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Suicide

~~Suicide~~

Willerman, L. & Cohen, D.B. (1990). Psychopathology. New York: McGraw-Hill, Inc.

The annual incidence of suicide per 100,00 is roughly fifteen in the United States and United Kingdom, and ranges from twenty-five in Czechoslovakia to two in Mexico. Given a life expectancy of 75 years, assuming that young children do not commit suicide, the lifetime risk is roughly 15 x 65 = 975 per 100,000 or about one per 100 in the United States.

Suicide should be distinguished from suicide attempts and suicide threats. For example the male/female ratio for suicide attempts is roughly 1 to 3 but 2-3 to 1 for actual suicides. Also, the ratio of suicide attempts to actual suicide is roughtly between 100 and 200 to 1 in high school populations, 10 to 1 in college populations, and 1 to 1 for those over 55... The difference appears to be a function of two things that develop with age: first, the older person is more committed to the act for its own sake than as a means of manipulating others, and second, the older person is more competent to plan and execute the act. Finally, the more lethal the attempt - the more likely death would have occurred had it not been for some fortunate accident like being discovered in time - the more likely a subsequence suicide will occur. (p.385)

~~Risk Enhancing Factors In Predicting Suicide:~~

SEX:
Male rates are always higher. On the average, the M:F ratio is
roughly 2:1, reduced from 4:1 about thirty years ago, and
compared to a 1:3 ratio of suicide attempts

RACE:
Whites have a higher rate than blacks, though the rate for
blacks has doubled in recent years

AGE:
The elderly have the highest rates, with male rates
climbing throughout the life cycle vs. female rates
which peak between 40 and 60 years old and then decline

LIVING CONDITIONS:
Family strife increases the risk

PHYSICAL CONDITIONS:
Physical infirmity or disability increases the risk

PERSONAL LOSS OR FAILURE:
In males, loss of a job or any significant downward
mobility in socioeconomic status is paramount.
In females, loss of, or failure to attain, a
persoanlly significant relationship with a lover,
spouse, or friend is of greater significance

BEREAVEMENT OR ISOLATION:
Divorced or separated males have an especially high
rate (roughly 69 per 100,000); the rate for females
is much lower (about 18). Lack of community
affiliation (church or social groups) or interests
(hobbies) increases the risk even further

TIME OF YEAR:
Risks are greatest during the springtime, especially
in April

BEHAVIOR FACTORS:
History of alcohol abuse, previous suicide attempts,
or a note or other communication of intent is a
significant risk-enhancing factor

PSYCHIATRIC DIAGNOSIS:
Personal or family history of depressive disorder
or suicide is a major indicator. Alcoholism is
another major risk factor (p.386)

Psychoeducational Index