[L. sui, of oneself + -cide]
Intentionally causing one's own death. In the U.S., about 35,000 people commit suicide each year; about 325,000 people who attempt suicide receive care in emergency departments. Currently, suicide is the ninth most common cause of death in the U.S.
Although suicide attempts are more frequently made by young women than any other group, successful suicide is most likely to occur when attempted by older men who live alone or young veterans returning from war. These men are most likely to use violent means in their suicide attempts, e.g., shooting themselves, jumping from heights, or hanging. Other risk factors for suicide include having a first-degree relative with a mood disorder; recurrent thoughts or discussion of suicide, esp. if a concrete plan for suicide has been contemplated; the means to commit suicide, esp. a weapon in one's possession; alcoholism; a new diagnosis of a mortal illness; living alone; being an adopted adolescent; a recent divorce or job loss; or uncontrolled pain caused by physical illness. Many people who kill themselves have consulted a health care provider in the months or weeks immediately before their death, which suggests that opportunities to intervene in the at-risk population are often missed.
Health care professionals should be alert to the warning signs of suicide, e.g., statements indicating a desire to die or a prediction that suicide will occur. People contemplating suicide may be depressed, act to get their lives in order, give away possessions, have failing grades or poor work performance, adopt risk-taking behavior, or have a history of alcoholism or drug abuse.
Management of those who are contemplating or have attempted suicide includes removal of lethal means from them and the provision of professional, social, and family support. If the patient is being treated as an outpatient, then he or she should be scheduled for specific future appointments and informed of a telephone number where help or assistance will be immediately available on a 24-hr basis. During a crisis, the patient should not be left alone even for a few minutes. For medicolegal reasons, careful and complete medical records should be kept concerning the plans and actions for management of the patient.
Although many agents treat mood disorders or thought disorders, the only drug proven to reduce the risk of suicide is lithium carbonate.
SUICIDE Suicide rates in the U.S. 1989-1998. Number of counties, with respect to national percentiles: [red] 308 at or above the 90th percentile; [blue] 460 at or above the 75th but less than the 90th percentile; [white] 2304 less than the 75th percentile.
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