Bereavement after the Suicide of a Significant Other

By Pompili, Maurizio; Shrivastava, Amresh et al. | Indian Journal of Psychiatry, July-September 2013 | Go to article overview

Bereavement after the Suicide of a Significant Other


Pompili, Maurizio, Shrivastava, Amresh, Serafini, Gianluca, Innamorati, Marco, Milelli, Mariantonietta, Erbuto, Denise, Ricci, Federica, Lamis, Dorian, Scocco, Paolo, Amore, Mario, Lester, David, Girardi, Paolo, Indian Journal of Psychiatry


Byline: Maurizio. Pompili, Amresh. Shrivastava, Gianluca. Serafini, Marco. Innamorati, Mariantonietta. Milelli, Denise. Erbuto, Federica. Ricci, Dorian. Lamis, Paolo. Scocco, Mario. Amore, David. Lester, Paolo. Girardi

Context: It is estimated that approximately one in four people know someone who has taken their own life and that one suicide death leaves six or more suicide survivors. Aims: The aim of this paper was to review the literature regarding the association between suicide and bereavement, focusing also on the supportive and therapeutic resources available for survivors. Materials and Methods: Careful MedLine and PsycINFO searches for the period 1980-2013. Results: The review of the literature indicates that emotional turmoil in suicide survivors may last a long time and, in some cases, may end with their own suicide. Conclusion: Future research should evaluate the efficacy of professional treatments and of support groups targeting suicide survivors. Practice Implications: It is crucial to understand the bereavement process after the suicide of a significant other in order to provide proper care, reduce stigma, and improve the outcomes of related psychiatric conditions.

Introduction

The "survivors of suicides" (or "suicide survivors"; in this paper we will consider these two terms interchangeably) include family members and friends who experience the loss of a loved one. [sup][1],[2] It is estimated that approximately one in four people know someone who has taken their own life and that one suicide death leaves six or more suicide survivors. [sup][3],[4] As Shneidman noted, suicide survivors represent the largest mental health casualty area related to suicide. [sup][2],[5]

The SOS Handbook for Survivors of Suicide published by the American Association of Suicidology reports that the trauma of losing a loved one to suicide is "catastrophic". [sup][5],[6],[7] The grief process is always difficult, but a loss through suicide is like no other. It is shocking, painful, unexpected, and more challenging for several reasons. [sup][3] For example, suicide can isolate the survivors from their community and even from other family members, [sup][8],[9] a situation exacerbated by stigma, [sup][10] or the survivors may experience mixed emotions. On one hand, the suicidal act may seem like an assault on or a rejection of those left behind. [sup][3] On the other hand, survivors may blame themselves for failing to predict the death or to have effectively intervened.

The risk of becoming depressed and/or abusing alcohol/substances is increased after the loss of a partner to suicide. [sup][11],[12] However, mental health symptoms usually subside after the first 3 years following the suicide, although sometimes the unbearable psychological pain of survivors may lead them to consider suicide and to ultimately take their life if they are not provided with help from adequate programs of assistance. [sup][13],[14] Suicide risk is elevated after stressful life events such as the death of a partner or even a twin from any cause. [sup][12],[15]

The aim of this paper is to review the literature regarding the associations among suicide bereavement, mourning, and risk of suicide in survivors; while also focusing on supportive and therapeutic resources available for suicide survivors.

Materials and Methods

We performed careful MedLine, PsycINFO, and TRIP searches for the period from 1980 to 2013. The following search terms were used: "survivors", "bereavement" OR "mourning", "suicidFNx01" (which comprises suicide, suicidal, suicidality, and other suicide-related terms). Each category was cross-referenced with the others using the MeSH method (Medical Subjects Headings). Those studies published in English peer-reviewed journals that added an original contribution to the literature were included.

Results

The risk of suicide by survivors

Krysinska noted that suicidal behaviour may be precipitated by an individual's experience of the loss of a loved one from suicide. …

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