Psychiatric consultations in the emergency room: Focus on suicide attempters with and without longitudinal psychiatric disorders

Abstract

Introduction

The role of mental illness in the pathway leading to suicide is widely discussed in the literature. Nonetheless, the debate about this issue is open, both from a clinical and philosophical point of view.

Aims

The purpose of the present study was to compare suicide attempters with and without a history of psychiatric disorder, in order to highlight the possible differences between the two groups, with a specific focus on intent to die and methods of the attempt.

Methods

Data from all ER referrals undergoing a psychiatric consultation in the period 2008–2015 at the Maggiore della Carità Hospital, Novara, Italy, were gathered. Comparison of qualitative data was performed by means of the Chi² test. Statistical significance was set at P ≤ 0.05.

Results

We have already gathered data from more than 2000 ER psychiatric consultations, including 495 suicide attempters. Preliminary results suggest that these kinds of behaviours are more common in subjects without psychiatric disorders but with clinical history of previous contact with mental health services and in psychopharmacological therapy. Reasons for self-harming are associated with relational problems rather than psychiatric symptoms. Among Axis II diagnoses, almost half of cases are affected by histrionic personality disorder.

Conclusions

The results described above should be considered as preliminary, as data collection and statistical analyses are still ongoing. Anyway, the observed correlation between previous contact with mental health services, socio-relational issues and suicide attempt, and the significant frequency of attempts in histrionic personality disorders seem to be particularly interesting. Implications will be discussed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.