title: The terrorist attacks of September 11, 2001, as psychological toxin: increase in suicide attempts.
abstract: Previous studies of psychological morbidity produced by September 11, 2001, focused primarily on short-term development of posttraumatic stress disorder or depression in East Coast cities targeted. This study aimed to determine whether suicide attempts medically harmful enough to necessitate admission to the general hospital increased in the 2 years following September 11, 2001, in a region not on the East Coast, and if so, to characterize individuals contributing to this increase. This retrospective study compared two time periods: 2 years preceding and 2 years following September 11, 2001. Psychiatric consultation reports for all suicide attempters medically admitted to the University of Michigan Health Systems Hospital in Ann Arbor, Michigan, were examined (N = 254). In the 2-year period following September 11, 2001, there was a 49% increase in the number of individuals making a harmful suicide attempt (p = 0.002). The effect was greatest in the months following the attacks but continued over the next year, with a stepwise decline corresponding to the number of months elapsed since September 11. In the period following September 11, 2001, fewer subjects reported multiple personal stressors (p = 0.03). The subjects in the two time periods were not significantly different in age, gender, prior suicide attempts, prior psychiatric treatment, alcohol abuse, substance abuse, depression, or psychosis. Overrepresentation by those most vulnerable to suicide attempts did not account for the increased number of suicide attempts. The effects of chronic stress in the general population across the United States elicited by the terrorism of September 11, 2001, may have been of greater magnitude and longer lasting than previously realized.
authors.affiliation: Department of Psychiatry and Depression Center, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Monica N
authors.initials: MN
authors.lastname: Starkman
mesh_terms: D000328:Adult; D017677:Age Distribution; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008016:Life Change Events; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D012189:Retrospective Studies; D047851:September 11 Terrorist Attacks / Q000523:psychology*; D017678:Sex Distribution; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data*; D013997:Time Factors