Who commits suicide after a suicide attempt?

One hundred and sixty-three individuals in a suburban catchment area of 72,000 inhabitants made registered suicide attempts during 1975-1976 (i.e. 159/100,000 greater than or equal to 18 years). They were followed up by means of the Swedish Register of Death Causes over a period of 8-10 years. Police reports, autopsies and psychiatric records were also studied. Six cases of verified suicide were found and four additional cases were considered as probable or possible suicides. Thus the cumulative rate over 8-10 years was 3.7-6.1%. There was a mean number of 3.5 suicide attempts before the eventual suicide. The most important common factor overall was alcohol or drug abuse with social deterioration (seven in 10 cases). The rest (three in 10 cases) were depressed women with long-standing suicidal processes. The importance of recognizing chronic abuse as probably the most important background factor is stressed. The total group encompasses individuals with longstanding and severe life problems and difficulties in relating to society. The realistic chances of being able to provide effective suicide prophylaxes for most of these patients requires well planned and longstanding treatment and rehabilitation programmes.