The duration of the suicidal process: how much time is left for intervention between consideration and accomplishment of a suicide attempt?

Eberhard A Deisenhammer, Chy-Meng Ing, Robert Strauss, Georg Kemmler, Hartmann Hinterhuber, Elisabeth M Weiss
Journal of Clinical Psychiatry 2009, 70 (1): 19-24

OBJECTIVE: A history of suicide attempts is a major predictive factor for completed suicide with repeated self-harm constituting a particularly high risk. This study was undertaken to investigate suicide attempters' reports on the length of the period between consideration and accomplishment of a suicide attempt.

METHOD: Eighty-two patients referred to a psychiatric university hospital after a suicide attempt were approached within 3 days after the act. A semistructured interview focusing on the duration and related aspects of the suicidal process, the Barratt Impulsiveness Scale, the Beck Suicide Intent Scale, and the Montgomery-Asberg Depression Rating Scale were administered. Data were collected from July 2004 to December 2005.

RESULTS: Nearly half of the patients (47.6%; N = 39) reported that the period between the first current thought of suicide and the actual attempt had lasted 10 minutes or less. Those patients in which this process had taken longer showed a higher suicidal intent (p < .001). Impulsivity was not associated with the duration of the suicidal process. Although the majority of the patients were alone during the suicidal process, 76.8% (N = 63) reported having had any kind of interpersonal contact.

CONCLUSION: The process from the emergence of suicidal thoughts to the accomplishment of a suicide attempt, and thus the time for intervention, generally is short. However, in a considerable number of suicide attempters, there is at least some readiness for interpersonal contact with partner, family, or friends. Professional helpers appear to have limited potential for intervention during this phase. Thus, spreading information on signs of suicidality and interventional measures among the general population should be incorporated into suicide prevention strategies.

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