Postdischarge Suicide and Death in South Korean Children and Adolescents Hospitalized for a Psychiatric Illness

Abstract

The postdischarge suicide rate in children and adolescents ever hospitalized for a psychiatric illness is much higher than that of children and adolescents in the general population. We aimed to investigate the postdischarge death and suicide among children and adolescents hospitalized for a psychiatric illness using the Korean National Health Insurance database and causes of death statistics from the National Statistics Office. We identified children and adolescents less than 18 years of age who experienced at least one psychiatric hospitalization from 2008 to 2013 with a principal diagnosis of a psychiatric disorder based on the International Classification of Diseases, 10th Revision, Code Fxx.x). Postdischarge deaths (all-cause death or suicide) after the first psychiatric hospitalization were investigated. The total number of patients hospitalized for a psychiatric illness was 14,097, and the numbers of all-cause deaths and suicide deaths after discharge were 93 and 64, respectively. The rates of suicide according by diagnostic group were 440.1 (per 100,000 person-years) for psychosis, 248.8 for depression, 155.4 for conduct disorder, 153.6 for bipolar disorder, 103.4 for posttraumatic stress disorder, 93.0 for anxiety disorder, and 38.4 for attention-deficit/hyperactivity disorder. As suicide is the main cause of postdischarge death, there is an urgent need to develop and implement effective prevention strategies after psychiatric hospitalization.