On Suicide Prediction and Prevention

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Abstract
Suicide is a major preventable cause of death. Prevention is facilitated by identification of populations at increased risk. It further requires the ability to estimate accurately the degree of risk in a given person at a given time and to intervene effectively. Considerable progress has been made in identifying high-risk groups. However, though demographic data identify large groups with greater than average risk (eg, the single, widowed, and divorced), they are far too general to be of practical use. They identify large numbers of persons who are never at risk.1 That suicide rarely occurs in the absence of psychiatric illness2-4 further defines the field of special concern. Still, only a minority of those so afflicted will commit suicide. The lifetime risk of suicide in affective disorder is about 15%, not 50% or 90%.5 Thus, knowledge of the association between psychiatric illness and suicide falls far short of

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