[Suicidality].
Prevention of suicidal behaviour remains difficult, despite increasing knowledge of its determinants. Health service efforts hardly affect suicide rates. Recent shifts in the epidemiology of suicidal behaviour are rising rates among the young and increasing use of violent methods; these can be linked to emerging aetiological insights. Early stages of the suicidal process often manifest themselves at an early age, as emotional and behavioural instability. Epidemiological evidence suggests that the suicidal process increasingly concentrates itself in a vulnerable minority in whom it progresses rapidly to a phase of relative unresponsiveness to environmental influences including preventive efforts. Thus, prevention should focus not only on persons in the later stages of the suicidal process like psychiatric patients, but especially on individuals who, as youngsters, show signs of entering its very first stages. Since high suicide risk implies high risk of other adverse health outcomes as well, this should, in time, yield health gains in more domains than suicide reduction only.
Neeleman
J
J
Academisch Ziekenhuis/Rijksuniversiteit, disciplinegroep Psychiatrie, Postbus 30.001, 9700 RB Groningen. j.neeleman@med.rug.nl
D000367:Age Factors; D016021:Epidemiologic Studies; D020022:Genetic Predisposition to Disease / Q000523:psychology*; D006801:Humans; D015994:Incidence; D008016:Life Change Events; D001523:Mental Disorders / Q000150:complications* / Q000188:drug therapy; D009426:Netherlands / Q000453:epidemiology; D011322:Primary Prevention / Q000379:methods*; D012737:Sex Factors; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data; D000092864:Suicide Prevention