Nearly one in five people who attempt suicide either have no history of prior mental illness or do not meet the criteria for a diagnosis of mental illness at the time of the attempt, a study in JAMA Psychiatry suggests.
“This finding challenges clinical notions of who is at risk for suicidal behavior and raises questions about the safety of limiting suicide risk screening to psychiatric populations,” wrote Past APA President Maria A. Oquendo, M.D., Ph.D., of the University of Pennsylvania and colleagues.
The researchers analyzed data from 1,948 adults (66.8% female) aged 20 to 65 years with a history of suicide attempts who were surveyed between April 2012 and June 2013 in the U.S. National Epidemiologic Study of Addictions and Related Conditions III.
The researchers found that 6.2% of the respondents did not have a diagnosis of mental illness at any time prior to attempting suicide or afterwards up to the point they completed the survey. They also found that an additional 13.4% made a first suicide attempt before the onset of mental illness, and some did not meet the criteria for a mental illness until several years after their suicide attempt. All told, an estimated 19.6% of adults reported a lifetime suicide attempt with no evidence of a mental illness prior to their first attempt; this prevalence was approximately the same in males and females.
“From a clinical standpoint, these findings suggest that a history of suicide attempts should be obtained regardless of whether the person has a psychiatric disorder, given that suicide attempts are associated with future attempts and future suicide,” Oquendo and colleagues wrote.
“[P]olicy makers, clinicians, and health systems should weigh the costs and benefits of expanding suicide risk screening beyond the current targets and consider universal screening to prevent suicide attempts, which have significant morbidity as well as medical and other costs,” they added.
For related information, see the Psychiatric News article “Half of Patients With Suicidal Thoughts Deny It.”
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