The method chosen in a suicide attempt may predict the risk of a future suicide attempt.
New research suggests that individuals who use more violent methods such as hanging, drowning, firearms or jumping from heights are more likely to repeat similar attempts.
“People who attempt suicide by highly lethal methods are likely to choose the same means at the final suicidal act,” writes Professor Bo Runeson from the Department of Clinical Neuroscience at Karolinska Institutet in Stockholm who led the study.
“The results may be of help in acute risk assessment following a suicide attempt,” says Runeson. “There are a number of important factors, including psychiatric disorder and suicide intention, but it’s also important to factor in whether a person chose a violent method when assessing the long- and short-term risk.”
Suicide is one of the most common causes of death, particularly in young people, where it is the third leading cause of death. There are a number of known risk factors for suicide, including substance abuse and psychiatric disorders. For those who have attempted suicide in the past, more than 10 percent will make an attempt in the future.
Runeson and his team studied the records of 48,649 patients in Sweden who had attempted suicide between 1973 and 1982 to assess whether the method chosen was a risk factor for future suicide attempts. All suicides and attempted suicides in Sweden are required by law to be reported.
Runeson’s team followed the records through 2003 to determine whether a future suicide was attempted, and if so, what method was chosen, and whether the attempt was successful. The researchers statistically adjusted for other factors such as age, sex, education, and psychiatric diagnosis.
Overall, 12 percent of all patients who had attempted suicide later went on to successfully commit suicide.
The majority (84 percent) attempted suicide using poisoning as a method, which predicted the least risk of a followup attempt. Patients who attempted suicide by hanging were six times more likely to commit suicide and 87 percent did so within the first year following the initial attempt. Those who used drowning as a method were four times more likely to attempt suicide again, and gassing, jumping from a great height, firearms, or use of explosives were also high-risk methods. Cutting and other methods were at similar levels of risk to poisoning.
Treatment for patients who have made a suicide attempt is based on determination of several factors that are used to try to determine the level of risk for another attempt. Patients are assessed to determine if they are a danger to themselves, and if they have a suicide plan or a psychiatric disorder.
Runeson’s findings are important because they give providers another risk factor in determining the level of risk. “Our findings strongly indicate that such assessments should also be guided by the method used as people who attempt suicide by hanging, drowning, shooting by firearm, or jumping from a height are at substantially higher risk for completed suicide in the short- and long-term.”
Dr. Runeson’s results are available in the July 13 issue of the British Medical Journal.
Source: British Medical Journal