Suicide and attempted suicide (deliberate self-harm)

What is Suicide and attempted suicide?

Suicide describes the intentional act of killing oneself. Identification of patients at risk of this behaviour is the most difficult but important task of psychiatry.

Statistics on Suicide and attempted suicide?

The act of suicide occurs throughout the world, accoutning for 2% of male and 1% of female deaths each year. The rate of suicide increases with age, commonly occurring between the ages of 60 and 70 years old. A disturbing trend of recent years are the significantly high rates of suicide in young males aged 15-34. Suicide is the second leading cause of death in this age group. In contrast to thise trend, the suicide rates of the elderly population is falling.

Risk Factors for Suicide and attempted suicide

There are a number of proven factors that increase the likelihood of any given patient committing suicide. These include:1. Being male.2. Increased age.3. Social Isolation.4. Immigrant status.5. Recent severe loss such as bereavement, separation or divorce.6. Recent loss of a job or retirement.7. Family history of depression, suicide or alcohol abuse.8. Personal history of depression, alcohol or drug abuse.9. Previous suicide attempt.10. Alcohol or drug addiction.11. Severe depression or early dementia.12. Incapacitating painful physical illness.13. Lack of social supports such as frriends and family.

How is Suicide and attempted suicide Diagnosed?

It can be very hard to know if someone is experiencing suicidal tendencies, especially is they lack any real support network.Tests can be done to check blood serum levels of certain proteins and nutrients to gauge whether a eating disorder may be linked to suicidal thoughts for example but an actual diagnosis relies heavily on the patient coming forward for help.

Prognosis of Suicide and attempted suicide

The prognosis of suicidal behaviour is poor, as a previous attempt at suicide is a risk factor for further suicide attempts. Having said this if a support network is in place and help is sought immediatly a more positive prognosis may exist.

How is Suicide and attempted suicide Treated?

Following a failed attempt at suicide, patients require intensive treatment to ensure that there are no recurrences of suicidal behaviour. The patient must be screened for psychiatric disease such as depression and schizophrenia, for inadequate treatment of these conditions will increase the likelihood of suicidal behaviour.Patients should be referred for assessment by psychiatrist if there is reason to believe they suffer from clinical depression or psychotic illness. Patients which have made convincing attempts at suicide or persist with suicidal behaviour should also be referred for psychiatric review. On occasion, patients may be admitted as an involuntary patient of a mental hospital (under the Mental Health Act) if they are believed to be a significant risk to themselves, risk to others or risk to property. During admission, patients should be formally assessed for the presence of psychiatric illness, and medicated appropriately.

Suicide and attempted suicide References

[1] eMedicine.[2] Angst J, Angst F, Stassen HH: Suicide risk in patients with major depressive disorder. J Clin Psychiatry 1999; 60 Suppl 2: 57-62; discussion 75-6, 113-6.[3] Kumar P, Clark M. Clinical Medicine. Fourth Ed. WB Saunders, 2002.[4] Oquendo MA, Malone KM, Mann JJ: Suicide: risk factors and prevention in refractory major depression. Depress Anxiety 1997; 5(4): 202-11.