Lower mortality from suicidal trauma among patients with a psychiatric diagnosis upon admission: Nationwide japanese retrospective cohort study

Psychiatry Res. 2020 Nov;293:113456. doi: 10.1016/j.psychres.2020.113456. Epub 2020 Sep 17.


Suicide and self-harm are major public health issues. Few studies have compared mortality from suicidal trauma between patients with and without contact with psychiatric services. This study aimed to compare the in-hospital mortality of suicidal trauma between patients with and without a psychiatric diagnosis upon hospital admission. Data on 15- to 90-year-old patients with suicidal trauma between 2004 and 2015 was extracted from the Japan Trauma Data Bank. In-hospital mortality were compared between patients with and without a psychiatric diagnosis. A total of 9,803 patients were included. The median age was 42 years (interquartile range: 29-59), and 5,010 patients (51.1%) were male. The most frequent method of injury was falling from a height (53.4%), followed by stabbing (32.3%) and burns (6.2%). In total, 4,878 patients (49.8%) had a psychiatric diagnosis upon admission. The proportion of patients with a psychiatric diagnosis was significantly lower among males, teenagers, and older people. In-hospital mortality was significantly lower among patients with a psychiatric diagnosis than those without (10.9%vs18.7%). Contact with psychiatric services might be protective among people with suicidal trauma. However, the proportion of psychiatric service use was generally low. These findings show the importance of delivering appropriate psychiatric services to high-risk patients.

Keywords: Mortality; Psychiatric contact; Suicide; Trauma.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Japan / epidemiology
  • Male
  • Mental Disorders / diagnosis*
  • Mental Disorders / epidemiology
  • Mental Disorders / psychology
  • Middle Aged
  • Mortality / trends*
  • Patient Admission / statistics & numerical data*
  • Retrospective Studies
  • Self-Injurious Behavior / epidemiology*
  • Suicidal Ideation
  • Suicide / psychology
  • Suicide / statistics & numerical data*
  • Suicide, Attempted / psychology
  • Suicide, Attempted / statistics & numerical data
  • Young Adult