Suicide risk factors

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Suicide Microchapters


Patient Information



Epidemiology and Demographics

Risk Factors


Physical Examination

Laboratory Findings

Psychiatric evaluation


Medical Therapy




Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief:


Common risk factors include family history of suicidal behavior, mental disorders such as major depression, substance use disorders, hospitalization or psychotic disorders, history of physical or sexual abuse, previous suicide attempt or exposure to suicide, gay, lesbian, or bisexual orientation, or transgender or gender non-conforming identity, biologic factors, access to firearms, alcohol and drug abuse, social stress, social isolation, adoption, emotional and cognitive factors. Mnemonic for identification of risk factors "IS PATH WARM".

Risk factors

Common Risk Factors

  • Risk factors for suicide may include:[1][2][3][4]
    • Family history of suicidal behavior
    • Mental disorders such as major depression, substance use disorders, hospitalization or psychotic disorders
    • History of physical or sexual abuse
    • Previous suicide attempt or exposure to suicide
    • Gay, lesbian, or bisexual orientation, or transgender or gender non-conforming identity[5]
    • Biologic factors
    • Access to means
      • Firearms
    • Alcohol and drug use
    • Social stress
      • Social isolation
    • Adoption
    • Emotional and cognitive factors

Less Common Risk Factors

  • Poor self-esteem[6]
  • Impulsivity and risk-taking behavior[7]
  • Aggressiveness[8]
  • Delinquent behavior[9]
  • Family dysfunction[10]
  • Parenting style characterized by little warmth and little control (rejecting and neglectful)
  • Nonintact family
  • Having run away from home

Warning Signs

Warning signs help to determine one at risk for suicide, especially if the behavior is new, has increased, or seems related to a painful event. Warning signs include:

  • Talking about wanting to die or to kill themselves
  • Looking for a way to kill themselves, like searching online or buying a gun
  • Talking about feeling hopeless or having no reason to live
  • Talking about feeling trapped or in unbearable pain
  • Talking about being a burden to others
  • Increasing the use of alcohol or drugs
  • Acting anxious or agitated; behaving recklessly
  • Sleeping too little or too much
  • Withdrawing or isolating themselves
  • Showing rage or talking about seeking revenge
  • Extreme mood swings

Mnemonic for Identification of risk factors


I Ideation
S Substance abuse – Increased substance use
P Purposelessness
A Anxiety – Worry, fear, agitation, or changes in sleep pattern
T Trapped – Feeling like there is no way out of a bad situation
H Hopelessness
W Withdrawal from friends, family, and society
A Anger
R Recklessness
M Mood changes


  1. Shain B (July 2016). "Suicide and Suicide Attempts in Adolescents". Pediatrics. 138 (1). doi:10.1542/peds.2016-1420. PMID 27354459.
  2. Shain BN (September 2007). "Suicide and suicide attempts in adolescents". Pediatrics. 120 (3): 669–76. doi:10.1542/peds.2007-1908. PMID 17766542.
  3. Press BR, Khan SA (June 1997). "Management of the suicidal child or adolescent in the emergency department". Curr. Opin. Pediatr. 9 (3): 237–41. PMID 9229162.
  4. Brent DA (March 1997). "The aftercare of adolescents with deliberate self-harm". J Child Psychol Psychiatry. 38 (3): 277–86. PMID 9232474.
  5. "Office-based care for lesbian, gay, bisexual, transgender, and questioning youth". Pediatrics. 132 (1): 198–203. July 2013. doi:10.1542/peds.2013-1282. PMID 23796746.
  6. Weitoft GR, Hjern A, Haglund B, Rosén M (January 2003). "Mortality, severe morbidity, and injury in children living with single parents in Sweden: a population-based study". Lancet. 361 (9354): 289–95. doi:10.1016/S0140-6736(03)12324-0. PMID 12559862.
  7. Yen S, Kuehn K, Tezanos K, Weinstock LM, Solomon J, Spirito A (March 2015). "Perceived family and peer invalidation as predictors of adolescent suicidal behaviors and self-mutilation". J Child Adolesc Psychopharmacol. 25 (2): 124–30. doi:10.1089/cap.2013.0132. PMC 4367518. PMID 25264807.
  8. Donath C, Graessel E, Baier D, Bleich S, Hillemacher T (April 2014). "Is parenting style a predictor of suicide attempts in a representative sample of adolescents?". BMC Pediatr. 14: 113. doi:10.1186/1471-2431-14-113. PMC 4011834. PMID 24766881.
  9. Wichstrøm L (May 2000). "Predictors of adolescent suicide attempts: a nationally representative longitudinal study of Norwegian adolescents". J Am Acad Child Adolesc Psychiatry. 39 (5): 603–10. doi:10.1097/00004583-200005000-00014. PMID 10802978.
  10. Woods ER, Lin YG, Middleman A, Beckford P, Chase L, DuRant RH (June 1997). "The associations of suicide attempts in adolescents". Pediatrics. 99 (6): 791–6. PMID 9164770.

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