Suicidal behavior across a broad range of psychiatric disorders

Area of Science:

• Psychiatry and Behavioral Sciences
• Clinical Psychology
• Public Health

Background:

• Suicidal behavior (SB) is a significant global health concern, with millions affected annually.
• Current treatment paradigms primarily focus on addressing "underlying" psychiatric disorders.
• The full spectrum of diagnoses associated with SB remains incompletely understood.

Purpose of the Study:

• To review and document the range of psychiatric diagnoses comorbid with suicidal behavior (SB) across the lifespan.
• To explore the clinical, research, and nosological implications of SB's broad diagnostic associations.
• To advocate for improved clinical documentation and targeted interventions for SB.

Main Methods:

• Conducted a narrative literature review using search terms "suicid*" and individual psychiatric diagnoses.
• Included studies with DSM-5 diagnoses and data on suicide or suicide attempts, excluding case reports and studies solely on ideation or non-suicidal self-injury (NSSI).
• Analyzed 366 relevant studies from an initial pool of 587.

Main Results:

• Suicidal behavior (SB) was found to be associated with 72 out of 145 psychiatric diagnoses, with varying data quality.
• SB is not exclusive to Major Depressive Episode (MDE) or Borderline Personality Disorder (BPD), conditions for which it is a diagnostic criterion.
• Genetic factors may contribute to SB independently of psychiatric diagnoses.

Conclusions:

• The widespread association of SB with numerous diagnoses underscores the necessity of assessing SB irrespective of a patient's diagnosis.
• The findings support the addition of specific SB charting codes to the DSM-5 for better tracking and research.
• Implementing targeted suicide prevention interventions alongside treatments for comorbid conditions is crucial for effective SB management.