Does asking about suicide and related behaviours induce suicidal ideation? What is the evidence?

Dazzi, T.; Gribble, Rachael; Wessely, Simon; Fear, Nicola T.

doi:10.1017/s0033291714001299

Cited by 248 publications

(194 citation statements)

References 19 publications

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“…Findings indicated that those respondents who did report thoughts of self-harm or suicide did not report higher distress as a result of participation in the study, nor did it impact upon their return to complete a second survey several years later. These findings complement existing literature which indicates that inclusion of such questions does not increase suicidal ideation or distress and may in fact have positive outcomes for participants experiencing these symptoms [8,20]. The findings of this paper confirmed the high levels of trauma in the study sample.…”

Section: Discussionsupporting

confidence: 86%

Distress and satisfaction with research participation: Impact on retention in longitudinal disaster research

Gibbs

Molyneaux

Whiteley³

et al. 2018

International Journal of Disaster Risk Reduction

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Section: Discussionsupporting

confidence: 86%

Distress and satisfaction with research participation: Impact on retention in longitudinal disaster research

Gibbs

Molyneaux

Whiteley³

et al. 2018

International Journal of Disaster Risk Reduction

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“…(12) Acknowledging and discussing suicide may reduce, instead of aggravate, suicidal ideation. Asking about suicide may help primary care physicians to identify high-risk patients who require urgent intervention (such as hospitalisation) and to uncover risk factors, some of which are amenable to intervention.…”

Section: What Can I Do In My Practice?mentioning

confidence: 99%

Depression in primary care: assessing suicide risk

Ng¹,

How²,

Ng³

2017

smedj

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Major depression is a risk factor for suicide, accounting for up to 60% of suicides.(1-4) The literature has shown that a large proportion of patients who died by suicide had made contact with a primary care health provider within the three months preceding their deaths.(5-7) Patients who died by suicide were also more likely to visit their primary care practitioner than a psychiatrist.(6) This suggests that primary care practitioners are in a unique position to identify at-risk individuals and possibly intervene. (6,8,9) Primary care practitioners have been identified as one of the key potential gatekeepers in suicide prevention efforts.(10) Despite this, not all primary care practitioners routinely ask about suicide in depressed patients. WHAT CAN I DO IN MY PRACTICE?There are concerns that enquiring about suicide in patients who are depressed may trigger suicide, but evidence has shown this to be untrue. (12) Acknowledging and discussing suicide may reduce, instead of aggravate, suicidal ideation. Asking about suicide may help primary care physicians to identify high-risk patients who require urgent intervention (such as hospitalisation) and to uncover risk factors, some of which are amenable to intervention. (9) There are numerous tools to screen for suicide risk. One of the more widely used suicide assessment tools is the SAD PERSONS scale. This is a ten-item mnemonic, which was first developed as a tool for medical students and non-psychiatrist physicians to guide suicide risk assessment.(13) The use of the tool has been found to improve identification of persons with suicidal ideation. (14) The letters in the mnemonic represent demographic, behavioural and psychosocial risk factors for suicide (Box 1). Each risk factor that is present is accorded a score of 1 point, for a maximum of 10 points. Patterson et al recommended that: (a) patients with scores of 3-4 should be closely monitored; (b) hospitalisation should be strongly considered for those with scores of 5 and 6; and (c) patients with scores of 7-10 should be hospitalised for further assessment.(13) A systematic review of the performance of the SAD PERSONS scale in the clinical setting concluded that it did not acutely predict suicide behaviour. (15) Nonetheless, it is an easy scale to remember and use in the primary care setting.Information acquired via such assessment tools can add to the overall information obtained during a thorough suicide assessment. However, a systematic review concluded that there was insufficient evidence for the usefulness of suicide risk screening tools and that suicide assessment tools should not replace a thorough suicide assessment. (16) Each risk factor that is present is accorded a score of 1 point, for a maximum of 10 points.Patterson et al (13) recommended:• Close monitoring for patients with scores of 3 to 4• To strongly consider hospitalisation for those with scores of 5 and 6• Hospitalisation for further assessment for patients with scores of 7-10Note: Regardless of the score obtained, overall clinic...

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“…In the general population, it is established that discussing suicide does not induce thoughts of suicide but rather, may offer beneficial long term outcomes (Dazzi et al 2014). It is unknown if perseverative thinking in some individuals with ASD without adaptive coping skills may incline them to dwell on the topic without benefit.…”

Section: Future Considerations: Practice-informed Research and Evidenmentioning

confidence: 99%

Suicidality in Autism Spectrum Disorder: a Commentary

Lai

Rhee

Nicholas

2017

Adv Neurodev Disord

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Recent studies report a higher prevalence of suicidality (ideation, attempts and deaths by suicide) among individuals with autism spectrum disorder (ASD) than in the general population. Unfortunately, there is little research addressing the conceptualization and management of suicidality in the ASD population. In this commentary, we explore potential modifications in the processes leading to suicidality in individuals with ASD and considerations relevant to clinical support and service development. Specifically, based on a multilevel framework, we highlight individual, contextual and systemic risk factors of suicidality in the ASD population noted in the literature. We discuss how patterns of ASD-related behaviours may modify specific pathways in theories of suicide as developed for the general population. We explore how ASD symptomology may contribute to maladaptive coping strategies and dynamics between those with ASD and their care providers. Considerations for prevention and proactive responses at various levels of practice and implications for support and service development are discussed as future directions in the field.

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Does asking about suicide and related behaviours induce suicidal ideation? What is the evidence?

Cited by 248 publications

References 19 publications

Distress and satisfaction with research participation: Impact on retention in longitudinal disaster research

Distress and satisfaction with research participation: Impact on retention in longitudinal disaster research

Depression in primary care: assessing suicide risk

Suicidality in Autism Spectrum Disorder: a Commentary

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