Categories of attempted suicide: a longitudinal study

Area of Science:

• Psychiatry
• Psychology
• Public Health

Background:

• Suicide attempts are a significant public health concern.
• Understanding the diverse motivations and circumstances surrounding suicide attempts is crucial for effective intervention.
• Previous research has explored risk factors, but categorization of index attempts can refine understanding.

Purpose of the Study:

• To categorize index suicide attempts based on situation and motivation.
• To analyze patient disposition following emergency room contact.
• To evaluate the effectiveness of follow-up care and identify predictors of re-attempt or suicide.

Main Methods:

• Categorization of 151 index suicide attempts into three groups: heightened emotionality/limited stress, life crisis, and psychiatric disorder symptomatology.
• Analysis of initial disposition (discharge, medical admission, psychiatric transfer).
• Assessment of follow-up ambulatory care success and two-year re-attempt/suicide rates, considering prior treatment status.

Main Results:

• 56% of attempts were linked to heightened emotionality/limited stress, 9% to life crisis, and 35% to psychiatric disorder symptoms.
• 69% of patients were discharged from the emergency room; 18% received medical care, and 13% were transferred to psychiatric care.
• Successful referral correlated with intensive early post-attempt contact; 16% re-attempted and 2% died by suicide within two years.

Conclusions:

• A brief hospitalization (2-3 days) may serve as a bridge to further ambulatory care, particularly for stress-related attempts.
• Intensive early follow-up is critical for successful referral and patient engagement.
• Ongoing treatment at the time of the index attempt, especially with substance abuse or prior attempts, is a high-risk factor requiring careful disposition planning.