Suicide in special populations and circumstances: A review

Abstract

Suicide is associated with certain diagnoses. In addition to its association with depression, suicide is related to panic disorder, borderline personality disorder, and schizophrenia, more so than other psychological disorders. Therefore, full understanding of the individual, including his or her psychiatric diagnosis, is important in dealing with someone who is suicidal. Suicide is associated with certain traumas. The trauma of physical and sexual abuse as a child increases risk both in childhood and in adulthood. In studying the connection between different types of abuse and suicide, prospective research is needed that uses clear definitions and distinguishes between physical, sexual, and combined abuse. Also, the trauma of contracting AIDS may heighten suicide risk, particularly near the time of HIV testing or if dementia or drug treatment clouds consciousness. At these times clinicians should take special care to assess for suicidality. Suicide is associated with certain groups more than others. Adolescents, the elderly, and certain ethnic groups, such as Caucasians, have higher rates than others. Prevention strategies that acknowledge the uniqueness of the individual and take place at home, in school, and in the community have become extremely important. Suicide may be contagious. Contagion is more likely if the model is a celebrity, if the publicity is extensive, and if people are asked about others rather than themselves. Suicide is so complex that current knowledge, though enabling us to predict which special populations and circumstances increase risk, is not sufficient to predict the specific individuals who will attempt or succeed in killing themselves.