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Suicide Prevention Should Focus on High-Risk Periods

First 12 weeks after psychiatric hospitalization has highest rate of suicides

WEDNESDAY, Jan. 7 (HealthDay News) -- The first 12 weeks after psychiatric hospitalization are the highest risk period for suicide, and health systems with limited resources should focus their suicide prevention efforts there, according to research published in the January issue of the Journal of Affective Disorders.

Marcia Valenstein, M.D., of the Department of Veterans Affairs Medical Center in Ann Arbor, Mich., and colleagues conducted a study of 887,859 Veteran Affairs patients who were treated for depression from April 1999 to September 2004. As well as psychiatric hospitalizations, the investigators looked at other readily identifiable 12-week periods, including new courses of antidepressants within the previous six months, other types of commencement of antidepressant therapy and dose changes.

Within the first 12 weeks of psychiatric hospitalization, there were 568 suicides per 100,000 person-years, versus 210/100,000 after new antidepressants treatment, 193/100,000 after other starts and 154/100,000 after changes to dosage, the researchers report. For those who underwent psychiatric hospitalization, suicide rates were still above the base rate after 48 weeks, the investigators found. Patients at the highest risk of suicide were those aged 61 to 80 years, the data revealed.

"Health systems with limited resources may need to first focus on the highest-risk treatment periods which follow psychiatric hospitalization," the authors write. "If resources permit, health systems might also consider providing closer monitoring in the first 12 weeks immediately following antidepressant starts, across all adult age-groups."

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