The World Health Organization estimates about 1.5 million deaths by suicide per year worldwide by 2020. We will discuss how social adversity and psychological/social pain interact in this model and help to better understand suicidal process at individual level.

Émile Durkheim [1Durkheim E. Le suicide  : Presse Universitaires de France (1987). 

Cliquez ici pour aller à la section Références] viewed suicide as a social fact. According to his theory the variations in suicidal rate on a macro-level could also be explained by society-scale phenomena rather than individual's feelings and motivations. In the 21st century, three major points have to be highlighted to underline a possible relationship between economic crisis and suicide:

– suicide rate of employees is becoming more similar to the suicide rate of workers while working conditions are getting worse;

– increase of suicide rate for young working men was observed since 1970, i.e. the beginning of oil crisis;

– suicides in workplace occur, sometimes serial suicides in (inter)national companies. Nowadays, suicidal acts may be best understood within a stress-vulnerability model, where it is assumed that only vulnerable patients, when submitted to environmental stressors, will kill themselves.

At the individual level, the transition to the suicidal act is usually precipitated by psychosocial stress. Nearly all suicide victims have experienced at least one or more adverse life event within 1 year of death (concentrated in last few months). Interpersonal conflict was at the greatest risk of suicidal act [2Foster T. “Adverse life events proximal to adult suicide: a synthesis of findings from psychological autopsy studies” Arch Suicide Res 2011 ;  15 (1) : 1-15 [cross-ref]

Cliquez ici pour aller à la section Références]. Being excluded or rejected signals a threat for which reflexive detection in the form of pain and distress is adaptive for survival [3Williams K.D. “Ostracism” Annu Rev Psychol 2007 ;  58 : 425-452 [cross-ref]

Cliquez ici pour aller à la section Références]. Thus, we assume that social pain should be considered as a subtype of psychological pain emerging from the threat of affiliation. Unbearable pain, particularly psychological pain, is a frequent theme of suicide notes. Thus, suicidal acts should be considered as the expression of an attempt to escape from this psychological suffering.