Further exploration of suicidal behavior: from mental to psychopathological perspectives

M. Pompili 1, A. Rossi 2

1 Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Italy; 2 Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L’Aquila, Italy

Suicide is a major public health problem on a global scale, with large regional variations. According to the World Health Organization, about 880,000 suicides are reported each year 1. This estimate represents the tip of an iceberg that hides self-injurious behavior, hospitalization for self-inflicted injuries, suicide ideation and attempts. In fact, it is estimated that suicide attempts represent 30 times the estimate of suicide deaths 2. Although, mental disorders are important contributing factors to suicide risk, new trends in neuroscience, psychiatry, and suicidology suggest that neurodevelopmental factors are of crucial importance. Of course, among mental disorders, mood disorders, substance use disorders, and psychoses as well as some personality disorders heighten the risk for suicide.

Knowledge of these aspects is important in order to address and prevent suicide through comprehensive assessment and management strategies.

In this issue, Pompili suggests that a phenomenological approach is of crucial importance for a proper understanding of the human experience of mental pain. Although an empathic understanding of the pain of the suicidal individual is not sufficient, it is the first step of a process that may eventually prevent suicide in unique individuals.

Following the multiaxial organization of current diagnostic systems, the features and main innovations that can guide clinicians in their assessment and clinical management of suicide risk are examined by Lingiardi et al.

Recent systematic reviews and meta-analyses confirmed that Obsessive- Compulsive Disorder (OCD), historically considered to be associated with a relatively low risk of suicide, is actually in itself associated with considerable risk for lifetime suicide attempts and suicidal ideation (Albert et al.).

Maina et al. reported on the high rate of suicide attempts and deaths in bipolar disorder patients and the social impact of this behaviour, suggesting the need for the early recognition and treatment of such patients. Among medical disorders, Ciuffini et al. reported that epilepsy represents a challenge for life expectancy and quality of life either for social and relational consequences due to stigma than for the consequences of the disorder itself. Suicidal behaviors are more frequent among individuals with epilepsy than in the general population.

Rossi et al. systematically reviewed evidence on the mediating role of dissociation between trauma and non-suicidal self-injury that has not been addressed in the literature and needs further exploration/examination/investigation (one of these words would be better) 

This special issue dedicated by the Journal of Psychopathology to ‘suicide’ addresses peculiar topics that advance our understanding of the complex problem of suicide, providing further support to clinicians in the management of this multifaced human phenomenon.

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