Determinants of completed railway suicides by psychiatric in-patients: case-control study.

Lukaschek, Karoline; Baumert, Jens; Krawitz, Marion; Erazo, Natalia; Förstl, Hans; Ladwig, Karl-Heinz

doi:10.1192/bjp.bp.113.139352

2014

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Title:: Determinants of completed railway suicides by psychiatric in-patients: case-control study.
Document type:: Journal Article; Article
Author(s):: Lukaschek, Karoline; Baumert, Jens; Krawitz, Marion; Erazo, Natalia; Förstl, Hans; Ladwig, Karl-Heinz
Abstract:: Suicide prediction during psychiatric in-patient treatment remains an unresolved challenge.To identify determinants of railway suicides in individuals receiving in-patient psychiatric treatment.The study population was drawn from patients admitted to six psychiatric hospitals in Germany during a 10-year period (1997-2006). Data from 101 railway suicide cases were compared with a control group of 101 discharged patients matched for age, gender and diagnosis.Predictors of suicide were change of therapist (OR = 22.86, P = 0.004), suicidal ideation (OR = 7.92, P<0.001), negative or unchanged therapeutic course (OR = 7.73, P<0.001), need of polypharmaceutical treatment (OR = 2.81, P = 0.04) and unemployment (OR = 2.72, P = 0.04). Neither restlessness nor impulsivity predicted in-patient suicide.Suicidal ideation, unfavourable clinical course and the use of multiple psychotropic substances (reflecting the severity of illness) were strong determinants of railway suicides. The most salient finding was the vital impact of a change of therapist. These findings deserve integration into the clinical management of patients with serious mental disease.
Journal title abbreviation:: Br J Psychiatry
Year:: 2014
Journal volume:: 205
Journal issue:: 5
Pages contribution:: 398-406
Language:: eng
Fulltext / DOI:: doi:10.1192/bjp.bp.113.139352
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/25257065
Print-ISSN:: 0007-1250
TUM Institution:: Klinik und Poliklinik für Psychiatrie und Psychotherapie; Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie (Prof. Henningsen)2014

mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Psychiatrie und Psychotherapie (Prof. Priller)2014