Can temperament identify affectively ill patients who engage in lethal or near-lethal suicidal behavior? A 14-year prospective study.
Among affectively ill patients followed naturalistically for up to 14 years, 36 committed suicide, 120 attempted suicide, and 373 had no recorded suicide attempt. Comparing these three groups on clinical and intake personality revealed that suicide completed within 12 months was predicted by clinical but not personality variables, and suicide beyond 12 months was predicted by newly derived temperament factors, not clinical variables. Attempters and completers shared core characteristics: previous attempts, impulsivity, substance abuse, and psychic turmoil within a cycling/mixed bipolar disorder. Such temperament attributes as impulsivity and assertiveness were the best prospective predictors of completed suicides beyond 12 months with a sensitivity level of 74% and specificity level of 82%.
Maser
Jack D
JD
Department of Psychiatry, University of California San Diego, USA. JMaser@VApop.UCSD.edu
Akiskal
Hagop S
HS
Schettler
Pamela
P
Scheftner
William
W
Mueller
Timothy
T
Endicott
Jean
J
Solomon
David
D
Clayton
Paula
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis* / Q000523:psychology*; D010555:Personality Inventory; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013405:Suicide / Q000523:psychology*; D013406:Suicide, Attempted / Q000517:prevention & control / Q000523:psychology; D013694:Temperament; D014481:United States; D000092864:Suicide Prevention