Comments: Is America Using Suicide As A Scare Tactic?
Where did you come up with the "30,000 suicides per year" figure?
Posted by Jon S. at November 20, 2007 04:34 AM
I wonder if your five-to-seven per cent suicide rate among people with bipolar and schizophrenia includes iatrogenically caused suicide by drug reaction? I know the difference, having watched my son have 100% illness-related suicidality as a person with bipolar, and my daughter, who had drug-induced suicidality triggered by both Lexapro and Lamictal - with results lingering for months. We know there at least WERE a goodly number of SSRI suicides as the law firms have been kept busy, and some number of the same with the atypicals. I wonder how these numbers parse out...50% from the illness, 50% from the drugs?
Posted by Sprrpwgi; at November 20, 2007 05:48 AM
I agree they scare us onto meds, and I think I'd sooner buy the 5-7% but the statistic I'm most curious about is attempted suicides. I know that's harder, almost impossible to track. The 30,000 a year if attempts were included would jump significantly I suspect. Triple perhaps or more? I mean I know a fair amount that weren't successful. Cough cough. That percentage might be more of a number that would scare people onto meds or to stay on them. I know I'm scared to come off my meds due to suicidal ideation that still persists off and on while on medications, but now it's manageable. The lithium has what like a 9 times reduction of chance of suicide?
Posted by Nathaniel at November 20, 2007 06:01 AM
Your guesstimate is pretty good. Here are data for suicide in patients with depression. The old number one still sees thrown around of 15% lifetime suicide risk is no longer accepted.
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Citation 1. Unique Identifier 11097952
Authors Bostwick JM. Pankratz VS.
Institution Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA. bostwick.john@mayo.edu
Title Affective disorders and suicide risk: a reexamination.[see comment].
Comments
Comment in: Am J Psychiatry. 2001 Nov;158(11):1934-5; PMID: 11691715, Comment in: Am J Psychiatry. 2001 Nov;158(11):1934; author reply 1935; PMID: 11691716
Source American Journal of Psychiatry. 157(12):1925-32, 2000 Dec.
Abstract
OBJECTIVE: In 1970, Guze and Robins published a meta-analysis of suicide in patients with affective illness that inferred a lifetime risk of 15%. Since then, this figure has been generalized to all depressive disorders and cited uncritically in many papers and textbooks. The authors argue for an alternative estimate of suicide risk and question the generalizability of the Guze and Robins estimate. METHOD: The authors sorted studies obtained through a literature search that included data pertaining to suicide occurrence in affective illness into one of three groups: outpatients, inpatients, or suicidal inpatients. Suicide risks were calculated meta-analytically for these three groups, as well as for two previously published collections. RESULTS: There was a hierarchy in suicide risk among patients with affective disorders. The estimate of the lifetime prevalence of suicide in those ever hospitalized for suicidality was 8.6%. For affective disorder patients hospitalized without specification of suicidality, the lifetime risk of suicide was 4.0%. The lifetime suicide prevalence for mixed inpatient/outpatient populations was 2.2%, and for the nonaffectively ill population, it was less than 0.5%. CONCLUSIONS: The percentage of subjects dead due to suicide (case fatality prevalence) is a more appropriate estimate of suicide risk than the percentage of the dead who died by suicide (proportionate mortality prevalence). More important, it is well established that patients with affective disorders suffer a higher risk of suicide relative to the general population. However, no risk factor, including classification of diagnostic subtype, has been reliably shown to predict suicide. This article demonstrates a hierarchy of risk based on the intensity of the treatment setting. Given that patients with a hospitalization history, particularly when suicidal, have a much elevated suicide prevalence over both psychiatric outpatients and nonpatients, the clinical decision to hospitalize in and of itself appears to be a useful indicator of increased suicide risk.
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Posted by Bernard Carroll at November 20, 2007 06:21 AM
that comes from the cdc/natl ctr for health stats.
Posted by Philip Dawdy at November 20, 2007 09:46 AM
You need to weigh suicides or attempted suicides while on meds against the self-damaging behavior (not necessary physical self-damage) that occurs with the subjects who are not meds but who ought to be. I define self-damaging behavior broadly to include bad judgment, failure to appreciate harm to oneself, etc.
Posted by Red Rover at November 20, 2007 03:14 PM
Red Rover, I really don't think we can consider "bad judgement" to be a symptom of mental illness. Ditto "failure to appreciate harm." What about the smokers? Kentucky Fried Chicken diners? Gamblers? Fat people? People who drive too fast? Don't wear seatbelts? This is Big Pharma's wet dream: 100% of the population being diagnosable.
Posted by Francesca Allan at November 22, 2007 08:12 AM
I agree that the numbers are WAY off. However, I think the idea of "scaring people onto their meds" with the whole suicide aspect is somewhat true (despite the ridiculous number). From my perspective, no statistic needs to scare me onto my meds (but I must admit that the percentage stat for those suffering from bipolar is scary); decreases in dosage are enough to send me into a tailspin.
As I contemplate tapering off of Lamictal (which I have tried in the past), I face the challenge of battling an onslaught of suicidal thoughts. Even a 50 mg drop (from 200 to 150) had me going nuts. This prompted a "smackdown" from my psych and an increase in dosage at which the thoughts abated.
This is what scares many people onto their meds. Trying to come of their drug(s) only to find that they are plagued with suicidal thoughts that they may have never experienced before or had subsided to a small degree. (The latter has been my experience.) As a result, people become addicted to their meds. Why experience suicidal thoughts in an attempt to come off the drug when you can simply remain on the drug and keep the thoughts away?
This is the conundrum those who want to tape off face. Brave are the souls who take the risk (literally with their lives) to battle the thoughts and come off the drug successfully. I hope I can be one of those someday.
Posted by Marissa at January 13, 2009 06:48 AM