What's different about those who attempt suicide rather than just thinking about it?

Only a minority of people who think about committing suicide actually go ahead and make a suicide attempt. Is there something different about these people – some way, perhaps, to identify those suicidal people who are at most risk?

Kate Fairweather and colleagues identified 522 people (aged between 20 and 44) from a massive community survey who said they had thought about taking their own life in the last year. Among these people, just under 10 per cent also reported that they had made an attempt on their life.

The researchers found those individuals who had actually attempted suicide, rather than just thinking about it, were more likely to have serious ill-health, to be unemployed and to have poor relationships with their friends and family. And these factors had a cumulative effect – a participant with two of these factors was three times more likely to have attempted suicide; someone with all three factors was 11 times more likely to have made an attempt.

Surprisingly perhaps, rates of self-reported depression and anxiety were no greater among the suicide attempters than among those who only thought about suicide.

There were also gender- and age-specific associations. For example, among men only, those reporting high levels of ‘mastery’ (feeling in control of the forces affecting their lives) were 20 per cent less likely to attempt suicide. “…[T]he male role prescribes autonomy, self-confidence and being goal-orientated. Accordingly, males who believe they are lacking in these domains may feel socially marginalised or incompetent”, the researchers said.

Among people aged between 40 and 44, unemployment was a particular risk, increasing the likelihood of a suicide attempt nine-fold. Perhaps people in this age group were particularly dependent on their workplace for social support.

“Contrary to the view that mental health differentiates suicide attempters from ideators…”, the researchers concluded, “…This [research] suggests that mental health professionals may be able to intervene in the progression of ideation into attempt if they identify recent instances of upsetting social interactions, diagnosis of a disabling physical illness or recent job losses”.
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Fairweather, A.K., Anstey, K.J., Rodgers, B. & Butterworth, P. (2006). Factors distinguishing suicide attempters from suicide ideators in a community sample: social issues and physical health problems. Psychological Medicine, 36, 1235-1245.

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