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Methods of attempts predict later completions of suicides


Suicide, a leading cause of death, has been the focus of a recent study published on July 15, 2010 on BMJ.com. The study hoped to see if past methods used in attempted suicides could predict completed suicides later. The study authors believe that they have found the evidence to conclude that method of suicide attempts does predict later successful suicides.

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Using data from Sweden national registers, researchers found that after accounting for other criteria (such as sociodemographics, and co-occurring psychiatric disorders) that the methods of hanging, strangulation, or suffocation had the highest future completion rate, 54% for men, and 57% for women. 87% of those in this group completed suicide within a year of the previous attempt. The lowest completion rate occurred with those who attempted suicide by cutting had the best prognosis along with late effect of suicide attempts (poisoning) and other self-inflicted harm.

48, 649 individuals admitted to a hospital in 1973-1982 were studied. They were then followed through to 2003 to compare attempts with later completions. After ruling out for sex, age, education, immigration status, and so forth, they were able to find a direct link between the types of methods used in prior attempts and the future completions and noticed a trend that highly planned and violent suicides had the most completion rates. Although poisoning accounted for the most often used method and therefore had the most completions, they did a cohort study to ensure a representative sample of other methods were included. It is important to note that this cohort study could only use data for those individuals whose attempts resulted in inpatient care at a hospital, the researchers lacked information on unemployment, treatment, intent, or hopelessness. Cutting was not linked with a higher suicide mortality rate than poisoning, possibly because there is usually no intent to suicide with cutting but is an emotional regulation issue.

The benefit of this study is the knowledge to provide intense aftercare for those individuals whose attempted suicides were from hanging, strangulation, drowning, firearm, jumping from height, and gassing. While all individuals who attempt suicide should receive aftercare, those whose suicide attempts used the previous methods are at an especially high risk.