Risk factors

An increased risk of suicide is associated with the following risk factors:

• biologic
  • male
• psychological
  • psychiatric illness (personal or family) e.g. - depression, anxiety (e.g., posttraumatic stress disorder) and schizophrenia
  • history of suicide attempts
  • (personal or family)
  • substance use, abuse, dependence
  • severe insomnia
  • hopelessness
  • recent discharge from psychiatric hospital
    • the risk is higher during the first week after discharge and remains high for the first few months.
    • a UK study carried out among psychiatric patients reported that a quarter of suicides occurred within three months of discharge out of which almost half of patients die within the first month (often before the preliminary follow up)
    • patients who were hospitalised for attempted suicide had the highest risk after discharge
• childhood history of trauma, sexual abuse/rape
• environmental/social
  • availability of means e.g., access to guns, medications
  • recent illness diagnosis or chronic disease, especially chronic painful disorders
  • recent suicide in the community, state, nation
  • stressful life event e.g., death of a friend or family member, loss of employment, end of a relationship, legal issues, personal economic crisis
  • unmarried or limited social support (1,2,3)

Reference:

• (1) Norris D, Clark MS. Evaluation and treatment of the suicidal patient. Am Fam Physician. 2012;85(6):602-5.
• (2) Bolton JM, Gunnell D, Turecki G.Suicide risk assessment and intervention in people with mental illness. BMJ. 2015;351:h4978
• (3) Gordon M, Melvin G. Risk assessment and initial management of suicidal adolescents. Aust Fam Physician. 2014;43(6):367-72.