Friday, December 4, 2015

Study Points to Risk Factors That May Predict Suicidal Behavior Within 12 Months of ED Visit


Prior self-injury and alcohol abuse are among the variables identified as predictive of suicidal behavior 12 months after an initial positive screen for suicide risk in the emergency department (ED), according to a report published this week in Psychiatric Services in Advance.

Researchers from several institutions, who presented the findings at a meeting of the American College of Emergency Physicians in Chicago last year, analyzed data from the Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE). The latter was an eight-center study designed to test an approach to universal screening for suicide risk and post-visit telephone intervention among ED patients.

At baseline, 577 out of 874 participants (66%) had suicidal ideation only, whereas 297 (34%) had a suicide attempt in the past week. In the 12 months after the index ED visit, 195 (25%) had documentation of having attempted or died by suicide.

The researchers found that participants were more likely to have suicidal behavior if, at the index ED visit, they reported that their highest level of education was high school completion or less, were unemployed, had a history of chronic health conditions, had a history of depression, had an ED visit within the past six months, or had a high suicidal ideation severity score on the Columbia Suicide Severity Rating Scale. In addition, individuals reporting at least one past suicide attempt, a history of non-suicidal self-injury, or indicating suicidal ideation with intent or intent with a plan were significantly more likely than others to engage in future suicidal behavior.

Greg Simon, M.D. (pictured above), a psychiatrist and senior investigator at the Group Health Research Institute (who is also on the editorial board of Psychiatric Services), told Psychiatric News the new data confirm that people who seek care for suicidal ideation are at high risk for suicide attempt over the next year. “Suicidal ideation reflects an enduring vulnerability—rather than just a short-term crisis,” he said.

For related information, see the Psychiatric News article “Clinicians’ Language in Notes May Show Signs of Patients at Risk for Suicide.”

(Image: Group Health Research Institute)

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