TY  - JOUR
PY  - 2016//
TI  - Repeated suicide attempts and suicide among individuals with a first emergency department contact for attempted suicide: a prospective, nationwide, Danish register-based study
JO  - Journal of clinical psychiatry
A1  - Fedyszyn, Izabela E.
A1  - Erlangsen, Annette
A1  - Hjorthøj, Carsten
A1  - Madsen, Trine
A1  - Nordentoft, Merete
SP  - 832
EP  - 840
VL  - 77
IS  - 6
N2  - OBJECTIVE: Emergency departments are important, albeit underutilized, sites for suicide prevention. Preventive strategies and interventions could benefit from a greater understanding of factors influencing the course of suicide risk after emergency department contact due to attempted suicide. The aim of our study was 2-fold: to identify predictors of repeated suicide attempts and suicide and to investigate the timing of these events. <br><br>METHODS: Data from Danish nationwide, longitudinal registers were used in this prospective, population-based study of all individuals first presenting to an emergency department after attempted suicide (index attempt) between January 1, 1996, and December 31, 2011 (N = 11,802). Cox regression analysis identified predictors, and Kaplan-Meier survival analysis modeled the time to repeated suicide attempts and suicide. <br><br>RESULTS: Sixteen percent of the sample repeated suicide attempt, and 1.4% died by suicide. Repetition was less likely among men than women (adjusted hazard ratio [AHR] = 0.70; 95% CI, 0.63-0.79), whereas those most prone to repeated attempts were individuals with recent psychiatric treatment (AHR = 2.19; 95% CI, 1.97-2.43) and those with recent psychiatric treatment (AHR = 2.19; 95% CI, 1.97-2.43). Predictors of suicide included age over 35 years (AHR = 5.56; 95% CI, 2.89-10.69); hanging, strangling, or suffocation as the method of the index attempt (AHR = 2.55; 95% CI, 1.29-5.01); and receiving psychiatric hospitalization for the index attempt (AHR = 1.74; 95% CI, 1.22-2.49). The cumulative rates of repeated attempts and suicide deaths in the total sample were particularly high within the first week of the index attempt, reaching 3.6% and 0.1%, respectively. <br><br>CONCLUSIONS: Preventive efforts need to target the period close to discharge from emergency departments.<br><br>© Copyright 2016 Physicians Postgraduate Press, Inc.<p />  <p>Language: en</p>
LA  - en
SN  - 0160-6689
UR  - http://dx.doi.org/10.4088/JCP.15m09793
ID  - ref1
ER  -