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Effect of previous emergency psychiatric consultation on suicide re-attempts – A multi-center observational study

  • Jeong Min Son
    Affiliations
    Department of Emergency Medicine, Seoul National University Hospital, South Korea
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  • Joo Jeong
    Correspondence
    Corresponding author at: Seoul National University Bundang Hospital, 82 Gumi-173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, South Korea.
    Affiliations
    Department of Emergency Medicine, Seoul National University Hospital, South Korea

    Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, South Korea
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  • Young Sun Ro
    Affiliations
    Department of Emergency Medicine, Seoul National University Hospital, South Korea

    Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, South Korea
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  • Wonpyo Hong
    Affiliations
    Department of Emergency Medicine, Seoul National University Hospital, South Korea

    Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, South Korea
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  • Ki Jeong Hong
    Affiliations
    Department of Emergency Medicine, Seoul National University Hospital, South Korea

    Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, South Korea
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  • Kyoung-Jun Song
    Affiliations
    Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, South Korea

    Department of Emergency Medicine, Seoul National University Boramae Medical Center, South Korea
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  • Sang Do Shin
    Affiliations
    Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, South Korea

    Department of Emergency Medicine, Seoul National University College of Medicine, South Korea
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      Highlights

      • Many suicide attempters do not receive emergency psychiatric consultations.
      • Suicide attempters with emergency psychiatric consultation die less on subsequent retries.
      • Lower mortality is made because they choose less lethal methods.

      Abstract

      Background

      The emergency department (ED) is one of the first gateways when suicide attempt patients seek health care services. The purpose of this study was to analyze the hypothesis that people who received emergency psychiatric services in previous suicide attempts will have a lower mortality rate in current ED visits owing to subsequent suicide attempts.

      Method

      This retrospective study included patients who visited six EDs, and participated in the injury surveillance and in-depth suicide surveillance for 10 years, from January 2008 to December 2017. The study subjects were adult patients 18 years or older who visited EDs due to suicide attempts. The main explanatory variable is whether psychiatric treatment was provided in previous suicide attempts. The main outcome variable was suicide related mortality.

      Results

      The study included 2144 suicide attempt patients with a previous history of suicide attempts. Among these, 1335 patients (62.2%) had received psychiatric treatment in previous suicide attempts. Mortality was significantly different between the psychiatric consultation group (n = 33, 2.5%) and non-consultation group (n = 47, 5.8%) (P < 0.01). In multivariate logistic regression analysis, previous psychiatric consultation showed a significant association with low mortality (adjusted OR 0.41; 95% CI [0.23–0.72]) and selecting non-fatal suicide methods (adjusted OR 0.47; 95% CI [0.36–0.61]).

      Conclusion

      Patients who received psychiatric consultation in previous suicide attempts had a lower suicide-related mortality in current ED visits as compared to patients who did not, and this may have been related to choosing non-fatal suicide methods.

      Keywords

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