HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH Psychiatric Bulletin Advances in Psychiatric Treatment All RCPsych Journals		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

Electronic Letters to:

PAPERS: ISABELLE M. HUNT, NAVNEET KAPUR, JO ROBINSON, JENNY SHAW, SANDRA FLYNN, HAYLEY BAILEY, JANET MEEHAN, HARRIET BICKLEY, JAMES BURNS, LOUIS APPLEBY, and REBECCA PARSONS Suicide within 12 months of mental health service contact in different age and diagnostic groups: National clinical survey The British Journal of Psychiatry 2006; 188: 135-142 [Abstract] [Full text] [PDF]

eLetters: Submit a response to this article

Electronic letters published:

Suicide in psychiatric patients... we can only ‘prevent’ what we can ‘predict’

Emad Salib, Lavanya sebastian, Frances Lindon, Mark Theouphanous   (1 February 2007)

Suicide in psychiatric patients... we can only ‘prevent’ what we can ‘predict’ 1 February 2007
Emad Salib, Consultant Psychiatrist Peasley Cross Hospital, 5 Boroughs partnership Trust, St Helens, Lavanya sebastian, Frances Lindon, Mark Theouphanous Send letter to journal: Re: Suicide in psychiatric patients... we can only ‘prevent’ what we can ‘predict’ esalib{at}hotmail.com Emad Salib, et al.	We read with interest the paper by Hunt et al (2006). The paper presented social and clinical characteristics of suicide by mentally ill patients within 12 months of mental health services contact. The paper did not address the question as to whether the mentally ill victims, differed from the total suicide population in their age groups, sex and method of suicide. Therefore, we examined, the April 1996- March 2000 suicide and open verdict data from the Office of National statistics (ONS), totalling 26,787 from which the study sample of 4859 (18 %) was selected to see whether there were any differences. 1. There was an almost identical age distribution in the categories used in the study in the 2 groups, except in the age group of 75 and over, 8.4% in the total suicide population compared to 4% in the mentally ill elderly (P<. 05) 2. Male: female ratio in the study was 2:1 and became 1:1 in older age groups while in the total suicide population the ratio was 3.5:1 and became 1.6:1 in the over 65 groups. The difference was statistically significant (P<. 01). 3. Mentally ill people within the age categories applied in the study used, almost exactly the same methods of suicide (P>.05) with only on interesting exception. Significantly fewer suicide victims, who were mentally ill, used C0 poisoning as a method of fatal self-harm compared to the suicide population in England and Wales during the same period. The use of CO poisoning was four times more likely to be used by other victims compared to the mentally ill group. This is probably due to a much lower probability of owning a car in psychiatric patients. The results clearly show that there are some differences between suicide victims with history of mental illness, who constitute 24% of total suicide in England & Wales (DoH 1999) and the general suicide population in respect of age groups, sex and method of suicide. There is another major difference between the two groups which is the simple fact that all the mentally ill group are expected to have had detailed risk assessment at some stage within 12 months prior to the fatal act compared to the 76% of victims who did not. It is interesting to note that the paper shows that clinical diagnosis did not have any real impact on the choice of method of suicide as can be easily deduced from distribution of methods of suicide age groups and gender. Identifying suicide predictors is the only way to increase the likelihood of future prevention of suicide in psychiatric patients. Detailed descriptive analysis of suicide data is interesting but has limited clinical value, either in prediction or prevention. If we cannot predict, then how can we prevent? References: Hunt I., Kapur N., Robinson J., Shaw J., Flynn S., Bailey H., Meehan J., Bickley H., Parsons R., Burns J, Amos T., Appleby L (2006) Suicide within 12 months of mental health service contact in different age and diagnostic groups British Journal of Psychiatry 188, 135-142 Appleby L., Shaw J., Amos T., et al (1999) Safer Services: Report of the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. London Department of Health Conflict of interest: none Emad Salib Consultant in Old Age psychiatry Lavanya Sebastian SHO in Psychiatry Fracnces Lindon Consultant in Old Age Psychiatry Mark Theouphanous Consultant in Old age Psychiatry Peasley Cross Hospital St Helens, Merseyside