Aetiological factors in attempted suicide.

In recent years there have been major advances in our understanding of attempted suicide. In particular, several important studies have thrown light upon the psychopathology and social effects (Stengel, Cook, and Kreeger, 1958), epidemiology (Schneidman and Farberow, 1961 ; Kessel, 1965; Parkin and Stengel, 1965), and prognosis (Dahlgren, 1945; Schneider, 1954; Riiegsegger, 1963) of this behaviour disturbance. Less satisfactory, however, is the present state of knowledge concerning the causes. This is not surprising, since the difficulties of studying the manifold circumstances which may contribute to suicidal behaviour are formidable. But a legitimate criticism is that, hitherto, reported findings have been based almost entirely on uncontrolled observations. Thus the aetiological significance of suggested predisposing factors, which include physical and mental illness, social isolation and disorganization, interpersonal conflicts, and parental deprivation in childhood, remains obscure in the absence of similar data for nonsuicidal controls. It is evident that suicidal behaviour results from the complex interaction of a variety of adverse circumstances in the life of any given individual. Furthermore, these predisposing factors will vary considerably from person to person. Nevertheless, it