What are signs and risk factors for suicide potential?

Updated: Jul 26, 2021
  • Author: Stephen Soreff, MD; Chief Editor: Glen L Xiong, MD  more...
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The following is a list of 13 things that should alert a clinician to a real suicide potential:

  • Patients with definite plans to kill themselves - People who think or talk about suicide are at risk; however, a patient who has a plan (eg, to get a gun and buy bullets) has made a clear statement regarding risk of suicide

  • Patients who have pursued a systematic pattern of behavior in which they engage in activities that indicate they are leaving life - This includes saying goodbye to friends, making a will, writing a suicide note, and developing a funeral plan

  • Patients with a strong family history of suicide - A family history of suicide is especially indicative of suicide risk if the patient is approaching the anniversary of a family member’s suicide or the age at which a relative committed suicide

  • The presence of a gun, especially a handgun

  • Psychotic symptoms especially in adolescents - Kelleher et al reported in a prospective cohort study of 1112 school-based adolescents (aged 13-16 y), that 7% of the total sample reported psychotic symptoms at baseline. Of that subsample, 7% reported a suicide attempt by the 3-month follow-up compared with 1% of the rest of the sample. The authors concluded that adolescents with psychopathology who report psychotic symptoms are at clinical high risk for suicide attempts. Psychotic symptoms in adolescents may serve as a marked for that population being at high suicidal risk. [4]

  • Being under the influence of alcohol or other mind-altering drugs - Drug abuse is especially significant if the drugs are depressants

  • If the patient encounters a severe, immediate, unexpected loss, such as when a person is fired suddenly or left by a spouse

  • If the patient is isolated and alone

  • If the person has a depression of any type

  • If the patient experiences command hallucination - A command hallucination ordering suicide can be a powerful message of action leading to death

  • Discharge from psychiatric hospitals - Patients are at suicide risk upon discharge from a psychiatric hospital, which is a very difficult time of transition and stress; the structure, support, and safety of the institution are no longer available to the patient

  • Anxiety - Anxiety in all of its forms leads to a risk of suicide; the constant sense of dread and tension proves unbearable for some

  • Clinician's feelings - Regardless of what the patient says or does, it matters if the clinician has a feeling that the patient is going to commit suicide

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