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Patients With Depression Face Highest Risk for Suicide in Days After Hospital Discharge

People treated at psychiatric hospitals are at highest risk of committing suicide immediately after their discharge if they suffer from depression, a new study reports.

Patients hospitalized for depression are hundreds of times more likely to commit suicide within the first three days of discharge, compared to the suicide rate of the general population, results show.

“Although we found a decreasing trend over time, the high-risk post-discharge period still requires intensified attention,” wrote the authors, who were led by Dr. Kari Aaltonen of the University of Helsinki in Finland. “Continuity of care and access to enhanced psychiatric outpatient care within days of discharge should be imperative.”

More than half of all people who die by suicide are depressed, and about 40% had been recently hospitalized for psychiatric reasons, researchers said in an American Psychiatric Association news release.

For the study, researchers analyzed health data on more than 91,000 Finnish people hospitalized for depression between 1996 and 2017. Each person was tracked for up to two years following their discharge.

A total of 1,219 men and 757 women died by suicide during the study period, results show.

Researchers found that within the first three days of discharge, the suicide rate was 6,063 per 100,000 person-years. Person-years take into account both the number of people in a study and the amount of time each person spends in the study.

That rate is 330 times higher than the suicide rate for Finland overall, researchers noted.

The suicide rate remained high through the first week after discharge, running at 3,884 per 100,000 person-years on days four through seven, results show.

But the rate then fell steadily, dropping to 478 per 100,000 person-years after one year.

People admitted to the hospital due to a suicide attempt by firearm or hanging had the highest risk of death by suicide in the first three days after discharge, researchers said.

Other factors associated with immediate suicide risk included psychotic depression, severe mental illness with impaired function, and a history of suicide attempts. Men were at higher risk, as well as those age 40 and above, results show. 

Some risk factors changed over time, researchers found.

For example, people with higher household incomes had a higher suicide risk right after discharge, but it fell over time compared to those with less money.

On the other hand, alcoholics had a lower immediate suicide risk following discharge, but their risk increased over time.

The new study was published recently in the journal JAMA Psychiatry.

If you or a loved one is having suicidal thoughts, the 988 Suicide and Crisis Lifeline offers free, anonymous 24/7 help.

More information

The U.S. Centers for Disease Control and Prevention has more about risk factors for suicide.

SOURCE: American Psychiatric Association, news release, Feb. 14, 2024

Source: HealthDay


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