RISK-FACTORS FOR SUICIDES OF INPATIENTS WITH DEPRESSIVE PSYCHOSES

Research on identifying the relevant risk factors for suicides is face d with a multitude of methodological problems. The present study attem pts to improve on some of these problems and to isolate those risk fac tors that are accessible in the early stages of the treatment of inpat ients. A total of 3792 inpatients with monopolar or bipolar depression were treated during the period 1981-1992. Suicides (n = 33) and contr ols (n = 3759) were compared with respect to 77 sociodemographic and a namnestic variables and 195 standardised items of the admission summar y. In addition to an analysis of contingency tables a discriminant ana lysis was performed. The suicide rate of patients with depressive psyc hosis was 2.7 times higher than the average rate of 0.324% for the ent ire clinic. Suicidal tendencies on admission proved to be the best pre dictor with a frequency of 91% in the suicide group and 40% in the con trol group, previous attempted suicide being the second best predictor . We conclude that the rate of inpatient suicide may have been underes timated for methodological reasons in the past decades. Many of the ri sk factors discussed in the literature may be of little predictive val ue at least in the initial stages of hospital treatment.