Suicide attempts preceding completed suicide

Background This study investigated three questions with major implications for suicide prevention: the sensitivity of the history of previous suicide attempt(s) as an indicator of suicide risk, the time interval from a preced ing suicide attempt to the fatal one, and switching of suicide methods by t hose eventually completing suicide. Method The lifetime history of suicide attempts and the methods the victims (n=1397) used were examined in a nationwide psychological autopsy study co mprising all suicides in Finland within a 12-month research period in 1987- 1988. Results Overall, 56% of suicide victims were found to have died at their fi rst suicide attempt, more males (62%) than females (38%). In 19% of males a nd 39% of females the victim had made a non-fatal attempt during the final year. Of the victims with previous attempts, 82% had used at least two diff erent methods in their suicide attempts (the fatal included). Conclusions Most male and a substantial proportion of female suicides die i n their first suicide attempt, a fact that necessitates early recognition o f suicide risk, particularly among males. Recognition of periods of high su icide risk on the grounds of recent non-fatal suicide attempts is likely to be important for suicide prevention among females. Subjects completing sui cide commonly switch from one suicide method to another, a finding that wea kens but does not negate the credibility of restrictions on the availabilit y of lethal methods as a preventive measure.