@article{ref1,
title="Hopelessness is associated with repeated suicidal behaviors after discharge in patients admitted to emergency departments for attempted suicide",
journal="Journal of affective disorders",
year="2020",
author="Tsujii, Noa and Shirakawa, Osamu and Niwa, Atsushi and Yonemoto, Naohiro and Kawanishi, Chiaki and Yamamoto, Kenji and Sugimoto, Tatsuya and Hirayasu, Yoshio",
volume="272",
number="",
pages="170-175",
abstract="BACKGROUND: Hopelessness may be associated with an increased risk of suicide. However, findings regarding the long-term predictive ability of the Beck Hopelessness Scale (BHS) for suicide are inconsistent. This study investigated the long-term predictive ability of BHS scores for subsequent self-harm episodes in individuals admitted to an emergency department after attempting suicide. <br><br>METHODS: The BHS was administered to 805 adult patients with a DSM-IV-TR axis I disorder admitted to an emergency department following a suicide attempt. The patients were followed for at least 18 months and up to 5 years. The incidence of the first subsequent suicidal behavior (attempt or dying by suicide) was examined and the numbers per person-year of overall repeat self-harm episodes, suicide attempt episodes, and non-suicidal self-harm episodes were evaluated. <br><br>RESULTS: The total BHS scores showed significant associations with the overall number of self-harm episodes per person-year (incidence rate ratio [IRR], 1.05; 95% confidence interval [CI], 1.03-1.07; p < 0.0001), the number of suicide attempt episodes per person-year (IRR, 1.05; 95%CI, 1.03-1.08; p < 0.0001), and the number of non-suicidal self-harm episodes per person-year (IRR, 1.05; 95%CI, 1.03-1.07; p < 0.0001). LIMITATIONS: The study excluded children and adolescents. The sample size, while large, was insufficient to ensure generalizability, or to allow subanalyses based on specific disorders. <br><br>CONCLUSIONS: Hopelessness scores assessed in the emergency department after a self-harming episode were associated with a rate of repetition of suicidal behaviors after discharge. Additional strategies to address hopelessness of these patients are warranted.<br><br>Copyright © 2020 Elsevier B.V. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0165-0327",
doi="10.1016/j.jad.2020.04.037",
url="http://dx.doi.org/10.1016/j.jad.2020.04.037"
}