Comorbidity of Psychiatric and Personality Disorders in First Suicide Attempters

Abstract

Background:Attempted suicide is a common clinical problem in a general hospital setting. It has a serious clinical and socio-economical impact too.Aims:To study the psychosocial, psychiatric, and personality profile of the first suicide attempters in a general hospital.Settings and Design:Cross-sectional, hospital-based, descriptive study.Materials and Methods:All the consecutive cases of first suicide attempt (n=100) treated in a general hospital were studied to know the clinical profile. Variables related to socio-demographic characteristics, family background, suicide characteristics, psychiatric morbidity, and comorbidity were analyzed. Risk-Rescue rating was applied to know the medical seriousness of the suicide attempt. Presumptive stressful life event scale was utilized to calculate life events score. Structured clinical interview (MINI Plus) and semi-structured clinical interview (IPDE) were used for axis-I and axis-II (personality) diagnoses. The results were analyzed using appropriate statistical measures.Results:Family history of psychiatric illnesses (31%) and suicide (11%) were noted. Insecticides and pesticides were the most common agents (71%) employed to attempt suicide. Interpersonal difficulties (46%) were the most frequent stressor. Overall medical seriousness of the suicide attempt was of moderate lethality. 93% of the suicide attempters had at least one axis-I and/or axis-II psychiatric disorder. Most common diagnostic categories were mood disorders, adjustment disorders, and substance-related disorders, with axis-I disorders (89%), personality disorders (52%), and comorbidity of psychiatric disorders (51.6%).Conclusion:Individuals who made first suicide attempt were young adults, had lower educational achievement; overall seriousness of the suicide attempt was of moderate lethality, high prevalence of psychiatric morbidity, personality disorders, and comorbidity, and had sought medical help from general practitioners.

Clinical and genetic factors associated with suicide in mood disorder patients

“…Seeking auto-medication by means of alcohol and substance abuse [104,105] may also elicit an additive risk on suicide outcome [101]. Finally, family history of suicide was associated indeed with a higher likelihood of having attempted suicide, in line with prior observations [106]. Interestingly, family history of BD or MDD was not associated with a suicide attempt status.…”

“…Interestingly, family history of BD or MDD was not associated with a suicide attempt status. Prior literature shows evidence of an increased frequency of psychiatric conditions in the family of patients who committed suicide [107,108] and in the family of attempters [106]; our observations are in the same direction but did not reach statistical significance. Our sample size has adequate power; thus, we conclude that prior psychiatric family history is not strongly associated with suicide attempt status in mood disorder patients, but family history of suicide is.…”

Personality traits of patients with attempted suicide: a hospital based study

“…Low representation of unemployment in the sample study in contrast to Western study may be due to difficulty in its identification in agrarian rather than in industrialized countries and also that lower need of employment in students and in most females of the sample patients who were housewives. 23,25 Poisoning is the most common method of attempted suicide. 26,27 As with the present study, where 93% patients had consumed organophosphorus compounds (OPC), most of the Indian studies also report that consumption of OPC as one of the commonest mode of suicidal attempts.…”

“…This may be due to its easy availability especially in semi-urban and rural population. 25 Studies have shown that only a small number of people who make suicide attempt, commit suicide later. 28,29 Present study too had only 14% patients with history of previous suicide attempts.…”

Indicadores de risco para tentativa de suicídio por envenenamento: um estudo caso-controle

“…Admite-se que a exposição ao mesmo tempo de vários fatores de risco predisporia à morte por suicídio 31 . Quanto ao gênero e à ocorrência de tentativa de suicí-dio, destaca-se a correlação dessa variável com outras questões 32,33 que contribuem para o risco em geral, mas que podem estar presentes em graus distintos em homens e mulheres. Quando se analisam, por exemplo, as influências culturais, estas agem de modo particular entre os gêneros.…”