Suicide May Be 'Contagious'

Megan Brooks

January 28, 2016

People bereaved by the sudden death of a friend or relative by suicide are much more likely to attempt suicide themselves, a new study suggests.

Previous studies have shown family history of suicide to be a risk factor for suicide attempt. The new study suggests that a history of suicide among non–blood relatives and friends should also be considered when assessing suicide risk, the authors note.

"Our results highlight the profound impact that suicide might have on friends and family members," Alexandra Pitman, PhD, from the Division of Psychiatry, University College London, United Kingdom, said in a news release. "Suicide risk assessment of young adults should involve screening for a history of suicide in blood relatives, non–blood relatives, and friends," she and her colleagues say.

The study was published online January 26 in BMJ Open.

Taboo Subject

The investigators studied 3432 staff and students at UK universities who had been exposed to the sudden death of a friend or relative to examine the specific effects associated with bereavement by suicide. The participants were 18 to 40 years old; 614 had lost a friend or relative to suicide, 712 had lost a friend or relative to death by sudden, unnatural causes, and the remaining 2106 had lost a friend or relative to death by sudden, natural causes.

The likelihood of attempting suicide was higher in adults bereaved by suicide (adjusted odds ratio [AOR], 1.65; 95% confidence interval [CI], 1.12 - 2.42; P = .012) than in those bereaved through sudden, natural causes. There was no such increased risk in adults bereaved by sudden, unnatural causes.

There were no between-group differences in the probability of suicidal ideation. The effect of suicide bereavement was similar whether bereaved participants were blood relatives of the deceased or not.

The study also showed that those bereaved by suicide were 80% more likely to drop out of school or work. In total, 8% of the people bereaved by suicide had dropped out of an educational course or a job since the death.

The researchers note, however, that the significant association between bereavement by suicide and suicide attempt became nonsignificant when they accounted for perceived stigma (AOR, 1.11; 95% CI, 0.74 - 1.67; P = .610).

Adults who had been bereaved by suicide tended to perceive more social stigma associated with the death, the authors report. When the results were adjusted for perceived social stigma to reflect this, the significant differences in suicide attempts and occupational functioning disappeared. This suggests that addressing the social stigma attached to suicide bereavement might be one way to limit its impact on people's lives, the authors note.

"British people can be very uncomfortable talking about death, and suicide in particular is often perceived as a taboo subject. However, avoiding the subject can make a bereaved person feel very isolated and stigmatized, and sometimes even blamed for the death," Dr Pitman said in the release.

"We know that people can find it difficult to know what to say to someone who has recently been bereaved," she noted. "However, saying something is often better than saying nothing, and simple gestures like offering practical help with day-to-day activities can mean a lot. Employers should be aware of the significant impact that suicide bereavement has on people's working lives and make adjustments to help their staff return to work," Dr Pitman advised.

The study was funded by the Medical Research Council. The authors have disclosed no relevant financial relationships.

BMJ Open. Published online January 26, 2016. Full text

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