Hostname: page-component-745bb68f8f-cphqk Total loading time: 0 Render date: 2025-01-11T02:07:48.812Z Has data issue: false hasContentIssue false
  • English
  • Français

Suicide attempts preceding completed suicide

Published online by Cambridge University Press:  03 January 2018

Erkki T. Isometsä  and
Jouko K. Lönnqvist
Erkki T. Isometsä*
Affiliation:
Chief of Research on Mood Disorders and Self-Destructive Behaviour
Jouko K. Lönnqvist
Affiliation:
Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland
*
Erkki Isometsä, MD, PhD, Department of Mental Health and Alcohol Research, National Public Health Institute, Mannerheimintie 166, FIN-00300 Helsinki, Finland. Fax: +358-9-4744 8658; e-mail: erkki.isometsa@ktl.fi
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

This study investigated three questions with major implications for suicide prevention: the sensitivity of the history of previous suicide attempt(s) as an indicator of suicide risk, the time interval from a preceding suicide attempt to the fatal one, and switching of suicide methods by those eventually completing suicide.

Method

The lifetime history of suicide attempts and the methods the victims (n=1397) used were examined in a nationwide psychological autopsy study comprising all suicides in Finland within a 12-month research period in 1987–1988.

Results

Overall, 56% of suicide victims were found to have died at their first suicide attempt, more males (62%) than females (38%). In 19% of males and 39% of females the victim had made a non-fatal attempt during the final year. Of the victims with previous attempts, 82% had used at least two different methods in their suicide attempts (the fatal included).

Conclusions

Most male and a substantial proportion of female suicides die in their first suicide attempt, a fact that necessitates early recognition of suicide risk, particularly among males. Recognition of periods of high suicide risk on the grounds of recent non-fatal suicide attempts is likely to be important for suicide prevention among females. Subjects completing suicide commonly switch from one suicide method to another, a finding that weakens but does not negate the credibility of restrictions on the availability of lethal methods as a preventive measure.

Type
Papers
Information
The British Journal of Psychiatry , Volume 173 , Issue 6 , December 1998 , pp. 531 - 535
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Carney, S. S., Rich, C. L., Burke, P. A., et al (1994) Suicide over 60: The San Diego Study. Journal of the American Geriatric Society, 42, 174–180.CrossRefGoogle ScholarPubMed
Cassidy, S. & Henry, J. (1987) Fatal toxicity of antidepressant drugs in overdose. British Medical Journal, 295, 1021–1024.CrossRefGoogle ScholarPubMed
Cheng, A. T. A. (1995) Mental illness and suicide. A case – control study in East Taiwan. Archives of General Psychiatry. 52, 594–603.CrossRefGoogle ScholarPubMed
Clark, D. C. & Horton-Deutsch, S. L. (1992) Assessment in absentia: The value of the psychological autopsy method for studying the antecedents of suicide and predicting future suicides. In Assessment and Prediction of Suicide (eds Maris, R. W., Berman, A. L., Maltsberger, J. T., et al), pp. 144–182. New York: Guilford Press.Google Scholar
Conwell, Y., Duberstein, P. R., Cox, C., et al (1998) Age differences in behaviors leading to completed suicide. American Journal of Geriatric Psychiatry, 6, 122–126.CrossRefGoogle ScholarPubMed
Cullberg, J., Wasserman, D. & Stefansson, C. G. (1988) Who commits suicide after a suicide attempt? Acta Psychiatrica Scandinavica, 77, 598–603.CrossRefGoogle ScholarPubMed
Gunnel, D. & Frankel, S. (1994) Prevention of suicide: aspirations and evidence. British Medical Journal, 308, 1227–1233.CrossRefGoogle Scholar
Harris, E. C. & Barradough, B. (1997) Suicide as an outcome for mental disorders. A meta-analysis. British Journal of Psychiatry, 170, 205–228.CrossRefGoogle ScholarPubMed
Heikkinen, M. E., Isometsä, E. T., Marttunen, M. J., et al (1995) Social factors in suicide. British Journal of Psychiatry. 167, 747–753.CrossRefGoogle ScholarPubMed
Henriksson, M. M., Aro, H. M., Marttunen, M. J., et al (1993) Mental disorders and comorbidity in suicide. American Journal of Psychiatry, 150, 935–940.Google ScholarPubMed
Henry, J. A., Alexander, C. A. A Sener, E. K. (1995) Relative mortality from overdose of antidepressants. British Medical Journal, 310, 221–224.CrossRefGoogle ScholarPubMed
Isacsson, G., Holmgren, P., Wassermann, D., et al (1994) Use of antidepressants among people committing suicide in Sweden. British Medical Journal, 308, 506–509.CrossRefGoogle ScholarPubMed
Isometsä, E. T., Henriksson, M. M., Aro, H. M., et al (1994) Suicide in major depression. American Journal of Psychiatry, 151, 530–536.Google ScholarPubMed
Isometsä, E. T., Heikkinen, M. E., Marttunen, M. J., et al (1995) The last appointment before suicide: is suicide intent communicated? American Journal of Psychiatry, 152, 919–922.Google ScholarPubMed
Isometsä, E. T., Heikkinen, M. E., Henriksson, M., et al (1996) Suicide in non-major depressions. Journal of Affective Disorders, 36, 117–127.CrossRefGoogle ScholarPubMed
Jick, S. S., Dean, A. D. & Jick, H. (1995) Antidepressants and suicide. British Medical Journal, 310, 215–218.CrossRefGoogle Scholar
Kapur, S., Mieczkowski, T. & Mann, J. J. (1992) Antidepressant medications and the relative risk of suicide attempt and suicide. Journal of the American Medical Association, 268, 3441–3445.Google Scholar
Lewis, G., Hawton, K. & Jones, P. (1997) Strategies for preventing suicide. British Journal of Psychiatry, 171, 351–354.Google Scholar
Maris, R. W. (1981) Pathways to Suicide: A Survey of Self-Destructive Behaviors. Baltimore, MD: Johns Hopkins University Press.Google Scholar
Maris, R. W. (1992) The relation of nonfatal suicide attempts to completed suicides. In Assessment and Prediction of Suicidie (eds Maris, R. W., Berman, A. L., Maltsberger, J. T., et al), pp. 362–380. New York: Guilford Press.Google Scholar
Marttunen, M. J., Aro, H. M., Henriksson, M. M., et al (1991) Mental disorder in adolescent suicide: DSM–III–R axes I and II among 13 to 19 year olds in Finland. Archives of General Psychiatry, 48, 834–839.CrossRefGoogle Scholar
Ohberg, A., Vuori, E., Ojanperä, I., et al (1996) Alcohol and drugs in suicides. British Journal of Psychiatry, 169, 75–80.CrossRefGoogle ScholarPubMed
Robins, E., Gassner, S., Kayas, J., et al (1959) The communication of suicidal intent: A study of 134 consecutive cases of successful (completed) suicide. American Journal of Psychiatry, 115, 724–733.CrossRefGoogle ScholarPubMed
Taylor, S. J., Kingdom, D. & Jenkins, R. (1997) How are nations trying to prevent suicide? An analysis of national suicide prevention strategies. Acta Psychiatrica Scandinavica, 95, 457–463.Google Scholar
World Health Organization (1993) World Health Statistics Annual 1992. Geneva: WHO.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.