Predictors of early suicide: identification and appropriate intervention

The ability to assess the risk of patient suicide and to determine the appropriate and timely intervention is a critical skill for psychiatrists. Data from an ongoing prospective investigation evaluating the suicide risk in patients with major affective disorders have identified several heretofore unrecognized factors as highly correlated with early suicide. The risk factors associated with early suicide--that is, suicide within a year of the diagnosis of major affective disorder--include anhedonia, psychic anxiety (as demonstrated both clinically and by elevated 24-hour 17-hydroxycorticosteroid), panic attacks, depressive turmoil, and moderate alcohol abuse. Recognition and identification of those risk factors, coupled with effective treatment strategies, may help the clinician prevent imminent suicides in high-risk patients.