Suicides in psychiatric in-patient treatment

Objective: The aim of this study was to evaluate characteristics and predictors for in-patient suicides. Method: All in-patient suicides registered by the psychiatric basic documentation for the period 1989-1999 were described and analysed by the means of chi (2_) tests and multivariate logistic regression. Results: A total of 30 in-patient suicides were found among 39372 cases, corresponding to a mean annual suicide rate of 76 per 100 000 admissions. All suicides were committed using violent methods and took place outside the hospital in more than 75% of the cases. Nearly 85% of the patients were on leave or an outing. According to the logistic regression the risk of hospital suicides is significantly increased for patients with schizophrenia, a higher cumulative length of stay and a previous suicide attempt, but not suicidality or suicide attempt before index admission. Conclusion: Schizophrenic patients represent the high risk group for suicide in psychiatric hospital. An especially focussed prevention on this group could reduce in-patient suicide rates.