MiFID

Out o f th e 4 6 pa t i en t s respond i ng to seventeen ( 37.4%) re ported making at

the Follow-Up Q ue s t i o nna i re ,

lea s t one fu rther sui c i d e a t temp t ( see Figu re 3 ) . Th i s .� tat i s t ic inc ludes one sub j ec t who had k i l led himse l f du r i ng the six months afte r his d i s cha rge from ho s p i tal . Jus t over 1 7% o f the subj e c ts repo rted a sui c i d e a t tempt res u l t i ng i n hos p i t a l adm i ssion ( s e e Figure 4 ) . _{Th i s pe rcentage i s i n l ine w i th previous} re search on the pa t t e rns o f read m i s s i o n to hospi tal fo r sui c i d e a t temp te rs after d i s charge ( see Adam et al , 1 983 ; Banc roft and Ma rsack , 1 977 ) .

The rea t temp t i ng figures fo r fi rs t time a t t empters and repea t e rs a re shown in Tab le 1 7 . Th e tab l e shows 1 0 of the 35 f i rs t a t temp t e rs had mad e a further attempt d u r i ng the s i x mon t h fo l low-up , whi l e seven o f the 32

repea t e rs had mad e further a t temp t s . However there was a higher ra t e of non -res pond ing in the repea t e r g ro up wi th 4 1 % _{not replying compa red to} 2 3 %

for the f i r s t a t t empter group . Thi s d i fference was no t s i gni fi can t ( Chi squared= 2.46, d . f= 1 ) . Non-respondents also did no t d iffer f rom respond e n t s on sex ( Chi squared= 1 . 34 , d . f= 1 ) , me thod of attempt ( C h i squared= 3 . 8 , d . f= 2 ) or o n age ( t= . 64 , d . f=47 ) . The re were a l so no d ifferences between non- respond ents and respond ents on any of the scales in the Pa t i e n t Ques t ionna i re . Thus no sys tema t i c d i fferences ex is ted be tween respond e n t s and non - responde n t s on the variables of i n t e res t .

C ronbach a l phas were compu ted fo r the sca les used i n the Fo l low-Up Ques t ionna i re . The Zung Sel f-Ra t in g Depress ion S c a l e had an a l pha of . 89 and the four i tem Sui c idal Idea t i o n Scale ( Payke l e t a l , 1 97 4 ) , an a l pha

FI G U R E 3 ; N U M B E R O F R E P O RTE D FU RTH E R AlfE M PTS A RE R _SIX M O NTH FOL LOW - U P

'tWO A11EWPIS 2

HO HOSPITAL REPEAT 9 u�.sx HOSPirAL REPEA"'S 8 17.4X FI G UR E4 ; N U M B E R O F R E P E AlER S _{H OSPirALISED} AFlER SIX M O NTH FO LLOW- U P

Tab l e 1 7 ; C ro s s tabula t i o n o f fi rs t and

at ad m i s s i on with non- repeat e rs and re pea t e rs after six mon t h s

A t Adm ission F i r s t time at t emp t e rs Repeat at tempters •ro t a l No repea t 1 7 1 2 29 A t Fol low-up

Repeat Non Response

1 0 8

7 1 3

1 7 2 1

8 . 6 _{Pred i c t ing depres sion level a t the s i x month fo l low-up}

To tal

35

32

67

The hyp o thes i s tha t low s e l f es t eem , poo r so c ia l sk i l l s and h igh hopelessness at admission wo uld be rel a t ed to depre s s i o n level a t fol low-up was inves t igated . The o rt hogonal fac tors o f a l l s i x i nd epend ent variab l e s we r e ent e red into a mu ltiple regre s s i o n equ a t i o n pred ic t i ng depres s i o n . The res u l ts pres ented in Tab l e 1 8 show s e l f e s t e em to be the only variab l e tha t is sign i f i c an t ly related to depres s i o n . S e l f e s t e em was a be t t e r pred i c to r o f fut u re depres s io n than bo th the pa t i ent ' s previ o us depres s i o n , and hopelessness l eve l . A l l other fac t o rs , a pa r t

from tho se measu r i ng social ski l l s , d o show reas onabl e beta weigh t s but are not s i gni fican t ly large enough to reach sign i fi cance in this sampl e .

Tab l e 1 8 ; Mu l t i p le Regress ion Equa t i o n Pred ic ti ng Lev el o f Depres s i o n a t Fo l low-up

VAR IABLES IN THE EQUAT I ON - - - -

VARI ABLE

ASSERTION FACTOR FLEXIBILI TY FACTOR SELF ESTEEJVI FAC 'rOR DEPRESS ION FACTOR HOPELESSNESS FACTOR SOC IAL AN XIETY FACTOR

(CONSTANT) ** = p < . 0 1 f1ULT IPLE R R SQUARE 0.609 o . 371 B BETA T 1 . 530 0 . 1 58 1 . 060 -2 . 6 1 1 -0 . 2 1 9 -1 . 5 1 4 -4 . 4 1 1 -0 . 439 -) . 1 2 4 ** 2 . 585 0 . 261 1 . 86 6 2 . 798 o . 277 1 . 9 66 -0 . 6 1 3 -0 . 059 -0 . 4 1 4 27.949

ANALYSI S OF VAR IANCE

REGRESSION RES I DUAL F = DF 6 33 SUM OF SQUARES 1 7 1 6 . 387 2903 . 1 1 2 MEAN SQUARE 286 . 06 4 87 . 973 3 . 2 52 SIGNIF F = 0 . 01 3

8 . 7 P red i c t ing su i c i d a l idea t i o n a t the s i x mon t h fo l l ow-up

The hypo thes i s tha t sujc idal idea t i o n at fo l l o w -up would be rel a ted t o low self es t eem , poo r soc i a l sk i l l s and h igh hope l essne s s a t adm i s s i o n wa s tested nex t . A l l s i x fac t o rs were en t e red into a mul t i p l e reg ress io n w i t h suic i d a l idea t i o n a t fo l l ow-up the d e pendent variable . The res u l t s o f th i s ana lys i s a re shown in Tab l e 1 9 . The tab l e shows only t wo variables s i gni f i c an t ly pred i c t ed suic i d al idea t i on , these were sel f e s t e em and ass P. r t i o n . Th i s resu l t confi rmed the hypo the s i s tha t low s e l f e s teem would be re lated to suic idal ideation at foll o w-up but d id no t supp o r t the hope l es sness and soc i a l ski l l s hypo thes e s . The fac t that high a s s e r t ion is significantly rel a t ed to sui c idal idea t i o n i s a sup r i s i ng re s u l t and d i re c t ly con t ra ry to p red i c t i on s . Other fac t o rs whi l e no t s i gn i f i c a n t , do explain some of the pred i c t iv e variance a re low flexibil i ty and low s o c i a l anx i e t y .

8 . 8 Di sc rimina t i ng rea t t empters after s i x mon ths .

To t e s t the hyp o t h e s i s tha t pa tients maki ng a repe a t su i c i d e a t tempt during the six mon th fol low-up would be chara c terised by low s e l f es t eem ,

low levels of so c ia l ski l ls and h igh l evels of hope l es sn e s s , a

d i s c riminant func t i on ana lys i s on repea t e rs and non- repea t e rs wa s perfo rmed . Three sub j e c ts were excluded f rom the ana lys i s because they had more than two m i ss i ng fac t o r scores . Thi s left 43 subj ec ts ; 1 5 who had made a repea t a t t empt (repea t e rs) and 28 non - repea t e rs . The res u l t s o f the discrim inant analys i s are shown i n Tables 20 , 2 1 and 22 .

Table 1 9 ; Mu l t i p l e Regress ion Equa t i o n Pred i c t i ng Sui c id a l Idea t i o n at Fo l l ov1-up