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Risk factors and trends in attempting or committing suicide in Dutch general practice in 1983–2009 and tools for early recognition.
Donker, G.A., Wolters, I., Schellevis, F. Risk factors and trends in attempting or committing suicide in Dutch general practice in 1983–2009 and tools for early recognition. European Journal of Public Health: 2010, 20(suppl. 1), p. 50. Abstract. 3rd European Public Health Conference 'Integrated Public Health', 10-13 November 2010, Amsterdam.
Background: Many patients visit their general practitioner (GP) before attempting or committing suicide. This study analyses determinants and trends of suicidal behaviour to enhance early recognition of risk factors in general practice. Method: Analysis of trends, patient and treatment characteristics in suicide and suicide attempts occurring from 1983–2009 in practices participating in the Dutch General Practice Sentinel Network, covering 140 000 persons, 0.8% of the Dutch population. Data were collected by continuous morbidity registration and questionnaires filled in by GPs. Trends were analysed by linear regression. Results: The incidence of committing (N= 306) and attempting suicide (N= 1473) showed a decreasing trend between 1983 and 2009 (P < 0.01 for both trend lines). Male patients committed twice as often (P < 0.01) and female patients attempted twice as often (P < 0.01) suicide compared with the opposite gender. Living alone was a risk factor for committing and attempting suicide: 44 and 30% of the patients respectively versus 15% of the total Dutch population (odds ratio = 4.5 and 2.4 respectively, P < 0.01 for both comparisons). The age group of 80 years and older is at risk in committing suicide: 11% in men and 12% in women versus 3% of the Dutch population, P < 0.01 for both comparisons). The majority of the patients who committed (65%) or attempted (59%) suicide were diagnosed as depressed, of whom 39% were treated by their GP with an antidepressant. Referral to a psychiatrist or other mental health professional occurred in 68% of the cases before committing and 66% of patients before attempting suicide. Patients expressing suicidal ideation were referred in 87% of cases. In retrospect GPs recalled that they had foreseen suicide in 19% and suicide attempts in 12% in case of contact in the preceding month. Conclusions: Early recognition of risk factors and accelerated referral to psychiatric care may further enhance prevention of suicide and suicide attempts.
Background: Many patients visit their general practitioner (GP) before attempting or committing suicide. This study analyses determinants and trends of suicidal behaviour to enhance early recognition of risk factors in general practice. Method: Analysis of trends, patient and treatment characteristics in suicide and suicide attempts occurring from 1983–2009 in practices participating in the Dutch General Practice Sentinel Network, covering 140 000 persons, 0.8% of the Dutch population. Data were collected by continuous morbidity registration and questionnaires filled in by GPs. Trends were analysed by linear regression. Results: The incidence of committing (N= 306) and attempting suicide (N= 1473) showed a decreasing trend between 1983 and 2009 (P < 0.01 for both trend lines). Male patients committed twice as often (P < 0.01) and female patients attempted twice as often (P < 0.01) suicide compared with the opposite gender. Living alone was a risk factor for committing and attempting suicide: 44 and 30% of the patients respectively versus 15% of the total Dutch population (odds ratio = 4.5 and 2.4 respectively, P < 0.01 for both comparisons). The age group of 80 years and older is at risk in committing suicide: 11% in men and 12% in women versus 3% of the Dutch population, P < 0.01 for both comparisons). The majority of the patients who committed (65%) or attempted (59%) suicide were diagnosed as depressed, of whom 39% were treated by their GP with an antidepressant. Referral to a psychiatrist or other mental health professional occurred in 68% of the cases before committing and 66% of patients before attempting suicide. Patients expressing suicidal ideation were referred in 87% of cases. In retrospect GPs recalled that they had foreseen suicide in 19% and suicide attempts in 12% in case of contact in the preceding month. Conclusions: Early recognition of risk factors and accelerated referral to psychiatric care may further enhance prevention of suicide and suicide attempts.
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