Survey Of Suicidal Ideation Among Suicide Attempters At Critical Emergency Units Of Four Tertiary General Hospitals In Shenyang

Suicide and suicide attempters are important public health issues.The suicide rate in China is 23 per 100 000 and there is a total of 287 000 suicide deaths per year. Suicide was the fifth most important cause of death.In addition,an estimated 2 million suicide attempts occur each year.Moreover,it is reported that there would had 10%-14%of suicide attempters died from suicide finally.Suicidal ideation is an important risk factor for suicide attempts and suicide completion.The purpose of this study was to explore the prevalence and risk factors for suicidal ideation among suicide attempters at critical emergency units of 4 tertiary general hospitals in Shenyang. Furthermore,this research could provide some information for preventing suicidal behaviors among suicide attempters occur again.Methods239 consecutive cases of attempted suicide who were admitted to emergency department of 4 tertiary general hospitals in Shenyang were interviewed by trained psychiatric and psychological graduate students,focusing on psychological assessment (The Assessment Tables of Base Line)to check up suicidal ideation and DSM-Ⅳ(Structured Clinical Interview for DSM-Ⅳ-TR Axis I Disorders-Patient Edition (SCID-I/P))diagnosis to find whether with psychiatric disorders or not.Moreover, they were divided into two groups according to with or without suicidal ideation,and the two groups were compared.The study analyzed the risk factors for suicidal ideation by multivariate logistic analysis and the prevalence of psychiatric disorders of the two groups was compared.We also compare psychiatric disorders with non-psychiatric disorders among suicide attempters with suicidal ideation and then analyzed their difference in suicide intension.The 4 hospitals selected from all tertiary general hospitals located at different area in Shenyang by random sampling.ResultsThe lifetime prevalence of suicidal ideation among suicide attempters at critical emergency units of 4 tertiary general hospitals in Shenyang was 69.46%(95%CI:60. 25%～79.25%).Multivariate logistic analysis found that the most important risk factors for suicidal ideation were having suicidal thoughts or deliberate self-harm behaviors in the prior year(OR=8.84),having hopelessness in the prior week(OR= 2.88),having current psychiatric disorders(OR=2.78),the time they had considered suicide before acting was 2 hours and more(OR=2.53),the main aim of the self-harm was releasing themselves from their suffering(OR=2.29).Among these suicide attempters with suicidal ideation,one with psychiatric disorders had higher suicide intension than those without.The total prevalence of psychiatric disorders with suicidal ideation among survivors are significantly higher than those without(84.34%比35.62%,X~2=56.73,p＜0.0001).ConclusionThe prevalence of suicidal ideation among suicide attempters at critical emergency units of 4 tertiary general hospitals in Shenyang are higher than expected.Major depression and anxiety disorders among suicide attempters with suicidal ideation are all higher than those without,which could intensify their suicide intension and would be risk factors for suicidal behaviors occurring again.Effective measures should be taken duly to prevent these situations.