Suicidal communication signifies suicidal intent in Chinese completed suicides

Recognizing suicidal communication from the distressful catharsis in a high-risk group with suicidal tendencies is essential
for suicide prevention. This study analyzes whether suicidal communication can indicate the severity of suicidal intent. Various
types of suicidal communication are defined, and their clinical significance is further explored.

A comprehensive analysis of the psychological autopsy data of 200 victims of completed suicide, including their general socio-demographic
status, suicidal communication methods, previous suicide attempts, mental disorders, and psychosocial situation.

Our results showed that 39.5% of all the subjects were suicidal communicators, 23.0% had previously attempted suicide, and
14.0% left suicide notes; 32.4% of 142 subjects free of physical disease suffered from mental disorders. Suicidal communication
included verbal communication, behavioral communication, and suicidal notes. Younger people with a higher level of education
were more inclined to communicate their suicidal intent by leaving a suicide note. Suicide notes, but not previous suicide
attempts or psychosocial situation, were significantly correlated with suicidal intent. Suicidal communicators showed higher
depression scores than non-communicators. Those who suffered from mood disorders with higher levels of both depression and
suicidal intent were more likely to expose their intent through behavioral communication.

The present study provides strong evidence that suicidal communication can indicate the severity of suicidal intent. Current
findings help interpret high-risk, self-destructive behavior and consequently provide the theoretical basis for a feasible
suicide prevention program.