Psychiatric disorders in male prisoners who made near-lethal suicide attempts: case-control study

Background:
Although male prisoners are five times more likely to die by
suicide than men of a similar age in the general population,
the contribution of psychiatric disorders is not known.
Aims:
To investigate the association of psychiatric disorders with
near-lethal suicide attempts in male prisoners.
Method:
A matched case–control study of 60 male prisoners who
made near-lethal suicide attempts (cases) and 60 prisoners
who had never carried out near-lethal suicide attempts in
prison (controls) was conducted. Psychiatric disorders were
identified with the Mini International Neuropsychiatric
Interview (MINI), and information on sociodemographic
characteristics and criminal history was gathered using a
semi-structured interview.
Results:
Psychiatric disorders were present in all cases and 62% of
controls. Most current psychiatric disorders were associated
with near-lethal suicide attempts, including major depression (odds ratio (OR) = 42.0, 95% CI 5.8–305), psychosis (OR = 15.0, 95% CI 2.0–113), anxiety disorders (OR = 6.0, 95% CI 2.3–15.5)and drug misuse (OR = 2.9, 95% CI 1.3–6.4). Lifetime psychiatric disorders associated with near-lethal attempts included recurrent depression and psychoses. Although cases were more likely than controls to meet criteria for antisocial personality disorder, the difference was not statistically significant. Comorbidity was also significantly more common among cases than controls for both current and lifetime disorders.
Conclusions:
In male prisoners, psychiatric disorders, especially
depression, psychosis, anxiety and drug misuse, are
associated with near-lethal suicide attempts, and hence
probably with suicide.