Abstract
Background: Taiwan is a high-risk area for suicide. Repeated suicide attempts are an important factor of suicide mortality. Yet there has been little research on the factors associated with repeated suicidal behavior in Taiwan. Aims: To explore the characteristics of repeated suicide attempts. Methods: Data were obtained from the National Health Insurance Research Database for 2005 to 2008. We then classified repeated suicide attempts into single method, two different methods, and three different methods. Results: A total of 1,004 inpatients were admitted to Taiwanese hospitals due to repeated suicide attempts, and the use of a single suicide method constituted the majority of the cases (71%). Risk factors related to repeated suicide attempts included being female, aged 30–39, suicide by poisoning using solid and/or liquid substances, the fall season, living in Northern Taiwan, more psychiatric nature of injury codes (N-codes), seeking medical attention from a psychiatrist, receiving more surgeries or procedures, a longer length of stay in a hospital, coming from a low-income background, and having a serious illness. Conclusions: Consultation and treatment are particularly crucial for patients with mental illnesses and other concomitant diseases, so that the psychiatric symptoms such as auditory and visual hallucinations can be controlled.
References
2002). General practice based intervention to prevent repeat episodes of deliberate self-harm: Cluster randomised controlled trial. British Medical Journal, 324, 1254–1257.
(2009). Repetition and severity of suicide attempts across the life cycle: A comparison by age group between suicide victims and controls with severe depression. BMC Psychiatry, 9, 62.
(1999). Preventing suicide: What will work and what will not. The Medicine Journal of Australia, 170, 620–621.
(2005). Repeated self-poisoning: Increasing severity of self-harm as a predictor of subsequent suicide. The British Journal of Psychiatry, 186, 253–257.
(2008). Predictors of repeat suicidal attempts after first-ever attempt: A two-year follow-up study. Hong Kong Journal of Psychiatry, 18, 131–135.
(2009). Suicide methods used by women in Korea, Sweden, Taiwan and the United States. Journal of the Formosan Medical Association, 108, 452–459.
(2007). Predictors of treatment response and length of stay for inpatients with major depression. Journal of the Formosan Medical Association, 106, 903–910.
(2007). Risk of repetition of suicide attempt, suicide or all deaths after an episode of attempted suicide: A register-based survival analysis. The Australian and New Zealand Journal of Psychiatry, 41, 257–265.
(2004). The incidence and repetition of attempted suicide in Ireland. European Journal of Public Health, 14(1), 19–23.
(2009). Factors associated with repeated suicide attempts. Preliminary results of the WHO Multisite Intervention Study on Suicidal Behavior (SUPRE-MISS) from Campinas, Brazil. Crisis, 30, 73–78.
(1999). Cultural issues in suicide and old age. Crisis, 20, 53–55.
(2010). Statistics of causes of death – Number of deaths classified according to the basic tabulation list by gender and age. Retrieved from www.doh.gov.tw/CHT2006/DisplayStatisticFile.aspx?d=75 924&s=1
. (1998). Repetition of parasuicide – ICD-10 personality disorders and adversity. Acta Psychiatrica Scandinavica, 98, 208–213.
(2004). Social fragmentation, severe mental illness and suicide. Social Psychiatry and Psychiatric Epidemiology, 39, 165–170.
(2002). Reducing suicide: A national imperative. Washington, DC: National Academies Press.
(2003). Comorbidity of axis I and axis II disorders in patients who attempted suicide. The American Journal of Psychiatry, 160, 1494–1500.
(1996). Repetition of parasuicide: A predictive study. Suicide and Life-Threatening Behavior, 26, 395–404.
(2006). Duration of hospitalization and post discharge suicide. Suicide and Life-Threatening Behavior, 36, 682–686.
(2003). Worst-point suicidal plans: A dimension of suicidality predictive of past suicide attempts and eventual death by suicide. Behaviour Research and Therapy, 41, 1469–1480.
(1990). Statistical issues in the identification of risk factors for suicidal behavior: The application of survival analysis. Psychiatry Research, 31(1), 99–108.
(2006). Projections of global mortality and burden of disease from 2002 to 2030. PLoS Medicine, 3, e442. Retrieved from www.ncbi.nlm.nih.gov/pmc/articles/PMC1664601/pdf/pmed.0030442.pdf
(2003). Suicide and attempted suicide among people of Caribbean origin with psychosis living in the UK. The British Journal of Psychiatry, 183, 40–44.
& UK700 Group. (2011). National Health Insurance Research Database – Introduction of service. Retrieved from w3.nhri.org.tw/nhird/brief_01.htm
. (2010). Mental disorders, comorbidity and suicidal behavior: Results from the National Comorbidity Survey Replication. Molecular Psychiatry, 15, 868–876.
(1995). Survival analysis of suicide risk after attempted suicide. Acta Psychiatrica Scandinavica, 91, 336–340.
(2008). World report on child injury prevention. Retrieved from whqlibdoc.who.int/publications/2008/9789241563574_eng.pdf
(2009). Suicide prevention (SUPRE). Retrieved from www.who.int/mental_health/prevention/suicide/suicideprevent/en/
. (