Suicide risk in medically ill inpatients referred to consultation-liaison psychiatric services: A multicenter study.

Humans Male Middle Aged Female Inpatients Suicidal Ideation Referral and Consultation Hospitals, General Mental Health Services Risk Factors
Consultation-liaison Hospital Illness perception Medically ill Screening Suicide

Journal

Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073

Informations de publication

Date de publication:
15 12 2022
Historique:
received: 24 01 2022
revised: 23 05 2022
accepted: 26 08 2022
pubmed: 4 9 2022
medline: 16 11 2022
entrez: 3 9 2022
Statut: ppublish

Résumé

The aim of this multicenter study was to investigate the suicide risk in medically ill patients admitted to six Italian hospitals for whom a consultation-liaison intervention was requested. Participants completed socio-demographic and clinical report forms and the Brief Illness Perception Questionnaire. Suicidality was assessed using the P4 screener that investigates the presence of Past suicide attempts, Plans to commit a suicide, Probability of completing suicide, and Preventive factors. Participants were categorized as being at no, low or high suicide risk. Univariate and multivariable associations of categorical and continuous variables with suicide risk were investigated using multinomial logistic regression. Of the 641 inpatients, with mean age 60 years (SD = 16.9) and 49.2 % male, 13.2 % were at high suicidal risk (HR), 7.6 % low risk (LR) and 79.2 % no risk. Contacts with psychiatrists in the previous six months were associated with LR and HR (OR = 2.159 and 2.634, respectively), ongoing benzodiazepine use was associated with a threefold likelihood of LR (OR = 3.005), and the experienced intensity of illness symptoms was associated with LR and HR (OR = 1.257 and OR = 1.248, respectively). CL psychiatrists prescribed appropriate psychotropic drugs and activated liaison interventions and psychological support for the level of suicidal risk. The use of self-report measures bears the risk of recall bias. Our findings based on psychiatric consultations in the general hospital underscore the need to include suicide risk in the routine assessment of inpatients referred to CL psychiatric services and to plan an appropriate management of suicidal risk after discharge.

Sections du résumé

BACKGROUND
The aim of this multicenter study was to investigate the suicide risk in medically ill patients admitted to six Italian hospitals for whom a consultation-liaison intervention was requested.
METHODS
Participants completed socio-demographic and clinical report forms and the Brief Illness Perception Questionnaire. Suicidality was assessed using the P4 screener that investigates the presence of Past suicide attempts, Plans to commit a suicide, Probability of completing suicide, and Preventive factors. Participants were categorized as being at no, low or high suicide risk. Univariate and multivariable associations of categorical and continuous variables with suicide risk were investigated using multinomial logistic regression.
RESULTS
Of the 641 inpatients, with mean age 60 years (SD = 16.9) and 49.2 % male, 13.2 % were at high suicidal risk (HR), 7.6 % low risk (LR) and 79.2 % no risk. Contacts with psychiatrists in the previous six months were associated with LR and HR (OR = 2.159 and 2.634, respectively), ongoing benzodiazepine use was associated with a threefold likelihood of LR (OR = 3.005), and the experienced intensity of illness symptoms was associated with LR and HR (OR = 1.257 and OR = 1.248, respectively). CL psychiatrists prescribed appropriate psychotropic drugs and activated liaison interventions and psychological support for the level of suicidal risk.
LIMITATIONS
The use of self-report measures bears the risk of recall bias.
CONCLUSIONS
Our findings based on psychiatric consultations in the general hospital underscore the need to include suicide risk in the routine assessment of inpatients referred to CL psychiatric services and to plan an appropriate management of suicidal risk after discharge.

Identifiants

DOI: 10.1016/j.jad.2022.08.113 PMID: 36057291
pubmed: 36057291
pii: S0165-0327(22)00969-7
doi: 10.1016/j.jad.2022.08.113
pii:
doi:

Types de publication

Multicenter Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

329-335

Informations de copyright

Copyright © 2022. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Conflict of interest The authors have no conflicts of interest to declare.

Auteurs

Matteo Balestrieri (M)

Psychiatric Unit, Department of Medicine, University of Udine, Udine, Italy. Electronic address: matteo.balestrieri@uniud.it.

Paola Rucci (P)

Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy. Electronic address: paola.rucci2@unibo.it.

Martino Belvederi Murri (MB)

Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy. Electronic address: martino.belvederimurri@unife.it.

Rosangela Caruso (R)

Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy. Electronic address: rosangela.caruso@unife.it.

Armando D'Agostino (A)

Department of Health Sciences, University of Milan, Italy; Department of Mental Health, ASST Santi Paolo e Carlo, Milan, Italy. Electronic address: armando.dagostino@unimi.it.

Silvia Ferrari (S)

Department of Diagnostic-Clinical Medicine and Public Health, Section of Psychiatry, University of Modena and Reggio Emilia, Modena, Italy. Electronic address: silvia.ferrari@unimore.it.

Maria Giulia Nanni (MG)

Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy. Electronic address: mariagiulia.nanni@unife.it.

Laura Palagini (L)

Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; Department of Clinical and Experimental Medicine, Psychiatric Clinic, University of Pisa, Pisa, Italy.

Stefano Pini (S)

Department of Clinical and Experimental Medicine, Psychiatric Clinic, University of Pisa, Pisa, Italy. Electronic address: stefano.pini@unipi.it.

Pierluigi Politi (P)

Department of Brain and Behavioral Science, University of Pavia, Pavia, Italy. Electronic address: pierluigi.politi@unipv.it.

Matteo Rocchetti (M)

Department of Brain and Behavioral Science, University of Pavia, Pavia, Italy. Electronic address: matteo.rocchetti@unipv.it.

Luigi Zerbinati (L)

Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy. Electronic address: zrblgu@unife.it.

Luigi Grassi (L)

Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy. Electronic address: luigi.grassi@unife.it.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Suicide risk in medically ill inpatients...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Suicide risk in medically ill inpatients...
questionsmedicales.fr › Personnes › Patients › Patients hospitalisés › Suicide risk in medically ill inpatients...
questionsmedicales.fr › Sciences sociales › Sociologie › Problèmes sociaux › Suicide › Idéation suicidaire › Suicide risk in medically ill inpatients...
questionsmedicales.fr › Administration des services de santé › Organisation et administration › Pratique professionnelle › Orientation vers un spécialiste › Suicide risk in medically ill inpatients...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Établissements de santé › Hôpitaux › Hôpitaux généraux › Suicide risk in medically ill inpatients...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Services de santé mentale › Suicide risk in medically ill inpatients...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Probabilité › Risque › Facteurs de risque › Suicide risk in medically ill inpatients...