Assessment Of Suicide Attempts Research Articles

Optimizing the assessment of suicide attempters with a decision tree

BackgroundOptimizing psychiatric assessments could help to standardize the use of structured instruments in clinical practice. In recent years, several research groups have applied Computerized Adaptive Tests (CATs) to simplify assessments in depression, anxiety and also suicidal behaviors. We aimed to construct a shortened test to classify suicide attempters using a decision tree methodology that allows the integration of relevant clinical information, namely the history of past suicide attempts, in the construction of the test.MethodsThe sample was composed of 902 adult participants in three subsamples: first-time suicide attempters, psychiatric inpatients that never attempted suicide and healthy controls. The performance of a decision tree built using the items of a previously developed scale for suicidal risk was examined. The history of past suicide attempts was used to separate patients in the decision tree. The data was randomly divided in a training set and a test set. The test set, that contained 25% of the data, was used to determine the accuracy of the decision tree. Twenty-five cross-validations of this set up were conducted.ResultsThe first four items of the decision tree classified correctly 81.4% of the patients.ConclusionAs a result of a methodology based on decision trees that, contrary to CATs, can incorporate relevant information in building the test we were able to create a shortened test capable of separating suicidal and non-suicidal patients. Using all the information that is available improves the precision and utility of instruments adapted for psychiatric assessments.Disclosure of interestThe authors have not supplied their declaration of competing interest.

An assessment of suicide attempts by self-poisoning in the west of Iran

Intentional self-poisoning that is widely used all over the world is one of the most common methods of suicide. This study aim was to determine the rate of attempted intentional self-poisoning and to identify high risk persons in the west of Iran (Kermanshah). A total of 3138 people (1279 M and 1859 F) studied. The average annual rate of suicide in Kermanshah was 153 persons per 100 000 people. The most number of attempted intentional self-poisoning (55.5%) were in the 20–29 year age group. The most popular toxic substances for self-poisoning were drugs (71%) and oil and fuels (15%), respectively. The most number of intentional self-poisoning suicides are attempted by drugs. By considering the high rate of intentional self-poisoning, low age of suicide attempts and also its high mortality rate in Kermanshah, it is necessary to stop the opportunity to buy over-the-counter (OTC) drugs, especially those being most misused.

P03-465 - Assessment of suicide attempts in an emergency service of a General Hospital

IntroductionThere is a high frequency of attendance at emergency medical service for suicide attempts.ObjectivesDetermine the type of urgency for suicide attempt in our country.Material and methodsThe present study treats of suicide attempts (n = 248) attended by the Psychiatric Emergency Service of Hospital in our city between 2004–2008. The diagnoses were made by clinical interview following ICD-10 criteria.Results248 suicide attempts (60% women), with age between 15 and 88 years.There are equal proportions of singles and married (a 38%). 53% live with couple with/without children, 30%live with parents and a 10%live alone. >55% of patients have a middle education and socioeconomic level. The average time from suicide attempt until the assessment in the emergency department is 2.71 ± 3.64 hours. The day of the week with more assistance for this reason is Monday. Also it's observed an increase in the months between May and October. The cases are uniformly distributed throughout the month, although there is a decrease in the number of cases in the initial and final days of the month. 60% of patients haven’t history of previous attempts and use an only method that is drug overdose. Personality disorders are the most frequent diagnose and 44% patients need an internment in a psychiatric ward.ConclusionsProfile of the patient who makes a suicide attempt and that is evaluated in the Psychiatric Emergency Service of our Hospital: woman 36 years old, married/with couple and lives with him/her. She comes to emergency department in the first 4 hours after the drug overdose. She hasn’t history of previous attempts.She is diagnosed of emotionally unstable personality disorder.

Reassessment of Suicide Attempters at Home, Shortly After Discharge from Hospital

Assessment of suicide attempters in a general hospital may be influenced by the condition of the patient and the unfavorable circumstances of the hospital environment. To determine whether the results of a reassessment at home shortly after discharge from hospital differ from the initial assessment in the hospital. In this prospective study, systematic assessment of 52 suicide attempters in a general hospital was compared with reassessment at home, shortly after discharge. Reassessments at home concerning suicide intent, motives for suicide attempt, and dimensions of psychopathology did not differ significantly from the initial hospital assessment. However, patients' motives for the suicide attempt had changed to being less impulsive and more suicidal, worrying was significantly higher, and self-esteem was significantly lower. A third of the patients had forgotten their aftercare arrangements and most patients who initially felt no need for additional help had changed their mind at reassessment. Results from this group of suicide attempters suggest that a brief reassessment at home shortly after discharge from hospital should be considered.

A Comparative Follow-up Study of Aftercare and Compliance of Suicide Attempters Following Standardized Psychosocial Assessment

This comparative longitudinal study investigated aftercare and compliance of attempted suicide patients after standardized psychosocial assessment. Structured interviews were conducted 1 month (FU1) and 6 months (FU2) after an index suicide attempt. Assessment was associated with more frequent discussion of treatment options with the patient at the hospital and a shorter interval between discharge and contacting the general practitioner (GP). A near significant effect was found for discussing the suicide attempt with the GP more frequently and with start or change of the medication scheme after the index attempt. The current findings support the use of a standardized tool for the assessment of suicide attempters and are in line with the chain of care model for suicide attempters.