Method of attempted suicide as predictor of subsequent successful suicide: national long term cohort study.

BMJ : British Medical Journal
Bo RunesonNiklas Långström

Abstract

To study the association between method of attempted suicide and risk of subsequent successful suicide. Cohort study with follow-up for 21-31 years. Swedish national register linkage study. 48,649 individuals admitted to hospital in 1973-82 after attempted suicide. Completed suicide, 1973-2003. Multiple Cox regression modelling was conducted for each method at the index (first) attempt, with poisoning as the reference category. Relative risks were expressed as hazard ratios with 95% confidence intervals. 5740 individuals (12%) committed suicide during follow-up. The risk of successful suicide varied substantially according to the method used at the index attempt. Individuals who had attempted suicide by hanging, strangulation, or suffocation had the worst prognosis. In this group, 258 (54%) men and 125 (57%) women later successfully committed suicide (hazard ratio 6.2, 95% confidence interval 5.5 to 6.9, after adjustment for age, sex, education, immigrant status, and co-occurring psychiatric morbidity), and 333 (87%) did so with a year after the index attempt. For other methods (gassing, jumping from a height, using a firearm or explosive, or drowning), risks were significantly lower than for hanging but still raised at 1.8 to ...Continue Reading

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