Suicide in a large population of former psychiatric inpatients

Gabriele Sani, Leonardo Tondo, Athanasios Koukopoulos, Daniela Reginaldi, Giorgio D. Kotzalidis, Alexia E. Koukopoulos, Giovanni Manfredi, Lorenzo Mazzarini, Isabella Pacchiarotti, Alessio Simonetti, Elisa Ambrosi, Gloria Angeletti, Paolo Girardi, Roberto Tatarelli

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

Aims: The aim of this study was to identify predictors of completed suicide in a wide sample of psychiatric inpatients receiving retrospective and prospective DSM-IV diagnoses. Methods: We followed up 4441 severe psychiatric patients who were hospitalized for some time during a 35-year period in a private hospital setting. We collected sociodemographic, clinical and temperamental data. Results: Ninety-six patients from the sample committed suicide. There were no sex differences in suicide completion and no differences between major psychiatric disorders, but people who had been hospitalized for anxiety disorders did not commit suicide and people with bipolar disorders were more likely to commit suicide than people with unipolar major depression. Shorter-term treatment with lithium and anticonvulsants, longer-term treatment with antidepressants, history of suicide attempts, suicidal thinking, and single status positively predicted completed suicide. Suicide tended to occur after a mean period of about 14 years of duration of disease. Patients' symptoms during the period preceding suicide were assessed through interviewing patients' physicians or family members. Symptoms occurring in >10% of cases were, in decreasing order, inner tension, racing/crowded thoughts, aggressive behavior, guilt, psychomotor agitation, persecutory ideation, anxiety, and hallucinations. Surprisingly, cyclothymic temperament was less associated with completed suicide as compared to other temperaments. Conclusions: Suicide is likely to occur in a milieu of agitation, mixed anxiety and depression, and psychosis. Longer-term mood stabilizer treatment may reduce the rate of completed suicide.

Original languageEnglish
Pages (from-to)286-295
Number of pages10
JournalPsychiatry and Clinical Neurosciences
Volume65
Issue number3
DOIs
Publication statusPublished - Apr 2011

Fingerprint

Suicide
Psychiatry
Inpatients
Population
Temperament
Anxiety
Psychomotor Agitation
Private Hospitals
Guilt
Hallucinations
Depressive Disorder
Anxiety Disorders
Bipolar Disorder
Lithium
Sex Characteristics
Diagnostic and Statistical Manual of Mental Disorders
Psychotic Disorders
Anticonvulsants
Antidepressive Agents
Therapeutics

Keywords

  • agitation
  • antidepressant drugs
  • bipolar disorder
  • schizophrenia
  • suicide

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Psychiatry and Mental health
  • Neuroscience(all)

Cite this

Sani, G., Tondo, L., Koukopoulos, A., Reginaldi, D., Kotzalidis, G. D., Koukopoulos, A. E., ... Tatarelli, R. (2011). Suicide in a large population of former psychiatric inpatients. Psychiatry and Clinical Neurosciences, 65(3), 286-295. https://doi.org/10.1111/j.1440-1819.2011.02205.x

Suicide in a large population of former psychiatric inpatients. / Sani, Gabriele; Tondo, Leonardo; Koukopoulos, Athanasios; Reginaldi, Daniela; Kotzalidis, Giorgio D.; Koukopoulos, Alexia E.; Manfredi, Giovanni; Mazzarini, Lorenzo; Pacchiarotti, Isabella; Simonetti, Alessio; Ambrosi, Elisa; Angeletti, Gloria; Girardi, Paolo; Tatarelli, Roberto.

In: Psychiatry and Clinical Neurosciences, Vol. 65, No. 3, 04.2011, p. 286-295.

Research output: Contribution to journalArticle

Sani, G, Tondo, L, Koukopoulos, A, Reginaldi, D, Kotzalidis, GD, Koukopoulos, AE, Manfredi, G, Mazzarini, L, Pacchiarotti, I, Simonetti, A, Ambrosi, E, Angeletti, G, Girardi, P & Tatarelli, R 2011, 'Suicide in a large population of former psychiatric inpatients', Psychiatry and Clinical Neurosciences, vol. 65, no. 3, pp. 286-295. https://doi.org/10.1111/j.1440-1819.2011.02205.x
Sani G, Tondo L, Koukopoulos A, Reginaldi D, Kotzalidis GD, Koukopoulos AE et al. Suicide in a large population of former psychiatric inpatients. Psychiatry and Clinical Neurosciences. 2011 Apr;65(3):286-295. https://doi.org/10.1111/j.1440-1819.2011.02205.x
Sani, Gabriele ; Tondo, Leonardo ; Koukopoulos, Athanasios ; Reginaldi, Daniela ; Kotzalidis, Giorgio D. ; Koukopoulos, Alexia E. ; Manfredi, Giovanni ; Mazzarini, Lorenzo ; Pacchiarotti, Isabella ; Simonetti, Alessio ; Ambrosi, Elisa ; Angeletti, Gloria ; Girardi, Paolo ; Tatarelli, Roberto. / Suicide in a large population of former psychiatric inpatients. In: Psychiatry and Clinical Neurosciences. 2011 ; Vol. 65, No. 3. pp. 286-295.
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