Psychosomatics 40:18-27, February 1999
© 1999 The Academy of Psychosomatic Medine
Suicide Risk Assessment: A Review of Risk Factors for Suicide in 100 Patients Who Made Severe Suicide Attempts
Evaluation of Suicide Risk in a Time of Managed Care
Richard C. W. Hall, M.D.,
Dennis E. Platt, M.D., and
Ryan C. W. Hall
Received May 1, 1998; revised June 9, 1998; accepted July 22, 1998. From the University of Florida, Gainesville. At the time this study was undertaken, Dr. Hall was Medical Director of Psychiatric Programs, Center for Psychiatry, Florida Hospital, Orlando, Florida. Dr. Platt was Chief of Psychiatric Emergency Services, Center for Psychiatry, Florida Hospital, Orlando, Florida. Mr. Ryan Hall was a research assistant to the Office of the Medical Director, Center for Psychiatry, Florida Hospital, Orlando, Florida, and a biology major/premed student at the Johns Hopkins University, Baltimore, Maryland. Address correspondence and reprint requests to Dr. R.C.W. Hall, 100 East Sybelia Avenue, Suite 210, Maitland, FL 32751.
A study of 100 patients who made a severe suicide attempt suggested that the managed care criteria often applied for approving admission to hospitals for potentially suicidal patients were not, in fact, predictive of features seen in patients who actually made such attempts. Severe anxiety, panic attacks, a depressed mood, a diagnosis of major affective disorder, recent loss of an interpersonal relationship, recent abuse of alcohol or illicit substances coupled with feelings of hopelessness, helplessness, worthlessness, global or partial insomnia, anhedonia, inability to maintain a job, and the recent onset of impulsive behavior were excellent predictors of suicidal behavior. The presence of a specific suicide plan or suicide note were not. Patients with managed care were overrepresented by 245% in the study.
Key Words: Suicide • Managed Care • Risk Assessment • Review
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