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Suicide Risk Factors

Understand Your Suicide Risk

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Updated June 11, 2014

Who is at suicide risk? Are there factors that predict whether someone will commit suicide?

Suicide is among the leading causes of death. It is common among people with mood disorders (like depression and bipolar disorder). It is remarkably common among people with borderline personality disorder (BPD). Research has shown that around 70% of people with BPD will have at least one suicide attempt in their lifetime, and many will make multiple suicide attempts. Eight percent to 10% of people with BPD will complete suicide; this rate is more than 50 times the rate of suicide in the general population.

But, is there a way to predict who is at greatest risk for attempting or committing suicide? This article covers two kinds of risk factors for suicide attempts: distal and proximal risk factors. Distal risk factors are background characteristics or underlying vulnerabilities that heighten a person’s risk for a suicide attempt in their lifetime. Proximal risk factors are those risk factors that put someone at more immediate risk of a suicide attempt. Usually people who do attempt suicide have some combination of distal and proximal risk factors. (Note that this piece singles out only a few of the many distal and proximal suicide risk factors.)

Distal Suicide Risk Factors

Psychiatric Diagnosis. Any psychiatric diagnosis is a risk factor for suicide. However, certain diagnoses convey the greatest risk. These are: depression, bipolar disorder, substance use disorders, and personality disorders. In addition, people with comorbid conditions (such as more than one diagnosis) are at elevated risk.

Previous Suicide Attempts. If you have previously made a suicide attempt, you have a much greater risk of making a future attempt. For this reason, clinicians will ask you about any previous attempts and the characteristics of these attempts.

Family History of Suicide Attempts or Completed Suicide. If you have had a family member attempt or commit suicide, you are at greater risk of an having an attempt yourself.

Proximal Suicide Risk Factors

Recent Onset of Suicidal Thoughts. Most suicide attempts occur within one year of first having suicidal thoughts. For this reason, this one-year window is seen as a critical time for treatment.

Hopelessness. Feelings of hopelessness can be an immediate risk factor for suicide.

Having a Suicide Plan. While not everyone who has a plan for suicide will carry out that plan, the presence of a plan can indicate that an attempt is imminent.

Access to Firearms. Access to firearms is a very significant proximal suicide risk factor because firearms that are not stored safely provide a lethal means for an attempt.

Major Loss or Stressful Event. Many people who make suicide attempts report a significant stressful event immediately prior to the attempt. The loss of a job, death of a loved one, major financial loss, or divorce may precipitate an attempt.

Contagion by Other Recent Suicides. The contagion effect is well-documented in suicide research: You are more likely to attempt suicide if you have recently learned about another suicide, either by a friend, peer, or media figure.

Incarceration. Finally, incarceration is a major risk factor for a suicide attempt. Many people need to be monitored for suicidality after a recent incarceration.

Summary – Understanding Suicide Risk

It is important to note that many people will have one or more of these risk factors and never be in danger of a suicide attempt. However, if you or a loved one has a combination of many of these factors, it may make sense to be assessed for suicidality regularly by a mental health professional.

In addition, someone at high risk for suicide should have a safety plan in place to reduce the likelihood that an attempt will occur. For more on safety planning, see “How To Create a Safety Plan.”

To learn more about what to do if you or someone else is at imminent risk of suicide, see “What To Do In A Crisis.”

Sources:

Kessler RC, Borges G, Walters EE. “Prevalence of and Risk Factors for Lifetime Suicide Attempts in the National Comorbidity Survey.” Archives of General Psychiatry, 56(7): 617-26, 1999.

Moscicki EK. “Epidemiology of Completed and Attempted Suicide: Toward a Framework for Prevention.” Clinical Neuroscience Research, 1:310-23, 2001.

Nock MK, Borges G, Bromet EJ, Angermeyer M, Bruffaerts R, de Girolamo G, de Graaf R, Haro JM, Karam E, Williams D, Posada-Villa J, Ono Y, Medina-Mora ME, Levinson D, Lepine JP, Kessler RC, Huang Y, Gureje O, Gluzman S, Chiu WT, Beautrais A, Alonso J. “Cross-national Prevalence and Risk Factors for Suicidal Ideation, Plans and Attempts.” British Journal of Psychiatry. 192(2):98-105, 2008.

Work Group on Borderline Personality Disorder. "Practice Guidelines for the Treatment of Patients with Borderline Personality Disorder." American Journal of Psychiatry, 158:1-52.

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