The contribution of environmental events and social support to serious suicide attempts in primary depressive disorder.

Interviewed patients (18–65 yrs old) about the events that occurred to them or their spouse in the 12 mo previous to the suicide attempt. Only primary depressive attempters (14 Ss) were selected, and for purposes of comparison, a primary depressive control group (14 Ss) was selected. Ss were administered the Hamilton Rating Scale for Depression. Moreover, seriousness of suicide attempts was quantified and assessed in each patient, and only moderately or severely serious attempters were chosen. Results show that the occurrence of serious suicide attempts is strongly associated with an increased rate of independent events (events not influenced by the patient's behavior, decisions, or disorder) in the year preceding the attempt, and that a particularly high density of such events between episodic onset and the attempt may serve as the direct initiator of an attempt. Data also suggest that exit events, where an important social support is lost to the patient, may play a significant role in initiating an attempt. Implications for the highest risk period of suicide are discussed. (40 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)