Adult Suicidal Behaviour of Native Psychiatric Inpatients: A Retrospective, Record-Based Study

Introduction: Suicidal behaviour is seen in the context of a variety of mental disorders and while many believe that, in general, first episode psychosis is a particularly high-risk period for suicide, no general agreement regarding higher prevalence of suicide in first episode psychosis is achievable. In the present study, suicides and suicide attempts among psychiatric in-patients has been evaluated to assess the general profile of suicidal behaviour among native psychiatric inpatients and probing any relationship between serum cholesterol level and suicidal behaviour.

Methods: Five acute academic wards, which have been specified for admission of first episode adult psychiatric patients, and five acute nonacademic wards, which have been specified for admission of recurrent episode adult psychiatric patients, had been selected for current study. All inpatients with suicidal behaviour (successful suicide and attempted suicide, in total), during the last five years (2013-2018), had been included in the present investigation. Also, assessment of serum lipids, including triglyceride, cholesterol, low density lipoprotein and high-density lipoprotein, had been accomplished, for comparing the suicidal subjects with non-suicidal ones.

Results: Among 19160 psychiatric patients hospitalized in razi psychiatric hospital during a sixty months period, 63 suicidal behaviours, including one successful suicide and sixty-two suicide attempts, had been recorded by the safety board of hospital. The most frequent mental illness was bipolar I disorder, which was significantly more prevalent in comparison with other mental disorders (p<0.04, p<0.02, p<0.007, and p<0.003 in comparison with schizophrenia, depression, personality disorders and substance abuse, respectively). Self-mutilation, self-poisoning and hanging were the preferred methods of suicide among 61.11%, 19.44% and 19.44% of cases, respectively. In addition, no significant difference was evident between the first admission and recurrent admission inpatients, totally and separately, particularly with respect to psychotic disorders. Besides, with respect to different components of serum lipids, no specific or significant pattern was evident.

Conclusion: While in the present study the suicidal behaviour was significantly more evident in bipolar disorder in comparison with other psychotic or no-psychotic disorders, no significant difference was evident between first admission and recurrent admission psychiatric inpatients. Moreover, no significant relationship between suicidal behaviour and serum lipids was palpable.

Keywords: Psychiatric disorders; Suicide; Suicide attempt; First admission; Recurrent admission; Schizophrenia; Bipolar disorder; Depression; Substance abuse disorder