Health & wellbeing

A comprehensive study conducted in Finland has shed light on the heightened risk of suicide among patients suffering from depression in the days immediately following their discharge from psychiatric hospital care. According to research by the Helsinki and Uusimaa Hospital District (HUS) and the University of Helsinki, the risk of suicide for these patients peaks in the first three days post-discharge, being 330 times higher compared to the general population.

The study underscores the critical importance of continuous care during the transition from hospital to outpatient treatment. "Patients are often hospitalized precisely because of the risk of suicide. Our findings clearly show that the danger does not necessarily pass with the conclusion of hospital treatment. The transition phase from hospital to outpatient care is a critical period," explains Erkki Isometsä, Chief Psychiatrist at HUS and Professor at the University of Helsinki.

This extensive Finnish research project tracked suicides occurring after depression patients' discharge from psychiatric hospital care and was published in the internationally respected JAMA Psychiatry journal. It analyzed registry data covering all individuals hospitalized for depression in Finland between 1996 and 2017, totaling 91,161 patients and 193,197 treatment episodes. Out of these, 1,976 patients died by suicide during a follow-up period of up to two years.

The study, spanning 22 years, noted a significant overall decrease in suicide mortality in Finland, including among depression patients. It highlighted that the severity of depression and previous suicidal behavior are significant factors affecting suicide risk.

The research provides crucial insights for clinical decision-making regarding risk factors for suicide and the periods during which they are most influential. In the short term, factors such as the severity of depression and the nature of previous self-harm behavior were particularly emphasized. These aspects have not been as clearly identified in prior studies for periods of extremely high risk.

"The study strongly advocates for close cooperation between hospital and outpatient care services. It's also essential to ensure that the treatment for depression has been effective in the hospital," Isometsä adds.

While the study did not explore the specifics of the treatment received by patients, it highlighted the significant role of care continuity as patients transition from psychiatric hospitalization to outpatient services.

The lead author of the study is Kari Aaltonen, Department Chief Physician at HUS Psychiatry, with contributions from Professor Erkki Isometsä of HUS Psychiatry and the University of Helsinki, Assistant Professor Christian Hakulinen from the University of Helsinki and the Finnish Institute for Health and Welfare, Professor Reijo Sund from the University of Eastern Finland, and Professor Sami Pirkola from Tampere University.