Risk Factors: What to Look Out For
An understanding of the risk factors for suicide can facilitate therecognition of high risk patients, and help in their assessment. Patientcharacteristics that increase suicide risk include:
: Half of suicide completers attempted suicide previously and1 out of 100 suicide attempt survivors die by suicide within the next year, arisk 100-fold greater than that in the general population.
: Patients with multiple psychiatric conditions appear to be athigher risk than those with uncomplicated depression or an anxietydisorder. Psychiatric disorders most frequently associated with suicideinclude depression, bipolar disorder, alcoholism or other substance abuse,schizophrenia, personality disorders, anxiety disorders (including panicdisorder), posttraumatic stress disorders, and delirium.[8,9] Anxietydisorders double risk for suicide attempt (odds ratio = 2.2) but acombination of depression and anxiety greatly increases the risk (odds ratio= 17). In depressed patients, comorbid personality disorder alsocorrelates strongly with suicide attempts. In addition, 20% to 25% of suicidecompleters are intoxicated at the time.
Age, sex, and race
: Although young adults attempt suicide more often thanolder adults, the risk for completed suicide increases with age. Men are3 times more likely to complete suicide, although women attempt suicide 4times more often than men. These differences are the result of thelethality of the chosen method (eg, firearms) more than to a differenceacross age or sex in completion rates for a particular method. Whitepeople complete about 90% of suicides in the United States; 72% are bywhite men.
: Unemployed and unskilled individuals are at increased riskcompared to those employed and skilled; occupational failure may lead tohigher risk. Physicians, particularly female physicians, may be at increasedrisk; a 25-study meta-analysis yielded a suicide rate ratio for female