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Letter to the Editor: Suicidal ideation and research ethics committees: a reply

Published online by Cambridge University Press:  02 October 2014

T. Dazzi
Affiliation:
School of Medicine, King's College London, London, UK
R. Gribble
Affiliation:
Department of Psychological Medicine, King's College London, London, UK
S. Wessely*
Affiliation:
Department of Psychological Medicine, King's College London, London, UK
N. T. Fear
Affiliation:
Department of Psychological Medicine, King's College London, London, UK
*
*Address correspondence to: S. Wessely, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK. (Email: simon.wessely@kcl.ac.uk)
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Abstract

Type
Correspondence
Copyright
Copyright © Cambridge University Press 2014 

We welcome the insightful comments from Dieneke Hubbeling (Hubbeling, Reference Hubbeling2014) and the opportunity to clarify the primary objective of our editorial (Dazzi et al. Reference Dazzi, Gribble, Wessely and Fear2014).

While we agree that the evidence the editorial was based on is limited somewhat by the outcome that the studies were measuring, we feel it is important that the decisions ethics committee reach are evidence based. If the available evidence does not support an association between asking questions about suicide and suicidality, then any limitations placed on a proposed research project should be justified, particularly as the general direction of travel seems to be that asking questions is more likely to reduce suicidality than increase it (see for example: Cedereke et al. Reference Cedereke, Monti and Ojehagen2002; Vaiva et al. Reference Vaiva, Ducrocq, Meyer, Mathieu, Philippe, Libersa and Goudemand2006; Biddle et al. Reference Biddle, Cooper, Owen-Smith, Klineberg, Bennewith, Hawton, Kapur, Donovan and Gunnel2013). We are not saying that such a situation can never be found, but that a good case needs to be made if restrictions are put in place.

We respectfully disagree with the comment that the scientific benefits of such research are limited if only suicidal ideation, rather than completed or attempted suicide is studied. First, such a step would miss the opportunity for early intervention among those expressing suicidal intent. Second, preventing researchers from asking about suicidal intent among those who have attempted suicide, for example, would do little to advance much-needed research in this area. Finally, suicide is fortunately a rare outcome, and notoriously difficult to predict by even the most experienced clinician. We suspect that obtaining definitive data on that particular question will always prove problematical.

References

Biddle, L, Cooper, J, Owen-Smith, A, Klineberg, E, Bennewith, O, Hawton, K, Kapur, N, Donovan, J, Gunnel, D (2013). Qualitative interviewing with vulnerable populations: individuals’ experiences of participating in suicide and self-harm based research. Journal of Affective Disorders 145, 356362.Google Scholar
Cedereke, M, Monti, K, Ojehagen, A (2002). Telephone contact with patients in the year after a suicide attempt: does it affect treatment attendance and outcome? A randomised controlled study. European Psychiatry 17, 8291.Google Scholar
Dazzi, T, Gribble, R, Wessely, S, Fear, NT (2014). Does asking about suicide and related behaviours induce suicidal ideation? What is the evidence? Psychological Medicine. Published online: 7 July 2014 . doi:10.1017/S0033291714001299.Google Scholar
Hubbeling, D (2014). Suicidal ideation and research ethics committees [Letter]. Psychological Medicine. doi:10.1017/S003329171400227X. Google Scholar
Vaiva, G, Ducrocq, F, Meyer, P, Mathieu, D, Philippe, A, Libersa, C, Goudemand, M (2006). Effect of telephone contact on further suicide attempts in patients discharged from an emergency department: randomised controlled study. British Medical Journal 332, 12411245.Google Scholar