Schizophrenia Bulletin Advance Access published online on February 16, 2008
Schizophrenia Bulletin, doi:10.1093/schbul/sbn007
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Are Psychiatrist Characteristics Associated With Postdischarge Suicide of Schizophrenia Patients?
2 Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan
3 Department of Psychiatry, School of Medicine
4 School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
1 To whom correspondence should be addressed; School of Health Care Administration, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan; tel: 886-2-2736-1661 ext. 3613, fax: 886-2-2378-9788, e-mail: henry11111{at}tmu.edu.tw.
Information on the relationship between characteristics of mental healthcare providers, including hospitals and psychiatrists, and postdischarge suicide is scanty. This study aims to identify the risk factors for suicide among schizophrenia patients in the 3-month postdischarge period. The study cohort comprised all patients with a principal diagnosis of schizophrenia discharged from psychiatric inpatient care from 2002 to 2004 who committed suicide within 90 days of discharge. The control cohort consisted of all surviving schizophrenia patients discharged from psychiatric inpatient care in the same period and were matched to cases for age, gender, and date of discharge. There were 87 and 348 cases in the study and control cohorts, respectively. For suicide cases, death most frequently occurred on the first day after leaving the hospital (16.1%). The adjusted hazard ratios for committing suicide during the 90-day postdischarge period were 2.639 times greater for patients without previous psychiatric admission than for those hospitalized more than 3 times in the year preceding the index hospitalization. The adjusted suicide hazard for schizophrenia patients treated by male psychiatrists was significantly higher than for patients treated by female psychiatrists, by a multiple of 5.117 (P = .032). The adjusted suicide hazard among patients treated by psychiatrists over age 44 years was 2.378 times (P = .043) that for patients treated by psychiatrists aged younger than 35 years. Risk factors related to psychiatric hospitalization, including number of psychiatric admissions in the previous year and length of stay, together with gender and age of the psychiatrist providing inpatient care, are identified.
Keywords: suicide / schizophrenia / postdischarge