Suicides in close connection with psychiatric care: an analysis of 57 cases in a Swedish county

Among 523 suicides committed in 1977-1984, 10 took place in a psychiatric hospital ward, 17 after the patient had left the ward without permission, 21 while the patient was on leave and nine 0-7 days after discharge. These 57 subjects were compared with 271 suicides committed more than 7 days after discharge or during outpatient care only (PCO). The male:female ratio was 1.0 in the former (PCI) group and 2.0 in the PCO group. The median age of the PCI subjects was 38 years. The suicide method was hanging in all 10 suicides (2 males, 8 females) committed in the psychiatric hospital ward. Depressive syndromes and, particularly schizophrenic and paranoid psychoses were more frequent among the PCI than among the PCO subjects. The extent of psychiatric care, as assessed by the number of admissions, was much greater in the PCI than in the PCO subjects. Environmental factors that might have been of causative importance for the suicidal act were of various kinds and differed to some extent between the two groups. Among the PCI subjects women seemed to have experienced family troubles more often than men, and situations of stressful psychiatric rehabilitation were more common among men.