Suicides and Suicide Attempts among Psychiatric Hospital Inpatients in Iran

Background: Suicidal behavior is seen in the context of a variety of mental disorders. While many believe that, in general, first-episode psychosis is a particularly high-risk period for suicide, no general agreement regarding higher prevalence of suicide in first-episode psychosis is achievable. Objective: In the present study, suicides and suicide attempts among psychiatric in-patients have been evaluated to assess the general profile of suicidal behavior among native psychiatric inpatients and any relationship between serum cholesterol level and suicidal behavior. Methods: Five acute academic wards, which have been specified for admission of first episode adult psychiatric patients, and five acute non-academic wards, which have been specified for admission of recurrent episode adult psychiatric patients, were selected for the current study. All inpatients with suicidal behavior (successful suicide and attempted suicide, in total), during the last five years (2013-2018), were included in the present investigation. Also, the assessment of serum lipids, including triglyceride, cholesterol, low-density lipoprotein and high-density lipoprotein, was done, for comparing the suicidal subjects with non-suicidal ones. Results: Among 19160 psychiatric patients hospitalized in Razi psychiatric hospital during a sixty-months period, 63 suicidal behaviors, including one successful suicide and sixty-two suicide attempts, were recorded by the safety board of hospital. The most frequent mental illness was bipolar I disorder, which was significantly more prevalent in comparison with other mental disorders (p<0.04, p<0.02, p<0.007, and p<0.003 in comparison with schizophrenia, depression, personality disorders and substance abuse, respectively). Self-mutilation, self-poisoning and hanging were the preferred methods of suicide among 61.11%, 19.44% and 19.44% of cases, respectively. In addition, no significant difference was evident between the first admission and recurrent admission inpatients, totally and separately, particularly with respect to psychotic disorders. Besides, with respect to different components of serum lipids, no specific or significant pattern was evident. Conclusion: While in the present study, the suicidal behavior was significantly more evident in bipolar disorder in comparison with other psychotic or no-psychotic disorders, no significant difference was evident between the first admission and recurrent admission of psychiatric inpatients. Moreover, no significant relationship between suicidal behavior and serum lipids was found.