Jiunn Yew Thong
Institute of Mental Health, Singapore
Internet and Suicide. Hauppauge, New York: Nova Science Publishers, 2009, 452 pages.

Studies have demonstrated that most individuals who attempted suicide have a mental illness, the most common being depression and substance abuse or dependence. Individuals suffering from schizophrenia also have high mortality from suicide. Certain factors increase the suicide risk of this already at-risk population with mental illness. Having a comorbid mental illness increases suicide risk significantly, especially in combinations such as depression with comorbid alcohol abuse or dependence, and schizophrenia with comorbid depression. For those mentally-ill individuals who are unfortunate enough to be diagnosed with a serious and debilitating medical illness, their suicide risk is also increased. Anyone who attempted suicide, especially those who used a highly lethal method to try to kill themselves, should be assessed thoroughly and followed-up adequately. Besides depression being a risk for suicide, a psychotic state of mind (such as delusions) is also associated with suicidal behaviour. Clinicians should pay attention to the period following discharge from inpatient treatment, as this period of one month or so is a time of highest risk for suicide. This is the time when the depressed regain enough drive to carry out suicidal acts, and when individuals with schizophrenia regain insight to appreciate the devastating effects of the illness on their lives. Closer monitoring is vital during this period.