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Original Article

Factors mediating suicidal behaviour: Their utility in primary and secondary prevention

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Pages 3-26 | Published online: 06 Jul 2009
 

Abstract

Can we prevent suicidal behaviour? This paper reviews the evidence on what factors mediate both suicide and parasuicide. Sociodemographic factors including recent trends in age and sex ratios, impact of life events and difficulties such as unemployment, and the extent to which such behaviour may be imitative are examined. Psychiatric factors which affect vulnerability in people with different diagnoses are considered, and the depressive component is seen as the “final common pathway” of such conditions. Vulnerability rises when these variables are combined with psychological factors including difficulties in emotion regulation, hopelessness, and cognitive dysfunction (especially memory deficits) leading to poor problem solving. Research evidence suggests that teaching primary care agencies to be vigilant for signs and symptoms of depression may affect the probability of suicide, at least temporarily. The paper considers what some of the barriers to such vigilance might be. Finally, secondary prevention of suicidal behaviour demands intensive structured psychotherapy focused on problem solving and emotion regulation.

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