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Abstract
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"Suicide" comes from Latin sui (of oneself) and caedere (kill), and means "(to) intentionally kill oneself" (verb) or "action of killing oneself intentionally" (noun) (https://www.lexico.com/definition/suicide, accessed August 14, 2020: 0900). Suicide denotes an existential paradox--a significant departure from the natural instinct of self-preservation. As noted by Durkheim,1 an intent to die originates in major psychological and sociological upheavals, the likes of which have become more common in the 21st century, especially within the younger population.
Fortunately, not all suicidal attempts (SA) terminate in fatality. However, it is important--and difficult at the same time--to differentiate such attempts from a close clinical mimic, "in the absence of lethal intent."2 Termed nonsuicidal self-injury (NSSI), these have been described in association with several psychiatric diagnoses, considered manifestations of poor impulse control, and recommended as a separate diagnostic category.2 DSM-5 describes NSSI with a clear absence of intent to die, and with an instrumental role in modifying psychosocial interactions of the individual; and contrasts this with suicidal behavior disorder--both under Section III. With significant resources being committed to suicidology all over the world, it is imperative that this differentiation is translated into research. With a fundamental difference in their nature3-5, it is expected that the efforts in identifying and managing acts with an intent to die would not be identical to those for NSSIs. Such contrasting is, thus, likely to generate focussed and rigorous recommendations4.
We conducted a proof-of-concept search on PubMed for the term "'Suicid*' [Ti]" for Clinical Trials published in the previous year (accessed September 2, 2020: 1000). The rationale behind including trials was to understand the nature of recent studies, which would eventually add to level-I evidence in suicide interventions. A total of 25 articles were identified during the initial search, and after discarding three non-clinical-trials and one article in German, 21 papers were assessed for (a) clear a priori definition of "suicide" and (b) attempted differentiation from NSSI. The latter was done by searching for the term "self" in available texts--since mention of NSSI/deliberate self-harm (DSH)/self-harm/self-injury or self-injurious behavior would have this term contained within...
Language: en |