Demographic, Behavioral, and Psychiatric Risk Factors for Suicide

Crisis ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 104-111 ◽  
Author(s):  
Nomi Werbeloff ◽  
Bruce P. Dohrenwend ◽  
Itzhak Levav ◽  
Ziona Haklai ◽  
Rinat Yoffe ◽  
...  
Keyword(s):  
Suicide Attempts ◽  
Mortality Data ◽  
Recall Bias ◽  
Community Based ◽  
Major Depressive ◽  
High Functioning ◽  
Psychiatric Hospitalizations ◽  
Male Sex ◽  
Nonclinical Sample

Abstract. Background: There have been very few prospective studies of death by suicide in the general population. Rather, studies of suicide have generally used psychological autopsies, a method that has the potential weakness of recall bias. Aims: To examine correlates of death by suicide among a community-based nonclinical sample prospectively assessed years before death by suicide. Method: We analyzed data from an epidemiological study of a 10-year birth cohort (n = 4,914) conducted in Israel in the 1980s, with follow-up mortality data over 25 years. Results: Eight participants died by suicide during follow-up (6/100,000 per year; mean follow-up to suicide = 18.3 ± 2.0 years), the majority of whom were rated as functioning relatively well at baseline. Male sex, psychiatric hospitalizations, major depressive disorder, and previous suicide attempts were associated with later suicide. Conclusion: In this nonclinical sample of persons assessed between ages 25 and 34, several correlates of suicide were identified, but the majority of persons who died by suicide were relatively high functioning at baseline. Major precursors of suicide may be more proximal factors of acute or chronic negative changes in life circumstances.

Subsequent Mortality in Medically Serious Suicide Attempts: A 5 Year Follow-Up

2003 ◽  
Vol 37 (5) ◽  
pp. 595-599 ◽  
Author(s):  
Annette L. Beautrais
Keyword(s):  
Suicide Attempts ◽  
Motor Vehicle ◽  
Population Sample ◽  
Term Treatment ◽  
Mortality Data ◽  
Consecutive Series ◽  
Vehicle Accidents ◽  
National Mortality ◽  
Long Term Treatment

Objective: To document mortality in a consecutive series of 302 individuals who made medically serious suicide attempts and were followed-up for 5 years. Method: All sources of mortality were examined in a 5 year prospective study of 302 individuals who made medically serious suicide attempts. Mortality data were obtained by checks with the national mortality database and, for suicide and accidental deaths, were confirmed by review of coronial records. Results: Within 5 years of making a medically serious suicide attempt, one in 11 (8.9%) participants had died. Most deaths (59.2%) were by suicide. Comparison of mortality in this series with rates expected in a comparable general population sample showed the excess mortality was attributable to death by suicide and by motor vehicle accidents. Conclusion: Mortality among those who make medically serious suicide attempts is high. These findings imply the need for the development of enhanced and long-term treatment, follow-up and surveillance programmes for those who make medically serious suicide attempts.

Familial depression versus depression identified in a control group: are they the same?

1995 ◽  
Vol 25 (4) ◽  
pp. 797-806 ◽  
Author(s):  
G. Winokur ◽  
W. Coryell ◽  
J. Endicott ◽  
H. Akiskal ◽  
M. Keller ◽  
...  
Keyword(s):  
Psychological Functioning ◽  
Suicide Attempts ◽  
Collaborative Study ◽  
Study Data ◽  
Control Group ◽  
Psychiatric Hospitalizations ◽  
Comparison Groups ◽  
Research Criteria ◽  
Better Than

SYNOPSISSubjects who meet the criteria for an affective syndrome possibly are aetiologically heterogeneous. An approach to this possibility involves examining affectively ill subjects obtained by different methods of ascertainment. This study compares depressed and manic subjects who are related to affectively ill probands with affectively ill subjects who were obtained from a study of a control population, and, therefore, were less likely to be familial. The subjects were identified in a large collaborative study of depression where both family members as well as controls were personally interviewed and followed up for 6 years after admission to the study. Data were obtained on subtypes of affective disorder using the Research Diagnostic Criteria and information was gathered about psychiatric hospitalizations, suicide attempts, alcoholism and psychological functioning prior to admission. Similar assessments were made for the comparison groups for the 6 year period between intake and follow-up. Relatives of bipolar I/schizoaffective manic probands were more likely to show mania than affectively ill controls or relatives of unipolar/schizoaffective depressed probands. Affectively ill controls were less likely to be hospitalized and less likely to suffer from an incapacitating depression. They were also likely to have functioned in a more healthy fashion than the affectively ill relatives of the bipolars and unipolars, in the 5 years before admission to the study. In the 6 year follow-up, both the subjects themselves and raters assessed the depressed controls as functioning better than the affectively ill relatives of the probands. Further, assessment of global adjustment during the 6 year period was worse for the relatives of affectively ill probands than for the depressed controls. Length of major depression was longer in relatives of bipolar and unipolar probands than in controls. Though all of the subjects in this study met research criteria for an affective illness, there were marked differences in the qualitative aspects of these illnesses with the relatives of affectively ill probands, who functioned less well and had longer and more severe episodes and more hospitalizations.

scholarly journals Do Suicide Attempts of Mood Disorder Patients Directly Increase the Risk for a Reattempt?

2020 ◽  
Vol 11 ◽  
Author(s):  
Kari I. Aaltonen ◽  
Tom Rosenström ◽  
Pekka Jylhä ◽  
Irina Holma ◽  
Mikael Holma ◽  
...  
Keyword(s):  
Suicide Attempt ◽  
Mood Disorder ◽  
Major Depressive Episode ◽  
Suicide Attempts ◽  
Ordinal Number ◽  
Major Depressive ◽  
Individual Level ◽  
Level Data ◽  
Depressive States

Background: Preceding suicide attempts strongly predict future suicidal acts. However, whether attempting suicide per se increases the risk remains undetermined. We longitudinally investigated among patients with mood disorders whether after a suicide attempt future attempts occur during milder depressive states, indicating a possible lowered threshold for acting.Methods: We used 5-year follow-up data from 581 patients of the Jorvi Bipolar Study, Vantaa Depression Study, and Vantaa Primary Care Depression Study cohorts. Lifetime suicide attempts were investigated at baseline and during the follow-up. At follow-up interviews, life-chart data on the course of the mood disorder were generated and suicide attempts timed. By using individual-level data and multilevel modeling, we investigated at each incident attempt the association between the lifetime ordinal number of the attempt and the major depressive episode (MDE) status (full MDE, partial remission, or remission).Results: A total of 197 suicide attempts occurred among 90 patients, most during MDEs. When the dependencies between observations and individual liabilities were modeled, no association was found between the number of past suicide attempts at the time of each attempt and partial remissions. No association between adjusted inter-suicide attempt times and the number of past attempts emerged during follow-up. No indication for direct risk-increasing effects was found.Conclusion: Among mood disorder patients, repeated suicide attempts do not tend to occur during milder depressive states than in the preceding attempts. Previous suicide attempts may indicate underlying diathesis, future risk being principally set by the course of the disorder itself.

One-Year Follow-up of Children and Adolescents with Major Depressive Disorder: Relationship between Clinical Variables and Abcb1 Gene Polymorphisms

2016 ◽  
Vol 49 (06) ◽  
pp. 248-253 ◽  
Author(s):  
A. Blázquez ◽  
P. Gassó ◽  
S. Mas ◽  
M. Plana ◽  
A. Lafuente ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Suicide Risk ◽  
Suicide Attempts ◽  
Diagnostic Interview ◽  
Stressful Events ◽  
Major Depressive ◽  
Abcb1 Gene ◽  
One Year

Abstract Introduction: Differences in response to fluoxetine (FLX) may be influenced by certain genes that are involved in FLX transportation (ABCB1). We examined remission and recovery from the index episode in a cohort of patients treated with FLX, and also investigated associations between genetic variants in ABCB1 and remission, recovery, and suicide risk. Methods: This was a naturalistic 1-year follow-up study of 46 adolescents diagnosed with major depressive disorder (MDD). At 12 months they underwent a diagnostic interview with the K-SADS-PL. Results: It was found that remission was around 69.5% and recovery 56.5%. Remission and recovery were associated with lower scores on the CDI at baseline, with fewer readmissions and suicide attempts, and with lower scores on the CGI and higher scores on the GAF scale. No relationship was found between ABCB1 and remission or recovery. However, a significant association was observed between the G2677T ABCB1 polymorphism and suicide attempts. Conclusion: Other factors such as stressful events, family support, and other genetic factors are likely to be involved in MDD outcome.

Incidence and predictors of suicide attempts among primary-care patients with depressive disorders: a 5-year prospective study

2013 ◽  
Vol 44 (2) ◽  
pp. 291-302 ◽  
Author(s):  
K. Riihimäki ◽  
M. Vuorilehto ◽  
T. Melartin ◽  
J. Haukka ◽  
E. Isometsä
Keyword(s):  
Risk Factors ◽  
Primary Care ◽  
Substance Abuse ◽  
Depressive Disorder ◽  
Depressive Disorders ◽  
Suicide Attempts ◽  
Major Depressive ◽  
Primary Care Patients ◽  
Dsm Iv

BackgroundNo previous study has prospectively investigated incidence and risk factors for suicide attempts among primary care patients with depression.MethodIn the Vantaa Primary Care Depression Study, a stratified random sample of 1119 patients was screened for depression, and Structured Clinical Interviews for DSM-IV used to diagnose Axis I and II disorders. A total of 137 patients were diagnosed with a DSM-IV depressive disorder. Altogether, 82% of patients completed the 5-year follow-up. Information on timing of suicide attempts, plus major depressive episodes (MDEs) and partial or full remission, or periods of substance abuse were examined with life charts. Incidence of suicide attempts and their stable and time-varying risk factors (phases of depression/substance abuse) were investigated using Cox proportional hazard and Poisson regression models.ResultsDuring the follow-up there were 22 discrete suicide attempts by 14/134 (10.4%) patients. The incidence rates were 0, 5.8 and 107 during full or partial remission or MDEs, or 22.2 and 142 per 1000 patient-years during no or active substance abuse, respectively. In Cox models, current MDE (hazard ratio 33.5, 95% confidence interval 3.6–309.7) was the only significant independent risk factor. Primary care doctors were rarely aware of the suicide attempts.ConclusionsOf the primary care patients with depressive disorders, one-tenth attempted suicide in 5 years. However, risk of suicidal acts was almost exclusively confined to MDEs, with or without concurrent active substance abuse. Suicide prevention among primary care patients with depression should focus on active treatment of major depressive disorder and co-morbid substance use, and awareness of suicide risk.

Psychopathological predictors of suicide in patients with major depression during a 5-year follow-up

2001 ◽  
Vol 16 (5) ◽  
pp. 283-288 ◽  
Author(s):  
B. Schneider ◽  
M. Philipp ◽  
M.J. Müller
Keyword(s):  
Major Depression ◽  
Depressive Disorders ◽  
Suicide Attempts ◽  
Psychotic Symptoms ◽  
Mortality Data ◽  
Course Of Illness ◽  
Early Predictors ◽  
Increased Risk ◽  
A Prospective Study

SummaryObjective. It is widely known that the risk of suicide is higher in cases of major depressive disorders in comparison to the general population. The purpose of this study was to examine which psychopathologic symptoms during the index episode are predictors for an increased risk of suicide in the further course of major depression. Method. Mortality data were determined from a prospective study of 280 patients with major depression (DSM-III-R, single episode or recurrent) during a follow-up period of 5 years. The predictive power of different depressive symptoms including psychotic symptoms for suicide risk was investigated. Results. Patients who committed suicide (N = 16) during the follow-up period had reported significantly more often hypochondriacal preoccupations or delusions (but not delusions or preoccupations of impoverishment, guilt or sin), suicidal thoughts and suicide attempts as well as feelings of severe hopelessness during the index episode than still living patients or patients who had died from natural causes. Conclusion. These symptoms seem to be helpful early predictors for the risk of suicide during the further course of illness. This should be taken into account for suicide prevention in the course of major depression.

Investigating the Relationship Between Self-Esteem and Stigma Among Young Adults With History of Suicide Attempts

Crisis ◽  
2016 ◽  
Vol 37 (4) ◽  
pp. 265-270 ◽  
Author(s):  
Meshan Lehmann ◽  
Matthew R. Hilimire ◽  
Lawrence H. Yang ◽  
Bruce G. Link ◽  
Jordan E. DeVylder
Keyword(s):  
Young Adults ◽  
Suicide Attempts ◽  
Self Esteem ◽  
High Risk Population ◽  
High Functioning ◽  
People With Mental Illness ◽  
History Of ◽  
The Individual ◽  
The Impact ◽  
The Relationship

Abstract. Background: Self-esteem is a major contributor to risk for repeated suicide attempts. Prior research has shown that awareness of stigma is associated with reduced self-esteem among people with mental illness. No prior studies have examined the association between self-esteem and stereotype awareness among individuals with past suicide attempts. Aims: To understand the relationship between stereotype awareness and self-esteem among young adults who have and have not attempted suicide. Method: Computerized surveys were administered to college students (N = 637). Linear regression analyses were used to test associations between self-esteem and stereotype awareness, attempt history, and their interaction. Results: There was a significant stereotype awareness by attempt interaction (β = –.74, p = .006) in the regression analysis. The interaction was explained by a stronger negative association between stereotype awareness and self-esteem among individuals with past suicide attempts (β = –.50, p = .013) compared with those without attempts (β = –.09, p = .037). Conclusion: Stigma is associated with lower self-esteem within this high-functioning sample of young adults with histories of suicide attempts. Alleviating the impact of stigma at the individual (clinical) or community (public health) levels may improve self-esteem among this high-risk population, which could potentially influence subsequent suicide risk.

Gender Differences in Suicidal Intent and Choice of Method Among Suicide Attempters

Crisis ◽  
2008 ◽  
Vol 29 (4) ◽  
pp. 209-212 ◽  
Author(s):  
Merete Nordentoft ◽  
Jacob Branner
Keyword(s):  
Gender Differences ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Suicidal Intent ◽  
Suicide Intent ◽  
Suicidal Intention ◽  
National Patient ◽  
Prevention Center ◽  
Suicide Prevention Center

The objective was to examine gender differences in choice of method and suicidal intent among persons referred to a suicide prevention center. A total of 351 consecutive patients who had attempted suicide were interviewed using the European Parasuicide Study Interview Schedule I (EPSIS I) while participating in a 2-week inpatient treatment program. They were invited to a 1-year follow-up interview, and followed in the National Patient Register. Compared to women, men who had attempted suicide were older, had better self-esteem, fewer depressive symptoms, and higher total suicidal intention scores, but they were not more likely to use violent methods. Neither use of violent method nor dangerousness of the attempt was associated with suicidal intention. Although men had higher suicide intent scores than women, there were no significant gender differences in the number of repeat suicide attempts during a 1-year follow-up period. Suicidal intent was not related to dangerousness of suicide method.

Cathartic Effect of Suicide Attempts Not Limited to Depression

Crisis ◽  
2003 ◽  
Vol 24 (2) ◽  
pp. 73-78 ◽  
Author(s):  
Yves Sarfati ◽  
Blandine Bouchaud ◽  
Marie-Christine Hardy-Baylé
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Personality Traits ◽  
Rating Scales ◽  
Suicide Attempts ◽  
World Health ◽  
Life Questionnaire ◽  
Short Term

Summary: The cathartic effect of suicide is traditionally defined as the existence of a rapid, significant, and spontaneous decrease in the depressive symptoms of suicide attempters after the act. This study was designed to investigate short-term variations, following a suicide attempt by self-poisoning, of a number of other variables identified as suicidal risk factors: hopelessness, impulsivity, personality traits, and quality of life. Patients hospitalized less than 24 hours after a deliberate (moderate) overdose were presented with the Montgomery-Asberg Depression and Impulsivity Rating Scales, Hopelessness scale, MMPI and World Health Organization's Quality of Life questionnaire (abbreviated versions). They were also asked to complete the same scales and questionnaires 8 days after discharge. The study involved 39 patients, the average interval between initial and follow-up assessment being 13.5 days. All the scores improved significantly, with the exception of quality of life and three out of the eight personality traits. This finding emphasizes the fact that improvement is not limited to depressive symptoms and enables us to identify the relative importance of each studied variable as a risk factor for attempted suicide. The limitations of the study are discussed as well as in particular the nongeneralizability of the sample and setting.

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