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American Journal of Epidemiology Advance Access originally published online on March 14, 2008
American Journal of Epidemiology 2008 167(10):1155-1163; doi:10.1093/aje/kwn017
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American Journal of Epidemiology © The Author 2008. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Determinants and Outcomes of Serious Attempted Suicide: A Nationwide Study in Finland, 1996–2003

Jari Haukka1,2, Kirsi Suominen1,3, Timo Partonen1 and Jouko Lönnqvist1,4

1 Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland
2 School of Public Health, University of Tampere, Tampere, Finland
3 Department of Psychiatry, Jorvi Hospital, Helsinki University Central Hospital, Espoo, Finland
4 Department of Psychiatry, Faculty of Medicine, University of Helsinki, Helsinki, Finland

Correspondence to Dr. Jari Haukka, National Public Health Institute, Mannerheimintie 166, FIN-00800 Helsinki, Finland (e-mail: jari.haukka{at}ktl.fi).

Received for publication August 31, 2007. Accepted for publication January 16, 2008.

Suicide is among the 10 leading causes of death. Attempted suicide is 10–40 times more frequent than completed suicide and is the strongest single predictor of subsequent suicide. The current study population included all persons in Finland who were hospitalized with a diagnosis of attempted suicide between 1996 and 2003 (N = 18,199). Information on background variables and mortality was obtained by register linkage. The risk of repeated attempted suicide was 30% and the risk of suicide was 10%. The risks of repeated attempted suicide, completed suicide, and death from any cause were high immediately after discharge from the hospital. Analysis of competing causes of death revealed that while alcohol-related disorder was not associated with suicide, it markedly increased the risk of other violent death: The subdistribution hazards rate (SHR) was 2.61 (95% confidence interval (CI): 2.12, 3.21). Schizophrenia-related disorders (SHR = 1.87, 95% CI: 1.57, 2.21) and mood disorders (SHR = 1.72, 95% CI: 1.47, 2.01) were associated with the risk of suicide. The risks of suicide and all-cause mortality were extremely high immediately after hospitalization for attempted suicide.

mental disorders; mortality; suicide; suicide, attempted

Abbreviations: ICD-10, International Classification of Diseases, Tenth Revision


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