Suicide Deaths Among Hospitalized Patients With Delirium: A Case Series From a Nationwide Database in Japan

Abstract

Objective

Delirium is a common psychiatric condition in general hospitals and a known risk factor for suicidal ideation. However, little is known about suicide deaths among patients with delirium. This study examined the clinical characteristics of hospitalized patients with delirium who died by suicide.

Methods

Analyzed were anonymized medical incident data reported to the Japan Council for Quality Health Care from 2010 to 2022. Among reported inpatient suicide deaths, cases with documented delirium were identified and analyzed.

Results

A total of 403 inpatient suicides were identified during the study period, of which 12 (5.1%) involved patients with delirium, all of whom were admitted to medical wards. The most common methods of suicide were jumping from a height and hanging, often occurring in hospital rooms. Suicidal ideation and distress related to physical illness, including depression, anxiety, and pain, were frequently observed. However, only about half of the patients had received specialist interventions, such as psychiatric consultation. Patient characteristics, including sex and primary illness, were consistent with previous studies of inpatient suicide, with the exception of age.

Conclusions

While this study cannot determine whether delirium independently contributes to suicide risk, the findings suggest that recognizing and managing delirium—together with timely specialist interventions, such as psychiatric consultation, and standard inpatient safety measures, including restricting access to means and making appropriate decisions regarding patient leave—may be important components of suicide prevention in general hospital settings. Further research is needed to better understand how delirium influences suicide risk.