Summary and Conclusions: Effects of Medical Interventions on Suicidal Behavior

Background: An international symposium evaluated current knowledge of the epidemiology, psychobiology, and effects of medical treatment on suicidal behavior. Method: Moderators summarized the main findings and conclusions of the participants on the basis of presentations and consensusstatements at the meeting. Results: Despite striking advances in the medical treatment of mood disorders in the past half-century, rates of suicidal acts have changed little in the general population. Evidenceof reduction of long-term rates of suicidal acts in specific at-risk populations remains very limited,particularly persons with major affective illnesses and other common, primary or comorbidpsychiatric and substance use disorders. It is plausible that reduction of psychiatric morbidity shouldlimit suicidal risk, but very little is known about specific effects of most psychiatric treatments orother interventions aimed at suicide prevention. An exception is substantial evidence of lower suicidalrisk during long-term lithium treatment that was not equaled with carbamazepine. However, diagnosisand timely therapeutic interventions reach only a minority of psychiatrically ill persons at risk for suicide.Conclusion: Renewed efforts are strongly urged to: (1) improve public and professional awareness of risk factors for suicide, (2) enhance earlier access to appropriate clinical assessment and increasinglysafe and effective treatments for affective and psychotic disorders, and (3) encourage andsupport research to clarify specific benefits and risks of medical treatments and social interventionsaimed at preventing suicide.