Original Research September 4, 2018

Suicidality 6 Years After Occupational Injury

Wei-Shan Chin, PhD; Yue Leon Guo, PhD; Shih-Cheng Liao, PhD; Kuan-Han Lin, PhD; Chun-Ya Kuo, MD; Chih-Chieh Chen, PhD; Judith S. C. Shiao, PhD

J Clin Psychiatry 2018;79(5):17m11729

Article Abstract

Objective: Suicide attempts can result from traumatic events, including those caused by occupational injury. However, literature on the long-term prevalence rates of suicidality after occupational injury is relatively lacking. This study investigated the long-term prevalence of suicidality after occupational injury.

Methods: Between February 1 and August 31, 2009, 4,403 workers in Taiwan sustained occupational injuries and were hospitalized for 3 days or longer. Surveys were conducted at 3 and 12 months after occupational injury, and 2,308 workers responded to either survey. They were invited to join the follow-up at 6 years after occupational injury, using the Brief Symptom Rating Scale (BSRS-5), Posttraumatic Symptom Checklist (PTSC), and 1 question on suicidal ideation. Workers with a high score on the BSRS-5 or PTSC were invited to participate in an in-depth psychiatric evaluation using the Chinese version of the Mini-International Neuropsychiatric Interview (MINI).

Results: The estimated MINI-diagnosed suicidality rates at 3 months, 12 months, and 6 years after occupational injury were 5.4%, 4.8%, and 9.5%, respectively. Injured workers who reported that the injury majorly affected their physical appearance, experienced additional occupational injury requiring hospitalization for > 3 days, had unstable employment, and had lower income in the past 1 year than that before occupational injury had a higher risk of suicidal ideation. Injury majorly affecting the physical appearance, unstable employment, and lower income than that before occupational injury were the most crucial factors. These factors accounted for 12.7%, 13.2%, and 19.0% of suicidal ideation among the injured workers.

Conclusions: The suicidality rate increased at 6 years after occupational injury. The relevant factors for suicidal ideation were injury severity and work instability. Periodic monitoring of psychological and physical health and economic stability are warranted.

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