Practice guideline for the assessment and treatment of patients with suicidal behaviors.

ed to enable calculation of pooled SMRs for each condition. The authors concluded that the disorders demonstrating significantly increased risk for suicide included HIV/AIDS, Huntington’s disease, malignant neoplasm, multiple sclerosis, peptic ulcer disease, chronic hemodialysis-treated renal failure, spinal cord injury, and systemic lupus erythematosus. The data were insufficient to conclude whether amputation, valve replacement, intestinal diseases, cirrhosis, Parkinson’s disease, or systemic sclerosis conferred an increased risk for suicide. Surprising findings included the association of amyotrophic lateral sclerosis, blindness, stroke, diabetes mellitus, rheumatoid arthritis, and hypertension with only average risk that was no greater than that in the general population. Pregnancy and the puerperium were associated with a statistically reduced risk for suicide. Although the authors were unable to examine the influence of mental disorders or other mediating or moderating effects, many of the disorders associated with increased risk are also associated with mental disorders (e.g., multiple sclerosis with depression and peptic ulcer disease with alcohol abuse). Therefore, when the influence of comorbid psychiatric illness is accounted