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Psychosocial and clinical correlates of suicidal acts: Results from a national population survey

  • Emma Robertson Blackmore (a1), Sarah Munce (a2), Iris Weller (a3), Brandon Zagorski (a3), Stephen A. Stansfeld (a4), Donna E. Stewart (a2), Eric D. Caine (a1) and Yeates Conwell (a1)...
Abstract
Background

Clinical samples have identified a number of psychosocial risk factors for suicidal acts but it is unclear if these findings relate to the general population.

Aims

To describe the prevalence of and psychosocial risk factors for suicidal acts in a general adult population.

Method

Data were obtained from a Canadian epidemiological survey of 36 984 respondents aged 15 years and older (weighted sample n=23 662 430).

Results

Of these respondents, 0.6% (weighted n=130 143) endorsed a 12-month suicidal act. Female gender (OR=4.27, 95% CI 4.05–4.50), being separated (OR=37.88, 95% CI 33.92–42.31) or divorced (OR=7.79, 95% CI 7.22–8.41), being unemployed (OR=1.70, 95% CI 1.50–1.80), experiencing a chronic physical health condition (OR=1.70, 95% CI 1.67–1.86) and experiencing a major depressive episode in the same 12-month period as the act (OR=9.10, 95% CI 8.65–9.59) were significantly associated with a suicidal act.

Conclusions

The psychosocial correlates of suicidal acts in this sample are consistent with those previously reported in clinical and general population samples. These findings reinforce the importance of the determination of suicide risk and its prevention not only of psychiatric illness but of physical and psychosocial factors as well.

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Copyright
Corresponding author
Dr Emma Robertson Blackmore, Department of Psychiatry, BOX PSYCH 4-9200, University of Rochester Medical Centre, Rochester, New York 14642-8409, USA. Email: emma_robertsonblackmore@urmc.rochester.edu
Footnotes
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Declaration of interest

None. Funding detailed in Acknowledgements.

Footnotes
References
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Psychosocial and clinical correlates of suicidal acts: Results from a national population survey

  • Emma Robertson Blackmore (a1), Sarah Munce (a2), Iris Weller (a3), Brandon Zagorski (a3), Stephen A. Stansfeld (a4), Donna E. Stewart (a2), Eric D. Caine (a1) and Yeates Conwell (a1)...
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eLetters

Mental health needs and suicide risk of people with physical illness

Janet A Butler, Consultant Liaison Psychiatrist
09 April 2008

Dear Sir,Robertson Blackmore et al(1) describe psychosocial risk factors for suicidal acts from a population survey. They highlight the important association of physical illness with suicidal acts, which occurred in 77% of their sample. As a Liaison Psychiatrist involved in the management of patients presenting to a general hospital following self-harm, I was pleased to see the risk factor of physical illness highlighted as an important area to address since this is frequently seen in current clinical practice. The association has also been noted in a recently published survey of NHS Direct contacts prior to completed suicide(2). It is surprising that despite an association of physical illness and suicidalacts being reported for many years(3), both recent papers still suggest that this is a new avenue to explore.

It appears that the link is clear, what is now needed is more attention to the mental health needs of those with significant physical illness to enable early detection and management of problems in both primary care and general hospitals. Mental health services to general hospitals are widely recognised to be scarce(4,5) and well below levels recommended by the Royal College of Psychiatrists despite such services being ideally placed and skilled in assessing and managing the relationship between physical and mental illness. The study by Robertson Blackmore et al(1) adds to the already compelling evidence to improve detection and management of mental health issues in those with chronic physical illness. The time is now right for the profession to highlight the need to commissioners to ensure that appropriate Liaison Psychiatry services are commissioned and similar skills extended to primary care.

Yours sincerely

Dr Janet Butler PhD, MRCP, MRCPsych.Consultant Liaison Psychiatrist,Department of Psychological Medicine,Southampton General Hospital (MP 412),Southampton SO16 6YD.

1 Robertson Blackmore E, Munce S, Weller I, Zagorsi B, Stansfield SA,Stewart DE, Caine ED, Conwell Y. Psychosocial and clinical correlates of suicidal acts: results from a national population survey. Br J Psychiatry 2008; 192: 279-284.

2 Bessant M, King EA, Peveler R. Characteristics of suicides in recent contact with NHS direct. Psych Bulletin 2008; 32: 92-95.

3 Harris EC, Barraclough BM. Suicide as an outcome for mental disorders. Medicine 1994; 73: 281-298.

4 Ruddy R, House A. A standard liaison psychiatry service structure? Br J Psychiatry 2003; 27: 457-460.

5 Howe A, Hendry J, Potokar J. A survey of liaison psychiatry services in the south-west of England. Br J Psychiatry 2003; 192: 279-84.

Declaration of interests: Dr Butler is a Liaison Psychiatrist. There are no commercial or financial interests.
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Conflict of interest: None Declared

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