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Suicide risk factors

Suicide is not the result of one thing – there are always multiple factors that act together to increase a person’s vulnerability to suicidal behaviour.24

Compared to the general population, people at greater risk of suicide include those:

  • with a previous history of attempted suicide (strongest single predictive factor)
  • with a mental health disorder such as depression, bipolar disorder, schizophrenia, and/or an alcohol or drug use disorder – the early weeks of  treatment are also a time of increased vulnerability
  • who are Aboriginal and/or Torres Strait Islander peoples.18,25-28

Hopelessness, despair and impulsivity are also strongly associated with suicide.25

In many cases of suicide, not all of the factors are known; it’s like a jigsaw puzzle and sometimes pieces are missing (and may never be found).

Other risk factors include interpersonal conflict, divorce, unemployment, financial problems, bereavement, legal issues and physical illness (eg cancer, coronary heart disease, osteoporosis).20,29–31 Conversely, self-forgiveness, family and religious social bonds and access to GP services are important protective factors.20,25,32

For those with mental illness, starting and discontinuing antidepressant medication are key risk periods for suicide.33

References

  1. Australian Institute of Health and Welfare. Australia's health 2014. Australia's health series no. 14, cat. no. AUS 178. Canberra: AIHW, 2014.
  2. Alston M. Rural male suicide in Australia. Soc Sci Med 2012;74(4):515–22.
  3. Kõlves K, Milner A, McKay K, De Leo D. Suicide in rural and remote areas of Australia. Brisbane: Australian Institute for Suicide Research and Prevention, 2012.
  4. Bridge S. Suicide prevention – Targeting the patient at risk. Aust Fam Physician 2006;35(5):335–38.
  5. Snowdon J. Why have Australian suicide rates decreased? Aust N Z J Psychiatry 2016;50(1):13–15.
  6. Suicide Prevention Australia. Position statement: Responding to suicide in rural Australia. Leichgardt: SPA, 2008 [reviewed 2010].
  7. World Health Organization (WHO). Preventing suicide: A global imperative (World suicide report). Geneva: WHO, 2014.
  8. Schrieber J, Culpepper L. Suicide ideation and behavior in adults. UpToDate, 2016.  [Accessed 17 January 2016].
  9. Haukka J, Suominen K, Partonen T, Lonnqvist J. Determinants and outcomes of serious attempted suicide: A nationwide study in Finland, 1996-2003. Am J Epidemiol 2008;167(10):1155–63.
  10. Tidemalm D, Langstrom N, Lichtenstein P, Runeson B. Risk of suicide after suicide attempt according to coexisting psychiatric disorder: Swedish cohort study with long term follow-up. BMJ 2008;337:a2205.
  11. Gardner J. General practitioners: The frontline in suicide prevention. Health Issues 2009(98):20–22.
  12. Shand FL, Proudfoot J, Player MJ, et al. What might interrupt men's suicide? Results from an online survey of men. BMJ Open 2015;5(10):e008172.
  13. Buron P, Jimenez-Trevino L, Saiz PA, et al. Reasons for attempted suicide in Europe: Prevalence, associated factors, and risk of repetition. Arch Suicide Res 2016 20(1):45–58. doi:10.1080/13811118.2015.1004481.
  14. Webb RT, Kontopantelis E, Doran T, Qin P, Creed F, Kapur N. Suicide risk in primary care patients with major physical diseases: A case-control study. Arch Gen Psychiatry 2012;69(3):256–64.
  15. Cheavens JS, Cukrowicz KC, Hansen R, Mitchell SM. Incorporating resilience factors into the interpersonal theory of suicide: The role of hope and self-forgiveness in an older adult sample. J Clin Psychol 2016;72(1):58–69.
  16. Coupland C, Hill T, Morriss R, Arthur A, Moore M, Hippisley-Cox J. Antidepressant use and risk of suicide and attempted suicide or self harm in people aged 20 to 64: Cohort study using a primary care database. BMJ 2015;350:h517.

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After suicide: A resource for GPs