Clinical and epidemiological profiles of suicidal behavior in psychiatric emergency users: A 13-year retrospective study of 40,306 cases in Madrid, Spain
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Suicide is a major global public health concern. Although data on suicide mortality are well documented, large-scale studies examining the clinical and behavioral profiles of suicide attempts (SAs) presenting to Psychiatric Emergency Departments (PEDs) remain scarce, particularly in Spain. This study aimed to describe epidemiological patterns, clinical correlates, and care pathway discontinuities associated with suicidal behavior in a major urban PED. METHODS: A retrospective observational study was conducted using prospectively collected data from 40,306 consecutive presentations for suicidal ideation and/or SAs at the PED of Hospital Clínico San Carlos (Madrid, Spain) between 2006 and 2018. Variables included age, sex, ICD-10 psychiatric diagnosis, method of attempt, recurrence (repeat emergency presentations), and disposition following triage (psychiatric filiation). RESULTS: Suicidal behavior was more frequent among women (54.9%). Two age peaks emerged: one in young adults (18-24 years) and a second in middle-aged adults (34-46 years). Drug overdose was the most common method, predominantly among women (68% of intoxications), whereas higher-lethality methods (e.g., hanging, jumping) were more frequent in men. Psychiatric history was present in 86.6% of presentations. The most prevalent diagnoses were specific personality disorders in women and schizophrenia or alcohol use disorder in men. Only 70.9% of presentations were immediately routed to specialized psychiatric care after triage. CONCLUSIONS: The gender paradox in suicidal behavior is reflected in diagnostic patterns and method choice. High recurrence of emergency presentations underscores the central role of PEDs as points of clinical contact, while the 29.1% gap in immediate psychiatric filiation represents an observed discontinuity in care pathways. These findings may help inform efforts to optimize triage processes and strengthen continuity of care following emergency presentations for suicidal behavior.
Source: Journal of Affective Disorders
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: hybrid
Estimated APC paid: $3,790
OpenAlex ID: W7127618602