Effect of pre-existing psychiatric treatment in suicidal jumpers on the need for in-hospital treatment following injury

Abstract

Purpose: To study the effect of pre-existing psychiatric disorders on outcome following suicidal jump from a height.

Methods: Suicidal jumpers were identified from Helsinki Trauma Registry from 2006 to 2015. Trauma registry data were combined with administrative registry data to obtain long-term mortality and in-hospital treatment. The in-hospital treatment data was from 2 years preceding the index injury and up to 5 years post injury. Reasons for the in-hospital visits were also recorded. We analyzed the patients in two groups, namely patients without a pre-existing psychiatric diagnosis (group 1) and patients with a pre-existing psychiatric diagnosis (group 2).

Results: One-hundred twenty-seven patients were included in the analysis, with 73 patients having received pre-existing psychiatric treatment. A total of 57% of patients were males and 28% of patients suffered severe traumatic brain injury (head AIS ≥ 3). Group 2 patients had a higher number of in-hospital days pre- and post-injury than group 1 patients. Reason for in-hospital treatment in group 2 was psychiatric in over 80% of days except in the year beginning from the index injury. 30-day mortality was similar between the groups 1 and 2 (11% vs. 16%, p = 0.395). Five-year survival was 72% in group 2 patients to 86% in group 1 patients (p = 0.0001).

Conclusion: Patients with pre-existing psychiatric disorder reaching hospital alive have higher pre- and post-injury requirements for in-hospital treatment than patients without a pre-existing psychiatric disorder. Although pre-existing psychiatric disorder does not affect early mortality, long-term mortality is increased by 14%.

Trial registration: Trial registration number and date of registration: HUS/221/2017, 30.3.2017.

Keywords: Long-term; Mortality; Outcome; Trauma.

Fig. 1

Distribution of in-hospital days due to any diagnosis G1, group 1; G2, group 2; -0, no in-hospital days during the year; -1-30, 1 to 30 in-hospital days during the year; -30+, > 30 in-hospital days during the year

Fig. 2

Distribution of in-hospital days due to psychiatric reasons (F-diagnose) G1, group 1; G2, group 2; -0, no in-hospital days during the year; -1-30, 1 to 30 in-hospital days during the year; -30+, > 30 in-hospital days during the year

Fig. 3

Kaplan-Meier survival analysis No preinjury F dg, group 1; A preinjury F dg, group 2; Control 1, controls for group 1; Control 2, controls for group 2