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Apples to oranges?: A direct comparison between suicide attempters and suicide completers
Open accessAbstract
Background Suicide attempters and completers may represent different but overlapping groups of distressed individuals. Although depression is related to an increased risk of suicide, the presence of depression may not discriminate suicide attempters from completers. The present study compared suicide attempters and suicide completers on symptoms of depression, the presence of suicide-related variables and stressful life events.Aims The present study sought to identify the key differences between 50 suicide attempters and 50 completers, all diagnosed with a Major Depressive Disorder at the time of their suicidal act.Methods Suicide attempters and family member informants of suicide completers participated in a thorough psychosocial evaluation. To maximize comparisons with completers, suicide attempters were subclassified based on the lethality of their attempt.Results Suicide attempters and completers were similar on most measures of depressive symptoms. However, suicide completers were significantly more likely to use alcohol or drugs prior to their suicidal act and they were more likely to leave a suicide note. Suicide completers were significantly more likely to have encountered significant job stress and financial problems.Conclusions The present findings have documented several similarities and differences between suicide attempters and suicide completers. Future research may help to clarify the key warning signs that reflect the risk of completed suicide in adults who have been diagnosed with a Major Depressive Disorder.
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“In contrast, financial- and employment-related stress may be most relevant for predicting suicide in middle adulthood (DeJong et al. 2010; Innamorati et al. 2008), while health-related events and difficulties may play a more central role in suicide for older adults, particularly through their effects on cognitive-affective states like perceived burdensomeness (e.g., Cukrowicz et al. 2011).”
From Life stress and suicide in adolescents (2019) · cites this paper as DeJong et al. 2010
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National total Survey of German adolescent Suicide in Prison
Radeloff, D., Lempp, T., Herrmann, E. M., Kettner, M., Bennefeld-Kersten, K., & Freitag, C. M. (2014) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-014-0568-1 · Cited by 25
DeJong, T. M., & Overholser, J. C. (2009) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.2009.39.1.38 · Cited by 25
Self-citationSuzuki, E., Kashima, S., Kawachi, I. I., & Subramanian, S. V. (2013) · PLoS ONE · doi:10.1371/journal.pone.0063443 · Cited by 24
“It is important to realize that despite some similarities [54], suicide attempters and completers in Japan would have significant demographic, personality, and clinical differences [55].”
BackgroundSquassina, A., Manchia, M., Chillotti, C., Deiana, V., Congiu, D., Paribello, F., Roncada, P., Soggiù, A., Piras, C., Urbani, A., et al. (2013) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145713000655 · Cited by 24
“Studies comparing suicide completers and attempters have shown that these two groups of subjects have not only many clinical and demographic similarities but also important differences (Linehan, 1986; Beautrais, 2001, 2002; Fushimi et al., 2006; DeJong et al., 2010).”
BackgroundChávez‐Hernández, A., & García, L. F. M. (2015) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12166 · Cited by 24
An Examination of Suicide Attempts Among Incarcerated Sex Offenders
Jeglic, E. L., Spada, A. H., & Mercado, C. C. (2012) · Sexual Abuse · doi:10.1177/1079063212447201 · Cited by 24
Alcohol use and suicide proneness in college students: a proposed model
Lamis, D. A., Malone, P. S., & Jahn, D. R. (2013) · Mental Health and Substance Use · doi:10.1080/17523281.2013.781535 · Cited by 24
Feigelman, W. T., Joiner, T. E., Rosen, Z., & Silva, C. (2015) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12183 · Cited by 23
“…and depression from coroner’s records found that suicide decedents were more likely than other decedents to use alcohol or drugs prior to death, more likely to leave suicide notes, and more likely to have previously encountered significant job stress and financial problems (DeJong et al., 2010).”
BackgroundDai, Q., Wang, D., Wang, J., Xu, H., Andriescue, E. C., Wu, H. E., Xiu, M., Chen, D., & Zhang, X. (2020) · Brazilian Journal of Psychiatry · doi:10.1590/1516-4446-2020-0900 · Cited by 22
Blomdahl, C., Guregård, S., Rusner, M., & Wijk, H. (2021) · Art Therapy · doi:10.1080/07421656.2021.1922328 · Cited by 25
“Persons affected by depression have an enhanced risk of committing suicide (DeJong et al., 2010).”
BackgroundBarker, J., Oakes-Rogers, S., & Leddy, A. (2022) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2022.07.048 · Cited by 24
Rodríguez, A. D., Herdoiza-Arroyo, P. E., Martínez-Arriaga, R. J., Valerio, E. B., Mollá, J. M., la Rosa-Gómez, A. D., Farfallini, L., Jiménez, M. J. H., Esquivel-Santoveña, E. E., Ramírez-Martínez, F. R., et al. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.749236 · Cited by 23
Suicides and medically serious attempters are of the same population in Chinese rural young adults
Zhang, J., Sun, L., Conwell, Y., Qin, P., Jia, C.-X., Xiao, S., & Tu, X. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.02.005 · Cited by 20
“In illustrating the fact that suicide attempters and completers represented different but overlapping groups of distressed individuals, DeJong et al. (2010) identified several similarities and differences between suicide attempters and suicide completers from a US sample.”
BackgroundAfzali, M. H., Sunderland, M., Batterham, P. J., Carragher, N., & Slade, T. (2017) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867416683815 · Cited by 19
“Although non-fatal suicidal behaviours are reported as important risk factors of suicide deaths, some differences exist between fatal and non-fatal suicidal behaviours (DeJong et al., 2010).”
BackgroundDewar, C., Heggs, D. A., & Davies, J. (2021) · Archives of Suicide Research · doi:10.1080/13811118.2021.1939207 · Cited by 21
Dissociation et passage à l’acte violent : une revue de littérature
Vandevoorde, J., & Borgne, P. L. (2014) · L Évolution Psychiatrique · doi:10.1016/j.evopsy.2014.09.002 · Cited by 18
Switching Suicide Methods in Order to Achieve Lethality: A Study of Greek Suicide Victims
Paraschakis, A., Michopoulos, I., Douzenis, A., Christodoulou, C., Lykouras, L., & Koutsaftis, F. (2013) · Death Studies · doi:10.1080/07481187.2013.780111 · Cited by 19
“already mentioned in the literature (DeJong et al., 2009; Runeson et al., 2010).”
BackgroundWang, Y., Bhaskaran, J., Sareen, J., Wang, J., Spiwak, R. P., & Bolton, J. M. (2015) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000000320 · Cited by 16
“Given that some past research has indicated that suicide attempters and suicide completers are two very distinct groups of people who exhibit differential characteristics (DeJong et al., 2010; Fischer et al., 2003; Harris and Barraclough, 1997), it is possible, for example, that the items that did not contribute to ou…”
ResultCharacteristics of suicide completers and attempters in rural Chinese population
Liu, B.-P., Liu, X., & Jia, C.-X. (2016) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2016.07.005 · Cited by 19
Proteomic profiling of postmortem prefrontal cortex tissue of suicide completers
Kim, M. J., Do, M., Han, D., Son, M., Shin, D., Yeo, I., Yun, Y. H., Yoo, S. H., Choi, H. J., Shin, D., et al. (2022) · Translational Psychiatry · doi:10.1038/s41398-022-01896-z · Cited by 15
“, suicide attempters or patients with mood disorders), whose characteristics may differ from those of suicide completers [16, 17].”
BackgroundSuzuki, E., Kashima, S., Kawachi, I. I., & Subramanian, S. V. (2014) · European Journal of Public Health · doi:10.1093/eurpub/cku023 · Cited by 15
Langhinrichsen‐Rohling, J., Snarr, J. D., Slep, A. M. S., & Heyman, R. E. (2019) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000435 · Cited by 16
A 2-Year Psychological Autopsy Study of Completed Suicides in the Athens Greater Area, Greece
Paraschakis, A., Michopoulos, I., Christodoulou, C., Koutsaftis, F., Lykouras, L., & Douzenis, A. (2015) · Psychiatry Investigation · doi:10.4306/pi.2015.12.2.212 · Cited by 14
Comparison of Suicide Attempters and Decedents in the U.S. Army: A Latent Class Analysis
Skopp, N. A., Smolenski, D. J., Sheppard, S. C., Bush, N. E., & Luxton, D. D. (2016) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12227 · Cited by 14
Reshetukha, T., Alavi, N., Prost, E., Kirkpatrick, R. H., Sajid, S., Patel, C. B., & Groll, D. (2018) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2018.03.001 · Cited by 14
Wee, L.-H., Ibrahim, N., Wahab, S. B., Visvalingam, U., Yeoh, S. H., & Siau, C. S. (2018) · OMEGA - Journal of Death and Dying · doi:10.1177/0030222818814331 · Cited by 15
An oversimplification of psychosis, its treatment, and its outcomes?
PETERS, E. R. (2014) · The British Journal of Psychiatry · doi:10.1192/bjp.205.2.159a · Cited by 17
Rethinking suicides as mental accidents: towards a new paradigm
Ajdacic-Gross, V., Hepp, U., Seifritz, E., & Bopp, M. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.04.022 · Cited by 13
O’Donnell, S., Egan, T., Clarke, N., & Richardson, N. (2024) · BMC Public Health · doi:10.1186/s12889-024-18483-0 · Cited by 18
“Indeed, work stress and financial problems were more associated with individuals diagnosed with depression who died by suicide compared to those who attempted suicide [64].”
BackgroundPersons, J. E., Lodder, P., Coryell, W. H., Nürnberger, J. I., & Fiedorowicz, J. G. (2021) · Psychiatry Research · doi:10.1016/j.psychres.2021.114296 · Cited by 13
A systematic review of evidence-based aftercare for older adults following self-harm
Wand, A. P. F., Browne, R., Jessop, T., & Peisah, C. (2022) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/00048674211067165 · Cited by 14
“Although there may be important distinctions between people who die by suicide and those who attempt suicide and survive (DeJong et al., 2010), insights from those who have self-harmed may inform what is helpful in terms of aftercare.”
BackgroundLin, C., Huang, C., Karim, H. T., Liu, H., Lee, T. M.-C., Wu, C. W., Toh, C., Tsai, Y., Yen, T., & Lee, S. (2020) · Neurobiology of Aging · doi:10.1016/j.neurobiolaging.2020.12.016 · Cited by 12
Metadata
- Authors
- DeJong, T. M., Overholser, J. C., & Stockmeier, C. A.
- Affiliations
- Case Western Reserve University (US)
- University of Mississippi Medical Center (US)
- Corresponding author
- Overholser, James C.
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2010-07
- Volume
- 124
- Issue
- 1-2
- Pages
- 90-97
- ISSN
- 0165-0327 (ISSN-L)
- PMC
- PMC2875283
- OpenAlex
- W2089168194
- Cited by
- 198
- References
- 52
- Citations by year
- 2026: 4 · 2025: 15 · 2024: 15 · 2023: 8 · 2022: 11 · 2021: 16 · 2020: 10 · 2019: 14 · 2018: 16 · 2017: 6 · 2016: 12 · 2015: 18 · 2014: 22 · 2013: 13 · 2012: 10
- FWCI
- 6.38
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5p20rr017701-10)
- National Institute of Mental Health (R01MH067996, MH67996)
- National Center for Research Resources (P20-RR-017701)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Keywords
- suicide attempters, suicide completers, major depressive disorder, depression, suicide risk, life events, occupational stress, financial problems, alcohol and drug use, suicide notes
- MeSH terms
- Adolescent, Adult, Alcohol Drinking, Cause of Death, Depressive Disorder, Major, Major Depressive Disorder, Female, Humans, Life Change Events, Male, Middle Aged, Retrospective Studies, Risk, Suicide, Suicide, Attempted, Writing, Substance-Related Disorders, Young Adult
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