The Communication of Suicidal Intent: A Study of 134 Consecutive Cases of Successful (Completed) Suicide

Robins, Eli; Gassner, Seymour; Kayes, Jack; Wilkinson, Robert H.; Murphy, George E.

doi:10.1176/ajp.115.8.724

Cited by 279 publications

(101 citation statements)

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“…These communications of suicidal intent have been described in detail elsewhere. 23 The age of the manic-depressives appears to be an important factor in evaluating the probability of suicide. Only five out of 60 cases (8 per cent) were under 40.6 This finding appears even more striking when it is remem- t It is not definite whether care for the psychiatric illness was to some extent involved here.…”

Section: Methodsmentioning

confidence: 99%

Some Clinical Considerations in the Prevention of Suicide Based on a Study of 134 Successful Suicides

Robins¹,

Murphy²,

Wilkinson³

et al. 1959

Am J Public Health Nations Health

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658

233

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Section: Methodsmentioning

confidence: 99%

Some Clinical Considerations in the Prevention of Suicide Based on a Study of 134 Successful Suicides

Robins¹,

Murphy²,

Wilkinson³

et al. 1959

Am J Public Health Nations Health

Self Cite

658

233

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“…Fewer than 5% of suicides have been reported in the absence of psychiatric symptoms. [19][20][21][22] In Japan, although there has not yet been a complete psychological autopsy study, other studies of suicide attempters reveal that the majority of suicide victims had mental disorders. 23,24 …”

Section: Biological Social and Personal Factors Associated With Suimentioning

confidence: 99%

“…The relationship between alcohol dependence and completed suicide has been noted in numerous studies. 19,26,[36][37][38][39][40][41][42] Of 24 studies reviewed by Petty 43 and the Agency for Health Care Policy and Research Depression Guideline Panel, 34 most found that between 10% and 30% of patients with alcoholism also suffered from depression during acute evaluation. These findings mandate that patients entering the emergency treatment center, even those under the influence of alcohol or drugs, be questioned about depression.…”

Section: Emergency Evaluation Of Suicide Attemptersmentioning

confidence: 99%

“…Most studies suggest that this group accounts for fewer than 5% of suicide victims. [19][20][21][22] They are, however, a group with needs to address not commonly thought of outside of ethical circles. Most frequently seen in the medical setting, these patients talk about or attempt suicide because they do not want to suffer from chronic pain, do not want to be a financial or social burden on their relatives, or are just dissatisfied with their living situation.…”

Section: Emergency Evaluation Of Suicide Attemptersmentioning

confidence: 99%

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Assessment of Patients Who Attempt Suicide

Kishi¹,

Kathol

2002

Prim. Care Companion CNS Disord.

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“…That a substantial number of outpatients completed suicide soon after their last contact with staff supports the observation that most patients do not communicate their acute intent (24,(30)(31)(32). Nevertheless, the fact that more than one-quarter were seen within 3 days ofcompleting suicide underscores its apparent unpredictability in the short term; it may also have compounded the distress of staff who might question what they missed.…”

Section: Methodsmentioning

confidence: 64%

The Clarke Institute Experience with Completed Suicide: 1966 to 1997

Martin

2000

Can J Psychiatry

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Suicide as a cause ofdeath is one ofthe eventual outcomes ofmental illness, and the estimated risk ofsuicide for specific disorders is substantial, ranging from 4% to 10% for schizophrenia and up to 15% for severe affective disorders (1-6). The prevalence ofmental disorder in cases ofsuicide is 80% to 90% or higher (7-11). As a generalization, almost every substance abuse and severe mental disorder carries an increased risk of suicide (12,13). It will, therefore, inevitably be a cause of death in the caseload of every facility involved in the care of patients with serious mental illness.Not unexpectedly, then, the reported suicide rates for psychiatric caseloads are higher than those for general populations. An overview of the literature presents rates for both individual hospitals and groups ofhospitals over different time periods from the 19th century to 1985 (14). The more contemporary studies from 1950 on indicate a wide range in suicide rates. The cumulative rates for studies lasting from 3 to 21 years range from 79 to 684 per 100 000 patients treated or admitted; the rates for 5-year periods ranged from 35 to 629. The annual rates (in studies lasting 8 to 20 years) ranged from 49.6 to 208 per 100 000 patients. For schizophrenia alone, rates of 167, 411, and 456 per 100 000 patients have been reported (15)(16)(17). In several studies, these high rates are extrapolations from small numbers of actual suicide cases. Recent reports of inpatient suicide at Canadian hospitals do not cite the rates for registered patients at risk (18)(19)(20).Although inevitable and not uncommon within hospital caseloads, the occurrence of a suicide is generally very distressing to staff-often more so than a death from natural causes. To address both staffconcerns and more general quality assurance issues, many facilities conduct mandatory reviews ofall suicides in their caseloads. Such audits, including those conducted at the Clarke Institute, may address more than do traditional psychological autopsies, answering why the person died, what was the cause of death, and whether it was a suicide (21).The primary purpose of this report is to describe the experience with suicide in over 100 000 patients at a single psychiatric facility over a period ofmore than 30 years. The secondary purpose is to present an overview ofrecommendations made pursuant to audits of the documentation, management, and post-suicide response for each case. Although data on part of this caseload have been published previously (22,23), this is the first report of the entire cumulative experience with

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The Communication of Suicidal Intent: A Study of 134 Consecutive Cases of Successful (Completed) Suicide

Cited by 279 publications

References 1 publication

Some Clinical Considerations in the Prevention of Suicide Based on a Study of 134 Successful Suicides

Some Clinical Considerations in the Prevention of Suicide Based on a Study of 134 Successful Suicides

Assessment of Patients Who Attempt Suicide

The Clarke Institute Experience with Completed Suicide: 1966 to 1997

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