Learning Objective
Identify the epidemiology, risk factors, and warning signs for suicide across different age groups, and recognize the role of medical contact and neurobiology in risk assessment.
Suicide in Adults and Adolescents
Epidemiology
- 10th leading cause of death in the U.S.
- Men > women in completed suicides; women attempt more often (pills/poison)
- Older adults: less frequent attempts but higher lethality
- Adolescents: more frequent attempts
- Native Americans have the highest suicide rates (adolescents > older adults)
- Firearms account for >50% of completed suicides
Medical Contact
- ~50% of people who die by suicide have seen a physician in the prior month
High-Risk Factors
- Previous suicide attempt,
- Age,
- Male gender,
- High SES,
- Unemployment,
- Psychiatric/medical comorbidities,
- Hopelessness,
- Social isolation,
- Initiation of antidepressants (“suicide window”)
Neurobiology
- Decreased levels of 5-HIAA (serotonin metabolite) are associated with aggression and suicide
Activity
Key Concept: Older adults have the highest suicide completion rate, making early recognition and risk assessment crucial in clinical practice.
