Suicide Risk and Mental Disorders

Abstract

Suicide is a major health problem, and the global suicide mortality rate amounts to 1.4% of all deaths worldwide.Most suicides are related to psychiatric disease, with depression, substance use disorders and psychosis being the most relevant risk factors [1].However, anxiety, personality-, eating-, and trauma-related disorders, as well as organic mental disorders, also contribute.Psychological autopsies from the middle of the previous century and onwards have revealed that most people who have died by suicide have suffered from mental disorders [2].A recent figure suggests this number could be at least 90% [3,4].On the other hand, most people with mental disorders do not die by their own hand.The risk of suicide has been estimated to be 5-8% for several mental disorders, such as depression, alcoholism and schizophrenia [5,6].A stress-diathesis model has been proposed in which the risk for suicidal acts is determined not merely by a psychiatric illness (the stressor) but also by a diathesis, such as a tendency to experience more suicidal ideation and to be more likely to act on suicidal feeling [7].Thus, suicide risk is multi-factorial.Research on the risk factors among people with mental disorders is urgent in the efforts to predict and prevent suicide death.In the present special issue, including 13 articles, suicide risk and mental disorders are explored from several different perspectives.According to a review, most studies on ethnicity/immigrant status and suicide attempts showed higher rates among immigrants as compared to the native population [8], though the reverse was found in a few cases.Risk factors were found to be: language barriers, worrying about family back home and separation from family, often leading to hopelessness, depression, and anxiety.Furthermore, the lack of information on the health care system, loss of status, loss of social network, as well as acculturation (when an individual acquires attitudes, etc. from a different country) were identified as potential triggers.Adverse childhood experiences (ACE) have been implicated in a range of negative health outcomes in adulthood, including mental disorders and suicide death.One paper explores the relationship between ACE and hospital-treated self-harm in Glasgow [9].First-time and repeat self-harm were compared, including mental health, psychosocial measures, and attachment style.However, only ACE along with female gender and depressive symptoms differentiated between first-time and repeat self-harm.Participants with 4+ ACE were significantly more likely to repeat.There were no differentiating factors in the male group.The findings stress the importance of ACE as a risk factor for suicidal behaviour, but more research is needed for the male group.Suicide prevention efforts often depend on the disclosure of suicidal ideation (SI), an early step in the suicidal process.Data from the Dutch cross-sectional survey Health Monitor 2016 was used in one study [10].Of the adult participants, 5% reported SI and nearly half of those had not disclosed their SI.Thus, non-disclosure was a substantial problem, which may interfere with the efforts to prevent suicide.Adults who did not disclose SI were more likely to have few social contacts, while they were less likely to report poor mental health and frequent SI.There was no significant association found between emotional loneliness or marital status and SI.The availability of social support rather than the intimacy of relationship was suggested.In line with these findings, some subjects, in a long-term follow-up of

Cite this

Louise Brådvik (2018). Suicide Risk and Mental Disorders. International Journal of Environmental Research and Public Health. https://doi.org/10.3390/ijerph15092028

@article{louise2018suicide,
  title  = {Suicide Risk and Mental Disorders},
  author = {Brådvik, Louise},
  year   = {2018},
  journal = {International Journal of Environmental Research and Public Health},
  doi    = {10.3390/ijerph15092028}
}

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