Health-related quality of life in patients discharged from hospital after suicide attempt with violent methods compared to self-poisonings

Figures & data

Figure 1. Flowchart for patients using violent methods and self-poisoning in suicide attempts.

Table 1. Mean SF-36 scale scores for the VM and SF group at 3- and 12-month follow-up.

	3 months			12 months			Difference within groups over time
	VM	SP		VM	SP		VM	SP
mean (SD)	(n = 35)	(n = 30)	p value	(n = 31)	(n = 30)	p value	p value; paired samples t-test
PF	65.3 (28.9)	81.0 (20.5)	<.05*	69.8 (28.7)	79.5 (25.2)	.17	< .05**	.99
RP	27.0 (39.9)	55.8 (42.4)	<.05*	25.8 (37.4)	47.5 (42.2)	<.05*	.26	.28
BP	51.6 (28.6)	67.8 (24.8)	<.05*	56.1 (31.0)	70.0 (26.8)	. 06	.14	.65
GH	49.7 (28.7)	52.2 (17.5)	.69	54.4 (26.8)	53.0 (19.8)	.82	.16	.87
VT	42.6 (20.8)	39.0 (19.9)	.48	46.8 (23.4)	41.3 (21.5)	.34	.25	.65
SF	50.4 (30.5)	51.7 (29.3)	.86	57.6 (32.2)	61.3 (27.7)	.64	.33	.12
RE	27.0 (35.9)	48.9 (43.5)	<.05*	35.5 (42.1)	52.2 (43.5)	.13	.41	.33
MH	50.3 (26.2)	52.4 (23.1)	.79	56.9 (26.3)	56.1 (23.4)	.90	<.05**	.28

PF: Physical Functioning, RP: Role Limitation Physical, BP: Bodily Pain, GH: General Health, VT: Vitality, SF: Social Functioning, RE: Role Limitation Emotional, MH: Mental Health.

Mean: score on each scale, items are coded and transformed to a scale of 0 to 100 following standard guidelines, with a higher score indicating a higher level of functioning.

Independent Student`s t test compares the scales between the groups at same time. Paired sample t-test was performed to compare scores at two times point.

* p value < 0.05 between groups in same period.

**p < 0.05 in paired sample t-test within groups at two time points.

Table 2. SF-36 Scale Scores after suicide attempt by VM or SF according to gender and time to follow-up, and compared to the Norwegian living condition study.

	12 months follow-up				General population
	VM		SP		Norm-data 2015
mean (SD)	Male (n = 21)	Female (n = 10)	Male (n = 11)	Female (n = 19)	Male (n = 946)	Female (n = 1149)
Physical Functioning	74.3 (26.9)*	60.5 (31.5)*	76.8 (23.8)*	81.0 (26.5)	88.1 (17.0)	84.8 (20.8)
Role Limitation Physical	28.8 (39.1)**	20 (34.9)**	56.8 (44.8)*	42.1 (40.9)**	78.9 (35.3)	75.4 (37.7)
Bodily Pain	58.3 (33.7)*	51.5 (25.7)*	73.8 (28.7)	67.5 (26.2)	72.1 (25.4)	73.0 (26.6)
General Health	57.9 (22.5)**	47 (34.2)*	57.7 (22.8)*	50.2 (17.9)**	73.4 (20.8)	76.3 (22.5)
Vitality	50.2 (22.5)*	39.5 (24.8)*	46.8 (24.7)*	38.2 (19.5)**	61.9 (18.9)	56.9 (21.2)
Social Functioning	61.9 (34,3)**	48.8 (26.7)**	73.9 (23.4)*	53.5 (27.9)**	89.0 (19.3)	83.7 (23.1)
Role Limitation Emotional	41.3 (42.0)**	23.3 (41.7)**	57.6 (42.4)*	49.0 (44.7)**	89.5 (26.3)	79.1 (34.6)
Mental Health	63.6 (22.8)**	42.8 (28.8)*	59.3 (26.0)*	54.2 (22.2)**	81.9 (13.8)	(17.0)

Mean: score on each scale, items are coded and transformed to a scale of 0 to 100 following standard guidelines, with a higher score indicating a higher level of functioning. The scales in the groups were compared to the Norwegian norm-data by using OpenEpi Version 3, open-source calculator and a t test with unequal variance was performed by using sample size, mean and standard deviation and set a two-sided confidence interval to 95%, *p value set to < 0.05, **p value set to < 0.001.

Table 3. Hospital anxiety and depression scores at baseline, 3 months and 12 months for patients attempting suicide using violent methods compared to self-poisoning.

			Baseline				3-month follow-up			12-month follow-up
Patients, n = 161			n	mean	(95% CI)	p value	mean	(95% CI)	p value	mean	(95% CI)	p value	Effect (change) over time within groups, p value^a
HADS-A	All responders	VM*	80	10.3	(9.2–11.4)	.12
		SP*	81	11.5	(10.4–12.6)
	Follow-up responders	VM	31	9.3	(7.3–11.3)	<.05	8.9	(6.7–11.1)	.95	8.3	(6.3–10.3)	.84	p = .05
		SP	30	11.7	(9.9–13.4)		9.0	(7.0–11.0)		8.0	(5.9–10.1)		p < .05
HADS-D	All responders	VM*	80	8.7	(7.6–9.9)	.19
		SP*	81	9.8	(8.7–10.8)
	Follow-up responders	VM	31	8.6	(6.4–10.9)	.56	7.4	(5.7–9.2)	.86	7.0	(5.2–8.9)	.78	p < .05
		SP	30	9.4	(7.8–11.0)		7.6	(5.9–9.4)		6.7	(4.8–8.6)		p < .05

HADS-A (HADS Anxiety), HADS-D (HADS Depression), VM (Violent Methods), SP (Self-Poisoning).

* At baseline the scores for all participants are included for comparison to the respondents who completed the study at three and 12 months.

Independent-Samples t-test performed when comparing groups in HADS-A and HADS-D at the same time point.

^a General Linear Model, Multivariate tests, tests the multivariate effect of time. (Within-Subjects Factors; Anxiety; VM p =.051, SP p=.016. Depression; VM p=.019, SP p=.013). These tests are based on the linearly independent pairwise comparisons among estimated marginal means. p value set to 0.05.

Table 4. Multivariable linear regression analyses of SF-36 at 12 months follow-up and associations to hospital anxiety and depression score and adjusted for demographic variables according to method used in suicide attempt.

		Violent methods (n = 31)					Self-poisoning (n = 30)
		Model summary				Model summary
	Predictor variable	Adj. R^2a)	p ^b)	β	95% CI	Adj. R^2a)	p ^b)	β	95% CI
Physical functioning	Anxiety at 12 months	.235	.048	−.44	(−54.34–8.49)	−0.069	.274	.71	(2.40–63.67)
	Depression at 12 months			−.01	(−34.00–33.25)			−0.78	(−69.43 – -9.23)
Role limitation physical	Anxiety at 12 months	.437	.027	−.29	(−23.97–8.16)	.317	.147	.72	(2.86–42.33)
	Depression at 12 months			−.01	(−19.04–15.35)			−0.67	(−42.14 – -3.35)
Bodily pain	Anxiety at 12 months	.328	.014	−.26	(−9.28–3.43)	−.002	.456	.08	(−5.99–7.54)
	Depression at 12 months			−.09	(−7.96–5.55)			−0.30	(−9.90–3.39)
General health	Anxiety at 12 months	.470	.001	−.11	(−14.86–9.52)	.249	.045	.01	(−10.74–10.88)
	Depression at 12 months			−.42	(−24.52–1.58)			−0.64	(−23.25 – −1.99)
Vitality	Anxiety at 12 months	.609	<.001	−.43	(−14.68 – −0.05)	.619	.001	−0.39	(−12.96–.43)
	Depression at 12 months			−.30	(−13.63–2.03)			−0.53	(−15.72 – −2.55)
Social functioning	Anxiety at 12 months	.713	<.001	−.43	(−9.37 – −0.74)	.615	< .001	.41	(−0.16–8.50)
	Depression at 12 months			−.49	(−10.98 – −1.75)			−1.07	(−16.16 – −7.64)
Role limitation emotional	Anxiety at 12 months	.766	<.001	−.48	(−18.81 – −3.54)	.203	.077	−0.22	(−20.03–9.31)
	Depression at 12 months			−.35	(−17.10 – −0.75)			−0.40	(−24.83–9.31)
Mental health	Anxiety at 12 months	.822	<.001	−.56	(−20.47 – −6.57)	.771	<.001	−0.60	(−19.98 – −5.91)
	Depression at 12 months			−.32	(−16.14 – −1.26)			−0.40	(−16.24 – −2.41)

multiple linear regression was performed, and the results are reported as (a) adjusted R² (tells how much of the variance in the dependent variable is explained by the model) (adjusted for (gender, age), marital status, living condition, educational status, and employment status), (b). To test the null hypothesis that multiple R equals zero in the model; we assessed the statistical significance of the results from ANOVA. β = unstandardized beta with CI = Confidence Interval set to 95%, adjusted R², p = p value significant at 0.05* and < .001** for each predictor.

Data availability statement

Data relating to this article can be made available by agreement with the author. Data is linked to the hospital’s server and is subject to sensitive data.