@article{ref1,
title="Long-term risk factors for suicide in suicide attempters examined at a medical emergency in patient unit: results from a 32-year follow-up study",
journal="BMJ open",
year="2020",
author="Probert-Lindström, Sara and Berge, Jonas and Westrin, Åsa and Ojehagen, Agneta and Skogman Pavulans, Katarina",
volume="10",
number="10",
pages="e038794-e038794",
abstract="OBJECTIVES: The overall aim of this study is to gain greater knowledge about the risk of suicide among suicide attempters in a very long-term perspective. Specifically, to investigate possible differences in clinical risk factors at short (≤5 years) versus long term (>5 years), with the hypothesis that risk factors differ in the shorter and longer perspective.  DESIGN: Prospective study with register-based follow-up for 21-32 years.   SETTING: Medical emergency inpatient unit in the south of Sweden.   PARTICIPANTS: 1044 individuals assessed by psychiatric consultation when admitted to medical inpatient care for attempted suicide during 1987-1998.   OUTCOME MEASURES: Suicide and all-cause mortality.   RESULTS: At follow-up, 37.6% of the participants had died, 7.2% by suicide and 53% of these within 5 years of the suicide attempt. A diagnosis of psychosis at baseline represented the risk factor with the highest HR at long-term follow-up, that is, >5 years, followed by major depression and a history of attempted suicide before the index attempt. The severity of a suicide attempt as measured by SIS (Suicide Intent Scale) showed a non-proportional association with the hazard for suicide over time and was a relevant risk factor for suicide only within the first 5 years after an attempted suicide.   CONCLUSIONS: The risk of suicide after a suicide attempt persists for up to 32 years after the index attempt. A baseline diagnosis of psychosis or major depression or earlier suicide attempts continued to be relevant risk factors in the very long term. The SIS score is a better predictor of suicide risk at short term, that is, within 5 years than at long term. This should be considered in the assessment of suicide risk and the implementation of care for these individuals.<p /> <p>Language: en</p>",
language="en",
issn="2044-6055",
doi="10.1136/bmjopen-2020-038794",
url="http://dx.doi.org/10.1136/bmjopen-2020-038794"
}