Abstract
Suicide is a major public health problem and cause of death, as well as years of life lost. The US suicide rate is at its highest level in over 15 years, and has become an epidemic in both our military forces and veterans of military service. (American Foundation for Suicide prevention). At present there is no evidence that suicide is clinically predictable in an individual, even though the standard of care requires that suicide risk be assessed in psychiatric patients, who show an elevated risk in general, and clinical efforts be made to reduce risk. Clinical prediction may be improved in a number of suggested ways, which could lead to more effective short-term prevention. While at present, there is no evidence that short term (2–3 months) treatment can prevent suicide, there is evidence from long-term studies that maintaining maintenance medication can reduce suicide in high risk patients.
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References
Angst F, Stassen HH, Clayton PJ et al. (2002) Mortality of patents with mood disorders: follow-up over 34–38 years. J Affect Disord 68(2–3):67–81
Bandelow B, Bauer M, Vieta E et al (2014) Extended release quetiapine fumarate as adjunct to antidepressant therapy in patients with major depressive disorder: pooled analysis of patients with anxious depression versus low levels of anxiety at baseline. World J Biol Psychiatr 15(2):155–166
Beck AT et al (1989) Alcohol abuse ans eventual suicide: a 5- to 10-year prospective study of alcohol-abusing suicide attempters. J Stud Alcohol 50(3):202–209
Busch KA, Fawcett J, Jacobs D (2003) Clinical correlates of inpatient suicide. J Clin Psychiatr 64(1):14–19
Cipriani A (2013) Review: lithium reduces the risk of suicide compared with placebo in people with depression and bipolar disorder. Evid Based Mental health 16(4):112
Clayton PJ, Grove WM, Coryell W et al. (1991) Follow-up and family study of anxious depression. Am J Psychiatr 148(11):1512–1517
Conwell Y, Duberstein PH, Cox C et al (1996) Relationships of age and axis I diagnoses in victims of completed suicide: a psychological autopsy study. Am J Psychiatr 153(8):1001–1008
De Gloannis, DeLeo D (2014) Oral ketamine augmentation for chronic suicidality in treatment resistant depression. Audt-NZ J Psychiatr 48:686, 22 Jan 2014
Endicott J, Spiitzer R (1978) A diagnostic interview: the schedule for affective disorders and schizophrenia. Arch Gen Psychiatr 35(7):837–844
Fawcett J, Kravitz HM (1983) Anxiety syndromes and their relationship to depressive illness. J Clin Psychiatr 44(8):8–11
Fawcett J, Scheftner WA, Fogg L et al (1990) Time-related predictors of suicide in major affective disorder. Am J Psychiatr 147(9):1189–1194
Flansborg-Madsen T, Knop J, Mortensen EL et al (2009) Alcohol use disorders increase the risk of completed suicide- irrespective of other psychiatric disorders. A longitudinal cohort study. Psychiatry Res 167(1–2):123–130
Hall RC, Platt DE, Hall RC (1999) Suicide risk assessment: a review of risk factors for suicide in 100 patients who made severe suicide attempts. Evaluation of suicide risk in a time of managed care. Psychosomatics 40(1):18–27
Hennriksson S, Isacsson G (2006) Increased antidepressant use and fewer suicides in Jamtland County, Sweden, after a primary care educations programme on the treatment of depression. Acta Psychiatrica Scand 114:159–167
Isometsa ET, Heikkinen ME, Marttunen MJ et al (1995) The last appointment before suicide: is suicide intent communicated? Am J Psychiatr 152(6):919–922
Khan A, Khan S, Kolts R, Brown WA (2003) Suicide rates in clinical trials of SSRIs, other antidepressants, and placebo: analysis of FDS reports. Am J Psychiatr 160(4):790–792
Lambert MT (2002) Seven year outcomes of patients evaluated for suicidality. Psychiatric Serv 53(1):92–94
Lambert MT, Bonner J (1996) Characteristics and six month outcome of patients sho use suicide threats seek hospital admission. Psychiatr Serv 47(8):871–873
Large M, Sharma S, Cannon E et al. (2011) Risk factors for suicide within a year of discharge from a psychiatric hospital: a systematic analysis. Aust- NZ Psychiatr 45(8):619–628
Larkin GL, Beautrais SL (2011) A preliminary naturalistic study of low-dose ketamine for depression and suicide ideation in the emergency department. Int J Neuropsychopharmacol 14(8):1127–1131
Leon AC, Solomon DA, Li C et al (2011) Antidepressants and risk of suicide and suicide attempts: a 27-year observational study. J Clin Psychiatr 72(5):580–586
Luoma JB, Martin CE, Pearson JL (2002) Contact with mental health and primary care providers before suicide: a review of the evidence. Am J Psychiatr 159(6):909–916
Montgomery SA, Jocklear JC, Svedsafer H et al. (2014) Efficacy of once-daily extended release quetiapine fumarate in patients with different levels of severity of generalized anxiety disorder. Int Clin Psychopharmacol 3 Jan 2014
Nakagawa A et al (2008) Bipolar Disord 10:530–538
Nishiyama A, Matsumoto H (2013) Quetiapine reduces irritability and risk of suicide in patients with agitated depression. Tokai J Exp Clin Med 38(2):93–96
Nock MK, Hwang J, Sampson N et al (2009) Cross-national analysis of the association among mental disorders and suicidal behavior: findings for the WHO World Mental Health Surveys. PLOS Med 6(8):1371
Pfeiffer PN, Ganoczy D, Ilgen M (2009) Comorbid anxiety as a suicide risk factor among depressed veterans. Depress Anxiety 26(8):752–757
Pokorny AD (1983) Prediction of suicide in psychiatric patients: report of a prospective study. Arch Gen Psychiatr 49(3):249–257
Pokorny AD (1993) Suicide prediction revisited. Suicide Life Threat Behav 23(1):1–10
Robins E (1981) The final months, pp 424–425. Oxford University Press, Oxford
Sher L, Stanley BH, Posner K et al (2012) Decreased suicidal ideation in depressed patients with or without comorbid stress disorder treated with selective serotonin reuptake inhibitors: an open study. Psychiatry Res 190(2–3):261
Smith EG, Kim HM, Ganoczy D et al (2013) Suicide risk assessment received prior to suicide death by Veterans health administration patients with a history of depression. J Clin Psychiatr 74(3):226–232
Stordal E, Morken C, Mykietun A et al (2008) Monthly variation in prevalence rates of comorbid anxiety and depression in the general population at 63–65 degrees North: the HUNT study. J Affect Disord 106(3):273–278
American Foundation for Suicide Prevention. www.ASFP.org
Yerevanian BL, Koek RJ, Feusner JD et al. (2004) Antidepressants and suicidal behavior in unipolar depression. Acta Psychiatr Scand 110:452–458
Zigman D, Blier P (2013) Urgent ketamine infusion rapidly eliminated suicidal ideation for a patient with major depressive disorder: a case report. J Clin Psychopharmacol 33(2):270–272
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Fawcett, J. (2014). Is Suicide Clinically Preventable? What Is the Evidence?. In: Cannon, K., Hudzik, T. (eds) Suicide: Phenomenology and Neurobiology. Springer, Cham. https://doi.org/10.1007/978-3-319-09964-4_8
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DOI: https://doi.org/10.1007/978-3-319-09964-4_8
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