Association of prior history of suicide attempt and disease severity and subsequent suicidal acts among patients with psychiatric disorders in North China: a multicentre prospective study protocol.

introductionThe suicide risk among discharged psychiatric patients is substantially higher than that among patients with physical diseases and the general population. In China, few cohort studies have investigated suicidal acts in patients discharged from psychiatric facilities, and the factors that convey the risk of post-discharge suicidal acts in this specific population remain unclear. Therefore, we are conducting a prospective multicentre cohort study to investigate the association between suicide attempt history and disease severity in patients with common psychiatric disorders with post-discharge suicidal acts. METHODS AND ANALYSIS: This study will recruit 3000 inpatients with one of three common psychiatric disorders, namely schizophrenia, bipolar disorder and major depressive disorder, from three hospitals in North China: Beijing Huilongguan Hospital, Tianjin Anding Hospital and the First Hospital of Shanxi Medical University. Participants will include 1500 inpatients with schizophrenia, 900 inpatients with major depressive disorder and 600 inpatients with bipolar disorder. The baseline assessment includes determining whether each recruited patient meets the diagnostic criteria for schizophrenia, major depressive disorder or bipolar disorder using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth edition (DSM-IV) and obtaining details on prior histories of suicide attempts and the severity of the diagnosed disorders using several questionnaires. A 2-year follow-up will be conducted after the recruited patients have been completely assessed. Follow-ups are scheduled at 3, 6, 12 and 24 months after discharge. The primary outcomes are suicidal acts, including suicide attempts and death, that occurred during the follow-up period. A survival analysis will be performed to test for the supposed associations. ETHICS AND DISSEMINATION: This study was approved by the institutional review boards of Beijing Huilongguan Hospital (2022-67-Science), Tianjin Anding Hospital (2022-47) and First Hospital of Shanxi Medical University (2022-K155). All participants will be required to provide written informed consent before the baseline assessment. The recruitment methods will be explained to potential participants, and their confidentiality will be protected throughout the study. The findings of this study will be disseminated to peer-reviewed scientific journals and conference presentations. TRIAL REGISTRATION NUMBER: ChiCTR2200064610.