Cover Image

PAPERBACK
$23.00



View/Hide Left Panel

Risk Factors For Suicide

summary of a workshop

prepared by Sara K.Goldsmith

Board on Neuroscience and Behavioral Health

INSTITUTE OF MEDICINE

NATIONAL ACADEMY PRESS
Washington, D.C.



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement



Below are the first 10 and last 10 pages of uncorrected machine-read text (when available) of this chapter, followed by the top 30 algorithmically extracted key phrases from the chapter as a whole.
Intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text on the opening pages of each chapter. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

Do not use for reproduction, copying, pasting, or reading; exclusively for search engines.

OCR for page R1
Risk Factors for Suicide: Summary of a Workshop Risk Factors For Suicide summary of a workshop prepared by Sara K.Goldsmith Board on Neuroscience and Behavioral Health INSTITUTE OF MEDICINE NATIONAL ACADEMY PRESS Washington, D.C.

OCR for page R1
Risk Factors for Suicide: Summary of a Workshop NATIONAL ACADEMY PRESS 2101 Constitution Avenue, N.W. Washington, DC 20418 NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. Support for this project was provided by the Centers for Disease Control and Prevention, the National Institute of Mental Health, the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism, the Substance Abuse and Mental Health Services Administration and the Veterans Administration. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does the mention of trade names, commercial products, or organizations imply endorsement by the U.S. government. In general, any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project. International Standard Book Number 0-309-07625-0 Additional copies of this report are available for sale from the National Academy Press, 2101 Constitution Avenue, N.W., Box 285, Washington, D.C. 20055. Call (800) 624–6242 or (202) 334–3313 (in the Washington metropolitan area). The full text of this report is available online at http://www.nap.edu. For more information about the Institute of Medicine, visit the IOM home page at: www.iom.edu. Printed in the United States of America. Copyright 2001 by the National Academy of Sciences. All rights reserved. The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin.

OCR for page R1
Risk Factors for Suicide: Summary of a Workshop Knowing is not enough; we must apply. Willing is not enough; we must do. —Goethe INSTITUTE OF MEDICINE Shaping the Future for Health

OCR for page R1
Risk Factors for Suicide: Summary of a Workshop THE NATIONAL ACADEMIES National Academy of Sciences National Academy of Engineering Institute of Medicine National Research Council The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce M.Alberts is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Wm. A.Wulf is president of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Kenneth I.Shine is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce M. Alberts and Dr. Wm. A.Wulf are chairman and vice chairman, respectively, of the National Research Council.

OCR for page R1
Risk Factors for Suicide: Summary of a Workshop Committee on Pathophysiology and Prevention of Adolescent and Adult Suicide WILLIAM E.BUNNEY, JR., M.D., (Co-Chair), University of California, Irvine, California ARTHUR M.KLEINMAN, M.D., (Co-Chair), Harvard University, Cambridge, Massachusetts CARL C.BELL, M.D., Community Mental Health Council and University of Illinois, Chicago, Illinois DAVID A.BRENT, M.D., Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, Pennsylvania LEONA EGGERT, PH.D., FAAN, University of Washington, Seattle, Washington JAN FAWCETT, M.D., Rush Institute for Mental Well-Being, Chicago, Illinois ROBERT D.GIBBONS, PH.D., University of Illinois, Chicago, Illinois KAY REDFIELD JAMISON, PH.D., The Johns Hopkins University School of Medicine, Baltimore, Maryland JILL E.KORBIN, PH.D., Case Western Reserve University, Cleveland, Ohio J.JOHN MANN, M.D., New York State Psychiatric Institute and Columbia University, New York, New York PHILIP A.MAY, PH.D., University of New Mexico, Albuquerque, New Mexico CHARLES F.REYNOLDS, III, M.D., Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, Pennsylvania MING T.TSUANG, M.D., PH.D., Harvard Medical School, Boston, Massachusetts RICHARD G.FRANK, PH.D., (liaison to the Board on Neuroscience and Behavioral Health), Harvard Medical School, Boston, Massachusetts Staff TERRY C.PELLMAR, PH.D., Board Director, NBH SARA K.GOLDSMITH, PH.D., Study Director SANDRA P. AU, Research Associate ALLISON M.PANZER, Project Assistant MIRIAM DAVIS, PH.D., Consultant

OCR for page R1
Risk Factors for Suicide: Summary of a Workshop Board on Neuroscience and Behavioral Health ANN M.GRAYBIEL, PH.D., (Chair), Massachusetts Institute of Technology, Cambridge, Massachusetts KENNETH B.WELLS, M.D., M.P.H., (Vice-Chair), Neuropsychiatric Institute, University of California, Los Angeles, California NANCY E.ADLER, PH.D., University of California, San Francisco, California RICHARD J.BONNIE, LL.B., University of Virginia School of Law, Charlottesville, Virginia WILLIAM E.BUNNEY, M.D., University of California, Irvine, California RICHARD G.FRANK, PH.D., Harvard Medical School, Boston, Massachusetts JEROME KAGAN, PH.D., Harvard University, Cambridge, Massachusetts HERBERT D.KLEBER, M.D., Columbia University and New York State Psychiatric Institute, New York, New York BEVERLY B.LONG, M.S., M.P.H., World Federation for Mental Health, Atlanta, Georgia KATHLEEN R.MERIKANGAS, PH.D., Yale University, New Haven, Connecticut STEVEN M.MIRIN, M.D., American Psychiatric Association, Washington, D.C. STEVEN M.PAUL, M.D., Lilly Research Laboratories, Indianapolis, Indiana DAVID REISS, M.D., George Washington University Medical Center, Washington, D.C. RHONDA J.ROBINSON-BEALE, M.D., Blue Cross/Blue Shield of Michigan, Southfield, Michigan STEPHEN WAXMAN, M.D., PH.D., Yale Medical School, New Haven, Connecticut NANCY S.WEXLER, PH.D., Columbia University, New York, New York ANNE B.YOUNG, M.D., PH.D., Massachusetts General Hospital, Boston, Massachusetts Staff TERRY C.PELLMAR, PH.D., Director CAROLE A.CHRVALA, M.A., PH.D., Senior Program Officer SARA K.GOLDSMITH, PH.D., Senior Program Officer JANET E.JOY, PH.D., Senior Program Officer SANDRA P.AU, Research Associate ALLISON L.FRIEDMAN, Research Assistant LORA K.TAYLOR, Administrative Assistant AMELIA MATHIS, Project Assistant ALLISON M.PANZER, Project Assistant

OCR for page R1
Risk Factors for Suicide: Summary of a Workshop Reviewers This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the NRC’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report: CARL C.BELL, Community Mental Health Council, University of Illinois, Chicago, Illinois JAN FAWCETT, Rush Institute for Mental Well-Being, Rush-Presbyterian-St. Luke’s Medical Center, Chicago, Illinois DAVID A.JOBES, Department of Psychology, the Catholic University of America, Washington, D.C. GREGORY A.ORDWAY, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations nor did they see the final draft of the report before its release. The review of this report was overseen by John Kalafat, Graduate School of Professional Psychology, Rutgers University. Appointed by the National Research Council and Institute of Medicine, he was responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authors and the institution.

OCR for page R1
Risk Factors for Suicide: Summary of a Workshop This page in the original is blank.

OCR for page R1
Risk Factors for Suicide: Summary of a Workshop Contents     Introduction   1     Epidemiology of Suicide   1     Issues in Measurement of Suicide Risk Factors in Adults   4     Issues in Measurement of Suicide Risk Factors in Youth   5     Social and Cultural Factors in Suicide Risk   8     Neurobiology of Teenage and Adult Suicide: Possible Biological Markers for Identification of Suicidal Patients   10     Strategies to Identify Genes for Complex Diseases   11     Neurobiological Consequences of Childhood Abuse and Neglect   13     Association of Early Physical or Sexual Abuse with Suicide Attempts in Bipolar Illness   15     Psychologic Factors in Suicide   16     APPENDIXES     A   Agenda   19 B   Workshop Speakers   21

OCR for page R1
Risk Factors for Suicide: Summary of a Workshop This page in the original is blank.

OCR for page R1
Risk Factors for Suicide: Summary of a Workshop Risk Factors for Suicide

OCR for page R1
Risk Factors for Suicide: Summary of a Workshop This page in the original is blank.