Khanra Sourav, Mahintamani Tathagata, Bose Swarnali, Khess Christoday Raja Jayant, Umesh Shreekantiah, Ram Daya
Department of Psychiatry, Central Institute of Psychiatry, Ranchi, Jharkhand, India.
Department of Clinical Psychology, Central Institute of Psychiatry, Ranchi, Jharkhand, India.
Indian J Psychol Med. 2016 Nov-Dec;38(6):571-576. doi: 10.4103/0253-7176.194914.
Risk factors for inpatient suicide are different from those in the general population. We examined sociodemographic and clinical variables of patients who committed suicide as an inpatient in a psychiatric hospital in India.
Matched retrospective nested case-control design was adopted. Ten patients who died by suicide as inpatients between 2000 and 2013 were included, along with fifty controls, matched with respect to age, sex, diagnosis, and period of admission.
Suicide completers were mostly unskilled in occupation ( = 0.03), had a history of past suicide attempts ( < 0.001), shorter duration of hospital stay ( = 0.001), poorer improvement on psychopathology ( = 0.02), and were having more suicidal ideation ( = 0.02). Significantly more completers were receiving antidepressants ( = 0.04).
This study adds to the existing sparse literature on inpatient suicides from Asia. Strength of the study was close matching between case and controls and blindedness. Limitations were retrospective design, and variations in prescription behavior and treatment decisions.
住院患者自杀的风险因素与普通人群不同。我们研究了印度一家精神病医院中住院期间自杀患者的社会人口统计学和临床变量。
采用匹配的回顾性巢式病例对照设计。纳入了2000年至2013年间住院期间自杀死亡的10名患者，以及50名对照，这些对照在年龄、性别、诊断和入院时间方面进行了匹配。
自杀成功者大多职业无技能（P = 0.03），有既往自杀未遂史（P < 0.001），住院时间较短（P = 0.001），精神病理学改善较差（P = 0.02），且有更多自杀观念（P = 0.02）。显著更多的自杀成功者正在接受抗抑郁药治疗（P = 0.04）。
本研究补充了亚洲关于住院患者自杀的现有稀少文献。该研究的优势在于病例与对照之间的紧密匹配和设盲。局限性在于回顾性设计以及处方行为和治疗决策的差异。
