Box 1. Risk Factors for Suicide
Biological risk factors for suicide include:
Low cerebrospinal fluid 5-hydroxyindolacetic acid levels
Hypothalamic-pituitary-adrenal axis dysregulation
Low blood cholesterol levels
Medical or neurological illnesses (such as multiple sclerosis, stroke, Huntington disease, and epilepsy)
Cigarette smoking
Psychological risk factors include:
Acceptability of suicide
A childhood history of physical or sexual abuse
Discouraged help-seeking behavior
Aggressive/impulsive traits
Pessimism
Hopelessness
Low self-esteem
Poor access to psychiatric treatment
More proximal stressors that indicate an increased suicide risk include:
Relationship problems
Financial troubles
A family or personal history of suicide
Major depression
Substance use