Previous Suicide Attempt

Previous Suicide Attempt

About 20% of people who die by suicide have made a prior suicide attempt, and clinical studies have confirmed that such prior attempts increase a person’s risk for subsequent suicide death. Suicide risk appears to be especially elevated during the days and weeks following hospitalization for a suicide attempt, especially in people with diagnoses of major depression, bipolar disorder, and schizophrenia (Tidemalm, et al., 2008).
The majority of people who make a suicide attempt, however, do not ultimately die by suicide. Studies that have followed suicide attempters identified in hospital emergency rooms have found that just 7–10% died by suicide over the next two decades (Jenkins, et al., 2002; Carter, et al., 2007). Data collected by the Centers for Disease Control and Prevention show clear differences in the gender and age patterns of suicide attempters and those who die by suicide. Young women, for example, are estimated to make 100 or more suicide attempts for every completed suicide, but yet they have a low rate of completed suicide. In contrast, the elderly have a suicide rate that is twice the rate among youth, but make relatively few non-fatal suicide attempts. Greater overall frailty and increased likelihood of physical illnesses contributes to the lethality of suicide attempts in older adults.   

Family History of Suicide

Research has shown that the risk for suicide can be inherited (Juel-Nielsen & Videbech, 1970; Roy, et al., 1991; Lester, 2002). Identical twins, for example, have been found to have stronger concordance for suicide than fraternal twins, even when they are raised separately. Studies of people who were adopted and subsequently died by suicide have found suicide to be more common among these individuals’ biological parents than their adopted parents. Although studies show that depression and other psychopathology also runs in families, the heritability of suicide appears to exist even independent from inherited depression. Exposure to completed and attempted suicide in the family has also been found to increase suicide risk among  family members by providing a “social model” of self-harm behavior (de Leo & Heller, 2008).
While these studies indicate that a family history of suicide can be a risk factor for suicide, they do not suggest that a suicide in the family automatically heightens suicide risk for all family members. Family history is one among many factors that can contribute to a person’s vulnerability or resilience. As with other genetically-linked illnesses and conditions, awareness of possible risk and attention to early signs of problems in oneself or a loved one can be protective if it leads those who have lost a relative to suicide to seek timely treatment or intervention.

Medical Conditions and Pain

Patients with serious medical conditions such as cancer, HIV, lupus, and traumatic brain injury may be at increased risk for suicide. This is primarily due to psychological states such as hopelessness, helplessness, and desire for control over death. Chronic pain, insomnia and adverse effects of medications have also been cited as contributing factors. These findings point to a critical need for increased screening for mental disorders and suicidal ideation and behavior in general medical settings.