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Chapter 9 - Suicidal Ideation and Self-Harm

Published online by Cambridge University Press:  14 October 2021

Anne M. Doherty
Affiliation:
University College Dublin
Aoife M. Egan
Affiliation:
Division of Endocrinology and Metabolism, Mayo Clinic, Minnesota, USA
Sean Dinneen
Affiliation:
School of Medicine, National University of Ireland, Galway
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Summary

Suicide is a leading cause of death in many Western countries. Suicidal ideation and behaviours can be symptoms of depression, but they are also seen in people with other mental health problems, such as bipolar affective disorder, psychosis, substance abuse disorders and adjustment disorders. They are also seen in people who present with psychological distress rather than any diagnosable mental disorder. The consequences of suicidal acts may be especially serious in people with diabetes given the accessibility of lethal means on the one hand, but also the heightened risk of developing complications in cases of severe self-neglect due to a more passive death wish on the other. In Chapter 2, we discussed the relationship between depression and endocrine disorders. Although depression is associated with suicidal ideations and behaviours, it will be these symptoms rather than a diagnosis of mood disorder that are the focus of this chapter.

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Publisher: Cambridge University Press
Print publication year: 2021

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References

WHO. The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. World Health Organization, 1992.Google Scholar
Robins, E, Murphy, GE, Wilkinson, RH 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; 49 (7): 888–99.Google Scholar
Qin, P. The impact of psychiatric illness on suicide: differences by diagnosis of disorders and by sex and age of subjects. J Psychiatr Res. 2011; 45(11): 1445–52.Google Scholar
Shahtahmasebi, S. Suicides by mentally ill people. ScientificWorldJournal. 2003; 3: 684–93.Google Scholar
Bowers, L, Banda, T, Nijman, H. Suicide inside: a systematic review of inpatient suicides. J Nerv Ment Dis. 2010; 198(5): 315–28.CrossRefGoogle ScholarPubMed
Srivastava, A. Psychological attributes and socio-demographic profile of hundred completed suicide victims in the state of Goa, India. Indian J Psychiatry. 2013; 55(3): 268–72.Google Scholar
Parra Uribe, I, Blasco-Fontecilla, H, Garcia-Pares, G, Giro Batalla, M, Llorens Capdevila, M, Cebria Meca, A, et al. Attempted and completed suicide: not what we expected? J Affect Disord. 2013; 150(3): 840–6.Google Scholar
Giner, L, Blasco-Fontecilla, H, Mercedes Perez-Rodriguez, M, Garcia-Nieto, R, Giner, J, Guija, JA, et al. Personality disorders and health problems distinguish suicide attempters from completers in a direct comparison. J Affect Disord. 2013; 151(2): 474–83.Google Scholar
Mohan, C, Tembo, V, McNicholas, B, Doherty, AM. Defining high risk by clinical lethality: the different characteristics and management of the survivors of serious self-injury admitted to critical care, compared with lower lethality self-injury. Gen Hosp Psychiatry. 2020; 64: 131–2.Google Scholar
Snoek, FJ, Pouwer, F, Welch, GW, Polonsky, WH. Diabetes-related emotional distress in Dutch and U.S. diabetic patients: cross-cultural validity of the problem areas in diabetes scale. Diabetes Care. 2000; 23(9): 1305–9.Google Scholar
NICE. Self-Harm. Quality Standard [QS34]. National Institute for Health and Care Excellence, 2013.Google Scholar
Doshi, A, Boudreaux, ED, Wang, N, Pelletier, AJ, Camargo, CA Jr. National study of US emergency department visits for attempted suicide and self-inflicted injury, 1997–2001. Ann Emerg Med. 2005; 46(4): 369–75.Google Scholar
Fegan, J, Doherty, AM. Adjustment disorder and suicidal behaviours presenting in the general medical setting: a systematic review. Int J Environ Res Public Health. 2019; 16(16): 2967.Google Scholar
Roberts, SE, Goldacre, MJ, Neil, HA. Mortality in young people admitted to hospital for diabetes: database study. BMJ. 2004; 328(7442): 741–2.Google Scholar
Roy, A, Roy, M, Janal, M. Suicide attempts and ideation in African-American type 1 diabetic patients. Psychiatry Res. 2010; 179(1): 53–6.Google Scholar
Lofman, S, Hakko, H, Mainio, A, Timonen, M, Rasanen, P. Characteristics of suicide among diabetes patients: a population based study of suicide victims in northern Finland. J Psychosom Res. 2012; 73(4): 268–71.CrossRefGoogle ScholarPubMed
Pompili, M, Forte, A, Lester, D, Erbuto, D, Rovedi, F, Innamorati, M, et al. Suicide risk in type 1 diabetes mellitus: a systematic review. J Psychosom Res. 2014; 76(5): 352–60.Google Scholar
Petit, JM, Goueslard, K, Chauvet-Gelinier, JC, Bouillet, B, Vergès, B, Jollant, F, Quantin, C. Association between hospital admission for ketoacidosis and subsequent suicide attempt in young adults with type 1 diabetes. Diabetologia. 2020; 63: 1745–52.Google Scholar
Russell, KS, Stevens, JR, Stern, TA. Insulin overdose among patients with diabetes: a readily available means of suicide. Prim Care Companion J Clin Psychiatry. 2009; 11(5): 258–62.Google Scholar
von Mach, MA, Meyer, S, Omogbehin, B, Kann, PH, Weilemann, LS. Epidemiological assessment of 160 cases of insulin overdose recorded in a regional poisons unit. Int J Clin Pharmacol Ther. 2004; 42(5): 277–80.Google Scholar
Kjaerulff, M, Astrup, BS. Sudden death due to diabetic ketoacidosis following power failure of an insulin pump: autopsy and pump data. J Forensic Leg Med. 2019; 63: 34–9.Google Scholar
Boileau, P, Aboumrad, B, Bougneres, P. Recurrent comas due to secret self-administration of insulin in adolescents with type 1 diabetes. Diabetes Care. 2006; 29(2): 430–1.CrossRefGoogle ScholarPubMed
JBDS, RCPsych. The Management of Diabetes in Adults and Children with Psychiatric Disorders in Inpatient Settings. Joint British Diabetes Societies and Royal College of Psychiatrists, 2017.Google Scholar
Umpierrez, G, Korytkowski, M. Diabetic emergencies – ketoacidosis, hyperglycaemic hyperosmolar state and hypoglycaemia. Nat Rev Endocrinol. 2016; 12(4): 222–32.Google Scholar
Williams, G. What goes around, comes around. Lancet. 2012; 379(9833): 2235–6.Google Scholar
Bryden, KS, Dunger, DB, Mayou, RA, Peveler, RC, Neil, HA. Poor prognosis of young adults with type 1 diabetes: a longitudinal study. Diabetes Care. 2003; 26(4): 1052–7.Google Scholar
Pelizza, L, Pupo, S. Brittle diabetes: psychopathology and personality. J Diabetes Complications. 2016; 30(8): 1544–7.Google Scholar
Garrett, CJ, Choudhary, P, Amiel, SA, Fonagy, P, Ismail, K. Recurrent diabetic ketoacidosis and a brief history of brittle diabetes research: contemporary and past evidence in diabetic ketoacidosis research including mortality, mental health and prevention. Diabet Med. 2019; 36(11): 1329–35.Google Scholar
Goldston, DB, Kelley, AE, Reboussin, DM, Daniel, SS, Smith, JA, Schwartz, RP, et al. Suicidal ideation and behavior and noncompliance with the medical regimen among diabetic adolescents. J Am Acad Child Adolesc Psychiatry. 1997; 36(11): 1528–36.Google Scholar
Binks, CA, Fenton, M, McCarthy, L, Lee, T, Adams, CE, Duggan, C. Psychological therapies for people with borderline personality disorder. Cochrane Database Syst Rev. 2006; (1): CD005652.Google Scholar
Oldham, JM. Borderline personality disorder and suicidality. Am J Psychiatry. 2006; 163(1): 20–6.Google Scholar
Leichsenring, F, Leibing, E, Kruse, J, New, AS, Leweke, F. Borderline personality disorder. Lancet. 2011; 377(9759): 7484.Google Scholar
Attwood, J, Wilkinson-Tough, M, Lambe, S, Draper, E. Improving attitudes towards personality disorder: is training for health and social care professionals effective? J Pers Disord. 2019: 1–23.Google Scholar
Holmqvist, R. Staff feelings and patient diagnosis. Can J Psychiatry. 2000; 45(4): 349–56.Google Scholar
Tyrer, P. Why we need to take personality disorder out of the doghouse. Br J Psychiatry. 2020; 216(2): 65–6.Google Scholar
Cristea, IA, Gentili, C, Cotet, CD, Palomba, D, Barbui, C, Cuijpers, P. Efficacy of psychotherapies for borderline personality disorder: a systematic review and meta-analysis. JAMA Psychiatry. 2017; 74(4): 319–28.Google Scholar
Krahn, DD, Mackenzie, TB. Organic personality syndrome caused by insulin-related nocturnal hypoglycemia. Psychosomatics. 1984; 25(9): 711–2.CrossRefGoogle ScholarPubMed
McEnany, GW, Tescher, BE. Contracting for care. One nursing approach to the hospitalized borderline patient. J Psychosoc Nurs Ment Health Serv. 1985; 23(4): 11–8.Google Scholar
NICE. Depression: The Treatment and Management of Depression in Adults (Clinical Guideline 90). National Institute of Health and Care Excellence, 2009.Google Scholar
Dazzi, T, Gribble, R, Wessely, S, Fear, NT. Does asking about suicide and related behaviours induce suicidal ideation? What is the evidence? Psychol Med. 2014; 44(16): 3361–3.Google Scholar
O’Reilly, M, Kiyimba, N, Karim, K. ‘This is a question we have to ask everyone’: asking young people about self-harm and suicide. J Psychiatr Ment Health Nurs. 2016; 23(8): 479–88.Google Scholar
Mars, B, Heron, J, Klonsky, ED, Moran, P, O’Connor, RC, Tilling, K, et al. Predictors of future suicide attempt among adolescents with suicidal thoughts or non-suicidal self-harm: a population-based birth cohort study. Lancet Psychiatry. 2019; 6(4): 327–37.Google Scholar
Young-Hyman, D, de Groot, M, Hill-Briggs, F, Gonzalez, JS, Hood, K, Peyrot, M. Psychosocial care for people with diabetes: a position statement of the American Diabetes Association. Diabetes Care. 2016; 39(12): 2126–40.Google Scholar
Custal, N, Arcelus, J, Aguera, Z, Bove, FI, Wales, J, Granero, R, et al. Treatment outcome of patients with comorbid type 1 diabetes and eating disorders. BMC Psychiatry. 2014; 14: 140.Google Scholar
Garrett, C, Doherty, A. Diabetes and mental health. Clin Med (Lond). 2014; 14(6): 669–72.Google Scholar
Nordentoft, M, Qin, P, Helweg-Larsen, K, Juel, K. Restrictions in means for suicide: an effective tool in preventing suicide: the Danish experience. Suicide Life Threat Behav. 2007; 37(6): 688–97.Google Scholar
Kreitman, N. The coal gas story. United Kingdom suicide rates, 1960–71. Br J Prev Soc Med. 1976; 30(2): 8693.Google Scholar
Hawton, K, Simkin, S, Deeks, J, Cooper, J, Johnston, A, Waters, K, et al. UK legislation on analgesic packs: before and after study of long term effect on poisonings. BMJ. 2004; 329(7474): 1076.CrossRefGoogle ScholarPubMed
Katon, WJ, Lin, EH, Von Korff, M, Ciechanowski, P, Ludman, EJ, Young, B, et al. Collaborative care for patients with depression and chronic illnesses. N Engl J Med. 2010; 363(27): 2611–20.Google Scholar
Ellis, DA, Frey, MA, Naar-King, S, Templin, T, Cunningham, P, Cakan, N. Use of multisystemic therapy to improve regimen adherence among adolescents with type 1 diabetes in chronic poor metabolic control: a randomized controlled trial. Diabetes Care. 2005; 28(7): 1604–10.Google Scholar
Holmes-Walker, DJ, Llewellyn, AC, Farrell, K. A transition care programme which improves diabetes control and reduces hospital admission rates in young adults with type 1 diabetes aged 15–25 years. Diabet Med. 2007; 24(7): 764–9.Google Scholar
Wazaify, M, Abushams, L, Van Hout, MC. Abuse of sulfonylureas: is factitious hypoglycemia a cause for concern? Int J Clin Pharm. 2019; 41(1): 35.Google Scholar
Cassidy, EM, O’Halloran, DJ, Barry, S. Insulin as a substance of misuse in a patient with insulin dependent diabetes mellitus. BMJ. 1999; 319(7222): 1417–8.Google Scholar

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