Excess suicide among formerly hospitalized child psychiatry patients

The authors report suicide risk among 1331 child psychiatry inpatients followed up for 4 to 15 years in a record-linkage study. Age- and sex-matched comparisons were made with the general population of Iowa (the state from which most of the subjects were selected). Suicide rates were higher than expected for both sexes, but the excess (9 suicides) was significant only for males. No suicides occurred earlier than age 17. The risk of suicide was 80 times that expected for schizophrenic patients and 25 times that expected for patients with organic mental disorders. Unlike follow-up studies of adult inpatients, a significant excess of suicide was not associated with affective disorder, substance abuse, neurosis, or anorexia nervosa. Clinical variables indicating more complicated psychiatric disturbance were associated with an even greater rate of suicide; these variables included multiple hospitalizations, a hospital stay of more than 15 days, and the presence of a medical diagnosis.