Saturday, 1 October 2016

One of the best articles to discuss suicide risk and autism so far...

I'm cheating a little bit today as minus too much critical commentary or discussion, I'm drawing your attention to the paper by Tony Salvatore and colleagues [1] (open-access) on a most important topic: suicide risk and autism.

Written by authors who between them seem to know quite a bit about autism and also managing suicide prevention particularly under crisis conditions, I reckon this review article is one of the best we have so far in this area. I say that on the basis that not only are estimated prevalence figures included in the text but two very important discussion points on the key risk factors and also what might be protective against suicide behaviours are included. Importantly, the authors suggest that "suicide risk factors are similar for adults with and without ASD [autism spectrum disorder]". So rather than seeing suicide in relation to autism as something detached from suicidal behaviour on other occasions in other groups, they suggest common risk factors including comorbid mental illness as potentially 'precipitating suicidal ideation' or at least, increasing vulnerability to such behaviour are important.

Yes, I know we still have quite a way to go before any road maps or definitive protocols/toolkits are available to manage suicide risk in autism. But the Salvatore paper is as good a document as any to read on this important topic and potentially making moves to off-set at least some of the risk of this devastating behaviour. I might also add that other texts including talk of an 'acquired capability for suicide' among some groups might also offer some important links between something like self-harm and suicide risk which could also be relevant to [some] autism [2]. More investigations are very much needed including on the topic of suicide prevention [3].

And when it comes to biological risk factors also potentially associated with / linked to suicidal behaviour, the meta-analysis from Chang and colleagues [4] (open-access) initially highlighting fish oils and cytokines (inflammation?) as potentially being important might similarly prove applicable in the context of autism (minus any sweeping generalisations)...

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[1] Salvatore T. et al. Suicide Risk in Adults with Autism Spectrum Disorder: An Exploratory Discussion. The Journal of Special Populations. 2016; 1: 1.

[2] Paula-Perez I. & Artigas-Pallares J. Vulnerability to self-harm in autism. Rev Neurol. 2016;62 Suppl 1:S27-32.

[3] Zalsman G. et al. Suicide prevention strategies revisited: 10-year systematic review. Lancet Psychiatry. 2016 Jul;3(7):646-59.

[4] Chang BP. et al. Biological risk factors for suicidal behaviors: a meta-analysis. Translational Psychiatry. 2016. Sept 13.

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ResearchBlogging.org Chang, B., Franklin, J., Ribeiro, J., Fox, K., Bentley, K., Kleiman, E., & Nock, M. (2016). Biological risk factors for suicidal behaviors: a meta-analysis Translational Psychiatry, 6 (9) DOI: 10.1038/tp.2016.165