Spring heralds more sun, higher suicide rates

In Community Health, Feature by admin

There is an average of 129 suicides each day in this country, making it the 10th leading cause of death in America, according to the American Foundation for Suicide Prevention (AFSP).

In Kansas, suicide ranks 15 in causes of death, costing more than $510.4 million in combined lifetime medical and work loss costs, the AFSP reports. That’s an average of nearly $1.3 million per suicide death in Kansas.

Its prevalence has earned it the month of September as national Suicide Prevention Awareness Month. So why are we talking about this in March? Despite persistent myths that suicides go up during the holidays (not even September is a high-risk month), it’s actually the spring and summer months where spikes in suicide are highest.

“I think you can look at seasonal affective disorder,” said Wichita psychiatrist Dr. Dwight St. Clair, DO. “In the spring, people tend to have more sleep issues, and, when you look at obvious stressors, taxes are due soon. For some people, it doesn’t take much.”

March typically ranks third in most suicide deaths per day, surpassed only by May and July, according to the Centers for Disease Control and Prevention.

Even so, a report by the Annenberg Public Policy Center at the University of Pennsylvania found that 64 percent of newspapers stories “recycle the myth” that suicide rates rise during the holiday months. That’s why it’s important for physicians to be even more vigilant as March heralds spring weather.

Psychiatrists and other researchers have wondered for years why the arrival of spring seems to usher in a rise of suicide rates. Studies show that it is global phenomena not specific to the United States.

A 2012 study published in the International Journal of Environmental Research and Public Health took a look at the seasonality of suicidal behavior and what environmental factors may influence it.

As with most studies into this phenomenon, conclusions are inconsistent and definitive reasons are still not widely understood. But the researchers did acknowledge that physical conditions (bioclimatic factors such as sunshine, temperature and rainfall), chemical conditions (pollutants), and biological conditions (viruses, bacteria, protozoa and allergens) all factor as potential triggers of suicidal behaviors in spring or fall.

Physicians, then, should key in on the potential uptick of depressive and possibly suicidal patients they see throughout the year, particularly as March ushers in spring.

In fact, researchers of a study published in The Primary Care Companion to the Journal of Clinical Psychiatry found that active knowledge of high-risk factors help make primary care physicians more effective in identifying vulnerable patients.

“Physicians should be more on alert,” St. Clair said. “Be on the lookout for symptoms like anxiety, which (researchers) feel is the best short-term predictor of suicide. Ask about feelings of hopelessness, feeling overwhelmed.”

PCPs should look for these high-risk factors for suicide:
  • Past suicide attempts
  • Seriousness of previous attempts
  • Family history of suicide
  • Feelings of hopelessness
  • Substance abuse
  • Social isolation
  • Personal or family of history of psychiatric
  • Burden of physical health problems
  • History of loss
  • Preoccupation with death
Source: “Managing suicide attempts: Guidelines for the Primary Care Physician,” The Primary Care Companion to the Journal of Clinical Psychiatry (2003).