Suicide: Know the Warning Signs

suicide signs Dollarphotoclub_79868445Each year more than 34,000 individuals take their own life, leaving behind thousands of friends and family members to navigate the tragedy of their loss.

Suicide is the 10th leading cause of death among adults in the U.S. and the 3rd leading cause of death among adolescents.

Suicidal thoughts or behaviors are both damaging and dangerous and are therefore considered a psychiatric emergency. Someone experiencing these thoughts should seek immediate assistance from a health or mental health care provider.Having suicidal thoughts does not mean someone is weak or flawed.

Following are Seven Warning Signs

  • Threats or comments about killing themselves, also known as suicidal ideation, can begin with seemingly harmless thoughts like “I wish I wasn’t here” but can become more overt and dangerous
  • Increased alcohol and drug use
  • Aggressive behavior
  • Social withdrawal from friends, family and the community
  • Dramatic mood swings
  • Talking, writing or thinking about death
  • Impulsive or reckless behavior

See more at the NAMI National Site.

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Study Suggests Psychotic Experiences Help Predict Suicidal Behavior

????????FROM Psychiatric News Alert: Individuals with psychiatric disorders reporting psychotic experiences are more likely to report concurrent suicidal ideation and suicide attempts than those who do not report psychotic experiences, according to a study that appears online in JAMA Psychiatry. Psychotic experiences were especially prevalent among individuals reporting severe attempts and may account for nearly one-third of attempts with intent to die in the United States annually, according to the report.

Researchers from Columbia University, the New York State Psychiatric Institute, and the University of Maryland School of Social Work examined the association between 12-month suicidality and 12-month psychotic experiences. The researchers found that individuals reporting psychotic experiences were approximately five times more likely to report suicidal ideation and nearly 10 times more likely to report a suicide attempt during a 12-month period. In contrast, depressive, anxiety, and substance use disorders did not reliably identify those at risk for attempts among respondents with suicidal ideation.

Immediate past APA President Jeffrey Lieberman, M.D., a coauthor of the study, noted that the increased risk for suicidal ideation and suicide attempts was especially high among people aged 18 to 29, whether or not these young people had a primary diagnosis of psychotic disorder.

“This study of a community-based epidemiological sample identified psychotic experience as a predictor of suicidal behavior in young people in particular. This finding can be considered an important risk factor for suicide in youth in the context of a wide range of mental disorders and can be applied in clinical practice.”

For more information see the Psychiatric News article, “Teens’ Psychotic Symptoms Strongly Associated With Suicidal Behavior.”

CBT For Children With Anxiety May Confer Long-Term Suicide Prevention Benefit, Study Suggests

CBT for childhood anxiety disorder may confer long-term suicide prevention benefits. Credit: nenetus | DPC

CBT for childhood anxiety disorder may confer long-term suicide prevention benefits. Credit: nenetus | DPC

Successful cognitive-behavioral therapy (CBT) for childhood anxiety disorder may confer long-term benefits for suicide prevention, according to a report in the Journal of the Academy of Child and Adolescent Psychiatry.

Evidence for an independent relationship between anxiety and suicidality has been mixed. Researchers from the Center for Mental Health Policy and Services Research at the University of Pennsylvania Perelman School of Medicine examined the relationship between response to treatment for an anxiety disorder in childhood and suicidal ideation, plans, and attempts at a follow-up interval of seven to 19 years. In the study, 66 adults were assessed, having completed CBT treatment for anxiety as children. Information regarding suicidality at follow-up was obtained via the World Mental Health Survey Initiative Version of the World Health Organization Composite International Diagnostic Interview and the Beck Depression Inventory.

The follow-up data indicated that participants who responded favorably to CBT during childhood were less likely to endorse lifetime, past-month, and past-two-week suicidal ideation than were treatment nonresponders. This was consistent across self-report and interview-report of suicidal ideation.

“Results suggest more chronic and enduring patterns of suicidal ideation among those with anxiety in childhood that is not successfully treated,” the researchers stated. “This study adds to the literature that suggests successful CBT for childhood anxiety confers long-term benefits and underscores the importance of the identification and evidence-based treatment of youth anxiety.”

For more on research into suicide prevention, see the Psychiatric News article, “Novel Suicide-Prevention Treatment Targets Poor Sleep.”

Screening for Suicide Risk

From Psychiatric News Alert: While there is no screening tool proven to identify people at risk of suicide, a new study suggests that the commonly used Patient Health Questionnaire (PHQ-9) depression-assessment instrument may be a useful screening tool for detecting suicide risk.

In particular, Item 9 of that questionnaire (“Over the last two weeks, how often have you been bothered by thoughts that you would be better off dead, or of hurting yourself in some way” or a question to that effect depending on the version) was a strong predictor of suicide attempt and suicide death over the following year.

Even after accounting for treatment history and demographic factors, “item 9 remained a strong predictor of any suicide attempt,” the researchers said. In their report “Does Response on the PHQ-9 Questionnaire Predict Subsequent Suicide Attempt or Suicide Death?” in the December Psychiatric Services, Gregory Simon, M.D., M.P.H., and colleagues explained that the immediate risk of suicide attempt was low but increased over several days and continued to grow for several months, indicating a need for follow-up care to address ongoing risk. “Suicidal ideation should be viewed as an enduring vulnerability rather than simply a short-term crisis,” they said.

To read more about recent research on suicide risk, see the Psychiatric News article “Psychotic Symptoms Found to Be Strong Suicide Risk Factor in Teens.”