Suicide attempters using violent methods differ from non-violent attempters and may share more characteristics with suicide completers. In a study of Swedish conscripts focusing on psychiatric diagnoses at late adolescence, neurosis and personality disorders were strong predictors of both suicide attempt and suicide in the early and late phase of the follow-up period of 37 years. Violent behaviour and criminality, especially violent offending, have also been pointed out as risk factors for suicide. Having a disadvantaged background including low socio-economic status, parental psychiatric problems, i.e., high rates of depression and substance use, has been shown to be associated with suicide. High suicide intent and violent suicide attempt methods are both related to an elevated suicide risk compared to suicide attempts with low intent or non-violent suicide attempt methods. The risk of suicide seems to be highest during the first year following the index attempt. A higher life-time risk of suicide of about 15 % after a suicide attempt in patients with major depression has been reported. In a study from Finland, 8 % of suicide attempters committed suicide during a follow-up of 12 years. įurthermore, attempted suicide is up to 10–40 times more frequent than completed suicide and is considered to be the most predictive clinical risk factor for subsequent suicide.
In the Nordic countries, suicide was the second most common cause of death in the age category 15–24 years. More than 1 million people die due to suicide per year and the rates seem to be similar in both developed and developing countries. Suicide is an important public health problem and one of the leading causes of death among young people worldwide. The early risk factors related to the choice of either a violent or a non-violent suicide attempt method are interlinked and circumstantial factors temporally close to the suicide attempt, such as access to a specific method, may partly explain the choice of method. Violent suicide attempts, especially by hanging, are associated with a clearly elevated suicide risk in men and require special clinical and public health attention. The early risk factors for both violent and non-violent methods of suicide attempt were quite similar. Suicide victims had earlier onset of suicidal behaviour and had more often used hanging as a method of attempted suicide than those who did not later commit suicide. Half of the suicides occurred during the same year as the attempt. The number of suicide victims among the non-attempters was 482 (1 %). ResultsĪ total of 1195 (2.4 %) men had made a suicide attempt and of these, 133 (11.1 %) committed suicide later. Cox proportional hazard regression analyses were used to estimate the risk for different methods of attempted suicide and later suicide.
Two questionnaires concerning their psychosocial background were answered by each conscript.
MethodsĪ national Swedish cohort of 48 834 18–20-year-old young men conscripted for military service from 1969 to 1970 was followed through official registers during a 37-year period. Adolescent risk factors for the choice of violent or non-violent methods for suicide attempts and the risk of subsequent suicide were studied using a longitudinal design. There is a paucity of studies on the role of early risk factors for the choice of methods for violent suicide attempts.
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