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Risk of suicide in twins: Suicide has social side

BMJ 2003; 327 doi: (Published 13 November 2003) Cite this as: BMJ 2003;327:1168
  1. Gerald D Sack (sack{at}, lecturer in social anthropology
  1. Safed Regional Academic College, Jezre'el Valley Regional Academic College, Mitzpe Amoka, Doar Na Merom Hagalil, Israel 13802

    EDITOR—The article by Tomassini et al and the responses to it all show an unexpected degree of social naivety in that the analysis of European suicide is not mentioned or the analysis of Scandinavian suicide by Retterstol.14

    There seems to be an overemphasis verging on theoretical pathology, on the psychological factors involved in suicide, and a commensurate ignoring of the sociological factors. As Durkheim himself noted over a century ago, there is an explanatory problem with post facto psychological explanations of behaviour whose remarkable regularity over time strongly imply that factors external to the individual are operating.

    If this is so, sociological factors seem to be primary, and psychological factors important with regard to the timing of the suicide: they are a contributory, but not a sufficient, cause. The sufficient cause seems to be the social relationships in which individuals are involved. The more intense and the wider the range of social ties in which an individual is enmeshed the less likely he or she is to feel “out of things,” or socially marginal, and hence likely to take his or her life.

    Twins are reared together and may have a more intense social life than other children, and so the lower incidence than expected of suicide among twins is sociologically understandable.


    • Competing interests None declared.


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