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.