No Cathartic Effect in Suicide Attempters Admitted to the... : Journal of Psychiatric Practice® (original) (raw)

ARTICLES

No Cathartic Effect in Suicide Attempters Admitted to the Emergency Department

Pompili, Maurizio MD, PhD*; Innamorati, Marco PsyD†; Del Casale, Antonio MD‡; Serafini, Gianluca MD‡; Forte, Alberto MD‡; Lester, David PhD§; Raja, Michele MD‡; Amore, Mario MD∥; Tatarelli, Roberto MD‡; Girardi, Paolo MD‡

*Sant'Andrea Hospital, Sapienza University of Rome, and McLean Hospital-Harvard Medical School

†Università Europea di Roma and Sant'Andrea Hospital, Sapienza University of Rome

‡Sant'Andrea Hospital, Sapienza University of Rome

§The Richard Stockton College of New Jersey, Pomona

∥University of Parma

Please send correspondence to: Maurizio Pompili, MD, PhD, Department of Psychiatry-Sant'Andrea Hospital, Sapienza University of Rome, 1035 Via di Grottarossa, 00189 Roma Italy. [email protected] or [email protected]

The authors declare no conflicts of interest.

Abstract

The goal of the present study was to test the hypothesis that suicide attempts have a cathartic effect. We retrospectively investigated sociodemographic and clinical characteristics of suicide attempters admitted to the emergency department of a university hospital who were referred for a psychiatric assessment. The participants were 158 consecutive patients admitted to the emergency department because of a suicide attempt between January, 2006, and February, 2007; controls were 360 consecutive psychiatric referrals who did not report suicidal behavior. More than 70% of suicide attempters were coded on the triage classification system as critical/urgent. Loglinear analysis indicated that the risk of suicidal ideation was 9 times higher (p <0.001) and the risk of depressive mood was twice as high (p <0.001) among the attempters as in the control group of nonattempters, while their risk of anxiety (p <0.05) and agitation (p <0.05) was approximately half that of the nonattempters. The attempters also had a 5 times greater risk of being diagnosed with bipolar disorder (p <0.001) than the nonattempters. However, despite the fact that bipolar disorders were overrepresented in the group of attempters, suicidal ideation in the few hours after a suicide attempt was associated only with depressive mood. Based on these findings, it is recommended that psychiatric evaluation of suicide attempters in the emergency department should ideally include the use of psychometric instruments evaluating suicide ideation and suicide risk. (Journal of Psychiatric Practice 2009;15:433–441)