Abstract
BackgroundMore knowledge about suicidality and suicide risk profiles in acute psychiatric hospital patients (both first-time and chronic patients) is needed. While numerous factors are associated with suicidality in such populations, these may differ across cultures. Better understanding of factors underlying suicide risk can be informed by cross-cultural studies, and can aid development of therapeutic and preventive measures.MethodsAn explorative, cross-sectional cohort study was carried out. Acutely admitted patients at one psychiatric hospital in northwest Russia and two in northern Norway were included. At admission, demographic, clinical, and service use data were collected, in addition to an assessment of suicidal ideation and attempts, comprising five dichotomic questions. Data from 358 Norwegian and 465 Russian patients were analyzed with univariate and multivariate statistics. Within each cohort, attempters and ideators were compared with patients not reporting any suicidality.ResultsThe observed prevalence of suicidal ideation and attempts was significantly higher in the Norwegian cohort than in the Russian cohort (χ2 = 168.1, p < 0,001). Norwegian suicidal ideators and attempters had more depressed moods, more personality disorders, and greater problems with alcohol/drugs, but fewer psychotic disorders, cognitive problems or overactivity than non-suicidal patients. Russian suicidal ideators and attempters were younger, more often unemployed, had more depressed mood and adjustment disorders, but had fewer psychotic disorders and less alcohol/drug use than the non-suicidal patients.ConclusionsRates of suicidal ideation and non-fatal attempts in Norwegian patients were intermediate between those previously reported for patients admitted for the first time and those typical of chronic patients. However, the significantly lower rates of suicidal ideation and non-fatal attempts in our Russian cohort as compared with the Norwegian, contrasted with what might be expected in a region with much higher suicide rates than in northern Norway. We suggest that suicide-related stigma in Russia may reduce both patient reporting and clinicians’ recognition of suicidality. In both cohorts, overlapping risk profiles of ideators and attempters may indicate that ideators should be carefully evaluated and monitored, particularly those with depressed moods, alcohol/substance abuse disorders, and inadequate treatment continuity.
Highlights
More knowledge about suicidality and suicide risk profiles in acute psychiatric hospital patients is needed
Sample characteristics Demographics and healthcare use in the Norwegian and Russian patients There was no difference in age between the Norwegian and Russian cohorts (M = 46.53, SD = 14.07, range = 21–85)
Russians were more often diagnosed with alcohol/drug-related disorders and adjustment disorders
Summary
More knowledge about suicidality and suicide risk profiles in acute psychiatric hospital patients (both first-time and chronic patients) is needed. Strong evidence exists that the majority of suicide completers were suffering at the time of death from a psychiatric disorder, most commonly affective disorders and substance use disorders [7]. Reported lifetime risk of suicide is as high as 15 % for those with affective disorders, 10 % for those with schizophrenia, and 2–3 % for alcohol abusers [8]. For patients admitted to psychiatric hospitals, the suicide risk is even higher [9, 10], on first admission [11]. Mood disorders are a common suicide risk factor in high income countries, whereas impulse-control disorders (such as those related to alcohol abuse) may be more significant in low and middle income countries [13]. Depressed suicide attempters from New York made attempts of greater lethality and reported more lifetime aggressive behavior that depressed attempters in Madrid [14]
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