Critical Reviews in Oncology / Hematology
Volume 78, Issue 3 , Pages 206-219 , June 2011

Suicide and cancer: Where do we go from here?

  • Ilaria Spoletini

      Affiliations

    • IRCCS Santa Lucia Foundation, Rome, Italy
    • ,
  • Walter Gianni

      Affiliations

    • IRCCS INRCA, Rome, Italy
    • ,
  • Carlo Caltagirone

      Affiliations

    • IRCCS Santa Lucia Foundation, Rome, Italy
    • “Tor Vergata” University, Dept. of Neuroscience, Rome, Italy
    • ,
  • Raffaele Madaio

      Affiliations

    • Ospedale Israelitico, Rome, Italy
    • ,
  • Lazzaro Repetto

      Affiliations

    • IRCCS INRCA, Rome, Italy
    • ,
  • Gianfranco Spalletta

      Affiliations

    • IRCCS Santa Lucia Foundation, Rome, Italy
    • “Tor Vergata” University, Dept. of Neuroscience, Rome, Italy
    • Corresponding Author InformationCorresponding author at: IRCCS Santa Lucia Foundation, Laboratory of Clinical and Behavioural Neurology, Via Ardeatina, 306, 00179 Rome, Italy. Tel.: +39 06 51501575; fax: +39 06 51501575.

,Accepted 7 May 2010.

References 

  1. WHO . Global cancer rates could increase by 50% to 15 million by 2020. World Health Organization; 1999;
  2. Akechi T, Okuyama T, Sugawara Y, et al. Major depression, adjustment disorders, and post-traumatic stress disorder in terminally ill cancer patients: associated and predictive factors. J Clin Oncol. 2004;22(10):1957–1965
  3. Breitbart W, Rosenfeld B, Pessin H, et al. Depression, hopelessness, and desire for hastened death in terminally ill patients with cancer. JAMA. 2000;284(22):2907–2911
  4. Bjorkenstam C, Edberg A, Ayoubi S, et al. Are cancer patients at higher suicide risk than the general population?. Scand J Public Health. 2005;33(3):208–214
  5. Filiberti A, Ripamonti C. Suicide and suicidal thoughts in cancer patients. Tumori. 2002;88(3):193–199
  6. Henriksson MM, Isometsa ET, Hietanen PS, et al. Mental disorders in cancer suicides. J Affect Disord. 1995;36(1–2):11–20
  7. Quill TE. Suicidal thoughts and actions in cancer patients: the time for exploration is now. J Clin Oncol. 2008;26(29):4705–4707
  8. Sharma SP. High suicide rate among cancer patients fuels prevention discussions. J Natl Cancer Inst. 2008;100(24):1750–1752
  9. Hawton K, van Heeringen K. Suicide. Lancet. 2009;373(9672):1372–1381
  10. Hawton K, Sutton L, Haw C, et al. Suicide and attempted suicide in bipolar disorder: a systematic review of risk factors. J Clin Psychiatry. 2005;66(6):693–704
  11. Walker J, Waters RA, Murray G, et al. Better off dead: suicidal thoughts in cancer patients. J Clin Oncol. 2008;26(29):4725–4730
  12. WHO . World report on violence and health. Geneva: World Health Organization; 2002;
  13. Webber W. EU calls for action to prevent youth suicide. Lancet. 2000;356:1092
  14. Maltsberger J, Goldblatt M. Essential papers on suicide. New York, NY, USA: New York University Press; 1996;
  15. Appleby L, Morriss R, Gask L, et al. An educational intervention for front-line health professionals in the assessment and management of suicidal patients (The STORM Project). Psychol Med. 2000;30(4):805–812
  16. Plutchik R. Aggression, violence, and suicide. In:  Maris R,  Berman A,  Silverman M editor. Comprehensive textbook of suicidology. New York, NY: Guilford Press; 2000;p. 407–423
  17. Hirschfeld RM, Russell JM. Assessment and treatment of suicidal patients. N Engl J Med. 1997;337(13):910–915
  18. Cavanagh JT, Carson AJ, Sharpe M, et al. Psychological autopsy studies of suicide: a systematic review. Psychol Med. 2003;33(3):395–405
  19. Brent DA, Kalas R, Edelbrock C, et al. Psychopathology and its relationship to suicidal ideation in childhood and adolescence. J Am Acad Child Psychiatry. 1986;25(5):666–673
  20. Joiner TE. The trajectory of suicidal behavior over time. Suicide Life Threat Behav. 2002;32(1):33–41
  21. Goldney RD, Wilson D, Dal Grande E, et al. Suicidal ideation in a random community sample: attributable risk due to depression and psychosocial and traumatic events. Aust N Z J Psychiatry. 2000;34(1):98–106
  22. Welch SS. A review of the literature on the epidemiology of parasuicide in the general population. Psychiatr Serv. 2001;52(3):368–375
  23. Lish JD, Zimmerman M, Farber NJ, et al. Suicide screening in a primary care setting at a Veterans Affairs Medical Center. Psychosomatics. 1996;37(5):413–424
  24. Brent DA. Assessment and treatment of the youthful suicidal patient. Ann N Y Acad Sci. 2001;932:106–128[discussion 128–31]
  25. Hall RC, Platt DE, Hall RC. Suicide risk assessment: a review of risk factors for suicide in 100 patients who made severe suicide attempts. Evaluation of suicide risk in a time of managed care. Psychosomatics. 1999;40(1):18–27
  26. Goodwin RD, Kroenke K, Hoven CW, et al. Major depression, physical illness, and suicidal ideation in primary care. Psychosom Med. 2003;65(4):501–505
  27. Harris EC, Barraclough B. Suicide as an outcome for mental disorders. A meta-analysis. Br J Psychiatry. 1997;170:205–228
  28. Beautrais AL, Joyce PR, Mulder RT, et al. Prevalence and comorbidity of mental disorders in persons making serious suicide attempts: a case–control study. Am J Psychiatry. 1996;153(8):1009–1014
  29. Health N. In harm's way: suicide in America. Bethesda, MD: National Institute of Mental Health; 1998;
  30. Harris EC, Barraclough B. Excess mortality of mental disorder. Br J Psychiatry. 1998;173:11–53
  31. Nock MK, Hwang I, Sampson NA, et al. Mental disorders, comorbidity and suicidal behavior: results from the National Comorbidity Survey Replication. Mol Psychiatry. 2009;
  32. Nock MK, Borges G, Bromet EJ, et al. Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. Br J Psychiatry. 2008;192(2):98–105
  33. Borges G, Angst J, Nock MK, et al. Risk factors for the incidence and persistence of suicide-related outcomes: a 10-year follow-up study using the National Comorbidity Surveys. J Affect Disord. 2008;105(1–3):25–33
  34. Brent DA, Mann JJ. Family genetic studies, suicide, and suicidal behavior. Am J Med Genet C Semin Med Genet. 2005;133C(1):13–24
  35. Bondy B, Buettner A, Zill P. Genetics of suicide. Mol Psychiatry. 2006;11(4):336–351
  36. Shneidman ES. Suicide as psychache. J Nerv Ment Dis. 1993;181(3):145–147
  37. Baumeister RF. Suicide as escape from self. Psychol Rev. 1990;97(1):90–113
  38. Alloy LB, Abramson LY, Whitehouse WG, et al. Prospective incidence of first onsets and recurrences of depression in individuals at high and low cognitive risk for depression. J Abnorm Psychol. 2006;115(1):145–156
  39. Miranda R, Nolen-Hoeksema S. Brooding and reflection: rumination predicts suicidal ideation at 1-year follow-up in a community sample. Behav Res Ther. 2007;45(12):3088–3095
  40. Wagner KD, Rouleau M, Joiner T. Cognitive factors related to suicidal ideation and resolution in psychiatrically hospitalized children and adolescents. Am J Psychiatry. 2000;157(12):2017–2021
  41. Beck AT, Brown G, Steer RA. Prediction of eventual suicide in psychiatric inpatients by clinical ratings of hopelessness. J Consult Clin Psychol. 1989;57(2):309–310
  42. Nolen-Hoeksema S. Responses to depression and their effects on the duration of depressive episodes. J Abnorm Psychol. 1991;100(4):569–582
  43. Kinderman P, Bentall RP. Causal attributions in paranoia and depression: internal, personal, and situational attributions for negative events. J Abnorm Psychol. 1997;106(2):341–345
  44. Lyubomirsky S, Nolen-Hoeksema S. Effects of self-focused rumination on negative thinking and interpersonal problem solving. J Pers Soc Psychol. 1995;69(1):176–190
  45. Rudd MD. The prevalence of suicidal ideation among college students. Suicide Life Threat Behav. 1989;19(2):173–183
  46. Joiner TE, Rudd MD. Disentangling the interrelations between hopelessness, loneliness, and suicidal ideation. Suicide Life Threat Behav. 1996;26(1):19–26
  47. Rudd MD, Joiner T, Rajab MH. Relationships among suicide ideators, attempters, and multiple attempters in a young-adult sample. J Abnorm Psychol. 1996;105(4):541–550
  48. Schotte DE, Cools J, Payvar S. Problem-solving deficits in suicidal patients: trait vulnerability or state phenomenon?. J Consult Clin Psychol. 1990;58(5):562–564
  49. Rudd MD, Rajab MH, Orman DT, et al. Effectiveness of an outpatient intervention targeting suicidal young adults: preliminary results. J Consult Clin Psychol. 1996;64(1):179–190
  50. Petty F, Kramer G, Wilson L. Prevention of learned helplessness: in vivo correlation with cortical serotonin. Pharmacol Biochem Behav. 1992;43(2):361–367
  51. Ellis T. Cognition and suicide: theory, research, and therapy. Washington, DC: American Psychological Association; 2006;
  52. Harris EC, Barraclough BM. Suicide as an outcome for medical disorders. Medicine (Baltimore). 1994;73(6):281–296
  53. Moscicki EK. Gender differences in completed and attempted suicides. Ann Epidemiol. 1994;4(2):152–158
  54. Hendin H. Suicide, assisted suicide, and medical illness. J Clin Psychiatry. 1999;60(Suppl. 2):46–50[discussion 51–42, 113–6]
  55. Stenager E, Stenager E. Physical illness and suicidal behavior. In:  Hawton K,  van Heuringen K editor. The international handbook of suicide and attempted suicide. New York, NY: Wiley; 2000;
  56. Kissane DW, Clarke DM, Street AF. Demoralization syndrome—a relevant psychiatric diagnosis for palliative care. J Palliat Care. 2001;17(1):12–21
  57. Hietanen P, Lonnqvist J. Cancer and suicide. Ann Oncol. 1991;2(1):19–23
  58. Ripamonti C, Filiberti A, Totis A, et al. Suicide among patients with cancer cared for at home by palliative-care teams. Lancet. 1999;354(9193):1877–1878
  59. Noor-Mahomed SB, Schlebusch L, Bosch BA. Suicidal behavior in patients diagnosed with cancer of the cervix. Crisis. 2003;24(4):168–172
  60. Miller M, Mogun H, Azrael D, et al. Cancer and the risk of suicide in older Americans. J Clin Oncol. 2008;26(29):4720–4724
  61. Misono S, Weiss NS, Fann JR, et al. Incidence of suicide in persons with cancer. J Clin Oncol. 2008;26(29):4731–4738
  62. Muff Christensen ML, Yousaf U, Engholm G, et al. Increased suicide risk among Danish women with non-melanoma skin cancer, 1971–1999. Eur J Cancer Prev. 2006;15(3):266–268
  63. Allebeck P, Bolund C, Ringback G. Increased suicide rate in cancer patients. A cohort study based on the Swedish Cancer-Environment Register. J Clin Epidemiol. 1989;42(7):611–616
  64. Tanaka H, Tsukuma H, Masaoka T, et al. Suicide risk among cancer patients: experience at one medical center in Japan, 1978–1994. Jpn J Cancer Res. 1999;90(8):812–817
  65. Hem E, Loge JH, Haldorsen T, et al. Suicide risk in cancer patients from 1960 to 1999. J Clin Oncol. 2004;22(20):4209–4216
  66. Crocetti E, Arniani S, Acciai S, et al. High suicide mortality soon after diagnosis among cancer patients in central Italy. Br J Cancer. 1998;77(7):1194–1196
  67. Levi F, Bulliard JL, La Vecchia C. Suicide risk among incident cases of cancer in the Swiss Canton of Vaud. Oncology. 1991;48(1):44–47
  68. Innos K, Rahu K, Rahu M, et al. Suicides among cancer patients in Estonia: a population-based study. Eur J Cancer. 2003;39(15):2223–2228
  69. Yousaf U, Christensen ML, Engholm G, et al. Suicides among Danish cancer patients 1971–1999. Br J Cancer. 2005;92(6):995–1000
  70. Schairer C, Brown LM, Chen BE, et al. Suicide after breast cancer: an international population-based study of 723,810 women. J Natl Cancer Inst. 2006;98(19):1416–1419
  71. Allebeck P, Bolund C. Suicides and suicide attempts in cancer patients. Psychol Med. 1991;21(4):979–984
  72. Druss B, Pincus H. Suicidal ideation and suicide attempts in general medical illnesses. Arch Intern Med. 2000;160(10):1522–1526
  73. Miccinesi G, Crocetti E, Benvenuti A, et al. Suicide mortality is decreasing among cancer patients in Central Italy. Eur J Cancer. 2004;40(7):1053–1057
  74. Storm HH, Christensen N, Jensen OM. Suicides among Danish patients with cancer: 1971 to 1986. Cancer. 1992;69(6):1507–1512
  75. Fox BH, Stanek EJ, Boyd SC, et al. Suicide rates among cancer patients in Connecticut. J Chronic Dis. 1982;35(2):89–100
  76. Kondrichin SV, Lester D. Correlates of regional suicide and cancer mortality rates. Percept Mot Skills. 2001;93(2):338
  77. Kondrichin SV, Lester D. Cancer and suicide. Percept Mot Skills. 2001;92(2):468
  78. Kendal WS. Suicide and cancer: a gender-comparative study. Ann Oncol. 2007;18(2):381–387
  79. Filiberti A, Ripamonti C, Totis A, et al. Characteristics of terminal cancer patients who committed suicide during a home palliative care program. J Pain Symptom Manage. 2001;22(1):544–553
  80. Dormer NR, McCaul KA, Kristjanson LJ. Risk of suicide in cancer patients in Western Australia, 1981–2002. Med J Aust. 2008;188(3):140–143
  81. Llorente MD, Burke M, Gregory GR, et al. Prostate cancer: a significant risk factor for late-life suicide. Am J Geriatr Psychiatry. 2005;13(3):195–201
  82. Bolund C. Suicide and cancer II. Medical and care factors in suicides by cancer patients in Sweden, 1973–76. J Psychosoc Oncol. 1985;3:31–52
  83. Lin HC, Wu CH, Lee HC. Risk factors for suicide following hospital discharge among cancer patients. Psychooncology. 2009;
  84. Foley KM. The relationship of pain and symptom management to patient requests for physician-assisted suicide. J Pain Symptom Manage. 1991;6(5):289–297
  85. Massie MJ, Gagnon P, Holland JC. Depression and suicide in patients with cancer. J Pain Symptom Manage. 1994;9(5):325–340
  86. Siegel K, Tuckel P. Rational suicide and the terminally ill cancer patient. Omega (Westport). 1984;15(3):263–269
  87. Hietanen P, Lonnquist J, Henriksson M, et al. Do cancer suicides differ from others?. Psycho-oncology. 1994;3:189–195
  88. Akechi T, Okamura H, Nishiwaki Y, et al. Predictive factors for suicidal ideation in patients with unresectable lung carcinoma. Cancer. 2002;95(5):1085–1093
  89. Massie MJ, Holland JC. Depression and the cancer patient. J Clin Psychiatry. 1990;51(Suppl.):12–17[discussion 18–9]
  90. Akechi T, Nakano T, Akizuki N, et al. Clinical factors associated with suicidality in cancer patients. Jpn J Clin Oncol. 2002;32(12):506–511
  91. Sellick SM, Crooks DL. Depression and cancer: an appraisal of the literature for prevalence, detection, and practice guideline development for psychological interventions. Psychooncology. 1999;8(4):315–333
  92. Spoletini I, Gianni W, Repetto L, et al. Depression and cancer: an unexplored and unresolved emergent issue in elderly patients. Crit Rev Oncol Hematol. 2008;65(2):143–155
  93. Akechi T, Okamura H, Yamawaki S, et al. Why do some cancer patients with depression desire an early death and others do not?. Psychosomatics. 2001;42(2):141–145
  94. Davies AD, Davies C, Delpo MC. Depression and anxiety in patients undergoing diagnostic investigations for head and neck cancers. Br J Psychiatry. 1986;149:491–493
  95. Lydiatt WM, Denman D, McNeilly DP, et al. A randomized, placebo-controlled trial of citalopram for the prevention of major depression during treatment for head and neck cancer. Arch Otolaryngol Head Neck Surg. 2008;134(5):528–535
  96. Breitbart W. Suicide in cancer patients. Oncology (Williston Park). 1987;1(2):49–55
  97. Akechi T. Desire or early death in cancer patients and clinical oncology. Jpn J Clin Oncol. 1999;29(12):646
  98. Akechi T, Okuyama T, Sugawara Y, et al. Suicidality in terminally ill Japanese patients with cancer. Cancer. 2004;100(1):183–191
  99. Chochinov HM, Wilson KG, Enns M, et al. Desire for death in the terminally ill. Am J Psychiatry. 1995;152(8):1185–1191
  100. Rasic DT, Belik SL, Bolton JM, et al. Cancer, mental disorders, suicidal ideation and attempts in a large community sample. Psychooncology. 2008;17(7):660–667
  101. Silberfarb PM, Maurer LH, Crouthamel CS. Psychosocial aspects of neoplastic disease. I. Functional status of breast cancer patients during different treatment regimens. Am J Psychiatry. 1980;137(4):450–455
  102. Ternestedt BM. Expressed desire for hastened death by patients with advanced cancer had several meanings and uses. Evid Based Nurs. 2005;8(3):96
  103. Filiberti A, Ripamonti C, Saita L, et al. Frequency of suicide by cancer patients at the National Cancer Institute of Milan over 1986–90. Ann Oncol. 1991;2(8):610
  104. Chochinov HM. Depression in cancer patients. Lancet Oncol. 2001;2(8):499–505
  105. Nissim R, Gagliese L, Rodin G. The desire for hastened death in individuals with advanced cancer: a longitudinal qualitative study. Soc Sci Med. 2009;
  106. O’Mahony S, Goulet J, Kornblith A, et al. Desire for hastened death, cancer pain and depression: report of a longitudinal observational study. J Pain Symptom Manage. 2005;29(5):446–457
  107. Mystakidou K, Parpa E, Katsouda E, et al. The role of physical and psychological symptoms in desire for death: a study of terminally ill cancer patients. Psychooncology. 2006;15(4):355–360
  108. Coyle N, Sculco L. Expressed desire for hastened death in seven patients living with advanced cancer: a phenomenologic inquiry. Oncol Nurs Forum. 2004;31(4):699–709
  109. Brown JH, Henteleff P, Barakat S, et al. Is it normal for terminally ill patients to desire death?. Am J Psychiatry. 1986;143(2):208–211
  110. Wilson KG, Scott JF, Graham ID, et al. Attitudes of terminally ill patients toward euthanasia and physician-assisted suicide. Arch Intern Med. 2000;160(16):2454–2460
  111. Sullivan M, Rapp S, Fitzgibbon D, et al. Pain and the choice to hasten death in patients with painful metastatic cancer. J Palliat Care. 1997;13(3):18–28
  112. Akechi T, Kugaya A, Okamura H, et al. Suicidal thoughts in cancer patients: clinical experience in psycho-oncology. Psychiatry Clin Neurosci. 1999;53(5):569–573
  113. Rudd MD, Dahm PF, Rajab MH. Diagnostic comorbidity in persons with suicidal ideation and behavior. Am J Psychiatry. 1993;150(6):928–934
  114. Mann JJ, McBride PA, Brown RP, et al. Relationship between central and peripheral serotonin indexes in depressed and suicidal psychiatric inpatients. Arch Gen Psychiatry. 1992;49(6):442–446
  115. Mann JJ. Neurobiology of suicidal behaviour. Nat Rev Neurosci. 2003;4(10):819–828
  116. Mann JJ, Waternaux C, Haas GL, et al. Toward a clinical model of suicidal behavior in psychiatric patients. Am J Psychiatry. 1999;156(2):181–189
  117. Coryell W, Schlesser M. The dexamethasone suppression test and suicide prediction. Am J Psychiatry. 2001;158(5):748–753
  118. Tan TT, Coussens LM. Humoral immunity, inflammation and cancer. Curr Opin Immunol. 2007;19(2):209–216
  119. Lin WW, Karin M. A cytokine-mediated link between innate immunity, inflammation, and cancer. J Clin Invest. 2007;117(5):1175–1183
  120. Reiche EM, Nunes SO, Morimoto HK. Stress, depression, the immune system, and cancer. Lancet Oncol. 2004;5(10):617–625
  121. Maes M, Meltzer HY, Stevens W, et al. Natural killer cell activity in major depression: relation to circulating natural killer cells, cellular indices of the immune response, and depressive phenomenology. Prog Neuropsychopharmacol Biol Psychiatry. 1994;18(4):717–730
  122. Levy SM, Herberman RB, Maluish AM, et al. Prognostic risk assessment in primary breast cancer by behavioral and immunological parameters. Health Psychol. 1985;4(2):99–113
  123. Levy S, Wise B. Psychosocial risk factors and cancer progression. Chichester: John Wiley & Sons; 1988;
  124. Andersen BL, Kiecolt-Glaser JK, Glaser R. A biobehavioral model of cancer stress and disease course. Am Psychol. 1994;49(5):389–404
  125. Levy S, Herberman R, Lippman M, et al. Correlation of stress factors with sustained depression of natural killer cell activity and predicted prognosis in patients with breast cancer. J Clin Oncol. 1987;5(3):348–353
  126. Raison CL, Capuron L, Miller AH. Cytokines sing the blues: inflammation and the pathogenesis of depression. Trends Immunol. 2006;27(1):24–31
  127. Schiepers OJ, Wichers MC, Maes M. Cytokines and major depression. Prog Neuropsychopharmacol Biol Psychiatry. 2005;29(2):201–217
  128. Tuglu C, Kara SH, Caliyurt O, et al. Increased serum tumor necrosis factor-alpha levels and treatment response in major depressive disorder. Psychopharmacology (Berl). 2003;170(4):429–433
  129. Kokai M, Kashiwamura S, Okamura H, et al. Plasma interleukin-18 levels in patients with psychiatric disorders. J Immunother. 2002;25(Suppl. 1):S68–S71
  130. Maes M. Major depression and activation of the inflammatory response system. Adv Exp Med Biol. 1999;461:25–46
  131. Irwin M. Depression and immunity. In:  Ader R,  Felten D,  Cohen N editor. Psychoneuroimmunology. New York: Academic Press; 2004;p. 383–398
  132. Anisman H, Merali Z. Cytokines, stress and depressive illness: brain–immune interactions. Ann Med. 2003;35(1):2–11
  133. Capuron L, Dantzer R. Cytokines and depression: the need for a new paradigm. Brain Behav Immun. 2003;17(Suppl. 1):S119–S124
  134. Yirmiya R. Endotoxin produces a depressive-like episode in rats. Brain Res. 1996;711(1–2):163–174
  135. Rivier C. The hypothalamo-pituitary-adrenal axis response to immune signals. In:  Ader R,  Felten D,  Cohen N editor. Psychoneuroimmunology. New York: Academic Press; 2001;p. 633–648
  136. Lapchak PA, Araujo DM, Hefti F. Cholinergic regulation of hippocampal brain-derived neurotrophic factor mRNA expression: evidence from lesion and chronic cholinergic drug treatment studies. Neuroscience. 1993;52(3):575–585
  137. Elenkov IJ, Iezzoni DG, Daly A, et al. Cytokine dysregulation, inflammation and well-being. Neuroimmunomodulation. 2005;12(5):255–269
  138. Capuron L, Gumnick JF, Musselman DL, et al. Neurobehavioral effects of interferon-alpha in cancer patients: phenomenology and paroxetine responsiveness of symptom dimensions. Neuropsychopharmacology. 2002;26(5):643–652
  139. Massie M, Chertkov L, Roth A. Psychological issues. In:  DeVita VJ,  Hellman S,  Rosenberg S editor. Cancer: principles and practice of oncology. Philadelphia, PA: Lippincott Williams & Wilkins; 2001;p. 3058–3065
  140. Hann D, Baker F, Denniston M, et al. The influence of social support on depressive symptoms in cancer patients: age and gender differences. J Psychosom Res. 2002;52(5):279–283
  141. Durkheim E. Suicide: a study in sociology. New York: Free Press; 1951;
  142. Posner K, Oquendo MA, Gould M, et al. Columbia Classification Algorithm of Suicide Assessment (C-CASA): classification of suicidal events in the FDA's pediatric suicidal risk analysis of antidepressants. Am J Psychiatry. 2007;164(7):1035–1043
  143. Beck AT, Brown GK, Steer RA, et al. Suicide ideation at its worst point: a predictor of eventual suicide in psychiatric outpatients. Suicide Life Threat Behav. 1999;29(1):1–9
  144. Kreitman N. Parasuicide. London, England: John Wiley and Sons; 1977;
  145. APA . Diagnostic and statistical manual of mental disorders. 4th ed. rev.. Washington: American Psychiatric Press; 2000;

PII: S1040-8428(10)00125-3

doi: 10.1016/j.critrevonc.2010.05.005

Critical Reviews in Oncology / Hematology
Volume 78, Issue 3 , Pages 206-219 , June 2011

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