Suicidal behaviour and intensity of psychiatric care in a region at high risk for suicide.

BACKGROUND Suicidal behaviour represents a social and health-related issue of prime importance in both the general and psychiatric population. People with mental illness are at great risk of suicide, but indirect evidence suggests that the treatment of psychiatric disorders may prevent suicide. The aim of our study was to compare the risk of suicide in the population of psychiatric patients with that of the general population in Friuli Venezia-Giulia (FVG). METHOD We analyzed the suicide rates, based on the official statistical database, relating to the resident population in FVG during the years 1998-1999. The sucide rates (per 100 000 subjects) were standardised by sex and age. The characteristics of suicidal behaviour in subjects who had been in contact with (Community Mental Health Centres) CMHC (n=65) were compared with that of suicidal subjects not in contact (n=237). RESULTS There was an increase in the suicide phenomenon in the elderly population in FVG over the tested period. The rates were three times higher in males than in females. The rates of patients in contact with CMHC in 1998 and in 1999 were, respectively, 14 and 20 times higher than that of the general population. Most suicidal schizophrenics and 37% of the depressed patients have been previously hospitalised. CONCLUSION The population of north-eastern Italy is at high risk of suicide compared to other regions. The mortality ratio of psychiatric subjects who commit suicide in our sample is elevated. Since Italian community-oriented services rely less on hospitalisation than in other countries, the fact that about 50% of suicidal psychiatric patients have been previously admitted in a psychiatric ward may indicate that previous hospitalisation is a hierarchic factor related to suicide.