Suicide risk after psychiatric discharge: study protocol of a naturalistic, long-term, prospective observational study
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STUDY PROTOCOL
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Suicide risk after psychiatric discharge: study protocol of a naturalistic, long-term, prospective observational study Tim J. Krause1†, Annette Lederer1, Magdalena Sauer2, Jasmin Schneider3†, Cathrin Sauer4, Burkhard Jabs2, Elmar Etzersdorfer3, Axel Genz4, Michael Bauer5, Susann Richter5, Dan Rujescu1 and Ute Lewitzka5*
Abstract Background: Suicide risk of psychiatric patients has proven to be strongly increased in the months after discharge from a psychiatric hospital. Despite this high risk, there is a lack of systematic research on the causes of this elevated suicide risk as well as a lack of treatment and intervention for patients at high risk after discharge. The main objective of this pilot study is, firstly, to examine the factors contributing to the elevated suicide risk and, secondly, to investigate whether an additional setting of care starting at discharge may reduce suicidality. Methods: In this multi-centre pilot study, treatment as usual is complemented by an additional 18-month postdischarge setting of care for psychiatric patients at high risk for suicide. Two groups of patients differing in the amount of post-discharge personal contacts will be compared. One group of patients will be offered continuous personal contacts after discharge (months 1–6: monthly contacts; months 6–18: every 2 months) while another group of patients will receive contacts only at months 6, 12, and 18 after discharge. Data on suicidality, as well as associated with other symptoms, treatment, and significant events, will be collected. In the case of health-related severe events, the setting of care allows the patient to have the opportunity to connect with the doctor or therapist treating the patient. Discussion: The results of this study will contribute to identifying critical factors raising suicide risk after discharge and will demonstrate the potential influence on suicide prevention of a setting of care with regular personal contact after discharge. Trial registration: ZMVI1-2517FSB135 – funded by the German Federal Ministry of Health. Keywords: Suicide risk, Suicidality, Suicidality after discharge, Suicide prevention, Affective disorders, Schizophrenia, Perfectionism, Public health
Background Approximately 800,000 people die by suicide globally every year [1]. According to the World Health Organization (WHO), the average suicide rate is 10.6 suicides per 100,000 persons in 2016 [2]. Europe’s average suicide rate is 15.4; the highest rate of all world regions. * Correspondence: [email protected] † Tim J. Krause and Jasmin Schneider are co-first authors and contributed equally. 5 Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, D-01307 Dresden, Germany Full list of author information is available at the end of the article
Several programmes of the European Union focussed on reducing suicide rates. In Germany, a national suicide prevention programme (Nationales Suizidpräventionsprogramm, Na
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