Suicide attempts by hospitalized medical and surgical patients.

To characterize siucidal behavior among hospitalized medical and surgical patients, all suicide attempts in the Peter Bent Brigham Hospital were surveyed for seven years. Seventeen attempts occurred, non of them fatal. Only four patients were seriously ill, two with neoplasia. All the attempts were impulsive and were associated with stress and disturbances of impulse control. Anger, not depression, was the effect most often seen before the attempts. In all cases the precipitating stress was loss of emotional support. However, patient vulnerability to suicide seemed to be the key determinant. Fifteen patients had mental disorders, including eight with personality disorders, three with schizophrenia, three with organic brain syndromes, and one with manic depressive psychosis. Seven were psychotic, and six had made prior suicide attempts. These findings suggest that the characteristics of impulsive suicide should be considered when a suicide prevention program is being developed for a general hospital.