title: Risk of completed suicide in 89,049 young males assessed by a mental health professional.
abstract: In an individual who seeks help or is referred to a mental health professional it is common sense and clinical practice to assume that suicidal thoughts and previous attempts constitute risk factors for imminent suicide. However, this assumption has not been supported by large, population-based longitudinal studies. The current study investigated whether reports of current suicidal ideation and a history of suicide attempts indeed increase risk for later completed suicide in a historical prospective study design. Sequential records on 89,049 young males assessed by mental health professionals were screened for suicidal ideation and a history of suicide attempts. The data were linked with death records from the Israeli Central Bureau of Statistics. Over a follow-up period ranging from 2 months to 9.8 years, 54 individuals died by suicide, constituting an average suicide rate of 6.48 per 100,000 person-years. Overall, neither reporting current suicidal ideation (without a history of suicide attempts; HR=1.29, 95% CI=0.57-2.90) nor reporting a history of suicide attempts (with or without current suicidal ideation; HR=1.67, 95% CI=0.71-3.97) were significantly associated with increased risk for later completed suicide. However, young males with a previously diagnosed psychiatric disorder who reported current suicidal ideation (HR=4.52, 95% CI=1.08-18.91) or a history of suicide attempts (HR=6.43, 95% CI=1.54-26.90) were at increased risk of death by suicide. These findings indicate that in this particular population reports of current suicidal ideation or of a history of suicide attempts are helpful in predicting future suicide only among those with a previous diagnosis of a psychiatric disorder.
authors.affiliation: Department of Psychiatry, Sheba Medical Center, Ramat Gan, Israel; IDF Medical Corps, IDF, Tel Hashomer, Israel; Department of Psychiatry, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: mweiser@netvision.net.il.
authors.forename: Mark
authors.initials: M
authors.lastname: Weiser
authors.affiliation: Department of Psychiatry, Sheba Medical Center, Ramat Gan, Israel.
authors.forename: Shira
authors.initials: S
authors.lastname: Goldberg
authors.affiliation: Department of Psychiatry, Sheba Medical Center, Ramat Gan, Israel.
authors.forename: Nomi
authors.initials: N
authors.lastname: Werbeloff
authors.affiliation: Department of Psychiatry, Sheba Medical Center, Ramat Gan, Israel.
authors.forename: Daphna
authors.initials: D
authors.lastname: Fenchel
authors.affiliation: Department of Psychiatry and Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Abraham
authors.initials: A
authors.lastname: Reichenberg
authors.affiliation: IDF Medical Corps, IDF, Tel Hashomer, Israel.
authors.forename: Leah
authors.initials: L
authors.lastname: Shelef
authors.affiliation: School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Matthew
authors.initials: M
authors.lastname: Large
authors.affiliation: Department of Psychiatry, Sheba Medical Center, Ramat Gan, Israel; Department of Psychiatry, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Michael
authors.initials: M
authors.lastname: Davidson
authors.affiliation: IDF Medical Corps, IDF, Tel Hashomer, Israel.
authors.forename: Eyal
authors.initials: E
authors.lastname: Fruchter
mesh_terms: D000293:Adolescent; D016208:Databases, Factual / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data*; D013406:Suicide, Attempted / Q000523:psychology*; D055815:Young Adult
keywords: Mental health examination; Suicidal ideation; Suicide; Suicide attempts