Suicidal communication of persons attempting suicide and responses of significant others

Forty consecutively admitted suicide attempt patients in an intensive care unit, their therapists, and 70 significant others of 37 of the patients, were investigated by means of 300 semi-structured interviews. The patients belonged to three diagnostic groups: neurosis, alcohol and drug abuse, and prepsychosis/psychosis. Thirty-seven of the patients had communicated their suicidal intentions to people around them. All patients used protracted indirect verbal communication. Immediately before the suicide attempt, most of the neurotics continued often to indirect verbal communication, amplified by demanding behaviour. Drug and alcohol abusers, moreover, also employed direct verbal communication, and prepsychosis/psychosis patients indirect non-verbal communication. The majority of significant others understood the patients' suicidal communication and responded with near-total silence. Ambivalence about continuing the relationship characterised most partners of patients in all diagnostic groups, and also persons other than partners in the abuse group. Ambivalence about helping the patient, and aggression expressed by significant others were most prevalent in the abuse group.