Is Passive Suicidal Ideation Really Passive?

An article by Robert I Simon, M.D. in Current Psychiatry, Vol 13, No 3, March 2014, talks about passive suicidal ideation and feels that active suicidal ideation [a plan] is also present. Dr. Simon believes that there is always a continuum of severity of thoughts and feelings and indicates changes in the patient’s psychiatric disorder. He recommends a careful clinical assessment of suicide risk for anyone with even “fleeting, passive” suicidal ideation. He comments on a study by Hall et al in Psyhosomatics, 1999, 40(1):18-27 found that 69 out of 100 patients who made severe suicide attempts had only “fleeting” or no suicidal ideation before their attempt.

I have previously blogged about assessing the risk of suicidal behavior if someone has suicidal ideation. I reported that 60% of adolescents who had a suicidal plan attempted suicide within one year of the onset of suicidal ideation. This would seem to support the importance of a clinical assessment of suicide risk by a trained professional. I also reported on factors that increased the risk of a suicide attempt. These were: being a female; diagnoses with depression,dysthymia, eating disorders, ADHD and conduct disorder; and symptoms of anxiety, agitation and poor behavioral control. Less risk of suicide attempts was associated with living with both parents and having siblings.

It is clearly very important to have a trained professional carefully evaluate anyone with any type of suicidal ideation.