Citation

McClay MM, O'Connor SS, Groh BN, Baudino M, Venanzi L, Shields A, Wilson JE, Bone J, Nicolson SE. Psychiatr. Serv. 2018; 69(6): 657-663.

Affiliation

Mr. McClay and Ms. Groh are with the Department of Psychological Sciences, Western Kentucky University, Bowling Green. Dr. O'Connor is with the Department of Psychiatry and Behavioral Sciences, University of Louisville, Louisville. Ms. Baudino, Ms. Venanzi, Dr. Shields, Dr. Wilson, and Mr. Bone are with the Department of Psychiatry, Vanderbilt University, Nashville, Tennessee. Dr. Nicolson is with Beth Israel Deaconess Hospital, Plymouth, Massachusetts.

Copyright

(Copyright © 2018, American Psychiatric Association)

DOI

10.1176/appi.ps.201700130

PMID

29540114

Abstract

OBJECTIVE: Evidence suggests that suicide attempts by self-inflicted gunshot wound (GSW) are underreported and may in turn affect disposition following hospitalization. This study aimed to evaluate the clinical characteristics and use of services among individuals who do not disclose suicidal intent following a self-inflicted GSW.

METHODS: Electronic medical record data from 128 survivors of self-inflicted GSWs at a level 1 trauma center were analyzed to identify factors associated with nondisclosure of a suicide attempt to medical staff.

RESULTS: Results indicated that 29% of patients denied that a self-inflicted GSW was a suicide attempt, and 43% of patients who denied suicidal intent were identified by the psychiatric consultation and liaison service as presenting under circumstances suspicious of a suicide attempt. Logistic regression analyses indicated that patients who denied having attempted suicide were 10.86 times more likely to be discharged to home than patients who disclosed suicidal intent. In a multiple regression model, no clinical or demographic characteristics were significantly associated with nondisclosure of suicide intent.

CONCLUSIONS: Patients' nondisclosure of suicidal intent following a self-inflicted GSW may present a barrier to care for patients whose injuries are the result of a suicide attempt. Implications for reducing barriers to care for a high-risk population are discussed, including the impact of nondisclosure on future treatment and the potential utility of brief interventions for suicide risk reduction.

Language: en

Keywords

Self-mutilation & self-destructive behavior; self-destructive behavior, Suicide &