Reviews
19 February 2002

A Current Perspective of Suicide and Attempted Suicide

Publication: Annals of Internal Medicine
Volume 136, Number 4

Abstract

Suicide and suicide attempts are a major cause of death and morbidity worldwide. Suicide is generally a complication of a psychiatric disorder, but it requires additional risk factors because most psychiatric patients never attempt suicide. This review includes a hypothesized stress-diathesis model, which has implications for detection of high-risk patients and treatment interventions, and discusses promising treatment approaches that have been recently identified.

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References

1.
Burvill PWWoodings TLStenhouse NSMcCall MG. Suicide during 1961-70 migrants in Australia. Psychol Med. 1982;12:295-308. [PMID: 7100353]
2.
Cantor CNeulinger K. The epidemiology of suicide and attempted suicide among young Australians. Aust N Z J Psychiatry. 2000;34:370-87. [PMID: 10881962]
3.
Barraclough BBunch JNelson BSainsbury P. A hundred cases of suicide: clinical aspects. Br J Psychiatry. 1974;125:355-73. [PMID: 4425774]
4.
Robins EMurphy GEWilkinson RH JrGassner SKayes J. Some clinical considerations in the prevention of suicide based on a study of 134 successful suicides. Am J Public Health. 1959;49:888-99.
5.
Rich CLFowler RCFogarty LAYoung D. San Diego Suicide Study. III. Relationships between diagnoses and stressors. Arch Gen Psychiatry. 1988;45:589-92. [PMID: 3377646]
6.
Dorpat TLRipley HS. A study of suicide in the Seattle area. Compr Psychiatry. 1960;1:349-59.
7.
Isometsä EHenriksson MMarttunen MHeikkinen MAro HKuoppasalmi Ket al . Mental disorders in young and middle aged men who commit suicide. BMJ. 1995;310:1366-7. [PMID: 7787539]
8.
Beautrais ALJoyce PRMulder RTFergusson DMDeavoll BJNightingale SK. Prevalence and comorbidity of mental disorders in persons making serious suicide attempts: a case–control study. Am J Psychiatry. 1996;153:1009-14. [PMID: 8678168]
9.
Maris RWBerman ALSilverman MM. Comprehensive Textbook of Suicidology. New York: Guilford Pr; 2000:26-61.
10.
Mann JJWaternaux CHaas GLMalone KM. Toward a clinical model of suicidal behavior in psychiatric patients. Am J Psychiatry. 1999;156:181-9. [PMID: 9989552]
11.
Stengel E. Suicide and Attempted Suicide. New York: Aronson; 1974.
12.
Schmidtke ABille-Brahe UDeLeo DKerkhof ABjerke TCrepet Pet al . Attempted suicide in Europe: rates, trends and sociodemographic characteristics of suicide attempters during the period 1989-1992. Results of the WHO/EURO Multicentre Study on Parasuicide. Acta Psychiatr Scand. 1996;93:327-38. [PMID: 8792901]
13.
Beck ATWeissman ALester DTrexler L. Classification of suicidal behaviors. II. Dimensions of suicidal intent. Arch Gen Psychiatry. 1976;33:835-7. [PMID: 942287]
14.
Shearer SLPeters CPQuaytman MSWadman BE. Intent and lethality of suicide attempts among female borderline inpatients. Am J Psychiatry. 1988;145:1424-7. [PMID: 3189601]
15.
Mann JJMalone KMPsych MRSweeney JABrown RPLinnoila Met al . Attempted suicide characteristics and cerebrospinal fluid amine metabolites in depressed inpatients. Neuropsychopharmacology. 1996;15:576-86. [PMID: 8946432]
16.
Mann JJMcBride PABrown RPLinnoila MLeon ACDeMeo Met al . Relationship between central and peripheral serotonin indexes in depressed and suicidal psychiatric inpatients. Arch Gen Psychiatry. 1992;49:442-6. [PMID: 1376106]
17.
Linehan MM. Suicidal people. One population or two? Ann N Y Acad Sci. 1986;487:16-33. [PMID: 3471160]
18.
Malone KMHaas GLSweeney JAMann JJ. Major depression and the risk of attempted suicide. J Affect Disord. 1995;34:173-85. [PMID: 7560545]
19.
Beck ATSteer RA. Clinical predictors of eventual suicide: a 5- to 10-year prospective study of suicide attempters. J Affect Disord. 1989;17:203-9. [PMID: 2529288]
20.
Beck ATBeck RKovacs M. Classification of suicidal behaviors: I. Quantifying intent and medical lethality. Am J Psychiatry. 1975;132:285-7. [PMID: 1115273]
21.
Leon ACFriedman RASweeney JABrown RPMann JJ. Statistical issues in the identification of risk factors for suicidal behavior: the application of survival analysis. Psychiatry Res. 1990;31:99-108. [PMID: 2315425]
22.
Kelly TMMann JJ. Validity of DSM-III-R diagnosis by psychological autopsy: a comparison with clinician ante-mortem diagnosis. Acta Psychiatr Scand. 1996;94:337-43. [PMID: 9124080]
23.
Shaffer DGould MSFisher PTrautman PMoreau DKleinman Met al . Psychiatric diagnosis in child and adolescent suicide. Arch Gen Psychiatry. 1996;53:339-48. [PMID: 8634012]
24.
Murphy GEWetzel RDRobins EMcEvoy L. Multiple risk factors predict suicide in alcoholism. Arch Gen Psychiatry. 1992;49:459-63. [PMID: 1599370]
25.
Murphy GE. Suicide and substance abuse. Arch Gen Psychiatry. 1988;45:593-4. [PMID: 3377647]
26.
Rich CLRuneson BS. Mental illness and youth suicide [Letter]. Am J Psychiatry. 1995;152:1239-40. [PMID: 7625487]
27.
Henriksson MMAro HMMarttunen MJHeikkinen MEIsometsä ETKuoppasalmi KIet al . Mental disorders and comorbidity in suicide. Am J Psychiatry. 1993;150:935-40. [PMID: 8494072]
28.
Runeson B. Mental disorder in youth suicide. DSM-III-R Axes I and II. Acta Psychiatr Scand. 1989;79:490-7. [PMID: 2750550]
29.
Marttunen MJAro HMHenriksson MMLönnqvist JK. Mental disorders in adolescent suicide. DSM-III-R axes I and II diagnoses in suicides among 13- to 19-year-olds in Finland. Arch Gen Psychiatry. 1991;48:834-9. [PMID: 1929774]
30.
Frances AFyer MClarkin J. Personality and suicide. Ann N Y Acad Sci. 1986;487:281-93. [PMID: 2882718]
31.
Jamison KR. Suicide and bipolar disorders. Ann N Y Acad Sci. 1986;487:301-15. [PMID: 3471163]
32.
Johns CAStanley MStanley B. Suicide in schizophrenia. Ann N Y Acad Sci. 1986;487:294-300. [PMID: 2882719]
33.
Roy ALinnoila M. Alcoholism and suicide. Suicide Life Threat Behav. 1986;16:244-73. [PMID: 2428141]
34.
Murphy GEWetzel RD. The lifetime risk of suicide in alcoholism. Arch Gen Psychiatry. 1990;47:383-92. [PMID: 2181963]
35.
Bostwick JMPankratz VS. Affective disorders and suicide risk: a reexamination. Am J Psychiatry. 2000;157:1925-32. [PMID: 11097952]
36.
Roy ALamparski DDeJong JMoore VLinnoila M. Characteristics of alcoholics who attempt suicide. Am J Psychiatry. 1990;147:761-5. [PMID: 2343921]
37.
Roy ALamparski DDe Jong JAdinoff BRavitz BGeorge DTet al . Cerebrospinal fluid monoamine metabolites in alcoholic patients who attempt suicide. Acta Psychiatr Scand. 1990;81:58-61. [PMID: 1691893]
38.
Dulit RAFyer MRHaas GLSullivan TFrances AJ. Substance use in borderline personality disorder. Am J Psychiatry. 1990;147:1002-7. [PMID: 2375433]
39.
Marzuk PMMann JJ. Suicide and substance abuse. Psychiatric Annals. 1988;18:639-45.
40.
Brodsky BSMalone KMEllis SPDulit RAMann JJ. Characteristics of borderline personality disorder associated with suicidal behavior. Am J Psychiatry. 1997;154:1715-9. [PMID: 9396951]
41.
Brent DA. Overrepresentation of epileptics in a consecutive series of suicide attempters seen at a children's hospital, 1978-1983. J Am Acad Child Psychiatry. 1986;25:242-6. [PMID: 3700912]
42.
Breslau NDavis GCAndreski P. Migraine, psychiatric disorders, and suicide attempts: an epidemiologic study of young adults. Psychiatry Res. 1991;37:11-23. [PMID: 1862159]
43.
Schoenfeld MMyers RHCupples LABerkman BSax DSClark E. Increased rate of suicide among patients with Huntington's disease. J Neurol Neurosurg Psychiatry. 1984;47:1283-7. [PMID: 6239910]
44.
Farrer LA. Suicide and attempted suicide in Huntington disease: implications for preclinical testing of persons at risk. Am J Med Genet. 1986;24:305-11. [PMID: 2940862]
45.
Breslau N. Migraine, suicidal ideation, and suicide attempts. Neurology. 1992;42:392-5. [PMID: 1736172]
46.
Breslau NKilbey MAndreski P. Nicotine dependence, major depression, and anxiety in young adults. Arch Gen Psychiatry. 1991;48:1069-74. [PMID: 1845224]
47.
Breslau NKilbey MMAndreski P. Nicotine dependence and major depression. New evidence from a prospective investigation. Arch Gen Psychiatry. 1993;50:31-5. [PMID: 8422219]
48.
Glassman AHHelzer JECovey LSCottler LBStetner FTipp JEet al . Smoking, smoking cessation, and major depression. JAMA. 1990;264:1546-9. [PMID: 2395194]
49.
Glassman AH. Cigarette smoking: implications for psychiatric illness. Am J Psychiatry. 1993;150:546-53. [PMID: 8465868]
50.
Brent DAJohnson BAPerper JConnolly JBridge JBartle Set al . Personality disorder, personality traits, impulsive violence, and completed suicide in adolescents. J Am Acad Child Adolesc Psychiatry. 1994;33:1080-6. [PMID: 7982858]
51.
Brent DAJohnson BBartle SBridge JRather CMatta Jet al . Personality disorder, tendency to impulsive violence, and suicidal behavior in adolescents. J Am Acad Child Adolesc Psychiatry. 1993;32:69-75. [PMID: 8428886]
52.
Cornelius JRSalloum IMMezzich JCornelius MDFabrega H JrEhler JGet al . Disproportionate suicidality in patients with comorbid major depression and alcoholism. Am J Psychiatry. 1995;152:358-64. [PMID: 7864260]
53.
Cornelius JRThase MESalloum IMCornelius MDBlack AMann JJ. Cocaine use associated with increased suicidal behavior in depressed alcoholics. Addict Behav. 1998;23:119-21. [PMID: 9468750]
54.
Elliott FA. Violence. The neurologic contribution: an overview. Arch Neurol. 1992;49:595-603. [PMID: 1596194]
55.
Clifton GL, Kreutzer JS, Choi SC, Devany CW, Eisenberg HM, Foulkes MA, et al. Relationship between Glasgow Outcome Scale and neuropsychological measures after brain injury. Neurosurgery. 1993; 33:34-8; discussion 38-9. [ 8355845]
56.
Frost EA. Perioperative management of the head trauma patient. Ann Acad Med Singapore. 1994;23:497-502. [PMID: 7979124]
57.
McAllister TW. Neuropsychiatric sequelae of head injuries. Psychiatr Clin North Am. 1992;15:395-413. [PMID: 1603732]
58.
Gorenstein EENewman JP. Disinhibitory psychopathology: a new perspective and a model for research. Psychol Rev. 1980;87:301-15. [PMID: 7384345]
59.
Raine ABuchsbaum MLaCasse L. Brain abnormalities in murderers indicated by positron emission tomography. Biol Psychiatry. 1997;42:495-508. [PMID: 9285085]
60.
Roy A. Family history of suicide. Arch Gen Psychiatry. 1983;40:971-4. [PMID: 6615160]
61.
Roy ASegal NLCenterwall BSRobinette CD. Suicide in twins. Arch Gen Psychiatry. 1991;48:29-32. [PMID: 1984759]
62.
Roy ASegal NLSarchiapone M. Attempted suicide among living co-twins of twin suicide victims. Am J Psychiatry. 1995;152:1075-6. [PMID: 7793447]
63.
Schulsinger FKety SSRosenthal DWender PH. A family study of suicide. In: Schou M, Strömgren E, eds. Origin, Prevention, and Treatment of Affective Disorders. London: Academic Pr; 1979:277-87.
64.
Brent DABridge JJohnson BAConnolly J. Suicidal behavior runs in families. A controlled family study of adolescent suicide victims. Arch Gen Psychiatry. 1996;53:1145-52. [PMID: 8956681]
65.
Mann JJBrent DAArango V. The neurobiology and genetics of suicide and attempted suicide: a focus on the serotonergic system. Neuropsychopharmacology. 2001;24:467-77. [PMID: 11282247]
66.
Henriksson MMIsometsä ETHietanen PSAro HMLönnqvist JK. Mental disorders in cancer suicides. J Affect Disord. 1995;36:11-20. [PMID: 8988260]
67.
Marzuk PMTierney HTardiff KGross EMMorgan EBHsu MAet al . Increased risk of suicide in persons with AIDS. JAMA. 1988;259:1333-7. [PMID: 3339837]
68.
Lishman WA. Organic Psychiatry: The Psychological Consequences of Cerebral Disorder. 2nd ed. Oxford: Blackwell Scientific Publications; 1987.
69.
Vauhkonen K. Suicide among the male disabled with war injuries to the brain. Acta Psychiatr Scand. 1959; Suppl 137 90-1.
70.
Smith JCMercy JAConn JM. Marital status and the risk of suicide. Am J Public Health. 1988;78:78-80. [PMID: 3337311]
71.
Beautrais ALJoyce PRMulder RT. Access to firearms and the risk of suicide: a case control study. Aust N Z J Psychiatry. 1996;30:741-8. [PMID: 9034462]
72.
Boyd JH. The increasing rate of suicide by firearms. N Engl J Med. 1983;308:872-4. [PMID: 6835283]
73.
Marzuk PMLeon ACTardiff KMorgan EBStajic MMann JJ. The effect of access to lethal methods of injury on suicide rates. Arch Gen Psychiatry. 1992;49:451-8. [PMID: 1599369]
74.
Lester DAbe K. The effect of restricting access to lethal methods for suicide: a study of suicide by domestic gas in Japan. Acta Psychiatr Scand. 1989;80:180-2. [PMID: 2801166]
75.
Lambert MTSilva PS. An update on the impact of gun control legislation on suicide [Review]. Psychiatr Q. 1998;69:127-34. [PMID: 9627930]
76.
. Firearms injuries and deaths: a critical public health issue. American Medical Association Council on Scientific Affairs. Public Health Rep. 1989;104:111-20. [PMID: 2495544]
77.
Brent DAPerper JAAllman CJMoritz GMWartella MEZelenak JP. The presence and accessibility of firearms in the homes of adolescent suicides. A case–control study. JAMA. 1991;266:2989-95. [PMID: 1820470]
78.
Kellermann ALRivara FPSomes GReay DTFrancisco JBanton JGet al . Suicide in the home in relation to gun ownership. N Engl J Med. 1992;327:467-72. [PMID: 1308093]
79.
Kapur SMieczkowski TMann JJ. Antidepressant medications and the relative risk of suicide attempt and suicide. JAMA. 1992;268:3441-5. [PMID: 1460734]
80.
Gould MS. Teenage suicide clusters [Letter]. JAMA. 1990;263:2051-2. [PMID: 2319666]
81.
Schmidtke AHäfner H. The Werther effect after television films: new evidence for an old hypothesis. Psychol Med. 1988;18:665-76. [PMID: 3263660]
82.
Gould MSPetrie KKleinman MHWallenstein S. Clustering of attempted suicide: New Zealand national data. Int J Epidemiol. 1994;23:1185-9. [PMID: 7721521]
83.
Gould MSWallenstein SKleinman M. Time-space clustering of teenage suicide. Am J Epidemiol. 1990;131:71-8. [PMID: 2293755]
84.
Mann JJ. The neurobiology of suicide. Nat Med. 1998;4:25-30. [PMID: 9427602]
85.
Mann JJHuang YYUnderwood MDKassir SAOppenheim SKelly TMet al . A serotonin transporter gene promoter polymorphism (5-HTTLPR) and prefrontal cortical binding in major depression and suicide. Arch Gen Psychiatry. 2000;57:729-38. [PMID: 10920459]
86.
Arango VUnderwood MDGubbi AVMann JJ. Localized alterations in pre- and postsynaptic serotonin binding sites in the ventrolateral prefrontal cortex of suicide victims. Brain Res. 1995;688:121-33. [PMID: 8542298]
87.
Malone KMCorbitt EMLi SMann JJ. Prolactin response to fenfluramine and suicide attempt lethality in major depression. Br J Psychiatry. 1996;168:324-9. [PMID: 8833686]
88.
Mann JJArango V. Neurobiology of suicidal behavior. In: Jacobs D, eds. The Harvard Medical School Guide To Suicide Assessment and Intervention. San Francisco: Jossey-Bass; 1999:98-114.
89.
Cooper SJKelly CBKing DJ. 5-Hydroxyindoleacetic acid in cerebrospinal fluid and prediction of suicidal behaviour in schizophrenia. Lancet. 1992;340:940-1. [PMID: 1383659]
90.
Roy ADe Jong JLinnoila M. Cerebrospinal fluid monoamine metabolites and suicidal behavior in depressed patients. A 5-year follow-up study. Arch Gen Psychiatry. 1989;46:609-12. [PMID: 2472124]
91.
Nordström PSamuelsson MAsberg MTräskman-Bendz LAberg-Wistedt ANordin Cet al . CSF 5-HIAA predicts suicide risk after attempted suicide. Suicide Life Threat Behav. 1994;24:1-9. [PMID: 7515519]
92.
Muldoon MFManuck SBMatthews KA. Lowering cholesterol concentrations and mortality: a quantitative review of primary prevention trials. BMJ. 1990;301:309-14. [PMID: 2144195]
93.
Muldoon MFRossouw JEManuck SBGlueck CJKaplan JRKaufmann PG. Low or lowered cholesterol and risk of death from suicide and trauma. Metabolism. 1993;42:45-56. [PMID: 8412786]
94.
Golomb BA. Cholesterol and violence: is there a connection? Ann Intern Med. 1998;128:478-87. [PMID: 9499332]
95.
Kaplan JRShively CAFontenot MBMorgan TMHowell SMManuck SBet al . Demonstration of an association among dietary cholesterol, central serotonergic activity, and social behavior in monkeys. Psychosom Med. 1994;56:479-84. [PMID: 7532867]
96.
Arango VUnderwood MDMann JJ. Fewer pigmented locus coeruleus neurons in suicide victims: preliminary results. Biol Psychiatry. 1996;39:112-20. [PMID: 8717609]
97.
Ordway GA. Pathophysiology of the locus coeruleus in suicide. Ann N Y Acad Sci. 1997;836:233-52. [PMID: 9616802]
98.
Nemeroff CBOwens MJBissette GAndorn ACStanley M. Reduced corticotropin releasing factor binding sites in the frontal cortex of suicide victims. Arch Gen Psychiatry. 1988;45:577-9. [PMID: 2837159]
99.
Buchheit KHGamse RPfannkuche HJ. SDZ 205-557, a selective antagonist at 5-HT4 receptors in the isolated guinea pig ileum. Eur J Pharmacol. 1991;200:373-4. [PMID: 1782999]
100.
Carroll BJFeinberg MGreden JFTarika JAlbala AAHaskett RFet al . A specific laboratory test for the diagnosis of melancholia. Standardization, validation, and clinical utility. Arch Gen Psychiatry. 1981;38:15-22. [PMID: 7458567]
101.
Bunney WE JrFawcett JADavis JMGifford S. Further evaluation of urinary 17-hydroxycorticosteroids in suicidal patients. Arch Gen Psychiatry. 1969;21:138-50. [PMID: 5804011]
102.
Fawcett JBusch KAJacobs DKravitz HMFogg L. Suicide: a four-pathway clinical-biochemical model. Ann N Y Acad Sci. 1997;836:288-301. [PMID: 9616805]
103.
Brown RPStoll PMStokes PEFrances ASweeney JKocsis JHet al . Adrenocortical hyperactivity in depression: effects of agitation, delusions, melancholia, and other illness variables. Psychiatry Res. 1988;23:167-78. [PMID: 3363026]
104.
Isacsson GBoëthius GBergman U. Low level of antidepressant prescription for people who later commit suicide: 15 years of experience from a population-based drug database in Sweden. Acta Psychiatr Scand. 1992;85:444-8. [PMID: 1642127]
105.
Rutz WWålinder JVon Knorring LRihmer ZPihlgren H. Prevention of depression and suicide by education and medication: impact on male suicidality. An update from the Gotland Study. International Journal of Psychiatry in Clinical Practice. 1997;1:39-46.
106.
Isacsson GHolmgren PWasserman DBergman U. Antidepressants and suicide [Letter]. BMJ. 1995;310:127. [PMID: 7833710]
107.
Hirschfeld RMRussell JM. Assessment and treatment of suicidal patients. N Engl J Med. 1997;337:910-5. [PMID: 9302306]
108.
Isometsä EHenriksson MHeikkinen MAro HLönnqvist J. Suicide and the use of antidepressants. Drug treatment of depression is inadequate [Letter]. BMJ. 1994;308:915. [PMID: 8173378]
109.
Rutz Wvon Knorring LWålinder J. Frequency of suicide on Gotland after systematic postgraduate education of general practitioners. Acta Psychiatr Scand. 1989;80:151-4. [PMID: 2801163]
110.
Oquendo MAMalone KMEllis SPSackeim HAMann JJ. Inadequacy of antidepressant treatment for patients with major depression who are at risk for suicidal behavior. Am J Psychiatry. 1999;156:190-4. [PMID: 9989553]
111.
Harkavy-Friedman JMRestifo KMalaspina DKaufmann CAAmador XFYale SAet al . Suicidal behavior in schizophrenia: characteristics of individuals who had and had not attempted suicide. Am J Psychiatry. 1999;156:1276-8. [PMID: 10450275]
112.
Pokorny AD. Prediction of suicide in psychiatric patients. Report of a prospective study. Arch Gen Psychiatry. 1983;40:249-57. [PMID: 6830404]
113.
Goldstein RBBlack DWNasrallah AWinokur G. The prediction of suicide. Sensitivity, specificity, and predictive value of a multivariate model applied to suicide among 1906 patients with affective disorders. Arch Gen Psychiatry. 1991;48:418-22. [PMID: 2021294]
114.
Isometsä ETHeikkinen MEMarttunen MJHenriksson MMAro HMLönnqvist JK. The last appointment before suicide: is suicide intent communicated? Am J Psychiatry. 1995;152:919-22. [PMID: 7755124]
115.
Baldessarini RJ, Tondo L, Hennen J. Effects of lithium treatment and its discontinuation on suicidal behavior in bipolar manic-depressive disorders. J Clin Psychiatry. 1999; 60 Suppl 2:77-84; discussion 111-6. [ 10073392]
116.
Nilsson A. Lithium therapy and suicide risk. J Clin Psychiatry. 1999; 60 Suppl 2:85-8; discussion 111-6. [ 10073393]
117.
Meltzer HYOkayli G. Reduction of suicidality during clozapine treatment of neuroleptic-resistant schizophrenia: impact on risk–benefit assessment. Am J Psychiatry. 1995;152:183-90. [PMID: 7840350]
118.
Walker AMLanza LLArellano FRothman KJ. Mortality in current and former users of clozapine. Epidemiology. 1997;8:671-7. [PMID: 9345668]
119.
Reid WHMason MHogan T. Suicide prevention effects associated with clozapine therapy in schizophrenia and schizoaffective disorder. Psychiatr Serv. 1998;49:1029-33. [PMID: 9712207]

Information & Authors

Information

Published In

cover image Annals of Internal Medicine
Annals of Internal Medicine
Volume 136Number 419 February 2002
Pages: 302 - 311

History

Published online: 19 February 2002
Published in issue: 19 February 2002

Keywords

Authors

Affiliations

J. John Mann, MD
From Columbia University, New York, New York.
Acknowledgments: The author thanks Drs. Victoria Arango, Mark Underwood, and Kevin Malone for ideas and suggestions.
Grant Support: By the National Institute of Mental Health (MH46745, MH48514, MH40210, MH56390).
Corresponding Author: J. John Mann, MD, Department of Neuroscience, New York State Psychiatric Institute, 1051 Riverside Drive, Box 42, New York, NY 10032; e-mail, [email protected].

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J. John Mann. A Current Perspective of Suicide and Attempted Suicide. Ann Intern Med.2002;136:302-311. [Epub 19 February 2002]. doi:10.7326/0003-4819-136-4-200202190-00010

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