Attempted suicide

A suicidal act that does not end in death is commonly called a "suicide attempt" or a "suicidal gesture." In the technical literature people prefer the use of the neologism parasuicide, or describe such acts as "deliberate self-harm" (DSH) – both of these terms avoid the question of the intent of the action. Those who attempt DSH are, as a group, quite different from those who actually die from suicide. DSH is far more common, and the majority are amongst females aged under 35. They are rarely physically ill and while psychological factors are highly significant, they are rarely clinically ill and severe clinical depression is uncommon. Social issues are key &mdash; DSH is most common among those living in overcrowded conditions, in conflict with their families, with disrupted childhoods and history of drinking, criminal behavior and violence. Individuals under these stresses become anxious and depressed and then, usually in reaction to a single particular crisis, they attempt to harm themselves. The motivation may be a desire for relief from emotional pain or to communicate feelings, although the motivation will often be complex and confused. DSH may also result from an inner conflict between the desire to end life and to continue living.

Epidemiology
Nearly half of all suicides are preceded by an attempt at suicide that does not end in death. Those with a history of such attempts are significantly more likely eventually to end their own lives than those without.

A suicidal act that did not end in death is commonly called a "suicide attempt" or a "suicidal gesture". In the technical literature people prefer the use of the neologism parasuicide, or describe such acts as "deliberate self-harm" (DSH); both of these terms avoid the question of the intent of the action. Those who attempt to harm themselves are, as a group, quite different from those who actually die from suicide. Self-harm is far more common, and the majority are amongst females aged under 35, though it occurs in men and women of all ages. Although they are rarely physically ill, they are considered psychiatrically unstable.

Social issues are key—DSH is most common among those living in conflict with their families, with disrupted childhoods and a history of drinking, criminal behavior, violence, and abuse are associated with DSH, though this is not always the case for a majority of those that DSH. Individuals under these stresses become anxious and depressed and then, usually in reaction to crisis, be it considered small or huge to others, they attempt to harm themselves. The motivation may be a desire for relief from emotional pain or to communicate feelings, although the motivation will often be complex and confused. Self-harm may also result from an inner conflict between the desire to end life and to continue living.

Papers
Hirsch SR, Walsh C, Draper R. Parasuicide: a review of treatment interventions. J Affect Disord 1982;4:299–311.

Papers

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