Suicide 30 to 50 Times Higher After ED Visit for Self-Harm, Suicidal Ideation

TUESDAY, Dec. 17, 2019 (HealthDay News) — Emergency department patients presenting with deliberate self-harm or suicidal ideation are at substantially increased risk for suicide in the year following discharge, according to a study published online Dec. 13 in JAMA Network Open.

Sidra Goldman-Mellor, Ph.D., from the University of California in Merced, and colleagues examined the one-year incidence of suicide and other mortality among emergency department patients (2009 through 2011) who presented with nonfatal deliberate self-harm, suicidal ideation, or any other chief concern. Sociodemographic and clinical factors associated with suicide mortality risk were examined.

The researchers identified 648,646 individuals (mean [SD] age, 43.8 years; 54.1 percent women) who visited a California emergency department. In the year after index presentation, the rates of suicide deaths per 100,000 person-years were 693.4 deaths among 83,507 individuals presenting with deliberate self-harm (standardized mortality ratio [SMR], 56.8), 384.5 deaths among 67,379 individuals presenting with suicidal ideation but not self-harm (SMR, 31.4), and 23.4 deaths among 497,760 reference patients (SMR, 1.9). The rates of suicide mortality were higher among men (deliberate self-harm: 1,011.1 deaths per 100,000 person-years; suicidal ideation: 539.8 deaths; reference: 36.6 deaths), people aged 65 years or older (deliberate self-harm: 1,919.5 deaths; suicidal ideation: 691.2 deaths; reference: 28.6 deaths), and non-Hispanic white patients (deliberate self-harm: 914.1 deaths; suicidal ideation: 511.6 deaths; reference: 33.8 deaths) versus their respective referent groups.

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