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Suicide following acute admissions for physical illnesses across England and Wales

  • S. E. Roberts (a1) (a2), A. John (a1) (a2), U. Kandalama (a1), J. G. Williams (a1) (a2), R. A. Lyons (a1) (a2) and K. Lloyd (a1) (a2)...

Abstract

Background

The study aim was to establish and quantify suicide risk following acute admissions for all major physical illnesses, for confirmatory purposes, from two independent information sources from different countries.

Methods

Record linkage of inpatient and death certificate data for 11 004 389 acute admissions for physical illnesses in England and 713 496 in Wales. The main outcome measure was standardised mortality ratios (SMRs) for suicide at 1 year following discharge from hospital.

Results

There were 1781 suicides within 1 year of discharge in England (SMR = 1.7; 95% = 1.6–1.8) and 131 in Wales (SMR = 2.0; 1.7–2.3). Of 48 major physical illnesses that were associated with at least eight suicides in either country, there was high consistent suicide mortality (significant SMR >3) in both countries for constipation (SMR = 4.1 in England, 7.5 in Wales), gastritis (4.4 and 4.9) and upper gastrointestinal bleeding (3.4 and 4.5). There was high suicide mortality in one country for alcoholic liver disease, other liver disease and chronic pancreatitis; for epilepsy and Parkinson's disease; for diabetes, hypoglycaemia and hypo-osmolality & hyponatraemia; and for pneumonia, back pain and urinary tract infections.

Conclusions

There is little or no increased suicide mortality following acute admissions for most physical illnesses. Much of the increased suicide mortality relates to gastrointestinal disorders that are often alcohol related or specific chronic conditions, which may be linked to side effects from certain therapeutic medications. Acute hospital admissions for physical illnesses may therefore provide an opportunity for targeted suicide prevention among people with certain conditions, particularly alcohol related disorders.

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Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

*Address for correspondence: S. E. Roberts, Swansea University Medical School, Singleton Park, Swansea University, Swansea SA2 8PP, UK. (Email: stephen.e.roberts:@swansea.ac.uk)

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Suicide following acute admissions for physical illnesses across England and Wales

  • S. E. Roberts (a1) (a2), A. John (a1) (a2), U. Kandalama (a1), J. G. Williams (a1) (a2), R. A. Lyons (a1) (a2) and K. Lloyd (a1) (a2)...

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