A closer look at inpatient suicide.

BACKGROUND

We examined the risk factors for suicide among inpatients in an Ontario provincial psychiatric hospital.

METHODS

Forty-four inpatients who had committed suicide during their hospital stay from 1969 to 1995 were compared with a group of inpatient controls matched for sex, age and date of admission. The diagnosis for each patient was reviewed by the authors.

RESULTS

Suicide victims were more likely to have had a mood disorder, family history of psychiatric problems, mention of suicide risk in chart notes and a previous suicide attempt. Two findings necessitated further scrutiny: The most common diagnosis among inpatients who committed suicide in this study was a mood disorder and not schizophrenia as previously reported. A large proportion of patients (24) had experienced a rapidly fluctuating clinical course prior to the time of suicide.

CONCLUSIONS

The implications of these findings, including the possible role of antidepressants in the induction of cycling prior to suicide, are discussed.