Suicide: An Update | Rates & Risk Factors

Co-Author(s): Dr. Ross Baldessarini

Date and time: 27 Mar 2022 from 10:15 to 11:15

Location: Virtual  

Covering Dr. Baldessarini's work on post-hospital discharge risk, and new findings concerning rates and risk factors in bipolar disorder patients as well as an overview of pertinent, changing, and current rates and risk factors for the general population of the US and Canada.

Abstract:
Suicide remains a major challenge for clinical psychiatry. Major psychiatric disorders carry substantial mortal risks, largely owing to suicide, especially in younger patients, but also from adverse outcomes of co-occurring medical disorders in older patients. Important basic relationships among suicidal ideation, attempts, and fatalities require consideration: the ratio of ideation to suicide is ≥200 in the general population, and that of attempts/suicide (an index of lethality) is ≥30 in the general population and ≤10 with major mood
disorders and severe substance abuse. Suicide rates vary widely across cultures, regions, and time. Although suicide rates have tended to decline in many countries in recent years, those in Canada have remained quite stable, whereas rates in the US have been rising steadily, and across regions and age-groups. Risk factors including previous suicide attempt, relative social isolation (well documented in the US, Canada, and Europe), losses, and recent discharge from psychiatric hospitalization are well known, but have limited clinical value in predicting suicidal acts in individuals at particular times. Therapeutics aimed at reducing suicidal risk has been remarkably slow to develop, particularly for medical-pharmacological treatments, though clozapine is the first treatment of any kind with regulatory recognition for an antisuicidal effect in schizophrenia patients, and evidence supporting lithium in major mood disorders is substantial.

Learning Objectives:
Objective #1 Review basic epidemiological facts about suicide risk in US and Canada.
Objective #2 Consider risk factors for suicide and their limitations.
Objective #3 Briefly review effects of modern psychiatric treatments on suicidal risk.

References & Recommended Reading

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Baldessarini RJ, Goodwin FK: Antisuicidal efficacy of lithium products: Citizen’s petition to the United States Food and Drug Administration, Washington, DC, September, 2005, 50 pp. Available at  ww.fda.gov/ohrms/dockets/dockets/05p0402/05p-0402- cp00001-001-vol1.pdf; 10-17-2005.

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Baldessarini RJ, Lau WK, Sim J, et al. Suicidal risks in reports of long-term treatment trials for major depressive disorder. Int J Neuropsychopharmacol 2015; Int J Neuropsychopharmacol 2015;19:pyv107.

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Disclosure of Conflict of Interest

1. Do you have a relationship with a for-profit and/or a not-forprofit organization to disclose?

No

2. All other investments or relationships that could be seen by a reasonable, well-informed participant as having the potential to influence the content of the educational activity

None

3. Patents on a drug, product, or device

None relevant to topic

4. Funded grants or clinical trials

None

5. Membership on advisory boards or speakers' bureaus

None

6. Any direct financial payments including receipt of honoraria

Occasional modest honoraria for teaching at universities other than my home institution

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Yes

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