admission psychiatric patients1
ST. BLUMENTHAL, V. BELL, N.-U. NEUMANN, R. SCHÜTTLER and R. VOGEL
The majority of the studies dealing with the topic of suicide ( Shneidman 1976; Shneidman and Farberow, 1961; Becket al. 1974) are ex post facto investigations, i.e. the collection of relevant data from hospital records takes place after the fact, usually in an unsystematic manner. It is common knowledge that a retrospective approach is perhaps economical, but open to criticism of its methodology. When the topic of suicide is investigated in patients of a psychiatric hospital, more often than not the patients who are studied have already made a suicide attempt, have expressed suicidal tendencies, or are possible readmissions ( Wolfersdorfet al. 1984; 1986). In this context, the following fact should be taken into consideration: the more distant the index suicide attempt, the greater the possibility that uncontrolled factors have had an influence on the completed suicide. Therefore, it would be wise to identify persons in danger of suicide as soon as possible.
The present study attempts to address this particular point of criticism. Most importantly, it is a prospective longitudinal study in which the data were systematically collected during and after the respective hospital stay. The data on patients who had committed suicide within the period before the five-year follow-up were used in the study. Also of importance is the fact that we studied only first admission psychiatric patients. This enabled us to limit the study to patients who were still in an early phase of the mental illness which afflicted them. The patient's first contact with institutional psychiatry was chosen as 'day 1' of a study period.