Abstract

Objective

Inpatient suicides are rare incidents; however, the impacts of such events on associated families and hospital staff are severe. Therefore, preventive strategies need to focus on risk factors. Clinical management in a hospital setting must integrate the home environment and social life of patients. Nevertheless, home leaves require careful preparation.

Methods

Suicides were reported systematically from all psychiatric departments of the Landschaftsverband Rheinland (an assembly of municipalities) using a structured form during two periods (1995–2004, 2005–2014). From these reports we extracted data on suicide methods and sociodemographic and clinical variables. Only patients 65 years and older were included.

Results

From a total of 551 reports on suicides in the period of 1995–2014, 103 patients 65 years and older (60 women, 43 men) died by suicide. In contrast to the general trend in Germany during this period, no decline in overall suicide rates was found. Most patients were treated because of depression (73.8%); schizophrenic psychosis was diagnosed in 11.7%; and dementia was only diagnosed in 1.9%. The most frequent suicide method was hanging (40%). All suicides within the hospital were hangings. The majority of suicides occurred outside the hospital during approved home leaves. Only 7% of suicides occurred when patients left the hospital without permission. Almost half of the patients (n = 44) died by suicide during the first month of treatment. With longer duration of hospitalization, the risk of suicide decreased. There were no significant trends with regard to suicide methods between the two periods.

Conclusions

In the first weeks of hospitalizations the patients are most endangered to die by suicide. Therefore, home leaves need careful consideration.

中文翻译：

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晚年住院自杀：对拥有九家精神病诊所的医院集团的回顾性分析

摘要

客观的

住院自杀是罕见的事件；然而，此类事件对相关家庭和医院工作人员的影响是严重的。因此，预防策略需要关注风险因素。医院环境中的临床管理必须将患者的家庭环境和社会生活结合起来。然而，回家需要仔细准备。

方法

在两个时期（1995-2004 年，2005-2014 年），Landschaftsverband Rheinland（市议会）的所有精神病科都使用结构化的形式系统地报告了自杀事件。从这些报告中，我们提取了有关自杀方法以及社会人口学和临床变量的数据。仅包括 65 岁及以上的患者。

结果

在 1995 年至 2014 年期间共有 551 份自杀报告中，103 名 65 岁及以上的患者（60 名女性，43 名男性）死于自杀。与这一时期德国的总体趋势相反，总体自杀率没有下降。大多数患者因抑郁症接受治疗（73.8%）；精神分裂症精神病被诊断为 11.7%；痴呆症的诊断率仅为 1.9%。最常见的自杀方法是上吊（40%）。医院内的所有自杀者都是绞刑。大多数自杀事件发生在获准休假期间在医院外。只有 7% 的自杀发生在患者未经许可离开医院时。几乎一半的患者（n = 44) 在治疗的第一个月死于自杀。随着住院时间的延长，自杀风险降低。两个时期之间的自杀方法没有显着趋势。

结论

在住院的最初几周，患者最有可能死于自杀。因此，回家的叶子需要仔细考虑。