Suicidal ideation in medical inpatients: psychosocial and clinical correlates

• Published in: General hospital psychiatry Vol. 33; no. 6; pp. 572 - 578
• Main Authors: Furlanetto, Letícia M., Stefanello, Bianca
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.11.2011; Elsevier
• Subjects: Adult and adolescent clinical studies; Biological and medical sciences; Cross-Sectional Studies; Female; Humans; Inpatients - psychology; Logistic Models; Male; Medical inpatients, Psychiatric comorbidity; Medical sciences; Mental Disorders - psychology; Middle Aged; Psychiatric Status Rating Scales; Psychiatry; Psychology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Severity of Illness Index; Social Support; Statistics, Nonparametric; Stress, Psychological - psychology; Suicidal Ideation; Suicide; Suicidal ideation; Medical inpatients, Psychiatric comorbidity; Social support; Concomitant disease; Medical inpatients; Mental disorder; Hospital environment; Psychiatric comorbidity; Psychosocial factor; Suicide ideation
• ISSN: 0163-8343; 1873-7714; 1873-7714
• DOI: 10.1016/j.genhosppsych.2011.08.002

To identify psychosocial and clinical correlates of suicidal ideation in medical inpatients. In a cross-sectional study, all adults consecutively admitted to the medical wards of a University Hospital had their names recorded and were randomized and evaluated during the first week of admission. Suicidal ideation was assessed using Item 9 of Patient Health Questionnaire-9. The Beck Depression Inventory, the Beck Anxiety Inventory, the WHO Subjective well-being scale, the Charlson Comorbidity Index and other numerical rating scales (pain and self-reported physical illness severity) were used. Patients with less than four confidants were considered with poor social support. The Student's t test, Mann-Whitney U test, chi-square test and stepwise logistic regression analysis were used. Of the 1092 patients who composed the sample, 7.2% reported having suicidal ideation. After adjusting for psychosocial and clinical confounders, prior suicide attempts (OR: 4.41; 95% CI: 2.12–9.15; P<.001), depressive symptoms (OR: 1.11; 95% CI: 1.06–1.17; P<.001), severe anxiety symptoms (OR: 3.04; 95% CI: 1.47–6.26; P=.003) and poor social support (OR: 2.02; 95% CI:1.03–3.96; P=.04) were independently associated with suicidal ideation. Three out of the four correlates of suicidal ideation in medical inpatients are potentially modifiable factors: severe anxiety, depressive symptoms and poor social support. The fourth variable, prior suicide attempts, is not modifiable but should serve as a red flag to suspect and investigate current suicide risk. These findings highlight the importance of suicidal ideation as a proxy for the distress that is incumbent upon physicians to manage if they wish to provide excellent and comprehensive inpatient care.