The Development of Intensive Care Program for Depressed Patients in Reducing Suicidal Risk at Psychiatric OPD, Rayong Hospital
Article Sidebar
Main Article Content
Abstract
Objective: To study the results of developing an intensive care and monitoring system for depressed patients at risk of suicide to reduce the rate of hospital admissions due to suicide attempts in depressed patients. This includes examining factors associated with suicide attempts, as well as causes and protective factors in patients with depression who are at risk of suicide attempts and receiving treatment at the Psychiatric Department of Rayong Hospital.
Methods: Randomized control trial by systematic sampling. To use Questionnaires 2Q9Q8Q Case record forms at the first and last visit (12 weeks from first visit) and Case record forms for follow up of Intensive Care Program. Data were analyzed using descriptive statistics and inferential statistics.
Results: A total of 348 depressed patients were at risk of suicide. The study group was followed up via telephone or video call via the LINE application, 172 patients (49.42%) were hospitalized with suicide attempts, 5 patients or 2.91 percent, which was less than the control group of 176 patients (50.58%) who were hospitalized with suicide attempts, 11 patients or 6.25 percent, but no statistical significance was found (p-value = 0.200). From the factor analysis, it was found that the 8Q suicide risk score was only one factor that was significantly associated with suicide attempts. It was found that depressed patients admitted to the hospital with suicide attempts had scores of 33.25 ± 14.67 compared to the control group with scores of 17.23 ± 13.86. When the 8Q score increased by 1 point, the risk increased 1.05 times (aOR = 1.05, 95%CI = 1.02 - 1.09, p-value = 0.003). The most common cause of suicidal thoughts was relationship problems (65.23%), while the most frequently reported protective factor preventing suicidal thoughts was having a commitment, such as to children, parents, or loved ones (57.47%).
Conclusion: The development of an intensive care and monitoring system for depressed patients could not reduce the rate of hospital admissions due to suicide attempts in depressed patients receiving services at the psychiatric department of Rayong Hospital, But it can solve limitations and expand future research. Factors found to be associated with suicide attempts, such as the 8q suicide risk score, along with causes and protective factors, will be used to guide future follow-up care strategies.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Articles submitted for consideration must not have been previously published or accepted for publication in any other journal, and must not be under review by any other journal.
References
Evans-Lacko S, Aguilar-Gaxiola S, Al-Hamzawi A, Alonso J, Benjet C, Bruffaerts R, et al. Socio-economic variations in the mental health treatment gap for people with anxiety, mood, and substance use disorders: results from the WHO World Mental Health (WMH) surveys. Psychol Med 2018;48(9): 1560–71.
Sadock BJ, Sadock VJ. Concise textbook of clinical psychiatry derived from Kaplan & Sadock’ S synopsis of psychiatry. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2004.
Limsontikul C. Suicide rates in Thailand 2008. J Ment Health Thai 2009;17(1): 52–5.
Rungreangkulkij SR, Kotnara I, Thamnoi R, Yodklang O, Anusak B. Experience of suicide attempt: gender differences. J Psychiatr Assoc Thailand 2013;58(3): 245–56.
Chang SS, Gunnell D, Sterne JAC, Lu TH, Cheng ATA. Was the economic crisis 1997–1998 responsible for rising suicide rates in East/Southeast Asia: a time–trend analysis for Japan, Hong Kong, South Korea, Taiwan, Singapore and Thailand. Soc Sci Med 2009;68(7): 1322–31.
Lotrakul M. Suicide in Thailand during the period 1998-2003. Psychiatry Clin Neurosci 2006;60(1): 90–5.
Penglia Y, Tippunya S, Puksorn K, Likasitdamrongkul W, Thanee S, Luprasong S. Application of community participatory programs for suicide prevention: a case study at Jarim sub-district, Tha-Pla district, Uttaradit province. J Ment Health Thai 2018;26(3): 184–96.
Yingseree O, Yingseree S. The factors associated with committed suicide in Hang Chat district by psychological autopsy during 2008 and application to community prevention. J Psychiatr Assoc Thailand 2010;55(4): 297-304.
Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV) [Internet]. [cited 2021 Jan 30]. Available from: https://www.who.int/news/item/30-01-2020-statement-on-the-second-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of-novel-coronavirus-(2019-ncov).
WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020 [Internet]. [cited 2021 Jan 11]. Available from: https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020.
WHO Director-General’s opening remarks at the media briefing – 5 May 2023 [Internet]. [cited 2024 Jan 01]. Available from: https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing---5-may-2023.
Coronavirus declared global health emergency by WHO. 2020 Jan 30 [Internet]. [cited 2021 Jan 11]; Available from: https://www.bbc.com/news/world-51318246.
Wongwilai P. Factors related to suicidal behavior at Sansai hospital Chiang Mai province. Academic Psychiatry and Psychology Journal 2021;37(2): 94–107.
Khamma A. Risk factors associated with suicide :a case - control study in Sukhothai province. J Psychiatr Assoc Thailand 2013;58(1): 3–16.
Lotrakul M. Suicide trends in Thailand categorized by age and gender. J Psychiatr Assoc Thailand 1998;43: 2-13.
Sukhawaha S, Arunpongpaisal S. Risk factor and suicide theory associated with suicide in adolescents: a narrative reviews. J Psychiatr Assoc Thailand 2017;62: 359-78.
Ekasawin S. Multiple suicides among psychiatric adolescents. J Ment Health Thai 2004;12: 54-63.
Parra-Uribe I, Blasco-Fontecilla H, Garcia-Parés G, Martínez-Naval L, Valero-Coppin O, Cebrià-Meca A, et al. Risk of re-attempts and suicide death after a suicide attempt: a survival analysis. BMC Psychiatry 2017;17: 163.
Rukkhajeekul S. Depression and suicidal behaviors among Naresuan University students. J Psychiatr Assoc Thailand 2013;58(4): 359–70.
Worapani P, Bamrerraj S, Su-khaws S. To study the factors influencing suicide attempts in patients of Kongklailas hospital. Community health development quarterly Khon Kaen University 2013;1(1): 69-78.
Kamondham S, Kaewdee R. The factors associated with committed suicide in Muang District, Lampang Province by psychological autopsy from october, 2010 to september 2013. J Psychiatr Assoc Thailand 2018;63(1): 47–54.
Nock MK, Borges G, Bromet EJ, Alonso J, Angermeyer M, Beautrais A, et al. Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. Br J Psychiat 2008;192(2): 98–105.
Leejongpermpoon J, Kongsuk T, Sriruenthong W, Pangchuntr W, Kenbubpha K, Yingyeun R, et al. P-1432 - The suicidality in thai population: a national survey. Eur Psychiatry 2012;27: 1.
Petpornprapas E. Depression: prevalence and associated factors of suicidal attempts at Bangplee hospital, Samutprakarn province. J Psychiatr Assoc Thailand 2020;65(2): 167–78.
Khummeeseenon P, Khummeeseenon P, Chokrussameehirun J, Srichanla E, Khamchompu S, Saokaew W. Risk and protective factors of people who attempted suicide in the 7th health district of Thailand. J Suicide Prev Thai 2020;1(1): 25-40.
Organization WH. Live life: an implementation guide for suicide prevention in countries [Internet]. World Health Organization; 2021 [cited 2021 Feb 11]. Available from: https://iris.who.int/handle/10665/341726
Lotrakul M. Lotrakul M, Sukanit P, editors. Ramathibodi’s Essential of Psychiatry. 3rd edition. Bangkok: Faculty of Medicine Ramathibodi Hospital 2010. (in Thai). [cited 2021 Feb 11]; Available from: https://www.academia.edu/249010/Lotrakul_M_Sukanit_P_editors_Ramathibodi_s_Essential_of_Psychiatry_3rd_edition_Bangkok_Faculty_of_Medicine_Ramathibodi_Hospital_2010_in_Thai_
Peter AG, Molina ML, Cardoso T de A, Mondin TC, Silva RA da, Jansen K, et al. Incidence and risk factors for suicide attempts in patients diagnosed with major depressive disorder. Psychol Res Behav Manag 2020 ;13: 1147-57.
Vijayakumar L, Umamaheswari C, Shujaath Ali ZS, Devaraj P, Kesavan K. Intervention for suicide attempters: a randomized controlled study. Indian J Psychiatry 2011;53(3): 244–8.
Paholpak S. Mood disorder. Khon Kaen: Siriphan offset; 1999
Serisathien P, Ucharatana W, Boonchome, An epidemiological study of suicidal attempt patients in governmental hospitals at Rayong province. J Psychiatr Assoc Thailand 1998;43(1): 14-21.
Warren M, O’Connor C, Lee JE, Burton J, Walton D, Keathley J, et al. Predispose, precipitate, perpetuate, and protect: how diet and the gut influence mental health in emerging adulthood. Front Nutr 2024;11: 1339269.
Krychiw JK, Ward-Ciesielski EF. Factors related to suicide’s unpredictability: a qualitative study of adults with lived experience of suicide attempts. Int J Qual Stud Health Well-being 2019;14(1): 1650585.
Howarth EJ, O’Connor DB, Panagioti M, Hodkinson A, Wilding S, Johnson J. Are stressful life events prospectively associated with increased suicidal ideation and behaviour: a systematic review and meta-analysis. J Affect Disord 2020;266: 731–42.
Riera-Serra P, Navarra-Ventura G, Castro A, Gili M, Salazar-Cedillo A, Ricci-Cabello I, et al. Clinical predictors of suicidal ideation, suicide attempts and suicide death in depressive disorder: a systematic review and meta-analysis. Eur Arch Psychiatry Clin Neurosci 2024;274(7): 1543–63.
Sher L, Oquendo MA. Suicide: An overview for clinicians. Med Clin North Am 2023;107(1): 119–30.