Meehan Janet, Kapur Navneet, Hunt Isabelle M, Turnbull Pauline, Robinson Jo, Bickley Harriet, Parsons Rebecca, Flynn Sandra, Burns James, Amos Tim, Shaw Jenny, Appleby Louis
Centre for Suicide Prevention, University of Manchester, Williamson Building, Oxford Road, Manchester M13 9PL, UK.
Br J Psychiatry. 2006 Feb;188:129-34. doi: 10.1192/bjp.188.2.129.
Suicide prevention is a health service priority. Suicide risk may be greatest during psychiatric in-patient admission and following discharge.
To describe the social and clinical characteristics of a comprehensive sample of in-patient and post-discharge cases of suicide.
A national clinical survey based on a 4-year (1996-2000) sample of cases of suicide in England and Wales who had been in recent contact with mental health services (n=4859).
There were 754 (16%) current in-patients and a further 1100 (23%) had been discharged from psychiatric in-patient care less than 3 months before death. Nearly a quarter of the in-patient deaths occurred within the first 7 days of admission; 236 (31%) occurred on the ward, the majority by hanging. Post-discharge suicide was most frequent in the first 2 weeks after leaving hospital; the highest number occurred on the first day.
Suicide might be prevented among in-patients by improving ward design and removing fixtures that can be used in hanging. Prevention of suicide after discharge requires early community follow-up and closer supervision of high-risk patients.
预防自杀是卫生服务的重点。自杀风险在精神科住院期间及出院后可能最高。
描述住院患者及出院后自杀案例综合样本的社会和临床特征。
基于1996年至2000年期间英格兰和威尔士近期与精神卫生服务机构有接触的自杀案例样本（n = 4859）开展的一项全国性临床调查。
有754名（16%）为当前住院患者，另有1100名（23%）在死亡前不到3个月已从精神科住院护理中出院。近四分之一的住院患者死亡发生在入院后的前7天内；236例（31%）发生在病房，多数为上吊自杀。出院后自杀在出院后的前2周最为常见；最高数量发生在第一天。
通过改善病房设计和移除可用于上吊的固定装置，可能预防住院患者自杀。出院后预防自杀需要早期社区随访以及对高危患者进行更密切的监督。
