Of the multitudinous threats to public health, suicide is perhaps uniquely characterized by a confluence of three critical features: it can be difficult to predict, it has the potential for catastrophic outcome, and it is preventable. Although some persons will admit freely to feelings of sadness and wishes for their lives to be over, many others—for reasons of shame, hopelessness, actual or perceived isolation—offer little if any overt forecasting of impending self-harm. Many of these same people will seek help under other auspices, however; up to two thirds of those who commit suicide have visited a physician during the preceding month.<sup>5 Hirschfeld R., Russel J. Assessment and treatment of suicidal patients N Engl J Med 1997 ;  337 : 910-915  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> Recognizing the signs and symptoms (other than the explicit declaration of suicidal intent) with which a suicide-prone person could present to the emergency department (ED) could prove central to the prevention of unnecessary death, as well as the injury and disability from a failed attempt.

This article provides a review of the common presentations of patients who should be considered as at risk for suicide, as well as some of the psychiatric conditions with well-known risk for suicide attempts. Although suicidality is associated with a variety of psychiatric diagnoses, the focus of this is on those patients grouped in the affective (mood) spectrum. Overviews of major depressive and bipolar disorders are also provided.