Madsen Trine, Egilsdottir Eybjørg, Damgaard Chanette, Erlangsen Annette, Nordentoft Merete
Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen University Hospital - Mental Health Services, Copenhagen, Denmark.
Copenhagen Research Center for Mental Health, Mental Health Centre Copenhagen, Copenhagen University Hospital - Mental Health Services, Copenhagen, Denmark.
Front Psychiatry. 2021 Apr 20;12:643303. doi: 10.3389/fpsyt.2021.643303. eCollection 2021.
The suicide rate in first week after psychiatric discharge is alarmingly high. Although a risk assessment prior to discharge is standard praxis, it can be difficult to take into consideration the obstacles that patient will meet once discharged. A follow-up-visit during the first week after discharge is an opportunity to reevaluate whether a person may be at risk of suicide. To determine how many patients, of those who were assessed, were evaluated to be at elevated risk of suicide during the first week after psychiatric discharge and secondarily to identify predictors of this and predictors for receiving a follow-up visit during first week after discharge. All patients discharged between March 1st 2018 to January 17th 2019 were offered a home visit including a systematic risk assessment. Socio-demographics and clinical variables were obtained from medical records and logistic regression analyses were used to identify predictors of a higher suicide risk assessment as well as receiving a follow-up visit. Information from 1905 discharges were included. Of these, 1,052 were seen in follow-up meetings. Risk assessments was conducted in a total of 567 discharge procedures, of which 28 (5%) had an elevated risk of suicide. A history of suicide attempt, suicide risk having been the reason for admission, a first diagnosis of a psychiatric disorder was associated with an elevated risk of suicide after discharge. Follow-up visits could serve as an important tool to identify people whose suicidal risk were overlooked at discharge or exposed to severe stressors after discharge.
精神科出院后第一周的自杀率高得惊人。尽管出院前进行风险评估是标准做法,但很难考虑到患者出院后会遇到的障碍。出院后第一周的随访是重新评估一个人是否有自杀风险的机会。目的是确定在精神科出院后的第一周内,那些接受评估的患者中有多少被评估为自杀风险升高,其次是确定与此相关的预测因素以及出院后第一周接受随访的预测因素。对2018年3月1日至2019年1月17日期间出院的所有患者进行了家访,包括系统的风险评估。从病历中获取社会人口统计学和临床变量,并使用逻辑回归分析来确定自杀风险评估较高以及接受随访的预测因素。纳入了1905例出院患者的信息。其中,1052例患者参加了随访会议。总共对567例出院病例进行了风险评估,其中28例(5%)自杀风险升高。自杀未遂史、因自杀风险而入院、首次诊断为精神障碍与出院后自杀风险升高有关。随访可以作为一种重要工具,用于识别那些在出院时自杀风险被忽视或出院后面临严重压力源的人。