Psychiatric consultation following attempted suicide

In a study of a psychiatric consultation service, the medical records of 282 patients admitted to University Hospital in Portland, Oregon, following suicide attempts in 1979 and 1980 were reviewed. Some patients were admitted directly to the psychiatry wards, but most were sent initially to the intensive care unit or to medical-surgical wards and were evaluated there. These patients often had chronic psychiatric disorders and usually had overdosed on medications. Although diagnoses of major depressive disorders were uncommon, many patients had taken overdoses of antidepressants. The psychiatric consultants arranged transfer to the psychiatry wards for about half of the patients they evaluated. Patients who had had such transfers were readmitted about as often as those who had been discharged directly. The usefulness of psychiatric consultation is discussed in relation to psychiatric diagnosis, medication evaluation, suicide risk assessment, and disposition planning.