Proportion of Impulsive Suicide Attempts among Persons Admitted with Suicide Attempts in a Tertiary Care Hospital: A Cross - Sectional Study

Background: Suicides are regarded as a major public health issue worldwide. Attempted suicides are many times more frequent than fatal suicides and a considerable number of these attempts are impulsive. The clinical profile of patients with impulsive suicide attempts seems to be distinct suggesting implications in management and prevention. There appears a paucity of research in Kerala regarding the proportion of impulsive suicide attempts and various risk factors associated with it. Hence, this study was done to estimate the proportion of impulsive suicide attempts, among adult patients admitted with suicide attempts between the age group 18 - 60 years in a tertiary care hospital in Thiruvananthapuram and to compare the clinical and socio - demographic profile of impulsive and non - impulsive suicide attempts. Methods: A cross - sectional study was conducted among adult inpatients (18 - 60 years) admitted with attempted suicide in Medicine, Surgery and Psychiatry wards in a tertiary care hospital in Thiruvananthapuram. Consecutive sampling was used to select 110 subjects. Written informed consent was taken and sociodemographic and clinical details were entered in the semi structured proforma. Lethality and intent of the suicide attempt were clinically assessed. Psychiatric morbidity was assessed using DSM5 criteria, impulsiveness using Barratt impulsiveness scale (BIS) and Stressful Life Events using Presumptive Stressful Life Events Scale (PSLES). Chi square test was used for comparison of proportion. Odds ratio was calculated to determine the strength of association. Binary logistic regression was used to find adjusted odds ratio and their statistical significance. Results: Majority of the participants belonged to age group of 21 - 30years (35.5%) and were females (59.1%). The proportion of impulsive suicide attempts was found to be 47.3%. Most common method was by consumption of insecticide/poisoning. Multivariate analysis using binary logistic regression showed that age less than 30 years, being unemployed, methods of attempt like slashed wrist and drug over dosage, history of psychiatric disorders like borderline personality disorder and adjustment disorder and impulsiveness were found to have statistically significant association with impulsive suicide attempts. Conclusion: The proportion of impulsive suicide attempts was found to be high. The distinct clinical and sociodemographic profile suggests the need for a thorough psychiatric evaluation of every suicide attempt and steps for its intervention and prevention.