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The Suicide Risk Heading in DSM-5: Promising Start or Flubbed Launch?

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Abstract

The text of DSM-5 includes a new heading—Suicide Risk—meant to educate users about the suicide risk posed by specific mental disorders. But, how well do the Suicide Risk sections fulfill their didactic intent? A review of the sections shows that topical coverage is uneven, noteworthy disorders are omitted, and there are inaccurate statements. In addition, the text frequently uses pejorative terms for suicidal behavior and self-injury. Although the DSM-5 Task Force should be lauded for giving concentrated attention to psychiatry’s most lethal outcome, DSM-5 has limited utility for educating students about the suicide risk posed by mental disorders. I make four recommendations to improve the manual’s focus on suicide risk and redress the use of stigmatizing terminology.

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References

  1. American Association of Suicidology. (2018). Suicide reporting recommendations. Retrieved from https://suicidology.org/reporting-recommendations/. Accessed 1 Feb 2019.

  2. American Psychiatric Association. Practice guideline for the assessment and treatment of patients with suicidal behaviors. Am J Psychiatr. 2003;160(11 Suppl):1–60.

    Google Scholar 

  3. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, Fifth Edition. Arlington: American Psychiatric Publishing; 2013.

    Book  Google Scholar 

  4. Brenner LA, Breshears RE, Betthauser LM, Bellon KK, Holman E, Harwood JE, et al. Implementation of a suicide nomenclature within two VA healthcare settings. J Clin Psychol Med Settings. 2011;18(2):116–28. https://doi.org/10.1007/s10880-011-9240-9.

    Article  PubMed  Google Scholar 

  5. Crosby, A. E., Ortega, L., & Melanson, C. (2011). Self-directed Violence Surveillance: Uniform Definitions and Recommended Data Elements, Version 1.0. Atlanta, Georgia: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control.

  6. Franklin JC, Ribeiro JD, Fox KR, Bentley KH, Kleiman EM, Huang X, et al. Risk factors for suicidal thoughts and behaviors: a meta-analysis of 50 years of research. Psychol Bull. 2017;143(2):187–232. https://doi.org/10.1037/bul0000084.

    Article  PubMed  Google Scholar 

  7. Heilbron N, Compton JS, Daniel SS, Goldston DB. The problematic label of suicide gesture: alternatives for clinical research and practice. Prof Psychol Res Pract. 2010;41(3):221–7. https://doi.org/10.1037/a0018712.

    Article  Google Scholar 

  8. Huang X, Fox KR, Ribeiro JD, Franklin JC. Psychosis as a risk factor for suicidal thoughts and behaviors: a meta-analysis of longitudinal studies. Psychol Med. 2018;48(5):765–76. https://doi.org/10.1017/S0033291717002136.

    Article  CAS  PubMed  Google Scholar 

  9. Kessler RC, Warner CH, Ivany C, Petukhova MV, Rose S, Bromet EJ, et al. Predicting suicides after psychiatric hospitalization in US Army soldiers: the Army study to assess risk and resilience in service members (Army STARRS). JAMA Psychiat. 2015;72(1):49–57. https://doi.org/10.1001/jamapsychiatry.2014.1754.

    Article  Google Scholar 

  10. Nock MK, Borges G, Bromet EJ, Alonso J, Angermeyer M, Beautrais A, et al. Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. Br J Psychiatry. 2008;192(2):98–105. https://doi.org/10.1192/bjp.bp.107.040113.

    Article  PubMed  PubMed Central  Google Scholar 

  11. O’Carroll PW, Berman AL, Maris RW, Moscicki EK, Tanney BL, Silverman MM. Beyond the tower of babel: a nomenclature for suicidology. Suicide Life Threat Behav. 1996;26(3):237–52.

    PubMed  Google Scholar 

  12. Posner K, Oquendo MA, Gould M, Stanley B, Davies M. Columbia classification algorithm of suicide assessment (C-CASA): classification of suicidal events in the FDA’s pediatric suicidal risk analysis of antidepressants. Am J Psychiatr. 2007;164(7):1035–43. https://doi.org/10.1176/ajp.2007.164.7.1035.

    Article  PubMed  Google Scholar 

  13. Samaritans. (2013). Media guidelines for reporting on suicide. Retrieved from www.samaritans.org/mediaguidelines. Accessed 5 Feb 2019.

  14. Schmitz WM, Allen MH, Feldman BN, Gutin NJ, Jahn DR, Kleespies PM, et al. Preventing suicide through improved training in suicide risk assessment and care: an American Association of Suicidology Task Force report addressing serious gaps in U.S. mental health training. Suicide Life Threat Behav. 2012;42(3):292–304. https://doi.org/10.1111/j.1943-278X.2012.00090.x.

    Article  PubMed  Google Scholar 

  15. Silverman MM, Berman AL, Sanddal ND, O’Carroll PW, Joiner TEJ. Rebuilding the tower of babel: a revised nomenclature for the study of suicide and suicidal behaviors: part 2: suicide-related ideations, communications and behaviors. Suicide Life Threat Behav. 2007;37(3):264–77. https://doi.org/10.1521/suli.2007.37.3.264.

    Article  PubMed  Google Scholar 

  16. Walsh BW. Treating self-injury: a practical guide. 2nd ed. New York: Guilford; 2012.

    Google Scholar 

  17. Yeh H-H, Westphal J, Hu Y, Peterson EL, Williams LK, Prabhakar D, et al. Diagnosed mental health conditions and risk of suicide mortality. Psychiatr Serv. 2019;70(9):750–7. https://doi.org/10.1176/appi.ps.201800346.

    Article  PubMed  Google Scholar 

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Correspondence to Joseph H. Obegi.

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Obegi, J.H. The Suicide Risk Heading in DSM-5: Promising Start or Flubbed Launch?. Psychiatr Q 91, 729–733 (2020). https://doi.org/10.1007/s11126-020-09728-3

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