Most provocative study of suicide ever? Best predictors of suicide are psychiatric treatment

[HereSince1628]

From the September issue of the journal Social Psychiatry and Psychiatric Epidemiology.

This is one of those times when you say correlation -isn't- proof of causation, but just WOW!

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http://www.alternet.org/personal-health/research-suggests-psychiatric-interventions-admission-mental-facility-could-increase

<snip>
University of Copenhagen researchers led a nationwide study in Denmark comparing individuals who died from suicide to matched controls between the years 1996 and 2009. They then graded the type of psychiatric treatment people had experienced within one year of their suicide on a scale which included no treatment, psychiatrically medicated, contact with an outpatient psychiatric clinic, entrance to a psychiatric emergency room, and admission, voluntarily or involuntarily, into a psychiatric hospital.

From 2,429 suicides and 50,323 controls,

the researchers found that taking psychiatric medications during the previous year made a person 5.8 times more likely to have killed themselves. If a person had made contact with a psychiatric outpatient clinic, they were 8.2 times more likely to have killed themselves. Visiting a psychiatric emergency room was linked to a 27.9 times greater likelihood of committing suicide. And if someone had actually been admitted to a psychiatric hospital, they were 44.3 times more likely to have commited suicide within the year.

[cbayer]

1. I think a possible explanation for this is that there is a positive correlation between level

of care and severity of illness.

[HereSince1628]

2. Yes that's surely part of it.

But because suicide tends to be impulsive, people usually don't become progressively more suicidal, a couple of other important things are possible...

First, the people who are "44 times more likely to succeed at suicide" first seek help with symptoms serious enough to warrant hospitalization. That's potentially very useful as it clearly identifies the cohort with great need not only during hospitalization but in the year following that event. Those patients pretty clearly need to be followed regularly for at least a year and possibly longer after a psychiatric hospitalization. That's pretty important as insurance companies, and many psych clinics restrict the number and frequency of visits.

Second, the study might be interpreted as indicating that the treatment for the patients at highest risk for suicide doesn't yield a satisfactorily durable resolution of the crisis--suicidal behaviors return at too high a relative risk within a year. Whether that is because the treatments used are inadequate for that severity of patient, or if the patients with the highest risk are also most resistant to treatment would be an open question.

In any case the study certainly suggests there are follow-up research questions worthy of pursuit.

[cbayer]

3. Agree with your take on this and do not discount the poor coverage for psychiatric illnesses

in any way.

It does open the door for further research.

[k8conant]

4. It's probably the medications.

Many psychiatric medications are proven to increase suicidal thoughts. (hello, big Pharma!)

But just try to get shrinks to admit to that.