Self-destructive acts occurring during medical general hospitalization

Although several articles about suicide in general hospitals have been publ ished, the rates of self-destructive individuals among various diseases and departments have not been reported previously. Moreover, self-destructive acts in Chinese general hospital inpatients have been neglected. We retrosp ectively investigated self-destructive incidents among medical general inpa tients. A total of 75 self-destructive incidents, including 15 fatalities, were identified during the 10-year study period. The self-destructive rate was 8.7 per 100,000, and the fatality rate was 1.8 per 100,000 admissions. The highest self-destructive rate occurred in patients admitted to the reha bilitation weird (33.4 per 100,000) followed by the neurology ward (29.9 pe r 100,000). The highest fatality rate occurred among patients in the neurol ogy ward (6.7 per 100,000). The majority of self-destructive patients suffe red from a chronic or terminal illness with the most frequent types of illn esses being malignant neoplasm (31.1%), neurological disease (20.3%), and c hronic obstructive pulmonary disease (COPD, 10.8%). COPD patients had the h ighest rate of self-destructive behavior (64.0 per 100,000) and the highest fatality rate (16.0 per 100,000) due to these incidents. The most common s elf-destructive incident was knife-cutting More than one-half (53.4%) of th e self-destructive incidents occurred within the first 2 weeks of admission , and nearly one-half (46.7%) occurred during the night shift. Moreover, th e majority of severe or fatal incidents also occurred during the night shif t. The results suggest that close supervision of high-risk patients should be mandatory within the first 2 weeks following admission, especially durin g the night shift. (C) 2000 Elsevier Science Inc.