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Clinical Crossroads
May 24/31, 2000

A 52-Year-Old Suicidal Man

Author Affiliations

Author Affiliation: Dr Jacobs is Associate Clinical Professor of Psychiatry, Harvard Medical School, Boston, and Executive Director, Screening for Mental Health, Wellesley Hills, Mass.


Clinical Crossroads Section Editor: Margaret A. Winker, MD, Deputy Editor.

JAMA. 2000;283(20):2693-2699. doi:10.1001/jama.283.20.2693

DR PARKER: Mr D is a 52-year-old man who, in despair, almost jumped in front of a moving train. He attributes this episode to gambling debts piled up in the prior 6 months and the ensuing conflict with his family. He is a resident of Boston and has health insurance through his blue-collar job.

Mr D describes a history of depression dating to his youth. He grew up in a "tough" family, with a father who gambled and drank and brothers who used drugs and alcohol. He has had suicidal thoughts on many occasions but strongly contemplated suicide only once before when he was briefly held in solitary confinement while in jail for a minor crime.