Am J Psychiatry 1993; 150:108-112
Copyright © 1993 by American Psychiatric Association
Suicidal behaviors in adult psychiatric outpatients, I: Description and prevalence
GM Asnis, TA Friedman, WC Sanderson, ML Kaplan, HM van Praag and JM Harkavy- Friedman
Department of Psychiatry, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY 10467-2490.
OBJECTIVE: Because the findings of previous studies of suicidal behaviors
in psychiatric outpatients may not necessarily generalize to outpatients
with a wide spectrum of psychiatric diagnoses, the authors evaluated the
prevalence of suicidal behaviors in a large general psychiatric outpatient
clinic whose patients represented a full spectrum of psychiatric illness.
METHOD: A total of 651 patients participated in the study between 1987 and
1989. These patients had sought treatment at the outpatient psychiatry
department of a private nonprofit hospital. Before being interviewed for
treatment, all patients were given a comprehensive self-rating survey
packet that included the Harkavy Asnis Suicide Survey and the Hopkins
Symptom Checklist-90. The Harkavy Asnis Suicide Survey is a self-report
questionnaire that assesses demographic variables, current and past history
of suicidal behaviors of the patient as well as family members and peers,
and a detailed description of each previous attempt. RESULTS: Fifty-five
percent of the patients had a history of suicidal ideation, and 25%
reported at least one previous suicide attempt. Approximately half of the
suicide attempters reported multiple attempts. The predominant methods of
attempt were overdose (53%), jumping (17%), and wrist cutting (17%).
Suicidal behavior was prevalent in most diagnostic groups. The rates of
suicidal ideation among patients with mood disorders (major depression,
dysthymia, and bipolar disorder), adjustment disorders, and
alcohol/substance abuse were significantly greater than that of the
patients with generalized anxiety disorder. CONCLUSIONS: The authors
conclude that suicidal behavior is prevalent among patients who seek
treatment in a general outpatient department.
