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by Nico Peruzzi, Ph.D. & Bruce Bongar, Ph.D.

New research reported in the December issue of Professional Psychology: Research and Practice, published by the American Psychological Association, has identified eight critical risk factors for suicide in patients with major depression.

Amongst Americans age 15-44, suicide is the second leading cause of death for women and the fourth leading cause for men. According to the recently released Surgeon General's Call To Action to Prevent Suicide, there are an estimated 4.5 million suicide-attempt survivors nationwide.

Regardless of these prevalence rates, evaluating suicide risk continues to be a clinically difficult and scientifically imperfect task for mental health providers. In an attempt to learn from the clinical experience of practicing psychologists, researchers Nico Peruzzi, Ph.D., of MyPsych.com, a division of Hemisphere Healthcare and Bruce Bongar, Ph.D., of the Pacific Graduate School of Psychology and Stanford University School of Medicine, surveyed 500 psychologists nationwide. Participants were presented with 48 risk factors for suicide and were asked to rate the factors from low importance to critical or high importance.

The most critical risk factors for suicide completion (in order of their seriousness) were: the medical seriousness of previous suicide attempts, history of suicide attempts, acute suicidal ideation, severe hopelessness, attraction to death, family history of suicide, acute overuse of alcohol, and loss/separations. The remaining 40 risk factors all received ratings of "moderate risk". No factors were considered to be of low importance (see attached chart).

Respondents rated the medical seriousness of past attempts and a history of suicide attempts as the two most dangerous risk factors. Regarding family history of suicide attempts, the researchers suggest that it is important to determine how close the patient was to the relative who committed suicide --both biologically and emotionally. Concerning lethality, the seriousness of the suicide risk can be associated with the speed at which the suicide act can cause death. For example, it is more possible to save the life of someone who has experienced blood loss from cutting rather than someone who has hanged himself or herself.

Reference: "Assessing Risk for Completed Suicide in Patients With Major Depression: Psychologists' View of Critical Factors." Nico Peruzzi, Ph.D, and Bruce Bongar, Ph.D., Professional Psychology: Research and Practice, Vol. 30, No. 6.


The American Psychological Association (APA), in Washington, DC, is the largest scientific and professional organization representing psychology in the United States and is the world's largest association of psychologists. APA's membership includes more than 159,000 researchers, educators, clinicians, consultants and students. Through its divisions in 50 subfields of psychology and affiliations with 58 state, territorial and Canadian provincial associations, APA works to advance psychology as a science, as a profession and as a means of promoting human welfare.


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