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Improvement and Recovery From Suicidal and Self-Destructive Phenomena in Treatment-Refractory Disorders

Perry, Christopher J. MPH, MD*†; Fowler, James C. PhD*; Bailey, Adrian BA*; Clemence, A Jill PhD*; Plakun, Eric M. MD*; Zheutlin, Barbara MA*; Speanburg, Stefanie MSW*

The Journal of Nervous and Mental Disease: January 2009 - Volume 197 - Issue 1 - p 28-34
doi: 10.1097/NMD.0b013e3181927598
Original Articles

Long-term data about recovery from suicidal and self-destructive phenomena are limited. We examined these phenomena in a naturalistic, follow-along study of 226 adults with treatment-refractory disorders admitted at the Austen Riggs Center. Follow-along interviews systematically rated suicidal ideation, suicide attempts, self-mutilation, and other self-destructive phenomena. We identified vital status in 98.7%, finding 1 death by suicide. Among 79 who made at least 1 suicide attempt in the 6 months before admission, 61 (77.2%) were estimated to be free of suicidal acts by a median of 7.18 years. Self-mutilation and other self-destructive phenomena showed slightly longer times to recovery. Among 156 individuals with suicidal ideation, 79 (50.6%) attained sustained recovery at a median of 8.69 years. On average 2.9 to 5.2 years were required from the last observed self-destructive event to attain sustained recovery. Most participants showed significant improvement in suicidal phenomena, whereas between 50.6% and 77.2% attained sustained recoveries.

From the *The Austen Riggs Center, Stockbridge, Massachusetts; and †The Institute of Community and Family Psychiatry, Sir Mortimer B. Davis Jewish General Hospital, McGill University, Montreal, Quebec, Canada.

The Austen Riggs Follow-along Study was supported by the Austen Riggs Center and grants from The Jeffrey Gutin Fund of the Suicide Prevention Partnership and the Ethel and Irving Edelman Foundation.

This paper was presented at the annual meetings of the American Association of Suicidology, Seattle, Washington, April 28, 2006 to May 1, 2006 and the Society for Psychotherapy Research, Edinburgh, Scotland, June 21, 2006 to June 24, 2006.

Send reprint requests to Christopher Perry J, MPH, MD, The Austen Riggs Center, 25 Main St., Stockbridge, MA 01262-0962. E-mail:

© 2009 Lippincott Williams & Wilkins, Inc.