The Wessex Recent In-Patient Suicide Study, 2. Case-control study of 59 in-patient suicides

Psychiatric patients have an elevated risk of suicide while in hospital.

To compare social, clinical and health-care delivery factors in in-patient and out-patient suicides and their controls.

Retrospective case-control study of 59 in-patients and 106 controls, matched for age, gender, diagnosis and admission date. Odds ratios were calculated using conditional multiple logistic regression.

There were seven independent increased-risk factors: history of deliberate self-harm, admission under the Mental Health Act, involvement of the police in admission, depressive symptoms, violence towards property, going absent without leave and a significant care professional being on leave. When compared with out-patient suicides, in-patients were more often female and male in-patients had a psychotic illness. Unlike the out-patient suicides, social factors were not found to be significant.

The characteristics of in-patient and out-patient suicides differ. Identified risk factors have relatively low sensitivity and specificity.