Abstract
BackgroundSuicidal behavior is a growing public health concern resulting in morbidity and premature death. Although certain factors such as age, sex, and psychiatric disorders have been consistently reported to be associated with suicidal behavior, other factors including biological markers, diet, and physical activity may also influence suicidal behavior. The purpose of this pilot study was to evaluate the feasibility of conducting a full-scale study to identify the conventional and novel risk factors of suicidal behavior in individuals who made a recent suicide attempt.MethodsThis pilot study was a case-control study of participants with recent (within 1 month of admission) suicide attempts admitted to hospital and compared to two control groups: 1) psychiatric inpatient participants without a history of suicide attempts and 2) community-based controls. We collected information on demographic variables, circumstances of suicide attempts (for cases), medical and psychiatric diagnoses, behavioral patterns, physical measurements, and social factors. Blood and urine samples were also collected for biological markers. Feasibility outcomes are as follows: 1) 50 % of all eligible cases will consent to participate, 2) 50 cases and 100 controls per year can be recruited, and 3) at least 80 % of the participants will provide blood samples for DNA and biological markers.ResultsWe recruited 179 participants in total; 51 cases, 57 psychiatric controls without suicide attempt, and 71 non-psychiatric controls in Hamilton, Ontario. Recruitment rate was 70 % (213/304), and we obtained urine and blood specimens from 90 % (191/213) of participants. Questionnaire completion rates were high, and data quality was very good with few data-related queries to resolve. We learned that cases tended to be hospitalized for long periods of time and the suicide attempt occurred more than a month ago in many of the cases; therefore, we expanded our inclusion criterion related to timing of suicide attempt to 3 months instead of 1 month.ConclusionsThe study procedures needed certain modifications including extending the time between suicide attempt and date of recruitment, and more detailed questionnaires related to diet were necessary while other questionnaires such as social support needed to be shortened. Overall, this study showed that it is feasible to conduct a larger-scale study.Electronic supplementary materialThe online version of this article (doi:10.1186/s40814-015-0012-4) contains supplementary material, which is available to authorized users.
Highlights
Suicidal behavior is a growing public health concern resulting in morbidity and premature death
Suicidal behavior (SB) is reported to be among the most important risk factors for suicide [4,5,6]; it tends to be underreported due to several factors including a lack of recognition by services, denial of attempts, avoidance of legal inquiries, access to health services, stigma attached to suicidal behavior, financial consequences such as insurance claims, and lack of a national registry of SB
We aimed to provide a comprehensive evaluation and phenotypic characterization of individuals with suicide attempts, and we propose a theoretical model of risk factors (Fig. 1) and how the interaction of these factors can lead to SB
Summary
Suicidal behavior is a growing public health concern resulting in morbidity and premature death. Certain factors such as age, sex, and psychiatric disorders have been consistently reported to be associated with suicidal behavior, other factors including biological markers, diet, and physical activity may influence suicidal behavior. The purpose of this pilot study was to evaluate the feasibility of conducting a full-scale study to identify the conventional and novel risk factors of suicidal behavior in individuals who made a recent suicide attempt. Over 90 % of individuals with SB have an identifiable psychiatric disorder [7]; not all patients with psychiatric disorders attempt suicide, suggesting a “diathesis” or predisposition to SB in susceptible individuals independent of underlying psychopathology [3]
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