Textbook of psychiatry
H7.2 Suicidal behaviour
Most patients who make a suicide attempt or take their own lives consult their GP shortly
before doing so. For psychiatrists, suicide is their patients’ main cause of death. Over 90% of
individuals who take their own lives are found to have a psychiatric disorder. However, most
people with a psychiatric disorder do not take their own life.
Syndrome:
Motivation for suicide: to stop unbearable psychological stress the patient sees it as the
only way out of desperation and suffering.
At least 40% of suicides are preceded by a suicide attempt. They are far more common than
suicides, especially in women, and the aim is usually not to die.
Mainly carried out using medication
Suicides are often carefully prepared, and the aim is usually to die.
Dangerous methods
o Hanging
o Jumping from a height or into a moving vehicle
o Drowning
Development, course and impact:
The suicidal process can be described using the stress-vulnerability model. It describes the
development and progression of suicidal tendency as a process taking place in an individual
in interaction with the environment. It assumes the presence of underlying susceptibility.
The dotted horizontal line shows an important part of the process: the lower the line,
the sooner the process becomes observable, and the sooner preventative measure
can be taken. Lowering the dotted line can therefore make a major contribution in
preventing suicide.
discuss suicide in consultation with a patient with depressive disorder
The risk of subsequent suicide
increases with each attempt.
There is a highly increased risk of
suicide in surviving relatives.
H7.2 Suicidal behaviour
Most patients who make a suicide attempt or take their own lives consult their GP shortly
before doing so. For psychiatrists, suicide is their patients’ main cause of death. Over 90% of
individuals who take their own lives are found to have a psychiatric disorder. However, most
people with a psychiatric disorder do not take their own life.
Syndrome:
Motivation for suicide: to stop unbearable psychological stress the patient sees it as the
only way out of desperation and suffering.
At least 40% of suicides are preceded by a suicide attempt. They are far more common than
suicides, especially in women, and the aim is usually not to die.
Mainly carried out using medication
Suicides are often carefully prepared, and the aim is usually to die.
Dangerous methods
o Hanging
o Jumping from a height or into a moving vehicle
o Drowning
Development, course and impact:
The suicidal process can be described using the stress-vulnerability model. It describes the
development and progression of suicidal tendency as a process taking place in an individual
in interaction with the environment. It assumes the presence of underlying susceptibility.
The dotted horizontal line shows an important part of the process: the lower the line,
the sooner the process becomes observable, and the sooner preventative measure
can be taken. Lowering the dotted line can therefore make a major contribution in
preventing suicide.
discuss suicide in consultation with a patient with depressive disorder
The risk of subsequent suicide
increases with each attempt.
There is a highly increased risk of
suicide in surviving relatives.
