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The British Journal of Psychiatry 173: 531-535 (1998)
© 1998 The Royal College of Psychiatrists

Suicide attempts preceding completed suicide

ET Isometsa and JK Lonnqvist
Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland. erkki.isometsa@ktl.fi

BACKGROUND: This study investigated three questions with major implications for suicide prevention: the sensitivity of the history of previous suicide attempt(s) as an indicator of suicide risk, the time interval from a preceding suicide attempt to the fatal one, and switching of suicide methods by those eventually completing suicide. METHOD: The lifetime history of suicide attempts and the methods the victims (n = 1397) used were examined in a nationwide psychological autopsy study comprising all suicides in Finland within a 12-month research period in 1987-1988. RESULTS: Overall, 56% of suicide victims were found to have died at their first suicide attempt, more males (62%) than females (38%). In 19% of males and 39% of females the victim had made a non-fatal attempt during the final year. Of the victims with previous attempts, 82% had used at least two different methods in their suicide attempts (the fatal included). CONCLUSIONS: Most male and a substantial proportion of female suicides die in their first suicide attempt, a fact that necessitates early recognition of suicide risk, particularly among males. Recognition of periods of high suicide risk on the grounds of recent non-fatal suicide attempts is likely to be important for suicide prevention among females. Subjects completing suicide commonly switch from one suicide method to another, a finding that weakens but does not negate the credibility of restrictions on the availability of lethal methods as a preventive measure.


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Copyright © 1998 The Royal College of Psychiatrists.