Background

Suicidality, depression & the role of the family doctor

Since the 1980s, the number of suicides in Germany has decreased by about half, reaching 9206 in 2020. However, the WHO estimates that the number of suicide attempts is 10-20 times higher. About 10% of GP patients have suicidal thoughts, with a depressive illness being the most important risk factor in the transition from suicidal thoughts to a suicide attempt. The suicide rate increases steadily in old age, which is particularly relevant from a GP perspective, as GP visits also increase significantly in old age.

General practice plays a central role in depression care and thus also in suicide prevention because of the relationship of trust between GPs and general practitioners. Half of the people diagnosed with depression are cared for exclusively by general practitioners, and only one fifth are referred for specialist care. The majority of all people with depression receive treatment with GP involvement.

Studies show that about half of all people who commit suicide still had contact with primary care in the four weeks before their death. At the same time, people seeking help report suicidal thoughts to the GP comparatively rarely on their own initiative. Regular active exploration of suicidality on the part of the general practitioner thus represents an important opportunity for suicide prevention, since general practitioners are usually the first and sometimes the only contact persons.

Tools to detect suicidality & benefits of the study

However, this important project presents a challenge due to the limited time resources available in GP practices. There are hardly any German-language standardised suicidality screening instruments that are easy to handle in GP practices due to a small number of questions.

The aim is to design a new, time-efficient short questionnaire - especially for primary care - which, in addition to suicide risk factors, also takes into account the respective protective aspects that prevent those affected from attempting suicide. In this way, the attending physician also receives direct information on initial prevention options within the scope of the diagnosis.

According to the current guidelines for dealing with acute suicidal tendencies in depressive patients, the basis of a conversation and relationship offer to suicidal patients is an "open, direct and serious approach to suicidal tendencies". The SuPr-X can be used very well for this purpose.