Self-Harm History, Anxiety-Depression, Severity of Disease, and Insight Are Significantly Associated With Suicide Risk in Forensic Psychiatric Inpatients of China.

Huijuan Guo,Ningzhi Gou,Juntao Lu,Fanglan Wang,Xiaoping Wang,Yuchen Yue,Xiaoxi Liang,Qiguang Li,Jiansong Zhou,Qiaoling Sun,Shaoling Zhong

doi:10.3389/fpsyt.2021.706416

Abstract

Background: Forensic psychiatric patients have higher suicide risk than the general population. This study aimed to evaluate the extent of suicide risk and to explore the associated factors in forensic psychiatric inpatients in China.Methods: We conducted a cross-sectional study from 1st November, 2018 to 30th January, 2019 in the Forensic Psychiatric Hospital of Hunan Province, China. Patient's information on socio-demographic, clinical, and criminological characteristics was collected. The suicidality subscale of the MINI-International Neuropsychiatric Interview (M.I.N.I.), the Brief Psychiatric Rating Scale (BPRS), and the Severity of Illness of Clinical Global Impressions Scale (CGI-SI) were used to measure present suicide risks, psychiatric symptoms, and the severity of the patient's disease, respectively. Binary logistic regression models were used to examine factors associated with suicide risk.Results: Twenty-one percent (84/408) of the forensic psychiatric inpatients reported suicide risk. Logistic regression analysis suggested that self-harm history (OR:3.47, 95% confidence interval CI: 1.45–8.33), symptoms of anxiety-depression (OR:1.15, 95% CI:1.04–1.27), and more severe mental disorder (OR:1.42, 95% CI:1.08–1.87) were associated with elevated suicide risk, while insight disorder (OR:0.81, 95% CI:0.65–0.99) was related to decreasing suicide risk.Conclusion: The study supplied useful clinical information to recognize high suicide risk in forensic psychiatric inpatients and may aid the development of valuable strategies for preventing and reducing suicide events.

Highlights

Forensic psychiatric institutions typically provide high secure health services for psychiatric patients with criminal involvement
Patients were excluded for the following reasons: refusal to participate in the interview (n = 41) and unable to talk or write (n = 12)
91.2% of all patients were diagnosed with schizophrenia in the hospital

Summary

Introduction

Forensic psychiatric institutions typically provide high secure health services (including full range of clinical assessments and treatments) for psychiatric patients with criminal involvement. In China, under criminal law, mentally ill offenders who are identified as “incapable of criminal responsibility,” and the risk assessments show that they may still pose serious harm to the public must be detained in forensic psychiatric hospitals, which are similar to maximum-security hospitals in the UK and US. This study aimed to evaluate the extent of suicide risk and to explore the associated factors in forensic psychiatric inpatients in China. Binary logistic regression models were used to examine factors associated with suicide risk

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Conclusion