Suicide is the tenth leading cause of death in US and each year approximately 42,773 Americans die by suicide with highest rates seen in white middle men. The annual age-adjusted suicide rate is approximately 12.93/100,000 and costs the US $ 44 Billion annually (AFSP). Even though the cause of suicidal behavior/ ideation could be multi-factorial, one of the most common risk factor is a psychiatric disorder (Lee and Kim, 2010) which has been further supported by a meta-analysis that showed amongst 3275 suicides, 87.3% ( SD 10%) of patients had been diagnosed with a psychiatric disorder prior to their death. Although suicide occurs with any psychiatric disorder, research shows that suicide is most commonly seen in mood disorders, major depressive
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Suicide, suicidal behavior and attempted suicide are highly complex behaviors which are multifactorial and can be divided into proximal stressors/triggers and distal stressors (Mann and Courier, 2010). These stressors can be compartmentalized into various psychological models to better understand the mechanisms leading to suicidal behavior. A dozen psychological models of suicide have been described in literature that have been tested and empirically supported (Shira Barzilay and Alan Apter, 2014). Currently the most common model used to formulate depression and suicide in clinical practice is the psychoanalytic theory of Freud and cognitive model of Beck. Freud postulated suicide as an inwardly turned aggression against an “introjected, ambivalently cathected love object” whereas Beck stated that hopelessness plays a significant role in suicide by disturbing the classical cognitive triad of beliefs about self, others and the future. Amongst most of these models, stress seems to be a key factor in the cause for primary psychopathology and suicide is often picturized as a reaction to extreme unbearable stress. Contrastingly an interesting observation needs to be made that stress models of suicidal behavior cannot explain the reasons why extreme stress does not lead to suicide in all …show more content…
The authors designed a study to examine suicide attempts in patients with mood disorders, psychoses and other diagnosis which included borderline personality disorder comorbid with axis I diagnosis. Lifetime suicidal attempts, aggression traits and impulsivity, objective and subjective severity of psychopathology, developmental and family history and past substance abuse including alcoholism were evaluated. Suicide attempters demonstrated higher scores on subjective depression, more life time episodes of major depression/psychosis, higher scores on suicidal ideation and fewer reasons for living when compared to non-attempters. Also suicide attempters showed higher rates of lifetime aggression and impulsivity along with comorbid borderline personality disorder, smoking, past substance abuse/alcoholism, family history of suicide, head injury and child abuse when compared to non-attempters. Duration of current episode, which is a measure of severity of depression, was longer in non-attempters showing that attempters’ current episode was more acute. By factor analyses of the psychopathology rating scales, two state factors (psychosis and depression) and one trait factor (aggression/impulsivity) were generated. Using logistic regression, authors demonstrated that the aggression/impulsivity was strongly
Suicide, suicidal behavior and attempted suicide are highly complex behaviors which are multifactorial and can be divided into proximal stressors/triggers and distal stressors (Mann and Courier, 2010). These stressors can be compartmentalized into various psychological models to better understand the mechanisms leading to suicidal behavior. A dozen psychological models of suicide have been described in literature that have been tested and empirically supported (Shira Barzilay and Alan Apter, 2014). Currently the most common model used to formulate depression and suicide in clinical practice is the psychoanalytic theory of Freud and cognitive model of Beck. Freud postulated suicide as an inwardly turned aggression against an “introjected, ambivalently cathected love object” whereas Beck stated that hopelessness plays a significant role in suicide by disturbing the classical cognitive triad of beliefs about self, others and the future. Amongst most of these models, stress seems to be a key factor in the cause for primary psychopathology and suicide is often picturized as a reaction to extreme unbearable stress. Contrastingly an interesting observation needs to be made that stress models of suicidal behavior cannot explain the reasons why extreme stress does not lead to suicide in all …show more content…
The authors designed a study to examine suicide attempts in patients with mood disorders, psychoses and other diagnosis which included borderline personality disorder comorbid with axis I diagnosis. Lifetime suicidal attempts, aggression traits and impulsivity, objective and subjective severity of psychopathology, developmental and family history and past substance abuse including alcoholism were evaluated. Suicide attempters demonstrated higher scores on subjective depression, more life time episodes of major depression/psychosis, higher scores on suicidal ideation and fewer reasons for living when compared to non-attempters. Also suicide attempters showed higher rates of lifetime aggression and impulsivity along with comorbid borderline personality disorder, smoking, past substance abuse/alcoholism, family history of suicide, head injury and child abuse when compared to non-attempters. Duration of current episode, which is a measure of severity of depression, was longer in non-attempters showing that attempters’ current episode was more acute. By factor analyses of the psychopathology rating scales, two state factors (psychosis and depression) and one trait factor (aggression/impulsivity) were generated. Using logistic regression, authors demonstrated that the aggression/impulsivity was strongly