Physical illness and parasuicide: Evidence from the European Parasuicide Study Interview Schedule (EPSIS/WHO-EURO)

Objective: The aim of this research was to identify psychosocial characteri stics which might predict future suicidal behavior in parasuicidal subjects in Europe. Method: The interview utilized for the survey (European Parasui cide Study Interview Schedule-EPSIS) was administered to 1269 parasuicides aged fifteen years and over, within one week of hospital admission after a suicide attempt, and is part of a longitudinal multicenter study. EPSIS inc luded a brief medical questionnaire, scales rating depression, hopelessness , self-esteem, suicide intention, questions on sociodemographic characteris tics, an interview on Life events and social support, a description of the parasuicidal act, and an evaluation of factors precipitating the index para suicide. Results: Physical illness proved to be very frequent among suicide attempters. One in two subjects suffered from an acute, chronic, or chroni c disorder in relapse at the time of the parasuicide. Subjects with a physi cal illness were significantly more depressed, particularly subjects from t he intermediate age band and ones affected by a chronic physical disease in relapse. Forty-two percent of patients with physical illness rated their s omatic problem as a factor precipitating the attempt and 22 percent judged it to be major one. Furthermore, subjects with physical illnesses considere d psychiatric symptoms and disorders to be relevant factors in triggering s uicidal behavior, to a greater extent than non-sufferers. The importance of physical illness in contributing to suicidal behavior increased with advan cing age. Conclusions: More careful attention to somatic conditions and the ir subjective implications would probably augment chances of effectively pr eventing suicide.