Suicide attempt method affects prognosis

The method used for a suicide attempt is highly significant for the risk of subsequent successful suicide, reveals a long-term study from Karolinska Institutet. The results may be of help in acute risk assessment following a suicide attempt.

Suicide is one of the most common causes of death among those aged 15 to 44. Previous research has shown that those who have previously attempted to take their own lives are at a greatly increased risk of committing suicide. Other known risk factors are psychiatric disorders and drug abuse. The new study, which followed people who had attempted suicide, is one of the first to compare groups who used different methods for their attempted suicide.

The results, published in the British Medical Journal (BMJ), show that the risk of successful suicide is particularly high among those who attempted suicide by hanging, drowning, jumping from height or using firearms.  For example, suicide is six times more likely after a hanging attempt, and four times more likely after a drowning attempt, than after a poisoning attempt, which is the most common method.

The researchers also found that the risk was particularly high immediately after a hanging attempt, and that the same method was often used for both the attempted suicide and the successful suicide.

"The results may be of help in acute risk assessment following a suicide attempt," says professor Bo Runeson, who worked on the study. "There are a number of important factors, including psychiatric disorder and suicidal intention, but it's important also to factor in whether the person chose a violent method when assessing the short- and long-term risk."

The study covered almost 50,000 people hospitalised following a suicide attempt in the period 1973-82. During the follow-up period, which ran until 2003, 12% of this group, or 5,740 people, successfully committed suicide.