Risk factors for suicide

Major risk factors for suicide include:

 Sex - males are more likely to die out of a suicidal attempt while women are more likely
to attempt suicide.
 Age - Older patients are more likely to commit suicide.
 Employment - Unemployment is a risk factor for suicidal attempts.
 Health - sick or disabled patients are more likely to try to commit suicide.
 Mental disorder - Most of those who attempted suicide were diagnosed with a mental
disorder, mostly depression.
 Alcohol abuse - 25% of those who tried to commit suicide abused alcohol at some point,
prior to the attempt.
 Prior suicidal attempt - perhaps the strongest indicator of risk of future suicidal
behavior.
Major risk factors for suicide include male sex, advanced age, previous suicide attempt, alcohol
abuse, physical and mental illness.

Children & Adolescents Risk Factors

1. About 40% of youth who complete suicide had previous psychiatric treatment
2. About 40 percent had made a previous suicide attempt
3. The most common method of completed suicide in children and adolescents is the use
of firearms, which accounts for about two-thirds of all suicides in boys and almost one-
half of suicides in girls
4. A child who has lost a parent by any means before age 13 is at higher risk for mood
disorders and suicide
5. The precipitating factors include loss of face with peers, a broken romance, school
difficulties, unemployment, bereavement, separation, and rejection
6. There are reports of clusters of suicides that occur among adolescents who know one
another and go to the same school
7. Suicidal behavior can precipitate other such attempts within a peer group through
identification-so-called copycat suicides
8. Some studies have found a transient increase in adolescent suicides after television
programs in which the central theme was the suicide of a teenager

Adult Risk Factors

History, Signs, and Symptoms of Suicidal Risk
1. Previous attempt or fantasized suicide
2. Anxiety, depression, exhaustion
3. Availability of means of suicide
4. Concern for effect of suicide on family members
5. Verbalized suicidal ideation
6. Preparation of a will, resignation after agitated depression
7. Proximal life crisis, such as mourning or impending surgery
8. Family history of suicide
9. Pervasive pessimism or hopelessness
Adult Medical and Demographic Risk Factors
10. Persons with medical illness > Without medical or surgical problems
- Incapacitating or catastrophic medical illness, especially if accompanied by severe pain.
11. Men over 45 years of age
12. No social support
13. Previous suicide attempt
14. Alcohol dependence:
Factors Associated with Suicide in Persons with Alcohol Use Disorder
15. Suicide among persons with alcohol-related disorders range from 10–15%
16. Presence of a major depressive episode
17. Weak psychosocial support systems
18. A serious coexisting medical condition
19. Unemployment
20. Living alone
21. About 15% of persons with alcohol abuse or alcohol dependence commit suicide

Geriatric Suicide Risk

1. Elderly persons have a higher risk of suicide than any other population.
2. The suicide rate for white men over age of 65 is 5 times higher than the general
population.
3. 1/3 of elderly persons report loneliness as the principal reason for considering suicide.
4. Approximately 10% of elderly individuals with suicidal ideation report financial
problems, poor medical health, or depression as reasons for suicidal thoughts.
5. Suicide victims differ demographically from individuals who attempt suicide:
- About 60 % of those who commit suicide are Men
- About 75% of those who attempt suicide are Women
6. Methods Used by Suicide Victims:
- As a rule, use guns or hang themselves
 - About 70% of suicide attempters take a drug overdose
- About 20% cut or slash themselves
7. Most elderly persons who commit suicide have had a psychiatric disorder; Most
commonly depression.
8. Psychiatric disorders of suicide victims, however, often do not receive medical or
psychiatric attention.
9. More elderly suicide victims are Widowed, and fewer (less) are Single, Separated, or
Divorced than is true of younger adults.
10. Violent methods of suicide are more common in the elderly, whereas alcohol use and
psychiatric histories appear to be less common.
11. The most common precipitants of suicide in older individuals are physical illness and
loss, whereas problems with employment, finances, and family relationships are more
frequent precipitants in younger adults.
12. Many elderly persons who commit suicide communicate their suicidal thoughts to family
or friends before the act of suicide.
 Older patients with significant medical illnesses or a recent loss should be evaluated
for depressive symptomatology and suicidal ideation or plans.
 Thoughts and fantasies about the meaning of suicide and life after death may reveal
information that the patient cannot share directly.
 There should be no reluctance to question patients about suicide because no
evidence indicates that such questions increase the likelihood of suicidal behavior.

Old Book 11th

Suicide is one of the common psychiatric emergencies. There are above 35,000 deaths a year in
the US due to suicide acts, yet the amount of attempts are estimated to be approximately 25
times the amount of deaths.
The decision whether or not to hospitalize a patient with suicidal thoughts is one of the most
important decisions that can be made by the clinician. Not all patients with suicidal thoughts
must be hospitalized, and outpatient treatment can be considered when the patient has a
strong social support system, no history of impulsive behavior and no concrete suicidal plan.
The Guidelines for selecting a treatment setting for patients after a suicidal attempt or in the
presence of suicidal ideation states that a patient may be released from the ER with
recommendations for an outpatient follow up when:
• The attempt of suicide was in reaction to a precipitating event (such as relationship problems,
life or occupational distress, failure in an exam etc.), especially if the patient's view of his
problems changed since he came to the ER.
• His plan of committing suicide is not lethal
• The patient has a stable and supportive social system
• The patient shows the willingness to cooperate with the medical recommendations and follow
The decision whether or not to hospitalize a patient with suicidal thoughts is one of the most
important decisions that can be made by the clinician. Not all patients with suicidal thoughts
must be hospitalized and it is important to remember who are the low risk patients that can be
discharged from the ER and treated as outpatients.