Peter C Britton1, Brady Stephens2, Jing Wu2, Cathleen Kane2, Autumn Gallegos3, Lisham Ashrafioun3, Xin Tu3, Kenneth R Conner3. 1. VISN 2 Center of Excellence for Suicide Prevention, Department of Veteran Affairs Medical Center, Canandaigua, NY, USA; Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA. Electronic address: peter.britton@va.gov. 2. VISN 2 Center of Excellence for Suicide Prevention, Department of Veteran Affairs Medical Center, Canandaigua, NY, USA. 3. VISN 2 Center of Excellence for Suicide Prevention, Department of Veteran Affairs Medical Center, Canandaigua, NY, USA; Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
Abstract
OBJECTIVE: The purpose of this study is to identify predictors of nonfatal suicide attempts in veterans discharged from acute hospitalization with depression and/or alcohol use disorder (AUD) diagnoses. We hypothesized that primary depression confers similar risk for attempt whether or not it is accompanied by secondary AUD, and that a suicide attempt in the prior year would confer greatest risk of the variables studied. METHOD: Veteran Health Administration (VHA) patients discharged from acute inpatient hospitalization in 2011 with AUD and/or non-bipolar depression diagnoses (N=22,319) were analyzed using information from the computerized record system and national database on suicidal behavior. Proportional hazard regression models estimated unadjusted and adjusted hazard ratios (AHR) and confidence intervals (95% CI) for risk of a nonfatal attempt within one year following discharge. RESULTS: As hypothesized, primary depression with secondary AUD [AHR (95% CI)=1.41 (1.04, 1.92)] and without secondary AUD [AHR (95% CI)=1.30 (1.00, 1.71)] conferred similar prospective risk for attempt (AUD without depression, reference). Although prior suicide attempt was associated with increased risk, acute care in "general psychiatry" during hospitalization [AHR (95% CI)=6.35 (3.48, 13.00)] conferred the greatest risk among the variables studied. Transfer to another inpatient setting reduced risk [AHR (95% CI=0.53 (0.34, 0.79). LIMITATIONS: Analyses were based on administrative data and did not include information on mortality. CONCLUSION: When primary depression is severe enough to warrant inpatient hospitalization, a secondary diagnosis of AUD may not contribute additional prospective risk for nonfatal attempt. Within VHA, acute psychiatric care during hospitalization is a potential marker for increased risk for nonfatal attempt. Transfer to an additional inpatient setting may reduce risk for nonfatal attempt. Published by Elsevier B.V.
OBJECTIVE: The purpose of this study is to identify predictors of nonfatal suicide attempts in veterans discharged from acute hospitalization with depression and/or alcohol use disorder (AUD) diagnoses. We hypothesized that primary depression confers similar risk for attempt whether or not it is accompanied by secondary AUD, and that a suicide attempt in the prior year would confer greatest risk of the variables studied. METHOD: Veteran Health Administration (VHA) patients discharged from acute inpatient hospitalization in 2011 with AUD and/or non-bipolar depression diagnoses (N=22,319) were analyzed using information from the computerized record system and national database on suicidal behavior. Proportional hazard regression models estimated unadjusted and adjusted hazard ratios (AHR) and confidence intervals (95% CI) for risk of a nonfatal attempt within one year following discharge. RESULTS: As hypothesized, primary depression with secondary AUD [AHR (95% CI)=1.41 (1.04, 1.92)] and without secondary AUD [AHR (95% CI)=1.30 (1.00, 1.71)] conferred similar prospective risk for attempt (AUD without depression, reference). Although prior suicide attempt was associated with increased risk, acute care in "general psychiatry" during hospitalization [AHR (95% CI)=6.35 (3.48, 13.00)] conferred the greatest risk among the variables studied. Transfer to another inpatient setting reduced risk [AHR (95% CI=0.53 (0.34, 0.79). LIMITATIONS: Analyses were based on administrative data and did not include information on mortality. CONCLUSION: When primary depression is severe enough to warrant inpatient hospitalization, a secondary diagnosis of AUD may not contribute additional prospective risk for nonfatal attempt. Within VHA, acute psychiatric care during hospitalization is a potential marker for increased risk for nonfatal attempt. Transfer to an additional inpatient setting may reduce risk for nonfatal attempt. Published by Elsevier B.V.
Authors: Peter C Britton; Kipling M Bohnert; Mark A Ilgen; Cathleen Kane; Brady Stephens; Wilfred R Pigeon Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2017-04-11 Impact factor: 4.328
Authors: Hilario Blasco-Fontecilla; Maria Rodrigo-Yanguas; Lucas Giner; Maria Jose Lobato-Rodriguez; Jose de Leon Journal: Curr Psychiatry Rep Date: 2016-10 Impact factor: 5.285
Authors: Hua He; Naiji Lu; Brady Stephens; Yinglin Xia; Robert M Bossarte; Cathleen P Kane; Wan Tang; Xin M Tu Journal: Stat Methods Med Res Date: 2017-09-21 Impact factor: 3.021
Authors: Kevin A Hallgren; Richard K Ries; David C Atkins; Kristin Bumgardner; Peter Roy-Byrne Journal: J Am Board Fam Med Date: 2017 Mar-Apr Impact factor: 2.657
Authors: Rosa M Crum; Kerry M Green; Elizabeth A Stuart; Lareina N La Flair; Marc Kealhofer; Andrea S Young; Noa Krawczyk; Kayla N Tormohlen; Carla L Storr; Anika A H Alvanzo; Ramin Mojtabai; Lauren R Pacek; Bernadette A Cullen; Beth A Reboussin Journal: Drug Alcohol Depend Date: 2018-04-10 Impact factor: 4.492
Authors: Mina M Rizk; Hanga Galfalvy; Jeffrey M Miller; Matthew Milak; Ramin Parsey; Michael Grunebaum; Ainsley Burke; M Elizabeth Sublette; Maria A Oquendo; Barbara Stanley; J John Mann Journal: J Psychiatr Res Date: 2020-10-30 Impact factor: 4.791