Cargando…
Method of attempted suicide as predictor of subsequent successful suicide: national long term cohort study
Objective To study the association between method of attempted suicide and risk of subsequent successful suicide. Design Cohort study with follow-up for 21-31 years. Setting Swedish national register linkage study. Participants 48 649 individuals admitted to hospital in 1973-82 after attempted suici...
Autores principales: | , , , , |
---|---|
Formato: | Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group Ltd.
2010
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2903664/ https://www.ncbi.nlm.nih.gov/pubmed/20627975 http://dx.doi.org/10.1136/bmj.c3222 |
_version_ | 1782183828199047168 |
---|---|
author | Runeson, Bo Tidemalm, Dag Dahlin, Marie Lichtenstein, Paul Långström, Niklas |
author_facet | Runeson, Bo Tidemalm, Dag Dahlin, Marie Lichtenstein, Paul Långström, Niklas |
author_sort | Runeson, Bo |
collection | PubMed |
description | Objective To study the association between method of attempted suicide and risk of subsequent successful suicide. Design Cohort study with follow-up for 21-31 years. Setting Swedish national register linkage study. Participants 48 649 individuals admitted to hospital in 1973-82 after attempted suicide. Main outcome measure Completed suicide, 1973-2003. Multiple Cox regression modelling was conducted for each method at the index (first) attempt, with poisoning as the reference category. Relative risks were expressed as hazard ratios with 95% confidence intervals. Results 5740 individuals (12%) committed suicide during follow-up. The risk of successful suicide varied substantially according to the method used at the index attempt. Individuals who had attempted suicide by hanging, strangulation, or suffocation had the worst prognosis. In this group, 258 (54%) men and 125 (57%) women later successfully committed suicide (hazard ratio 6.2, 95% confidence interval 5.5 to 6.9, after adjustment for age, sex, education, immigrant status, and co-occurring psychiatric morbidity), and 333 (87%) did so with a year after the index attempt. For other methods (gassing, jumping from a height, using a firearm or explosive, or drowning), risks were significantly lower than for hanging but still raised at 1.8 to 4.0. Cutting, other methods, and late effect of suicide attempt or other self inflicted harm conferred risks at levels similar to that for the reference category of poisoning (used by 84%). Most of those who successfully committed suicide used the same method as they did at the index attempt—for example, >90% for hanging in men and women. Conclusion The method used at an unsuccessful suicide attempt predicts later completed suicide, after adjustment for sociodemographic confounding and psychiatric disorder. Intensified aftercare is warranted after suicide attempts involving hanging, drowning, firearms or explosives, jumping from a height, or gassing. |
format | Text |
id | pubmed-2903664 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | BMJ Publishing Group Ltd. |
record_format | MEDLINE/PubMed |
spelling | pubmed-29036642010-07-14 Method of attempted suicide as predictor of subsequent successful suicide: national long term cohort study Runeson, Bo Tidemalm, Dag Dahlin, Marie Lichtenstein, Paul Långström, Niklas BMJ Research Objective To study the association between method of attempted suicide and risk of subsequent successful suicide. Design Cohort study with follow-up for 21-31 years. Setting Swedish national register linkage study. Participants 48 649 individuals admitted to hospital in 1973-82 after attempted suicide. Main outcome measure Completed suicide, 1973-2003. Multiple Cox regression modelling was conducted for each method at the index (first) attempt, with poisoning as the reference category. Relative risks were expressed as hazard ratios with 95% confidence intervals. Results 5740 individuals (12%) committed suicide during follow-up. The risk of successful suicide varied substantially according to the method used at the index attempt. Individuals who had attempted suicide by hanging, strangulation, or suffocation had the worst prognosis. In this group, 258 (54%) men and 125 (57%) women later successfully committed suicide (hazard ratio 6.2, 95% confidence interval 5.5 to 6.9, after adjustment for age, sex, education, immigrant status, and co-occurring psychiatric morbidity), and 333 (87%) did so with a year after the index attempt. For other methods (gassing, jumping from a height, using a firearm or explosive, or drowning), risks were significantly lower than for hanging but still raised at 1.8 to 4.0. Cutting, other methods, and late effect of suicide attempt or other self inflicted harm conferred risks at levels similar to that for the reference category of poisoning (used by 84%). Most of those who successfully committed suicide used the same method as they did at the index attempt—for example, >90% for hanging in men and women. Conclusion The method used at an unsuccessful suicide attempt predicts later completed suicide, after adjustment for sociodemographic confounding and psychiatric disorder. Intensified aftercare is warranted after suicide attempts involving hanging, drowning, firearms or explosives, jumping from a height, or gassing. BMJ Publishing Group Ltd. 2010-07-13 /pmc/articles/PMC2903664/ /pubmed/20627975 http://dx.doi.org/10.1136/bmj.c3222 Text en © Runeson et al 2010 This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode. |
spellingShingle | Research Runeson, Bo Tidemalm, Dag Dahlin, Marie Lichtenstein, Paul Långström, Niklas Method of attempted suicide as predictor of subsequent successful suicide: national long term cohort study |
title | Method of attempted suicide as predictor of subsequent successful suicide: national long term cohort study |
title_full | Method of attempted suicide as predictor of subsequent successful suicide: national long term cohort study |
title_fullStr | Method of attempted suicide as predictor of subsequent successful suicide: national long term cohort study |
title_full_unstemmed | Method of attempted suicide as predictor of subsequent successful suicide: national long term cohort study |
title_short | Method of attempted suicide as predictor of subsequent successful suicide: national long term cohort study |
title_sort | method of attempted suicide as predictor of subsequent successful suicide: national long term cohort study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2903664/ https://www.ncbi.nlm.nih.gov/pubmed/20627975 http://dx.doi.org/10.1136/bmj.c3222 |
work_keys_str_mv | AT runesonbo methodofattemptedsuicideaspredictorofsubsequentsuccessfulsuicidenationallongtermcohortstudy AT tidemalmdag methodofattemptedsuicideaspredictorofsubsequentsuccessfulsuicidenationallongtermcohortstudy AT dahlinmarie methodofattemptedsuicideaspredictorofsubsequentsuccessfulsuicidenationallongtermcohortstudy AT lichtensteinpaul methodofattemptedsuicideaspredictorofsubsequentsuccessfulsuicidenationallongtermcohortstudy AT langstromniklas methodofattemptedsuicideaspredictorofsubsequentsuccessfulsuicidenationallongtermcohortstudy |