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Risk Factors for Suicide in Psychiatric Patients

Risk Factors for Suicide in Psychiatric Patients Abstract • In a matched controlled study of 90 psychiatric patient suicides, I found that significantly more of the suicides suffered from chronic schizophrenia (33.3%) or recurrent affective disorder (18.8%) and had made a previous suicide attempt (46.6%). The suicides were young and significantly more were unmarried (84.5%), unemployed (66%), living alone, (55.5%) and depressed (65.5%), and 44.4% had a primary diagnosis of depressive disorder. Of the 75 outpatient suicides, 58% had seen a psychiatrist within the previous week, 61 of the 75 (81.3%) had been admitted in their last episode of contact, and 44% of these suicided within a month of discharge. References 1. Dublin L: Suicide: A sociological and statistical study . New York, Ronald Press, 1963. 2. Robins E, Murphy G, Wilkinson RH: Some clinical observations in the prevention of suicide based on a study of 134 successful suicides . Am J Public Health 1959;49:888-889.Crossref 3. Dorpat T, Ripley H: A study of suicide in the Seattle area . Compr Psychiatry 1960;1:349-359.Crossref 4. Barraclough B, Bunch J, Nelson B, et al: A hundred cases of suicide: Clinical aspects . Br J Psychiatry 1974;125:355-373.Crossref 5. Murphy G, Robins E: Social factors in suicide . JAMA 1967;199:303-308.Crossref 6. Flood R, Seager C: A retrospective examination of psychiatric case records of patients who subsequently committed suicide . Br J Psychiatry 1968;114:443-450.Crossref 7. Myers D, Neal C: Suicide in psychiatric patients . Br J Psychiatry 1978;133:38-44.Crossref 8. Robins A, Brooke E, Freeman-Browne D: Some aspects of suicide in psychiatric patients in Southend . Br J Psychiatry 1968;114:739-747.Crossref 9. Sainsbury P: Community psychiatry , in Perlin S (ed): A Handbook for the Study of Suicide . New York, Oxford University Press, 1975, chap 9. 10. Bagley C, Jacobson S, Rehin A: Completed suicide: A taxonomic analysis of clinical and social data . Psychol Med 1976;6:429-438.Crossref 11. Farberow N, Shneidman E, Neuringer C: Case history and hospitalization factors in suicides of neuropsychiatric hospital patients . J Nerv Ment Dis 1966;142:32-44.Crossref 12. Seager C, Flood R: Suicide in Bristol . Br J Psychiatry 1965;111:919-932.Crossref 13. Pokorny A: Characteristics of 44 patients who subsequently committed suicide . Arch Gen Psychiatry 1960;2:314-323.Crossref 14. Pokorny A: Suicide rates in various psychiatric disorders . J Nerv Ment Dis 1964;139:499-506.Crossref 15. Temoche A, Pugh T, MacMahon B: Suicide rates amongst current and former mental institution patients . J Nerv Ment Dis 1964;138:124-130.Crossref 16. Ettlinger R: Suicides in a group of patients who had previously attempted suicide . Acta Psychiatr Scand 1964;40:363.Crossref 17. Dorpat T, Jackson J, Ripley H: Broken homes and attempted and completed suicide . Arch Gen Psychiatry 1965;12:213-216.Crossref 18. Zilboorg G: Suicide amongst primitive and civilized races . Am J Psychiatry 1936;92:1346-1369. 19. Murphy G: Clinical identification of suicidal risk . Arch Gen Psychiatry 1972;27:356-359.Crossref 20. Monk M: Epidemiology , in Perlin S (ed): A Handbook for the Study of Suicide . New York, Oxford University Press, 1975, chap 10. 21. Goldthorpe JH, Hope K: The Social Grading of Occupation: A New Approach and Scale . New York, Oxford University Press, 1974, pp 134-143. 22. American Psychiatric Association, Committee on Nomenclature and Statistics: Diagnostic and Statistical Manual of Mental Disorders , ed 3. Washington, DC, American Psychiatric Association, 1978. 23. Hellon C, Solomon M: Suicide and age in Alberta, Canada, 1951 to 1977: The changing profile . Arch Gen Psychiatry 1980;37:505-510.Crossref 24. Solomon M, Hellon C: Suicide and age in Alberta, Canada, 1951 to 1977: A cohort analysis . Arch Gen Psychiatry 1980;37:511-513.Crossref 25. Murphy G, Wetzel R: Suicide risk by birth cohort in the United States, 1949 to 1974 . Arch Gen Psychiatry 1980;37:519-523.Crossref 26. Stengel E: Suicide and Attempted Suicide . New York, Penguin Books, 1964. 27. Perlin S, Schmidt C: Psychiatry , in Perlin S (ed): A Handbook for the Study of Suicide . New York, Oxford University Press, 1975, chap 8. 28. Guze S, Robins E: Suicide and primary affective disorders . Br J Psychiatry 1970;117:437-483.Crossref 29. Juel-Nielsen N: Suicide risk in manic depressive disorders , in Schou M, Strömgren E (eds): Origin, Prevention and Treatment of Affective Disorders . New York, Academic Press Inc, 1979, pp 269-276. 30. Ottosson J: The suicidal patient—can the psychiatrist prevent his suicide? in Schou M, Strömgren E (eds): Origin, Prevention and Treatment of Affective Disorders . New York, Academic Press Inc, 1979, pp 257-267. 31. Baastrup PC, Poulsen JC, Schou M, et al: Prophylactic lithium: Doubleblind discontinuation in manic-depressive and recurrent depressive disorders . Lancet 1970;2:326-330.Crossref 32. Melia PI: Prophylactic lithium: A double-blind trial in recurrent affective disorders . Br J Psychiatry 1970;116:621-624.Crossref 33. Coppen A, Noguera R, Bailey J, et al: Prophylactic lithium in affective disorders . Lancet 1971;2:275-279.Crossref 34. Hullin RP, McDonald R, Allsop MNE: Prophylactic lithium in recurrent affective disorders . Lancet 1972;1:1044-1046.Crossref 35. Cundall RL, Brooks PW, Murray LG: A controlled evaluation of lithium prophylaxis in affective disorders . Psychol Med 1972;2:308-311.Crossref 36. Prien RF, Caffey EM Jr, Klett CJ: Prophylactic efficacy of lithium carbonate in manic-depressive illness: Report of the Veterans Administration and National Institute of Mental Health Collaborative Study Group . Arch Gen Psychiatry 1973;28:337-341.Crossref 37. Prien RF, Klett CJ, Caffey EM Jr: Lithium carbonate and imipramine in the prevention of affective episodes: A comparison of recurrent affective illness . Arch Gen Psychiatry 1973;29:420-425.Crossref 38. Stallone R, Shelly E, Mendlewicz J, et al: The use of lithium in affective disorders: III. A double-blind study in prophylaxis in bipolar illness . Am J Psychiatry 1973;130:1006-1010. 39. Fieve R, Kumbaraci T, Dunner D: Lithium prophylaxis of depression in bipolar I and bipolar II and unipolar patients . Am J Psychiatry 1976;133:925-926. 40. Mindham R, Howland C, Shepherd M: An evaluation of continuation therapy with tricyclic antidepressants in depressive illness . Psychol Med 1973;3:5-17.Crossref 41. Glen A, Johnson A, Shepherd M: Continuation therapy with lithium and amitriptyline in unipolar depressive illness: A controlled clinical trial . Psychol Med 1981;11:409-416.Crossref 42. Klerman G, DiMascio A, Weissman M, et al: Treatment of depression by drugs and psychotherapy . Am J Psychiatry 1974;131:186-191. 43. Weissman MM, Kasl SV, Klerman G: Follow-up of depressed women after maintenance treatment . Am. J Psychiatry 1976;757-760. 44. Seager CP, Bird RL: Imipramine with electrical treatment in depression: A controlled trial . J Ment Sci 1962;108:704-707. 45. Imlah NW, Ryan E, Harrington JA: The influence of anti-depressant drugs in the response to electroconvulsive therapy and subsequent relapse rates . J Neuropsychopharmacol 1965;4:439-442. 46. Kay D, Fahy T, Garside R: A seven month double-blind trial of amitriptyline and diazepam in ECT treated depressive patients . Br J Psychiatry 1970;117:667-671.Crossref 47. Perry A, Tsuang MT: Treatment of unipolar depression following electroconvulsive therapy . J Affective Disord 1979;1:123-129.Crossref 48. Coppen A, Abou-Saleh M, Milln P, et al: Lithium continuation therapy following electroconvulsive therapy . Br J Psychiatry 1981;139:284-287.Crossref 49. Barraclough B, Pallis D: Depression followed by suicide: A comparison of depressed suicides with living depressives . Psychol Med 1975;5:55-61.Crossref 50. Roy A: Vulnerability factors and depression in women . Br J Psychiatry 1978;133:106-110Crossref 51. and correction, 1979;134:552 52. Roy A: Depression in chronic paranoid schizophrenia . Br J Psychiatry 1980;137:138-139.Crossref 53. Roy A: Vulnerability factors and depression in men . Br J Psychiatry 1981;138:75-77.Crossref 54. Roy A: Risk factors for depression in Canadian women . J Affective Disord 1981;3:65-70.Crossref 55. Roy A: Role of past loss in depression . Arch Gen Psychiatry 1981;38:301-302.Crossref 56. Roy A: Depression in the course of chronic undifferentiated schizophrenia . Arch Gen Psychiatry 1981;38:296-297.Crossref 57. Roy A: Specificity of risk factors for depression . Am J Psychiatry 1981;138:959-961. 58. Murphy G, Armstrong J, Hermele S, et al: Suicide and alcoholism . Arch Gen Psychiatry 1979;36:65-69.Crossref 59. Paykel E, Myers J, Dienelt M, et al: Life events and depression . Arch Gen Psychiatry 1969;21:753-760.Crossref 60. Brown G, Harris T: Social Origins of Depression . London, Tavistock Publishers Ltd, 1978. 61. Pokorny A, Kaplan H: Suicide following psychiatric hospitalization . J Nerv Ment Dis 1976;162:119-125.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

Risk Factors for Suicide in Psychiatric Patients

Archives of General Psychiatry , Volume 39 (9) – Sep 1, 1982

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References (62)

Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1982.04290090071014
Publisher site
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Abstract

Abstract • In a matched controlled study of 90 psychiatric patient suicides, I found that significantly more of the suicides suffered from chronic schizophrenia (33.3%) or recurrent affective disorder (18.8%) and had made a previous suicide attempt (46.6%). The suicides were young and significantly more were unmarried (84.5%), unemployed (66%), living alone, (55.5%) and depressed (65.5%), and 44.4% had a primary diagnosis of depressive disorder. Of the 75 outpatient suicides, 58% had seen a psychiatrist within the previous week, 61 of the 75 (81.3%) had been admitted in their last episode of contact, and 44% of these suicided within a month of discharge. References 1. Dublin L: Suicide: A sociological and statistical study . New York, Ronald Press, 1963. 2. Robins E, Murphy G, Wilkinson RH: Some clinical observations in the prevention of suicide based on a study of 134 successful suicides . Am J Public Health 1959;49:888-889.Crossref 3. Dorpat T, Ripley H: A study of suicide in the Seattle area . Compr Psychiatry 1960;1:349-359.Crossref 4. Barraclough B, Bunch J, Nelson B, et al: A hundred cases of suicide: Clinical aspects . Br J Psychiatry 1974;125:355-373.Crossref 5. Murphy G, Robins E: Social factors in suicide . JAMA 1967;199:303-308.Crossref 6. Flood R, Seager C: A retrospective examination of psychiatric case records of patients who subsequently committed suicide . Br J Psychiatry 1968;114:443-450.Crossref 7. Myers D, Neal C: Suicide in psychiatric patients . Br J Psychiatry 1978;133:38-44.Crossref 8. Robins A, Brooke E, Freeman-Browne D: Some aspects of suicide in psychiatric patients in Southend . Br J Psychiatry 1968;114:739-747.Crossref 9. Sainsbury P: Community psychiatry , in Perlin S (ed): A Handbook for the Study of Suicide . New York, Oxford University Press, 1975, chap 9. 10. Bagley C, Jacobson S, Rehin A: Completed suicide: A taxonomic analysis of clinical and social data . Psychol Med 1976;6:429-438.Crossref 11. Farberow N, Shneidman E, Neuringer C: Case history and hospitalization factors in suicides of neuropsychiatric hospital patients . J Nerv Ment Dis 1966;142:32-44.Crossref 12. Seager C, Flood R: Suicide in Bristol . Br J Psychiatry 1965;111:919-932.Crossref 13. Pokorny A: Characteristics of 44 patients who subsequently committed suicide . Arch Gen Psychiatry 1960;2:314-323.Crossref 14. Pokorny A: Suicide rates in various psychiatric disorders . J Nerv Ment Dis 1964;139:499-506.Crossref 15. Temoche A, Pugh T, MacMahon B: Suicide rates amongst current and former mental institution patients . J Nerv Ment Dis 1964;138:124-130.Crossref 16. Ettlinger R: Suicides in a group of patients who had previously attempted suicide . Acta Psychiatr Scand 1964;40:363.Crossref 17. Dorpat T, Jackson J, Ripley H: Broken homes and attempted and completed suicide . Arch Gen Psychiatry 1965;12:213-216.Crossref 18. Zilboorg G: Suicide amongst primitive and civilized races . Am J Psychiatry 1936;92:1346-1369. 19. Murphy G: Clinical identification of suicidal risk . Arch Gen Psychiatry 1972;27:356-359.Crossref 20. Monk M: Epidemiology , in Perlin S (ed): A Handbook for the Study of Suicide . New York, Oxford University Press, 1975, chap 10. 21. Goldthorpe JH, Hope K: The Social Grading of Occupation: A New Approach and Scale . New York, Oxford University Press, 1974, pp 134-143. 22. American Psychiatric Association, Committee on Nomenclature and Statistics: Diagnostic and Statistical Manual of Mental Disorders , ed 3. Washington, DC, American Psychiatric Association, 1978. 23. Hellon C, Solomon M: Suicide and age in Alberta, Canada, 1951 to 1977: The changing profile . Arch Gen Psychiatry 1980;37:505-510.Crossref 24. Solomon M, Hellon C: Suicide and age in Alberta, Canada, 1951 to 1977: A cohort analysis . Arch Gen Psychiatry 1980;37:511-513.Crossref 25. Murphy G, Wetzel R: Suicide risk by birth cohort in the United States, 1949 to 1974 . Arch Gen Psychiatry 1980;37:519-523.Crossref 26. Stengel E: Suicide and Attempted Suicide . New York, Penguin Books, 1964. 27. Perlin S, Schmidt C: Psychiatry , in Perlin S (ed): A Handbook for the Study of Suicide . New York, Oxford University Press, 1975, chap 8. 28. Guze S, Robins E: Suicide and primary affective disorders . Br J Psychiatry 1970;117:437-483.Crossref 29. Juel-Nielsen N: Suicide risk in manic depressive disorders , in Schou M, Strömgren E (eds): Origin, Prevention and Treatment of Affective Disorders . New York, Academic Press Inc, 1979, pp 269-276. 30. Ottosson J: The suicidal patient—can the psychiatrist prevent his suicide? in Schou M, Strömgren E (eds): Origin, Prevention and Treatment of Affective Disorders . New York, Academic Press Inc, 1979, pp 257-267. 31. Baastrup PC, Poulsen JC, Schou M, et al: Prophylactic lithium: Doubleblind discontinuation in manic-depressive and recurrent depressive disorders . Lancet 1970;2:326-330.Crossref 32. Melia PI: Prophylactic lithium: A double-blind trial in recurrent affective disorders . Br J Psychiatry 1970;116:621-624.Crossref 33. Coppen A, Noguera R, Bailey J, et al: Prophylactic lithium in affective disorders . Lancet 1971;2:275-279.Crossref 34. Hullin RP, McDonald R, Allsop MNE: Prophylactic lithium in recurrent affective disorders . Lancet 1972;1:1044-1046.Crossref 35. Cundall RL, Brooks PW, Murray LG: A controlled evaluation of lithium prophylaxis in affective disorders . Psychol Med 1972;2:308-311.Crossref 36. Prien RF, Caffey EM Jr, Klett CJ: Prophylactic efficacy of lithium carbonate in manic-depressive illness: Report of the Veterans Administration and National Institute of Mental Health Collaborative Study Group . Arch Gen Psychiatry 1973;28:337-341.Crossref 37. Prien RF, Klett CJ, Caffey EM Jr: Lithium carbonate and imipramine in the prevention of affective episodes: A comparison of recurrent affective illness . Arch Gen Psychiatry 1973;29:420-425.Crossref 38. Stallone R, Shelly E, Mendlewicz J, et al: The use of lithium in affective disorders: III. A double-blind study in prophylaxis in bipolar illness . Am J Psychiatry 1973;130:1006-1010. 39. Fieve R, Kumbaraci T, Dunner D: Lithium prophylaxis of depression in bipolar I and bipolar II and unipolar patients . Am J Psychiatry 1976;133:925-926. 40. Mindham R, Howland C, Shepherd M: An evaluation of continuation therapy with tricyclic antidepressants in depressive illness . Psychol Med 1973;3:5-17.Crossref 41. Glen A, Johnson A, Shepherd M: Continuation therapy with lithium and amitriptyline in unipolar depressive illness: A controlled clinical trial . Psychol Med 1981;11:409-416.Crossref 42. Klerman G, DiMascio A, Weissman M, et al: Treatment of depression by drugs and psychotherapy . Am J Psychiatry 1974;131:186-191. 43. Weissman MM, Kasl SV, Klerman G: Follow-up of depressed women after maintenance treatment . Am. J Psychiatry 1976;757-760. 44. Seager CP, Bird RL: Imipramine with electrical treatment in depression: A controlled trial . J Ment Sci 1962;108:704-707. 45. Imlah NW, Ryan E, Harrington JA: The influence of anti-depressant drugs in the response to electroconvulsive therapy and subsequent relapse rates . J Neuropsychopharmacol 1965;4:439-442. 46. Kay D, Fahy T, Garside R: A seven month double-blind trial of amitriptyline and diazepam in ECT treated depressive patients . Br J Psychiatry 1970;117:667-671.Crossref 47. Perry A, Tsuang MT: Treatment of unipolar depression following electroconvulsive therapy . J Affective Disord 1979;1:123-129.Crossref 48. Coppen A, Abou-Saleh M, Milln P, et al: Lithium continuation therapy following electroconvulsive therapy . Br J Psychiatry 1981;139:284-287.Crossref 49. Barraclough B, Pallis D: Depression followed by suicide: A comparison of depressed suicides with living depressives . Psychol Med 1975;5:55-61.Crossref 50. Roy A: Vulnerability factors and depression in women . Br J Psychiatry 1978;133:106-110Crossref 51. and correction, 1979;134:552 52. Roy A: Depression in chronic paranoid schizophrenia . Br J Psychiatry 1980;137:138-139.Crossref 53. Roy A: Vulnerability factors and depression in men . Br J Psychiatry 1981;138:75-77.Crossref 54. Roy A: Risk factors for depression in Canadian women . J Affective Disord 1981;3:65-70.Crossref 55. Roy A: Role of past loss in depression . Arch Gen Psychiatry 1981;38:301-302.Crossref 56. Roy A: Depression in the course of chronic undifferentiated schizophrenia . Arch Gen Psychiatry 1981;38:296-297.Crossref 57. Roy A: Specificity of risk factors for depression . Am J Psychiatry 1981;138:959-961. 58. Murphy G, Armstrong J, Hermele S, et al: Suicide and alcoholism . Arch Gen Psychiatry 1979;36:65-69.Crossref 59. Paykel E, Myers J, Dienelt M, et al: Life events and depression . Arch Gen Psychiatry 1969;21:753-760.Crossref 60. Brown G, Harris T: Social Origins of Depression . London, Tavistock Publishers Ltd, 1978. 61. Pokorny A, Kaplan H: Suicide following psychiatric hospitalization . J Nerv Ment Dis 1976;162:119-125.Crossref

Journal

Archives of General PsychiatryAmerican Medical Association

Published: Sep 1, 1982

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