Psychosocial and psychiatric factors preceding death by suicide: A case–control psychological autopsy study involving multiple data sources

McMahon, Elaine M.; Greiner, Birgit A.; Corcoran, Paul; Larkin, Celine; Leitão, Sara; McCarthy, Jane; Cassidy, Eugene; Bradley, Colin; McAuliffe, Carmel; Griffin, Eve; Williamson, Eileen; Foster, Tom; Gallagher, J; Perry, Ivan J.; Kapur, Nav; Arensman, Ella

doi:10.1111/sltb.12900

Cited by 15 publications

(9 citation statements)

References 37 publications

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“…Seventeen factors were weakly to moderately associated with later suicide (1.5 ≤ OR < 2.5) listed in Note: [1] calculated based on categorical and continuous data so unable to calculate pooled outcome. [2] employed, connected to family, and married. [3] living alone or homeless, divorced or separated, single, widowed, and unemployed.…”

Section: Statistical Strength Of Clinical Risk Factors and Risk Categ...mentioning

confidence: 99%

“…1 About half of all suicides are preceded by self-harm or a suicide attempt. 2 While not all people who self-harm present for medical treatment, 3 self-harm that is severe or distressing enough to bring a person to hospital is associated with a subsequent suicide rate almost 50 times the global suicide rate. 4 Hence, people attending a hospital with suicidal thoughts and behaviours (STB) present an obvious opportunity for assessment and care planning.…”

Section: Introductionmentioning

confidence: 99%

“…The World Health Organisation estimates that there are currently about 700,000 annual deaths by suicide and 20 times more suicide attempts 1 . About half of all suicides are preceded by self‐harm or a suicide attempt 2 . While not all people who self‐harm present for medical treatment, 3 self‐harm that is severe or distressing enough to bring a person to hospital is associated with a subsequent suicide rate almost 50 times the global suicide rate 4 .…”

Section: Introductionmentioning

confidence: 99%

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Meta‐analysis of clinical risk factors for suicide among people presenting to emergency departments and general hospitals with suicidal thoughts and behaviours

Grover,

Huber,

Brewer

et al. 2023

Acta Psychiatr Scand

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BackgroundSuicidal thoughts and behaviours (STB) are a common reason for presentation to emergency departments and general hospitals. A meta‐analysis of the strength of clinical risk factors for subsequent suicide might aid understanding of suicidal behaviour and help suicide prevention.MethodsWe conducted a meta‐analysis of cohort and controlled studies on clinical risk factors and later suicide among people presenting to emergency departments and general hospitals with STB. Data were extracted from papers meeting inclusion criteria, published in Medline, PsycINFO, and Embase between 1 January 1960 and 10 October 2022 using papers located with the search terms ((suicide*).m_titl AND (emergency* OR accident and emergency OR casualty OR general hospital OR toxicology service).mp) or were indexed in PubMed and had titles located with the search terms (suicide* OR self‐harm OR self‐harm OR self‐injury OR self‐injury OR self‐poisoning OR self‐poisoning OR overdose OR para‐suicide OR parasuicide [title/abstract]) AND (Emergency department OR emergency room OR Casualty OR general hospital OR toxicology OR accident and emergency [all fields]). Data about the association between clinical risk factors and suicide extracted from three or more studies were included in a random‐effects meta‐analysis of the odds of later death by suicide. The study was registered in PROSPERO and conducted according to MOOSE and PRISMA guidelines.ResultsSeventy‐five studies reported on 741,624 people, of which 19,649 died by suicide (2.65%). Male sex (odds ratio (OR) = 1.99) and age (OR = 2.01) were the most consistently reported risk factors. The strongest associations with subsequent death by suicide related to violent self‐harm methods at the hospital presentation, including: unspecified violent method (OR = 4.97), any violent method (OR = 4.57) and the specific violent methods of drowning (OR = 4.32), hanging (OR = 4.26), and use of firearms (OR = 10.08). Patients categorised as higher risk using suicide prediction scales or any other method that combined risk factors had moderately increased odds of suicide (OR = 2.58). Younger age, Black and Hispanic ethnicity, overdose, a diagnosis of adjustment disorder, and the absence of any psychiatric diagnosis were protective against suicide.ConclusionsMost risk factors for suicide among people who have presented with STB are not strongly associated with later suicide. The strongest risk factors relate to self‐harm methods. In the absence of clear indicators of future suicide, all people presenting with suicidality warrant a thorough assessment of their needs, and further research is needed before we can meaningfully categorise people with STB according to suicide risk.

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Section: Statistical Strength Of Clinical Risk Factors and Risk Categ...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Meta‐analysis of clinical risk factors for suicide among people presenting to emergency departments and general hospitals with suicidal thoughts and behaviours

Grover,

Huber,

Brewer

et al. 2023

Acta Psychiatr Scand

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“…Furthermore, the higher incidence of suicide among men, regardless lithium intake, should be considered when interpreting these data. Finally, considering that suicide represents the result of different genetic, biological, demographic, psychiatric and environmental factors (McMahon et al, 2022[ 8 ]), the role of potentially confounder variables (i.e. economic availability, marital status, personality disorders, previous suicide attempts, previous psychiatric diagnosis…) in the association between water lithium intake and suicide risk should not be underestimated.…”

Section: ⁯⁯⁯mentioning

confidence: 99%

Comment to the letter to the editor entitled “Lithium in drinking water and suicide risk” by Tomoyuki Kawada

Luca

Luca²

2022

EXCLI Journal; 21:Doc1066; ISSN 1611-2156

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“…It is vital to understand the factors which are precursors to, and escalators of, suicidal experiences from numerous perspectives including epidemiological, neuropharmacological and psychosocial. A research focus on the former two perspectives continues with a robust impetus (9,10,11,12) but less so on the latter. A psychosocial understanding of the mechanisms underpinning suicidal thoughts and acts is important scienti cally but also clinically in that it provides an evidence-based foundation for developing e cacious and effective psychological therapies which can target suicide-related distress and prevent death by suicide (2,13,14,15).…”

Section: Introductionmentioning

confidence: 99%

The interplay between suicidal experiences, psychotic experiences and interpersonal relationships: a qualitative study

Gooding,

Haddock,

Harris

et al. 2023

Preprint

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Background Suicidal thoughts, acts, plans and deaths are considerably more prevalent in people with non-affective psychosis, including schizophrenia, compared to the general population. Social isolation and interpersonal difficulties have been implicated in pathways which underpin suicidal experiences in people with severe mental health problems. However, the interactions between psychotic experiences, such as hallucinations and paranoia, suicidal experiences, and the presence, and indeed, absence of interpersonal relationships is poorly understood and insufficiently explored. The current study sought to contribute to this understanding.Methods An inductive thematic analysis was conducted on transcripts of twenty-two, individual, semi-structured interviews with adult participants who had both non-affective psychosis and recent suicidal experiences. A purposive sampling strategy was used. Trustworthiness of the analysis was assured with researcher triangulation.Results Participants relayed both positive and negative experiences of interpersonal relationships. A novel conceptual model is presented reflecting a highly complex interplay between a range of different suicidal experiences, psychosis, and aspects of interpersonal relationships. Three themes fed into this interplay, depicting dynamics between perceptions of i. not mattering and mattering, ii. becoming disconnected from other people, and iii. constraints versus freedom associated with sharing suicidal and psychotic experiences with others.Conclusion This study revealed a detailed insight into ways in which interpersonal relationships are perceived to interact with psychotic and suicidal experiences in ways that can be both beneficial and challenging. This is important from scientific and clinical perspectives for understanding the complex pathways involved in suicidal experiences.Trial registration ClinicalTrials.gov (NCT03114917), 14th April 2017. ISRCTN (reference ISRCTN17776666 https://doi.org/10.1186/ISRCTN17776666); 5th June 2017). Registration was recorded prior to participant recruitment commencing.Trial registration ClinicalTrials.gov (NCT03114917), 14th April 2017 (14-04-2017). ISRCTN (reference ISRCTN17776666 https://doi.org/10.1186/ISRCTN17776666); 5th June 2017). Registration was recorded prior to participant recruitment commencing.

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Psychosocial and psychiatric factors preceding death by suicide: A case–control psychological autopsy study involving multiple data sources

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 15 publications

References 37 publications

Meta‐analysis of clinical risk factors for suicide among people presenting to emergency departments and general hospitals with suicidal thoughts and behaviours

Meta‐analysis of clinical risk factors for suicide among people presenting to emergency departments and general hospitals with suicidal thoughts and behaviours

Comment to the letter to the editor entitled “Lithium in drinking water and suicide risk” by Tomoyuki Kawada

The interplay between suicidal experiences, psychotic experiences and interpersonal relationships: a qualitative study

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