Prevalence and factors associated with suicide ideation and psychiatric morbidity among inpatients of a general hospital: A consecutive three-year study

Abstract

Using a self-administered questionnaire (the five-item Brief Symptom Rating Scale, BSRS-5), determine the prevalence of suicide ideation (SI), psychiatric morbidity (PM), and the factors associated with these conditions in a general hospital in Taiwan. All individuals aged 12 years or older, who were admitted to a Medical University Hospital between August 2014 and December 2016, were asked to fill out the BSRS-5 at admission. The study was conducted in a medical inpatient setting, excluding Intensive Care Units and the Emergency Service Department. The 93,129 participants were recruited for analysis. Pearson's correlation, regression analysis and path analysis were performed to test the association between SI and each item of psychopathology and to determine the discrimination validity of individual BSRS-5 items for predicting SI. The prevalence rate was 2.3% for SI and 2.0% for PM among all participants. PM was more prevalent in females and those aged 25-54 years. Individuals with PM had a significantly higher rate of SI (44.6%) than did others (1.4%). The prevalence of PM was varied by department, e.g., Psychiatry (44.3%), Rehabilitation Medicine (7.9%), and Nephrology (5.2%). The regression analysis and path analysis with structural equation model indicated that depression, hostility, anxiety, and inferiority were significant independent predictors of SI. The BSRS-5 is an efficient and useful screening tool to identify psychological distress and SI among inpatients in a general hospital. Its integration into the electronic medical chart facilitates identifying patients at risk.

Keywords: five-item brief symptom rating scale (BSRS-5); general hospital; inpatients; psychological distress; suicide ideation.

FIGURE 1

The path analysis with structural equation model for suicide ideation by sex and BSRS‐5 symptom domains [root mean square error of approximation (RMSEA) = 0.04; goodness of fit index (GFI) = 1.0; and adjusted goodness of fit index (AGFI) = 0.99]

FIGURE 2

ROC curve analysis on cutoff points of BSRS‐5 score to determine suicide ideation (area under curve = 0.968; with 95% CI of 0.964–0.972)