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Shorter and longer-term risk for non-fatal suicide attempts among male U.S. military veterans after discharge from psychiatric hospitalization
Journal of Psychiatric Research ( IF 4.8 ) Pub Date : 2021-08-19 , DOI: 10.1016/j.jpsychires.2021.08.027
Peter C Britton 1 , Dev Crasta 1 , Kipling M Bohnert 2 , Cathleen Kane 3 , John Klein 3 , Wilfred R Pigeon 1
Affiliation  

Although there are key differences in shorter-term (days 1–90) and longer-term (days 91–365) risk factors for suicide after discharge from inpatient psychiatry, there are no comparable data on non-fatal suicide attempts. Risk factors for non-fatal attempts in the first 90 days after discharge were compared with those over the remainder of the year to identify temporal changes in risk. Records were extracted from 208,554 male veterans discharged from Veterans Health Administration acute psychiatric inpatient units from 2008 through 2013. Proportional hazard regression models identified correlates of non-fatal attempts for 1–90 days and 91–365 days; adjusted piecewise proportional hazards regression compared risk between these time frames. 5010 (2.4%) veterans made a non-fatal attempt, 1261 (0.60%) on days 1–90 and 3749 (1.78%) on days 91–365. Risk across both time frames was highest among younger veterans ages 18–59, and those hospitalized with a suicide attempt or suicidal ideation. It was lowest among those with a dementia diagnosis. Risk estimates were generally stable over time but increased among those with substance use disorders and decreased among those with sleep disturbance and discharged against medical advice. Estimates of some risk factors for non-fatal attempts change over time in the year after discharge and differ from those that change for suicide. Different preventive approaches may be needed to reduce shorter and longer-term risk for non-fatal attempts and suicide in the year after discharge.



中文翻译:

美国男性退伍军人精神病院出院后发生非致命性自杀企图的短期和长期风险

尽管住院精神病院出院后自杀的短期(第 1-90 天)和长期(第 91-365 天)风险因素存在重大差异,但没有关于非致命性自杀企图的可比数据。将出院后前 90 天内非致命尝试的风险因素与当年剩余时间的风险因素进行比较,以确定风险的时间变化。记录提取自 2008 年至 2013 年退伍军人健康管理局急性精神病住院病房出院的 208,554 名男性退伍军人。比例风险回归模型确定了 1-90 天和 91-365 天非致命尝试的相关性;调整后的分段比例风险回归比较了这些时间范围之间的风险。5010 (2.4%) 名退伍军人进行了非致命尝试,1261 (0.60%) 在第 1-90 天和 3749 (1.78%) 在第 91-365 天。在这两个时间范围内,18-59 岁的年轻退伍军人以及因自杀未遂或自杀意念住院的退伍军人的风险最高。在痴呆症诊断患者中,这一比例最低。随着时间的推移,风险估计值总体上是稳定的,但在物质使用障碍患者中增加,在睡眠障碍患者中降低,并且不遵守医疗建议出院。在出院后的一年中,对非致命尝试的一些风险因素的估计会随着时间的推移而变化,并且与自杀的变化不同。可能需要不同的预防方法来降低出院后一年内非致命性企图和自杀的短期和长期风险。在痴呆症诊断患者中,这一比例最低。随着时间的推移,风险估计值总体上是稳定的,但在物质使用障碍患者中增加,在睡眠障碍患者中降低,并且不遵守医疗建议出院。在出院后的一年中,对非致命尝试的一些风险因素的估计会随着时间的推移而变化,并且与自杀的变化不同。可能需要不同的预防方法来降低出院后一年内非致命性企图和自杀的短期和长期风险。在痴呆症诊断患者中,这一比例最低。随着时间的推移,风险估计值总体上是稳定的,但在物质使用障碍患者中增加,在睡眠障碍患者中降低,并且不遵守医疗建议出院。在出院后的一年中,对非致命尝试的一些风险因素的估计会随着时间的推移而变化,并且与自杀的变化不同。可能需要不同的预防方法来降低出院后一年内非致命性企图和自杀的短期和长期风险。在出院后的一年中,对非致命尝试的一些风险因素的估计会随着时间的推移而变化,并且与自杀的变化不同。可能需要不同的预防方法来降低出院后一年内非致命性企图和自杀的短期和长期风险。在出院后的一年中,对非致命尝试的一些风险因素的估计会随着时间的推移而变化,并且与自杀的变化不同。可能需要不同的预防方法来降低出院后一年内非致命性企图和自杀的短期和长期风险。

更新日期:2021-08-23
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