Long-term risk factors for suicide mortality after attempted suicide--findings of a 14-year follow-up study

To determine the risk of suicide over a 14-year follow-up period, and to investigate the long-term risk factors for suicide using survival analysis.

Data were collected on all unselected deliberate self-poisoning patients (n=1018) treated during 1983 in the emergency unit of Helsinki University Central Hospital.

By the end of the 14 -year follow-up period 222 (21.7%) of these patients had died. Sixty-eight (6.7%) had committed suicide; 44 (9.2%) men and 24 (4.5%) women. The long-term risk factors for suicide were male sex, previous psychiatric treatment, previous suicide attempts, somatic disease and a self-reported 'wish to die' motive for the index suicide attempt.

The essential risk factors for suicide were being male and having previous suicide attempts. In addition, history of earlier psychiatric treatment, presence of somatic disease and genuine intent to die in the index suicide attempt suggest that the long-term risk has remained high for over a decade. The findings emphasize the need for long-term planning and treatment of suicide attempters met in the emergency room of general hospitals.