Examination of the lethality of the means used to attempt suicide and the seriousness of the resulting physical injuries – Clinical study review – *
[Objective] In cases of attempted suicide, it has been noted that many subjects who making more serious attempts to commit suicide also tend to have mental disorders in the strict sense (ex. psychoses, depressive disorders or psychoactive substance use disorders) as compared with persons making less serious attempts. A clinical study review of cases of attempted suicide was performed to examine the relationship between the lethality of the means used in a suicide attempt and the seriousness of the physical consequences. [Subjects] Relevant information on 56 patients who were hospitalized in the Department of Psychiatry of Kawasaki Medical School Hospital, after attempting suicide and in whose treatment the author was directly involveds and 18 patients who attempted suicide and were hospitalized in other department of the same hospital for more than one week with whom the author had indirect involvement was examined. [Methods] All 74 patients were investigated retrospectively. For risk determination, patients were initially classified into a "high risk group" and a "low risk group". However after it was found that some patients fit into neither category an " indefinable group" was established. In terms of the seriousness of the physical injuries sustained in the suicide attempts, patients were classified into a "severe injury group" and a "mild injury group". [Results] There were 42 cases in the "high risk group", 18 cases in the "low risk group", and 14 cases in the "indefinable group". There were 38 cases in the "severe injury group" and 36 cases in the"mild injury group". On the basis of the respective diagnoses, 85. 7% of the patients in the "high risk group" were judged to suffer from mental disorders whereas the proportion in the "low risk group" was 55.6% and that in the "indefinable group" was 85. 7%. In terms of the relationship between mental disorders and the extent of injuries, 84. 2% of the patients in the "severe injury group" had mental disorders with the figure being 72. 2% for the "mild injury group". A comparison of the ratio of mental disorders to risk revealed a statistically significant difference between the "high risk group" and the "low risk group" (P = 0. 011< 0. 05) by the chi-square test, but there was no statistically significant difference between the "high risk group" and the "indefinable group" (P = 0. 685). No statistically significant difference was found between the "severe injury group" and the "mild injury group" (P = 0.21). [Conclusion] There is evidence that mental disorders more significantly correlate with the lethality of the means in attempted suicides than with the seriousness of the physical injuries, and that for attempted suicides it is very important to determine both the lethality of the means as well as the seriousness of the injuries. When attempting to determine risk, an "indefinable group" was found to exist, but the characteristics of this "indefinable group" more closely resembled those of the "high risk group" than the "low risk group", (Accepted on August 23, 2002) KawasakiIgakkaishi 28(3) : 143-155, 2002
