SUICIDE ATTEMPTS AND SUICIDAL IDEATION IN HEALTH ... · * Integrated Care Program for Sick...
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SUICIDE ATTEMPTS AND SUICIDAL IDEATION IN HEALTH CAREGIVERS: DATA FROM THE BARCELONA INTEGRATED CARE PROGRAM FOR PHYSICIANS AND NURSES Braquehais MD, M.D., Ph.D.*/**, Bel M, M.D.*/**, Marcos V*, Lusilla P, M.D., Ph.D.**. * Integrated Care Program for Sick Physicians and Nurses. Galatea Foundation, Barcelona, Spain. ** Department of Psychiatry. Vall d’Hebron University Hospital, Autonomous University, Barcelona, Spain. Suicide rates are increased among physicians and nurses but few data are available about suicide attempts and suicidal ideation in both groups. We analyzed data from 492 health care professionals admitted to the Inpatient Unit of the Barcelona Integrated Care Program for Sick Physicians and Nurses. Suicidal behavior was associated with younger age, female gender, alcohol dependence, major depression and suicidal attempts. Small differences were found when considering suicidal ideation and current and past suicidal attempts as separate conditions. These findings should be considered when designing specific prevention programs. Abstract 386 inpatients were physicians and 81 nurses. 25 (5.1%) were admitted after a suicide attempt, and 19 (3.8%) were admitted because of their suicidal ideation. 46 inpatients (9.3%) had lifetime suicidal behavior. Suicide attempt before admission, lifetime suicide, and suicidal ideation were associated with: younger age, female gender, alcohol dependence, major depression, previous suicide attempt, higher scores in the BDI, and longer stay in the hospital. Suicidal ideation was also associated with dysthimia, obsessive compulsive disorder and family history of psychiatric disorders. Patients with previous suicide attempts showed higher scores in the STAI-T than those without lifetime suicide and had more cluster B disorders. No significant differences in suicidal behavior were found between physicians and nurses. Findings/ Results Suicidal ideation and suicide attempts are more frequent among health caregivers suffering from alcohol dependence and major depression. Women are also at high risk. New strategies should be developed in the future to decrease the significant morbidity and potential mortality associated with suicidal behavior in this group of patients. Conclusions 1. Simon W: Suicide among physicians: prevention and postvention. Crisis 1986; 7:1–13. 2. Schernhammer ES, Colditz GA. Suicide rates among physicians: A Quantitative and Gender Assessment (Meta-Analysis). Am J Psychiatry 2004; 161; 2295-2302. References 1. To describe and analyze variables associated with suicidal ideation and suicide attempts in a sample of physicians and nurses treated in the Inpatient Unit of the Barcelona Integrated Care Program for Physicians and Nurses. 2. To identify potential risk factors for suicidal behavior in order to improve not only primary but also secondary and tertiary preventive interventions. 3. To underscore the importance of developing new preventive strategies in the future to decrease the significant morbidity and potential mortality associated with suicidal behavior in this group of patients. Goals/ Learning objectives 492 inpatient admissions were consecutively evaluated from November 1997 to December 2007. All patients were diagnosed according to the DSM-IV criteria. Data about suicidal behavior were obtained during the clinical interview. The Beck Depression Inventory (BDI) and the State and Trait Anxiety Inventory (STAI-S and STAI-T) were also administered. Parametric (t-test, ANOVA) and no-parametric (Χ 2 ) tests were used to analyze the data. Material and methods Current suicide attempt/ Age/ Length admission/ BDI/ STAI-T/STAI-R. Current suicide attempt N Mean Standard deviation Statistics Days admission Yes 25 40,68 34,900 t=2,19; gl=490; p=0,034 No 467 30,73 21,963 Age at admisión Yes 25 40,32 9,348 t= -3,034;gl=490; p=0,003 No 467 45,57 8,383 BDI at admisión Yes 17 22,76 11,835 t= 2,724; gl =331; p=0,007 No 316 15,18 11,148 STAI-T at admission Yes 18 78,50 24,069 t=1,379; gl =333; p=0,169 No 317 68,79 29,313 STAI-S at admission Yes 18 60,94 28,845 t=0,958; gl =333; p=0,339 No 317 54,26 28,802 Number of admission Yes 25 1,80 1,291 t= 1,238; gl =489; p=0,216 No 466 1,50 1,157 CURRENT SUICIDE ATTEMPT Variable Χ 2 gl p Gender 6,549 1 0,007 Previous suicide 43,779 1 0,000 Alcohol dependence 11,890 1 0,000 Major Depression 8,692 1 0,008 CURRENT SUICIDAL IDEATION Alcohol dependence 14,750 3 0,002 Major Depression 28,159 1 0,000 Dysthimia 28,759 1 0,000 OCD 32.139 1 0,004 Family History Psych. 16,213 1 0,001 LIFETIME SUICIDAL BEHAVIOR Gender 13,576 1 0,000 Alcohol dependence 15,941 3 0,001 Major Depression 10,747 1 0,002 Cluster B 7,472 1 0,015 Clinical and sociodemographic variables associated with suicidal behavior Nurses Physician Current suicide attempt Yes No Past suicidal behavior Yes No Current suicidal ideation Yes No Health Care Professionals Distribution
Transcript of SUICIDE ATTEMPTS AND SUICIDAL IDEATION IN HEALTH ... · * Integrated Care Program for Sick...
SUICIDE ATTEMPTS AND SUICIDAL IDEATION IN HEALTH CAREGIVERS: DATA FROM THE �BARCELONA INTEGRATED CARE PROGRAM FOR PHYSICIANS AND NURSES
Braquehais MD, M.D., Ph.D.*/**, Bel M, M.D.*/**, Marcos V*, Lusilla P, M.D., Ph.D.**. * Integrated Care Program for Sick Physicians and Nurses. Galatea Foundation, Barcelona, Spain. �** Department of Psychiatry. Vall d’Hebron University Hospital, Autonomous University, Barcelona, Spain.
Suicide rates are increased among physicians and nurses but few data are available about suicide attempts and suicidal ideation
in both groups. We analyzed data from 492 health care professionals admitted to the Inpatient Unit of the Barcelona Integrated
Care Program for Sick Physicians and Nurses. Suicidal behavior was associated with younger age, female gender, alcohol
dependence, major depression and suicidal attempts. Small differences were found when considering suicidal ideation and
current and past suicidal attempts as separate conditions. These findings should be considered when designing specific
prevention programs.
Abstract
386 inpatients were physicians and 81 nurses. 25 (5.1%) were admitted after a suicide attempt, and 19 (3.8%) were
admitted because of their suicidal ideation. 46 inpatients (9.3%) had lifetime suicidal behavior. Suicide attempt before
admission, lifetime suicide, and suicidal ideation were associated with: younger age, female gender, alcohol dependence,
major depression, previous suicide attempt, higher scores in the BDI, and longer stay in the hospital. Suicidal ideation was
also associated with dysthimia, obsessive compulsive disorder and family history of psychiatric disorders. Patients with
previous suicide attempts showed higher scores in the STAI-T than those without lifetime suicide and had more cluster B
disorders. No significant differences in suicidal behavior were found between physicians and nurses.
Findings/ Results
Suicidal ideation and suicide attempts are more frequent among health caregivers suffering from alcohol dependence and
major depression. Women are also at high risk. New strategies should be developed in the future to decrease the significant
morbidity and potential mortality associated with suicidal behavior in this group of patients.
Conclusions
1. Simon W: Suicide among physicians: prevention and postvention. Crisis 1986; 7:1–13.
2. Schernhammer ES, Colditz GA. Suicide rates among physicians: A Quantitative and Gender Assessment (Meta-Analysis).
Am J Psychiatry 2004; 161; 2295-2302.
References
1. To describe and analyze variables associated with suicidal ideation and suicide attempts in a sample of physicians
and nurses treated in the Inpatient Unit of the Barcelona Integrated Care Program for Physicians and Nurses.
2. To identify potential risk factors for suicidal behavior in order to improve not only primary but also secondary
and tertiary preventive interventions.
3. To underscore the importance of developing new preventive strategies in the future to decrease the significant morbidity
and potential mortality associated with suicidal behavior in this group of patients.
Goals/ Learning objectives
492 inpatient admissions were consecutively evaluated from November 1997 to December 2007. All patients were
diagnosed according to the DSM-IV criteria. Data about suicidal behavior were obtained during the clinical interview.
The Beck Depression Inventory (BDI) and the State and Trait Anxiety Inventory (STAI-S and STAI-T) were also
administered. Parametric (t-test, ANOVA) and no-parametric (Χ2) tests were used to analyze the data.
Material and methods
Current suicide attempt/ Age/ Length admission/ BDI/ STAI-T/STAI-R.
Currentsuicide attempt N Mean
Standard deviation Statistics
Daysadmission
Yes 25 40,68 34,900 t=2,19; gl=490; p=0,034No 467 30,73 21,963
Age at admisión
Yes 25 40,32 9,348 t=-3,034;gl=490; p=0,003No 467 45,57 8,383
BDI at admisión
Yes 17 22,76 11,835 t= 2,724; gl=331; p=0,007No 316 15,18 11,148
STAI-T at admission
Yes 18 78,50 24,069 t=1,379; gl=333; p=0,169No 317 68,79 29,313
STAI-S atadmission
Yes 18 60,94 28,845 t=0,958; gl=333; p=0,339No 317 54,26 28,802
Number ofadmission
Yes 25 1,80 1,291 t= 1,238; gl=489; p=0,216No 466 1,50 1,157
CURRENT SUICIDE ATTEMPTVariable Χ2 gl p
Gender 6,549 1 0,007Previous suicide 43,779 1 0,000
Alcohol dependence 11,890 1 0,000Major Depression 8,692 1 0,008
CURRENT SUICIDAL IDEATIONAlcohol dependence 14,750 3 0,002Major Depression 28,159 1 0,000
Dysthimia 28,759 1 0,000OCD 32.139 1 0,004
Family History Psych. 16,213 1 0,001
LIFETIME SUICIDAL BEHAVIORGender 13,576 1 0,000
Alcohol dependence 15,941 3 0,001
Major Depression 10,747 1 0,002Cluster B 7,472 1 0,015
Clinical and sociodemographic variables associated with suicidal behavior
Nurses
Physician
Current suicide attempt
Yes
No
Past suicidal behavior
Yes
No
Current suicidal ideation
Yes
No
Health Care Professionals Distribution
