Clinical epidemiology of suicide.

The epidemiologic identification of risk factors for suicide attempts and suicide deaths is important to clinical decision making and preventive public health efforts. The risk factors for suicide attempts include female sex, a recent stressful life event, methods of low lethality, impulsivity, and previous attempts. Risk factors for suicide deaths include a family history of suicide, male sex, and a psychiatric disorder. Suicide deaths in the "youth" birth cohort increased nearly 150% between 1960 and 1980. The term "youth" refers to those in the transitional period from adolescence to adulthood--roughly, between the ages of 18 and 30 years. An increase in substance abuse and in depressive disorders in this group paralleled the increase in suicide incidence. A novel, but frightening, tendency also noted in this group was social contagion--evidenced by clusters of suicides "mimicking" the suicide method and creating mini-epidemics.