Completed Suicide and Psychiatric Diagnoses in Young People: A Critical Examination of the Evidence.

Department of Mental Health and Substance Dependence, World Health Organization, Geneva, Switzerland.
American Journal of Orthopsychiatry (Impact Factor: 1.36). 11/2005; 75(4):676-83. DOI: 10.1037/0002-9432.75.4.676
Source: PubMed


Suicide rates of young people are increasing in many geographic areas. There is a need to recognize more precisely the role of specific mental disorders and their comparative importance for understanding suicide and its prevention. The authors reviewed the published English-language research, where psychiatric diagnoses that met diagnostic criteria were reported, to reexamine the presence and distribution of mental disorders in cases of completed suicide among young people worldwide. The number and geographical distribution of cases were limited (N = 894 cases). The majority of cases (88.6%) had a diagnosis of at least 1 mental disorder. Mood disorders were most frequent (42.1%), followed by substance-related disorders (40.8%) and disruptive behavior disorders (20.8%). Those strategies focusing exclusively on the prevention and treatment of depression in young people need to be reconsidered. A comprehensive suicide prevention strategy among young people should target mental disorders as a whole, not depression alone, and consider contextual factors.

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Available from: Annette L. Beautrais
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    • "These findings highlight the importance of preventing childhood adversities in order to reduce the risk for suicide and other psychiatric disorders. The finding of a history of mental illness as an independent risk factor for suicide in our study is consistent with some studies in China[6,32,34]and Western countries[7,545556. In Western cultures, psychological autopsy studies revealed that 90-95 percent of suicide victims had a diagnosable psychiatric disorder at the time of the suicide[1], but only about half of suicide victims in China had a history of psychiatric diagnosis at the time of death[4,6,32,34]. "

    Preview · Article · Dec 2015
    • "Thus, identifying factors potentially contributing to suicidal ideation in family members bereaved by suicide is critical for the reduction and prevention of suicide thoughts and the transition from ideation to suicide (Kessler, Borges, & Walters, 1999;Mann et al., 2005). In suicide bereaved samples, mental illness has been found to relate to suicide risk (e.g.,Agerbo, Mortensen, Eriksson, Qin, & Westergaard-Nielsen, 2001;Agerbo et al., 2002;Fleischmann, Bertolote, Belfer, & Beautrais, 2005), and complicated grief and depression to increased likelihood of suicidal ideation (Mitchell, Kim, Prigerson, & Mortimer, 2005). However, the literature is scarce regarding the influence of other variables, namely other distress variables (e.g., anxiety) in suicidal ideation of individuals bereaved by suicide. "
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    ABSTRACT: The present study assessed the impact of suicide and distress on suicidal ideation in a sample of 93 Portuguese family members bereaved by suicide. A control community sample of 102 adults also participated. After controlling for educational level, those bereaved by the suicide of a family member were found to have higher levels of suicidal ideation. Forty-two percent of family members had Suicide Ideation Questionnaire scores at or above the cutoff point. General distress, depression, anxiety and hostility related to suicidal ideation, while time since suicide also interacted with general distress and depression in predicting suicidal ideation.
    No preview · Article · Dec 2014 · Death Studies
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    • "As we expected, we found a very close relationship between suicidal behavior and mental illness since 93.6% of suicide attempters and 85.9% of suicide completers presented psychiatric diagnoses (axis I and/or axis II). In general, studies report that at least 90% of suicide completers present some kind of mental illness (Arsenault-Lapierre et al., 2004; Fleischmann et al., 2005; Isometsa, 2001; Tidemalm et al., 2008). In agreement with the literature (Angst et al., 1999; Bertolote et al., 2003), we found Major Depressive Disorder to be a risk factor for suicide completion . "
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    ABSTRACT: BACKGROUND: Suicide attempters and suicide completers are two overlapping but distinct suicide populations. This study aims to present a more accurate characterization by comparing populations of suicide attempters and completers from the same geographical area. METHODS: Samples and procedure: All cases of attempted suicide treated at the emergency room of the Corporacio Sanitària i Universitària Tauli Parc de Sabadell in 2008 (n=312) were compared with all completed suicides recorded in the same geographical area from 2008 to 2011 (n=86). Hospital and primary care records were reviewed for sociodemographic and clinical variables. Statistical analysis: Chi-square, ANOVA, and Mann-Whitney U tests were used to identify characteristics related to suicide completion. RESULTS: Compared to suicide attempters, suicide completers were more likely to be male (73.3% vs. 37.8%; p<0.001), pensioners (73.7% vs. 23.4%; p<0.001), and people living alone (31.8% vs. 11.4%; p=0.006). Suicide completers more frequently presented somatic problems (71.7 vs. 15.7; p<0.001), Major Depressive Disorder (54.7% vs. 27.9%; p<0.001), and made use of more lethal methods (74.1 vs. 1.9; p<0.001). Suicide completers were more likely to have been followed by a primary care provider (50.0% vs. 16.0%; p<0.001). 92.3% of the suicides committed were completed during the first or second attempt. LIMITATIONS: Suicide completers were not evaluated using the psychological autopsy method. CONCLUSIONS: Despite presenting a profile of greater social and clinical severity, suicide completers are less likely to be followed by Mental Health Services than suicide attempters. Current prevention programs should be tailored to the specific profile of suicide completers.
    Full-text · Article · Apr 2013 · Journal of Affective Disorders
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