Abstract
Suicide rates are rising almost everywhere in the west; 3,500 Canadians currently take their lives each year. The causes are complex: conditions in society interact with individual life situations as well as with emotional disturbance, particularly depression. The family doctor has a role to play at primary, secondary and tertiary levels of prevention. As a group, doctors can press for social action aimed at influencing conditions rooted in society, but doctors act most effectively in their own offices when they routinely consider depression and suicide potential in their patients. The article suggests how this may be done and how suicidal thinking and behavior may be managed.
Full text
PDF




Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Barnes R. A., Braseliten C., Lippman D. H., Siegel L. A team approach to the problem of parasuicide in downtown Toronto. Can J Public Health. 1979 Jul-Aug;70(4):261–265. [PubMed] [Google Scholar]
- Barraclough B., Bunch J., Nelson B., Sainsbury P. A hundred cases of suicide: clinical aspects. Br J Psychiatry. 1974 Oct;125(0):355–373. doi: 10.1192/bjp.125.4.355. [DOI] [PubMed] [Google Scholar]
- Black D., Pond D. A. After the suicide attempt. Lancet. 1980 Oct 18;2(8199):867–868. doi: 10.1016/s0140-6736(80)90222-6. [DOI] [PubMed] [Google Scholar]
- Black D., Pond D. Management of patients after self-poisoning. Br Med J. 1980 Oct 25;281(6248):1141–1141. doi: 10.1136/bmj.281.6248.1141-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Blake D., Bramble M. G. Management of self-poisoned patients in hospital. Br Med J. 1978 Dec 23;2(6154):1788–1788. doi: 10.1136/bmj.2.6154.1788. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Brahma R. K. Policies on self-poisoning. Br Med J. 1979 Dec 15;2(6204):1583–1584. doi: 10.1136/bmj.2.6204.1583-d. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cain A. C., Fast I. Children's disturbed reactions to parent suicide. Am J Orthopsychiatry. 1966 Oct;36(5):873–880. doi: 10.1111/j.1939-0025.1966.tb02416.x. [DOI] [PubMed] [Google Scholar]
- Fieldsend R. C. Management of self-poisoned patients. Br Med J. 1979 Aug 25;2(6188):498–498. doi: 10.1136/bmj.2.6188.498-b. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gardner R., Hanka R., Evison B., Mountford P. M., O'Brien V. C., Roberts S. J. Consultation-liaison scheme for self-poisoned patients in a general hospital. Br Med J. 1978 Nov 18;2(6149):1392–1394. doi: 10.1136/bmj.2.6149.1392. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gardner R., Hanka R., O'Brien V. C., Page A. J., Rees R. Psychological and social evaluation in cases of deliberate self-poisoning admitted to a general hospital. Br Med J. 1977 Dec 17;2(6102):1567–1570. doi: 10.1136/bmj.2.6102.1567. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gardner R., Hanka R., Roberts S. J., Allon-Smith J. M., Kings A. A., Nicholson R. Psychological and social evaluation in cases of deliberate self-poisoning seen in an accident department. Br Med J (Clin Res Ed) 1982 Feb 13;284(6314):491–493. doi: 10.1136/bmj.284.6314.491. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Goldney R. D. Management of suicide risk. Br J Psychiatry. 1980 Sep;137:303–303. doi: 10.1192/bjp.137.3.303c. [DOI] [PubMed] [Google Scholar]
- Greer S., Bagley C. Effect of psychiatric intervention in attempted suicide: a controlled study. Br Med J. 1971 Feb 6;1(5744):310–312. doi: 10.1136/bmj.1.5744.310. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hassall C., Trethowan W. H. Suicide in Birmingham. Br Med J. 1972 Mar 18;1(5802):717–718. doi: 10.1136/bmj.1.5802.717. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Havens L. L. Recognition of suicidal risks through the psychologic examination. N Engl J Med. 1967 Jan 26;276(4):210–215. doi: 10.1056/NEJM196701262760405. [DOI] [PubMed] [Google Scholar]
- Hawton K., Gath D., Smith E. Management of attempted suicide in Oxford. Br Med J. 1979 Oct 27;2(6197):1040–1042. doi: 10.1136/bmj.2.6197.1040. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kaplan R. D., Kottler D. B., Frances A. J. Reliability and rationality in the prediction of suicide. Hosp Community Psychiatry. 1982 Mar;33(3):212–215. doi: 10.1176/ps.33.3.212. [DOI] [PubMed] [Google Scholar]
- Kennedy P. Efficacy of a regional poisoning treatment centre in preventing further suicidal behaviour. Br Med J. 1972 Nov 4;4(5835):255–257. doi: 10.1136/bmj.4.5835.255. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kreitman N. Reflections on the management of parasuicide. Br J Psychiatry. 1979 Sep;135:275–277. doi: 10.1192/bjp.135.3.275. [DOI] [PubMed] [Google Scholar]
- Kreitman N. The coal gas story. United Kingdom suicide rates, 1960-71. Br J Prev Soc Med. 1976 Jun;30(2):86–93. doi: 10.1136/jech.30.2.86. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lester D., Murrell M. E. The influence of gun control laws on suicidal behavior. Am J Psychiatry. 1980 Jan;137(1):121–122. doi: 10.1176/ajp.137.1.121. [DOI] [PubMed] [Google Scholar]
- Management of patients after self-poisoning. Br Med J. 1980 Nov 15;281(6251):1347–1348. doi: 10.1136/bmj.281.6251.1347-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Munro A. Psychological evaluation in cases of self-poisoning. Br Med J. 1978 Feb 18;1(6110):440–441. doi: 10.1136/bmj.1.6110.440-c. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Murphy G. E. Suicide and the right to die. Am J Psychiatry. 1973 Apr;130(4):472–473. doi: 10.1176/ajp.130.4.472. [DOI] [PubMed] [Google Scholar]
- Oliver R. G., Hetzel B. S. Rise and fall of suicide rates in Australia: relation to sedative availability. Med J Aust. 1972 Oct 21;2(17):919–923. [PubMed] [Google Scholar]
- Ovenstone I. M. Spectrum of suicidal behaviours in Edinburgh. Br J Prev Soc Med. 1973 Feb;27(1):27–35. doi: 10.1136/jech.27.1.27. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Priest R. G. Recognition of the suicidal patient. J Int Med Res. 1977;5(1 Suppl):157–163. [PubMed] [Google Scholar]
- ROBINS E., MURPHY G. E., WILKINSON R. H., Jr, GASSNER S., KAYES J. Some clinical considerations in the prevention of suicide based on a study of 134 successful suicides. Am J Public Health Nations Health. 1959 Jul;49(7):888–899. doi: 10.2105/ajph.49.7.888. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rudestam K. E. Physical and psychological responses to suicide in the family. J Consult Clin Psychol. 1977 Apr;45(2):162–170. doi: 10.1037//0022-006x.45.2.162. [DOI] [PubMed] [Google Scholar]
- Shepherd D. M., Barraclough B. M. The aftermath of parental suicide for children. Br J Psychiatry. 1976 Sep;129:267–276. doi: 10.1192/bjp.129.3.267. [DOI] [PubMed] [Google Scholar]
- Shepherd D., Barraclough B. M. The aftermath of suicide. Br Med J. 1974 Jun 15;2(5919):600–603. doi: 10.1136/bmj.2.5919.600. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Termansen P. E., Bywater C. S.A.F.E.R.: a follow-up service for attempted suicide in Vancouver. Can Psychiatr Assoc J. 1975 Feb;20(1):29–34. doi: 10.1177/070674377502000106. [DOI] [PubMed] [Google Scholar]
- Turner R. J., Morgan H. G. Patterns of health care in non-fatal deliberate self-harm. Psychol Med. 1979 Aug;9(3):487–492. doi: 10.1017/s0033291700032037. [DOI] [PubMed] [Google Scholar]
- West J. Psychological evalation in cases of self-poisoning. Br Med J. 1978 May 20;1(6123):1345–1346. doi: 10.1136/bmj.1.6123.1345-c. [DOI] [PMC free article] [PubMed] [Google Scholar]
