Hostname: page-component-76fb5796d-x4r87 Total loading time: 0 Render date: 2024-04-27T03:04:42.230Z Has data issue: false hasContentIssue false
  • English
  • Français

Characteristics of persons who die on their first suicide attempt: results from the National Violent Death Reporting System

Published online by Cambridge University Press:  20 June 2019

Joshua T. Jordan Open the ORCID record for Joshua T. Jordan [Opens in a new window]  and
Dale E. McNiel
Joshua T. Jordan*
Affiliation:
Department of Psychiatry, University of California, San Francisco, San Francisco, CA94143, USA
Dale E. McNiel
Affiliation:
Department of Psychiatry, University of California, San Francisco, San Francisco, CA94143, USA
*
Author for correspondence: Joshua T. Jordan, E-mail: jtjordan@ucsf.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Much of suicide research focuses on suicide attempt (SA) survivors. Given that more than half of the suicide decedent population dies on their first attempt, this means a significant proportion of the population that dies by suicide is overlooked in research. Little is known about persons who die by suicide on their first attempt–and characterizing this understudied population may improve efforts to identify more individuals at risk for suicide.

Methods

Data were derived from the National Violent Death Reporting System, from 2005 to 2013. Suicide cases were included if they were 18–89 years old, with a known circumstance leading to their death based on law enforcement and/or medical examiner reports. Decedents with and without a history of SA were compared on demographic, clinical, and suicide characteristics, and circumstances that contributed to their suicide.

Results

A total of 73 490 cases met criteria, and 57 920 (79%) died on their first SA. First attempt decedents were more likely to be male, married, African-American, and over 64. Demographic-adjusted models showed that first attempt decedents were more likely to use highly lethal methods, less likely to have a known mental health problem or to have disclosed their intent to others, and more likely to die in the context of physical health or criminal/legal problem.

Conclusions

First attempt suicide decedents are demographically different from decedents with a history of SA, are more likely to use lethal methods and are more likely to die in the context of specific stressful life circumstances.

Keywords

First suicide attemptsuicideviolent death
Type
Original Articles
Information
Psychological Medicine , Volume 50 , Issue 8 , June 2020 , pp. 1390 - 1397
Copyright
Copyright © Cambridge University Press 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ajdacic-Gross, V, Weiss, MG, Ring, M, Hepp, U, Bopp, M, Gutzwiller, F and Rössler, W (2008) Methods of suicide: international suicide patterns derived from the WHO mortality database. Bulletin of the World Health Organization 86, 726–732.CrossRefGoogle ScholarPubMed
Anestis, MD (2016) Prior suicide attempts are less common in suicide decedents who died by firearms relative to those who died by other means. Journal of Affective Disorders 189, 106–109.CrossRefGoogle ScholarPubMed
Anestis, MD, Khazem, LR, Law, KC, Houtsma, C, LeTard, R, Moberg, F and Martin, R (2015) The association between state laws regulating handgun ownership and statewide suicide rates. American Journal of Public Health 105, 2059–2067.CrossRefGoogle ScholarPubMed
Angelakis, I, Gillespie, EL and Panagioti, M (2019) Childhood maltreatment and adult suicidality: a comprehensive systematic review with meta-analysis. Psychological Medicine 49, 1–22.CrossRefGoogle ScholarPubMed
Austin, PC (2011) An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivariate Behavioral Research 46, 399–424.CrossRefGoogle ScholarPubMed
Blow, F, Brockmann, L and Barry, K (2004) Role of alcohol in late-life suicide. Alcoholism: Clinical and Experimental Research 28, 48S–56S.CrossRefGoogle ScholarPubMed
Bostwick, JM, Pabbati, C, Geske, JR and McKean, AJ (2017) Suicide attempt as a risk factor for completed suicide: even more lethal than we knew. American Journal of Psychiatry 173, 1094–1100.CrossRefGoogle Scholar
Buchman-Schmitt, JM, Chu, C, Michaels, MS, Hames, JL, Silva, C, Hagan, CR, Ribeiro, JD, Selby, EA and Joiner, TE Jr (2017) The role of stressful life events preceding death by suicide: evidence from two samples of suicide decedents. Psychiatry Research 256, 345–352.CrossRefGoogle ScholarPubMed
Carney, SS, Rich, CL, Burke, PA and Fowler, RC (1994) Suicide over 60: the San Diego study. Journal of the American Geriatrics Society 42, 174–180.CrossRefGoogle ScholarPubMed
Cavanagh, JTO, Carson, AJ, Sharpe, M and Lawrie, SM (2003) Psychological autopsy studies of suicide: a systematic review. Psychological Medicine 33, 395–405.CrossRefGoogle ScholarPubMed
Centers for Disease Control and Prevention (2016) National Violent Death Reporting System (NVDRS) coding manual version 5.1. Atlanta, GA.Google Scholar
Cheng, ATA (1995) Mental illness and suicide: a case-control study in East Taiwan. Archives of General Psychiatry 52, 594–603.CrossRefGoogle ScholarPubMed
Crosby, AE, Ortega, L and Melanson, C (2011) Self-directed violence surveillance: uniform definitions and recommended data elements, version 1.0. Atlanta, GA.Google Scholar
Drapeau, CW and McIntosh, JL (2017) U.S.A. Suicide 2016: Official Final Data.Washington, DC: American Association of Suicidology.Google Scholar
Freedenthal, S (2008) Assessing the wish to die: a 30-year review of Suicide Intent Scale. Archives of Suicide Research 12, 277–298.CrossRefGoogle ScholarPubMed
Goodwin, RD, Marusic, A and Hoven, CW (2003) Suicide attempts in the United States: the role of physical illness. Social Science & Medicine 56, 1783–1788.CrossRefGoogle ScholarPubMed
Hastie, TR, Tibshirani, RJ and Friedman, J (2001) The Elements of Statistical Learning, 1st Edn.New York: Springer.CrossRefGoogle Scholar
Hayes, LM (2012) National study of jail suicide: 20 years later. Journal of Correctional Health Care 18, 233–245.CrossRefGoogle ScholarPubMed
Hirano, K and Imbens, GW (2001) Estimation of causal effects using propensity score weighting: an application to data on right heart catheterization. Health Services and Outcomes Research Methodology 2, 259–278.CrossRefGoogle Scholar
Holmes, TH and Rahe, TH (1967) The social readjustment rating scale. Journal of Psychosomatic Research 11, 213–221.CrossRefGoogle ScholarPubMed
Innamorati, M, Pompili, M, Masotti, V, Pearsonéi, F, Lester, D, Tatarelli, R, Girardi, P and Amore, M (2008) Completed versus attempted suicide in psychiatric patients: a psychological autopsy study. Journal of Psychiatric Practice 14, 216–224.CrossRefGoogle ScholarPubMed
Isometsä, ET and Lönnqvist, JK (1998) Suicide attempts preceding completed suicide. The British Journal of Psychiatry: The Journal of Mental Science 173, 531–535.CrossRefGoogle ScholarPubMed
Jamison, EC and Bol, KA (2016) Previous suicide attempt and its association with method used in a suicide death. American Journal of Preventive Medicine 51, S226–S233.CrossRefGoogle Scholar
Joiner, T (2005) Why People Die by Suicide.Cambridge, Massachusetts: Harvard University Press.Google Scholar
Joiner, TE, Conwell, Y, Fitzpatrick, KK, Witte, TK, Schmidt, NB, Berlim, MT, Fleck, MP and Rudd, MD (2005) Four studies on how past and current suicidality relate even when “everything under the kitchen sink” is covaried. Journal of Abnormal Psychology 114, 291–303.CrossRefGoogle Scholar
Joiner, TE, Buchman-Schmitt, JM and Chu, C (2017) Do undiagnosed suicide decedents have symptoms of a mental disorder? Journal of Clinical Psychology 73, 1744–1752.CrossRefGoogle ScholarPubMed
Jordan, JT and Samuelson, KW (2015) Predicting suicide intent: the roles of experiencing or committing violent acts. Suicide and Life-Threatening Behavior 46, 293–300.CrossRefGoogle ScholarPubMed
Kivisto, A and Phalen, P (2018) Effects of risk-based firearm seizure laws in Connecticut and Indiana on suicide rates, 1981–2015. Psychiatric Services 69, 855–862.CrossRefGoogle ScholarPubMed
Klonsky, ED and May, AM (2015) The Three-Step Theory (3ST): a new theory of suicide rooted in the ‘Ideation-to-Action’ framework. International Journal of Cognitive Therapy 8, 114–129.CrossRefGoogle Scholar
Lee, J and Little, TD (2017) A practical guide to propensity score analysis for applied clinical research. Behaviour Research and Therapy 98, 76–90.CrossRefGoogle ScholarPubMed
Logan, JE, Skopp, NA, Reger, MA, Gladden, M, Smolenski, DJ, Floyd, F and Gahm, GA (2015) Precipitating circumstances of suicide among active duty U.S. Army personnel versus U.S. civilians, 2005–2010. Suicide and Life-Threatening Behavior 45, 65–77.CrossRefGoogle ScholarPubMed
Mann, JJ and Michel, CA (2016) Prevention of firearm suicide in the United States: what works and what is possible. American Journal of Psychiatry 173, 969–979.CrossRefGoogle ScholarPubMed
McCaffrey, DF, Ridgeway, G and Morral, AR (2004) Propensity score estimation with boosted regression for evaluating causal effects in observational studies. Psychological Methods 9, 403–425.CrossRefGoogle ScholarPubMed
Miller, M, Azrael, D and Hemenway, D (2004) The epidemiology of case fatality rates for suicide in the northeast. Annals of Emergency Medicine 43, 723–730.CrossRefGoogle ScholarPubMed
O'Connor, RC (2011) Towards an integrated motivational-volitional model of suicidal behavior. In O'Connor, RC, Platt, S and Gordon, J (eds), International Handbook of Suicide Prevention: Research, Policy, and Practice, 1st Edn.London: John Wiley & Sons, Ltd., pp. 181–198.CrossRefGoogle Scholar
Power, AK and McKeon, R (2012) Preventing suicide is a national imperative. American Journal of Public Health 102, S7.CrossRefGoogle ScholarPubMed
Robins, JM, Hernan, MA and Brumback, B (2000) Marginal structural models and causal inference in epidemiology. Epidemiology 11, 550–555.CrossRefGoogle ScholarPubMed
Rubin, DB (1979) Using multivariate matched sampling and regression adjustment to control bias in observational studies. Journal of the American Statistical Association 74, 318–328.Google Scholar
Schonlau, M (2005) Boosted regression (boosting): an introductory tutorial and a Stata plugin. The Stata Journal 5, 330–354.CrossRefGoogle Scholar
Spicer, RS and Miller, TR (2000) Suicide acts in 8 states: incidence and case fatality rates by demographics and method. American Journal of Public Health 90, 1885–1891.Google ScholarPubMed
StataCorp (2017) StataStatisical Software: Release 15. College Station, TX15.1: StataCorp LLC.Google Scholar
Steenkamp, M, Frazier, L, Lipskiy, N, Deberry, M, Thomas, S, Barker, L and Karch, D (2006) The National Violent Death Reporting System: an exciting new tool for public health surveillance. Injury Prevention 12, ii3–ii5.CrossRefGoogle ScholarPubMed
Stefansson, J, Nordström, P, Runeson, B, Åsberg, M and Jokinen, J (2015) Combining the suicide intent scale and the karolinskainterpersonal violence scale in suicide risk assessments.BMC Psychiatry 15, 226.CrossRefGoogle ScholarPubMed
Stein, DJ, Chiu, WT, Hwang, I, Kessler, RC, Sampson, N, Alonso, J, Borges, G, Bromet, E, Bruffaerts, R, de Girolamo, G, Florescu, S, Gureje, O, He, Y, Kovess-Masfety, V, Levinson, D, Matschinger, H, Mneimneh, Z, Nakamura, Y, Ormel, J, Posada-Villa, J, Sagar, R, Scott, KM, Tomor, T, Viana, MC, Williams, DR and Nock, MK (2010) Cross-national analysis of the associations between traumatic events and suicidal behavior: findings from the WHO World Mental Health Surveys. PLoS ONE 5, e10574.CrossRefGoogle ScholarPubMed
Swanson, JW, Norko, MA, Lin, H, Alanis-Hirsch, K, Frisman, LK, Baranoski, MV, Easter, MM, Robertson, AG, Swartz, MS and Bonnie, RJ (2017) Implementation and effectiveness of Connecticut's risk-based gun removal law: does it prevent suicides? Law and Contemporary Problems 80, 179–208.Google Scholar
Zaorsky, NG, Zhang, Y, Tuanquin, L, Bluethmann, SM, Park, SM, Park, HS and Chinchilli, VM (2019) Suicide among cancer patients. Nature Communications 10, 207.CrossRefGoogle ScholarPubMed