Suicidal ideation classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vindhya BellamKonda, M.B.B.S [2]

Overview

There is no established system for classification of suicidal ideation.

Classification of suicidal ideation

Classification	Definition	Examples
Suicidal events Completed suicide	A self-injurious behavior that resulted in fatality and was associated with at least some intent to die as a result of the act.	example:1) After a long argument with his girlfriend, which resulted in the end of their relationship, the patient collected a rope and rode his bike to an isolated area where he fatally hanged himself. A suicide note was later found. 2) After four documented attempts at suicide, the patient stole his uncle’s gun and shot himself and was fatally injured
Suicide attempt	A potentially self-injurious behavior, associated with at least some intent to die, as a result of the act. Evidence that the individual intended to kill him/ herself, at least to some degree, can be explicit or inferred from the behavior or circumstance. A suicide attempt may or may not result in actual injury	Example:fter a fight with her friends at school, in which they discontinued speaking with her, the patient ingested approximately 16 aspirin and eight other pills of different types on the school grounds. She said that she deserved to die, which was why she swallowed the pills. 2) The patient used a razor blade to lacerate his wrists, his antecubital fossae, and his back bilaterally. He told his therapist that the “the main objective was to stop feeling like that,” and he knew that he could die but didn’t care. According to the patient, he also ingested a bottle of rubbing alcohol because in his health class he heard “that the medulla will get more suppressed that way,” thereby increasing y increasing the chances that he would be “successful” and die
[Preparatory acts towards imminent suicidal behavior	The individual takes steps to injure him- or herself, but is stopped by self or others from starting the self-injurious act before the potential for harm has begun	her had gone to school and retrieved a recent “bad” report card. He was fearful of his father’s reaction. Upon his return home, a 5- to 6-hour argument with his parents ensued, and he took a vegetable (broad, sharp) knife and went to his room. He reported putting the knife to his wrist but never puncturing the skin. 2) The patient stated that he “couldn’t stand being depressed anymore” and “wanted to die.” He decided to hang himself. He tied a telephone cord to the door knob and placed the cord loosely around his neck. Then, he stopped himself and did not follow through with the attempt.
Suicidal ideation	Passive thoughts about wanting to be dead or active thoughts about killing oneself, not accompanied by preparatory behavior.a	Active: The patient reported to the doctor that he was thinking about hanging himself in the closet. He was taken to the hospital and admitted. Passive: The patient reported ideas about wanting to be dead but denied acting on these feelings.