What are the warning signs for suicide attempts?

Near-term risk of suicide attempt appears to be associated with experience of negative interpersonal life events, increased intensity of affective and cognitive responses, and acute alcohol use, among others, as reported in a study.

The study included 349 adults who were admitted to a hospital within 48 hours of a suicide attempt, with more than half of them (65 percent) having a previous history of a suicide attempt. In terms of treatment experiences in the past year, 35 percent of patients had psychiatric hospitalization, 46 percent underwent outpatient psychological counselling, and 71 percent received psychotropic medications.

The population had moderately severe depressive symptoms on average, and 36 percent patients had problematic alcohol use. The most common suicide attempt methods in the index events were overdose (77 percent), sharp instrument (18 percent), and hanging (5 percent). Attempts were more likely to occur in the afternoon (12:00–17:59 h; 34 percent) and in the evening (18:00–23:59 h; 37 percent) and less likely overnight (0:00–5:59 h; 14 percent) and in the morning (6:00–11:59 h; 15 percent).

Researchers interviewed the participants within days of their suicide attempt, and each patient served as their own control. Warning signs were evaluated using data from the Timeline Follow-back for Suicide Attempts Interview and were operationalized as factors that were present (vs absent) or that increased in frequency/intensity within an individual during the 6 hours preceding the suicide attempt (case period) compared to the corresponding 6 hours on the day before (control period).

A total of 11 behaviours and events and six affective responses were evaluated as potential warning signs. Of these, suicide-related communications, preparation of personal affairs, alcohol use, experiencing an interpersonal negative life event, perception of being a burden, and perceiving no reason to live significantly predicted near-term suicide attempt.

The present data may be valuable in improving risk recognition efforts by medical providers, patients, their families, and other stakeholders that can serve to inform acute risk management decisions.