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APA Practice Guidelines > Practice Guideline for the Assessment and Treatment of Patients With Suicidal Behaviors > Part A: Assessment, Treatment, and Risk Management Recommendations > II. Assessment of Patients With Suicidal Behaviors > E. Estimate Suicide Risk > Table 4. Factors Associated With an Increased Risk for Suicide  Suicidal thoughts/behaviors   Suicidal ideas (current or previous)   Suicidal plans (current or previous)   Suicide attempts (including aborted or interrupted attempts)   Lethality of suicidal plans or attempts   Suicidal intent Psychiatric diagnoses   Major depressive disorder   Bipolar disorder (primarily in depressive or mixed episodes)   Schizophrenia   Anorexia nervosa   Alcohol use disorder   Other substance use disorders   Cluster B personality disorders (particularly borderline personality disorder)   Comorbidity of axis I and/or axis II disorders Physical illnesses   Diseases of the nervous system     Multiple sclerosis     Huntington's disease     Brain and spinal cord injury     Seizure disorders   Malignant neoplasms   HIV/AIDS   Peptic ulcer disease   Chronic obstructive pulmonary disease, especially in men   Chronic hemodialysis-treated renal failure   Systemic lupus erythematosus   Pain syndromes   Functional impairment Psychosocial features   Recent lack of social support (including living alone)   Unemployment   Drop in socioeconomic status   Poor relationship with familya   Domestic partner violenceb   Recent stressful life event Childhood traumas   Sexual abuse   Physical abuse Genetic and familial effects   Family history of suicide (particularly in first-degree relatives)   Family history of mental illness, including substance use disorders Psychological features   Hopelessness   Psychic paina   Severe or unremitting anxiety   Panic attacks   Shame or humiliationa   Psychological turmoila   Decreased self-esteema   Extreme narcissistic vulnerabilitya   Behavioral features   Impulsiveness   Aggression, including violence against others   Agitation Cognitive features   Loss of executive functionb   Thought constriction (tunnel vision)   Polarized thinking   Closed-mindedness Demographic features   Male genderc   Widowed, divorced, or single marital status, particularly for men   Elderly age group (age group with greatest proportionate risk for suicide)   Adolescent and young adult age groups (age groups with highest numbers of suicides)   White race   Gay, lesbian, or bisexual orientationb Additional features   Access to firearms   Substance intoxication (in the absence of a formal substance use disorder diagnosis)   Unstable or poor therapeutic relationshipa aAssociation with increased rate of suicide is based on clinical experience rather than formal research evidence. bAssociated with increased rate of suicide attempts, but no evidence is available on suicide rates per se. cFor suicidal attempts, females have increased risk, compared with males.

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