title: Patterns of presentation for attempted suicide: analysis of a cohort of individuals who subsequently died by suicide.
abstract: All suicides and related prior attempts occurring in Northern Ireland over two years were analyzed, focusing on number and timing of attempts, method, and mental health diagnoses. Cases were derived from coroner's records, with 90% subsequently linked to associated general practice records. Of those included, 45% recorded at least one prior attempt (with 59% switching from less to more lethal methods between attempt and suicide). Compared with those recording one attempt, those with 2+ attempts were more likely to have used less lethal methods at the suicide (OR = 2.77: 95% CI = 1.06, 7.23); and those using less lethal methods at the attempts were more likely to persist with these into the suicide (OR = 3.21: 0.79, 13.07). Finally, those with preexisting mental problems were more likely to use less lethal methods in the suicide: severe mental illness (OR = 7.88: 1.58, 39.43); common mental problems (OR = 3.68: 0.83, 16.30); and alcohol/drugs related (OR = 2.02: 0.41, 9.95). This analysis uses readily available data to highlight the persisting use of less lethal methods by visible and vulnerable attempters who eventually complete their suicide. Further analysis of such conditions could allow more effective prevention strategies to be developed.
authors.affiliation: Open University, Milton Keynes, UK.
authors.forename: Sharon
authors.initials: S
authors.lastname: Mallon
authors.affiliation: Bamford Centre for Mental Health and Wellbeing, University of Ulster, Derry, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Rosato
authors.affiliation: Queens University, Belfast, UK.
authors.forename: Karen
authors.initials: K
authors.lastname: Galway
authors.affiliation: Northern Ireland Association for Mental Health (NIAMH), Belfast, UK.
authors.forename: Lynette
authors.initials: L
authors.lastname: Hughes
authors.affiliation: Northern Ireland Association for Mental Health (NIAMH), Belfast, UK.
authors.forename: Janeet
authors.initials: J
authors.lastname: Rondon-Sulbaran
authors.affiliation: Northern Ireland Association for Mental Health (NIAMH), Belfast, UK.
authors.forename: Sam
authors.initials: S
authors.lastname: McConkey
authors.affiliation: Bamford Centre for Mental Health and Wellbeing, University of Ulster, Derry, UK.
authors.forename: Gerard
authors.initials: G
authors.lastname: Leavey
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D033182:Intention; D007494:Ireland / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data; D000092864:Suicide Prevention