The Prevalence of Suicide and Parasuicide (`Attempted Suicide') in Edinburgh

This paper describes the prevalence patterns of both suicide and parasuicide (`attempted suicide') in Edinburgh during 1970. Doctors in a random sample of Edinburgh general practices provided information on all known parasuicides, whether or not they were admitted to hospital. A psychiatrist investigated all suspicious deaths, including accidents, reported to the Crown Office in order to detect cases of completed suicide. The comparative analysis presented here is believed to be the first using general practice data on parasuicide and psychiatrically evaluated data on suicide, in the same population at the same time. The main results were as follows: 1. Hospitalized parasuicides in Edinburgh were representative of all parasuicides detected in general practice with respect to sex, age and area of residence. Similarly, officially recorded suicides were in general representative on these variables. 2. The results confirmed that parasuicide and suicide are epidemiologically distinct and therefore likely to have different causes. Peak rates of parasuicide were found in young adult females in contrast to peak rates of suicide among middle-aged and older males. 3. Parasuicide and suicide rates varied with area of residence. Both were most frequent in the impoverished, socially disorganized, slum areas of the city. 4. The results also confirmed that though parasuicide and suicide are different, they are clearly related. One per cent of detected parasuicides committed suicide within the year of study. Forty-one per cent of detected cases of completed suicide had a history of parasuicide. Parasuicides are a very high risk group for eventual completed suicide and this has important implications for suicide prevention.