SUICIDAL

Suicide is the termination of ones life

intentionally.
According to 1999 data from the Centre for
Disease Control and Prevention, suicide kills
more people than homicide. Suicide was the
eleventh cause of death (homicide was
fourteenth), and the third leading cause of
death between ages 15 and 24 years.
Women attempt suicide more frequently than
men (3:1), although men commit suicide more
frequently (4.1:1.0).

Suicide and suicidal patient represent significant public

health problem.
The vast majority of people with suicidal intent have a major
psychiatric diagnosis. It has been estimated that 90% or
more of them can be shown to have a major psychiatric
illness.
A significant proportion, estimated as high as 70%, saw a
physician within 30 days prior to their death. Nearly 50%
had seen a physician in preceding week.
It was noted that only 18% of suicidal patients
communicated their intent to helping professionals, while
69% communicated their intent to an average of three close
relatives or associates, 73% within 12 months of their
suicide.

Risk Factors

Suicidal behaviour is the end result of a

complex interaction of psychiatric, social
and familial factors.
Excellent mnemonic for the major risk
factor is SAD PERSONS, devised by
Petterson et al.

Sex: Women are more likely to attempt suicide; men are more likely to
succeed.
Age: Age falls into a bimodal distribution, with teenagers and the elderly at
highest risk.
Depression: Fifteen per cent of depressive patients die by suicide.
Previous attempt: Ten per cent of those who have previously attempted
suicide die by suicide.
Ethanol abuse: Fifteen per cent of alcoholics commit suicide.
Rational thinking loss: Psychosis is a risk factor, and 10% of patients with
chronic schizophrenia die by suicide.
Social supports are lacking.
Organised plan: A well-formulated suicide plan is a red flag.
No spouse: Being divorced, separated, or widowed is a risk factor; having
responsibility for children is an important statistical protector against
suicide.
Sickness: Chronic illness is a risk factor.

Warning signs

Suicidal talk by patient

Preoccupation with death and dying.
Signs of depression
Behavioural changes
Giving away special possessions
Difficulty with appetite and sleep
Taking excessive risks
Increased drug use
Loss of interest in usual activities