Suicide

Suicide

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For other uses, see Suicide (disambiguation).

"Killing Yourself" redirects here. For the Alice in Chains song, see Music Bank.

Suicide

Classification and external resources

The Suicide by Édouard Manet 1877–1881

ICD-10

X60–X84

ICD-9

E950

MedlinePlus

001554

eMedicine

article/288598

MeSH

F01.145.126.980.875

Suicide (Latin suicidium, from sui caedere, "to kill oneself") is the act of intentionally causing one's own death. Suicide is often committed out ofdespair, the cause of which is frequently attributed to a mental disorder such as depression, bipolar disorder, schizophrenia, alcoholism, or drug abuse.[1] Stress factors such as financial difficulties or troubles with interpersonal relationships often play a role. Efforts to prevent suicide include limiting access to firearms, treating mental illness and drug misuse, and improving economic development.

The most commonly used method of suicide varies by country and is partly related to availability. Common methods include: hanging, pesticide poisoning, and firearms. Around 800,000 to a million people die by suicide every year, making it the 10th leading cause of death worldwide.[1][2] Rates are higher in men than in women, with males three to four times more likely to kill themselves than females.[3] There are an estimated 10 to 20 millionnon-fatal attempted suicides every year.[4] Attempts are more common in the young and females.

Views on suicide have been influenced by broad existential themes such as religion, honor, and the meaning of life. The Abrahamic religionstraditionally consider suicide an offense towards God due to the belief in the sanctity of life. During the samurai era in Japan, seppuku was respected as a means of atonement for failure or as a form of protest. Sati, a now outlawed Hindu funeral practice, expected the widow to immolate herself on her husband's funeral pyre, either willingly or under pressure from the family and society.[5]

Suicide and attempted suicide, while previously criminally punishable, is no longer in most Western countries. It remains a criminal offense in most Islamic countries. In the 20th and 21st centuries, suicide in the form of self-immolation has been used as a medium of protest, and kamikaze andsuicide bombings have been used as a military or terrorist tactic.[6]

Contents

[hide]

• 1 Definitions

• 2 Risk factors

o 2.1 Mental disorders

o 2.2 Substance use

o 2.3 Problem gambling

o 2.4 Medical conditions

o 2.5 Psychosocial states

o 2.6 Media

o 2.7 Rational

• 3 Methods

• 4 Pathophysiology

• 5 Prevention

o 5.1 Screening

o 5.2 Mental illness

• 6 Epidemiology

o 6.1 Gender

o 6.2 Age

• 7 History

• 8 Social and culture

o 8.1 Legislation

o 8.2 Religious views

o 8.3 Philosophy

o 8.4 Advocacy

o 8.5 Locations

• 9 Other species

• 10 Notable cases

• 11 Notes

• 12 Further reading

• 13 External links

Definitions

Suicide, also known as completed suicide, is the "act of taking one's own life".[7] Attempted suicide or non-fatal suicidal behavior is self-injury with the desire to end one's life that does not result in death.[8] Assisted suicide is when one individual helps another bring about their own death indirectly via providing either advice or the means to the end.[9] This is in contrast to euthanasia, where another person takes a more active role in bringing about a person's death.[9] Suicidal ideation is thinking of ending one's life.[8]

Risk factors

The precipitating circumstances for suicide from 16 American states in 2008.[10]

Factors that affect the risk of suicide include psychiatric disorders, drug misuse, psychological states, cultural, family and social situations, and genetics.[11] Mental illness and substance misuse frequently co-exist.[12] Other risk factors include having previously attempted suicide,[13] the ready availability of a means to commit the act, a family history of suicide, or the presence of traumatic brain injury.[14] For example, suicide rates have been found to be greater in households with firearms than those without them.[15] Socio-economic factors such as unemployment, poverty, homelessness, and discrimination may trigger suicidal thoughts.[16] About 15–40% of people leave a suicide note.[17] Genetics appears to account for between 38% and 55% of suicidal behaviors.[18] War veterans have a higher risk of suicide due in part to higher rates of mental illness and physical health problems related to war.[19]

Mental disorders

Mental disorders are often present at the time of suicide with estimates ranging from 27%[20] to more than 90%.[13] Of those who have been admitted to a psychiatric unit, their lifetime risk of completed suicide is about 8.6%.[13] Half of all people who die by suicide may have major depressive disorder; having this or one of the other mood disorders such as bipolar disorder increases the risk of suicide 20-fold.[21] Other conditions implicated include schizophrenia (14%), personality disorders (14%),[22] bipolar disorder,[21] and posttraumatic stress disorder.[13] About 5% of people with schizophrenia die of suicide.[23] Eating disorders are another high risk condition.[24]

A history of previous suicide attempts is the greatest predictor of eventual completion of suicide.[13] Approximately 20% of suicides have had a previous attempt and of those who have attempted suicide 1% complete suicide within a year[13] and more than 5% commit suicide after 10 years.[24] While acts of self-harm are not seen as suicide attempts, the presence of self-injurious behavior is related to increased suicide risk.[25]

In approximately 80% of completed suicides the individual has seen a physician within the year before their death,[26] including 45% within the prior month.[27] Approximately 25–40% of those who completed suicide had contact with mental health services in the prior year.[20][26]

Substance use

"The Drunkard's Progress", 1846 demonstrating how alcoholism can lead to suicide

Substance abuse is the second most common risk factor for suicide after major depression and bipolar disorder.[28] Both chronic substance misuse as well as acute intoxication are associated.[12][29] When combined with personal grief, such as bereavement, the

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