Sex-differences in determinants of suicide risk preceding psychiatric admission: An electronic medical record study

Using electronic medical record (EMR) data collected from psychiatric inpatient admissions, the objective of this study was to identify sex differences in risk factors for presence of suicide plans and/or attempts within the 30 days preceding hospital admission. Resident Assessment Instrument for Mental Health (RAI-MH) intake data were obtained for patients admitted to a Canadian tertiary-care hospital deemed a threat or danger to self during a ten-year period (2008-2018). Data was extracted for individuals categorized into three groups: non-suicidal (N=568), presence of suicide plan (N=178), and presence of suspected suicide attempt (N=124) in the 30 days prior to hospital admission. A multivariate logistic regression revealed that younger age (odds ratio=0.97), female sex (OR=1.56), disrupted family relationships (OR=1.54), recent stressors (OR=1.59), participation in social activities (OR=1.54), having no confidant (OR=1.55), and diagnosis of depressive disorder (OR=5.54) increased the odds of suicide plan and/or attempt in the 30 days prior to hospital admission. Stratifying the regression model by sex highlighted different risk factors for suicide plan and attempt specific to males and females. EMR-derived findings highlight psychosocial and clinical determinants associated with suicide plan or attempt prior to psychiatric admission that differ according to sex.