Suicide Risk Often Undetected

It is noteworthy that every person who completed suicide who had a diagnosis of BPD had at least one previous suicide attempt.

Suicide Risk Often Undetected

Megan Brooks

TORONTO ― Most people who die by suicide have no previous psychiatric diagnosis, new research shows.

A single-center study from California found that nearly two thirds of persons who completed suicide during a 3-year period had no established psychiatric diagnosis.

These findings suggest that “better detection of mental illness and treatment of at-risk patients may prevent completed suicides,” said Nisha Ramsinghani, DO, from the Community Regional Medical Center, Fresno, California.

The findings also suggest that repeated suicide attempts are a “serious indicator of eventual successful suicide,” she reported here at the American Psychiatric Association (APA) 2015 Annual Meeting.

“Our clinical observations suggested that the number of suicide attempts vary depending on the psychiatric diagnoses. We hypothesized that the number of previous attempts in completed suicides will also vary among different diagnoses,” Dr Ramsinghani and her coauthors note in meeting materials.

To investigate, they analyzed the records of 205 people cared for at the Community Regional Medical Center in Fresno who died by suicide between 2010 and 2013.

Most of these individuals (n = 177, 85.9%) had no prior suicide attempt, and only 29 (14.1%) had one or more prior attempts. Women were more apt to have at least one prior attempt than men (26% vs 9%; P = .004). The mean age of the persons who completed suicide was 46.4 years.

Major depressive disorder was the most frequent diagnosis among those who completed suicide (21.8%), followed by substance use disorder (SUD) (14.1%), generalized anxiety disorder (4.9%), bipolar disorder (3.9%), schizophrenia (2.4%), borderline personality disorder (BPD) (1.9%), and posttraumatic stress disorder (1.9%).

It is noteworthy, Dr Ramsinghani said, that every person who completed suicide who had a diagnosis of BPD had at least one previous suicide attempt. Nearly two thirds of those who completed suicide and who had SUD also made at least one attempt before dying by suicide.

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