Mortality and Further Suicidal Behaviour After an Index Suicide Attempt: a 10-Year Study

2005 ◽  
Vol 39 (1-2) ◽  
pp. 95-100 ◽  
Author(s):  
Sheree J. Gibb ◽  
Annette L. Beautrais ◽  
David M. Fergusson

Objective: To examine further suicide attempts and mortality in the 10 years after a suicide attempt requiring hospital admission. Method: Participants were a consecutive series of 3690 individuals admitted to Christchurch Hospital for attempted suicide during the 10-year period 1993–2002. Data were obtained on admissions to Christchurch Hospital for attempted suicide during the study period. Mortality subsequent to the index suicide attempt was established from the National Mortality Database. The influence of age, gender and method of index suicide attempt on mortality and further suicide attempts requiring hospitalization were examined. Results: Within 10 years, 28.1% of those who had been admitted for an index suicide attempt were readmitted for a further non-fatal suicide attempt, and 4.6% died by suicide. Risks and rates of readmission were higher in: females; those under 55; and those whose index attempt involved a method of low lethality. Risks and rates of suicide were higher in: males; those aged 25 and over; and those using an index suicide attempt method of high lethality. Risks and rates of readmission and mortality from suicide were highest in the first 2 years after the index attempt, although deaths and readmissions occurred throughout the 10 years study period. Conclusions: Those making suicide attempts requiring hospital admission are at high risk of further hospitalization for suicide attempt and of death from suicide. These findings suggest a need for ongoing support and monitoring, and for enhanced treatment and management of all those making suicide attempts which require hospital admission in an effort to reduce risks of further suicidal behaviour.

2006 ◽  
Vol 21 (6) ◽  
pp. 396-400 ◽  
Author(s):  
Slavko Ziherl ◽  
Bojan Zalar

AbstractObjective:All suicide attempts cannot predict suicide, therefore we examined those characteristics of suicide attempt which could most accurately predict completed suicide.Subject and methods:Subjects were all individuals registered as committed suicides (N = 16,522) or attempted suicides (N = 15,057) in the register of suicides of the Republic of Slovenia between 1970 and 1996. Log linear analysis of a frequency table was used to uncover relationship between categorical variables.Results:The model we found fit between variables: mode, number of repetitions and type, then between number of repetitions, type and gender, and between mode, type and gender.Discussion:The risk of suicide in those who previously attempted suicide is approximately 773 times higher than the risk of suicide without a previous suicide attempt. Those who attempt suicide by hanging (hanging being in Slovenia the most frequent mode of completed suicide) are at even greater risk to commit suicide.Conclusion:Our data suggests that clinicians should heighten their awareness that any suicide attempt can in some 20% predict suicide. Someone who has attempted suicide by hanging is at the highest risk of suicide.


2003 ◽  
Vol 37 (5) ◽  
pp. 595-599 ◽  
Author(s):  
Annette L. Beautrais

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.


1998 ◽  
Vol 28 (1) ◽  
pp. 209-218 ◽  
Author(s):  
A. L. BEAUTRAIS ◽  
P. R. JOYCE ◽  
R. T. MULDER

Background. This study used a case–control design to examine the association between unemployment and risk of medically serious suicide attempt.Method. A sample of 302 individuals who made serious suicide attempts was contrasted with 1028 randomly selected community control subjects.Results. Individuals who made serious suicide attempts reported higher rates of current unemployment (OR=4·2) than control subjects. This association was similar for males and females. However, even before adjustment for confounding factors it was evident that exposure to unemployment made only a small contribution to suicide attempt risk. The population attributable risk for exposure to unemployment was 7·3%. After adjustment for antecedent childhood, family and educational factors the association between unemployment and risk of serious suicide attempt was reduced but remained significant (OR=2·1), suggesting that common antecedent factors made a large contribution to risks of both unemployment and serious suicide attempt. When both antecedent family and childhood factors, and psychiatric morbidity were taken into account, unemployment was not significantly related to risks of serious suicide attempt.Conclusion. The results of this study provide support for the contention that much of the association between unemployment and suicidal behaviour is non-causal, and reflects common or correlated factors that contribute to risks of both unemployment and suicidal behaviour. Any remaining association between unemployment and suicide attempt risk appears to arise from the correlation that exists between unemployment and psychiatric disorder.


2016 ◽  
Vol 209 (4) ◽  
pp. 319-326 ◽  
Author(s):  
Yongsheng Tong ◽  
Michael R. Phillips ◽  
Kenneth R. Conner

BackgroundThere are meagre data on Axis II personality disorders and suicidal behaviour in China.AimsTo describe the prevalence of Axis II personality disorders in suicides and suicide attempts in China and to estimate risk for these outcomes associated with personality disorders.MethodPeople who died by suicide (n = 151), people who attempted suicide (n = 118) and living community controls (n = 140) were randomly sampled from four Chinese counties and studied using the Structured Clinical Interviews for DSM-IV-TR Axis I Disorders (SCID-I) and Axis II Personality Disorders (SCID-II). We also determined the prevalence of subthreshold versions of ten DSM-IV personality disorders.ResultsAxis II personality disorders were present in 7% of the suicide group, 6% of the suicide attempt group and 1% of the control group. Threshold and subthreshold personality disorders had adjusted odds ratios (point estimates) in the range of 2.7–8.0 for suicide and for suicide attempts.ConclusionsAxis II personality disorders may confer increased risk for suicidal behaviour in China, but their low prevalence in the community and among people with suicidal behaviour suggests that other personality constructs such as select dimensional traits may be a more fruitful avenue for understanding and preventing suicide in China.


2017 ◽  
Vol 52 (6) ◽  
pp. 552-560 ◽  
Author(s):  
Katelyn Kerr ◽  
Madeline Romaniuk ◽  
Sarah McLeay ◽  
Andrew Khoo ◽  
Michael T Dent ◽  
...  

Background: Military veterans have higher rates of suicidality and completed suicides compared to the general population. Previous research has demonstrated suicidal behaviour is higher in US combat veterans who are younger, suffer from posttraumatic stress disorder, depression and anxiety and score lower on measures of health. However, research on predictors of suicide for Australian veterans is limited. The aim of this study was to identify significant demographic and psychological differences between veterans with posttraumatic stress disorder who had attempted suicide and those with posttraumatic stress disorder who had not, as well as determine predictors of suicide attempts within an Australian cohort. Methods: A retrospective analysis was conducted on 229 ex-service personnel diagnosed with posttraumatic stress disorder who had attended a Military Service Trauma Recovery Day Program as outpatients at Toowong Private Hospital from 2007 to 2014. Patients completed a battery of mental health self-report questionnaires assessing symptoms of posttraumatic stress disorder, alcohol use, anger, depression, anxiety and quality of life. Demographic information and self-reported history of suicide attempts were also recorded. Results: Results indicated the average age was significantly lower, and the rates of posttraumatic stress disorder, anger, anxiety and depression symptoms were significantly higher in those veterans with history of a suicide attempt. Multivariate logistic regression analyses indicated posttraumatic stress disorder symptom severity, unemployment or total and permanent incapacity pension status significantly predicted suicide attempt history. Conclusion: Among a cohort of Australian veterans with posttraumatic stress disorder, psychopathology severity, unemployment and total and permanent incapacity status are significantly associated with suicidality. This study highlights the importance of early identification of posttraumatic stress disorder and psychopathology, therapeutic and social engagement, and prioritisation of tangible employment options or meaningful and goal-directed activities for veterans deemed unable to work.


2011 ◽  
Vol 26 (S2) ◽  
pp. 2018-2018
Author(s):  
D. Rujescu

Suicide is one of the leading causes of death worldwide, mortality from suicide being approximately 2%. Attempted suicide appears to be a major risk factor for suicide completion. Anger, aggression and impulsivity are personality traits associated with suicide attempt. We analysed anger, impulsivity and temperament/character scales as predictors of aggression and self-aggression in suicide attempters and compared this to anger- and aggression-related traits between impulsive and premeditated suicide attempts as well as between violent and non-violent suicide methods.The State-Trait Anger Expression Inventory (STAXI), the Questionnaire for Measuring Factors of Aggression (FAF), and the Temperament and Character Inventory (TCI) were assessed.Higher aggression scores, as measured by FAF, were predicted by being male, meeting criteria for borderline personality disorder and having higher angry temperament scores as assessed by STAXI. TCI dimensions associated with self-aggression were high harm avoidance, high impulsivity and low selfdirectedness.State anger, inwardly directed anger and inhibition of aggression were also predictors of self-aggression.In conclusion, impulsivity and harm avoidance have emerged as temperament dimensions independently associated with self-aggressive tendencies in personality. Such interactions could explain the correlation between temperament and suicidality but further research is needed. Anger and selfdirectedness appear to have some effects on suicide attempt.


2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Lisa Crona ◽  
Alexander Mossberg ◽  
Louise Brådvik

Objective. To describe the suicidal career in the long-term course of severe depression.Subjects and Method. Seventy-five former in-patients were interviewed by telephone about course of depression and suicide attempts 37–53 years after index admission. Medical records were read in many cases.Results. 29 subjects had attempted suicide, 13 repeated, 10 made severe, and 13 violent attempts. The risk of suicide attempt decreased by 10% for every decade spent depressed. Suicide attempts were made early in course of depression, and more time was spent depressed after suicide attempts than before.Conclusions. A healing process of the suicidal career, which may occur long before the end of the last depressive episode (sometimes decades), is proposed.


BMJ ◽  
2020 ◽  
pp. m2984 ◽  
Author(s):  
Linda L Magnusson Hanson ◽  
Anna Nyberg ◽  
Ellenor Mittendorfer-Rutz ◽  
Fredrik Bondestam ◽  
Ida E H Madsen

Abstract Objective To analyse the relation between exposure to workplace sexual harassment and suicide, as well as suicide attempts. Design Prospective cohort study. Setting Sweden. Participants 86 451 men and women of working age in paid work across different occupations responded to a self-report questionnaire including exposure to work related sexual harassment between 1995 and 2013. The analytical sample included 85 205 people with valid data on sexual harassment, follow-up time, and age. Main outcome measures Suicide and suicide attempts ascertained from administrative registers (mean follow-up time 13 years). Results Among the people included in the respective analyses of suicide and suicide attempts, 125 (0.1%) died from suicide and 816 (1%) had a suicide attempt during follow-up (rate 0.1 and 0.8 cases per 1000 person years). Overall, 11 of 4095 participants exposed to workplace sexual harassment and 114 of 81 110 unexposed participants committed suicide, and 61/4043 exposed and 755/80 513 unexposed participants had a record of suicide attempt. In Cox regression analyses adjusted for a range of sociodemographic characteristics, workplace sexual harassment was associated with an excess risk of both suicide (hazard ratio 2.82, 95% confidence interval 1.49 to 5.34) and suicide attempts (1.59, 1.21 to 2.08), and risk estimates remained significantly increased after adjustment for baseline health and certain work characteristics. No obvious differences between men and women were found. Conclusions The results support the hypothesis that workplace sexual harassment is prospectively associated with suicidal behaviour. This suggests that suicide prevention considering the social work environment may be useful. More research is, however, needed to determine causality, risk factors for workplace sexual harassment, and explanations for an association between work related sexual harassment and suicidal behaviour.


Crisis ◽  
2020 ◽  
Vol 41 (4) ◽  
pp. 304-312 ◽  
Author(s):  
Anisur Rahman Khan ◽  
Kopano Ratele ◽  
Najuwa Arendse ◽  
Md. Zahidul Islam ◽  
Isaac Dery

Abstract. Background: Suicide and attempted suicide are a serious but under-explored public health problem in Bangladesh. Survey estimates suggest that Jhenaidah District, one of the 64 districts that make up Bangladesh, is one of the highest suicide-prone regions in Bangladesh. Relatively little is known about the magnitude of suicide attempts in the district. Aims: This article describes the incidence of suicide and suicide attempts for Jhenaidah, Bangladesh for the period 2010–2018. Method: Primary descriptive analysis was performed on routine data collected by a Bangladesh-based nongovernment organization (NGO): Societies for Voluntary Activities (SOVA). Results: A total of 22,675 suicide attempts and 3,152 suicides occurred in the district. The rate of suicide attempts was found to be 136.35/100,000 and the suicide rate was found to be 20.6/100,000 in Jhenaidah. The subdistrict Sadar had the highest incidence of suicide attempt (38.09%) and suicide (33.47%). Poisoning was the most common method of suicide attempt for both males (77.07%) and females (77%). Limitations: Many cases of suicide attempts and suicide are unreported in Bangladesh owing to stigmatization; only reported cases form part of this investigation. Conclusion: Jhenaidah has very high rates of suicide and suicide attempts that surpass the global and Bangladesh averages. Although females demonstrate higher suicide rates, male suicide rates have gradually increased over the study period. Future studies are called for to better understand the local patterns and dynamics of fatal and nonfatal suicidal behaviors. Developing a sub-district-, district-, and national-level suicide prevention strategy ought to be considered a priority.


2021 ◽  
pp. 1-7 ◽  
Author(s):  
Massimiliano Orri ◽  
Francis Vergunst ◽  
Gustavo Turecki ◽  
Cédric Galera ◽  
Eric Latimer ◽  
...  

Background Youth who attempt suicide are more at risk for later mental disorders and suicide. However, little is known about their long-term socioeconomic outcomes. Aims We investigated associations between youth suicide attempts and adult economic and social outcomes. Method Participants were drawn from the Quebec Longitudinal Study of Kindergarten Children (n = 2140) and followed up from ages 6 to 37 years. Lifetime suicide attempt was assessed at 15 and 22 years. Economic (employment earnings, retirement savings, welfare support, bankruptcy) and social (romantic partnership, separation/divorce, number of children) outcomes were assessed through data linkage with government tax return records obtained from age 22 to 37 years (2002–2017). Generalised linear models were used to test the association between youth suicide attempt and outcomes adjusting for background characteristics, parental mental disorders and suicide, and youth concurrent mental disorders. Results By age 22, 210 youths (9.8%) had attempted suicide. In fully adjusted models, youth who attempted suicide had lower annual earnings (average last 5 years, US$ −4134, 95% CI −7950 to −317), retirement savings (average last 5 years, US$ −1387, 95% CI −2982 to 209), greater risk of receiving welfare support (risk ratio (RR) = 2.05, 95% CI 1.39 to 3.04) and were less likely to be married/cohabiting (RR = 0.82, 95% CI 0.73 to 0.93), compared with those who did not attempt suicide. Over a 40-year working career, the loss of individual earnings attributable to suicide attempts was estimated at US$98 384. Conclusions Youth who attempt suicide are at risk of poor adult socioeconomic outcomes. Findings underscore the importance of psychosocial interventions for young people who have attempted suicide to prevent long-term social and economic disadvantage.


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