Gun availability, psychopathology, and risk of death from suicide attempt by gun

PURPOSE: Suicide is the third leading cause of death among adolescents and the 8th leading cause of death overall. Guns figure prominently in this problem. Guns are the most lethal means of suicide, and in the United States about 60% of all suicides are committed by guns. We examined hospital admissions for suicide attempts (para-suicide) in the city of Chicago between 1990-1997. Our aim was to 1) quantify the risk of death from para-suicide by gun versus other methods, 2) determine whether individual with psychopathology are more likely than others to attempt suicide by gun, 3) determine proportion of variation in para-suicide by gun explained by community-level gun availability independent of individual-level determinants of para-suicide by gun.METHODS: Hospital admissions from city of Chicago during 1990-1997 were examined for cases of attempted or completed suicide. 11,584 individuals were identified with a diagnosis of para-suicide (E950-E959, classifiable to ICD-9CM). These individuals were then classified into suicide type (e.g., gun, crash, cut, poison) and were also identified as having a mental disorder or not (mental diagnoses classifiable to ICD-9CM).RESULTS: 1) Those attempting suicide by gun are about 70 times more likely to die from their injuries than those attempting suicide by other means. 2) Depressed and psychotic individuals compared with individuals with no-mental disorders are significantly more likely to attempt suicide with a gun (p < 0.001). 3) Inclusion of community-level gun availability in a hierarchical model reduced the variation in the model by 16%.CONCLUSIONS: Guns are the most lethal suicide method. Community-level availability, independent of individual-level factors, is an important determinant of suicide attempt by gun.