Mental Disorder and Suicide: What’s the Connection?

Maung, Hane Htut

doi:10.1093/jmp/jhab015

Cited by 5 publications

(5 citation statements)

References 28 publications

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“…Studies including nationally representative surveys documenting lifetime suicide attempts or suicidal ideation in psychiatrically healthy volunteers have not drawn attention to these data; instead, the information is typically only noted in a table or has to be derived from the report of the percentage of persons with lifetime suicide attempts who do have a psychiatric disorder . Furthermore, some authors have suggested that the absence of a psychiatric disorder in individuals who have made a suicide attempt must be due to a masked disorder such as depression, although a potential role of subclinical diagnoses has been raised . This general approach to reporting may reflect a clinical or cultural bias leading investigators not to focus on the occurrence of lifetime suicide attempts or suicidal ideation in healthy volunteers.…”

Section: Discussionmentioning

confidence: 99%

“…Instead, attempts may manifest like other psychiatric disorders, which are often comorbid with each other. One objection to considering suicidal behavior as a disorder is the view that self-inflicted death is not necessarily pathological . This argument is most often raised in the context of medical assistance in dying (MAID) or of culturally sanctioned suicide.…”

Section: Discussionmentioning

confidence: 99%

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Lifetime Suicide Attempts in Otherwise Psychiatrically Healthy Individuals

Oquendo,

Wall,

Wang

et al. 2024

JAMA Psychiatry

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ImportanceNot all people who die by suicide have a psychiatric diagnosis; yet, little is known about the percentage and demographics of individuals with lifetime suicide attempts who are apparently psychiatrically healthy. If such suicide attempts are common, there are implications for suicide risk screening, research, policy, and nosology.ObjectiveTo estimate the percentage of people with lifetime suicide attempts whose first attempt occurred prior to onset of any psychiatric disorder.Design, Setting, and ParticipantsThis cross-sectional study used data from the US National Epidemiologic Study of Addictions and Related Conditions III (NESARC-III), a cross-sectional face-to-face survey conducted with a nationally representative sample of the US civilian noninstitutionalized population, and included persons with lifetime suicide attempts who were aged 20 to 65 years at survey administration (April 2012 to June 2013). Data from the NESARC, Wave 2 survey from August 2004 to September 2005 were used for replication. Analyses were performed from April to August 2023.ExposureLifetime suicide attempts.Main Outcomes and MeasuresThe main outcome was presence or absence of a psychiatric disorder before the first lifetime suicide attempt. Among persons with lifetime suicide attempts, the percentage and 95% CI of those whose first suicide attempt occurred before the onset of any apparent psychiatric disorders was calculated, weighted by NESARC sampling and nonresponse weights. Separate analyses were performed for males, females, and 3 age groups (20 to &lt;35, 35-50, and &gt;50 to 65 years).ResultsIn the total sample of 36 309 respondents, 1948 persons had lifetime suicide attempts; 66.8% (95% CI, 64.1%-69.4%) were female, and 6.2% (95% CI, 4.9%-7.4%) had no apparent lifetime psychiatric diagnoses when surveyed. In addition, 13.4% (95% CI, 11.6%-15.2%) made their first suicide attempt prior to psychiatric disorder onset. Thus, an estimated 19.6% of respondents first attempted suicide without an antecedent psychiatric disorder. No significant age or sex differences were detected in the percentage of those with lifetime suicide attempts absent psychiatric disorders, although females were more likely than males to attempt suicide in the year of psychiatric disorder onset (14.9% [95% CI, 12.5%-17.3%] vs 8.6% [95% CI, 6.0%-11.2%]; P &lt; .001), and attempts were less frequent among those older than 50 to 65 years (3.9% [95% CI, 3.5%-4.4%] vs 6.1% [95% CI, 5.4%-6.8%] for 35-50 years and 6.2% [95% CI, 5.6%-6.9%] for 20 to &lt;35 years; P &lt; .001).Conclusions and RelevanceIn this study, an estimated 19.6% of individuals who attempted suicide did so despite not meeting criteria for an antecedent psychiatric disorder. This finding challenges clinical notions of who is at risk for suicidal behavior and raises questions about the safety of limiting suicide risk screening to psychiatric populations.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Lifetime Suicide Attempts in Otherwise Psychiatrically Healthy Individuals

Oquendo,

Wall,

Wang

et al. 2024

JAMA Psychiatry

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“…For instance, the symptoms experienced by persons with mental illnesses can generate distress, suffering and impairment, thus increasing suicide risk. 34 In addition to improving mental health awareness and gatekeeper training, another strategy that addresses stigma reduction is suicide decriminalisation. Attempted suicide remains a criminal offence in Kenya, punishable by up to a 2-year jail term.…”

Section: Discussionmentioning

confidence: 99%

“…For instance, the symptoms experienced by persons with mental illnesses can generate distress, suffering and impairment, thus increasing suicide risk. 34 …”

Section: Discussionmentioning

confidence: 99%

Perspectives on reasons for suicidal behaviour and recommendations for suicide prevention in Kenya: qualitative study

et al. 2023

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Background Little is known about the reasons for suicidal behaviour in Africa, and communities’ perception of suicide prevention. A contextualised understanding of these reasons is important in guiding the implementation of potential suicide prevention interventions in specific settings. Aims To understand ideas, experiences and opinions on reasons contributing to suicidal behaviour in the Coast region of Kenya, and provide recommendations for suicide prevention. Method We conducted a qualitative study with various groups of key informants residing in the Coast region of Kenya, using in-depth interviews. Audio-recorded interviews were transcribed and translated from the local language before thematic inductive content analysis. Results From the 25 in-depth interviews, we identified four key themes as reasons given for suicidal behaviour: interpersonal and relationship problems, financial and economic difficulties, mental health conditions and religious and cultural influences. These reasons were observed to be interrelated with each other and well-aligned to the suggested recommendations for suicide prevention. We found six key recommendations from our thematic content analysis: (a) increasing access to counselling and social support, (b) improving mental health awareness and skills training, (c) restriction of suicide means, (d) decriminalisation of suicide, (e) economic and education empowerment and (f) encouraging religion and spirituality. Conclusions The reasons for suicidal behaviour are comparable with high-income countries, but suggested prevention strategies are more contextualised to our setting. A multifaceted approach in preventing suicide in (coastal) Kenya is warranted based on the varied reasons suggested. Community-based interventions will likely improve and increase access to suicide prevention in this study area.

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“…No predictors have been reliably identified, and attempts to decrease mortality due to suicides have not been successful (Franklin et al, 2017). There are no reliable data which would allow treating suicide as an aspect of any clinical distortion or even reveal regular correlations of a suicide with any clinical syndrome (see a detailed discussion of this issue in Maung, 2021).…”

Section: Suicidal Behavior As a Reaction To Psychological Crisis: The...mentioning

confidence: 99%

Meaning of life as a resource for coping with psychological crisis: Comparisons of suicidal and non-suicidal patients

Kalashnikova

Leontiev²,

Rasskazova³

et al. 2022

Front. Psychol.

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IntroductionMeaning is an important psychological resource both in situations of accomplishment and in situations of ongoing adversity and psychological crisis. Meaning in life underlies the reasons for staying alive both in everyday and in critical circumstances, fulfilling a buffering function with respect to life adversities.AimThe aim of the present study was to reveal the role of both meaningfulness, including specific sources of meaning and reasons for living, and meaninglessness (alienation) in patients suffering from profound crisis situations with or without suicidal intentions and behavior.MethodsThe sample included 148 patients (all Caucasian) who were referred to a crisis center in Moscow, Russia. Seventy-seven patients (54 females, mean age 32.00 ± 11.98 years) reported a current crisis situation in their life but denied suicidal thoughts or behavior. Twenty-nine patients (21 females, mean age 31.55 ± 13.76 years) reported suicidal ideations but denied suicidal attempts or self-harming behavior. Forty-two patients (31 females, mean age 30.64 ± 11.38 years) had episodes of suicidal attempts or self-harming behavior accompanied by suicidal intentions. There were no significant gender or age differences between groups.Participants completed a number of measures of different aspects of meaning and meaninglessness, well-being, ill-being and psychological resources. For some patients (N = 74), a clinical checklist was completed by their doctors assessing 28 various characteristics associated with the patient’s clinical status.Results and discussionMeaningfulness and reasons for living were more helpful in distinguishing between reactions to profound crisis situations (suicidal intentions versus non-suicidal behavior) than were measures of well-being, ill-being, meaning crisis or personality resources. In both suicidal and non-suicidal crisis patients meaningfulness predicted more positive reasons for living. The relationship between meaningfulness and most reasons for living remained significant after controlling for clinically appraised suicidal “readiness,” acute stress and lack of social support. Self-transcendence was the major specific source of meaning predicting higher reasons for living after adjusting for general meaningfulness.ConclusionThe data cast some light on the psychological meaning of suicide. It follows that prevention efforts are to be focused not on eliminating the factors “pushing” one to suicidal behavior, but rather on supporting inner strengths conducive of a positive decision, to be, through enhancing meaningfulness and reasons for living.

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Mental Disorder and Suicide: What’s the Connection?

Cited by 5 publications

References 28 publications

Lifetime Suicide Attempts in Otherwise Psychiatrically Healthy Individuals

Lifetime Suicide Attempts in Otherwise Psychiatrically Healthy Individuals

Perspectives on reasons for suicidal behaviour and recommendations for suicide prevention in Kenya: qualitative study

Meaning of life as a resource for coping with psychological crisis: Comparisons of suicidal and non-suicidal patients

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