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Suicide in the 18 Years After Deliberate Self-harm

A Prospective Study

Published online by Cambridge University Press:  02 January 2018

Gregory M. De Moore  and
Andrew R. Robertson
Gregory M. De Moore
Affiliation:
Department of Consultation-Liaison Psychiatry, The New York Hospital–Cornell University Medical Center, New York, USA
Andrew R. Robertson*
Affiliation:
Department of Psychiatry, Westmead Hospital, Westmead, Australia
*
Dr Andrew R. Robertson, Senior Visiting Specialist, Department of Psychiatry, Westmead Hospital, Westmead, NSW 2145, Australia
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Abstract

Background

Clinical and demographic information on patients seen as a result of deliberate self-harm (DSH) was collected in an attempt to identify factors in the index episode of DSH predictive of subsequent suicide.

Method

Specific data were prospectively collected on all DSH patients who lived in Blacktown Municipality, Sydney, Australia, and seen from October 1975 to September 1976. Follow-up at 18 years was by evaluation of coroners' records and identification of ‘probable suicide’.

Results

Two hundred and twenty-three patients harmed themselves on one or more occasions. Follow-up at 18 years showed that 15 of the 223 (6.7%) had completed suicide. The proportion at five and eight years was 4.0% and at 10 years was 4.5%. Identified predictors of suicide were: narcotic overdose; more than one episode of DSH in the year of the study; planned episode; and mental illness. Teenage narcotic-abusing males were at greatest risk, and in females a planned episode was the most powerful predictor.

Conclusions

Suicides continued to occur over 18 years. One of the striking differences between this and other studies is the finding of teenage male DSH, associated with narcotic abuse, as a strong predictor of subsequent suicide. These findings are particularly relevant to the issue of young male suicide, which increased from the 1970s onwards in Australia and elsewhere.

Type
Papers
Information
The British Journal of Psychiatry , Volume 169 , Issue 4 , October 1996 , pp. 489 - 494
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

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References

Adelstein, A. & Mardon, C. (1975) Suicides 1961–74. Population Trends, 2, 13–18.Google Scholar
Beck, A. T. & Steer, R. A. (1989) Clinical predictors of eventual suicide: a 5- to 10-year prospective study of suicide attempters. Journal of Affective Disorders, 17, 203–209.CrossRefGoogle ScholarPubMed
Cantor, C. H. (1994) Clinical management of parasuicides: critical issues in the 1990s. Australian and New Zealand Journal of Psychiatry, 28, 212–221.CrossRefGoogle ScholarPubMed
Cullberg, J., Wasserman, D. & Stefansson, C.-G. (1988) Who commits suicide after a suicide attempt? Acta Psychiatrica Scandinavica, 77, 598–603.CrossRefGoogle ScholarPubMed
Dahlgren, K. O. (1977) Attempted suicides – 35 years afterwards. Suicide and Life Threatening Behaviour, 7, 75–79.CrossRefGoogle Scholar
Ekeberg, O., Ellingsen, O. & Jacobsen, D. (1991) Suicide and other causes of death in a five-year follow-up of patients treated for self-poisoning in Oslo. Acta Psychiatrica Scandinavica, 83, 432–437.CrossRefGoogle Scholar
Graham, C. & Burvill, P. W. (1992) A study of coroners' records of suicide in young people, 1986–1988, in Western Australia. Australian and New Zealand Journal of Psychiatry, 26, 30–39.CrossRefGoogle Scholar
Hassan, R. & Carr, J. (1989) Changing patterns of suicide in Australia. Australian and New Zealand Journal of Psychiatry, 23, 225–234.CrossRefGoogle ScholarPubMed
Hawton, K. & Catalan, J. (1987) Attempted Suicide: A Practical Guide to its Nature and Management (2nd edn). Oxford: Oxford University Press.Google Scholar
Hawton, K. & Fagg, J. (1988) Suicide, and other causes of death, following attempted suicide. British Journal of Psychiatry, 152, 359–366.CrossRefGoogle ScholarPubMed
Hawton, K., Fagg, J., Platt, S., et al (1993) Factors associated with suicide after parasuicide in young people. British Medical Journal, 306, 1641–1644.CrossRefGoogle ScholarPubMed
Kosky, R. (1987) Is suicidal behaviour increasing among Australian youth? Medical Journal of Australia, 147, 164–166.CrossRefGoogle ScholarPubMed
Kosky, R. & Goldney, R. D. (1994) Youth suicide: a public health problem? Australian and New Zealand Journal of Psychiatry, 28, 186–187.CrossRefGoogle ScholarPubMed
Kotila, L. & Lonnqvist, J. (1988) Adolescent suicide attempts: sex differences predicting suicide. Acta Psychiatrica Scandinavica, 77, 264–270.CrossRefGoogle ScholarPubMed
Nielsen, B., Wang, A. G. & Bille-Brahe, U. (1990) Attempted suicide in Denmark. IV. A five-year follow-up. Acta Psychiatrica Scandinavica, 81, 250–254.CrossRefGoogle Scholar
Nordentoft, M., Breum, L., Munck, L. K., et al (1993) High mortality by natural and unnatural causes: a 10 year follow up study of patients admitted to a poisoning treatment centre after suicide attempts. British Medical Journal, 306, 1637–1641.CrossRefGoogle ScholarPubMed
Pokorny, A. D. (1982) Prediction of suicide in psychiatric patients. Archives of General Psychiatry, 30, 1089–1095.Google Scholar
Schneider, P. B. (1954) La tentative de suicide. Etude statistique, clinique psychologique et catamnestique. Neuchâtel, Paris: Delachauz et Niestle SA.Google Scholar
Suokas, J. & Lonnqvist, J. (1991) Outcome of attempted suicide and psychiatric consultation: risk factors and suicide mortality during a five-year follow-up. Acta Psychiatrica Scandinavica, 84, 545–549.CrossRefGoogle ScholarPubMed
Tunving, K. (1988) Fatal outcome in drug addiction. Acta Psychiatrica Scandinavica, 77, 551–566.CrossRefGoogle ScholarPubMed
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