An Epidemiological Survey of Parasuicide (`Attempted Suicide') in General Practice

¹ Lecturer, Edinburgh University Department of Psychiatry
² MRC Unit for Epidemiological Studies in Psychiatry, University Department of Psychiatry, Royal Edinburgh Hospital, Morningside Park, Edinburgh, EH10 5HF

A prospective survey of parasuicides known to general practitioners in Edinburgh was carried out to supplement previous intensive research based on admissions to the Regional Poisoning Treatment Centre at the Royal Infirmary of Edinburgh, by including non-admitted cases also. The primary aim was to determine to what extent findings in this hospital-treated population are contaminated by factors influencing referral, and thus to examine whether aetiological explanations of this behaviour and endeavours in prevention have been misled by hospital studies.

It was demonstrated that good co-operation could be obtained from a large random sample of general practitioners, that the problems of defining this behaviour for operational use could be overcome, and that general practitioners can provide detailed information on their patients which is reliable.

The main findings were:

1. Hospital studies in Edinburgh underestimate the frequency of parasuicide by at least 30%.

2. Hospital sampling of parasuicides in Edinburgh has not misled attempts to understand this behaviour: persons sampled in the hospital during 1970 were no different from others detected in general practice on the demographic, social and psychiatric variables which feature prominently in explanations of parasuicide. However, hospital sampling of individual episodes of parasuicide was biased on variables relating to previous psychiatric contact and earlier episodes, which may be important in understanding and predicting further suicidal behaviour.