Clinical features

Non-fatal suicidal behaviours can have very different motivations, varying from an intention to die to a cry for help. These behaviours may be well prepared or carried out impulsively, and may have different physical consequences. The degree of lethality and the degree of medical seriousness of the consequences thus depend upon intention, preparation, knowledge, and expectations of the method chosen, and sometimes upon coincidental factors, such as intervention from others.

It is often difficult to assess the true intent of non-fatal suicidal behaviour. Because of fear for consequences, such as admission to a psychiatric hospital, or because of psychological defence mechanisms, people sometimes deny or conceal their intention to die. They also may exaggerate their intention to die in order to receive help. Sometimes people engage in potentially highly lethal self-destructive behaviour without any wish to die, for example when they do not have adequate knowledge of the medication used. People who present at a general hospital with minor self-injury or minor self-poisoning may have had strong intentions to die, but had insufficient knowledge of the lethality of the method. Therefore one cannot always reliably infer what the precise meaning of the behaviour was, either from its overt characteristics, or from the person's self-report.

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