Suicidal ideation in the psychiatric emergency room: prevalence and associated factors

Background: Suicidal ideation (SI) is not uncommon in ER settings. Past studies have shown an association of SI with alcohol use, female gender, and younger age with a prevalence of approximately 35% in psychiatric ERs. However, there have not been recent studies. In this study, we examined the prevalence and associated factors of SI in the psychiatric emergency room setting. Methods: 226 consecutive psychiatric ER patients from an academic medical center were examined by retrospective chart review. Data included demographics, clinical variables, past history of SI or suicide attempt (SA), current SI/SA, psychiatric diagnoses, substance use, and family history. Data was entered into SPSS and analyzed. Results: Suicidal ideation was present in 33.8% and 20.9% had a suicidal plan. A suicidal plan was present in 16.9% and 8.9% had active SI. Twenty (8.9%) had a suicide attempt on presentation to the emergency room. Eighty percent had an overdose while 10% cutting and 10% other method. Variables associated with having SI included current alcohol and stimulant use, being single, family history of alcoholism, prior history of SA, and diagnoses of schizophrenia, major depression, or bipolar depression. Interestingly, there was no association with age, gender, family history of SA, psychosis, or other substance use. Conclusion: Presence of suicidal ideation is common in the psychiatric emergency room, seen in one-third in this sample. However, the current study differs from past studies showing no differences in SI to age or gender. Differences and similarities of the current study to past studies are discussed.