Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-24T13:09:07.019Z Has data issue: false hasContentIssue false
  • English
  • Français

The influence of comorbidity on the prevalence of suicidal behaviour

Published online by Cambridge University Press:  16 April 2020

Y. Lecrubier
Y. Lecrubier*
Affiliation:
Hôpital de la Salpêtrière, Pavillon Clérambault, 47, boulevard de l'Hôpital, 75651Paris cedex13, France
*
*Correspondence and reprints. E-mail address: [email protected] (Y. Lecrubier).
Get access

Summary

The existence of mental disorders is almost constant in subjects who try to kill themselves. In addition, a majority of attempters have more than one diagnosis.

This is especially true if Axis II or Axis I subthreshold conditions are taken into account. The existence of a disorder largely explains the association between most socioeconomic variables (sex, marriage, education level) and suicidality. Depressive disorders are the major risk factor, a risk probably linked to a current episode just before the attempt. The association to depressive episodes of an anxiety disorder or the existence of impulsive traits (and/or cluster B personality disorder or drug abuse) increases the risk of acting out. Ideation and attempts show parallel onset curves peaking between the ages of 14 and 20 years, with the existence of a previous DSM III R diagnosis as a strong predictor. The number of associated disorders linearly increases the probability of attempting suicide and is the only significant predictor for lethality. A proper treatment of mental disorders could substantially lower suicidality.

Keywords

co-morbiditydiagnosisimpulsivitypersonalitysuicide
Type
Original article
Information
European Psychiatry , Volume 16 , Issue 7 , November 2001 , pp. 395 - 399
Copyright
Copyright © European Psychiatric Association 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Allebeck, PAllugander, CFisher, LD.Predictors of completed suicide in a cohort of 50,465 young men: role of personality and deviant behaviour. Br Med J 1988; 297: 176–8.CrossRefGoogle Scholar
Balázs, JBitter, ILecrubier, YCsiszér, NOstorharics, G.Prevalence of subthreshold forms of psychiatric disorders in persons making suicide attempts in Hungary. Eur Psychiatry 2000; 15: 354–61.CrossRefGoogle ScholarPubMed
Beautrais, AJoyce, PMulder, RFergusson, DDeavoll, BNightingale, S.Prevalence and comorbidity of mental disorders in persons making serious suicide attempts: A case-control study. Am J Psychiatry 1996; 153: 1009–14.Google ScholarPubMed
Cheng, ATA.Mental illness and suicide. Arch Gen Psychiatry 1995; 52: 594–603.CrossRefGoogle ScholarPubMed
Cremniter, DJain, SKollenbach, KAlvarez, JCLecrubier, YGilton, A. et al. CSF 5-HVA levels are lower in impulsive as compared to non impulsive violent suicide attempters and controls. Biol Psychiatry 1999; 45: 1572–9.CrossRefGoogle Scholar
Henriksson, MAro, HMarttunen, MHeikkinen, MIsometsä, EKuoppasalmi, K. et al. Mental disorders and comorbidity in suicide. Am J Psychiatry 1993; 150: 935–40.Google ScholarPubMed
Isometsä, EHenriksson, MHeikkinen, MAro, HMarttunen, MKuoppasalmi, K. et al. Suicide among subjects with personality disorders. Am J Psychiatry 1996; 153: 667–73.Google ScholarPubMed
Kessler, RBorges, GWalters, E.Prevalence of and risk factors for lifetime suicide. Attempts in the National Comorbidity Survey. Arch Gen Psychiatry 1999; 56: 617–26.CrossRefGoogle ScholarPubMed
Lecrubier, Y.The impact of comorbidity on the treatment of panic disorder. J Clin Psychiatry 59(Suppl) 8 1998 11–4.Google ScholarPubMed
Lecrubier, Y.Risk factors for suicide attempts: epidemiological evidence. Eur Neuropsychopharmacol X 1998 S114.CrossRefGoogle Scholar
Lecrubier, YÜstün, TB.Panic and depression: a worldwide primary care perspective. Int Clin Psychopharmacol 13(Suppl) 4 1998 7–11.Google ScholarPubMed
Mann, JWaternaux, CHaas, GLMalone, K.Toward a clinical model of suicidal behavior in psychiatric patients. Am J Psychiatry 1999; 156: 181–9.Google Scholar
McDermut, WMattia, JZimmerman, M.Brief report. Comorbidity burden and its impact on psychosocial morbidity in depressed outpatients. J Affective Disord 2001; 65: 289–95.CrossRefGoogle Scholar
Moscicki, EKO’Carroll, PRae, DSLocke, BZRoy, ARegier, DA.Suicide attempts in the epidemiologic catchment area study. Yale J Biol M 1988; 61: 259–68.Google ScholarPubMed
Petronis, KRSamuels, JFMoscicki, EKAnthony, UJC.An epidemiologic investigation of potential risk factors for suicide attempts. Soc Psychiatry Psychiatr Epidemiol 1990; 25: 193–9.Google ScholarPubMed
Pokorny, AD.Prediction of suicide in psychiatric patients: report of a prospective study. Arch Gen Psychiatry 1983; 40: 249–53.CrossRefGoogle ScholarPubMed
Reinherz, HZGiaconia, RMSilverman, ABFriedman, APakiz, BFrost, AK. et al. Early psychosocial risks for adolescent suicidal ideation and attempts. J Am Acad Child Adolesc Psychiatry 1995; 34: 599–611.CrossRefGoogle ScholarPubMed
Rich, CLRuneson, BS.Similarities in the diagnostic comorbidity between suicide among young people in Sweden and the United States. Acta Psychiatr Scand 1992; 86: 335–9.CrossRefGoogle ScholarPubMed
Rudd, MDDahm, PDRajab, MH.Diagnostic comorbidity in persons with suicidal ideation and behavior. Am J Psychiatry 1993; 150: 928–34.Google ScholarPubMed
Sakinofsky, IRoberts, RSBrown, YCumming, CJames, P.Problem resolution and repetition of parasuicide: a prospective study. Br J Psychiatry 1990; 156: 395–9.CrossRefGoogle ScholarPubMed
Samuels, JFNestadt, GRomanoski, AJFolstein, MFMcHugh, PR.DSM-III personality disorders in the community. Am J Psychiatry 1994; 151: 1055–62.Google Scholar
Sartorius, NUstün, TBCosta de Silva, JAGoldberg, DLecrubier, YOrmel, J.An international study of psychological problems in primary care: preliminary report from the World Health Organisation project on psychological problems in general health care. Arch Gen Psychiatry 1993; 50: 819–24.CrossRefGoogle Scholar
Sorenson, SBGolding, JM.Suicide ideation and attempts in Hispanics and non-Hispanic whites: demographic and psychiatric disorder issues. Suicide Life Threat Behav 1988; 18: 205–18.CrossRefGoogle ScholarPubMed
Strakowski, SMMcElroy, SLKeck, PEWest, SA.Suicidality among patients with mixed and manic bipolar disorder. Am J Psychiatry 1996; 153: 674–6.Google ScholarPubMed
Szadoczky, EVitrai, JRihmer, ZFüredi, J.Suicide attempts in the Hungarian adult population. Their relation with DIS/DSM-III-R affective and anxiety disorders. Eur Psychiatry 2000; 15: 343–7.CrossRefGoogle ScholarPubMed
Tondo, LBaldessarini, RHennen, JMinnai, GPSalis, PScamonatti, L. et al. Suicide attempts in major affective disorder patients with comorbid substance use disorders. J Clin Psychiatry 1999; 60 (Suppl) 2: 63–9.Google ScholarPubMed
Weissman, MMKlerman, GLMarkowitz, JSOuellette, R.Suicidal ideation and suicide attempts in panic disorder and attacks. N Engl J M 1989; 321: 1209–14.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.