Risk factors for suicide in psychiatric outpatients: A 20-year prospective study.

TLDR

The study prospectively evaluated 6,891 psychiatric outpatients to identify risk factors for suicide. Deaths were tracked via the National Death Index and modifiable psychological variables were measured with standardized scales. Forty‑nine suicides (1%) were identified; univariate analysis linked depression severity, hopelessness, and ideation to risk, while multivariate analysis highlighted suicide ideation, major depressive disorder, bipolar disorder, and unemployment as independent predictors.

Abstract

To determine the risk factors for suicide, 6,891 psychiatric outpatients were evaluated in a prospective study. Subsequent deaths for the sample were identified through the National Death Index. Forty-nine (1%) suicides were determined from death certificates obtained from state vital statistics offices. Specific psychological variables that could be modified by clinical intervention were measured using standardized scales. Univariate survival analyses revealed that the severity of depression, hopelessness, and suicide ideation were significant risk factors for eventual suicide. A multivariate survival analysis indicated that several modifiable variables were significant and unique risk factors for suicide, including suicide ideation, major depressive disorder, bipolar disorder, and unemployment status.