by violent methods compared with suicide attempters using deliberate self-poisoning (DSP). In Norway, 550 suicides were recorded in 2014; of these 443 used violent methods (http://statistikkbank.fhi.no/ dar/) and 401 were males. A study from Sweden demonstrated that the risk of suicide was high among those who attempted suicide by violent methods such as hanging, drowning, jumping from height or using firearms [6]. The relative risk for completed suicide was six times greater after an attempt by hanging and four times greater after an attempt by drowning than after an attempt by deliberate self-poisoning (DSP), which is the most common method of suicide attempt in Norway (https://www.fhi.no/nettpub/hin/helse-og-sykdom/selvmord-og-selvmordsforsok-i-norge/). Surviving patients are at risk for repeated suicide attempts, often by using more violent and fatal methods [9, 10]
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