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Sammanfattning

Preventing suicide is a prioritized focus in mental health care in Norway, and patient safety campaigns have especially directed attention to acute psychiatric wards. Treatment and intervention to prevent suicide is a core acute psychiatric task, and a high proportion of hospitalizations in acute psychiatric wards involve managing suicide-associated issues. Suicide rate associated with acute psychiatric hospitalization has been estimated to 0.1–0.4 %. The major aim of the present study is to analyze all suicides and severe suicide attempts with clear suicide intent in the period 2005-2014 at the acute psychiatric ward at Oslo University Hospital. Clinical information from the final week before suicide or attempt was extracted from the patient administrative system. Displayed symptoms were categorized with DSM-5 anxiety specifier for major depression. There were 9170 hospitalizations in the period and 16 severe suicide attempts and 19 registered suicides. This gives a suicide rate of 0.2 %. The majority of suicides took place on leave from the department or within 30 days of discharge. A large majority of the patients (85 %) had reported suicidal thoughts at hospitalization and affective disorders were the major psychiatric condition. Half of the patients displayed symptoms compatible with severe anxiety or an agitated condition. Although individual prediction is difficult, we conclude that the combination of suicidal thoughts, agitation, depressive symptoms and hopelessness should lead to great caution in high-risk situations such as leave from department or discharge.

MeSH