• Trine Madsen, Esben Agerbo, Preben B Mortensen, and Merete Nordentoft.
• Psychiatric Center Copenhagen, Copenhagen University Hospital, Bispebjerg Bakke 23, Building 13A, 2400, Copenhagen, Denmark. trine.madsen@regionh.dk
• Soc Psychiatry Psychiatr Epidemiol. 2013 Sep 1; 48 (9): 1481-9.

PurposePsychiatric illness and deliberate self-harm (DSH) are major risk factors of suicide. In largely 15% of psychiatric admissions in Denmark, the patient had an episode of DSH within the last year before admission. This study examined the survival and predictors of suicide in a suicidal high-risk cohort consisting of hospitalized psychiatric patients with recent DSH.MethodsThis national prospective register-based study examined all hospitalized psychiatric patients who self-harmed within a year before admission. All admitted patients, in the time period 1998-2006, were followed and survival analyses techniques were used to identify predictors of suicide.ResultsThe study population consisted of 17,257 patients; 520 (3%) died by suicide during follow-up; 50% of the suicides occurred within a year from the index admission. A rate of 1,645 suicides per 100,000 person-years in the first year after psychiatric admission was found. Adjusted analyses showed that a higher degree of education, having DSH within a month before psychiatric admission and contact with a private psychiatrist increased the risk of suicide.ConclusionsPsychiatric hospitalized patients with recent DSH revealed high suicide rates, even during hospitalization. When discharging psychiatric patients with recent DSH careful arrangement of follow-up treatment in the outpatient setting is recommendable.

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