Suicidality, ethnicity and immigration in the United States

PubMed Central

Borges, Guilherme; Orozco, Ricardo; Rafful, Claudia; Miller, Elizabeth; Breslau, Joshua

2013-01-01

Background Suicide is the eleventh cause of death in the US. This rate varies across ethnic groups. Whether suicide behavior differs by ethnic groups in the US in the same way as observed for suicide death is a matter of current discussion. The goal of this report is to compare the lifetime prevalence of suicide ideation and attempt among four main ethnic groups (Asians, Blacks, Hispanics, and Whites) in the US. Methods Suicide ideation and attempts were assessed using the World Mental Health version of the Composite International Diagnostic Interview. Discrete time survival analysis was used to examine risk for life-time suicidality by ethnicity and immigration among 15,180 participants in the Collaborative Psychiatric Epidemiological Surveys, a group of cross-sectional surveys. Results Suicide ideation was most common among Non-Hispanic Whites (16.10%), least common among Asians (9.02%), and intermediate among Hispanics (11.35%) and Non-Hispanic Blacks (11.82%). Suicide attempts were equally common among Non-Hispanic Whites (4.69%), Hispanics (5.11%) and Non-Hispanic Blacks (4.15%) and slightly less common among Asians (2.55%). These differences in the crude prevalence rates of suicide ideation decreased but persisted after control for psychiatric disorders, but disappeared for suicide attempt. Within ethnic groups, risk for suicidality was low among immigrants prior to migration compared to the US-born, but equalized over time after migration. Conclusions Ethnic differences in suicidal behaviors are partly explained by differences in psychiatric disorders and low risk prior to arrival in the US. These differences are likely to decrease as the US-born proportion of Hispanics and Asians increases. PMID:22030006

Gender Differences in Suicide Prevention Responses: Implications for Adolescents Based on an Illustrative Review of the Literature

PubMed Central

Hamilton, Emma; Klimes-Dougan, Bonnie

2015-01-01

Background: There are well-documented gender differences in adolescent suicidal behavior; death by suicide is more common in males, while nonfatal suicide attempts are more common among females. Over the past three decades, researchers have documented the effectiveness of a myriad of suicide prevention initiatives. However, there has been insufficient attention to which types of suicide prevention interventions are effective in changing attitudes and behaviors for young males and females. In this review of the literature, we consider common examples of primarily universal suicide prevention programs from three implementation settings: school-based, community-based, and healthcare-based. Our purpose is to delineate how the potential gender bias in such strategies may translate into youth suicide prevention efforts. Methods: Research in which gender was found to moderate program success was retrieved through online databases. Results: The results that feature programming effects for both males and females are provocative, suggesting that when gender differences are evident, in almost all cases, females seem to be more likely than males to benefit from existing prevention programming. Conclusions: We conclude by considering recommendations that may benefit males more directly. Implications for adolescent suicide prevention in particular are discussed. Personalization of suicide intervention is presented as a promising solution to reduce suicide rates. PMID:25711358

The impact of pesticide suicide on the geographic distribution of suicide in Taiwan: a spatial analysis.

PubMed

Chang, Shu-Sen; Lu, Tsung-Hsueh; Sterne, Jonathan Ac; Eddleston, Michael; Lin, Jin-Jia; Gunnell, David

2012-04-02

Pesticide self-poisoning is the most commonly used suicide method worldwide, but few studies have investigated the national epidemiology of pesticide suicide in countries where it is a major public health problem. This study aims to investigate geographic variations in pesticide suicide and their impact on the spatial distribution of suicide in Taiwan. Smoothed standardized mortality ratios for pesticide suicide (2002-2009) were mapped across Taiwan's 358 districts (median population aged 15 or above = 27 000), and their associations with the size of agricultural workforce were investigated using Bayesian hierarchical models. In 2002-2009 pesticide poisoning was the third most common suicide method in Taiwan, accounting for 13.6% (4913/36 110) of all suicides. Rates were higher in agricultural East and Central Taiwan and lower in major cities. Almost half (47%) of all pesticide suicides occurred in areas where only 13% of Taiwan's population lived. The geographic distribution of overall suicides was more similar to that of pesticide suicides than non-pesticide suicides. Rural-urban differences in suicide were mostly due to pesticide suicide. Areas where a higher proportion of people worked in agriculture showed higher pesticide suicide rates (adjusted rate ratio [ARR] per standard deviation increase in the proportion of agricultural workers = 1.58, 95% Credible Interval [CrI] 1.44-1.74) and overall suicide rates (ARR = 1.06, 95% CrI 1.03-1.10) but lower non-pesticide suicide rates (ARR = 0.91, 95% CrI 0.87-0.95). Easy access to pesticides appears to influence the geographic distribution of suicide in Taiwan, highlighting the potential benefits of targeted prevention strategies such as restricting access to highly toxic pesticides.

Attempted suicide in Kuala Lumpur.

PubMed

Habil, M H; Ganesvaran, T; Agnes, L S

A total of 306 patients were admitted to the University Hospital in Kuala Lumpur in 1989 after attempting suicide. Fourteen of them succumbed to injuries. Psychosocial data of 296 patients out of the 306 survivors are reported. Suicidal behaviour is more common in the young and especially amongst the females. Nearly 45.0% of them are from social class IV and V. Persons of Indian ethnic origin are overrepresented, while in Malays suicidal behavior seemed to be less common. Self-poisoning was reported to be the commonest method in attempting suicide. Diagnosis of adjustment disorder was made in 58.5% of the patients. Two-thirds of the patients had an intention score of less than 10 on the Pierce's Scale.

Paraquat prohibition and change in the suicide rate and methods in South Korea.

PubMed

Myung, Woojae; Lee, Geung-Hee; Won, Hong-Hee; Fava, Maurizio; Mischoulon, David; Nyer, Maren; Kim, Doh Kwan; Heo, Jung-Yoon; Jeon, Hong Jin

2015-01-01

The annual suicide rate in South Korea is the highest among the developed countries. Paraquat is a highly lethal herbicide, commonly used in South Korea as a means for suicide. We have studied the effect of the 2011 paraquat prohibition on the national suicide rate and method of suicide in South Korea. We obtained the monthly suicide rate from 2005 to 2013 in South Korea. In our analyses, we adjusted for the effects of celebrity suicides, and economic, meteorological, and seasonal factors on suicide rate. We employed change point analysis to determine the effect of paraquat prohibition on suicide rate over time, and the results were verified by structural change analysis, an alternative statistical method. After the paraquat prohibition period in South Korea, there was a significant reduction in the total suicide rate and suicide rate by poisoning with herbicides or fungicides in all age groups and in both genders. The estimated suicide rates during this period decreased by 10.0% and 46.1% for total suicides and suicides by poisoning of herbicides or fungicides, respectively. In addition, method substitution effect of paraquat prohibition was found in suicide by poisoning by carbon monoxide, which did not exceed the reduction in the suicide rate of poisoning with herbicides or fungicides. In South Korea, paraquat prohibition led to a lower rate of suicide by paraquat poisoning, as well as a reduction in the overall suicide rate. Paraquat prohibition should be considered as a national suicide prevention strategy in developing and developed countries alongside careful observation for method substitution effects.

Epidemiology, neurobiology and pharmacological interventions related to suicide deaths and suicide attempts in bipolar disorder: Part I of a report of the International Society for Bipolar Disorders Task Force on Suicide in Bipolar Disorder

PubMed Central

Schaffer, Ayal; Isometsä, Erkki T; Tondo, Leonardo; Moreno, Doris H; Sinyor, Mark; Kessing, Lars Vedel; Turecki, Gustavo; Weizman, Abraham; Azorin, Jean-Michel; Ha, Kyooseob; Reis, Catherine; Cassidy, Frederick; Goldstein, Tina; Rihmer, Zoltán; Beautrais, Annette; Chou, Yuan-Hwa; Diazgranados, Nancy; Levitt, Anthony J; Zarate, Carlos A; Yatham, Lakshmi

2016-01-01

Objectives Bipolar disorder is associated with elevated risk of suicide attempts and deaths. Key aims of the International Society for Bipolar Disorders Task Force on Suicide included examining the extant literature on epidemiology, neurobiology and pharmacotherapy related to suicide attempts and deaths in bipolar disorder. Methods Systematic review of studies from 1 January 1980 to 30 May 2014 examining suicide attempts or deaths in bipolar disorder, with a specific focus on the incidence and characterization of suicide attempts and deaths, genetic and non-genetic biological studies and pharmacotherapy studies specific to bipolar disorder. We conducted pooled, weighted analyses of suicide rates. Results The pooled suicide rate in bipolar disorder is 164 per 100,000 person-years (95% confidence interval = [5, 324]). Sex-specific data on suicide rates identified a 1.7:1 ratio in men compared to women. People with bipolar disorder account for 3.4–14% of all suicide deaths, with self-poisoning and hanging being the most common methods. Epidemiological studies report that 23–26% of people with bipolar disorder attempt suicide, with higher rates in clinical samples. There are numerous genetic associations with suicide attempts and deaths in bipolar disorder, but few replication studies. Data on treatment with lithium or anticonvulsants are strongly suggestive for prevention of suicide attempts and deaths, but additional data are required before relative anti-suicide effects can be confirmed. There were limited data on potential anti-suicide effects of treatment with antipsychotics or antidepressants. Conclusion This analysis identified a lower estimated suicide rate in bipolar disorder than what was previously published. Understanding the overall risk of suicide deaths and attempts, and the most common methods, are important building blocks to greater awareness and improved interventions for suicide prevention in bipolar disorder. Replication of genetic findings and stronger prospective data on treatment options are required before more decisive conclusions can be made regarding the neurobiology and specific treatment of suicide risk in bipolar disorder. PMID:26185269

Suicide in Northern Ireland: An Analysis of Gender Differences in Demographic, Psychological, and Contextual Factors.

PubMed

O'Neill, Siobhan; Corry, Colette; McFeeters, Danielle; Murphy, Sam; Bunting, Brendan

2016-01-01

The circumstances surrounding death by suicide can give us insight into the factors affecting suicide risk in particular regions. This study examined gender and circumstances surrounding death by suicide in Northern Ireland from 2005 to 2011. The study analyzed 1,671 suicides (77% male and 23% female cases) using information contained from the coroner's files on suicides and undetermined deaths. Hanging was the most common method and more than one third of the deceased had prior suicide attempts. There was evidence of alcohol use in 41% of the cases. Only, 61% of cases had recorded adverse events; most had multiple and complex combinations of experiences. Relationship and interpersonal difficulties were the most common category of adverse event (40.3%). However, illness and bereavement, employment /financial crisis, and health problems were also common. One third of those who died by suicide were employed, compared with 50.3% who were not in employment. Just over half (50.1%) were known to have a mental health disorder. The results provide the first profile of deaths by suicide in Northern Ireland. They highlight the need to target people who have difficult life experiences in suicide prevention work, notably men, people with employment, financial and relationship crises, and those with mental disorders.

Suicide by pesticide poisoning remains a priority for suicide prevention in China: Analysis of national mortality trends 2006-2013.

PubMed

Page, Andrew; Liu, Shiwei; Gunnell, David; Astell-Burt, Thomas; Feng, Xiaoqi; Wang, Lijun; Zhou, Maigeng

2017-01-15

Despite recent declines, suicide remains a priority for China. Ease of availability of high-lethality suicide methods, such as pesticides and firearms, contributes to the overall incidence and is an important target for suicide prevention. This study investigates whether changes in the distribution of methods of suicide have contributed to the recent reduction in suicide in China. Suicide rates (2006-2013) were calculated using the Chinese Disease Surveillance Points system, stratified by gender, age group, and urban-rural residence, to investigate trends in suicide over the study period. Multilevel negative binomial regression models were used to investigate associations between socio-demographic factors and method-specific suicide. The most common method of suicide in China for both males and females was pesticide poisoning, followed by hanging. All methods declined over the study period, with the exception of suicide by jumping in males. Suicide rates for pesticide poisoning and for hanging increased exponentially with age in those aged over ≥45 years in both sexes. Pesticide poisoning declined from 55% to 49% of all suicides, while hanging increased from 27% to 31%. This was an ecological study of a time series of suicide rates, with risk factor adjustment being limited to population-level point estimates derived from a single census. Suicide by pesticide poisoning and hanging remain the leading methods of suicide in China. Changes to the safe use of pesticides and targeted prevention initiatives to restrict access, along with socio-economic development and urbanisation, are likely contributors to declines in suicide by pesticide poisoning. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

An Assessment of Attempted Suicides among Adolescent Cherokee Indians.

ERIC Educational Resources Information Center

Thurman, Pam Jumper; And Others

1985-01-01

Examined the rate and reasons for suicidal attempts among adolescent Cherokee Indians (N=28). Results indicated a two percent rate of attempted suicides with overdose of medication and body cuts being the most commonly used methods. Behavioral patterns of attempters are discussed as well as implications for intervention. (BL)

Prior suicide attempts are less common in suicide decedents who died by firearms relative to those who died by other means.

PubMed

Anestis, Michael D

2016-01-01

Suicide prevention efforts often center on the identification of risk factors (e.g., prior suicide attempts); however, lists of risk factors without consideration of context may prove incapable of impacting suicide rates. One contextual variable worth considering is attempt method. Utilizing data from the National Violent Death Reporting System (2005-2012), I examined suicide deaths (n=71,775) by firearms and other means to determine whether prior suicide attempts were more common in one group versus the other. Significantly fewer suicide decedents who died by firearms reported a prior history of suicide attempts (12.10%) than did decedents who died by other means (28.66%). This result was further replicated within each state that contributed data to the NVDRS. Only 17 states have contributed to the NVDRS thus far and, within those states, not all suicide deaths were reported. Due to the nature of the data, I was unable to test proposed mediators within our model. Suicide decedents who die by firearms may die on their first attempt more often than other decedents due to a capability and willingness to utilize a highly lethal means. Current risk assessment protocols may be ill equipped to identify such individuals prospectively on their own. Broader methods of implementing means restriction (e.g., legislation) may thus be pivotal in suicide prevention efforts. Copyright © 2015 Elsevier B.V. All rights reserved.

Temporal patterns of charcoal burning suicides among the working age population in Hong Kong SAR: the influence of economic activity status and sex

PubMed Central

2012-01-01

Background Charcoal burning in a sealed room has recently emerged as the second most common suicide means in Hong Kong, causing approximately 200 deaths each year. As charcoal burning suicide victims have a unique sociodemographic profile (i.e., predominantly economically active men), they may commit suicide at specific times. However, little is known about the temporal patterns of charcoal burning suicides. Methods Suicide data from 2001 to 2008 on victims of usual working age (20–59) were obtained from the registered death files of the Census and Statistics Department of Hong Kong. A total of 1649 cases of charcoal burning suicide were analyzed using a two-step procedure, which first examined the temporal asymmetries in the incidence of suicide, and second investigated whether these asymmetries were influenced by sex and/or economic activity status. Poisson regression analyses were employed to model the monthly and daily patterns of suicide by economic activity status and sex. Results Our findings revealed pronounced monthly and daily temporal variations in the pattern of charcoal burning suicides in Hong Kong. Consistent with previous findings on overall suicide deaths, there was an overall spring peak in April, and Monday was the common high risk day for all groups. Although sex determined the pattern of variation in charcoal burning suicides, the magnitude of the variation was influenced by the economic activity status of the victims. Conclusion The traditional classification of suicide methods as either violent or nonviolent tends to elide the temporal variations of specific methods. The interaction between sex and economic activity status observed in the present study indicates that sex should be taken into consideration when investigating the influence of economic activity status on temporal variations of suicide. This finding also suggests that suicide prevention efforts should be both time- and subgroup-specific. PMID:22770504

[Suicidality in the elderly - what the general practitioner can do].

PubMed

Haas, Sebastian; Minder, Jacqueline; Harbauer, Gregor

2014-09-03

Suicide rates in Switzerland and most other countries are higher among the elderly than among the population as a whole. Suicidality in the old age is commonly associated with the presence of a mental disorder, especially depression. Medical doctors in primary healthcare have outstanding prominence in detecting suicidal states within elderly patients, because of their common long-standing and confidential relationship and the fact that suicidality is often concealed behind somatisation or other medical complaints. A new practical approach called PRISM-S task enables an assessment of the degree of suicidality in less than five minutes with a simple, visual instrument. Besides the importance of public mental health measures PRISM-S offers a brief, easy-to-administer method for all healthcare professionals to assess suicidality in adult patients (18-65 years). Further investigation will explore its specific usefulness for elderly patients (over 65 years).

Child and adolescent suicides in Bosnia and Herzegovina before and after the war (1992-1995).

PubMed

Fajkic, Almir; Lepara, Orhan; Voracek, Martin; Kapusta, Nestor D; Niederkrotenthaler, Thomas; Amiri, Leena; Sonneck, Gernot; Dervic, Kanita

2010-01-01

Evidence on youth suicides from Southeastern Europe is scarce. We are not aware of previous reports from Bosnia and Herzegovina, which experienced war from 1992 to 1995. Durkheim's theory of suicide predicts decreased suicide rates in wartime and increased rates afterward. To compare child and adolescent suicides in Bosnia and Herzegovina before and after the war. Data on youth suicide for prewar (1986-90) and postwar (2002-06) periods were analyzed with respect to prevalence, sex and age differences, and suicide methods. Suicide data from 1991 through 2001 were not available. Overall youth suicide rates were one-third lower in the postwar than in the prewar period. This effect was most pronounced for girls, whose postwar suicide rates almost halved, and for 15-19-year-old boys, whose rates decreased by about a one-fourth. Suicides increased among boys aged 14 or younger. Firearm suicides almost doubled proportionally and were the predominant postwar method, while the most common prewar method had been hanging. The findings from this study indicate the need for public education in Bosnia and Herzegovina on the role of firearm accessibility in youth suicide and for instructions on safe storage in households. Moreover, raising societal awareness about suicide risk factors and suicide prevention is needed.

Completed suicide in childhood.

PubMed

Dervic, Kanita; Brent, David A; Oquendo, Maria A

2008-06-01

Suicide in children and young adolescents up to 14 years of age has increased in many countries, warranting research and clinical awareness. International reported suicide rates per 100,000 in this young population vary between 3.1 and 0 (mean rate worldwide, approximately 0.6/100.000; male-female ratio, 2:1). Suicide occurs only in vulnerable children; this vulnerability begins with parental mood disorder and impulsive aggression, and family history of suicide. Childhood affective and disruptive disorders and abuse are the most often reported psychiatric risk factors. Suicide becomes increasingly common after puberty, most probably because of pubertal onset of depression and substance abuse, which substantially aggravate suicide risk. Biologic findings are scarce; however, serotonergic dysfunction is assumed. The most common precipitants are school and family problems and may include actual/anticipated transitions in these environments. Suicides in children and young adolescents up to 14 years of age often follow a brief period of stress. Cognitive immaturity/misjudgment, age-related impulsivity, and availability of suicide methods play an important role. Psychologic autopsy studies that focus on suicides in this age group are needed.

Toxicology and methods of committing suicide other than overdose.

PubMed

Coklo, Miran; Stemberga, Valter; Cuculic, Drazen; Sosa, Ivan; Bosnar, Alan

2009-11-01

Suicide represents a serious public health problem throughout the world. Toxicology plays a crucial role in the investigation of suicide. Psychoactive substances are recognized in the literature as the main suicide-generating stimuli. Ethanol is known to produce disinhibition and increased self-confidence. Other psychoactive substances can predominantly be central nervous system (CNS) stimulants or depressors. In cases of overdose as a method of suicide, the link between toxicology and the method of suicide is a matter of common sense and requires no additional explanation. On the other hand, in cases of non-overdose suicides this link is much more complex, and has not yet been extensively elucidated. We hypothesize a close relationship between toxicology and the choice of the method of committing suicide other than overdose. Negative findings may reflect either poor prescribed drug compliance in psychiatric patients, or suggest the role of other (non-toxicological) suicide-generating stimuli. On the other hand, positive findings influence the choice of the suicide method in a way that it depends on the prevalence of either stimulation or depression of the CNS, and consequent degree of behavioral aggression. Simplified, if the prevailing effect is CNS stimulation (with an increase in aggression), the method would be more drastic and more immediately fatal one, while with the CNS depression the method would be less immediately fatal and less drastic. There are only a few studies on the prevalence of psychoactive substances amongst completed suicides and even fewer studies have attempted to examine the relationship between substances used and the circumstances surrounding suicide. In evaluation of our hypothesis, we suggest thorough studies of toxicology and the choice of methods of committing suicides other than overdose. The scientific knowledge gained this way will eventually make toxicology a useful target in suicide prevention, especially amongst younger population.

Suicide tourism in Manhattan, New York City, 1990-2004.

PubMed

Gross, Charles; Piper, Tinka Markham; Bucciarelli, Angela; Tardiff, Kenneth; Vlahov, David; Galea, Sandro

2007-11-01

Suicide accounts for over 30,000 deaths per year in the United States and is associated with psychiatric illness and substance abuse. Research suggests a strong relationship between method of suicide and the lethal means that are readily available in one's community of residence. However, certain individuals may also seek the opportunity for suicide outside their proximal environment, often in well-known places. Whereas prevention efforts have been aimed at certain repeatedly used sites for suicide (i.e., Golden Gate Bridge), little research has studied "suicide tourism," the phenomenon of out of town accompanied by suicide. We collected data on all suicide deaths in New York City (NYC) between 1990 and 2004 from the Office of the Chief Medical Examiner of NYC. We examined trends and correlates of out-of-town residents who committed suicide in NYC. Manhattan accounted for 274 of the 407 nonresident suicides in NYC, which represented over 10% of all suicides committed in Manhattan. The most common methods of suicide for the Manhattan nonresidents were long fall, hanging, overdose, drowning, and firearms; the most common locations included hotels and commercial buildings, followed by outside locations such as bridges, parks, and streets. Nonresident victims tended to be younger, more often white and Asian and less often black and Hispanic than their residential counterparts. An analysis of nonresident suicides in Manhattan revealed that it is a location where individuals travel and take their lives, often by similar means and in similar locations. A comparison with residential suicide implied that a different type of individual is at risk for nonresidential suicide, and further research and prevention efforts should be considered.

Department of Defense Suicide Event Report Calendar Year 2013 Annual Report

DTIC Science & Technology

2014-07-24

suicide attempt DoDSERs, the most common method was drug/alcohol overdose . Prescription and over-the- MARINE CORPS DoDSER RESULTS The DoDSER system...24 JUL 2014 2. REPORT TYPE 3. DATES COVERED 00-00-2014 to 00-00-2014 4. TITLE AND SUBTITLE Department of Defense Suicide Event Report Calendar...LEFT BLANK 1CALENDAR YEAR 2013 ANNUAL REPORT Chapter 1: Suicide Rates Chapter 1 SUICIDE RATES 3CALENDAR YEAR 2013 ANNUAL REPORT Chapter 2: DoDSER

Suicide in Inmates in Nazis and Soviet Concentration Camps: Historical Overview and Critique

PubMed Central

López-Muñoz, Francisco; Cuerda-Galindo, Esther

2016-01-01

Living conditions in concentration camps were harsh and often inhumane, leading many prisoners to commit suicide. We have reviewed this topic in Nazi concentration camps (KL), Soviet special camps, and gulags, providing some preliminary data for our research. Data show that the incidence of suicide in Nazi KL could be up to 30 times higher than the general population and was also much higher than in Soviet special camps (maybe due to more favorable conditions for prisoners and the abolishment of death penalty), while available data on Soviet gulags are contradictory. However, data interpretation is very controversial, because, for example, the Nazi KL authorities used to cover-up the murder victims as suicides. Most of the suicides were committed in the first years of imprisonment, and the method of suicide most commonly used was hanging, although other methods included cutting blood vessels, poisoning, contact with electrified wire, or starvation. It is possible to differentiate two behaviors when committing suicide; impulsive behavior (contact with electrified barbed wire fences) or premeditated suicide (hanging up or through poison). In Soviet special camps, possible motives for suicides could include feelings of guilt for crimes committed, fear of punishment, and a misguided understanding of honor on the eve of criminal trials. Self-destructive behaviors, such as self-mutilation in gulag camps or prisoners who let themselves die, have been widely reported. Committing suicide in concentration camps was a common practice, although precise data may be impossible to obtain. PMID:27303312

Epidemiology of suicide among children and adolescents in Austria, 2001-2014.

PubMed

Laido, Zrinka; Voracek, Martin; Till, Benedikt; Pietschnig, Jakob; Eisenwort, Brigitte; Dervic, Kanita; Sonneck, Gernot; Niederkrotenthaler, Thomas

2017-02-01

Previous epidemiological analyses indicated a decreasing trend of suicide rates for 10-19-year-olds in Austria for the period 1970-2001. However, data from the new millennium are missing. This epidemiological update reports on youth suicide in Austria, covering the period 2001-2014 in order to inform suicide preventive interventions targeting adolescents. The data on registered suicides among Austrian minors (10-19 years) and the population size were obtained from Statistics Austria. Chi-squared tests were used to analyze the associations between the suicide methods used and sex, as well as between suicide methods and Austrian federal states. Spearman correlations were calculated to assess time trends in the suicide rates. One-way ANOVA was used to investigate annual suicide rates of age groups 10-14, 15-19, and 10-19 years across the nine Austrian federal states. The total average suicide rate for Austrian minors was 4.57 per 100,000. The male-female ratio was 3.5:1. The total youth suicide rate and male suicide rate significantly declined from 2001 to 2014, whereas there were no significant changes in female rates. More than one third of suicides among Austrian youth occurred through hanging, whereas jumping in front of a moving object was the second-most common suicide method. A spring peak was found, with most suicides occurring in April and May. Suicide rates among minors in Austria continue to decrease. The present findings help to inform the ongoing implementation of the National Austrian Suicide Prevention Plan (SUPRA).

Suicide in young Singaporeans aged 10-24 years between 2000 to 2004.

PubMed

Loh, Cheryl; Tai, Bee-Choo; Ng, Wai-Yee; Chia, Audrey; Chia, Boon-Hock

2012-01-01

The objective of this study was to understand the features of young suicide in order to contribute to suicide prevention efforts. In this article, the demographic, clinical, and suicide-related features of all cases of young suicide (aged 10-24 years) in Singapore for the years 2000-2004 are described. We also compared those who sought mental health services to those who did not. Overall, the suicide rate was 5.7 per 100, 000, with gender ratio of 1:1 and higher rates among ethnic Indians. Psychosocial stressors and suicide by jumping from height were common. Mental health service use was associated with unemployment, previous suicide attempts, family history of suicide, more use of lethal methods, lack of identifiable stressor, and less suicide notes. Suicide prevention efforts should promote awareness of suicide risks and access to mental health services.

Acute and chronic alcohol use correlated with methods of suicide in a Swiss national sample.

PubMed

Pfeifer, P; Bartsch, C; Hemmer, A; Reisch, T

2017-09-01

Chronic and acute alcohol use are highly associated risk factors for suicides worldwide. Therefore, we examined suicide cases with and without alcohol use disorder (AUD) using data from the SNSF project "Suicide in Switzerland: A detailed national survey". Our investigations focus on correlations between acute and chronic alcohol use with reference to suicide and potential interactions with the methods of suicide. We used data from the SNSF project in which all cases of registered completed suicide in Switzerland reported to any of the seven Swiss institutes of legal and forensic medicine between 2000 and 2010 were collected. We extracted cases that were tested for blood alcohol to use in our analysis. We compared clinical characteristics, blood alcohol concentrations, and methods of suicide in cases with and without AUD. Out of 6497 cases, 2946 subjects were tested for acute alcohol use and included in our analysis. Of the latter, 366 (12.4%) persons had a medical history of AUD. Subjects with AUD significantly had higher blood alcohol concentrations and were more often in medical treatment before suicide. Drug intoxication as method of suicide was more frequent in cases with AUD compared to NAUD. Overall, we found a high incidence of acute alcohol use at the time of death in chronic alcohol misusers (AUD). The five methods of suicide most commonly used in Switzerland differed considerably between individuals with and without AUD. Blood alcohol concentrations varied across different methods of suicide independently from the medical history in both groups. Copyright © 2017 Elsevier B.V. All rights reserved.

Change in suicide rates in Switzerland before and after firearm restriction resulting from the 2003 “Army XXI” reform.

PubMed

Reisch, Thomas; Steffen, Timur; Habenstein, Astrid; Tschacher, Wolfgang

2013-09-01

Firearms are the most common method of suicide among young men in Switzerland. From March 2003 through February 2004, the number of Swiss soldiers was halved as a result of an army reform (Army XXI), leading to a decrease in the availability of guns nationwide. The authors investigated the patterns of the overall suicide rate and the firearm suicide rate before and after the reform. Using a naturalistic study design, the authors compared suicide rates before (1995–2003) and after the intervention (2004–2008) in the affected population (men ages 18–43) and in two comparison groups (women ages 18–44 and men ages 44–53). Data were received from the Swiss Federal Statistical Office. Interrupted time series analysis was used to control for preexisting temporal trends. Alternative methods (Poisson regression, autocorrelation analysis, and surrogate data tests) were used to check validity. The authors found a reduction in both the overall suicide rate and the firearm suicide rate after the Army XXI reform. No significant increases were found for other suicide methods overall. An increase in railway suicides was observed. It was estimated that 22% of the reduction in firearm suicides was substituted by other suicide methods. The attenuation of the suicide rate was not compensated for during the follow-up years. Neither of the comparison groups showed statistically significant changes in firearm suicide rate and overall suicide rate. The restriction of firearm availability in Switzerland resulting from the Army XXI reform was followed by an enduring decrease in the general suicide rate.

Epidemiology, neurobiology and pharmacological interventions related to suicide deaths and suicide attempts in bipolar disorder: Part I of a report of the International Society for Bipolar Disorders Task Force on Suicide in Bipolar Disorder.

PubMed

Schaffer, Ayal; Isometsä, Erkki T; Tondo, Leonardo; Moreno, Doris H; Sinyor, Mark; Kessing, Lars Vedel; Turecki, Gustavo; Weizman, Abraham; Azorin, Jean-Michel; Ha, Kyooseob; Reis, Catherine; Cassidy, Frederick; Goldstein, Tina; Rihmer, Zoltán; Beautrais, Annette; Chou, Yuan-Hwa; Diazgranados, Nancy; Levitt, Anthony J; Zarate, Carlos A; Yatham, Lakshmi

2015-09-01

Bipolar disorder is associated with elevated risk of suicide attempts and deaths. Key aims of the International Society for Bipolar Disorders Task Force on Suicide included examining the extant literature on epidemiology, neurobiology and pharmacotherapy related to suicide attempts and deaths in bipolar disorder. Systematic review of studies from 1 January 1980 to 30 May 2014 examining suicide attempts or deaths in bipolar disorder, with a specific focus on the incidence and characterization of suicide attempts and deaths, genetic and non-genetic biological studies and pharmacotherapy studies specific to bipolar disorder. We conducted pooled, weighted analyses of suicide rates. The pooled suicide rate in bipolar disorder is 164 per 100,000 person-years (95% confidence interval = [5, 324]). Sex-specific data on suicide rates identified a 1.7:1 ratio in men compared to women. People with bipolar disorder account for 3.4-14% of all suicide deaths, with self-poisoning and hanging being the most common methods. Epidemiological studies report that 23-26% of people with bipolar disorder attempt suicide, with higher rates in clinical samples. There are numerous genetic associations with suicide attempts and deaths in bipolar disorder, but few replication studies. Data on treatment with lithium or anticonvulsants are strongly suggestive for prevention of suicide attempts and deaths, but additional data are required before relative anti-suicide effects can be confirmed. There were limited data on potential anti-suicide effects of treatment with antipsychotics or antidepressants. This analysis identified a lower estimated suicide rate in bipolar disorder than what was previously published. Understanding the overall risk of suicide deaths and attempts, and the most common methods, are important building blocks to greater awareness and improved interventions for suicide prevention in bipolar disorder. Replication of genetic findings and stronger prospective data on treatment options are required before more decisive conclusions can be made regarding the neurobiology and specific treatment of suicide risk in bipolar disorder. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Suicide Methods in Singapore (2000-2004): Types and Associations

ERIC Educational Resources Information Center

Chia, Boon-Hock; Franzco, Audrey Chia; Ng, Wai-Yee; Tai, Bee-Choo

2011-01-01

The choice of suicide methods varies between countries. Common methods used in Singapore between 2000 and 2004 were jumping (72.4%), hanging (16.6%), and poisoning (5.9%). Those who jumped were more likely to be young, single, female, and to have had a major mental illness. By comparison, those who hung themselves were more likely to be older (OR…

Analysis of suicide deaths in a 15-year period in Eskisehir, western Anatolia, Turkey and the determination of risk factors.

PubMed

Karbeyaz, Kenan; Akkaya, Harun; Balci, Yasemin

2013-01-01

It is estimated that every year 1 million people die all around the world due to suicide. The average rate of suicide in the world is reported as 16/100,000. In this study, we aimed to evaluate and discuss the suicide cases in our city Eskisehir that is located in western Anatolia. This is a retrospective study covering the period 1997-2011. All deaths in Eskisehir caused due to the consumption of forensic medicines in a 15-year period between 1997 and 2011 were evaluated retrospectively. A total of 553 cases were determined to be suicidal following both forensic and criminal investigations, and were included in the study. Furthermore, death examination and autopsy reports were investigated, and judicial investigation records were also taken into account. In this period, the average rate of suicide in our city was determined as 5.1/100,000 of which 71.4% of the cases were male. It was determined that the suicides most commonly occurred between the ages of 19 and 29 (32.4%, n=179). The most commonly encountered suicide method was hanging (60.9%, n=337). It was ascertained that the suicide rate in our city was lower than the average rate in the world, but it was higher than the average rate in Turkey. Unemployment was determined as the most common risk factor in our study. A follow-up should be provided for people with a history of attempting to commit suicide or with a tendency to committing suicide due to a psychological disorder.

Temporal patterns of charcoal burning suicides among the working age population in Hong Kong SAR: the influence of economic activity status and sex.

PubMed

Law, Chi-kin; Leung, Candi M C

2012-07-06

Charcoal burning in a sealed room has recently emerged as the second most common suicide means in Hong Kong, causing approximately 200 deaths each year. As charcoal burning suicide victims have a unique sociodemographic profile (i.e., predominantly economically active men), they may commit suicide at specific times. However, little is known about the temporal patterns of charcoal burning suicides. Suicide data from 2001 to 2008 on victims of usual working age (20-59) were obtained from the registered death files of the Census and Statistics Department of Hong Kong. A total of 1649 cases of charcoal burning suicide were analyzed using a two-step procedure, which first examined the temporal asymmetries in the incidence of suicide, and second investigated whether these asymmetries were influenced by sex and/or economic activity status. Poisson regression analyses were employed to model the monthly and daily patterns of suicide by economic activity status and sex. Our findings revealed pronounced monthly and daily temporal variations in the pattern of charcoal burning suicides in Hong Kong. Consistent with previous findings on overall suicide deaths, there was an overall spring peak in April, and Monday was the common high risk day for all groups. Although sex determined the pattern of variation in charcoal burning suicides, the magnitude of the variation was influenced by the economic activity status of the victims. The traditional classification of suicide methods as either violent or nonviolent tends to elide the temporal variations of specific methods. The interaction between sex and economic activity status observed in the present study indicates that sex should be taken into consideration when investigating the influence of economic activity status on temporal variations of suicide. This finding also suggests that suicide prevention efforts should be both time- and subgroup-specific.

Indigenous Knowledge Approach to Successful Psychotherapies with Aboriginal Suicide Attempters

PubMed Central

2016-01-01

Introduction: Suicide is disproportionately common among Aboriginal people in Canada. Methods: Life stories were collected from 54 Aboriginal suicide attempters in northern Saskatchewan. Constant comparison techniques and modified grounded theory identified common themes expressed. Results: Three common plots/themes preceded suicide attempts: 1) relationship breakup, usually sudden, unanticipated, involving a third person; 2) being publicly humiliated by another person(s), accompanied by high levels of shame; and 3) high levels of unremitting, chronic life stress (including poverty) with relative isolation. We found 5 common purposes for suicide attempts: 1) to “show” someone how badly they had hurt the attempter, 2) to stop the pain, 3) to save face in a difficult social situation, 4) to get revenge, and 5) don’t know/don’t remember/made sense at the time, all stated by people who were under the influence of alcohol and/or drugs at the time of their suicide attempt. We found 5 common beliefs about death: 1) you just cease to exist, and everything just disappears; 2) you go into the spirit world and can see and hear everything that is happening in this world; 3) you go to heaven or hell; 4) you go to a better place; and 5) don’t know/didn’t think about it. Discussion: The idea of personal and cultural continuity is essential to understanding suicide among First Nations youth. Interventions targeted to the individual’s beliefs about death, purpose for suicide, and consistent with the life story (plot) in which they find themselves may be more successful than one-size-fits-all programs developed outside of aboriginal communities. PMID:27738250

Comorbidity of Psychiatric and Personality Disorders in First Suicide Attempters

PubMed Central

Rao, K. Nagaraja; Kulkarni, Ranganath R.; Begum, Shamshad

2013-01-01

Background: Attempted suicide is a common clinical problem in a general hospital setting. It has a serious clinical and socio-economical impact too. Aims: To study the psychosocial, psychiatric, and personality profile of the first suicide attempters in a general hospital. Settings and Design: Cross-sectional, hospital-based, descriptive study. Materials and Methods: All the consecutive cases of first suicide attempt (n=100) treated in a general hospital were studied to know the clinical profile. Variables related to socio-demographic characteristics, family background, suicide characteristics, psychiatric morbidity, and comorbidity were analyzed. Risk-Rescue rating was applied to know the medical seriousness of the suicide attempt. Presumptive stressful life event scale was utilized to calculate life events score. Structured clinical interview (MINI Plus) and semi-structured clinical interview (IPDE) were used for axis-I and axis-II (personality) diagnoses. The results were analyzed using appropriate statistical measures. Results: Family history of psychiatric illnesses (31%) and suicide (11%) were noted. Insecticides and pesticides were the most common agents (71%) employed to attempt suicide. Interpersonal difficulties (46%) were the most frequent stressor. Overall medical seriousness of the suicide attempt was of moderate lethality. 93% of the suicide attempters had at least one axis-I and/or axis-II psychiatric disorder. Most common diagnostic categories were mood disorders, adjustment disorders, and substance-related disorders, with axis-I disorders (89%), personality disorders (52%), and comorbidity of psychiatric disorders (51.6%). Conclusion: Individuals who made first suicide attempt were young adults, had lower educational achievement; overall seriousness of the suicide attempt was of moderate lethality, high prevalence of psychiatric morbidity, personality disorders, and comorbidity, and had sought medical help from general practitioners. PMID:23833346

Strategies in treatment of suicidality: identification of common and treatment-specific interventions in empirically supported treatment manuals.

PubMed

Weinberg, Igor; Ronningstam, Elsa; Goldblatt, Mark J; Schechter, Mark; Wheelis, Joan; Maltsberger, John T

2010-06-01

Many reports of treatments for suicidal patients claim effectiveness in reducing suicidal behavior but fail to demonstrate which treatment interventions, or combinations thereof, diminish suicidality. In this study, treatment manuals for empirically supported psychological treatments for suicidal patients were examined to identify which interventions they had in common and which interventions were treatment-specific. Empirically supported treatments for suicidality were identified through a literature search of PsychLit and MEDLINE for the years 1970-2007, employing the following search strategy: [suicide OR parasuicide] AND [therapy OR psychotherapy OR treatment] AND [random OR randomized]. After identifying the reports on randomized controlled studies that tested effectiveness of different treatments, the reference list of each report was searched for further studies. Only reports published in English were included. To ensure that rated manuals actually correspond to the delivered and tested treatments, we included only treatment interventions with explicit adherence rating and scoring and with adequate adherence ratings in the published studies. Five manualized treatments demonstrating efficacy in reducing suicide risk were identified and were independently evaluated by raters using a list of treatment interventions. The common interventions included a clear treatment framework; a defined strategy for managing suicide crises; close attention to affect; an active, participatory therapist style; and use of exploratory and change-oriented interventions. Some treatments encouraged a multimodal approach and identification of suicidality as an explicit target behavior, and some concentrated on the patient-therapist relationship. Emphasis on interpretation and supportive interventions varied. Not all methods encouraged systematic support for therapists. This study identified candidate interventions for possible effectiveness in reducing suicidality. These interventions seem to address central characteristics of suicidal patients. Further studies are needed to confirm which interventions and which combinations thereof are most effective. 2010 Physicians Postgraduate Press, Inc.

Clinical contact preceding suicide.

PubMed

Obafunwa, J O; Busuttil, A

1994-06-01

Of the 400 consecutive completed suicides investigated over a 5-year period, 114 (28.5%) who had consulted a doctor in the week preceding death were specifically reviewed and compared with those who did not. The study comprised an analysis of the medical history, the scene of death and a complete autopsy with histological and toxicological examination and the identification of features which occurred more frequently in this group when compared with other suicides not contacting their doctors. Suicide-associated factors include psychiatric illness (58.8%), deteriorating health (16.7%), and a loss of spouse (7.0%); all these features were manifested by this group of suicides more frequently than by those who made no clinical contact (P < 0.001). A pre-indication of suicidal intention was made by 45% of these patients. This feature, as with previous attempts, occurred more commonly in patients who consulted a doctor (P < 0.001). Drug overdose was the most common suicidal method chosen (50.9%) and anti-depressants predominated (35%); 78% of those who overdosed ingested prescribed drugs. Poisoning was more common in this group (P < 0.001). Half of the victims committed suicide within 24 hours following consultation; of these, 51% overdosed on drugs with 61% of them ingesting their prescribed drugs. Of these 114 cases, the final consultation in 43% was to collect more drugs. All suicidal threats should be taken seriously, and particular care should be taken in prescribing and dispensing medication which may be fatal in overdose.

Patterns of presentation for attempted suicide: analysis of a cohort of individuals who subsequently died by suicide.

PubMed

Mallon, Sharon; Rosato, Michael; Galway, Karen; Hughes, Lynette; Rondon-Sulbaran, Janeet; McConkey, Sam; Leavey, Gerard

2015-06-01

All suicides and related prior attempts occurring in Northern Ireland over two years were analyzed, focusing on number and timing of attempts, method, and mental health diagnoses. Cases were derived from coroner's records, with 90% subsequently linked to associated general practice records. Of those included, 45% recorded at least one prior attempt (with 59% switching from less to more lethal methods between attempt and suicide). Compared with those recording one attempt, those with 2+ attempts were more likely to have used less lethal methods at the suicide (OR = 2.77: 95% CI = 1.06, 7.23); and those using less lethal methods at the attempts were more likely to persist with these into the suicide (OR = 3.21: 0.79, 13.07). Finally, those with preexisting mental problems were more likely to use less lethal methods in the suicide: severe mental illness (OR = 7.88: 1.58, 39.43); common mental problems (OR = 3.68: 0.83, 16.30); and alcohol/drugs related (OR = 2.02: 0.41, 9.95). This analysis uses readily available data to highlight the persisting use of less lethal methods by visible and vulnerable attempters who eventually complete their suicide. Further analysis of such conditions could allow more effective prevention strategies to be developed. © 2014 The American Association of Suicidology.

First and Subsequent Lifetime Alcoholism and Mental Disorders in Suicide Victims With Reference to a Community Sample-the Lundby Study 1947-1997.

PubMed

Holmstrand, Cecilia; Bogren, Mats; Mattisson, Cecilia; Brådvik, Louise

2018-01-01

Background: Suicide victims have been found to frequently suffer from mental disorders, often more than one, and comorbidity has also been found to be a risk factor for suicide. The aim of the present study was to determine the first disorder and possible subsequent disorders in suicide victims during their lifetimes and to compare their development with the development of mental and alcohol use disorders (AUDs) in a community sample. Methods: The Lundby Study is a prospective longitudinal study of mental health in a general population comprising 3,563 subjects, including 68 suicide victims, followed by four field investigations from 1947 to 1997; mortality was monitored up to 2011. Results: AUD was most common as a first diagnosis (26/68, 38.2%) among suicide victims, followed by "depression" (20/68, 29.4%) and "anxiety" (7/68, 10.3%). A predominance of AUD as a first diagnosis was found in the male group, whereas "depression" was the most common first diagnosis in the female group. However, there were very few females with AUD in the Lundby Study. In the whole population, it was more common for someone who started with an AUD to develop a subsequent mental disorder than the other way around. The same was true for AUD in relation to depression. Conclusions: AUD was the most common first mental disorder among male suicide victims and could thus be considered a starting point in the suicidal process. We propose that in addition to detecting and treating depression, it is important to detect and treat AUD vigorously and to be alert for subsequent symptoms of depressive and other mental disorders in suicide prevention efforts.

Influential Factors for and Outcomes of Hospitalized Patients with Suicide-Related Behaviors: A National Record Study in Taiwan from 1997–2010

PubMed Central

Lin, Yu-Wen; Huang, Hui-Chuan; Lin, Mei-Feng; Shyu, Meei-Ling; Tsai, Po-Li; Chang, Hsiu-Ju

2016-01-01

Background Investigating the factors related to suicide is crucial for suicide prevention. Psychiatric disorders, gender, socioeconomic status, and catastrophic illnesses are associated with increased risk of suicide. Most studies have typically focused on the separate influences of physiological or psychological factors on suicide-related behaviors, and have rarely used national data records to examine and compare the effects of major physical illnesses, psychiatric disorders, and socioeconomic status on the risk of suicide-related behaviors. Objectives To identify the characteristics of people who exhibited suicide-related behaviors and the multiple factors associated with repeated suicide-related behaviors and deaths by suicide by examining national data records. Design This is a cohort study of Taiwan’s national data records of hospitalized patients with suicide-related behaviors from January 1, 1997, to December 31, 2010. Participants The study population included all people in Taiwan who were hospitalized with a code indicating suicide or self-inflicted injury (E950–E959) according to the International Classification of Disease, Ninth Revision, Clinical Modification. Results Self-poisoning was the most common method of self-inflicted injury among hospitalized patients with suicide-related behaviors who used a single method. Those who were female, had been hospitalized for suicide-related behaviors at a younger age, had a low income, had a psychiatric disorder (i.e., personality disorder, major depressive disorder, bipolar disorder, schizophrenia, alcohol-related disorder, or adjustment disorder), had a catastrophic illness, or had been hospitalized for suicide-related behaviors that involved two methods of self-inflicted injury had a higher risk of hospitalization for repeated suicide-related behaviors. Those who were male, had been hospitalized for suicide-related behaviors at an older age, had low income, had schizophrenia, showed repeated suicide-related behaviors, had a catastrophic illness, or had adopted a single lethal method had an increased risk of death by suicide. Conclusions High-risk factors should be considered when devising suicide-prevention strategies. PMID:26900930

Suicide among the youth in Malaysia: What do we know?

PubMed

Bahar, Norharlina; Ismail, Wan Salwina Wan; Hussain, Nurulwafa; Haniff, Jamaiyah; Bujang, Mohamad Adam; Hamid, Abdul Muneer; Yusuff, Yusni; Nordin, Norhayati; Ali, Nor Hayati

2015-06-01

This article aims to study the pattern of youth suicide cases in Malaysia, following which preventive actions can then be planned and practiced to reduce these suicide cases. This is a cross-sectional study looking at notifications of all suicides involving members of the youth population, as had been reported to National Suicide Registry Malaysia from January 1, 2009 to December 31, 2009. Information such as profile demographics and methods of suicide were utilized accordingly. There were 53 youths between the ages of 15 and 24 years reported to have undergone completed suicides. The suicide rate among youths was 1.03 per 100,000 populations in 2009, accounting for the male gender (66.0%), with Indians being the highest suicide completers (40.4% and 5.6 per 100,000 populations). The most common method of suicide was hanging (56.6%) followed by self-poisoning (15.1%). The suicide rate among Malaysian youth is relatively lower compared with other countries in the Asian region. Majority were male, of Indian descent, and were still in secondary school. Preventive actions need to be taken especially for specific groups such as the Indian youth. © 2014 Wiley Publishing Asia Pty Ltd.

Suicide in Thailand during the period 1998-2003.

PubMed

Lotrakul, Manote

2006-02-01

The aim of this study was to examine the characteristic features of suicides in Thailand between 1998 and 2003. Collected data during 1998-2003 from the Bureau of Policy and Strategy, Ministry of Public Health were analyzed to reveal the mortality from suicide according to age, gender, rate and methods of suicides. Suicide rates were found to have increased to a peak of 8.6 per 100 000 (5290 suicides) in 1999 and then to have decreased to 7.1 per 100 000 in 2003. The average suicide rate during 1998-2003 was 7.9 per 100 000 with a male to female ratio of 3.4:1. Male suicide reached a peak for those aged 25-29 years (21.9 per 100 000) while female suicide showed less variation with age. Hanging was the most common method used, followed by ingestion of agricultural toxic substances. Suicide was most prevalent in upper northern region where HIV infection might be related to the high prevalence. Suicide prevention program should focus on males in early adulthood, and particular measures should be conducted to reduce risk factors related to HIV infection among people in northern Thailand.

Assessing Fidelity to Suicide Reporting Guidelines in Canadian News Media: The Death of Robin Williams

PubMed Central

Creed, Michael

2016-01-01

Objective: Mindset is a short recently-published booklet funded by the Mental Health Commission of Canada outlining evidence-based guidelines and best practices for journalists writing about mental health and suicide. Our study aimed to assess fidelity to Mindset recommendations in Canadian newspaper reports of a recent celebrity suicide. A secondary aim is to identify common themes discussed in these newspaper articles. Methods: Articles about Robin Williams’ suicide from major Canadian newspapers were gathered and coded for presence or absence of each of the 14 recommendations in the “Covering Suicide” section of Mindset. A threshold of 80% was set to test for high fidelity to the guidelines. A qualitative content analysis of the articles was also undertaken to discern common themes and social issues discussed in the articles. Results: Fifty-five per cent of articles surpassed the 80% threshold for high fidelity, while 85% applied at least 70% of the recommendations. The recommendation most commonly overlooked was “Do tell others considering suicide how they can get help,” which was absent in 73% of articles. The most common themes discussed were those of addictions and stigma. Conclusions: The news articles generally follow the evidence-based guidelines regarding the reporting of suicide set out in Mindset. This is a welcome development. Future research should continue to examine reporting of suicide to assess for further improvements, while also examining the wider impact of Mindset on the reporting of mental illness per se. PMID:27600531

Suicide in Children: A Systematic Review.

PubMed

Soole, Rebecca; Kõlves, Kairi; De Leo, Diego

2015-01-01

The objective of this study was to provide a review of studies on suicide in children aged 14 years and younger. Articles were identified through a systematic search of Scopus, MEDLINE, and PsychINFO. Key words were "children, suicide, psychological autopsy, and case-study." Additional articles were identified through manual search of reference lists and discussion with colleagues. Fifteen published articles were identified, 8 psychological autopsy studies (PA), and 7 retrospective case-study series. Suicide incidence and gender asymmetry increases with age. Hanging is the most frequent method. Lower rates of psychopathology are evident among child suicides compared to adolescents. Previous suicide attempts were an important risk factor. Children were less likely to consume alcohol prior to suicide. Parent-child conflicts were the most common precipitant.

Suicide deaths in rural Andhra Pradesh--a cause for global health action.

PubMed

Joshi, Rohina; Guggilla, Rama; Praveen, Devarsetty; Maulik, Pallab K

2015-02-01

To determine the proportion of deaths attributable to suicides in rural Andhra Pradesh, India over a 4-year period using a verbal autopsy method. Deaths occurring in 45 villages (population 185,629) were documented over a 4-year period from 2003 to 2007 by non-physician healthcare workers trained in the use of a verbal autopsy tool. Causes of death were assigned by physicians trained in the International Classification of Diseases, version 10. All data were entered and processed electronically using a secure study website. Verbal autopsies were completed for 98.2% (5786) of the deaths (5895) recorded. The crude death rate was 8.0/1000. 4.8% (95% CI 4.3-5.4) of all deaths were suicides, giving a suicide rate of 37.5/100,000 population. Forty-three percent of suicides occurred in the age group 15-29 years, and 62% were in men. In the younger age groups (10-29 years), suicides by women (56%) were more common than by men (44%). Poisoning (40%) was the most common method of self-harm followed by hanging (12%). The suicide rate in this part of rural Andhra Pradesh is three times higher than the national average of 11.2/100,000, but is in line with that reported in the Million Death Study. There is an urgent need to develop strategies targeted at young individuals to prevent deaths by suicide in India. © 2014 John Wiley & Sons Ltd.

Variations in suicide method and in suicide occurrence by season and day of the week in Russia and the Nenets Autonomous Okrug, Northwestern Russia: a retrospective population-based mortality study.

PubMed

Sumarokov, Yury A; Brenn, Tormod; Kudryavtsev, Alexander V; Nilssen, Odd

2015-09-23

Suicide is an important world health issue, especially in territories inhabited by indigenous people. This investigated differences in suicide rates, suicide methods, and suicide occurrence by month and day of the week among the indigenous and non-indigenous populations of the Nenets Autonomous Okrug (NAO) and to compare the findings from the NAO with national Russian statistics. In this retrospective population-based mortality study we investigated all suicides that occurred in the NAO in 2002-2012 (N = 252). Suicide method and the month and day of the week suicide occurred was taken from autopsy reports and disaggregated by ethnic group (indigenous and non-indigenous) and sex. Data from the NAO were then compared with national data from the Russian Federal Statistics Service (Rosstat). Hanging was the most common suicide method in the NAO in both indigenous and non-indigenous populations. The proportion of suicides by hanging among males was lower in the NAO than in national data (69.3 vs 86.2 %), but the inverse was true for females (86.5 vs 74.9 %). Suicide by firearm and by cutting was significantly higher among the indigenous population in the NAO when compared with national data. Peaks in suicide occurrence were observed in May and September in the NAO, whereas national data showed only one peak in May. Suicide occurrence in the indigenous population of the NAO was highest in April, while the non-indigenous population showed peaks in May and September. Suicide occurrence in the NAO was highest on Fridays; in national data this occurrence was highest on Mondays. We showed different relative frequencies of suicide by hanging, cutting, and firearm, as well as different suicide occurrence by month and day of the week in the NAO compared with Russia as a whole. These results can be used to plan suicide prevention activities in the Russian Arctic.

Reporting of suicide in the Australian media.

PubMed

Pirkis, Jane; Francis, Catherine; Blood, Richard Warwick; Burgess, Philip; Morley, Belinda; Stewart, Andrew; Putnis, Peter

2002-04-01

The media monitoring project aimed to establish a baseline picture of the extent, nature and quality of reporting of suicide by the Australian media, with a view to informing future strategies intended to optimize reporting of suicide. Newspaper, television and radio items on suicide were retrieved over 12 months. Identifying and descriptive information were extracted for each item. Approximately 10% of items were rated for quality, using a rating scale based on criteria from Achieving the Balance, a kit designed to promote awareness among media professionals of issues relating to suicide. The scale ranged from 0 (poor quality) to 100 (good quality). Reporting of suicide was extensive (with 4813 items retrieved). The nature of reporting was variable. Items tended to be about completed suicide (rather than attempted suicide or suicidal ideation), and most commonly involved content related to an individual's experiences, policy/programme initiatives and/or suicide statistics, although there were differences across media types. Items showed variability across dimensions of quality. The majority of suicide items did not have examples of inappropriate language, were not inappropriately located, did not use the word 'suicide' in the headline, and did not use explicit photographs/diagrams or footage. However, around half of the suicide items provided a detailed discussion of the method of self-harm and portrayed suicide as merely a social phenomenon. Where items concerned the suicide of a celebrity, reference was commonly made to that person's celebrity status. Most items failed to provide information on help services. The median total quality score was 57.1%. The reporting of suicide is extensive across all media types, and varies in nature and quality. In general, good items outnumber poorer items. However, there are still opportunities for improving media reporting of suicide.

Epidemiological survey of intentional poisoning suicide during 1993-2013 in Ilam Province, Iran.

PubMed

Azizpour, Yosra; Asadollahi, Khairollah; Sayehmiri, Kourosh; Kaikhavani, Satar; Abangah, Ghobad

2016-08-30

Suicide is an important social tragic phenomenon which occurs by different tools or methods in different communities. Considering deliberate poisoning as a common and important method in Ilam province for suicide, the present study was launched to epidemiologically assess committing suicide in Ilam province, Iran, based on intentional poisoning. By a retrospective study, all the recorded data associated with intentional poisoning suicide in Ilam Province during 1993-2013 were analyzed. All the demographic variables and the suicides' outcomes were analyzed using the Chi-Square test, and the univariate and multivariate logistic regression models. Totally, 6794 cases of suicide (annual incidence rate of 87.28/ 100, 000) associated with poisoning were evaluated. The incidence rate of suicide attempts was 84.63/ 100, 000 (94.51 in female and 74.98 in male) and the incidence rate of completed suicide was 2.17/ 100, 000 (1.94 in female and 2.40 in male). Also, the highest rates of attempted and completed suicide (annual incidence rate of 172.42 and 4.14, respectively) were attributed to the age group of 15-24 year. Females had a greater tendency to commit suicide by poisoning, and the lower level of education, the age group of 15-24 years and single individuals were more associated with suicide using poisonings. The incidence of attempted suicide in females and completed suicide in males was higher in this method. Considering the high rate of suicide by poisoning, further attention and supervision on the sale and reserve of drugs and poisons is necessary. Meanwhile, it seems that due to momentary emotions during the pubertal stage, the risk of committing suicide is increased especially among unemployed individuals; therefore, performing an extensive psychotherapy intervention is needed in the societies with younger populations.

[The epidemiology of suicide in bipolar disorder in the manic episode--preliminary reports].

PubMed

Wierzbiński, Piotr; Zdanowicz, Anna; Klekowska, Justyna; Broniarczyk-Czarniak, Marta; Zboralski, Krzysztof

2014-04-01

Suicide is among ten leading causes of death in each country and the third most common cause of death in the age group 16-35. The presence of mental illness is the most important risk factor for suicide. Affective disorders contribute to 15-25% of deaths due to suicide attempts. Depression is the most likely cause of the patients attempt on his life. Contrary to popular opinion, manic episode can also increase the risk of suicide, especially if the patient dominates by productive symptoms in the form of delusions. The aim of study was to determine the frequency of suicide attempts and their determinants in an episode of mania in bipolar disorder. The study included 16 people with a diagnosed bipolar disorder, hospitalized with manic episode at the age of 28-76. Patients hospitalized in the Department of Adult Psychiatry were selected randomly. The number of suicide attempts, comorbid conditions, and basic epidemiological data were estimated. Five patients declared suicide attempt, one of which wanted to make more than one attempt at suicide. 3 people took it during an episode of depression, two in an episode of mania. The methods of suicide were associated with an overdose of medication and this was accompanied by a greater amount of alcohol intake. 11 persons did not declare any willingness to attempt suicide. A mania episode did not increase the risk of suicide in bipolar disorder compared to an episode of depression in the study conducted. The importance of somatic illness in patients with bipolar disorder is increased if the suicide attempt occurs in an episode of depression. Alcohol abuse showed no negative effects on suicidal behavior of patients. During abuse was the most common way of commit suicide.

The pattern of completed suicides seen in Kuala Lumpur General Hospital 1999.

PubMed

Hayati, A N; Salina, A A; Abdullah, A A; Eusni, R T; Mansar, A H

2004-06-01

A study was done on 76 suicide cases managed by the Forensic Pathology Department of Hospital Kuala Lumpur (HKL) from January till December 1999 to explore the pattern of suicide and psychiatric history. The Chinese contributed 52% (n=40) of cases followed by the Indians (29%, n=22) and the Malays (12%, n=9). After the age of sixty, 84.6% of the subjects were Chinese. The common methods of suicide were poisoning (39%), hanging (34%) and jumping from height (22%). Four out of 12 case-notes traced had documented psychiatric history i.e. schizophrenia. the suicide rate for Kuala Lumpur is estimated at 7.4 per 100,000. The Indians has the highest suicide rate of 21.1 per 100,000 in keeping with other local studies. The suicide rate for the Chinese is 8.6 per 100,000, but it increased to 23 per 100,000 among the elderly Chinese. The suicide rate for Malays is 2.6 per 100,000, higher than what was cited in previous local studies. The incidence of jumping from height as a suicide method had doubled over the last 2 decades.

Epidemiological study of suicide by physical methods between 1993 and 2013 in Ilam province, Iran.

PubMed

Azizpour, Yosra; Sayehmiri, Kourosh; Asadollahi, Khairollah; Kaikhavani, Satar; Bagheri, Maryam

2017-08-23

Suicide by aggressive physical methods such as firearms, hanging, and jumping is well known; however, different factors may influence a person while selecting a particular method. The aim of this study was to investigate the epidemiological factors involved in the selection and use of different physical methods for suicide over a long-term period in Ilam province, Iran. The present study was conducted retrospectively between 1993 and 2013 using recorded data from a comprehensive system for registration of suicide attempts in Ilam University of Medical Sciences. The epidemiological characteristics included person, time and place variables, and the outcomes of the suicide attempts. The chi square, univariate and multivariate logistic regression models were used for data analysis. Totally, 1516 suicide attempts were evaluated (the annual incidence rate: 19/100,000 individuals). The most commonly used suicide method in females (88.4%) and males (38.9%) was self-immolation. Furthermore, the annual incidence rate among males and females was within the age group of 15-24 years (24.6 and 47.8/100,000 individuals). The risk of death by suicide in the age group of 55-64 years was 2.93 compared with the age group of 10-14 years (OR = 2.93; 95% CI = 0.64-13.54, P = 0.168). This study revealed that self-immolation was the most selected physical method of suicide and had the highest incidence rate, and inflicted the survivors with severe physical and mental complications. In order to reduce the use of physical methods, especially self-immolation, life skills training becomes more important than ever.

Epidemiology of Suicide in Cuba, 1987-2014.

PubMed

Corona-Miranda, Beatriz; Hernández-Sánchez, Mariela; Lomba-Acevedo, Paula

2016-07-01

INTRODUCTION Suicide is a health problem influenced by biological, genetic, psychological, social and economic factors. It is responsible for 50% of violent deaths in the male population, worldwide, and 71% in the female. In the Americas, 65,000 deaths by suicide occur every year. It is the ninth most frequent cause of death in Cuba, and third among people aged 10-19. OBJECTIVE Characterize the epidemiology of suicide in Cuba from 1987 to 2014. METHODS A retrospective descriptive study was conducted. The information comprised all records of death by suicide from January 1, 1987 to December 31, 2014, in the Cuban Ministry of Public Health's National Statistics Division database. The variables were sex, age, skin color, employment status/occupation, marital status, and method of suicide. Crude and age-standardized mortality rates and age-sex specific mortality rates were calculated, all per 100,000 population, as well as the sex ratio. Relative change over the series was calculated as a percentage. Distribution of suicides by variable was calculated and proportions expressed as percentages. RESULTS A total of 51,113 deaths by suicide were reported (annual average 1825), of which 34,671 (67.8%) were among men. The sex ratio was 2.1:1 for the entire study period, and 3.9:1 for 2011-2014. Over the course of the period studied, age-standardized suicide rates decreased from 23.9 to 10.8 per 100,000 population (54.8% reduction). The group aged ≥60 years had the highest average age-standardized rate, 44.6 per 100,000 population. The highest suicide burden by age was in the group aged 20-59 years (60.5%). By skin color, the highest burden was in those recorded as white, 68.9%. By marital status, the highest burden was in persons with a stable partner (46.7%), and by employment status/occupation, in retired (25.9%). The most commonly used method was hanging (59.4%). CONCLUSIONS Over the course of about three decades, suicide mortality rates have declined by almost half and they are still slightly higher than overall rates in the Americas. The most commonly used method is hanging. The sex ratio is greater than two and has increased over time. The highest rates occur in the group aged ≥60 years, but finer stratification is needed to identify an age-related risk trend. In view of Cuba's aging population, these results are of interest for epidemiology and public health. KEYWORDS Suicide, suicide attempt, death, mental health, Cuba.

The effectiveness of suicide prevention programmes: urban and gender disparity in age-specific suicide rates in a Taiwanese population.

PubMed

Lung, F-W; Liao, S-C; Wu, C-Y; Lee, M-B

2017-06-01

The effectiveness of suicide prevention programmes is an important issue worldwide today. The impact of urbanization and gender is controversial in suicide rates. Hence, this study adjusted on potential risk factors and secular changes for suicide rates in gender and rural/urban areas. Observational study. A Suicide Prevention Center was established by the Executive Yuan in Taiwan in 2005 and tried to carry out suicidal intervention in the community in every city and town. There were two phases, including the first phase of the programme from 2005 to 2008, and the second phase of the programme from 2009 to 2013. The crude suicide rates data from the period of 1991-2013, which recruited nine urban and 14 rural areas in Taiwan, were extracted from the Taiwanese national mortality data file. The suicide rates in two areas of Taiwan (Taipei city and Yilan County) were further used to compare the differences between urban and rural areas. The results show that unemployment increased the suicide rate in men aged 45-64 years and in women older than 65 years of age in Taiwan. High divorce and unemployment rates resulted in increased suicide rates in men in the city, whereas emotional distress was the main cause of suicides in men in rural areas. The main method of suicide was jumping from a high building for both sexes in the city, whereas drowning was the most common method of suicide for men in rural areas. Following the intervention programme, suicide behaviour began to decrease in all urban and rural areas of Taiwan. This study showed the cumulative effect of the intervention programme in decreasing the suicide rate in Taiwan. Moreover, the gender-specific suicidal rate and disparity in suicidal methods in urban and rural areas should be considered in further preventive strategies in Taiwan. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Suicide in Asia: opportunities and challenges.

PubMed

Chen, Ying-Yeh; Wu, Kevin Chien-Chang; Yousuf, Saman; Yip, Paul S F

2012-01-01

Asian countries account for approximately 60% of the world's suicides, but there is a great mismatch in the region between the scale of the problem and the resources available to tackle it. Despite certain commonalities, the continent itself is culturally, economically, and socially diverse. This paper reviews current epidemiologic patterns of suicide, including suicide trends, sociodemographic factors, urban/rural living, suicide methods, sociocultural religious influences, and risk and protective factors in Asia, as well as their implications. The observed epidemiologic distributions of suicides reflect complex interplays among the traditional value/culture system, rapid economic transitions under market globalization, availability/desirability of suicide methods, and sociocultural permission/prohibitions regarding suicides. In general, compared with Western countries, Asian countries still have a higher average suicide rate, lower male-to-female suicide gender ratio, and higher elderly-to-general-population suicide ratios. The role of mental illness in suicide is not as important as that in Western countries. In contrast, aggravated by access to lethal means in Asia (e.g., pesticide poisoning and jumping), acute life stress (e.g., family conflicts, job and financial security issues) plays a more important role than it does in Western countries. Some promising suicide prevention programs in Asia are illustrated. Considering the specific socioeconomic and cultural aspects of the region, community-based suicide intervention programs integrating multiple layers of intervention targets may be the most feasible and cost-effective strategy in Asia, with its populous areas and limited resources.

Suicide in Elementary School-Aged Children and Early Adolescents

PubMed Central

Sheftall, Arielle H.; Asti, Lindsey; Horowitz, Lisa M.; Felts, Adrienne; Fontanella, Cynthia A.; Campo, John V.

2016-01-01

BACKGROUND AND OBJECTIVES: Suicide in elementary school–aged children is not well studied, despite a recent increase in the suicide rate among US black children. The objectives of this study were to describe characteristics and precipitating circumstances of suicide in elementary school–aged children relative to early adolescent decedents and identify potential within-group racial differences. METHODS: We analyzed National Violent Death Reporting System (NVDRS) surveillance data capturing suicide deaths from 2003 to 2012 for 17 US states. Participants included all suicide decedents aged 5 to 14 years (N = 693). Age group comparisons (5–11 years and 12–14 years) were conducted by using the χ2 test or Fisher’s exact test, as appropriate. RESULTS: Compared with early adolescents who died by suicide, children who died by suicide were more commonly male, black, died by hanging/strangulation/suffocation, and died at home. Children who died by suicide more often experienced relationship problems with family members/friends (60.3% vs 46.0%; P = .02) and less often experienced boyfriend/girlfriend problems (0% vs 16.0%; P < .001) or left a suicide note (7.7% vs 30.2%; P < .001). Among suicide decedents with known mental health problems (n = 210), childhood decedents more often experienced attention-deficit disorder with or without hyperactivity (59.3% vs 29.0%; P = .002) and less often experienced depression/dysthymia (33.3% vs 65.6%; P = .001) compared with early adolescent decedents. CONCLUSIONS: These findings raise questions about impulsive responding to psychosocial adversity in younger suicide decedents, and they suggest a need for both common and developmentally-specific suicide prevention strategies during the elementary school–aged and early adolescent years. Further research should investigate factors associated with the recent increase in suicide rates among black children. PMID:27647716

Antecedents of Suicide among Youth Aged 11-15: A Multistate Mixed Methods Analysis.

PubMed

Holland, Kristin M; Vivolo-Kantor, Alana M; Logan, Joseph E; Leemis, Ruth W

2017-07-01

Suicide is the second leading cause of death for youth aged 11 to 15, taking over 5,500 lives from 2003 to 2014. Suicide among this age group is linked to risk factors such as mental health problems, family history of suicidal behavior, biological factors, family problems, and peer victimization and bullying. However, few studies have examined the frequency with which such problems occur among youth suicide decedents or the context in which decedents experience these risk factors and the complex interplay of risk that results in a decedent's decision to take his/her own life. Data from a random sample of 482 youth (ages 11-15) suicide cases captured in the National Violent Death Reporting System from 2003 to 2014 were analyzed. The sample had fewer girls than boys (31 vs. 69 %) and comprised primarily White youth (79 %), but also African Americans (13 %), Asians (4 %), and youth of other races (4 %). Narrative data from coroner/medical examiner and law enforcement investigative reports were coded and analyzed to identify common behavioral patterns that preceded suicide. Emergent themes were quantified and examined using content and constant comparative analysis. Themes regarding antecedents across multiple levels of the social ecology emerged. Relationship problems, particularly with parents, were the most common suicide antecedent. Also, a pattern demonstrating a consistent progression toward suicidal behavior emerged from the data. Narratives indicated that youth were commonly exposed to one or more problems, often resulting in feelings of loneliness and burdensomeness, which progressed toward thoughts and sometimes plans for or attempts at suicide. Continued exposure to negative experiences and thoughts/plans about suicide, and/or self-injurious acts resulted in an acquired capacity to self-harm, eventually leading to suicide. These findings provide support for theories of suicidal behavior and highlight the importance of multi-level, comprehensive interventions that address individual cognitions and build social connectedness and support, as well as prevention strategies that increase awareness of the warning signs and symptoms of suicide, particularly among family members of at-risk youth.

Antecedents of Suicide among Youth Aged 11–15: A Multistate Mixed Methods Analysis

PubMed Central

Vivolo-Kantor, Alana M.; Logan, Joseph E.; Leemis, Ruth W.

2018-01-01

Suicide is the second leading cause of death for youth aged 11 to 15, taking over 5,500 lives from 2003 to 2014. Suicide among this age group is linked to risk factors such as mental health problems, family history of suicidal behavior, biological factors, family problems, and peer victimization and bullying. However, few studies have examined the frequency with which such problems occur among youth suicide decedents or the context in which decedents experience these risk factors and the complex interplay of risk that results in a decedent’s decision to take his/her own life. Data from a random sample of 482 youth (ages 11–15) suicide cases captured in the National Violent Death Reporting System from 2003 to 2014 were analyzed. The sample had fewer girls than boys (31 vs. 69 %) and comprised primarily White youth (79 %), but also African Americans (13 %), Asians (4 %), and youth of other races (4 %). Narrative data from coroner/medical examiner and law enforcement investigative reports were coded and analyzed to identify common behavioral patterns that preceded suicide. Emergent themes were quantified and examined using content and constant comparative analysis. Themes regarding antecedents across multiple levels of the social ecology emerged. Relationship problems, particularly with parents, were the most common suicide antecedent. Also, a pattern demonstrating a consistent progression toward suicidal behavior emerged from the data. Narratives indicated that youth were commonly exposed to one or more problems, often resulting in feelings of loneliness and burdensomeness, which progressed toward thoughts and sometimes plans for or attempts at suicide. Continued exposure to negative experiences and thoughts/plans about suicide, and/or self-injurious acts resulted in an acquired capacity to self-harm, eventually leading to suicide. These findings provide support for theories of suicidal behavior and highlight the importance of multi-level, comprehensive interventions that address individual cognitions and build social connectedness and support, as well as prevention strategies that increase awareness of the warning signs and symptoms of suicide, particularly among family members of at-risk youth. PMID:27844461

Pathways to Suicide in Australian Farmers: A Life Chart Analysis.

PubMed

Kunde, Lisa; Kõlves, Kairi; Kelly, Brian; Reddy, Prasuna; De Leo, Diego

2017-03-28

Farmers have been found to be at increased risk of suicide in Australia. The Interpersonal-Psychological Theory of Suicidal Behaviour suggests that the proximal factors leading to the suicidal desire or ideation include an individual's experiences of both perceived burdensomeness and thwarted belongingness. Suicidal desire with acquired capability to engage in lethal self-injury is predictive of suicidal behaviour. This study investigates the pathways to suicide of 18 Australian male farmers in order to understand the suicidal process and antecedents to suicide in Australian male farmers. The psychological autopsy (PA) method was used to generate life charts. Two pathways with distinct suicidal processes were identified: acute situational (romantic relationship problems and financial concerns/pending retirement) and protracted (long-term psychiatric disorder). Long working hours, interpersonal conflicts, physical illnesses and pain, alcohol abuse, access to firearms, and exposure to drought were additional common factors identified. An understanding of the interrelatedness of diverse distal and proximal risk factors on suicidal pathways in the wider environmental context for male farmers is required when developing and implementing rural suicide prevention activities.

Pathways to Suicide in Australian Farmers: A Life Chart Analysis

PubMed Central

Kunde, Lisa; Kõlves, Kairi; Kelly, Brian; Reddy, Prasuna; De Leo, Diego

2017-01-01

Farmers have been found to be at increased risk of suicide in Australia. The Interpersonal-Psychological Theory of Suicidal Behaviour suggests that the proximal factors leading to the suicidal desire or ideation include an individual’s experiences of both perceived burdensomeness and thwarted belongingness. Suicidal desire with acquired capability to engage in lethal self-injury is predictive of suicidal behaviour. This study investigates the pathways to suicide of 18 Australian male farmers in order to understand the suicidal process and antecedents to suicide in Australian male farmers. The psychological autopsy (PA) method was used to generate life charts. Two pathways with distinct suicidal processes were identified: acute situational (romantic relationship problems and financial concerns/pending retirement) and protracted (long-term psychiatric disorder). Long working hours, interpersonal conflicts, physical illnesses and pain, alcohol abuse, access to firearms, and exposure to drought were additional common factors identified. An understanding of the interrelatedness of diverse distal and proximal risk factors on suicidal pathways in the wider environmental context for male farmers is required when developing and implementing rural suicide prevention activities. PMID:28350368

Assessing the Efficacy of Restricting Access to Barbecue Charcoal for Suicide Prevention in Taiwan: A Community-Based Intervention Trial

PubMed Central

Chen, Ying-Yeh; Chen, Feng; Chang, Shu-Sen; Wong, Jacky; Yip, Paul S F

2015-01-01

Objective Charcoal-burning suicide has recently been spreading to many Asian countries. There have also been several cases involving this new method of suicide in Western countries. Restricting access to suicide means is one of the few suicide-prevention measures that have been supported by empirical evidence. The current study aims to assess the effectiveness of a community intervention program that restricts access to charcoal to prevent suicide in Taiwan. Methods and Findings A quasi-experimental design is used to compare method-specific (charcoal-burning suicide, non-charcoal-burning suicide) and overall suicide rates in New Taipei City (the intervention site, with a population of 3.9 million) with two other cities (Taipei City and Kaohsiung City, the control sites, each with 2.7 million residents) before (Jan 1st 2009- April 30th 2012) and after (May 1st 2012-Dec. 31st 2013) the initiation of a charcoal-restriction program on May 1st 2012. The program mandates the removal of barbecue charcoal from open shelves to locked storage in major retail stores in New Taipei City. No such restriction measure was implemented in the two control sites. Generalized linear regression models incorporating secular trends were used to compare the changes in method-specific and overall suicide rates before and after the initiation of the restriction measure. A simulation approach was used to estimate the number of lives saved by the intervention. Compared with the pre-intervention period, the estimated rate reduction of charcoal-burning suicide in New Taipei City was 37% (95% CI: 17%, 50%) after the intervention. Taking secular trends into account, the reduction was 30% (95% CI: 14%, 44%). No compensatory rise in non-charcoal-burning suicide was observed in New Taipei City. No significant reduction in charcoal-burning suicide was observed in the other two control sites. The simulation approach estimated that 91 (95%CI [55, 128]) lives in New Taipei City were saved during the 20 months of the intervention. Conclusion Our results demonstrate that the charcoal-restriction program reduced method-specific and overall suicides. This study provides strong empirical evidence that restricting the accessibility of common lethal methods of suicide can effectively reduce suicide rates. PMID:26305374

Suicide in adolescents: findings from the Swiss National cohort.

PubMed

Steck, Nicole; Egger, Matthias; Schimmelmann, Benno G; Kupferschmid, Stephan

2018-01-01

Suicide in adolescents is the second most common cause of death in this age group and an important public health problem. We examined sociodemographic factors associated with suicide in Swiss adolescents and analysed time trends in youth suicide in the Swiss National Cohort (SNC). The SNC is a longitudinal study of the whole Swiss resident population, based on linkage of census and mortality records. We identified suicides in adolescents aged 10-18 years from 1991 to 2013. A total of 2.396 million adolescents were included and 592 suicides were recorded, corresponding to a rate of 3.7 per 100,000 [95% confidence interval (CI) 3.4-4.0]. Rates increased with age from 0.0 per 100,000 at age 10 years to 14.8 per 100,000 (95% CI 12.6-17.5) at 18 years in boys, and from 0.0 to 5.4 per 100,000 (4.1-7.2) in girls. Being a boy, living in a single parent household, being an only or middle-born child, and living in rural regions were factors associated with a higher rate of suicide. Hanging was the most common method in boys, and railway suicides were most frequent in girls. There was no clear evidence for an increase or decrease over calendar time. We conclude that familial and socioeconomic factors including type of household, birth order and urbanity are associated with youth suicide in Switzerland. These factors should be considered when designing prevention programmes for youth suicide.

Non-Suicidal Self-Injury in the Media

ERIC Educational Resources Information Center

Purington, Amanda; Whitlock, Janis

2010-01-01

Non-suicidal self-injury (NSSI) is a common and increasingly prevalent maladaptive coping method, often used by adolescents. The role of the media in the transmission of NSSI acceptance and adoption in mainstream culture is explored in this article. The increasing reach of the media, the particular susceptibility of adolescent and young adults to…

Gatekeeper Training in Campus Suicide Prevention

ERIC Educational Resources Information Center

Wallack, Cory; Servaty-Seib, Heather L.; Taub, Deborah J.

2013-01-01

Gatekeeper training is one of the most commonly employed methods for identifying and intervening with at-risk students (Davidson and Locke, 2010). Within the context of campus suicide prevention, a gatekeeper is broadly defined as any individual who has the potential to come into contact with at-risk students (Davidson and Locke, 2010). Although…

Suicide or accident? A psychological autopsy study of suicide in youths under the age of 16 compared to deaths labeled as accidents

PubMed Central

2012-01-01

Objective In the present paper, we describe suicide in youths under 16 years of age and compare their risk factors for suicide to those of older adolescents as described in the literature. Furthermore, we evaluate the possible mislabeling of suicides as accidents, and vice versa. Method We used the data from a nationwide psychological autopsy of youths 15 years and younger who had committed suicide or died in accidents in Norway from 1993 to 2004 (n = 84). We additionally constructed a suicide index to distinguish between the two causes of death. Results The young suicide victims presented, with little gender difference, fewer obvious risk factors and less suicide intent than commonly described for older adolescents. The suicide index distinguished quite well between suicides and accidents, with few cases indicating a possible mislabeling, although some suicide cases could have been labeled as uncertain. Conclusion In line with previous research, suicides in 11-15-year-olds have many similarities to suicides in older adolescents in terms of external circumstances, but they present less apparent warning signs. In our total sample of 84 deaths, there were few indications of incorrect labeling. PMID:22971572

Suicidal attempts among Emergency Department patients: one-year of clinical experience.

PubMed

Elisei, Sandro; Verdolini, Norma; Anastasi, Serena

2012-09-01

Suicidal ideation and attempts account for a significant number of Emergency Department visits and represent a major public and mental health problem. Suicide and suicide attempts are a major cause of death and morbidity worldwide. 111 suicide attempters (81 F (73%), 30 M (27%)) were consequently recruited in the Emergency Department of the Santa Maria della Misericordia, Perugia, Italy between June 2011 and June 2012. Patients were assessed and demographic and clinical data were collected in clinical records. Data analysis was conducted using SPSS software. Chi-square test and logistic regression were used as appropriate. A p-value <0.05 was considered statistically significant. Females attempt suicide 3 times more frequently than males and generally use a non-violent suicide attempt method. In our sample unmarried status is the most represented and the most common diagnosis is major depressive disorder, followed by borderline personality disorder. Suicide attempts are more frequent in January. It is of crucial importance to conduct a suicide risk assessment when subjects are admitted to an ED given that the strongest known predictor for future suicide is attempted suicide.

The relationship between therapeutic alliance and patient's suicidal thoughts, self-harming behaviours and suicide attempts: A systematic review.

PubMed

Dunster-Page, Charlotte; Haddock, Gillian; Wainwright, Laura; Berry, Katherine

2017-12-01

Suicidality is a common concern for people with mental health problems. The interpersonal nature of suicidality suggests that therapeutic alliance may be important when working clinically with suicidal patients. This paper is a systematic review of studies investigating the association between alliance and treatment outcome relating to suicidal ideation and behaviours. Systematic searches of PsychINFO, MEDLINE, AMED, EMBASE, Web of Science and CINAHL were completed using words that captured the concepts of alliance and suicidality. Eligible studies: involved participants aged 18-years-old or over; used a validated measure of therapeutic alliance; and reported associations between alliance and suicidality. Abstracts, qualitative studies and articles not written in English were excluded. Twelve studies were included. Findings indicated that alliance is associated with suicidality. Alliance was related to suicidality in eleven of the papers. Self-harming behaviours had the strongest association with patient-rated alliance. Suicide attempts had the weakest association, possibly due to the infrequency of suicide attempts in the studies reviewed. The twelve studies were heterogeneous in terms of the measure of alliance used, method of assessing suicidality, clinical setting and professional-type. This variability limited the degree to which findings could be synthesised. Therapists, care-coordinators and mental health teams should recognise the importance of building a strong therapeutic alliance with suicidal patients. Researchers should use consistent methods of measuring alliance and assessing suicidality in future studies. Clinicians and researchers should note that suicidal thoughts, self-harm and suicide attempts may be related to alliance in different ways and therefore should be assessed as separate constructs. Copyright © 2017 Elsevier B.V. All rights reserved.

Suicide Among Patients in the Veterans Affairs Health System: Rural–Urban Differences in Rates, Risks, and Methods

PubMed Central

Blow, Frederic C.; Ignacio, Rosalinda V.; Ilgen, Mark A.; Austin, Karen L.; Valenstein, Marcia

2012-01-01

Objectives. Using national patient cohorts, we assessed rural–urban differences in suicide rates, risks, and methods in veterans. Methods. We identified all Department of Veterans Affairs (VA) patients in fiscal years 2003 to 2004 (FY03–04) alive at the start of FY04 (n = 5 447 257) and all patients in FY06–07 alive at the start of FY07 (n = 5 709 077). Mortality (FY04–05 and FY07–08) was assessed from National Death Index searches. Census criteria defined rurality. We used proportional hazards regressions to calculate rural–urban differences in risks, controlling for age, gender, psychiatric diagnoses, VA mental health services accessibility, and regional administrative network. Suicide method was categorized as firearms, poisoning, strangulation, or other. Results. Rural patients had higher suicide rates (38.8 vs 31.4/100 000 person-years in FY04–05; 39.6 vs 32.4/100 000 in FY07–08). Rural residence was associated with greater suicide risks (20% greater, FY04–05; 22% greater, FY07–08). Firearm deaths were more common in rural suicides (76.8% vs 61.5% in FY07–08). Conclusions. Rural residence is a suicide risk factor, even after controlling for mental health accessibility. Public health and health system suicide prevention should address risks in rural areas. PMID:22390583

Postmortem computed tomography findings in suicide victims.

PubMed

Garetier, M; Deloire, L; Dédouit, F; Dumousset, E; Saccardy, C; Ben Salem, D

2017-02-01

Suicide is the eighth cause of mortality in France and the leading cause in people aged between 25 and 34 years. The most common methods of suicide are hanging, self-poisoning with medicines and firearms. Postmortem computed tomography (CT) is a useful adjunct to autopsy to confirm suicide and exclude other causes of death. At autopsy, fractures of the hyoid bone or thyroid cartilage, or both, are found in more than 50% of suicidal hangings. Cervical vertebra fractures are rare and only seen in suicide victims jumping from a great height. Three-dimensional reconstructions from CT data are useful to visualize the ligature mark on the neck. In suicides by firearm, postmortem CT shows entry and exit wounds, parenchymal lesions along the bullet path, as well as projectiles in case of penetrating trauma. However, in the chest and abdomen it is more difficult to identify the path of the projectile. Postmortem CT also shows specific features of suicide by drowning or stabbing, but its use is limited in cases of self-poisoning. The use of postmortem CT is also limited by decomposition and change of body position. This article presents the imaging features seen on postmortem CT according to the method of suicide. Copyright © 2016 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

Relationship between Personality Profiles and Suicide Attempt via Medicine Poisoning among Hospitalized Patients: A Case-Control Study

PubMed Central

Shafiee-Kandjani, Ali Reza; Amiri, Shahrokh; Arfaie, Asghar; Ahmadi, Azadeh; Farvareshi, Mahmoud

2014-01-01

Objectives. Inflexible personality traits play an important role in the development of maladaptive behaviors among patients who attempt suicide. This study was conducted to investigate the relationship between personality profiles and suicide attempt via medicine poisoning among the patients hospitalized in a public hospital. Materials and Methods. Fifty-nine patients who attempted suicide for the first time and hospitalized in the poisoning ward were selected as the experimental group. Sixty-three patients hospitalized in the other wards for a variety of reasons were selected as the adjusted control group. Millon Clinical Multiaxial Personality Inventory, 3rd version (MCMI-III) was used to assess the personality profiles. Results. The majority of the suicide attempters were low-level graduates (67.8% versus 47.1%, OR = 2.36). 79.7% of the suicide attempters were suffering from at least one maladaptive personality profile. The most common maladaptive personality profiles among the suicide attempters were depressive personality disorder (40.7%) and histrionic personality disorder (32.2%). Among the syndromes the most common ones were anxiety clinical syndrome (23.7%) and major depression (23.7%). Conclusion. Major depression clinical syndrome, histrionic personality disorder, anxiety clinical syndrome, and depressive personality disorder are among the predicators of first suicide attempts for the patients hospitalized in the public hospital due to the medicine poisoning. PMID:27433491

A meta-analysis of acute alcohol use and the risk of suicide attempt

PubMed Central

Borges, Guilherme; Bagge, Courtney; Cherpitel, Cheryl J.; Conner, Kenneth; Orozco, Ricardo; Rossow, Ingeborg

2016-01-01

Background While there are reviews reporting on the prevalence of acute use of alcohol (AUA) prior to suicide attempts, no review has used a meta-analytic approach to estimate common odds ratios (OR) of the effect of AUA on suicide attempts. We aim to report the results of the first meta-analysis of controlled epidemiological studies on acute alcohol use and suicide attempt. Methods The English language literature on Medline, PsychInfo, Google Scholar, and public-use databases was searched for original articles and critical review reports on acute alcohol use and suicide attempt for the period ranging from 1996–2015. Studies had to report an OR estimate for this association. Common odds ratios and 95% Confidence Intervals (95%CI) from random effects in meta-analyses for any acute alcohol use and 2 levels of alcohol use on suicide attempt were calculated. Results We gathered 7 studies that provided OR estimates for the likelihood of suicide attempt by acute alcohol use, compared to those who did not drink alcohol. Studies used case-control (3) and case-crossover design (4). All studies found increased ORs for acute alcohol use on suicide attempt. Meta-analysis revealed a common OR of 6.97 (95%CI=4.77, 10.17) for any acute alcohol use. Evidence from 4 studies suggests that «low levels of acute drinking» resulted in an OR of 2.71 (95%CI=1.56, 4.71) and «high levels» had much greater odds of suicide attempt, OR of 37.18 (95%CI=17.38, 79.53). Conclusions Acute use of alcohol is associated with increased likelihood of a suicide attempt, particularly at high doses. Such data should be incorporated into estimates of the burden of disease associated with alcohol use, which are currently limited by a consideration of only alcohol’s chronic effects. Future research should focus on the mechanisms through which acute use of alcohol confers risk for attempt. PMID:27928972

The Response in Twitter to an Assisted Suicide in a Television Soap Opera.

PubMed

Scourfield, Jonathan; Colombo, Gualtiero; Evans, Rhiannon; Jacob, Nina; Le Zhang, Meng; Burnap, Pete; Edwards, Adam; Housley, William; Williams, Matthew

2016-09-01

Concern has been expressed about the potentially contagious effect of television soap opera suicides and suicidal language in social media. Twitter content was analyzed during the week in which a fictional assisted suicide was broadcast on a British television soap opera, "Coronation Street." Tweets were collected if they contained language indicating possible suicidal intent or used the word suicide. The modified Thompson tau method was used to test for any differences in the volume of tweets in both categories on the day of screening. Content analysis broke down the use of the word suicide into six thematic categories. There was no evidence on the day of screening of an increase in tweets expressing possible suicidal intent but there was an increase in tweets containing the word suicide. Content analysis found the most common thematic category to be information or support, followed by the raising of moral issues in relation to suicide. It is possible that for certain high-profile media events Twitter may be used more as a civic reactive forum than as a medium for introspection or disclosure of distress.

[Suicide trends in Colombia, 1985-2002].

PubMed

Cendales, Ricardo; Vanegas, Claudia; Fierro, Marco; Córdoba, Rodrigo; Olarte, Ana

2007-10-01

To report trends in mortality from suicide in Colombia from 1985 to 2002 by sex, age group, and method, and determine the number of Years of Potential Life Lost (YPLL) to suicide during this period. Age- and sex-specific and age-adjusted crude mortality rates were calculated based on mortality and population information available from the official database of the Department of National Statistics Administration, Colombia. YPLL were estimated and adjusted for societal impact, age, and poor quality of mortality records. The results were tabulated according to codes X600-X849 and Y870 from the International Statistical Classification of Disease and Related Health Problems, 10th revision (ICD-10), and codes E950-E959 from the 9th revision (ICD-9). Suicide rates have been climbing in Colombia since 1998, particularly among young adults and males. The highest rates among males were in the age groups 20-29 years of age and over 70 years of age, and rates increased over time. Among females, the highest rates were recorded for the group 10-19 years of age. The YPLL rose in proportion with the increase in suicides, from 0.81% in 1981 to 2.20% in 2002. Among males, the most common methods used were firearms and explosives, hanging, and poison, with a relative increase in hanging; whereas among females, poison was most common. A rising trend in suicide rates in Colombia was confirmed, especially among the productive segment of the population, which has resulted in a marked increase in YPLL.

Suicides in national parks--United States, 2003-2009.

PubMed

2010-12-03

In 2007, the year for which the most recent national data on fatalities are available, 34,598 suicides occurred in the United States (rate: 11.3 per 100,000 population); 79% were among males. In 2009, an estimated 374,486 visits to hospital emergency departments occurred for self-inflicted injury, of which approximately 262,000 (70%) could be attributed to suicidal behavior. The majority (58%) were among females. Most suicides (77%) occur in the home, but many occur in public places, including national parks. In addition to the loss of life, suicides consume park resources and staff time and can traumatize witnesses. To describe the characteristics of and trends in suicides in national parks, CDC and the National Park Service (NPS) analyzed reports of suicide events (suicides and attempted suicides) occurring in the parks during 2003-2009. During this 7-year span, 84 national parks reported 286 suicide events, an average of 41 events per year. Of the 286 events, 68% were fatal. The two most commonly used methods were firearms and falls. Consistent with national patterns, 83% of suicides were among males. A comprehensive, multicomponent approach is recommended to prevent suicide events, including enhanced training for park employees, site-specific barriers, and collaboration with communities.

Characteristics of suicidal attempts among farmers in rural South India

PubMed Central

Kumar, Ravi S.; Hashim, Uzma

2017-01-01

Background: Globally, farming as an industry is considered a high-risk occupation for suicides. Certain states in India like Karnataka have a suicide rate higher than the national average, and this is generally attributed to the farmers’ suicide. Aims: The aim is to study the characteristics of suicidal attempts among the farmer community in South India, with special emphasis on gender differences, modes used, and the immediate precipitant causes. Materials and Methods: Retrospective, case register-based, explorative-descriptive study of 426 consecutive medicolegal case files of patients whose stated occupation was farming and who were admitted as cases of deliberate self-harm or suicide attempt to a rural tertiary care hospital in rural South India. Results: Out of the 426 farmers who attempted suicide, majority were male (355, 83.3%), in the age group of 21–40 years (318, 75%), married (358, 84%), and belonging to lower socioeconomic status (268, 62.9%). About 54% of them had attempted suicide by consuming pesticides (230). Surprisingly, 183 (43%) and 86 (20.2%) reported the immediate precipitant as being relationship issues and marital conflict, respectively, and only 100 (23.5%) attributed it to financial reasons. Females were significantly associated with a past history of suicidal attempt while males tended to abuse alcohol before an attempt more frequently. Conclusions: Pesticide poisoning was the most common mode for attempting suicide among the farmers. Contrary to public perception and other studies, relationship, and marital issues, not financial reasons were found to be the most common immediate precipitant for the attempters in our study. PMID:29456318

Association between suicidal symptoms and repeat suicidal behaviour within a sample of hospital-treated suicide attempters

PubMed Central

van Borkulo, Claudia D.; O’Connor, Rory C.

2017-01-01

Background Suicidal behaviour is the end result of the complex relation between many factors which are biological, psychological and environmental in nature. Network analysis is a novel method that may help us better understand the complex association between different factors. Aims To examine the relationship between suicidal symptoms as assessed by the Beck Scale for Suicide Ideation and future suicidal behaviour in patients admitted to hospital following a suicide attempt, using network analysis. Method Secondary analysis was conducted on previously collected data from a sample of 366 patients who were admitted to a Scottish hospital following a suicide attempt. Network models were estimated to visualise and test the association between baseline symptom network structure and suicidal behaviour at 15-month follow-up. Results Network analysis showed that the desire for an active attempt was found to be the most central, strongly related suicide symptom. Of the 19 suicide symptoms that were assessed at baseline, 10 symptoms were directly related to repeat suicidal behaviour. When comparing baseline network structure of repeaters (n=94) with the network of non-repeaters (n=272), no significant differences were found. Conclusions Network analysis can help us better understand suicidal behaviour by visualising the complex relation between relevant symptoms and by indicating which symptoms are most central within the network. These insights have theoretical implications as well as informing the assessment and treatment of suicidal behaviour. Declaration of interest None. Copyright and usage © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license. PMID:28507771

Youth suicide in New Mexico: a 26-year retrospective review.

PubMed

Singh, Veena D; Lathrop, Sarah L

2008-05-01

Although suicidal behavior in children and adolescents is a major public health problem, large-scale research on suicide in this population is uncommon. In this study, we reviewed autopsy and field reports for all pediatric suicide cases referred to the New Mexico Office of the Medical Investigator from 1979 to 2005. The age-adjusted suicide rate was 4.8 per 100,000. Psychologic stressors and parasuicidal behavior were identified in some cases. Seventy-six percent of suicides occurred in the victim's home or yard, and 25% left a suicide note. In 26% of cases, alcohol or other drugs were detected in postmortem. Gunshot wound was the most common method overall (58%), followed by hanging (30%). Although the age-adjusted suicide rate is higher in New Mexico than nationally, the trends in the population are similar. With a solid understanding of the circumstances, it may be possible to predict, and hopefully prevent, future cases of child and adolescent death.

Homicide-suicide in Konya, Turkey between 2000 and 2007.

PubMed

Dogan, Kamil Hakan; Demirci, Serafettin; Gunaydin, Gursel; Buken, Bora

2010-01-01

Homicide followed by the suicide of the murderer is a relatively rare lethal incident in which an individual kills another person and subsequently dies by suicide. Cases involving a homicide and a suicide in which death examinations and autopsies were performed at The Konya Branch of the Forensic Medicine Council between 2000 and 2007 were retrospectively investigated. During the studied time period, there were 10 homicide-suicide cases identified with 10 perpetrators killing 12 victims. Nine of the perpetrators were men and eight of the victims were women. The precipitating motive was an impending divorce in four of the cases. Two perpetrators were described as severely depressed, one had a diagnosis of antisocial personality disorder, and one was a pedophile who had reactive depression. Firearms were used in eight of the homicide cases and seven of the suicides. Constricting the use of firearms may reduce/prevent future homicide-suicide cases, as it is the most commonly used method to carry out homicide-suicides.

Suicidal behaviour across the African continent: a review of the literature

PubMed Central

2014-01-01

Background Suicide is a major cause of premature mortality worldwide, but data on its epidemiology in Africa, the world’s second most populous continent, are limited. Methods We systematically reviewed published literature on suicidal behaviour in African countries. We searched PubMed, Web of Knowledge, PsycINFO, African Index Medicus, Eastern Mediterranean Index Medicus and African Journals OnLine and carried out citation searches of key articles. We crudely estimated the incidence of suicide and suicide attempts in Africa based on country-specific data and compared these with published estimates. We also describe common features of suicide and suicide attempts across the studies, including information related to age, sex, methods used and risk factors. Results Regional or national suicide incidence data were available for less than one third (16/53) of African countries containing approximately 60% of Africa’s population; suicide attempt data were available for <20% of countries (7/53). Crude estimates suggest there are over 34,000 (inter-quartile range 13,141 to 63,757) suicides per year in Africa, with an overall incidence rate of 3.2 per 100,000 population. The recent Global Burden of Disease (GBD) estimate of 49,558 deaths is somewhat higher, but falls within the inter-quartile range of our estimate. Suicide rates in men are typically at least three times higher than in women. The most frequently used methods of suicide are hanging and pesticide poisoning. Reported risk factors are similar for suicide and suicide attempts and include interpersonal difficulties, mental and physical health problems, socioeconomic problems and drug and alcohol use/abuse. Qualitative studies are needed to identify additional culturally relevant risk factors and to understand how risk factors may be connected to suicidal behaviour in different socio-cultural contexts. Conclusions Our estimate is somewhat lower than GBD, but still clearly indicates suicidal behaviour is an important public health problem in Africa. More regional studies, in both urban and rural areas, are needed to more accurately estimate the burden of suicidal behaviour across the continent. Qualitative studies are required in addition to quantitative studies. PMID:24927746

Unplanned versus planned suicide attempters, precipitants, methods, and an association with mental disorders in a Korea-based community sample.

PubMed

Jeon, Hong Jin; Lee, Jun-Young; Lee, Young Moon; Hong, Jin Pyo; Won, Seung-Hee; Cho, Seong-Jin; Kim, Jin-Yeong; Chang, Sung Man; Lee, Hae Woo; Cho, Maeng Je

2010-12-01

Studies have consistently reported that a considerable proportion of suicidal attempts are unplanned. We have performed the first direct comparison between planned and unplanned attempts including associated methods and precipitants. A total of 6510 adults, who had been randomly selected through a one-person-per-household method, completed interviews (response rate 81.7%). All were interviewed using the K-CIDI and a questionnaire for suicide. Two hundred and eight subjects reported a suicide attempt in their lifetime, one-third of which had been unplanned. These individuals exhibited a lower level of education; however, no significant differences were found with regard to age, gender, marital and economic status. Further, 84.0% of unplanned attempters experienced previous suicidal ideation, experiencing their first attempt 1.9 years before ideation. Additionally, 94.4% of unplanned attempters had precipitants for attempts such as familial conflict and it was also found that methods such as the use of chemical agents or falling were three times more common in unplanned than planned attempters. With respect to unplanned attempters, they exhibited a significant association with alcohol use disorder, major depressive disorder, posttraumatic stress disorder, and bipolar disorder. In particular, bipolar disorder was found to be 3.5 times higher in these individuals. Results have revealed that unplanned suicide attempters experience suicidal ideation and precipitants prior to their attempt. Further, attempts were associated with affective and alcohol use disorders. Therefore, in order to reduce the number of suicidal attempts, it may be useful to evaluate suicidal ideation concurrent to the treatment of existing mental disorders. Copyright © 2010 Elsevier B.V. All rights reserved.

Epidemiological profile of suicide in the Santa Catarina Coal Mining Region from 1980 to 2007.

PubMed

Portella, Carolina H; Moretti, Gustavo P; Panatto, Ana P; Rosa, Maria I; Quevedo, João; Simões, Priscyla W T A

2013-01-01

Suicide is a public health problem worldwide. Estimates have indicated that over 1 million people commit suicide every year all over the world. Brazil has a moderate suicide death rate (4.1 per 100,000 inhabitants), but the fact that it is a large country leads to the coexistence of diverse characteristics and levels of development across the different Brazilian regions. In this sense, the South region has been shown to present suicide rates above the national average. To estimate the profile of suicide in municipalities comprising the Santa Catarina Coal Mining Region from 1980 to 2007. This ecological, time-series, descriptive study sought to characterize epidemiological aspects related to suicide method, marital status, sex, age, and occupation in the municipalities of the region in the years 1980 to 2007. A total of 474 suicides occurred in the period, yielding a mean death rate of 10.83 per 100,000 inhabitants. There was a predominance of males, at a 5:1 ratio, and a peak rate in the 55-64-year age group (11.31 per 100,000 inhabitants). The suicide method most commonly used was hanging (72%) and the most frequent occupation was hard labor work (11.60%); in relation to marital status, married subjects (48%) were the ones with the highest rates of suicide. The Santa Catarina Coal Mining Region has suicide mortality rates above the national average. This study highlights specific characteristics of suicide in the region and may contribute to the development of preventive measures.

Suicidal behavior in relatives or associates moderates the strength of common risk factors for suicide

PubMed Central

Tong, Yongsheng; Phillips, Michael R.; Duberstein, Paul; Zhan, Weihai

2014-01-01

The prevalence and odds ratios of different suicide risk factors were compared in three pairs of decedents: 80 suicides and 25 injury decedents with blood-relatives with suicidal behavior history (biologically-exposed); 259 suicides and 126 injury decedents with unrelated acquaintances with suicidal behavior history (socially-exposed); and 471 suicides and 523 injury decedents with neither relatives nor acquaintances with suicidal behavior history (unexposed). Negative life events and high psychological stress were more common in socially-exposed suicides than in other suicides. The adjusted odds ratios of most established suicide risk factors were higher in unexposed decedents than in biologically- or socially-exposed decedents, suggesting that the predictive value of established risk factors wanes in individuals who have been exposed to suicidal behavior in family or friends. PMID:25443455

Evaluating the High Risk Groups for Suicide: A Comparison of Logistic Regression, Support Vector Machine, Decision Tree and Artificial Neural Network

PubMed Central

AMINI, Payam; AHMADINIA, Hasan; POOROLAJAL, Jalal; MOQADDASI AMIRI, Mohammad

2016-01-01

Background: We aimed to assess the high-risk group for suicide using different classification methods includinglogistic regression (LR), decision tree (DT), artificial neural network (ANN), and support vector machine (SVM). Methods: We used the dataset of a study conducted to predict risk factors of completed suicide in Hamadan Province, the west of Iran, in 2010. To evaluate the high-risk groups for suicide, LR, SVM, DT and ANN were performed. The applied methods were compared using sensitivity, specificity, positive predicted value, negative predicted value, accuracy and the area under curve. Cochran-Q test was implied to check differences in proportion among methods. To assess the association between the observed and predicted values, Ø coefficient, contingency coefficient, and Kendall tau-b were calculated. Results: Gender, age, and job were the most important risk factors for fatal suicide attempts in common for four methods. SVM method showed the highest accuracy 0.68 and 0.67 for training and testing sample, respectively. However, this method resulted in the highest specificity (0.67 for training and 0.68 for testing sample) and the highest sensitivity for training sample (0.85), but the lowest sensitivity for the testing sample (0.53). Cochran-Q test resulted in differences between proportions in different methods (P<0.001). The association of SVM predictions and observed values, Ø coefficient, contingency coefficient, and Kendall tau-b were 0.239, 0.232 and 0.239, respectively. Conclusion: SVM had the best performance to classify fatal suicide attempts comparing to DT, LR and ANN. PMID:27957463

Mobile Apps for Suicide Prevention: Review of Virtual Stores and Literature

PubMed Central

Castillo, Gema; Arambarri, Jon; López-Coronado, Miguel; Franco, Manuel A

2017-01-01

Background The best manner to prevent suicide is to recognize suicidal signs and signals, and know how to respond to them. Objective We aim to study the existing mobile apps for suicide prevention in the literature and the most commonly used virtual stores. Methods Two reviews were carried out. The first was done by searching the most commonly used commercial app stores, which are iTunes and Google Play. The second was a review of mobile health (mHealth) apps in published articles within the last 10 years in the following 7 scientific databases: Science Direct, Medline, PsycINFO, Embase, The Cochrane Library, IEEE Xplore, and Google Scholar. Results A total of 124 apps related to suicide were found in the cited virtual stores but only 20 apps were specifically designed for suicide prevention. All apps were free and most were designed for Android. Furthermore, 6 relevant papers were found in the indicated scientific databases; in these studies, some real experiences with physicians, caregivers, and families were described. The importance of these people in suicide prevention was indicated. Conclusions The number of apps regarding suicide prevention is small, and there was little information available from literature searches, indicating that technology-based suicide prevention remains understudied. Many of the apps provided no interactive features. It is important to verify the accuracy of the results of different apps that are available on iOS and Android. The confidence generated by these apps can benefit end users, either by improving their health monitoring or simply to verify their body condition. PMID:29017992

Is daily shaving of axillary and pubic hair a feature of suicide in the Muslim community?

PubMed

Demirci, Serafettin; Dogan, Kamil Hakan; Erkol, Zerrin; Deniz, Idris

2008-12-01

In the Islamic context, "fitrah" refers to humanity's innate disposition toward virtue and the ability to differentiate between right and wrong. A common quote regarding fitrah, from the Prophet is "The fitrah consists of 5 things: circumcision, trimming the moustache, cutting the nails, plucking the armpit hairs, and shaving the pubic hairs."In this study, our aim was to determine the status of axillary and pubic shaving in medicolegal death cases that took place in the Konya Province of Turkey and to evaluate the relationship with the origin of suicide. Of 2850 medicolegal death cases, 206 (7.2%) were of suicidal origin. It was observed that the average age in the cases of suicidal origin was 36.76 +/- 17.72 years, and 146 of 206 cases (70.9%) were men. As a method of suicide, hanging was the chosen method in 100 cases (48.5%), whereas firearm injuries occurred in 54 cases (26.2%), and intoxication was involved in 37 cases (18.0%). Daily axillary and pubic shaving was observed in 26 of 2644 (1.0%) death cases that occurred with nonsuicidal reasons, but in 65 of 206 were (31.6%) suicidal cases. Because suicidal notes were present in 25 (12.1%) of all of the suicidal cases, the ratio of daily axillary and pubic shaving was significantly higher than that of the suicidal notes.In investigating the cases of suicidal origin for medicolegal purposes, evidence showing that this action was committed by the victim, the presence of a suicide note at the death scene and, a history of a previous suicidal attempt, it was thought that the presence of daily axillary and pubic shaving on external examination of the victim's body, when of Muslim faith, could also be considered a feature of suicide.

Attempted suicide by black men and women: an 11 year study.

PubMed

Frierson, R L; Lippmann, S B

1990-06-01

Two hundred and thirty-two black patients (103 men, 129 women) who attempted suicide were referred for psychiatric consultation from January 1976 through August 1987. Black male attempters were (1) more often schizophrenic; (2) more apt to be intoxicated; (3) more commonly psychotic; and (4) more prone to use violent methods. Black women were more likely to manifest clinical depression and much more inclined to choose drug overdose as a method. Women were also more apt to jump from buildings or bridges and deliberately set themselves ablaze. Referrals of suicide attempters increased for both sexes over the study period, and violent methods, particularly firearm use, rose steadily among black women over the 11 1/2 years. Recommendations for providing care to black suicide attempters include (1) appreciation of the psychological effects of racism; (2) increased sensitivity to depressive features in black schizophrenics; (3) consideration of affective disorders in young black males frequently involved in violent acts; and (4) awareness of one's own racially biased attitudes.

Self-reported Barriers to Professional Help Seeking Among College Students at Elevated Risk for Suicide

PubMed Central

Czyz, E. K.; Horwitz, A. G.; Eisenberg, D.; Kramer, A.; King, C.A.

2013-01-01

Research objectives This study sought to describe self-reported barriers to professional help seeking among college students who are at elevated suicide risk and determine if these barriers vary by demographic and clinical characteristics. Participants Participants were 165 non-treatment seekers recruited as part of a web-based treatment linkage intervention for college students at elevated suicide risk (from September 2010 through December 2011). Methods Data were collected using web-based questionnaires. Two coders coded students’ responses to an open-ended question about reasons for not seeking professional help. Results The most commonly reported barriers included: perception that treatment is not needed (66%); lack of time (26.8%); preference for self-management (18%). Stigma was mentioned by only 12% of students. There were notable differences based on gender, race, and severity of depression and alcohol abuse. Conclusions Efforts aimed at reaching students at elevated risk for suicidal behavior should be particularly sensitive to these commonly described barriers. PMID:24010494

Suicide attempts by exposure to toxic agents registered in a Toxicological Information and Assistance Center in Fortaleza, Ceará, Brazil, 2013.

PubMed

Gondim, Ana Paula Soares; Nogueira, Rachel Rabay; Lima, João Gabriel Barbosa; Lima, Rayra Aguiar Campos; Albuquerque, Polianna Lemos Moura Moreira; Veras, Maria do Socorro Batista; Ferreira, Maria Augusta Drago

2017-01-01

to describe cases of suicide attempts by exposure to toxic agents registered by the Toxicological Information and Assistance Center in Fortaleza, Ceará, Brazil. this is a descriptive study using secondary data of the cases registered in 2013. 410 cases were registered; 56.2% of the individuals were female and 79.7% were between 12 and 39 years old; most of them (86.4%) lived in urban areas and 67.2%, in Fortaleza; in 94.9% of the cases, the exposure took place in the individual's own home; the toxic agents most commonly used were pesticides (42.9%), especially for agricultural use (30.2%), medicines (39.5%) and house cleaning products (3.4%); of 16 suicide attempts that resulted in death, 15 were caused by agricultural pesticides. the study shows that the intake of toxic agents, especially of agricultural pesticides, is a common method used in suicide attempts; the integration between actions of promotion and prevention are essential.

Suicidality, ethnicity and immigration in the USA.

PubMed

Borges, G; Orozco, R; Rafful, C; Miller, E; Breslau, J

2012-06-01

Suicide is the 11th leading cause of death in the USA. Suicide rates vary across ethnic groups. Whether suicide behavior differs by ethnic groups in the USA in the same way as observed for suicide death is a matter of current discussion. The aim of this report was to compare the lifetime prevalence of suicide ideation and attempt among four main ethnic groups (Asians, Blacks, Hispanics, and Whites) in the USA. Suicide ideation and attempts were assessed using the World Mental Health version of the Composite International Diagnostic Interview (WMH-CIDI). Discrete time survival analysis was used to examine risk for lifetime suicidality by ethnicity and immigration among 15 180 participants in the Collaborative Psychiatric Epidemiological Surveys (CPES), a group of cross-sectional surveys. Suicide ideation was most common among Non-Hispanic Whites (16.10%), least common among Asians (9.02%) and intermediate among Hispanics (11.35%) and Non-Hispanic Blacks (11.82%). Suicide attempts were equally common among Non-Hispanic Whites (4.69%), Hispanics (5.11%) and Non-Hispanic Blacks (4.15%) and less common among Asians (2.55%). These differences in the crude prevalence rates of suicide ideation decreased but persisted after control for psychiatric disorders, but disappeared for suicide attempt. Within ethnic groups, risk for suicidality was low among immigrants prior to migration compared to the US born, but equalized over time after migration. Ethnic differences in suicidal behaviors are explained partly by differences in psychiatric disorders and low risk prior to arrival in the USA. These differences are likely to decrease as the US-born proportion of Hispanics and Asians increases.

Trends in suicide from drug overdose in the elderly in England and Wales, 1993-1999.

PubMed

Shah, Rajen; Uren, Zoë; Baker, Allan; Majeed, Azeem

2002-05-01

Drug overdose is a common method of suicide in the elderly. Hence, an understanding of current trends in epidemiology of these deaths is important when considering measures to decrease suicide rates. Analysis of the Office for National Statistics (ONS) database of deaths from overdose and poisoning. Suicide and undetermined deaths from drug overdose between 1993-1999 in the over 65 year olds were studied. Socio-demographic data from the four drug groups most commonly used in overdose were extracted, and age and sex specific mortality rates calculated. Enumeration districts were ranked into five quintiles based on their Carstairs scores, and death rates in each quintile for men and women calculated. There were 1864 deaths from drug overdose during the study period. Suicide and undetermined death rates from drug overdose remained stable between 1993-1999. Drugs most commonly used in overdose were (in order) paracetamol (and related compounds), benzodiazepines, antidepressants, and opiates. Women comprised 62% of deaths. Death rates increased with age, with highest rates in men over 75 (37.7 deaths per million). Benzodiazepines showed the most marked increase with age. Co-proxamol comprised 32% of deaths from paracetamol compounds, and 95% of antidepressant deaths were due to tricyclic antidepressants. There was no association in women between Carstairs area deprivation and suicide rates; in men rates were highest in the most deprived areas. Suicides in the over 65 year olds may be decreased by changes in prescription practice. Paracetamol, co-proxamol, tricyclic antidepressants and benzodiazepines should be prescribed with caution to the elderly with depression or at high risk of depression. Copyright 2002 John Wiley & Sons, Ltd.

Method of self-harm in adolescents and young adults and risk of subsequent suicide.

PubMed

Beckman, Karin; Mittendorfer-Rutz, Ellenor; Waern, Margda; Larsson, Henrik; Runeson, Bo; Dahlin, Marie

2018-03-05

Self-harm is common in youth and an important risk factor for suicide. Certain self-harm methods might indicate a higher risk of suicide. The main aim of this study was to determine whether some methods of self-harm in adolescents (10-17 years) and young adults (18-24 years) are associated with a particularly high risk of suicide. A secondary aim was to ascertain how different self-harm methods might affect the probability of psychiatric follow-up. Five Swedish registers were linked in a national population-based cohort study. All nonfatal self-harm events recorded in specialist health care, excluding psychiatry and primary care services, among 10-24 year olds between 2000 and 2009 were included. Methods were classified as poisoning, cutting/piercing, violent method (gassing, hanging, strangulation/suffocation, drowning, jumping and firearms), other and multiple methods. Hazard Ratios (HR) for suicide were calculated in Cox regression models for each method with poisoning as the reference. Odds Ratios (OR) for psychiatric inpatient care were determined in logistic regression models. Analyses were adjusted for important covariates and stratified by age group and treatment setting (inpatient/outpatient). Among adolescents with initial medical hospitalisation, use of a violent method was associated with a near eightfold increase in HR for suicide compared to self-poisoning in the adjusted analysis [HR 7.8; 95% confidence interval (CI) 3.2-19.0]. Among hospitalised young adult women, adjusted HRs were elevated fourfold for both cutting [4.0 (1.9-8.8)] and violent methods [3.9 (1.5-10.6)]. Method of self-harm did not affect suicide risk in young adult men. Adolescents using violent methods had an increased probability of psychiatric inpatient care following initial treatment for self-harm. Violent self-harm requiring medical hospitalisation may signal particularly high risk of future suicide in adolescents (both sexes) and in young adult women. For the latter group this is the case for cutting requiring hospitalisation as well. © 2018 Association for Child and Adolescent Mental Health.

Cross-sectional study of attitudes about suicide among psychiatrists in Shanghai

PubMed Central

2014-01-01

Background Attitudes and knowledge about suicide may influence psychiatrists’ management of suicidal patients but there has been little research about this issue in China. Methods We used the Scale of Public Attitudes about Suicide (SPAS) – a 47-item scale developed and validated in China – to assess knowledge about suicide and seven specific attitudes about suicide in a sample of 187 psychiatrists from six psychiatric hospitals in Shanghai. The results were compared to those of 548 urban community members (assessed in a previous study). Results Compared to urban community members, psychiatrists were more likely to believe that suicide can be prevented and that suicide is an important social problem but they had more stigmatizing beliefs about suicidal individuals and felt less empathy for them. The belief that suicide can be prevented was more common among female psychiatrists than male psychiatrists but male psychiatrists felt more empathy for suicidal individuals. Only 37% of the psychiatrists correctly agreed that talking about suicide-related issues with an individual would not precipitate suicidal behavior and only 41% correctly agreed that those who state that they intend to kill themselves may actually do so. Conclusions Many psychiatrists in Shanghai harbor negative attitudes about suicidal individuals and are concerned that directly addressing the issue with patients will increase the risk of suicide. Demographic factors, educational status and work experience are associated with psychiatrists’ attitudes about suicide and, thus, need to be considered when training psychiatrists about suicide prevention. PMID:24666549

Contact With Mental Health and Primary Care Providers Before Suicide: A Review of the Evidence

PubMed Central

Luoma, Jason B.; Martin, Catherine E.; Pearson, Jane L.

2016-01-01

Objective This study examined rates of contact with primary care and mental health care professionals by individuals before they died by suicide. Method The authors reviewed 40 studies for which there was information available on rates of health care contact and examined age and gender differences among the subjects. Results Contact with primary care providers in the time leading up to suicide is common. While three of four suicide victims had contact with primary care providers within the year of suicide, approximately one-third of the suicide victims had contact with mental health services. About one in five suicide victims had contact with mental health services within a month before their suicide. On average, 45% of suicide victims had contact with primary care providers within 1 month of suicide. Older adults had higher rates of contact with primary care providers within 1 month of suicide than younger adults. Conclusions While it is not known to what degree contact with mental health care and primary care providers can prevent suicide, the majority of individuals who die by suicide do make contact with primary care providers, particularly older adults. Given that this pattern is consistent with overall health-service-seeking, alternate approaches to suicide-prevention efforts may be needed for those less likely to be seen in primary care or mental health specialty care, specifically young men. PMID:12042175

Systemic vulnerabilities to suicide among veterans from the Iraq and Afghanistan Conflicts: review of case reports from a National Veterans Affairs Database.

PubMed

Mills, Peter D; Huber, Samuel J; Vince Watts, Bradley; Bagian, James P

2011-02-01

While suicide among recently returned veterans is of great concern, it is a relatively rare occurrence within individual hospitals and clinics. Root cause analysis (RCA) generates a detailed case report that can be used to identify system-based vulnerabilities following an adverse event. Review of a national database of RCA reports may identify common vulnerabilities and assist in the development of more robust prevention strategies. Our objective was to identify and compare common themes among reports of suicide among veterans of Operations Iraqi Freedom and Enduring Freedom (OIF/OEF) in the Veterans Affairs system. Common themes among root causes of suicide as identified in RCA reports were collected and compared as the primary outcome--systematic vulnerabilities. Actions recommended within the reports were coded as the secondary outcome--prevention strategies. Fifty-one RCA reports of OIF/OEF suicides were identified by our search. Coding generated 16 common categories among 132 root causes, and 13 categories among 108 recommended actions. Assessment of suicidal risk, coordination of care, timely access to care, and communication among providers were the most common root causes. Actions identified by RCA teams to reduce suicide included improving referral processes, staff education in suicide assessment, and follow-up with suicidal veterans. Review of multiple RCA reports can identify organizational vulnerabilities detected at the local level that may be applicable system wide. Attention to improving suicide assessment, coordination of care, and timely access may have the largest impact on reducing suicide among OIF/OEF veterans. © 2011 The American Association of Suicidology.

[Autism spectrum disorder and suicidality].

PubMed

Huguet, G; Contejean, Y; Doyen, C

2015-09-01

Most studies on suicide exclude subjects with autism spectrum disorders, yet there is a risk group. The purpose of this article is to present the data in the literature regarding the clinical and epidemiological characteristics of suicidality in subjects with autism spectrum disorders and to identify the factors that promote the transition to action. This review was carried out using the data set collected in Medline PubMed, items with "autism spectrum disorder", "pervasive developmental disorder", "Asperger's syndrome", "suicide", "suicide attempt", and "suicide behavior". In all subjects from our research on PubMed, 21.3% of subjects with autism spectrum disorder reported suicidal ideation, have attempted suicide or died by suicide (115 out of 539 subjects) and 7.7% of subjects supported for suicidal thoughts or attempted suicide exhibited an autism spectrum disorder (62 out of 806 subjects), all ages combined. Suicidal ideation and morbid preoccupation are particularly common in adolescents and young adults. Suicide attempts are accompanied by a willingness for death and can lead to suicide. They are more common in high-functioning autism and Asperger subjects. The methods used are often violent and potentially lethal or fatal in two cases published. Suicide risk depends on many factors that highlight the vulnerability of these subjects, following autistic and developmental symptoms. Vulnerability complicating the diagnosis of comorbid depressive and anxiety disorders are major factors associated with suicidality. Vulnerability but also directly related to suicidality, since the origin of physical and sexual abuse and victimization by peers assigning them the role of "scapegoat" are both responsible for acting out. Given the diversity of factors involved in the risk of suicide in this population, this does not validate "a" program of intervention, but the intervention of "customized programs". Their implementation should be as early as possible in order to treat while the brain has the greatest plasticity. The aim is to provide the necessary access to the greatest possible autonomy. Hence, including working communication skills and interaction, these subject will have independent means of protection, an essential complement to measures to protect vulnerable subjects; the vulnerability of direct and indirect suicidality. Comorbid diagnoses must take into account the specificities of these patients, their difficulties in communicating their mental state, and adapted and innovative therapeutic strategies must be offered and validated. Copyright © 2014 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Suicidality in Body Dysmorphic Disorder

PubMed Central

Phillips, Katharine A.

2008-01-01

Suicidal ideation, suicide attempts, and completed suicide appear common in individuals with body dysmorphic disorder (BDD). Available evidence indicates that approximately 80% of individuals with BDD experience lifetime suicidal ideation and 24% to 28% have attempted suicide. Although data on completed suicide are limited and preliminary, the suicide rate appears markedly high. These findings underscore the importance of recognizing and effectively treating BDD. However, BDD is underrecognized in clinical settings even though it is relatively common and often presents to psychiatrists and other mental health practitioners, dermatologists, surgeons, and other physicians. This article reviews available evidence on suicidality in BDD and discusses how to recognize and diagnose this often secret disorder. Efficacious treatments for BDD, ie, serotonin reuptake inhibitors (SRIs) and cognitive-behavioral therapy, are also discussed. Although data are limited, it appears that SRIs often diminish suicidality in these patients. Additional research is greatly needed on suicidality rates, characteristics, correlates, risk factors, treatment, and prevention of suicidality in BDD. PMID:18449358

Acute risk factors for suicide attempts and death: prospective findings from the STEP-BD study

PubMed Central

Ballard, Elizabeth D; Vande Voort, Jennifer L; Luckenbaugh, David A; Machado-Vieira, Rodrigo; Tohen, Mauricio; Zarate, Carlos A

2016-01-01

Objectives Suicide is unfortunately common in psychiatric practice, but difficult to predict. This study sought to assess which clinical symptoms increase in the months before suicidal behavior in a sample of psychiatric outpatients with bipolar disorder. Methods Data from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) trial were used. A total pf 103 participants who attempted suicide or died by suicide during the trial were included; a 15% random sample of the remaining participants (n = 427) was used as a comparison sample. Linear mixed models in the six months before suicidal behavior were conducted for each of five proposed acute risk factors for suicidal behavior. Participants were assessed using the Clinical Monitoring Form (CMF) at each visit for the following potential acute risk factors for suicidal behavior: suicidal ideation, loss of interest, anxiety, psychomotor agitation, and high-risk behavior. Results Each of the five symptoms was elevated overall in individuals who engaged in suicidal behavior (p < 0.05). The severity of both suicidal ideation and loss of interest significantly increased in the months before suicidal behavior (p < 0.001). Anxiety demonstrated comparable effect sizes across multiple models. Psychomotor agitation and high-risk behavior were not significantly elevated before suicidal behavior. Conclusions Suicidal ideation, loss of interest and, to a lesser extent, anxiety may represent acute suicide risk factors up to four months before suicidal behavior in outpatients with bipolar disorder. Further investigation of these potential acute risk factors in prospective analyses is warranted. PMID:27233466

Chronic Stress and Suicidal Thinking Among Medical Students

PubMed Central

Rosiek, Anna; Rosiek-Kryszewska, Aleksandra; Leksowski, Łukasz; Leksowski, Krzysztof

2016-01-01

Introduction: The subject of chronic stress and ways of dealing with it are very broad. The aim of this study was to analyze stress and anxiety and their influence on suicidal thinking among medical students. Materials and Methods: The study was conducted in the years 2014 to 2015 in Poland, at the Medical University—Nicolaus Copernicus University, Collegium Medicum. The objective of this study was to assess chronic stress and suicidal thinking among students and how students cope with this huge problem. Descriptive statistics and chi-square analyses were conducted to detect differences. Results: Analyses showed that students’ life is full of stressors. Students toward the end of their education cope better with stress than students starting their university studies. Chronic stress has a strong impact on mental health and suicidal thinking among students. Conclusions: The results of the study confirmed that chronic stress and anxiety have a negative influence on mental health and also confirm a relation to suicidal thinking in medical students. Students cope with stress by listening to music, talking to relatives or people close to them, resting or engaging in sports, with cycling, running and swimming being the most common methods used to affect suicidal thinking. PMID:26891311

Ten Commonalities of Suicide and Some Implications for Public Policy.

ERIC Educational Resources Information Center

Shneidman, Edwin S.

This paper describes 10 common characteristics of suicide that pertain to suicide committed at any age. Each characteristic is defined and analyzed, with specific approaches to treatment identified. The 10 characteristics, based on clinical experience and the relevant work of others, are listed. The commonalities discussed include: (1) the common…

The Burden of Suicide in Rural Bangladesh: Magnitude and Risk Factors.

PubMed

Sharmin Salam, Shumona; Alonge, Olakunle; Islam, Md Irteja; Hoque, Dewan Md Emdadul; Wadhwaniya, Shirin; Ul Baset, Md Kamran; Mashreky, Saidur Rahman; El Arifeen, Shams

2017-09-09

The aim of the paper is to quantify the burden and risk factors of fatal and non-fatal suicidal behaviors in rural Bangladesh. A census was carried out in seven sub-districts encompassing 1.16 million people. Face-to-face interviews were conducted at the household level. Descriptive analyses were done to quantify the burden and Poisson regression was run to determine on risk factors. The estimated rates of fatal and non-fatal suicide were 3.29 and 9.86 per 100,000 person years (PY) observed, respectively. The risk of suicide was significantly higher by 6.31 times among 15-17 and 4.04 times among 18-24 olds compared to 25-64 years old. Married adolescents were 22 times more likely to commit suicide compared to never-married people. Compared to Chandpur/Comilla district, the risk of suicide was significantly higher in Narshingdi. Students had significantly lower risk of non-fatal suicidal behavior compared to skilled laborers. The risk of non-fatal suicidal behavior was lower in Sherpur compared to Chandpur/Comilla. Among adolescents, unskilled laborers were 16 times more likely to attempt suicide than students. The common methods for fatal and non-fatal suicidal behaviors were hanging and poisoning. Suicide is a major public health problem in Bangladesh that needs to be addressed with targeted interventions.

Suicides in Aboriginal and Torres Strait Islander children: analysis of Queensland Suicide Register.

PubMed

Soole, Rebecca; Kõlves, Kairi; De Leo, Diego

2014-12-01

Suicide rates among Indigenous Australian children are higher than for other Australian children. The current study aimed to identify factors associated with Indigenous child suicide when compared to other Australian children. Using the Queensland Suicide Register, suicides in Indigenous children (10-14 years) and other Australian children in the same age band were compared. Between 2000 and 2010, 45 child suicides were recorded: 21 of Indigenous children and 24 of other Australian children. This corresponded to a suicide rate of 10.15 suicides per 100,000 for Indigenous children - 12.63 times higher than the suicide rate for other Australian children (0.80 per 100,000). Hanging was the predominant method used by all children. Indigenous children were significantly more likely to suicide outside the home, to be living outside the parental home at time of death, and be living in remote or very remote areas. Indigenous children were found to consume alcohol more frequently before suicide, compared to other Australian children. Current and past treatments of psychiatric disorders were significantly less common among Indigenous children compared to other Australian children. Western conceptualisation of mental illness may not adequately embody Indigenous people's holistic perspective regarding mental health. Further development of culturally appropriate suicide prevention activities for Aboriginal and Torres Strait Islander children is required. © 2014 Public Health Association of Australia.

Atmospheric pressure and suicide attempts in Helsinki, Finland

NASA Astrophysics Data System (ADS)

Hiltunen, Laura; Ruuhela, Reija; Ostamo, Aini; Lönnqvist, Jouko; Suominen, Kirsi; Partonen, Timo

2012-11-01

The influence of weather on mood and mental health is commonly debated. Furthermore, studies concerning weather and suicidal behavior have given inconsistent results. Our aim was to see if daily weather changes associate with the number of suicide attempts in Finland. All suicide attempts treated in the hospitals in Helsinki, Finland, during two separate periods, 8 years apart, were included. Altogether, 3,945 suicide attempts were compared with daily weather parameters and analyzed with a Poisson regression. We found that daily atmospheric pressure correlated statistically significantly with the number of suicide attempts, and for men the correlation was negative. Taking into account the seasonal normal value during the period 1971-2000, daily temperature, global solar radiation and precipitation did not associate with the number of suicide attempts on a statistically significant level in our study. We concluded that daily atmospheric pressure may have an impact on suicidal behavior, especially on suicide attempts of men by violent methods ( P < 0.001), and may explain the clustering of suicide attempts. Men seem to be more vulnerable to attempt suicide under low atmospheric pressure and women under high atmospheric pressure. We show only statistical correlations, which leaves the exact mechanisms of interaction between weather and suicidal behavior open. However, suicidal behavior should be assessed from the point of view of weather in addition to psychiatric and social aspects.

Alcohol Involvement in Suicide and Self-Harm.

PubMed

Larkin, Celine; Griffin, Eve; Corcoran, Paul; McAuliffe, Carmel; Perry, Ivan J; Arensman, Ella

2017-11-01

Alcohol misuse and alcohol consumption are significant risk factors for suicidal behavior. This study sought to identify factors associated with alcohol consumption in cases of suicide and nonfatal self-harm presentations. Suicide cases in Cork, Ireland, from September 2008 to June 2012 were identified through the Suicide Support and Information System. Emergency department presentations of self-harm in the years 2007-2013 were obtained from the National Self-Harm Registry Ireland. Alcohol consumption was detected in the toxicology of 44% out of 307 suicide cases. Only younger age was significantly associated with having consumed alcohol among suicides. Alcohol consumption was noted in the case notes in 21% out of 8,145 self-harm presentations. Logistic regression analyses indicated that variables associated with having consumed alcohol in a self-harm presentation included male gender, older age, overdose as a method, not being admitted to a psychiatric ward, and presenting out-of-hours. Data was limited to routinely collected variables by the two different monitoring systems. Alcohol consumption commonly precedes suicidal behavior, and several factors differentiated alcohol-related suicidal acts. Self-harm cases, in particular, differ in profile when alcohol is consumed and may require a tailored clinical approach to minimize risk of further nonfatal or fatal self-harm.

No association between serum cholesterol and death by suicide in patients with schizophrenia, bipolar affective disorder, or major depressive disorder

PubMed Central

2013-01-01

Background Previous research on serum total cholesterol and suicidality has yielded conflicting results. Several studies have reported a link between low serum total cholesterol and suicidality, whereas others have failed to replicate these findings, particularly in patients with major affective disorders. These discordant findings may reflect the fact that studies often do not distinguish between patients with bipolar and unipolar depression; moreover, definitions and classification schemes for suicide attempts in the literature vary widely. Methods Subjects were patients with one of the three major psychiatric disorders commonly associated with suicide: schizophrenia, bipolar affective disorder, and major depressive disorder (MDD). We compared serum lipid levels in patients who died by suicide (82 schizophrenia, 23 bipolar affective disorder, and 67 MDD) and non-suicide controls (200 schizophrenia, 49 bipolar affective disorder, and 175 MDD). Results Serum lipid profiles did not differ between patients who died by suicide and control patients in any diagnostic group. Conclusions Our results do not support the use of biological indicators such as serum total cholesterol to predict suicide risk among patients with a major psychiatric disorder. PMID:24308827

Association between suicidal behaviour and impaired glucose metabolism in depressive disorders.

PubMed

Koponen, Hannu; Kautiainen, Hannu; Leppänen, Esa; Mäntyselkä, Pekka; Vanhala, Mauno

2015-07-22

Disturbances in lipid metabolism have been linked to suicidal behaviour, but little is known about the association between suicide risk and abnormal glucose metabolism in depression. Hyperglycaemia and hyperinsulinaemia may increase the risk of depression and also the risk for suicide, we therefore studied associations between suicidal behaviour and disturbances in glucose metabolism in depressive patients who had been referred to depression nurse case managers. Patients aged 35 years and older (N = 448, mean age 51 years) who were experiencing a new depressive episode, who were referred to depression nurse case managers in 2008-2009 and who scored ≥10 on the Beck Depression Inventory were enrolled in this study. The study was conducted in municipalities within the Central Finland Hospital District (catchment area of 274 000 inhabitants) as part of the Finnish Depression and Metabolic Syndrome in Adults study. The patients' psychiatric diagnoses and suicidal behaviour were confirmed by the Mini-International Neuropsychiatric Interview. Blood samples, for glucose and lipid determinations, were drawn from participants after 12 h of fasting, which was followed by a 2-hour oral glucose tolerance test (OGTT) when blood was drawn at 0 and 2 h. Insulin resistance was measured by the Quantitative Insulin Sensitivity Check Index (QUICKI) method. Suicidal ideation (49 %) and previous suicide attempts (16 %) were common in patients with major depressive disorder or dysthymia. Patients with depression and suicidal behaviour had higher blood glucose concentrations at baseline and at 2 hours in the OGTT. Glucose levels associated positively with the prevalence of suicidal behaviour, and the linearity was significant at baseline (p for linearity: 0.012, adjusted for age and sex) and for 2-hour OGTT glucose (p for linearity: 0.004, adjusted for age and sex). QUICKI levels associated with suicidal behavior (p for linearity across tertiles of QUICKI: 0.026). Total and LDL cholesterol and triglyceride levels were also higher in those patients with suicidal behaviour. Multivariate analysis revealed that blood glucose levels, BDI scores and antidepressive medications associated with suicidal behaviour. Insulin resistance and disturbances in glucose and lipid metabolism may be more common in middle-aged depressive patients with suicidal behaviour.

Risk Factors for Suicidal Behaviour in Individuals on Disability Pension Due to Common Mental Disorders - A Nationwide Register-Based Prospective Cohort Study in Sweden

PubMed Central

Rahman, Syed; Alexanderson, Kristina; Jokinen, Jussi; Mittendorfer-Rutz, Ellenor

2014-01-01

Background Common mental disorders (CMD) have become one of the leading causes for disability pension (DP). Studies on predictors of adverse health outcome following DP are sparse. This study aimed to examine the association of different socio-demographic factors and health care consumption with subsequent suicidal behaviour among individuals on DP due to CMD. Method This is a population-based prospective cohort study based on register data. All individuals aged 18–64 years, living in Sweden on 31-Dec-2004 who in 2005 were on DP due to CMD (N = 46 745) were followed regarding suicide attempt and suicide (2006–10). Univariate and multivariate hazard ratios (HR) and 95% confidence intervals (CI) for suicidal behaviour were estimated by Cox regression. Results During the five-year follow-up, 1 046 (2.2%) and 210 (0.4%) individuals attempted and committed suicide, respectively. Multivariate analyses showed that young age (18–24 years) and low education predicted suicide attempt, while living alone was associated with both higher suicide attempt and suicide (range of HRs 1.23 to 1.68). Combined prescription of antidepressants with anxiolytics during 2005 and inpatient care due to mental diagnoses or suicide attempt (2001–05) were strongly associated with suicide attempt and suicide (range of HRs 1.3 to 4.9), while inpatient care due to somatic diagnoses and specialized outpatient care due to mental diagnoses during 2001–05 only predicted suicide attempt (HR 1.45; 95% CI: 1.3–1.7; HR 1.30; 95% CI: 1.1–1.7). Conclusions Along with socio-demographic factors, it is very important to consider type of previous healthcare use and medication history when designing further research or intervention aiming at individuals on DP due to CMD. Further research is warranted to investigate both characteristics of disability pension due to CMD, like duration, diagnoses and grade as well as mechanisms to subsequent suicidal behavior, taking potential gender differences into consideration. PMID:24869674

Exposure to Suicide in the Community: Prevalence and Correlates in One U.S. State

PubMed Central

Maple, Myfanwy; van de Venne, Judy; Moore, Melinda; Flaherty, Chris; Brown, Margaret

2016-01-01

Objective Suicide has been identified as a major public health issue. Exposure to suicide (i.e., knowing someone who died by suicide) is far more pervasive than previously considered and might be associated with significant adverse outcomes. As suicide becomes more commonly discussed in the public arena, a compelling need exists to determine who is exposed to suicide and how this exposure affects those left behind. This study estimated the proportion of the population exposed to suicide and delineated factors that predict significant psychiatric and psychosocial morbidity following that exposure. Methods A dual-frame random-digit-dial survey was conducted on a sample of 1,736 U.S. adults in the Commonwealth of Kentucky. Depression and anxiety were compared in suicide-exposed and suicide-unexposed individuals. Relationships were examined between psychiatric outcomes and perceptions of closeness to the decedent. Results Forty-eight percent of weighted participants (n=816/1,687) reported lifetime exposure to suicide. Current depression and anxiety symptoms were higher in suicide-exposed than in suicide-unexposed individuals. Suicide-exposed individuals were twice as likely as suicide-unexposed individuals to have diagnosable depression and almost twice as likely to have diagnosable anxiety. Suicide-exposed individuals were more likely than suicide-unexposed individuals to report suicide ideation (9% vs. 5%). Closeness to the decedent increased the odds of depression and anxiety and almost quadrupled the odds of posttraumatic stress disorder. Conclusion Exposure to suicide is pervasive and occurs beyond family; as such, it is imperative to identify those with perceived closeness to the decedent. This hidden cohort of suicide-exposed people is at elevated risk for psychopathology and suicidal ideation. PMID:26843675

Everyday functioning of male adolescents who later died by suicide: Results of a pilot case-control study using mixed-method analysis.

PubMed

Buhnick-Atzil, Ortal; Rubinstein, Katya; Tuval-Mashiach, Rivka; Fischer, Sharon; Fruchter, Eyal; Large, Matthew; Weiser, Mark

2015-02-01

Previous research has shown a link between difficulties in everyday functioning and suicidality in adolescence. The majority of research in this field focuses on suicidal ideation and attempts, rather than on completed suicide. The main goal of this study is to better characterize everyday functioning among young men who later completed suicide. Based on previous literature, we hypothesized that the functioning of adolescents who died by suicide would be poor, compared to controls. The current study is a record-driven study, which examined summaries of screening interviews performed by the Israeli Defense Forces (IDF) of 20 male adolescents who later completed suicide, compared with 20 matched living controls. The current study is a pilot stage of a larger project. The study used unique data, collected as part of the IDF pre-induction process, in the months or years before the tragic outcome. The data were extracted by two psychologists, blinded to the participants׳ suicide or non-suicide outcome, using mixed-method technique, combining qualitative and quantitative analysis. The main findings indicated that, in comparison with controls, male adolescents who later died by suicide were described as having more interpersonal difficulties, were more likely to be involved in violent behavior, had more difficulties in dealing with problems in everyday functioning and had an avoidant conflict resolution style. Functional difficulties are apparent in a wide range of behavioral domains in adolescents who later complete suicide. These findings indicate a need for interventions that might assist young persons, and it is possible that such assistance might reduce the likelihood of suicide. However, because suicide is a rare outcome and these behavioral traits are common in adolescence, the presence of such traits might not be useful in identifying people at risk of suicide. Copyright © 2014 Elsevier B.V. All rights reserved.

Comparison of suicide attempts in schizophrenia and major depressive disorder: an exploratory study.

PubMed

Banwari, Girish H; Vankar, Ganpat K; Parikh, Minakshi N

2013-12-01

Schizophrenia and major depressive disorder (MDD) are among the most common psychiatric diagnoses associated with suicide. There is a dearth of published research systematically comparing suicidal behavior in schizophrenia and MDD. The present study aimed to compare suicide attempts in schizophrenia and MDD. In this hospital-based, cross-sectional study, 50 outpatients each of schizophrenia and MDD were evaluated for their sociodemographic characteristics. In subjects with a history of suicide attempt(s), additional information related to the attempt(s) was obtained. Suicide Intent Scale (SIS) was used to assess the suicidal intent and Mini International Neuropsychiatric Interview (MINI) was used to measure the current suicidal risk. Thirty-four percent and 44% of patients with schizophrenia and MDD, respectively, attempted suicide. The attempters in schizophrenia compared to those in MDD were younger and more likely to be single (unmarried, separated or divorced). Suicidal intent was stronger in schizophrenia, while the attempters with MDD were more often preoccupied with a death wish and reported that stressful life events influenced the attempt. There were no differences in the attempt methods of the two groups. Current suicidal risk was higher in attempters compared to the non-attempters in schizophrenia as well as MDD. Suicide attempts in schizophrenia and MDD have similar features, with quite a few notable differences, which have been discussed at length in the present paper. Copyright © 2012 Wiley Publishing Asia Pty Ltd.

Associations of Tabloid Newspaper Use With Endorsement of Suicide Myths, Suicide-Related Knowledge, and Stigmatizing Attitudes Toward Suicidal Individuals.

PubMed

Till, Benedikt; Wild, Teresa A; Arendt, Florian; Scherr, Sebastian; Niederkrotenthaler, Thomas

2018-04-05

Educating the public about suicide is an important component of suicide prevention. So far, little is known about whether common misconceptions of suicide are related to individual tabloid newspaper use. This study aimed to investigate associations of time spent reading tabloids with endorsement of suicide myths, suicide-related knowledge, and with stigmatizing attitudes toward suicidal individuals. In this cross-sectional online survey, we assessed suicide-related knowledge and stigmatizing attitudes toward suicidal individuals among 456 study participants in Austria together with their endorsement of five common suicide myths (e.g., "suicidal individuals do not communicate their intent"). Furthermore, we assessed participants' time spent reading tabloids. Multivariate analyses controlling for gender, age, education, and the time spent reading broadsheet newspapers and watching television indicated that participants' time spent reading tabloids was associated with higher endorsement of suicide myths as well as with a lower level of suicide-related knowledge and a higher level of stigmatizing attitudes toward suicidal individuals. Due to the study's cross-sectional design, causality concerning these associations could not be assessed. The present findings confirm that readers of tabloids are an important target group for suicide education efforts.

Challenges and opportunities in suicide prevention in South-East Asia.

PubMed

Vijayakumar, Lakshmi

2017-04-01

Suicide is a global public health problem, with over 800 000 people worldwide dying by suicide in 2012, according to the World Health Organization (WHO). The WHO South-East Asia Region is especially affected, with 39% of global suicides occurring in the 11 countries in this region. Women are a particularly vulnerable population, for a variety of social and cultural reasons. In India specifically, deaths by suicide for women peak in the age range 15-29 years. There is sufficient evidence to show that reduction of easy access to means of suicide is an effective prevention strategy. A common method of suicide in the region is by ingestion of pesticides. Strategies that have targeted limiting access to pesticides as a means of preventing suicide, such as the use of central storage and locked boxes, have shown promising results. Given the limited human and economic resources in these countries, it is essential to involve all stakeholders, including health services, voluntary and community organizations, teachers, social workers, traditional healers and other gatekeepers, in suicide prevention. A multisectoral approach, specifically targeting women and reducing easy access to pesticides, should be the way forward to reducing suicides in this region. In addition, more research is needed, to identify cost-effective and sustainable strategies.

Suicide risk assessment and intervention in people with mental illness.

PubMed

Bolton, James M; Gunnell, David; Turecki, Gustavo

2015-11-09

Suicide is the 15th most common cause of death worldwide. Although relatively uncommon in the general population, suicide rates are much higher in people with mental health problems. Clinicians often have to assess and manage suicide risk. Risk assessment is challenging for several reasons, not least because conventional approaches to risk assessment rely on patient self reporting and suicidal patients may wish to conceal their plans. Accurate methods of predicting suicide therefore remain elusive and are actively being studied. Novel approaches to risk assessment have shown promise, including empirically derived tools and implicit association tests. Service provision for suicidal patients is often substandard, particularly at times of highest need, such as after discharge from hospital or the emergency department. Although several drug based and psychotherapy based treatments exist, the best approaches to reducing the risk of suicide are still unclear. Some of the most compelling evidence supports long established treatments such as lithium and cognitive behavioral therapy. Emerging options include ketamine and internet based psychotherapies. This review summarizes the current science in suicide risk assessment and provides an overview of the interventions shown to reduce the risk of suicide, with a focus on the clinical management of people with mental disorders. © BMJ Publishing Group Ltd 2015.

Precipitating Circumstances of Suicide among Active Duty U.S. Army Personnel Versus U.S. Civilians, 2005–2010

PubMed Central

Logan, Joseph E; Skopp, Nancy A; Reger, Mark A; Gladden, Matt; Smolenski, Derek J; Floyd, C Faye; Gahm, Gregory A

2015-01-01

To help understand suicide among soldiers, we compared suicide events between active duty U.S. Army versus civilian decedents to identify differences and inform military prevention efforts. We linked 141 Army suicide records from 2005 to 2010 to National Violent Death Reporting System (NVDRS) data. We described the decedents’ military background and compared their precipitators of death captured in NVDRS to those of demographically matched civilian suicide decedents. Both groups commonly had mental health and intimate partner precipitating circumstances, but soldier decedents less commonly disclosed suicide intent. PMID:25093259

Exposure to suicidal behaviors: A common suicide risk factor or a personal negative life event?

PubMed

Harris, Keith M; Bettiol, Silvana

2017-02-01

Numerous suicide risk factors have been proposed but not adequately validated for epidemiology, treatment and prevention efforts. Exposures to suicidal behaviors (ESB), from family and friend suicide attempts and completions, were tested for validity as a suicidal risk factor and also for measurement and construct adequacy. An anonymous online survey yielded 713 participants (aged 18-71), who reported ESB, completed the Suicidal Affect-Behavior-Cognition Scale (SABCS), and comprised a broad spectrum on those variables. Tests of dimensionality and internal consistency showed the four ESB variables (attempts/completions through family/friends) were independent and did not form a common factor or an identifiable ESB latent trait. ESB variables were, however, associated with demographic and psychiatric histories. A battery of tests revealed no meaningful associations between ESB and total suicidality or suicide risk factors (social support, depression, anxiety, stress, satisfaction with life and emotional stability). In addition, in contrast to previous reports, young adults ( n = 200; aged 18-20) showed no increased suicidality due to ESB. Results showed no validity for ESB as a common risk factor for suicidality or other psychopathology, or as a latent trait. ESB showed evidence as a personal negative life event with individual effects and interpretations.

Gender differences in suicide prevention responses: implications for adolescents based on an illustrative review of the literature.

PubMed

Hamilton, Emma; Klimes-Dougan, Bonnie

2015-02-23

There are well-documented gender differences in adolescent suicidal behavior; death by suicide is more common in males, while nonfatal suicide attempts are more common among females. Over the past three decades, researchers have documented the effectiveness of a myriad of suicide prevention initiatives. However, there has been insufficient attention to which types of suicide prevention interventions are effective in changing attitudes and behaviors for young males and females. In this review of the literature, we consider common examples of primarily universal suicide prevention programs from three implementation settings: school-based, community-based, and healthcare-based. Our purpose is to delineate how the potential gender bias in such strategies may translate into youth suicide prevention efforts. Research in which gender was found to moderate program success was retrieved through online databases. The results that feature programming effects for both males and females are provocative, suggesting that when gender differences are evident, in almost all cases, females seem to be more likely than males to benefit from existing prevention programming. We conclude by considering recommendations that may benefit males more directly. Implications for adolescent suicide prevention in particular are discussed. Personalization of suicide intervention is presented as a promising solution to reduce suicide rates.

Suicidal behaviour across the African continent: a review of the literature.

PubMed

Mars, Becky; Burrows, Stephanie; Hjelmeland, Heidi; Gunnell, David

2014-06-14

Suicide is a major cause of premature mortality worldwide, but data on its epidemiology in Africa, the world's second most populous continent, are limited. We systematically reviewed published literature on suicidal behaviour in African countries. We searched PubMed, Web of Knowledge, PsycINFO, African Index Medicus, Eastern Mediterranean Index Medicus and African Journals OnLine and carried out citation searches of key articles. We crudely estimated the incidence of suicide and suicide attempts in Africa based on country-specific data and compared these with published estimates. We also describe common features of suicide and suicide attempts across the studies, including information related to age, sex, methods used and risk factors. Regional or national suicide incidence data were available for less than one third (16/53) of African countries containing approximately 60% of Africa's population; suicide attempt data were available for <20% of countries (7/53). Crude estimates suggest there are over 34,000 (inter-quartile range 13,141 to 63,757) suicides per year in Africa, with an overall incidence rate of 3.2 per 100,000 population. The recent Global Burden of Disease (GBD) estimate of 49,558 deaths is somewhat higher, but falls within the inter-quartile range of our estimate. Suicide rates in men are typically at least three times higher than in women. The most frequently used methods of suicide are hanging and pesticide poisoning. Reported risk factors are similar for suicide and suicide attempts and include interpersonal difficulties, mental and physical health problems, socioeconomic problems and drug and alcohol use/abuse. Qualitative studies are needed to identify additional culturally relevant risk factors and to understand how risk factors may be connected to suicidal behaviour in different socio-cultural contexts. Our estimate is somewhat lower than GBD, but still clearly indicates suicidal behaviour is an important public health problem in Africa. More regional studies, in both urban and rural areas, are needed to more accurately estimate the burden of suicidal behaviour across the continent. Qualitative studies are required in addition to quantitative studies.

A Study of Users with Suicidal Ideation on Sina Weibo.

PubMed

Wang, Zheng; Yu, Guang; Tian, Xianyun; Tang, Jingyun; Yan, Xiangbin

2018-01-02

Suicide is a leading cause of death in China, and so suicide intervention on social media is an important issue in the field of public health. Sina Weibo (Weibo) is an emerging surveillance tool that may provide online assistance for users at the risk of suicide. Keyword-based methods and supervised classifiers were employed to conduct this research. A control group was established to explore the differences between Weibo users with suicidal ideation (USI) and the general population. A total of 114 USI were detected from 1 million active Weibo users. By studying the negative postings of these USI, disclosure of the reasons for their bad moods was the most common theme. The emotions of USI tend to be particularly down between 05:00 pm and midnight. Use of the first-person pronoun by Weibo USI is significantly frequent. Our findings may help to identify individuals with suicidal ideation who are not identified by the traditional clinical approach. Consequently, detecting and helping individuals who may be at risk of committing suicide may become more efficient.

Suicide, guns, and public policy.

PubMed

Lewiecki, E Michael; Miller, Sara A

2013-01-01

Suicide is a serious public health concern that is responsible for almost 1 million deaths each year worldwide. It is commonly an impulsive act by a vulnerable individual. The impulsivity of suicide provides opportunities to reduce the risk of suicide by restricting access to lethal means. In the United States, firearms, particularly handguns, are the most common means of suicide. Despite strong empirical evidence that restriction of access to firearms reduces suicides, access to firearms in the United States is generally subject to few restrictions. Implementation and evaluation of measures such as waiting periods and permit requirements that restrict access to handguns should be a top priority for reducing deaths from impulsive suicide in the United States.

Suicide, Guns, and Public Policy

PubMed Central

Miller, Sara A.

2013-01-01

Suicide is a serious public health concern that is responsible for almost 1 million deaths each year worldwide. It is commonly an impulsive act by a vulnerable individual. The impulsivity of suicide provides opportunities to reduce the risk of suicide by restricting access to lethal means. In the United States, firearms, particularly handguns, are the most common means of suicide. Despite strong empirical evidence that restriction of access to firearms reduces suicides, access to firearms in the United States is generally subject to few restrictions. Implementation and evaluation of measures such as waiting periods and permit requirements that restrict access to handguns should be a top priority for reducing deaths from impulsive suicide in the United States. PMID:23153127

Selecting Suicide Ideation Assessment Instruments: A Meta-Analytic Review

ERIC Educational Resources Information Center

Erford, Bradley T.; Jackson, Jessica; Bardhoshi, Gerta; Duncan, Kelly; Atalay, Zumra

2018-01-01

Psychometric meta-analyses and reviews were provided for four commonly used suicidal ideation instruments: the Beck Scale for Suicide Ideation, the Suicide Ideation Questionnaire, the Suicide Probability Scale, and Columbia--Suicide Severity Rating Scale. Practical and technical issues and best use recommendations for screening and outcome…

Psychotic experiences and suicide attempt risk in common mental disorders and borderline personality disorder.

PubMed

Kelleher, I; Ramsay, H; DeVylder, J

2017-03-01

Recent research has demonstrated a strong relationship between psychotic experiences and suicidal behaviour. No research to date, however, has investigated the role of borderline personality disorder (BPD) in this relationship, despite the fact that BPD is highly comorbid with common mental disorders and is associated with both recurrent suicidal behaviour and psychotic experiences. This paper examined the relationship between psychotic experiences and suicide attempts, including interrelationships with BPD and common mental disorders. We used the 2007 Adult Psychiatric Morbidity Study, a stratified, multistage probability sample of households in England, which recruited a nationally representative sample aged 16 years and older. Participants were assessed for common mental disorders, BPD (clinical and subclinical), suicidal behaviour, and psychotic experiences. Approximately 4% of the total sample (n = 323) reported psychotic experiences. Psychotic experiences were associated with increased odds of suicide attempts in individuals with BPD (OR = 2.23, 95% CI = 1.03-4.85), individuals with a common mental disorder (OR = 2.47, 95% CI = 1.37-4.43), individuals without a common mental disorder (OR = 3.99, 95% CI = 2.47-6.43), and individuals with neither a common mental disorder nor BPD (OR = 3.20, 95% CI = 1.71-5.98). Psychotic experiences are associated with high odds of suicidal behaviour in individuals with and without psychopathology. This relationship is not explained by clinical or subclinical BPD. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Suicide among adolescents in Jamaica: what do we know?

PubMed

Holder-Nevins, D; James, K; Bridgelal-Nagassar, R; Bailey, A; Thompson, E; Eldemire, H; Sewell, C; Abel, W D

2012-08-01

Suicide is increasingly acknowledged as a global problem. Yet little is known worldwide about suicide rates among adolescents. Several social factors that exist in Jamaica present as stressors and may predispose to suicide. Ascertaining prevailing patterns and associated factors is important for crafting interventions. This paper establishes adolescent suicide rates for the years 2007-2010 in Jamaica and provides related epidemiological data. Data pertaining to suicides were extracted from standardized data collected by the police. Information regarding the number of suicides among adolescents, 9-19 years of age, was reviewed for the years 2007-2010. Sociodemographic characteristics of cases: gender, location and occupation along with related variables were also examined. Variation of rates over time was ascertained. Statistically significant associations were determined by reference to p-values and confidence intervals. The incidence for suicide in adolescents was 1.1 per 100 000. Rates for males were significantly higher than females. Most suicide cases were students and the majority of cases was from rural areas (65%). Hanging was the main method used to commit suicide (96.2%). Items of clothing were commonly used for this purpose. Male adolescent suicide rates showed an upward trend in contrast to the downward trend for females in the four-year period studied. Continued surveillance is needed for greater understanding of adolescent suicides. Collaboration among health services, parents, schools and communities is integral in prevention efforts. Recent media coverage of suicides provides a window of opportunity to galvanize support for research and the development of intervention strategies.

[Relationship between cyberbullying and the suicide related psychological behavior among middle and high school students in Anhui Province].

PubMed

Wang, Gengfu; Fang, Yu; Jiang, Liu; Zhou, Guiyang; Yuan, Shanshan; Wang, Xiuxiu; Su, Puyu

2015-11-01

To examine the prevalence rate of cyberbullying in middle and high school students in Anhui Province and explore the relationship between cyberbullying and suicide related psychological behavior. A total of 5726 middle and high school students from the 7th to the 12th grades in three regular middle schools and three regular high schools recruited from three cities in the Anhui Province (Tongling, Chuzhou, and Fuyang). Tongling, Chuzhou, and Fuyang are in the south, middle and north of Anhui, respectively. Each city was selected one regular middle school and one regular high school, and 8 classes were selected form each grade from each school. A stratified cluster random sampling method was used to randomly select 5726 participants among the six schools. Self-reports on cyberbullying and suicide related psychological behavior were collected. Among these 5726 adolescents, 46.8% of them involved in cyberbullying. Among them, 3.2% were bullies, 23.8% were victims, and 19.8% were both. Prevalence rates of suicide idea, suicide plan, suicide preparation, suicide implementation were 19.3%, 6.9%, 4.7% and 1.8%, respectively. Cyberbullying involvement, as victims, bullies or bully-victims, increased the risk of four kinds of suicide related psychological behavior (suicide idea, suicide plan, suicide preparation, suicide implementation) (P < 0.05). Cyberbullying has become a common occurrence in middle and high school students. Additionally, cyberbullying is closely related to suicide related psychological behavior among middle and high school students.

Suicide as social logic.

PubMed

Kral, M J

1994-01-01

Although suicide is not viewed as a mental disorder per se, it is viewed by many if not most clinicians, researchers, and lay people as a real or natural symptom of depression. It is at least most typically seen as the unfortunate, severe, yet logical end result of a chain of negative self-appraisals, negative events, and hopelessness. Extending an approach articulated by the early French sociologist Gabriel Tarde, in this paper I argue that suicide is merely an idea, albeit a very bad one, having more in common with societal beliefs and norms regarding such things as divorce, abortion, sex, politics, consumer behavior, and fashion. I make a sharp contrast between perturbation and lethality, concepts central to Edwin S. Shneidman's theory of suicide. Evidence supportive of suicide as an idea is discussed based on what we are learning from the study of history and culture, and about contagion/cluster phenomena, media/communication, and choice of method. It is suggested that certain individuals are more vulnerable to incorporate the idea and act of suicide into their concepts of self, based on the same principles by which ideas are spread throughout society. Just as suicide impacts on society, so does society impact on suicide.

Suicide index reduction in Slovenia: the impact of primary care provision.

PubMed

Beškovnik, Lucija; Juričič, Nuša Konec; Svab, Vesna

2011-03-01

Background Education of primary care providers about diagnosis and treatment of depression and anxiety is an evidence-based suicide prevention measure.Aim To analyse suicide index, mental health epidemiological data and primary care provision in Slovenian regions and to identify examples of good suicide prevention practices in different Slovenian regions.Methods Analysis of existent epidemiological data on mental health in Slovenia.Results Anxiety and depression are the most common complaints in a representative sample of the Slovene population. The number of suicides in Slovenia had been dropping in the period from 2002 to 2006 and was again slowly rising in 2008. The number of visits to family physicians' practices because of mental health problems is low in comparison to other European countries, which might be attributed also to the high workload of family physicians. Suicide prevention programmes follow the example of the Suicide Prevention Project in the central-east region of Slovenia. This programme is based on education of primary care providers and the general public about recognition and treatment of depression in line with international guidelines.Conclusions The differentiation of causes for suicide reduction needs further research, as well as urgent improvement in the accessibility of primary care teams in Slovenia.

Suicide index reduction in Slovenia: the impact of primary care provision

PubMed Central

2011-01-01

Background Education of primary care providers about diagnosis and treatment of depression and anxiety is an evidence-based suicide prevention measure. Aim To analyse suicide index, mental health epidemiological data and primary care provision in Slovenian regions and to identify examples of good suicide prevention practices in different Slovenian regions. Methods Analysis of existent epidemiological data on mental health in Slovenia. Results Anxiety and depression are the most common complaints in a representative sample of the Slovene population. The number of suicides in Slovenia had been dropping in the period from 2002 to 2006 and was again slowly rising in 2008. The number of visits to family physicians' practices because of mental health problems is low in comparison to other European countries, which might be attributed also to the high workload of family physicians. Suicide prevention programmes follow the example of the Suicide Prevention Project in the central-east region of Slovenia. This programme is based on education of primary care providers and the general public about recognition and treatment of depression in line with international guidelines. Conclusions The differentiation of causes for suicide reduction needs further research, as well as urgent improvement in the accessibility of primary care teams in Slovenia. PMID:22479292

The Burden of Suicide in Rural Bangladesh: Magnitude and Risk Factors

PubMed Central

Sharmin Salam, Shumona; Alonge, Olakunle; Islam, Md Irteja; Wadhwaniya, Shirin; Ul Baset, Md Kamran; El Arifeen, Shams

2017-01-01

The aim of the paper is to quantify the burden and risk factors of fatal and non-fatal suicidal behaviors in rural Bangladesh. A census was carried out in seven sub-districts encompassing 1.16 million people. Face-to-face interviews were conducted at the household level. Descriptive analyses were done to quantify the burden and Poisson regression was run to determine on risk factors. The estimated rates of fatal and non-fatal suicide were 3.29 and 9.86 per 100,000 person years (PY) observed, respectively. The risk of suicide was significantly higher by 6.31 times among 15–17 and 4.04 times among 18–24 olds compared to 25–64 years old. Married adolescents were 22 times more likely to commit suicide compared to never-married people. Compared to Chandpur/Comilla district, the risk of suicide was significantly higher in Narshingdi. Students had significantly lower risk of non-fatal suicidal behavior compared to skilled laborers. The risk of non-fatal suicidal behavior was lower in Sherpur compared to Chandpur/Comilla. Among adolescents, unskilled laborers were 16 times more likely to attempt suicide than students. The common methods for fatal and non-fatal suicidal behaviors were hanging and poisoning. Suicide is a major public health problem in Bangladesh that needs to be addressed with targeted interventions. PMID:28891939

Association between suicidal symptoms and repeat suicidal behaviour within a sample of hospital-treated suicide attempters.

PubMed

de Beurs, Derek P; van Borkulo, Claudia D; O'Connor, Rory C

2017-05-01

Suicidal behaviour is the end result of the complex relation between many factors which are biological, psychological and environmental in nature. Network analysis is a novel method that may help us better understand the complex association between different factors. To examine the relationship between suicidal symptoms as assessed by the Beck Scale for Suicide Ideation and future suicidal behaviour in patients admitted to hospital following a suicide attempt, using network analysis. Secondary analysis was conducted on previously collected data from a sample of 366 patients who were admitted to a Scottish hospital following a suicide attempt. Network models were estimated to visualise and test the association between baseline symptom network structure and suicidal behaviour at 15-month follow-up. Network analysis showed that the desire for an active attempt was found to be the most central, strongly related suicide symptom. Of the 19 suicide symptoms that were assessed at baseline, 10 symptoms were directly related to repeat suicidal behaviour. When comparing baseline network structure of repeaters ( n =94) with the network of non-repeaters ( n =272), no significant differences were found. Network analysis can help us better understand suicidal behaviour by visualising the complex relation between relevant symptoms and by indicating which symptoms are most central within the network. These insights have theoretical implications as well as informing the assessment and treatment of suicidal behaviour. None. © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.

Alcoholism and Suicide.

ERIC Educational Resources Information Center

Roy, Alec; Linnoila, Markku

1986-01-01

Reviews knowledge about suicide in alcoholism: how commonly suicide among alcoholics occurs; which alcoholics commit suicide and why; suicide among alcoholic women and alcoholic physicians; possible predisposing biological factors; possible linkages with depression, adverse life events, and personality disorder; and future research and directions.…

Suicidal expressions in young Swedish Sami, a cross-sectional study

PubMed Central

Omma, Lotta; Sandlund, Mikael; Jacobsson, Lars

2013-01-01

Objectives To investigate the experience of suicidal expressions (death wishes, life weariness, ideation, plans and attempts) in young Swedish Sami, their attitudes toward suicide (ATTS), and experience of suicidal expressions and completed suicide in significant others and to compare with Swedes in general. Methods A cross-sectional study comprising 516 Swedish Sami, 18–28 years of age together with an age and geographically matched reference group (n=218). Parts of the ATTS questionnaire have been used to cover different aspects of the suicidal complex. Data were analysed with regard to gender, occupation, counties and experience of negative societal treatment due to Sami background. Results Both young Sami and young Swedes reported suicidal ideation, life weariness, and death wishes in a high degree (30–50%), but it was more common among the Sami. Having had plans to commit suicide showed a significant gender difference only in the Sami. The prevalence of suicide attempts did not differ significantly between Sami and Swedes. Subgroups of the Sami reported a higher degree of suicidal behaviour, Sami women and reindeer herders reported a 3, 5-fold higher odds of suicide attempts and a 2-fold higher odds having had plans committing suicide. Sami living in Vasterbotten/Jamtland/Vasternorrland and Sami with experience of ethnicity related bad treatment 2-fold higher odds of suicidal plans compared to those living in other counties. Conclusion An increased occurrence of suicidal ideation/death wishes/life weariness in young Sami compared to young majority Swedes was found, but not an increased prevalence of suicide attempts and positive attitudes together with an increased awareness to handle suicide problems could be a contributing factor. Severe circumstances and experience of ethnicity-related bad treatment seems to contribute to increased levels of suicidal plans and attempts in subgroups of Sami. PMID:23346555

Effects of perpetrator identity on suicidality and nonsuicidal self-injury in sexually victimized female adolescents

PubMed Central

Unlu, Gulsen; Cakaloz, Burcu

2016-01-01

Purpose Child sexual abuse and sexual dating violence victimization are common problems that are known to have long-term negative consequences. This study aimed to compare the sociodemographic, abuse-related, and clinical features of female adolescents who were sexually abused by different perpetrators, and identify the factors associated with suicidality and nonsuicidal self-injury (NSSI) in these cases. Patients and methods Data of 254 sexually abused female adolescents between the ages of 12–18 years were evaluated. The cases were classified into three groups, namely “sexual dating violence”, “incest”, and “other child sexual abuse”, according to the identity of the perpetrator. The three groups were compared in terms of sociodemographic, abuse-related, and clinical features. Results Major depressive disorder was the most common psychiatric diagnosis, which was present in 44.9% of the cases. Among all victims, 25.6% had attempted suicide, 52.0% had suicidal ideation, and 23.6% had NSSI during the postabuse period. A logistic regression analysis revealed that attempted suicide was predicted by dating violence victimization (adjusted odds ratio [AOR] =3.053; 95% confidence interval [CI] =1.473, 6.330) and depression (AOR =2.238; 95% CI =1.226, 4.086). Dating violence victimization was also the strongest predictor of subsequent suicidal ideation (AOR =3.500; 95% CI =1.817, 6.741). In addition, revictimization was determined to be an important risk factor for both suicidal ideation (AOR =2.897; 95% CI =1.276, 6.574) and NSSI (AOR =3.847; 95% CI =1.899, 7.794). Conclusion Perpetrator identity and revictimization are associated with negative mental health outcomes in sexually victimized female adolescents. Increased risk of suicidality and NSSI should be borne in mind while assessing cases with dating violence and revictimization histories, in particular. PMID:27382291

Predictors for repeat self-harm and suicide among older people within 12 months of a self-harm presentation.

PubMed

Cheung, Gary; Foster, Gisele; de Beer, Wayne; Gee, Susan; Hawkes, Tracey; Rimkeit, Sally; Tan, Yu Mwee; Merry, Sally; Sundram, Frederick

2017-08-01

A past history of self-harm is a significant risk factor for suicide in older people. The aims of this study are to (i) characterize older people who present with self-harm to emergency departments (EDs); and (ii) determine the predictors for repeat self-harm and suicide. Demographic and clinical data were retrospectively collected on older people (age 65+ years), who presented to seven EDs in New Zealand following an episode of self-harm between 1st July 2010 and 30th June 2013. In addition, 12-month follow-up information on repeat self-harm and suicide was collected. The sample included 339 older people (55.2% female) with an age range of 65-96 years (mean age = 75.0; SD = 7.6). Overdose (68.7%) was the most common method of self-harm. 76.4% of the self-harm cases were classified as suicide attempts. Perceived physical illness (47.8%) and family discord (34.5%) were the most common stressors. 12.7% of older people repeated self-harm and 2.1% died by suicide within 12 months. Older people who had a positive blood alcohol reading (OR = 3.87, 95% Cl = 1.35-11.12, p = 0.012) and were already with mental health services at the index self-harm (OR = 2.73, 95% Cl = 1.20-6.25, p = 0.047) were more likely to repeat self-harm/suicide within 12 months. Older people who self-harm are at very high risk of repeat self-harm and suicide. Screening and assessment for alcohol use disorders should be routinely performed following a self-harm presentation, along with providing structured psychological treatment as an adjunct to pharmacological treatment for depression and interventions to improve the person's resilience resources.

Factors influencing help seeking in mentally distressed young adults: a cross-sectional survey.

PubMed Central

Biddle, Lucy; Gunnell, David; Sharp, Debbie; Donovan, Jenny L

2004-01-01

BACKGROUND: Young adults, especially men, are among those least likely to consult healthcare professionals when mentally distressed or suicidal. AIMS: To investigate the help-seeking behaviours of mentally distressed young adults. Design of study: Cross-sectional survey. SETTING: Bristol and surrounding areas, including inner-city, suburban and urban locations. METHOD: A questionnaire was sent to a sample of 3004 young adults aged 16-24 years. This assessed probable mental disorder (using the 12-item general health questionnaire [GHQ-12]), suicidal thoughts (GHQ-28 suicide subscale), and help-seeking behaviours. RESULTS: Most responders who were assessed as having probable mental disorders (GHQ "cases") had not sought help. Help seeking was more common in female GHQ cases than male cases (34.8% and 21.8%,respectively; P = 0.003) and women with suicidal thoughts more commonly sought help than men with suicidal thoughts (41.6% and 30.9%, respectively; P = 0.15). Small proportions of male and female GHQ cases (7.5% and 8.9%, respectively; P = 0.6), and less than one in five responders with suicidal thoughts, had consulted a general practitioner. In more female than male cases, help was sought from family and friends (30.7% and 18.4%, respectively; P = 0.004). GHQ score was the strongest predictor of help seeking. Men had a higher threshold of severity at which they would seek help than women. Recent experience of suicidal thoughts appeared to be a stronger predictor of formal help seeking in mentally distressed women than mentally distressed men. CONCLUSION: Distressed young adults are reluctant to seek help. Men are particularly unlikely to do so unless severely distressed and tend not to seek lay support. Sex differences in help seeking may be important in understanding the high suicide rate for men. PMID:15113490

Homicide-suicide and the role of mental disorder: a national consecutive case series.

PubMed

Flynn, Sandra; Gask, Linda; Appleby, Louis; Shaw, Jenny

2016-06-01

There is a lack of robust empirical research examining mental disorder and homicide-suicide. Primary care medical records are seldom used in homicide-suicide research. The aims of this study were to describe the characteristics of offenders and victims; determine the prevalence of mental disorder and contact with mental health services and examine adverse events prior to the offence. This was a mixed-methods study based on a consecutive case series of offences in England and Wales occurring between 2006 and 2008. 60 homicide-suicides were recorded. Data sources included coroner's records, police files, General Practice (GP) and specialist mental health records, and newspaper articles. The results show that most victims were spouse/partners and/or children. Most perpetrators were male (88 %) and most victims were female (77 %). The incidents were commonly preceded by relationship breakdown and separation. 62 % had mental health problems. A quarter visited a GP for emotional distress within a month of the incident. Few had been in recent contact with mental health services before the incident (12 %). Self-harm (26 %) and domestic violence (39 %) were common. In conclusion, GPs cannot be expected to prevent homicide-suicide directly, but they can reduce risk generally, via the treatment of depression and recognising the risks associated with domestic violence.

Coping with youth suicide and overdose: one community's efforts to investigate, intervene, and prevent suicide contagion.

PubMed

Hacker, Karen; Collins, Jessica; Gross-Young, Leni; Almeida, Stephanie; Burke, Noreen

2008-01-01

From 2000-2005, Somerville, MA, experienced a number of youth overdoses and suicides. The community response followed CDC recommendations for contagion containment. A community coalition, Somerville Cares About Prevention, became a pivotal convener of community partners and a local research organization, the Institute for Community Health, provided needed expertise in surveillance and analysis. Mayoral leadership provided the impetus for action while community activists connected those at risk with mental health resources. Using a variety of data sources (including death certificates, youth risk surveys, 911 call data, and hospital discharges) overdose and suicide activity were monitored. Rates of suicide and overdose for 10-24-year-olds were higher than in previous years. Using case investigation methods, the majority of suicide victims were found to be linked through common peer groups and substance abuse. Subsequent community action steps included: a community-based trauma response team, improved media relationships, focus groups for suicide survivors, and prevention trainings to community stakeholders. Youth suicide and overdose activity subsided in May of 2005. The community partnerships were critical elements for developing a response to this public health crisis. This collaborative approach to suicide contagion used existing resources and provides important lessons learned for other communities facing similar circumstances.

Prospective study of risk factors for suicidal behavior in individuals with anxiety disorders.

PubMed

Uebelacker, L A; Weisberg, R; Millman, M; Yen, S; Keller, M

2013-07-01

Anxiety disorders are very common and increase risk for suicide attempts. Little is known about predictors of increased risk specifically among individuals with anxiety disorders. The purpose of this study was to investigate whether specific anxiety disorders and other co-morbid psychiatric disorders, physical health, or work or social functioning increased the future likelihood of a suicide attempts among individuals with anxiety disorders. Method In this prospective study, 676 individuals with an anxiety disorder were followed for an average of 12 years. As hypothesized, we found that post-traumatic stress disorder, major depressive disorder (MDD), intermittent depressive disorder (IDD), epilepsy, pain, and poor work and social functioning all predicted a shorter time to a suicide attempt in univariate analyses. In multivariate analyses, baseline MDD and IDD were independent predictors of time to suicide attempt, even when controlling for a past history of suicide attempt. No specific anxiety disorder was an independent predictor of time to attempt in this anxiety-disordered sample. Adding baseline physical health variables and social functioning did not improve the ability of the model to predict time to suicide attempt. Mood disorders and past history of suicide attempts are the most powerful predictors of a future suicide attempt in this sample of individuals, all of whom have an anxiety disorder.

School- and Community-Based Youth Suicide Prevention Interventions: Hot Idea, Hot Air, or Sham?

PubMed

Kutcher, Stan; Wei, Yifeng; Behzadi, Pegah

2017-06-01

Suicide in young people is a significant health concern, with numerous community- and school-based interventions promising to prevent suicide currently being applied across Canada. Before widespread application of any one of these, it is essential to determine its effectiveness and safety. We systematically reviewed the global literature on one of the most common community suicide prevention interventions in Canada and summarized data on 2 commonly applied school-based suicide prevention programmes. None of these has demonstrated effectiveness in preventing youth suicide or safety in application. Concurrently with their widespread distribution in Canada, the suicide rate in young women has increased-the first time in over 3 decades. Policy and regulatory implications of these findings are discussed.

School- and Community-Based Youth Suicide Prevention Interventions: Hot Idea, Hot Air, or Sham?

PubMed Central

Wei, Yifeng; Behzadi, Pegah

2016-01-01

Suicide in young people is a significant health concern, with numerous community- and school-based interventions promising to prevent suicide currently being applied across Canada. Before widespread application of any one of these, it is essential to determine its effectiveness and safety. We systematically reviewed the global literature on one of the most common community suicide prevention interventions in Canada and summarized data on 2 commonly applied school-based suicide prevention programmes. None of these has demonstrated effectiveness in preventing youth suicide or safety in application. Concurrently with their widespread distribution in Canada, the suicide rate in young women has increased—the first time in over 3 decades. Policy and regulatory implications of these findings are discussed. PMID:27407073

Suicide in older adults: a comparison with middle-aged adults using the Queensland Suicide Register.

PubMed

Koo, Yu Wen; Kõlves, Kairi; De Leo, Diego

2017-03-01

Globally, suicide rates increase with age, being highest in older adults. This study analyzed differences in suicides in older adults (65 years and over) compared to middle-aged adults (35-64 years) in Queensland, Australia, during the years 2000-2012. The Queensland Suicide Register was utilized for the analysis. Annual suicide rates were calculated by gender and age group, and odds ratios with 95% confidence intervals were examined. In Queensland, the average annual rate of suicides for older adults was 15.27 per 100,000 persons compared to 18.77 in middle-aged adults in 2000-2012. There were no significant changes in time trends for older adults in 2002-2012. Suicide methods differed between gender and age groups. Older adults who died by suicide were more likely to be male, widowed, living alone or in a nursing home, and out of the work force. The prevalence of untreated psychiatric conditions, diagnosed psychiatric disorders, and consultations with a mental health professional three months prior to death was lower in older adults than middle-aged adults. Somatic illness, bereavement, and attention to suicide in the media were more common among older adults than middle-age adults. Older females were particularly more likely to pay attention to suicide in the media. Our findings show older adults who died by suicide were more likely to experience somatic illnesses, bereavement, and pay attention to suicide in the media compared to middle aged. Preventing suicide in older adults would therefore require holistic and comprehensive approaches.

No-Suicide Contracts with Suicidal Youth: Mental Health Professionals' Perceptions and Current Practice

ERIC Educational Resources Information Center

Hansen, Andrea; Heath, Melissa Allen; Williams, Marleen; Fox, Jay; Hudnall, Gregory A.; Bledsoe, Catherine

2012-01-01

Commonly used in clinical and medical settings, no-suicide contracts (NSCs) solicit commitment from suicidal individuals not to attempt suicide. The prevalence of community and school-based Mental Health Professionals' (MHPs) use of NSCs with suicidal youth (SY) is unknown. Additionally, minimal feedback is available regarding MHPs' current…

Prevalence of suicidal behaviour and associated factors in a large sample of Chinese adolescents.

PubMed

Liu, X C; Chen, H; Liu, Z Z; Wang, J Y; Jia, C X

2017-10-12

Suicidal behaviour is prevalent among adolescents and is a significant predictor of future suicide attempts (SAs) and suicide death. Data on the prevalence and epidemiological characteristics of suicidal behaviour in Chinese adolescents are limited. This study was aimed to examine the prevalence, characteristics and risk factors of suicidal behaviour, including suicidal thought (ST), suicide plan (SP) and SA, in a large sample of Chinese adolescents. This report represents the first wave data of an ongoing longitudinal study, Shandong Adolescent Behavior and Health Cohort. Participants included 11 831 adolescent students from three counties of Shandong, China. The mean age of participants was 15.0 (s.d. = 1.5) and 51% were boys. In November-December 2015, participants completed a structured adolescent health questionnaire, including ST, SP and SA, characteristics of most recent SA, demographics, substance use, hopelessness, impulsivity and internalising and externalising behavioural problems. The lifetime and last-year prevalence rates were 17.6 and 10.7% for ST in males, 23.5 and 14.7% for ST in females, 8.9 and 2.9% for SP in males, 10.7 and 3.8% for SP in females, 3.4 and 1.3% for SA in males, and 4.6 and 1.8% for SA in females, respectively. The mean age of first SA was 12-13 years. Stabbing/cutting was the most common method to attempt suicide. Approximately 24% of male attempters and 16% of female attempters were medically treated. More than 70% of attempters had no preparatory action. Female gender, smoking, drinking, internalising and externalising problems, hopelessness, suicidal history of friends and acquaintances, poor family economic status and poor parental relationship were all significantly associated with increased risk of suicidal behaviour. Suicidal behaviour in Chinese adolescents is prevalent but less than that previously reported in Western peers. While females are more likely to attempt suicide, males are more likely to use lethal methods. Multiple child and family factors are associated with suicidal behaviour. These findings highlight the importance of early screening and intervention of suicidal behaviour in Chinese adolescents.

Prevention of suicide with regulations aimed at restricting access to highly hazardous pesticides: a systematic review of the international evidence.

PubMed

Gunnell, David; Knipe, Duleeka; Chang, Shu-Sen; Pearson, Melissa; Konradsen, Flemming; Lee, Won Jin; Eddleston, Michael

2017-10-01

Pesticide self-poisoning accounts for 14-20% of suicides worldwide. Regulation aimed at restricting access to pesticides or banning highly hazardous pesticides is one approach to reducing these deaths. We systematically reviewed the evidence of the effectiveness of pesticide regulation in reducing the incidence of pesticide suicides and overall suicides. We did a systematic review of the international evidence. We searched MEDLINE, PsycINFO, and Embase for studies published between Jan 1, 1960, and Dec 31, 2016, which investigated the effect of national or regional bans, and sales or import restrictions, on the availability of one or more pesticides and the incidence of suicide in different countries. We excluded other interventions aimed at limiting community access to pesticides. We extracted data from studies presenting pesticide suicide data and overall suicide data from before and after national sales restrictions. Two reviewers independently assessed papers for inclusion, extracted data, and assessed risk of bias. We undertook a narrative synthesis of the data in each report, and where data were available for the years before and after a ban, we pooled data for the 3 years before and the 3 years after to obtain a crude estimate of the effect of the ban. This study is registered through PROSPERO, number CRD42017053329. We identified 27 studies undertaken in 16 countries-five low-income or middle-income countries (Bangladesh, Colombia, India, Jordan and Sri Lanka), and 11 high-income countries (Denmark, Finland, Germany, Greece, Hungary, Ireland, Japan, South Korea, Taiwan, UK, and USA). Assessments largely focused on national bans of specific pesticides (12 studies of bans in six countries-Jordan, Sri Lanka, Bangladesh, Greece [Crete], South Korea, and Taiwan) or sales restrictions (eight studies of restrictions in five countries- India, Denmark, Ireland, the UK and the USA). Only five studies used optimum analytical methods. National bans on commonly ingested pesticides in five of the six countries studied, including four studies using optimum analytical methods, were followed by reductions in pesticide suicides and, in three of these countries, falls in overall suicide mortality. Greece was the only country studied that did not show a decrease in pesticide suicide following a ban. There were no high-quality studies of restricting sales to people for occupational uses; four of the seven studies (in three of the five countries studied-India, Denmark, and the USA) showed sales restrictions were followed by decreases in pesticide suicides; one of the two studies investigating trends in overall suicide mortality reported a fall in deaths in Denmark, but there were also decreases in suicide deaths from other methods. National bans on highly hazardous pesticides, which are commonly ingested in acts of self-poisoning, seem to be effective in reducing pesticide-specific and overall suicide rates. Evidence is less consistent for sales restrictions. A worldwide ban on the use of highly hazardous pesticides is likely to prevent tens of thousands of deaths every year. None. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Deaths from violence in North Carolina, 2004: how deaths differ in females and males

PubMed Central

Sanford, C; Marshall, S W; Martin, S L; Coyne‐Beasley, T; Waller, A E; Cook, P J; Norwood, T; Demissie, Z

2006-01-01

Objective To identify gender differences in violent deaths in terms of incidence, circumstances, and methods of death. Design Analysis of surveillance data. Setting North Carolina, a state of 8.6 million residents on the eastern seaboard of the US. Subjects 1674 North Carolina residents who died from violence in the state during 2004. Methods Information on violent deaths was collected by the North Carolina Violent Death Reporting System using data from death certificates, medical examiner reports, and law enforcement agency incidence reports. Results Suicide and homicide rates were lower for females than males. For suicides, females were more likely than males to have a diagnosis of depression (55% v 36%), a current mental health problem (66% v 42%), or a history of suicide attempts (25% v 13%). Firearms were the sole method of suicide in 65% of males and 42% of females. Poisonings were more common in female than male suicides (37% v 12%). Male and female homicide victims were most likely to die from a handgun or a sharp instrument. Fifty seven percent of female homicides involved intimate partner violence, compared with 13% of male homicides. Among female homicides involving intimate partner violence, 78% occurred in the woman's home. White females had a higher rate of suicide than African‐American females, but African‐American females had a higher rate of homicide than white females. Conclusions The incidence, circumstances, and methods of fatal violence differ greatly between females and males. These differences should be taken into account in the development of violence prevention efforts. PMID:17170164

The relationship between attitudes toward suicide and willingness to pay for suicide prevention: a cross-sectional study in Japan.

PubMed

Sueki, Hajime

2017-10-01

There are gaps in our knowledge of the role attitudes toward suicide play in determining people's willingness to participate (WTP) for suicide prevention. We conducted a large nationwide cross-sectional study with the aim of clarifying the relationship between WTP for reducing suicide risk and attitudes toward suicide. Ordinal logistic regression analyses (n = 1771) showed that there were significant associations of WTP for suicide prevention with 'Suicide as a right' (β = -.15, 95% CI: -.25 to -.04, p = .006), 'Preventability/readiness to help' (β = .81, 95% CI: .69-.94, p < .001) and 'Common occurrence' (β = .32, 95% CI: .19-.46, p < .001). 'Incomprehensibility/unpredictability' did not show an association with WTP. Taxpayer acceptance for suicide prevention is more likely to be achieved through provision of information that increases endorsement of 'preventability/readiness to help' and 'common occurrence' factors, and decreases 'suicide as a right' scores.

The Use of Cannabis as a Predictor of Early Onset of Bipolar Disorder and Suicide Attempts

PubMed Central

Leite, Rafaela Torres Portugal; Nogueira, Sarah de Oliveira; do Nascimento, João Paulo Rodrigues; de Lima, Laisa Soares; da Nóbrega, Taís Bastos; Virgínio, Mariana da Silva; Moreno, Lucas Monte da Costa; Sampaio, Bruno Henrique Barbosa; Souza, Fábio Gomes de Matos e

2015-01-01

Introduction. Bipolar disorder (BD) implies risk of suicide. The age at onset (AAO) of BD carries prognostic significance. Substance abuse may precede the onset of BD and cannabis is the most common illicit drug used. The main goal of this study is to review the association of cannabis use as a risk factor for early onset of BD and for suicide attempts. Materials and Methods. PubMed database was searched for articles using key words “bipolar disorder,” “suicide attempts,” “cannabis,” “marijuana,” “early age at onset,” and “early onset.” Results. The following percentages in bipolar patients were found: suicide attempts 3.6–42%; suicide attempts and substance use 5–60%; suicide attempts and cannabis use 15–42%. An early AAO was associated with cannabis misuse. The mean age of the first manic episode in individuals with and without BD and cannabis use disorder (CUD) was 19.5 and 25.1 years, respectively. The first depressive episode was at 18.5 and 24.4 years, respectively. Individuals misusing cannabis showed increased risk of suicide. Discussion. Cannabis use is associated with increased risk of suicide attempts and with early AAO. However, the effect of cannabis at the AAO and suicide attempts is not clear. PMID:26097750

Unintentional overdose and suicide among substance users: a review of overlap and risk factors.

PubMed

Bohnert, Amy S B; Roeder, Kathryn; Ilgen, Mark A

2010-08-01

Substance use is a risk factor for suicide, suicide attempts, and fatal and non-fatal overdose, but to date, little has been done to integrate the research on suicidal behavior and overdose among substance users. This study reviews the literature on suicide and overdose among substance users with the goal of illuminating the similarities and differences between these two events. A structured review resulted in 15 articles (describing 14 unique studies) published between 1990 and 2010 that examined both overdose and suicide in samples of substance users. There is some evidence that substance users who attempt suicide are more likely to report an overdose and vice versa. This relationship may be partially explained by the fact that overdose is a common method of suicide. The results of the literature review also indicate that substance users with a history of both events may represent a group with particularly poor psychological and social functioning and severe drug-related problems. Further research is needed to understand the overlap of, and differences between, suicide and accidental overdose among individuals who misuse substances, particularly individuals who primarily use substances other than heroin. An improved understanding of the interrelationships between suicide and unintentional overdose among individuals who use alcohol or drugs is necessary to guide the development of effective prevention and intervention approaches. Published by Elsevier Ireland Ltd.

Repetition of Attempted Suicide Among Immigrants in Europe

PubMed Central

Lipsicas, Cendrine Bursztein; Mäkinen, Ilkka Henrik; Wasserman, Danuta; Apter, Alan; Kerkhof, Ad; Michel, Konrad; Renberg, Ellinor Salander; van Heeringen, Kees; Värnik, Airi; Schmidtke, Armin

2014-01-01

Objectives To compare frequencies of suicide attempt repetition in immigrants and local European populations, and the timing of repetition in these groups. Method: Data from 7 European countries, comprising 10 574 local and 3032 immigrant subjects, were taken from the World Health Organization European Multicentre Study on Suicidal Behaviour and the ensuing Monitoring Suicidal Behaviour in Europe (commonly referred to as MONSUE) project. The relation between immigrant status and repetition of suicide attempt within 12-months following first registered attempt was analyzed with binary logistic regression, controlling for sex, age, and method of attempt. Timing of repetition was controlled for sex, age, and the recommended type of aftercare. Results: Lower odds of repeating a suicide attempt were found in Eastern European (OR 0.50; 95% CI 0.41 to 0.61, P < 0.001) and non-European immigrants (OR 0.68; 95% CI 0.51 to 0.90, P < 0.05), compared with the locals. Similar patterns were identified in the sex-specific analysis. Eastern European immigrants tended to repeat their attempt much later than locals (OR 0.58; 95% CI 0.35 to 0.93, P < 0.05). In general, 32% of all repetition occurred within 30 days. Repetition tended to decrease with age and was more likely in females using harder methods in their index attempt (OR 1.29; 95% CI 1.08 to 1.54, P < 0.01). Large variations in the general repetition frequency were identified between the collecting centres, thus influencing the results. Conclusions: The lower repetition frequencies in non-Western immigrants, compared with locals, in Europe stands in contrast to their markedly higher tendency to attempt suicide in general, possibly pointing to situational stress factors related to their suicidal crisis that are less persistent over time. Our findings also raise the possibility that suicide attempters and repeaters constitute only partially overlapping populations. PMID:25565687

Trained lay health workers reduce common mental disorder symptoms of adults with suicidal ideation in Zimbabwe: a cohort study.

PubMed

Munetsi, Epiphany; Simms, Victoria; Dzapasi, Lloyd; Chapoterera, Georgina; Goba, Nyaradzo; Gumunyu, Tichaona; Weiss, Helen A; Verhey, Ruth; Abas, Melanie; Araya, Ricardo; Chibanda, Dixon

2018-02-08

Suicidal ideation may lead to deliberate self-harm which increases the risk of death by suicide. Globally, the main cause of deliberate self-harm is depression. The aim of this study was to explore prevalence of, and risk factors for, suicidal ideation among men and women with common mental disorder (CMD) symptoms attending public clinics in Zimbabwe, and to determine whether problem solving therapy delivered by lay health workers can reduce common mental disorder symptoms among people with suicidal ideation, using secondary analysis of a randomised controlled trial. At trial enrolment, the Shona Symptom Questionnaire (SSQ) was used to screen for CMD symptoms. In the intervention arm, participants received six problem-solving therapy sessions conducted by trained and supervised lay health workers, while those in the control arm received enhanced usual care. We used multivariate logistic regression to identify risk factors for suicidal ideation at enrolment, and cluster-level logistic regression to compare SSQ scores at endline (6 months follow-up) between trial arms, stratified by suicidal ideation at enrolment. There were 573 participants who screened positive for CMD symptoms and 75 (13.1%) reported suicidal ideation at baseline. At baseline, after adjusting for confounders, suicidal ideation was independently associated with being aged over 24, lack of household income (household income yes/no; adjusted odds ratio 0.52 (95% CI 0.29, 0.95); p = 0.03) and with having recently skipped a meal due to lack of food (adjusted odds ratio 3.06 (95% CI 1.81, 5.18); p < 0.001). Participants who reported suicidal ideation at enrolment experienced similar benefit to CMD symptoms from the Friendship Bench intervention (adjusted mean difference - 5.38, 95% CI -7.85, - 2.90; p < 0.001) compared to those who had common mental disorder symptoms but no suicidal ideation (adjusted mean difference - 4.86, 95% CI -5.68, - 4.04; p < 0.001). Problem-solving therapy delivered by trained and supervised lay health workers reduced common mental disorder symptoms among participants with suicidal thoughts who attended primary care facilities in Zimbabwe. pactr.org ldentifier: PACTR201410000876178.

Does Assessing Suicidality Frequently and Repeatedly Cause Harm? A Randomized Control Study

PubMed Central

Law, Mary Kate; Furr, R. Michael; Arnold, Elizabeth Mayfield; Mneimne, Malek; Jaquett, Caroline; Fleeson, William

2015-01-01

Assessing suicidality is common in mental health practice and is fundamental to suicide research. Although necessary, there is significant concern that such assessments have unintended harmful consequences. Using a longitudinal randomized control design, we evaluated whether repeated and frequent assessments of suicide-related thoughts and behaviors negatively affected individuals, including those at-risk for suicide-related outcomes. Adults (N = 282), including many diagnosed with Borderline Personality Disorder (BPD), were recruited through psychiatric outpatient clinics and from the community at large, and were randomly assigned to assessment groups. A Control Assessment group responded to questions regarding negative psychological experiences several times each day during a 2-week Main Observation phase. During the same observation period, an Intensive Suicide Assessment group responded to the same questions, along with questions regarding suicidal behavior and ideation. Negative psychological outcomes were measured during the Main Observation phase (for BPD symptoms unrelated to suicide and for BPD-relevant emotions) and/or at the end of each week during the Main Observation phase and monthly for 6 months thereafter (for all outcomes, including suicidal ideation and behavior). Results revealed little evidence that intensive suicide assessment triggered negative outcomes, including suicidal ideation or behavior, even among people with BPD. A handful of effects did reach or approach significance, though these were temporary and non-robust. However, given the seriousness of some outcomes, we recommend that researchers or clinicians who implement experience sampling methods including suicide-related items carefully consider the benefits of asking about suicide and to inform participants about possible risks. PMID:25894705

An examination of DSM-IV depressive symptoms and risk for suicide completion in major depressive disorder: a psychological autopsy study.

PubMed

McGirr, Alexander; Renaud, Johanne; Seguin, Monique; Alda, Martin; Benkelfat, Chawki; Lesage, Alain; Turecki, Gustavo

2007-01-01

It is unclear whether certain DSM-IV depressive symptoms are more prevalent among individuals who die in the context of a major depressive episode and those who do not, whether this is associated with proximal or distal suicide risk, and whether depressive symptoms cluster to indicate suicide risk. A psychological autopsy method with best informants was used to investigate DSM-IV depressive symptoms among 156 suicides who died in the context of a major depressive episode and 81 major depressive controls. Suicides' depressive symptoms were more likely to include weight or appetite loss, insomnia, feelings of worthlessness or inappropriate guilt as well as recurrent thoughts of death or suicidal ideation. Fatigue and difficulties concentrating or indecisiveness were less prevalent among depressed suicides. These associations were independent of concomitant axis I and II psychopathology. The concomitant presence of (a) fatigue as well as impaired concentration or indecisiveness and (b) weight or appetite gain and hypersomnia was associated with decreased suicide risk. Inter-episode symptom concordance suggests that insomnia is an immediate indicator of suicide risk, while weight or appetite loss and feelings of worthlessness or guilt are not. This study employed proxy-based interviews. We found that discrete DSM-IV depressive symptoms and clusters of depressive symptoms help differentiate depressed individuals who die by suicide and those who do not. Moreover, some DSM-IV depressive symptoms are associated with an immediate risk for suicide, while others may result from an etiology of depression common to suicide without directly increasing suicide risk.

Repetition of attempted suicide among teenagers in Europe: frequency, timing and risk factors.

PubMed

Hultén, A; Jiang, G X; Wasserman, D; Hawton, K; Hjelmeland, H; De Leo, D; Ostamo, A; Salander-Renberg, E; Schmidtke, A

2001-09-01

Adolescents in many countries show high rates of suicide attempts and repetitions of attempts as a common feature. Attempted suicide is the best predictor of future suicide. Repetition of attempts further increases the risk of suicide. The present study sought to identify patterns and risk factors for repetition of attempts in older teenagers. Data were collected by uniform procedures in a longitudinal follow-up study in seven European centres participating in the WHO/EURO Multicentre Study on Suicidal Behaviour. Information on attempted suicide in the 15-19-year age group during the period 1989-1995 was analysed. A total of 1,720 attempts by 1,264 individuals over a mean follow-up period of 204 weeks (SD 108.9) were recorded. When life-table analysis was performed, 24% of the individuals who had previously attempted suicide made another attempt within one year after the index attempt, compared with 6.8% of the "first-evers", with no major gender difference. Cox regression analysis revealed that previous attempted suicide (OR 3.3, 95% CI 2.4-4.4) and use of "hard" methods (OR 1.5, 95% CI 1.1-2.1) were both significantly associated with repetition of attempted suicide. Stepwise Cox regression analysis showed that a history of previous attempted suicide was the most important independent predictor of repetition (OR 3.2, 95% CI 2.4-4.4). For young suicide attempters, follow-up and adequate aftercare are very important if repetition and risk of suicide are to be reduced. This applies particularly to those who have already made more than one attempt.

Does assessing suicidality frequently and repeatedly cause harm? A randomized control study.

PubMed

Law, Mary Kate; Furr, R Michael; Arnold, Elizabeth Mayfield; Mneimne, Malek; Jaquett, Caroline; Fleeson, William

2015-12-01

Assessing suicidality is common in mental health practice and is fundamental to suicide research. Although necessary, there is significant concern that such assessments have unintended harmful consequences. Using a longitudinal randomized control design, the authors evaluated whether repeated and frequent assessments of suicide-related thoughts and behaviors negatively affected individuals, including those at-risk for suicide-related outcomes. Adults (N = 282), including many diagnosed with borderline personality disorder (BPD), were recruited through psychiatric outpatient clinics and from the community at large, and were randomly assigned to assessment groups. A control assessment group responded to questions regarding negative psychological experiences several times each day during a 2-week main observation phase. During the same observation period, an intensive suicide assessment group responded to the same questions, along with questions regarding suicidal behavior and ideation. Negative psychological outcomes were measured during the main observation phase (for BPD symptoms unrelated to suicide and for BPD-relevant emotions) and/or at the end of each week during the main observation phase and monthly for 6 months thereafter (for all outcomes, including suicidal ideation and behavior). Results revealed little evidence that intensive suicide assessment triggered negative outcomes, including suicidal ideation or behavior, even among people with BPD. A handful of effects did reach or approach significance, though these were temporary and nonrobust. However, given the seriousness of some outcomes, the authors recommend that researchers or clinicians who implement experience sampling methods including suicide-related items carefully consider the benefits of asking about suicide and to inform participants about possible risks. (c) 2015 APA, all rights reserved).

Columbia-Suicide Severity Rating Scale

PubMed Central

Gipson, Polly Y.; Agarwala, Prachi; Opperman, Kiel J.; Horwitz, Adam; King, Cheryl A.

2016-01-01

Objective Despite the high prevalence of psychiatric emergency (PE) visits for attempted suicide and nonsuicidal self-injury (NSSI) among adolescents, we have limited information about assessment tools that are helpful in predicting subsequent risk for suicide attempts among adolescents in PE settings. This study examined the predictive validity of a highly promising instrument, the Columbia-Suicide Severity Rating Scale (C-SSRS). Method Participants were 178 adolescents (44.4% male; ages 13–17 years) seeking PE services. The C-SSRS interview and selected medical chart data were collected for the index visit and subsequent visits during a 1-year follow-up. Results A suicide risk concern was the most common chief complaint (50.6%) in this sample, and nearly one third of the adolescents (30.4%) reported a lifetime history of suicide attempt at index visit. Sixty-two adolescents (34.8%) had at least one return PE visit during follow-up. Lifetime history of NSSI predicted both return PE visits and a suicide attempt at return visit. The C-SSRS intensity scale score was a significant predictor of a suicide attempt at return visit for both the full sample of adolescents and the subsample who reported suicidal ideation at their index visit. In this subsample, one specific item on the intensity scale, duration, was also a significant predictor of both a return PE visit and a suicide attempt at return visit. Conclusions The C-SSRS intensity scale and NSSI had predictive validity for suicide attempts at return visit. Results also suggest that duration of adolescents’ suicidal thoughts may be particularly important to risk for suicidal behavior, warranting further study. PMID:25285389

[Internet Addiction, Suicidality and Non-Suicidal Self-Harming Behavior - A Systematic Review].

PubMed

Steinbüchel, Toni Andreas; Herpertz, Stephan; Külpmann, Ina; Kehyayan, Aram; Dieris-Hirche, Jan; Te Wildt, Bert Theodor

2017-11-23

Background Internet addiction (IA) is associated with a high rate of co-morbid mental disorders, especially depression, anxiety disorders, ADHD and personality disorders and a considerable level of psychological strain. In terms of risk assessment, the present work investigates the current research literature on suicidal behavior and non-suicidal self-injurious behavior (NSSI). Methods We performed a systematic literature search in 14 databases on title and abstract level for the most common keywords for IA, NSSI and suicidality. After deduction of multiple items, 2334 articles remained. They were filtered per inclusion and exclusion criteria. We identified studies that examined the relationship between IA, NSSI and suicidality, which were assessed by validated psychometric instruments. This allowed a total of 15 studies to be included. Results The relationship between IA and suicidality was examined in 10 studies, four studies examined the relationship of IA, suicidality, and NSSI, and one study exclusively focused on IA and NSSHB. All studies showed higher prevalence for NSSI and respectively suicidality of the subjects with an IA compared to subjects without IA, with point prevalence varying considerably between 1.6-18.7%. Discussion The results of the included publications suggest that Internet dependency is associated with an increased rate of non-suicidal self-harming behavior and increased suicidality, with suicidal ideation being more closely related to IA than suicidal actions. In order to develop a better understanding of causal relationships between IA, NSSI and suicidality, further longitudinal studies are required. Conclusion  Against the background of the presented studies NSSHB and suicidality need to be explicitly addressed within the assessment and treatment of IA patients. © Georg Thieme Verlag KG Stuttgart · New York.

Assessing the quality of media reporting of suicide news in India against World Health Organization guidelines: A content analysis study of nine major newspapers in Tamil Nadu.

PubMed

Armstrong, Gregory; Vijayakumar, Lakshmi; Niederkrotenthaler, Thomas; Jayaseelan, Mala; Kannan, Ramya; Pirkis, Jane; Jorm, Anthony F

2018-05-01

Suicide rates in India are among the highest in the world, resulting in an estimated 250,000 suicide deaths annually. How the media communicates with the Indian public on the topic of suicide has thus far gone without sufficient scrutiny. The objective of our study was to assess the quality of newspaper reporting of suicide-related news in India against World Health Organization suicide reporting guidelines. We used content analysis to assess the quality of suicide reporting against World Health Organization guidelines in nine of the most highly read daily newspapers in the southern state of Tamil Nadu between June and December 2016. Five of the nine newspapers under review were in the top 20 most circulated daily newspapers in the country. A total of 1681 suicide articles were retrieved. The mean number of suicide articles per day per newspaper was 0.9%, and 54.5% of articles were 10 sentences or less. The vast majority (95.9%) of articles primarily focused on reporting specific suicide incidents. Harmful reporting practices were very common (e.g. a detailed suicide method was reported in 43.3% of articles), while helpful reporting practices were rare (e.g. just 2.5% gave contact details for a suicide support service). We observed that a daily diet of short and explicit suicide-related news was served up to readers of newspapers. Attempts should be made to understand the perspectives of media professionals in relation to suicide reporting, and to devise strategies to boost the positive contribution that media can make to suicide prevention.

Precipitating circumstances of suicide among active duty U.S. Army personnel versus U.S. civilians, 2005-2010.

PubMed

Logan, Joseph E; Skopp, Nancy A; Reger, Mark A; Gladden, Matt; Smolenski, Derek J; Floyd, C Faye; Gahm, Gregory A

2015-02-01

To help understand suicide among soldiers, we compared suicide events between active duty U.S. Army versus civilian decedents to identify differences and inform military prevention efforts. We linked 141 Army suicide records from 2005 to 2010 to National Violent Death Reporting System (NVDRS) data. We described the decedents' military background and compared their precipitators of death captured in NVDRS to those of demographically matched civilian suicide decedents. Both groups commonly had mental health and intimate partner precipitating circumstances, but soldier decedents less commonly disclosed suicide intent. © Published 2014. This article is a U.S. Government work and is in the public domain in the USA. Suicide and Life-Threatening Behavior published by Wiley Periodicals, Inc. on behalf of American Association of Suicidology.

Nonsuicidal self-injury among a sample of United States military personnel and veterans enrolled in college classes.

PubMed

Bryan, Craig; Bryan, Annabelle

2014-09-01

To investigate the rate of nonsuicidal self-injury (NSSI), to describe sociodemographic and clinical correlates of NSSI, and to examine the association of NSSI with suicidal thoughts and behaviors in a sample of U.S. military personnel and veterans. An anonymous online survey was completed by 335 U.S. military personnel and veterans (70.0% male; age mean = 36.67, standard error = 10.59; 82.3% Caucasian, 4.9% African American, 2.8% Asian, 3.7% Native American, 1.2% Pacific Islander, and 7.6% other) enrolled in college classes. Descriptive statistics were calculated, and logistic regression was used to test the associations among NSSI, suicide ideation, suicide planning, and suicide attempts. Fourteen percent of the sample reported lifetime NSSI and 3% reported NSSI during the last 12 months. The most common method was cutting (78.7%), with 66% reporting use of 2 or more methods for NSSI. Average age of NSSI onset was 17.55 years. Increased likelihood of NSSI was associated with older age, shorter length of time in service, greater trauma exposure, female gender, Native American racial identity, and combat support deployments. Personnel in the Navy and with a history of combat deployment were significantly less likely to report NSSI. NSSI was significantly associated with suicide ideation, suicide planning, and suicide attempts even when adjusting for covariates. The rate of NSSI is comparable to estimates in nonmilitary U.S. samples. NSSI is a significant risk factor for suicidal thoughts and behaviors in this group. © 2014 Wiley Periodicals, Inc.

An Observational Study of Bullying as a Contributing Factor in Youth Suicide in Toronto

PubMed Central

Sinyor, Mark; Schaffer, Ayal; Cheung, Amy H

2014-01-01

Objective Bullying has been identified as a potential contributing factor in youth suicide. This issue has been highlighted in recent widely publicized media reports, worldwide, in which deceased youth were bullied. We report on an observational study conducted to determine the frequency of bullying as a contributing factor to youth suicide. Method: Coroner records were reviewed for all suicide deaths in youth aged between 10 and 19 in the city of Toronto from 1998 to 2011. Data abstracted were recent stressors (including bullying), clinical variables, such as the presence of mental illness, demographics, and methods of suicide. Results: Ninety-four youth suicides were included in the study. The mean age was 16.8 years, and 70.2% were male. Bullying was present in 6 deaths (6.4%), and there were no deaths where online or cyberbullying was detected. Bullying was the only identified contributing factor in fewer than 5 deaths. The most common stressors identified were conflict with parents (21.3%), romantic partner problems (17.0%), academic problems (10.6%), and criminal and (or) legal problems (10.6%). Any stressor or mental and (or) physical illness was detected in 78.7% of cases. Depression was detected in 40.4% of cases. Conclusions: Our study highlights the need to view suicide in youth as arising from a complex interplay of various biological, psychological, and social factors of which bullying is only one. It challenges simple cause-and-effect models that may suggest that suicide arises from any one factor, such as bullying. PMID:25702362

Patterns of Life Events Preceding the Suicide in Rural Young Chinese: A Case Control Study1

PubMed Central

Zhang, Jie; Ma, Zhenyu

2012-01-01

Background Previous studies on the Chinese suicide found some life events prior to the suicide different from those in the West, but there is a lack of summary of the Chinese life event patterns to better understand the effects of the social structure on Chinese suicide. Aim We tried to identify the life events that precede the Chinese rural youth suicides and compare them with what found in the West, so as to find the patterns that are particularly true in the Chinese culture contexts. Methods Suicide cases were investigated with a psychological autopsy study in rural China, and local community living controls were also interviewed with the same protocol. Results We collapsed 64 negative life events into six categories: (1) Marriage/Love, (2) Family/Home, (3) Work/Business, (4) Health/Hospital, (5) Law/Legal, (6) Friend/Relationship. About 92.3% of the suicides studied had experienced at least one type of negative life events. The three most common negative life events categories in the past one year were Family/Home (60.7%), Health/Hospital (53.8%) and Marriage/Love (51.3%) in the rural young suicide victims. Conclusions Among the negative life events, those related to family relations, love affairs, and marital issues were most likely to precede a suicide of rural suicides in China, and it is especially true of rural young women. Family is an important social institution in rural China for suicide prevention efforts. PMID:22595373

[Epidemiological analysis of suicide in Brazil from 1980 to 2006].

PubMed

Lovisi, Giovanni Marcos; Santos, Simone Agadir; Legay, Letícia; Abelha, Lucia; Valencia, Elie

2009-10-01

The objective of this study was to carry out an epidemiological analysis of the suicide rates found in Brazilian regions and state capitals between 1980 and 2006. Data on mortality rates due to suicide were collected from the Departamento de Informática do Sistema Unico de Saúde (Information Technology Department of the Brazilian Public Health System--DATASUS). A total of 158,952 suicide cases were registered between 1980 and 2006, excluding those cases in which the individual was less than 10 years old (n = 68). In the period under study, the total suicide rate in Brazil increased from 4.4 to 5.7 deaths per 100,000 inhabitants (29.5%). Higher average rates were found in the South (9.3) and Central-West (6.1) regions. Men were more likely to commit suicide. The highest suicide rates were found in the 70-years or above age range while the highest increases were found in the 20 to 59 year age bracket. The most dominant social-demographic characteristics of the persons who committed suicide in the period under study were low educational level and singlehood. The most common methods of suicide were hanging, fire arms and poisoning. Although in Brazil the rate increased 29.5% in 26 years, the national rate is still considered to be low when compared to worldwide suicide rates (average of 4.9 per 100,000 inhabitants). Suicide rates in Brazilian regions vary broadly, ranging from 2.7 to 9.3.

Lethality of firearms relative to other suicide methods: a population based study.

PubMed

Shenassa, E D; Catlin, S N; Buka, S L

2003-02-01

(1) To quantify lethality of firearms relative to other suicide methods, (2) to quantify the extent to which suicide mortality may be reduced by limiting access to firearms. Data on suicides and hospitalised para-suicides that occurred in the state of Illinois from 1990 to 1997 were combined. Total number of episodes for each suicide method was estimated as the sum of the number of suicides and the number of para-suicides for that method. Gender and suicide method were used as proxies for intention to die, and estimated lethality of suicide methods within method-gender groups (for example, male firearm users). Logistic regression was used to quantify the lethality of firearms relative to other suicide methods. Excess mortality associated with the use of firearms was estimated by conservatively assuming that in the absence of firearms the next most lethal suicide method would be used. From January 1990 to December 1997, among individuals 10 years or older in the state of Illinois, there were 37,352 hospital admissions for para-suicide and 10,287 completed suicides. Firearms are the most lethal suicide method. Episodes involving firearms are 2.6 times (95% CI 2.1 to 3.1) more lethal than those involving suffocation-the second most lethal suicide method. Preventing access to firearms can reduce the proportion of fatal firearms related suicides by 32% among minors, and 6.5% among adults. Limiting access to firearms is a potentially effective means of reducing suicide mortality.

Suicide and Western culture.

PubMed

Pridmore, Saxby; McArthur, Milford

2009-02-01

The aim of this paper is to examine the cultural roots and transmission of Western suicide and suicidal behaviour. We explored a period of antiquity (mythical Greece-61 CE) and selected accounts of 10 prominent suicides. The precipitating circumstances were tabulated and an assessment made of the most likely attendant emotions. The same process was followed for a recent period (1994-2008), from which 10 suicides were identified. The precipitating circumstances and the attendant emotions were compared. These circumstances and emotions were then compared to statements commonly encountered in clinical practice from people demonstrating suicidal behaviour. Finally, we looked for evidence that these stories (and the response models) had entered Western culture. Precipitating circumstances, loss of a loved one, actual or imminent execution or imprisonment, other losses and public disgrace, and the negative emotions of shame, guilt, fear, anger, grief and sorrow were common to both historical periods. These circumstances and emotions are similar to those commonly expressed by people who have demonstrated suicidal behaviour. There was a clear record (literature, visual arts) of these stories forming part of our cultural heritage. Models of maladaptive responses to certain adverse circumstances are part of Western culture. Suicide as a response to certain circumstances and negative emotions can be traced back more than 2000 years. Cultural change will be necessary to minimize suicide.

Murder-suicide: a review of the recent literature.

PubMed

Eliason, Scott

2009-01-01

There has been recent widespread media coverage of events that involve murder-suicide. In this paper, the author does an extensive literature review of studies about murder-suicide. The purpose is to determine whether the incidence of murder-suicide is increasing and what its risk factors are. The results of this review show that the incidence of murder-suicide remains at under 0.001%. Risk factors for murder-suicide are based on relationship between perpetrator and victims, history of domestic violence, sex or perpetrator and victim, age of perpetrator, presence of divorce/separation, use of weapon, and history of mental illness. This paper shows that the incidence of murder-suicide is low, stable, and similar to what has been reported in the past. There are, however, some distinct risk factors for murder-suicide including: substance abuse (not as common), mostly male perpetrators, depression (more common), and older male caregivers are at risk.

Suicide in children and adolescents: a Tunisian perspective from 2009 to 2015.

PubMed

Majdoub, Wael; Mosbahi, Amal; Naouar, Maroua; Beji, Meriem; Mannai, Jihene; Turki, Elyes

2017-12-01

This study presents the characteristics of child and adolescent suicides which occurred in Kairouan, Tunisia. Data were collected from autopsy records of the Forensic Department of the University Hospital Ibn El Jazzar of Kairouan. General characteristics of suicides among children and adolescents (under the age of 18) between 2009 and 2015 were retrospectively reviewed. A total of 49 cases, with a female predominance (61.2%) and a mean age of 15.4 ± 2.1, were registered. Most of the victims were from rural areas (93.1%). In most cases, suicide occurred in the victim's home or the surrounding area (73.4%). The identified precipitating factors were family problems in 55.1%, and school issues in 12.2%. The most common suicide method was hanging (69.38%) for both genders, followed by self-immolation for males and poisoning for females, the majority using pesticides. This study offers useful information to understand the risk factors in Tunisian child and adolescent suicides and provides a basis for the development of urgently needed preventive strategies.

Social inequalities in depression and suicidal ideation among older primary care patients

PubMed Central

Gilman, Stephen E.; Bruce, Martha L.; Have, Thomas Ten; Alexopoulos, George S.; Mulsant, Benoit H.; Reynolds, Charles F.; Cohen, Alex

2012-01-01

Purpose Depression and suicide are major public health concerns, and are often unrecognized among the elderly. This study investigated social inequalities in depressive symptoms and suicidal ideation among older adults. Methods Data come from 1,226 participants in PROSPECT (Prevention of Suicide in Primary Care Elderly: Collaborative Trial), a large primary care-based intervention trial for late-life depression. Linear and logistic regressions were used to analyze depressive symptoms and suicidal ideation over the two-year follow-up period. Results Mean Hamilton Depression Rating Scale (HDRS) scores were significantly higher among participants in financial strain (regression coefficient (b)=1.78, 95% confidence interval (CI)=0.67–2.89) and with annual incomes below $20,000 (b=1.67, CI=0.34–3.00). Financial strain was also associated with a higher risk of suicidal ideation (odds ratio=2.35, CI=1.38–3.98). Conclusions There exist marked social inequalities in depressive symptoms and suicidal ideation among older adults attending primary care practices, the setting in which depression is most commonly treated. Our results justify continued efforts to understand the mechanisms generating such inequalities, and to recognize and provide effective treatments for depression among high-risk populations. PMID:22948560

Suicidal ideation, depression, and conduct disorder in a sample of adolescent and young adult twins

PubMed Central

Linker, Julie; Gillespie, Nathan A; Maes, Hermine; Eaves, Lindon; Silberg, Judy L.

2012-01-01

Background The co-occurrence of suicidal ideation, depression, and conduct disturbance is likely explained in part by correlated genetic and environmental risk factors. Little is known about the specific nature of these associations. Method Structured interviews on 2814 twins from the Virginia Twin Study of Adolescent Behavioral Development (VTSABD) and young adult follow-up (YAFU) yielded data on symptoms of depression, conduct disorder and adolescent and young adult suicidal ideation. Results Univariate analyses revealed that the familial aggregation for each trait was explained by a combination of additive genetic and shared environmental effects. Suicidal ideation in adolescence was explained in part by genetic influences, but predominantly accounted for by environmental factors. A mixture of genetic and shared environmental influences explained ideation occurring in young adulthood. Multivariate analyses revealed that there are genetic and shared environmental effects common to suicidal ideation, depression, and conduct disorder. The association between adolescent suicidal ideation and CD was attributable to the same genetic and environmental risk factors for depression. Conclusions These findings underscore that prevention and intervention strategies should reflect the different underlying mechanisms involving depression and conduct disorder to assist in identifying adolescents at suicidal risk. PMID:22646517

Suicide and deliberate self-harm in Pakistan: a scoping review.

PubMed

Shekhani, Sualeha S; Perveen, Shagufta; Hashmi, Dur-E-Sameen; Akbar, Khawaja; Bachani, Sara; Khan, Murad M

2018-02-12

Suicide is a major global public health problem with more than 800,000 incidents worldwide annually. Seventy-five percent of the global suicides occur in low and middle-income countries (LMICs). Pakistan is a LMIC where information on suicidal behavior is limited. The aim of the review is to map available literature on determinants, risk factors and other variables of suicidal behavior in Pakistan. This study was based on Arksey and O'Malley's methodological framework of scoping review, combining peer reviewed publications with grey literature. Ten databases including Applied Social Sciences Index and Abstracts (ASSIA), Cochrane Trials Register (CRG), Cumulative Index to Nursing and Allied Health (CINAHL), National Library of Medicine Gateway (NLMG), ExcerptaMedica (EMBASE), National Library of Medicine's MEDLINE (PUBMED), PSYCHINFO, Social Science Citation Index and Science Citation Index (SCI) and Pakmedinet.com were searched from the beginning of their time frames until December 2016 using a combination of key terms. The inclusion criteria included studies of various study designs covering different aspects of suicidal behavior in English language. Six hundred and twenty three articles were initially retrieved from all ten databases. Two independent reviewers screened the titles and abstracts for relevance. One hundred and eighteen articles were read in full, out of which 11 were excluded because they did not fit the eligibility criteria. One hundred and ten articles, including two student theses and one report, were included in the final review. Most studies were descriptive in nature, with only three that used a case-control design. Majority of the studies were from urban areas, and addressed determinants rather than risk factors. Gender differences and age were predominantly reported, with more males committing suicide. Suicidal behavior was more common among individuals younger than 30 years of age. The three most common methods for suicides were hanging, poisoning and use of firearms. Mental illness as a risk factor for suicides was mentioned in only three studies. This review is the first attempt to synthesize available literature on suicidal behavior in Pakistan. The evidence is limited, and calls for more robust analytical research designs, along with a focus on risk factors.

Suicide Contagion: A Systematic Review of Definitions and Research Utility

PubMed Central

Cheng, Qijin; Li, Hong; Silenzio, Vincent; Caine, Eric D.

2014-01-01

Objectives Despite the common use of contagion to analogize the spread of suicide, there is a lack of rigorous assessment of the underlying concept or theory supporting the use of this term. The present study aims to examine the varied definitions and potential utility of the term contagion in suicide-related research. Methods 100 initial records and 240 reference records in English were identified as relevant with our research objectives, through systematic literature screening. We then conducted narrative syntheses of various definitions and assessed their potential value for generating new research. Results 20.3% of the 340 records used contagion as equivalent to clustering (contagion-as-cluster); 68.5% used it to refer to various, often related mechanisms underlying the clustering phenomenon (contagion-as-mechanism); and 11.2% without clear definition. Under the category of contagion-as-mechanism, four mechanisms have been proposed to explain how suicide clusters occurred: transmission (contagion-as-transmission), imitation (contagion-as-imitation), contextual influence (contagion-as-context), and affiliation (contagion-as-affiliation). Contagion-as-cluster both confounds and constrains inquiry into suicide clustering by blending proposed mechanism with the phenomenon to be studied. Contagion-as-transmission is, in essence, a double or internally redundant metaphor. Contagion-as-affiliation and contagion-as-context involve mechanisms that are common mechanisms that often occur independently of apparent contagion, or may serve as a facilitating background. When used indiscriminately, these terms may create research blind spots. Contagion-as-imitation combines perspectives from psychology, sociology, and public health research and provides the greatest heuristic utility for examining whether and how suicide and suicidal behaviors may spread among persons at both individual and population levels. Conclusion Clarifying the concept of “suicide contagion” is an essential step for more thoroughly investigating its mechanisms. Developing a clearer understanding of the apparent spread of suicide-promoting influences can, in turn, offer insights necessary to build the scientific foundation for prevention and intervention strategies that can be applied at both individual and community levels. PMID:25259604

Assisted suicide and the savings clause.

PubMed

Helminski, F

1995-06-01

In December 1994, the Michigan Supreme Court decided a group of cases comprising constitutional challenges to a Michigan statute against assisted suicide and prosecutions of Dr. Jack Kevorkian for his role in two incidents of suicide. The court rejected arguments that the statute infringed a right of "personal autonomy" under the Fourteenth Amendment to the US Constitution; it noted that, although US Supreme Court opinions indicate that decisions to withdraw or reject life-sustaining treatment are constitutionally protected, a legal difference exists between permitting death to occur by natural means and taking affirmative steps to end life. The Michigan court also decided that Kevorkian could not be charged with murder for supplying only the means by which suicide occurred, but he could be charged with a common law crime of assisting in suicide although the statute outlawing such actions became effective only after the suicides occurred. Because suicide was a crime under the prerevolutionary English Common Law, which forms the foundation of Michigan law, assisting in suicide is also a residual crime under the "savings clause" of the Michigan statutes, which incorporates common law crimes into the law of that state when no superseding statute exists.

Indigenous Knowledge Approach to Successful Psychotherapies with Aboriginal Suicide Attempters.

PubMed

Mehl-Madrona, Lewis

2016-11-01

Suicide is disproportionately common among Aboriginal people in Canada. Life stories were collected from 54 Aboriginal suicide attempters in northern Saskatchewan. Constant comparison techniques and modified grounded theory identified common themes expressed. Three common plots/themes preceded suicide attempts: 1) relationship breakup, usually sudden, unanticipated, involving a third person; 2) being publicly humiliated by another person(s), accompanied by high levels of shame; and 3) high levels of unremitting, chronic life stress (including poverty) with relative isolation. We found 5 common purposes for suicide attempts: 1) to "show" someone how badly they had hurt the attempter, 2) to stop the pain, 3) to save face in a difficult social situation, 4) to get revenge, and 5) don't know/don't remember/made sense at the time, all stated by people who were under the influence of alcohol and/or drugs at the time of their suicide attempt. We found 5 common beliefs about death: 1) you just cease to exist, and everything just disappears; 2) you go into the spirit world and can see and hear everything that is happening in this world; 3) you go to heaven or hell; 4) you go to a better place; and 5) don't know/didn't think about it. The idea of personal and cultural continuity is essential to understanding suicide among First Nations youth. Interventions targeted to the individual's beliefs about death, purpose for suicide, and consistent with the life story (plot) in which they find themselves may be more successful than one-size-fits-all programs developed outside of aboriginal communities. © The Author(s) 2016.

Treatment for Adolescents With Depression Study (TADS): Safety Results

PubMed Central

Emslie, Graham; Kratochvil, Christopher; Vitiello, Benedetto; Silva, Susan; Mayes, Taryn; McNulty, Steven; Weller, Elizabeth; Waslick, Bruce; Casat, Charles; Walkup, John; Pathak, Sanjeev; Rohde, Paul; Posner, Kelly; March, John

2012-01-01

Objective To compare the rates of physical, psychiatric, and suicide-related events in adolescents with MDD treated with fluoxetine alone (FLX), cognitive-behavioral therapy (CBT), combination treatment (COMB), or placebo (PBO). Method Safety assessments included adverse events (AEs) collected by spontaneous report, as well as systematic measures for specific physical and psychiatric symptoms. Suicidal ideation and suicidal behavior were systematically assessed by self- and clinician reports. Suicidal events were also reanalyzed by the Columbia Group and expert raters using the Columbia-Classification Algorithm for Suicidal Assessment used in the U.S. Food and Drug Administration reclassification effort. Results Depressed adolescents reported high rates of physical symptoms at baseline, which improved as depression improved. Sedation, insomnia, vomiting, and upper abdominal pain occurred in at least 2% of those treated with FLX and/or COMB and at twice the rate of placebo. The rate of psychiatric AEs was 11% in FLX, 5.6% in COMB, 4.5% in PBO, and 0.9% in CBT. Suicidal ideation improved overall, with greatest improvement in COMB. Twenty-four suicide-related events occurred during the 12-week period: 5 patients (4.7%) in COMB, 10 (9.2%) in FLX, 5 (4.5%) in CBT, and 3 (2.7%) in placebo. Statistically, only FLX had more suicide-related events than PBO (p = .0402, odds ratio [OR] = 3.7, 95% CI 1.00–13.7). Only five actual attempts occurred (2 COMB, 2 FLX, 1 CBT, 0 PBO). There were no suicide completions. Conclusions Different methods for eliciting AEs produce different results. In general, as depression improves, physical complaints and suicidal ideation decrease in proportion to treatment benefit. In this study, psychiatric AEs and suicide-related events are more common in FLX-treated patients. COMB treatment may offer a more favorable safety profile than medication alone in adolescent depression. PMID:17135989

Hospital-treated suicide attempts among Finnish fire setters: a follow-up study.

PubMed

Thomson, Annika; Tiihonen, Jari; Miettunen, Jouko; Virkkunen, Matti; Lindberg, Nina

2016-12-01

High rates of attempted and completed suicide have been reported among offenders, but there has been little attention in this respect to fire setters specifically. Aim Our aim was to investigate hospital-treated suicide attempts among male fire setters. For each of a consecutive series of 441 pre-trial fire setters, four controls matched for age, gender and place of birth were randomly selected from the Central Population Register. Data on hospitalisation and causes of death over a 39-year period were obtained from the Finnish national registers. The prevalence of suicide attempts was significantly higher among fire setters than among controls. Approximately every fifth fire setter had made at least one suicide attempt which had required hospital treatment. The most common method chosen was intentional self-poisoning or exposure to noxious substances. More than 1 in 10 fire setters with at least one hospitalisation for suicide-related behaviour eventually completed suicide. More attention should be paid to detecting and managing suicidal behaviours among fire setters as they are a high-risk group and accurate identification of their needs in this respect may not only be life-saving but also reduce recidivism. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Shattered Dreams of Professional Competence: The Impact of Client Suicides on Mental Health Practitioners and How to Prepare for It

ERIC Educational Resources Information Center

Juhnke, Gerald A.; Granello, Paul F.

2005-01-01

This article reviews the frequency of suicide, compares and contrasts suicide prediction to suicide assessment and provides a succinct overview of suicide high risk factors that mental health practitioners should be aware. Finally, the article describes common symptoms experienced by mental health practitioners who survive their clients' suicides,…

The epidemiology of homicide-suicide in Italy: a newspaper study from 1985 to 2008.

PubMed

Roma, Paolo; Spacca, Antonella; Pompili, Maurizio; Lester, David; Tatarelli, Roberto; Girardi, Paolo; Ferracuti, Stefano

2012-01-10

Homicide-suicide is an event in which the murderer commits suicide after the homicide. There are at least 14 epidemiological studies on the topic, and all have found that homicide-suicide is more common among family members. The murderers are most often males and the victims females. There is no recent research on this phenomenon in Italy. The purpose of the study was to evaluate the incidence of homicide-suicide in Italy over a period of 24 yrs and to compare Italian data with published international data. We used information gathered by press agencies and from the four major Italian newspapers. Between 1985 and 2008, 662 cases of homicide-suicide were identified, with 1776 deaths. The murderer was male in 84.6% of the cases, typically using a firearm. The most common motivation was romantic jealousy, followed by socio-economic stress. The rate of homicide-suicide was 0.04%. Comparison with international studies is not always possible due to the lack of information for certain categories. The common factors identified may be helpful for prevention. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Searching for Suicide Methods: Accessibility of Information About Helium as a Method of Suicide on the Internet.

PubMed

Gunnell, David; Derges, Jane; Chang, Shu-Sen; Biddle, Lucy

2015-01-01

Helium gas suicides have increased in England and Wales; easy-to-access descriptions of this method on the Internet may have contributed to this rise. To investigate the availability of information on using helium as a method of suicide and trends in searching about this method on the Internet. We analyzed trends in (a) Google searching (2004-2014) and (b) hits on a Wikipedia article describing helium as a method of suicide (2013-2014). We also investigated the extent to which helium was described as a method of suicide on web pages and discussion forums identified via Google. We found no evidence of rises in Internet searching about suicide using helium. News stories about helium suicides were associated with increased search activity. The Wikipedia article may have been temporarily altered to increase awareness of suicide using helium around the time of a celebrity suicide. Approximately one third of the links retrieved using Google searches for suicide methods mentioned helium. Information about helium as a suicide method is readily available on the Internet; the Wikipedia article describing its use was highly accessed following celebrity suicides. Availability of online information about this method may contribute to rises in helium suicides.

Differences in risk factors for self-harm with and without suicidal intent: Findings from the ALSPAC cohort

PubMed Central

Mars, Becky; Heron, Jon; Crane, Catherine; Hawton, Keith; Kidger, Judi; Lewis, Glyn; Macleod, John; Tilling, Kate; Gunnell, David

2014-01-01

Background There is a lack of consensus about whether self-harm with suicidal intent differs in aetiology and prognosis from non-suicidal self-harm, and whether they should be considered as different diagnostic categories. Method Participants were 4799 members of the Avon Longitudinal Study of Parents and Children (ALSPAC), a UK population-based birth cohort who completed a postal questionnaire on self-harm with and without suicidal intent at age 16 years. Multinomial logistic regression analyses were used to examine differences in the risk factor profiles of individuals who self-harmed with and without suicidal intent. Results Many risk factors were common to both behaviours, but associations were generally stronger in relation to suicidal self-harm. This was particularly true for mental health problems; compared to those with non-suicidal self-harm, those who had harmed with suicidal intent had an increased risk of depression (OR 3.50[95% CI 1.64, 7.43]) and anxiety disorder (OR 3.50[95% CI 1.72, 7.13]). Higher IQ and maternal education were risk factors for non-suicidal self-harm but not suicidal self-harm. Risk factors that appeared specific to suicidal self-harm included lower IQ and socioeconomic position, physical cruelty to children in the household and parental self-harm. Limitations i) There was some loss to follow-up, ii) difficulty in measuring suicidal intent, iii) we cannot rule out the possibility of reverse causation for some exposure variables, iv) we were unable to identify the subgroup that had only ever harmed with suicidal intent. Conclusion Self-harm with and without suicidal intent are overlapping behaviours but with some distinct characteristics, indicating the importance of fully exploring vulnerability factors, motivations, and intentions in adolescents who self harm. PMID:25108277

The impact of pesticide regulations on suicide in Sri Lanka

PubMed Central

Gunnell, D; Fernando, R; Hewagama, M; Priyangika, WDD; Konradsen, F; Eddleston, M

2010-01-01

Summary Background Between 1950 and 1995 suicide rates in Sri Lanka increased eight fold to a peak of 47 per 100,000 in 1995. By 2005 rates had halved. Our aim was to evaluate whether Sri Lanka’s regulatory controls on the import and sale of pesticides that are particularly toxic to humans were responsible for these changes in suicide. Methods Ecological analysis using graphical and descriptive approaches to identify times trends in suicide and risk factors for suicide in Sri Lanka, 1975-2005. Results Restrictions on the import and sales of WHO Class I toxicity pesticides in 1995 and endosulfan in 1998, coincided with reductions in suicide in both men and women of all ages. 19,800 fewer suicides occurred in 1996-2005 compared to 1986 – 1995. Secular trends in unemployment, alcohol misuse, divorce, pesticide use and the years associated with Sri Lanka’s Civil war did not appear to be associated with these declines. Conclusion These data indicate that in countries where pesticides are commonly used in acts of self-poisoning, import controls on the most toxic pesticides may have a favourable impact on suicide. In Asia there are an estimated 300,000 deaths from pesticide self-poisoning annually. National and international policies restricting the sales of pesticides that are most toxic to humans may have a major impact on suicides in the region. PMID:17726039

Screening for suicidal ideation in children with epilepsy.

PubMed

Jones, Jana E; Siddarth, Prabha; Gurbani, Suresh; Shields, W Donald; Caplan, Rochelle

2013-12-01

Given the FDA's warning regarding the potential connection between suicidal behavior and antiepileptic drugs, this study examined methods by which to detect suicidal ideation in children with epilepsy. It compared the sensitivity, specificity, and area under the curve for identifying children with suicidal behavior using the Child Behavior Checklist (CBCL) and a structured psychiatric interview. Parent-completed CBCLs provided behavioral problem scores on 177 children with epilepsy, aged 5-16years. Psychiatric diagnoses were made based on separate child and parent structured psychiatric interviews about the child. The children answered questions on suicidal behaviors during the interview. A clinically elevated score in the CBCL Total Problems scale and having more than one psychiatric diagnosis, irrespective of the type of diagnosis, were significant predictors and correctly classified children with suicidal ideation in 79% of the cases based on the CBCL and 80% of the cases with more than one psychiatric diagnosis. These findings indicate that elevated CBCL Total Problems scores, a commonly used instrument, can screen and identify risk for suicidal behavior in children with epilepsy. Additionally, irrespective of diagnosis, if a child with epilepsy has more than one psychiatric diagnosis, further assessment of suicidal behavior is warranted. Importantly, the results underscore the utility of having parents complete a questionnaire in the waiting room in order to identify children with epilepsy at risk for suicidal behavior. © 2013.

Psychiatric Comorbidity and Its Impact on Mortality in Patients Who Attempted Suicide by Paraquat Poisoning during 2000–2010

PubMed Central

Lin, Chemin; Yen, Tzung-Hai; Juang, Yeong-Yuh; Lin, Ja-Liang; Lee, Shwu-Hua

2014-01-01

Background Paraquat poisoning is a lethal method of suicide used around the world. Although restricting its accessibility had been widely discussed, the underlying psychopathological mechanism of paraquat self-poisoning and its association with mortality have not yet been explicitly evaluated. Methods We included all patients admitted to a tertiary general hospital in Taiwan between 2000 and 2010 following a suicide attempt by paraquat self-administration. Diagnoses were made upon psychiatric consultation based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. The risk of mortality was calculated by logistic regression with various psychiatric or medical covariates. Results The consultation-liaison psychiatry team assessed 157 patients who attempted suicide by paraquat poisoning. Mood disorders (54.0%), including dysthymic (26.7%) and major depressive disorders (24.7%), were the most common psychiatric diagnoses among the self-poisoning patients. Among those who attempted suicide, 87 patients (58.0%) died and dysthymic disorder (OR = 5.58, 95% CI: 1.13–27.69; p<0.05) significantly increased the mortality risk after adjustment for relevant medical variables, including age, gender, severity index of paraquat poisoning (SIPP), and risk for respiratory failure. Conclusions Awareness of comorbid psychiatric illnesses, especially dysthymic disorder, is vital in the prevention and treatment of suicide by paraquat poisoning. PMID:25386676

Media effects on suicide methods: A case study on Hong Kong 1998-2005.

PubMed

Cheng, Qijin; Chen, Feng; Yip, Paul S F

2017-01-01

Previous studies have suggested that mass media's reports of new suicide methods will increase suicides using the same method. The same pattern seems not to apply to a conventional suicide method, unless it was used by a celebrity. 1) to examine media effects on both new and non-new suicide methods during 1998 and 2005 in Hong Kong (HK), when a new method by burning charcoal (CB suicide) was spreading in the region. 2) to examine how CB competed with non-CB methods in terms of media coverage and "recruiting" suicidal persons in the socio-economic context. A self- and mutual- exciting process model was fitted to the data, adjusting for divorce rate, unemployment rate, and property price index. Breaking the whole period into onset, peak, and post-peak stages, the model was fitted again to examine the differences. Comparable copycat effects were found on both CB and non-CB suicide news. The only cross-method media effects were found in the onset stage when non-CB suicide news showed suppressing effect on CB suicides. CB suicides reported a significant self-excitation effect. A higher divorce rate and lower property price index were associated with significantly more suicides incidences and more suicide news. The emerging of CB suicide method did not substitute media coverage of non-CB suicide in HK. Media effects in this case were not limited to new suicide method or celebrity suicide. The effects were further fueled by adverse socio-economic conditions.

Media effects on suicide methods: A case study on Hong Kong 1998-2005

PubMed Central

Cheng, Qijin; Chen, Feng; Yip, Paul S. F.

2017-01-01

Background Previous studies have suggested that mass media’s reports of new suicide methods will increase suicides using the same method. The same pattern seems not to apply to a conventional suicide method, unless it was used by a celebrity. Objective 1) to examine media effects on both new and non-new suicide methods during 1998 and 2005 in Hong Kong (HK), when a new method by burning charcoal (CB suicide) was spreading in the region. 2) to examine how CB competed with non-CB methods in terms of media coverage and “recruiting” suicidal persons in the socio-economic context. Methods A self- and mutual- exciting process model was fitted to the data, adjusting for divorce rate, unemployment rate, and property price index. Breaking the whole period into onset, peak, and post-peak stages, the model was fitted again to examine the differences. Results Comparable copycat effects were found on both CB and non-CB suicide news. The only cross-method media effects were found in the onset stage when non-CB suicide news showed suppressing effect on CB suicides. CB suicides reported a significant self-excitation effect. A higher divorce rate and lower property price index were associated with significantly more suicides incidences and more suicide news. Conclusions The emerging of CB suicide method did not substitute media coverage of non-CB suicide in HK. Media effects in this case were not limited to new suicide method or celebrity suicide. The effects were further fueled by adverse socio-economic conditions. PMID:28403231

Suicide Attempts and Their Interrelation With the Economic Crisis in Chania, Greece: A Time-Series Analysis of the Period 2008-2015.

PubMed

Benioudakis, Emmanouil S; Lykiardopoulos, Vyronas; Georgiou, Vaggelis; Archontaki, Maria D; Tsourounaki, Alexandra; Botonaki, Georgia; Batzou, Aikaterini; Symiakos, Tsampikos; Seliniotaki, Theodora; Armagos, Athanasios; Pentari, Aikaterini; Moiradorakis, Konstantinos; Darakis, Eleanna; Melissari-Tzanakaki, Maria

2017-01-19

Greece has been in the grip of a severe economic crisis since 2008. It is well known that suicide attempts and actual suicides increase during periods of recession and austerity. The main aim of this study was to examine the economic crisis in relation to recorded suicide attempts in Chania, Greece, from 2008 to 2015, also taking unemployment rates into consideration. During the research period from January 1, 2008, to December 31, 2015, 436 suicide attempts (females: n = 305 and males: n = 131) were recorded in the archives of the General Hospital of Chania. The data collected, analyzed, and used in the present study were from the archives of the emergency outpatient unit of the hospital. The unemployment data are from the Hellenic Statistical Authority. The rate of suicide attempts peaked in 2012 and remained relatively high until 2015. The most common suicide attempt method was poisoning by medication, with a percentage of 74.4%. In addition, the most prominent stressors related to the suicide attempts were family problems and relationship problems between couples: 40.2%. There was a statistically significant relationship between suicide attempts and unemployment rates (adjusted RR: 1.08; 95% CI, 1.07-1.09). Severe economic crisis seems to increase the rates of suicide attempts. The need for more detailed investigation is essential to provide insight into this global problem. © Copyright 2017 Physicians Postgraduate Press, Inc.

Suicide and homicide in North Carolina: Initial findings from the North Carolina Violent Death Reporting System, 2004-2007.

PubMed

Martin, Sandra L; Proescholdbell, Scott; Norwood, Tammy; Kupper, Lawrence L

2010-01-01

Research concerning suicide and homicide in North Carolina is needed so that medical providers and others who develop and implement preventive and therapeutic interventions related to violence have an empirical base from which to work. North Carolina Violent Death Reporting System data composed of death certificates, medical examiner reports, and law enforcement reports were analyzed to examine the prevalence of suicide and homicide in North Carolina during 2004-2007 and to describe the sociodemographic characteristics of suicide and homicide victims. Suicides and homicides accounted for 2.3% of all North Carolina deaths during 2004-2007. There were 12.0 suicides (95% confidence interval [CI], 11.7-12.4) and 7.2 homicides (95% CI, 6.9-7.4) per 100,000 North Carolina residents. Suicide rates were higher among men and boys, whites, non-Hispanics, and persons aged > or = 35 years. Homicide rates were higher among men and boys, American Indians, blacks, Hispanics, and persons aged < or = 24 years. Firearms were the most common method used to commit suicide and homicide, accounting for 59.5% of suicides and 67.0% of homicides. Every day in North Carolina, approximately 3 persons kill themselves and approximately 2 persons are killed by others. Suicide and homicide inflict a high level of preventable mortality in North Carolina. Learning more about these violent deaths will help to inform the development of effective violence-prevention interventions.

Assessing Fidelity to Suicide Reporting Guidelines in Canadian News Media: The Death of Robin Williams.

PubMed

Creed, Michael; Whitley, Rob

2017-05-01

Mindset is a short recently-published booklet funded by the Mental Health Commission of Canada outlining evidence-based guidelines and best practices for journalists writing about mental health and suicide. Our study aimed to assess fidelity to Mindset recommendations in Canadian newspaper reports of a recent celebrity suicide. A secondary aim is to identify common themes discussed in these newspaper articles. Articles about Robin Williams' suicide from major Canadian newspapers were gathered and coded for presence or absence of each of the 14 recommendations in the "Covering Suicide" section of Mindset. A threshold of 80% was set to test for high fidelity to the guidelines. A qualitative content analysis of the articles was also undertaken to discern common themes and social issues discussed in the articles. Fifty-five per cent of articles surpassed the 80% threshold for high fidelity, while 85% applied at least 70% of the recommendations. The recommendation most commonly overlooked was "Do tell others considering suicide how they can get help," which was absent in 73% of articles. The most common themes discussed were those of addictions and stigma. The news articles generally follow the evidence-based guidelines regarding the reporting of suicide set out in Mindset. This is a welcome development. Future research should continue to examine reporting of suicide to assess for further improvements, while also examining the wider impact of Mindset on the reporting of mental illness per se.

[Suicidal and personality characteristics of women married to men with alcohol dependence and suicidal activity].

PubMed

Merinov, A V; Shustov, D I

2011-01-01

The effect of the suicidal activity in men with alcohol dependence on suicidal indexes, personal-codependency and psychological specifics of their wives has been studied. It has been found that women married to suicidal men with alcohol dependence significantly more frequently demonstrate suicidal activity (a phenomenon of suicidal matrimonial comorbidity) compared to wives of "non-suicidal" men. They also reveal non-suicidal behavioral patterns more frequently and prosuicidal predictors are quite common in them. This contingent of women has high suicidal potential that needs special attention during the therapeutic work.

Origins of suicidality: compatibility of lay and expert beliefs - qualitative study.

PubMed

Zadravec, Tina; Grad, Onja

2013-06-01

Today there exist different views on origins of suicidal behaviour, which can influence the help-seeking behaviour and the adherence to the treatment of suicidal people. The beliefs lay people and patients have about the origins of suicidal behaviour as well as the compatibility of their beliefs with the views of the mental health personnel (general practitioners and psychiatrists) were assessed. 45 semi-structured interviews with the general population, suicide attempters, general practitioners and psychiatrists were conducted, audio typed, transcribed and a thematic analysis of the data was carried out. The results indicated the incompatibility of the views. The general population and the suicide attempters favoured psychological explanations of suicidal behaviour, whereas the general practitioners and psychiatrists promoted medical explanations. The only common theme was perception of the suicidal crisis as a crucial factor in suicidality. Lay people and experts believe that suicidal crisis is the main origin of suicidal behaviour. The awareness of this common denominator and also of the differences in opinions between lay people and experts should be kept in mind when planning and implementing prevention and treatment programmes if we wish to promote help-seeking behaviour and attain good adherence to treatment.

Irritability is associated with anxiety and greater severity, but not bipolar spectrum features, in major depressive disorder

PubMed Central

Perlis, Roy H.; Fava, Maurizio; Trivedi, Madhukar H.; Alpert, Jonathan; Luther, James F.; Wisniewski, Stephen R.; Rush, A. John

2009-01-01

Objective Irritability is common during major depressive episodes, but its clinical significance and overlap with symptoms of anxiety or bipolar disorder remains unclear. We examined clinical correlates of irritability in a confirmatory cohort of Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study participants with major depressive disorder (MDD). Method Logistic regression was used to identify features associated with presence of irritability on the clinician-rated Inventory of Depressive Symptomatology. Results Of 2,307 study participants, 1067(46%) reported irritability at least half the time during the preceding week; they were more likely to be female, to be younger, to experience greater depression severity and anxiety, and to report poorer quality of life, prior suicide attempts, and suicidal ideation. Bipolar spectrum features were not more common among those with irritability. Conclusion Irritable depression is not a distinct subtype of MDD, but irritability is associated with greater overall severity, anxiety comorbidity, and suicidality. PMID:19207123

Use of the Suicide Status Form-II to investigate correlates of suicide risk factors in psychiatrically hospitalized children and adolescents

PubMed Central

Romanowicz, Magdalena; O’Connor, Stephen S.; Schak, Kathryn M.; Swintak, Cosima C.; Lineberry, Timothy W.

2013-01-01

Background Suicide is the third leading cause of death in the United States for youth 12–17 years or age. Acute psychiatric hospitalization represents a clear worst point clinically and acute suicide risk is the most common reason for psychiatric admission. We sought to determine factors associated with differences in individual suicide risk assessment for children and adolescents during acute psychiatric admission. Methods Study participants were 1,153 youth consecutively admitted to an inpatient psychiatry unit who completed a self-administered Suicide Status Form (SSF) within 24 hours of admission. Additional information on suicide risk factors was obtained through medical chart abstraction. Results Females reported significantly greater psychological pain, stress, hopelessness, and self-hate on the SSF and were significantly more likely to have made a suicide attempt just prior to the index hospital admission (OR = 1.59, SE = .29; CI = 1.12–2.26), report a family history of suicide (OR = 2.02, SE = .33; CI = 1.47–2.78), and had experienced a greater number of inpatient psychiatry admissions related to suicidal ideation (RR = 1.33, SE = .13; CI = 1.10–1.61). High school aged youth and those with a primary diagnosis of depression displayed consistently elevated SSF scores and risk factors for suicide compared to comparison groups. Limitations Diagnosis was determined through chart abstraction. Responses to access to firearm question had missing data for 46% of the total sample. Conclusions Systematic administration of a suicide-specific measure at admission may help clinicians improve identification of suicide risk factors in youth in inpatient psychiatry settings. PMID:23856283

[Clinical features of suicide occurring in schizophrenia (I). Risk-factors identification].

PubMed

Besnier, N; Gavaudan, G; Navez, A; Adida, M; Jollant, F; Courtet, P; Lançon, C

2009-04-01

Suicide is the leading cause of premature death in schizophrenia. Approximately 10 to 13% of deaths in schizophrenia are explained by suicide, despite widespread availability of generally effective antipsychotic treatments and suicide attempts have been reported among 20 to 50% of patients. This relatively low ratio of attempts/suicide is consistent with greater lethality of means - more violent - and intents - less ambivalence - in this population. Many studies have focused on risk factors and clinical characteristics for completed and/or attempted suicide. Commonly, sociodemographic risk factors for suicide are male sex, younger age and, among women, being unmarried, divorced or widowed. Previous suicidal behaviour is a strong risk factor for suicide and contrary to the common view, schizophrenic patients often communicate their suicidal intents shortly before death. Moreover, family history of suicide is associated with a heightened risk of suicide and is independent of the diagnosis, according to the growing literature that shows that vulnerability to suicidal behaviour is independent of psychiatric diagnosis. Suicide can occur throughout the entire course of schizophrenia. This is particularly true in those high-risk periods: early phase of the disease, active illness phase, period of relapse or during a depressive episode. The role of insight and positive symptoms remains unclear and probably needs further studies. Although not specifically for people with schizophrenia, hopelessness is a major risk factor and tragic loss is often presented as a trigger for suicide. It has been suggested that treatment side-effects, such as akathisia are associated with suicidal behaviour. A better knowledge of risk and protective factors is necessary to prevent suicide and suicidality.

Violent and non-violent methods of attempted and completed suicide in Swedish young men: the role of early risk factors.

PubMed

Stenbacka, Marlene; Jokinen, Jussi

2015-08-14

There is a paucity of studies on the role of early risk factors for the choice of methods for violent suicide attempts. Adolescent risk factors for the choice of violent or non-violent methods for suicide attempts and the risk of subsequent suicide were studied using a longitudinal design. A national Swedish cohort of 48 834 18-20-year-old young men conscripted for military service from 1969 to 1970 was followed through official registers during a 37-year period. Two questionnaires concerning their psychosocial background were answered by each conscript. Cox proportional hazard regression analyses were used to estimate the risk for different methods of attempted suicide and later suicide. A total of 1195 (2.4 %) men had made a suicide attempt and of these, 133 (11.1 %) committed suicide later. The number of suicide victims among the non-attempters was 482 (1 %). Half of the suicides occurred during the same year as the attempt. Suicide victims had earlier onset of suicidal behaviour and had more often used hanging as a method of attempted suicide than those who did not later commit suicide. The early risk factors for both violent and non-violent methods of suicide attempt were quite similar. Violent suicide attempts, especially by hanging, are associated with a clearly elevated suicide risk in men and require special clinical and public health attention. The early risk factors related to the choice of either a violent or a non-violent suicide attempt method are interlinked and circumstantial factors temporally close to the suicide attempt, such as access to a specific method, may partly explain the choice of method.

Risk assessment and suicide by patients with schizophrenia in secondary mental healthcare: a case-control study.

PubMed

Lopez-Morinigo, Javier-David; Ayesa-Arriola, Rosa; Torres-Romano, Beatriz; Fernandes, Andrea C; Shetty, Hitesh; Broadbent, Matthew; Dominguez-Ballesteros, Maria-Encarnacion; Stewart, Robert; David, Anthony S; Dutta, Rina

2016-09-27

To investigate the role of risk assessment in predicting suicide in patients with schizophrenia spectrum disorders (SSDs) receiving secondary mental healthcare. We postulated that risk assessment plays a limited role in predicting suicide in these patients. Retrospective case-control study. Anonymised electronic mental health record data from the South London and Maudsley National Health Service (NHS) Foundation Trust (SLaM) (London, UK) linked with national mortality data. In 242 227 SLaM service users up to 31 December 2013, 635 suicides were identified. 96 (15.1%) had a SSD diagnosis. Those who died before 1 January 2007 (n=25) were removed from the analyses. Thus, 71 participants with SSD who died from suicide over the study period (cases) were compared with 355 controls. Risk of suicide in relation to risk assessment ratings. Cases were younger at first contact with services (mean±SD 34.5±12.6 vs 39.2±15.2) and with a higher preponderance of males (OR=2.07, 95% CI 1.18 to 3.65, p=0.01) than controls. Also, suicide occurred within 10 days after last contact with services in half of cases, with the most common suicide methods being hanging (14) and jumping (13). Cases were more likely to have the following 'risk assessment' items previously recorded: suicidal history (OR=4.42, 95% CI 2.01 to 9.65, p<0.001), use of violent method (OR=3.37, 95% CI 1.47 to 7.74, p=0.01), suicidal ideation (OR=3.57, 95% CI 1.40 to 9.07, p=0.01) and recent hospital discharge (OR=2.71, 95% CI 1.17 to 6.28, p=0.04). Multiple regression models predicted only 21.5% of the suicide outcome variance. Predicting suicide in schizophrenia is highly challenging due to the high prevalence of risk factors within this diagnostic group irrespective of outcome, including suicide. Nevertheless, older age at first contact with mental health services and lack of suicidal history and suicidal ideation are useful protective markers indicative of those less likely to end their own lives. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Filicide and suicide in a family by paraphenylene diamine poisoning: a mother who committed suicide and poisoned her four children of which one died.

PubMed

Abdelraheem, Mohamed Babikir; Elbushra, Mohamed; Ali, El-Tigani; Ellidir, Rashid A; Bushara, Amna I; Abdelraheem, Waleed B; Zijlstra, Eduard E

2014-09-01

Paraphenylene diamine (PPD) hair dye poisoning is a common health problem in the Middle East and Indian subcontinent. It is the most common cause of suicide intent especially among females. We hereby present a 27-year-old female who presented with a clinical feature of PPD poisoning due to a suicidal attempt, and she died soon after arrival. She had survived a previous suicide attempt with PPD 4 years before. This time she also intentionally tried to kill her four children using PPD. One child died, one recovered after dialysis for acute kidney injury and the other two survived without any further intervention. This case illustrates that PPD poisoning may be used in filicide and suicide intent and that all patients who committed suicide should be reviewed and assessed by clinical psychiatrist. © The Author(s) 2012.

Association of school, family, and mental health characteristics with suicidal ideation among Korean adolescents.

PubMed

Lee, Gyu-Young; Choi, Yun-Jung

2015-08-01

In a cross-sectional research design, we investigated factors related to suicidal ideation in adolescents using data from the 2013 Online Survey of Youth Health Behavior in Korea. This self-report questionnaire was administered to 72,435 adolescents aged 13-18 years in middle and high school. School characteristics, family characteristics, and mental health variables were analyzed using descriptive statistics, χ(2) tests, and logistic regression. Both suicidal ideation and behavior were more common in girls. Suicidal ideation was most common in 11th grade for boys and 8th grade for girls. Across the sample, in logistic regression, suicidal ideation was predicted by low socioeconomic status, high stress, inadequate sleep, substance use, alcohol use, and smoking. Living apart from family predicted suicidal ideation in boys but not in girls. Gender- and school-grade-specific intervention programs may be useful for reducing suicidal ideation in students. © 2015 Wiley Periodicals, Inc.

Self-harm and suicide attempts in Schizophrenia.

PubMed

Jakhar, Kiran; Beniwal, Ram Pratap; Bhatia, Triptish; Deshpande, Smita N

2017-12-01

The risk of suicide among persons with schizophrenia (SZ) is higher than in general population, with multiple contributory factors. We assessed the prevalence of risk of deliberate self-harm and suicide attempts, along with associated socio-demographic and clinical factors in a group of SZ outpatients (n=61) as part of a larger study on overall schizophrenia-associated risks. To investigate factors associated with risk of deliberate self-harm and suicide among persons with schizophrenia. Out of 270 SZ participants evaluated for various risks using Ram Manohar Lohia Risk Assessment Interview (RML-RAI), 61 reported risk of self-harm including suicide attempt/s. The factors associated with this risk were further evaluated on clinical details and Diagnostic Interview for Genetic Studies. Risk of reported self-harm was 22.59%. Among them, 10% had attempted suicide at least once. Current age and past month Global Assessment of Functioning score from DIGS (GAF) were significantly correlated with suicide attempt. Attempters had significantly lower current GAF score, indicating poorer functioning. Among 27 attempters, 9 attempted at the onset of illness while 6 others attempted suicide within one year. Most common method of attempt was ingestion of insecticides or overdose of medication, followed by hanging or jumping from height. In our hospital-based sample of suicide attempters, 10% had attempted suicide, among them over 55% within first year of illness. Attempters were significantly older than non-attempters and suffered from significantly more severe illness than non-attempters. Positive symptoms were significantly associated with attempt, irrespective of time at which suicide was attempted. Copyright © 2017 Elsevier B.V. All rights reserved.

Suicide risk in long-term care facilities: A systematic review

PubMed Central

Mezuk, Briana; Rock, Andrew; Lohman, Matthew C.; Choi, Moon

2014-01-01

Objective Suicide risk is highest in later life, however, little is known about the risk of suicide among older adults in long-term care facilities (e.g., nursing homes, assisted living facilities). The goal of this paper is to review and synthesize the descriptive and analytic epidemiology of suicide in long-term care settings over the past 25 years. Methods Four databases (PubMed, CINAHL Plus, Web of Knowledge, and EBSCOHost) were searched for empirical studies of suicide risk in nursing homes, assisted living, and other residential facilities from 1985 to 2013. Of the 4,073 unique research articles identified, 36 were selected for inclusion in this review. Results Of the included reports, 20were cross-sectional, 10 were longitudinal, three qualitative, and five were intervention studies. Most studies indicate that suicidal thoughts (active and passive) are common among residents (prevalence in the past month: 5 – 33%), although completed suicide is rare. Correlates of suicidal thoughts among long-term care residents include depression, social isolation, loneliness, and functional decline. Most studies examined only individual-level correlates of suicide, although there is suggestive evidence that organizational characteristics (e.g., bed size, staffing) may also be relevant. Conclusions Existing research on suicide risk in long-term care facilities is limited, but suggests that this is an important issue for clinicians and medical directors to be aware of and address. Research is needed on suicide risk in assisted living and other non-nursing home residential settings, as well as the potential role of organizational characteristics on emotional well-being for residents. PMID:24854089

Association of migraine headaches with suicidal ideation among pregnant women in Lima, Peru

PubMed Central

Friedman, Lauren E.; Gelaye, Bizu; Rondon, Marta B.; Sánchez, Sixto E.; Peterlin, B. Lee; Williams, Michelle A.

2016-01-01

Background Suicide is a leading cause of maternal death globally, and suicide prevalence rates have been shown to be increased in those with migraine. No previous study has examined the association between migraine and suicidal ideation during pregnancy. Objective To examine the association between migraine and suicidal ideation among a cohort of pregnant women. Methods A cross-sectional study was conducted among 3,372 pregnant women attending prenatal care clinics in Lima, Peru. Suicidal ideation and depression were assessed using the Patient Health Questionnaire-9 (PHQ-9) scale during early pregnancy. Migraine classification (including migraine and probable migraine) was based on International Classification of Headache Disorders (ICHD)-III beta criteria. Multivariable logistic regression analyses were performed to estimate odd ratios (OR) and 95% confidence intervals (95%CI). Results Suicidal ideation was more common among those with migraine (25.6%) as compared to those with probable migraine (22.1%, p<0.001) or non-migraineurs (12.3%, p<0.001). After adjusting for confounders, including depression, those with migraine or probable migraine had a 78% increased odds of suicidal ideation (OR=1.78; 95%CI: 1.46–2.17), as compared with non-migraineurs. Women with both migraine and depression had a 4.14-fold increased odds of suicidal ideation (OR=4.14; 95%CI: 3.17–5.42) compared to those with neither condition. Conclusion Migraine is associated with increased odds of suicidal ideation in pregnant women even when controlling for depression. These findings support the consideration of screening women with comorbid migraine and depression for suicidal behavior during pregnancy. PMID:27016264

The adult suicide-prone patient: a review of the medical literature and implications for oral and maxillofacial surgeons.

PubMed

Friedlander, Arthur H; Rosenbluth, Susan C; Rubin, Robert T

2012-05-01

Suicide is the 11th most common cause of death among American adults. Some individuals who commit suicide may have been treated by oral and maxillofacial surgeons in the days preceding the event. Because suicide often is preventable, in this report we review methods that are useful in identifying individuals at risk of imminent suicide and give suggestions for obtaining interventional assistance. A Medline search using the key terms "suicide," "adult," and "oral surgery" was conducted. Articles selected were published in peer-reviewed journals. Individuals who have told their surgeon they have no further reason to live, have developed a suicide plan, have secured a lethal device, and have previously made such an attempt are at extreme risk and require immediate intervention. Additional risk factors include being white, aged older than 45 years, and unemployed; living alone, with poor social supports; having a current mental illness or history of mental illness, including substance abuse; and having a family history of suicide. Specialty-specific patients at highest risk are those treated for oral cancer and cosmetic issues and those with adverse surgical outcomes. With regard to assessment of these individuals, the modified SAD PERSONS acronym can assist surgeons in documenting the presence of major risk factors associated with adult suicide and in facilitating communication with emergency personnel. Suicide is a potentially preventable public health problem. Oral and maxillofacial surgeons can be key in elucidating clinically significant suicide potential in their patients and referring them for timely intervention. Published by Elsevier Inc.

Apocalyptic suicide: from a pathological to an eschatological interpretation.

PubMed

Dein, Simon; Littlewood, Roland

2005-09-01

The authors examine the possible interpretations of apocalyptic suicide--a form of suicide amongst a group which believes that the world will end imminently. Through a literature search the authors identify a number of paradigmatic cases exemplifying this phenomenon including Jonestown, Waco, The Order of the Solar Temple and Heaven's Gate. Interpretations of apocalyptic suicide might consider individual factors--the most common approach--but also the social and eschatological themes which are found in the group's ideological work. Religious violence (including suicide) may be precipitated in a dialectical interaction between group members and the perceived outside world. We consider here the ideological aspects that commonly lead to a dualist epistemology for the group. Apocalyptic suicide involves a shift of personal self and agency to the social self of the charismatic group.

[Recent life events preceding suicide attempt by drug overdose].

PubMed

Kubiak, Małgorzata; Musikowska, Barbara; Sein Anand, Jacek

2013-01-01

Recent stressful life events (ASLE) are considered to be one of the factors precipitating suicidal behavior. They precede a suicide attempt in most cases and according to research occur more often during the month or week before the suicide attempt. Interpersonal events are most common. The article presents an analysis of ASLE timing and incidence of events from specific categories during the month preceding suicide attempt by drug overdose. 124 patients admitted to the hospital because of suicidal intoxication were included in the study. Data regarding ASLE were collected with the use of a structured interview. Majority of patients attempting suicide by drug overdose experience a stressful event during the month prior to the suicide attempt. Nearly 4 out of 10 study subjects experience a stressful event on the day of the attempt or on the preceding day. Most common events that occur during the month prior to the attempt and immediately before the attempt are interpersonal events and most of them are related to relationships with spouses or partners.

Psychosocial interventions for self-harm, suicidal ideation and suicide attempt in children and young people: What? How? Who? and Where?

PubMed

Cox, Georgina; Hetrick, Sarah

2017-05-01

We reviewed the evidence for the effectiveness of indicated individual psychosocial interventions for the treatment of self-harm, suicidal ideation and suicide attempts in children and young people, with a particular emphasis on the emerging use of electronic methods to deliver psychological interventions. In total, 16 randomised controlled trials (RCTs) were identified, none of which included children under the age of 12 years. Cognitive-behavioural therapy is the most commonly implemented approach in RCTs until now, although problem-solving therapy, interpersonal psychotherapy, social support and distal support methods by provision of a green card and regular receipt of postcards have also been investigated. Young people have been recruited into RCTs within schools, outpatient clinics, emergency departments and inpatient facilities. Face-to-face delivery of therapy has dominated the intervention trials thus far; however, the use of the internet, social media and mobile devices to deliver interventions to young people and other family members allows for a more novel approach to suicide prevention in youth going forward. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Suicidal mothers

PubMed Central

Gentile, Salvatore

2011-01-01

Abstract: Background: Epidemiological research has demonstrated that suicidal ideation is a relatively frequent complication of pregnancy in both developed and developing countries. Hence, the aims of this study are: to assess whether or not pregnancy may be considered a period highly susceptible to suicidal acts; to recognize potential contributing factors to suicidal behaviors; to describe the repercussions of suicide attempts on maternal, fetal, and neonatal outcome; to identify a typical profile of women at high risk of suicide during pregnancy. Methods: Medical literature information published in any language since 1950 was identified using MEDLINE/PubMed, Scopus, and Google Scholar databases. Search terms were: "pregnancy", (antenatal) "depression", "suicide". Searches were last updated on 28 September 2010. Forty-six articles assessing the suicidal risk during pregnancy and obstetrical outcome of pregnancies complicated by suicide attempts were analyzed, without methodological limitations. Results: Worldwide, frequency of suicidal attempts and the rate of death by suicidal acts are low. Although this clinical event is rare, the consequences of a suicidal attempt are medically and psychologically devastating for the mother-infant pair. We also found that common behaviors exist in women at high risk for suicide during pregnancy. Review data indeed suggest that a characteristic profile can prenatally identify those at highest risk for gestational suicide attempts. Conclusions: Social and health organizations should make all possible efforts to identify women at high suicidal risk, in order to establish specific programs to prevent this tragic event. The available data informs health policy makers with a typical profile to screen women at high risk of suicide during pregnancy. Those women who have a current or past history of psychiatric disorders, are young, unmarried, unemployed, have incurred an unplanned pregnancy (eventually terminated with an induced abortion), are addicted to illicit drugs and/or alcohol, lack effective psychosocial support, have suffered from episodes of sexual or physical violence are particularly vulnerable. PMID:21498972

Sexual Orientation in Adolescents Who Commit Suicide.

ERIC Educational Resources Information Center

Shaffer, David; And Others

1995-01-01

Examined relationship between suicidal behavior and homosexuality in adolescence in an unselected, matched sample. Found no evidence that suicide is a common characteristic of gay youth, or that when suicide does occur among gay teenagers, that it is a direct consequence of stigmatization or lack of support. (JBJ)

Methods of suicide used by children and adolescents.

PubMed

Hepp, Urs; Stulz, Niklaus; Unger-Köppel, Jürg; Ajdacic-Gross, Vladeta

2012-02-01

Although relatively rare, suicide is a leading cause of death in children and adolescents in the Western world. This study examined whether children and adolescents are drawn to other methods of suicide than adults. Swiss suicides from 1998 to 2007 were examined. The main methods of suicide were analysed with respect to age and gender. Of the 12,226 suicides which took place in this 10-year period, 333 were committed by children and adolescents (226 males, 107 females). The most prevalent methods of suicide in children and adolescents 0-19 years were hanging, jumping from heights and railway-suicides (both genders), intoxication (females) and firearms (males). Compared to adults, railway-suicides were over-represented in young males and females (both P < .001). Jumping from heights was over-represented in young males (P < .001). Thus, availability has an important effect on methods of suicide chosen by children and adolescents. Restricting access to most favoured methods of suicide might be an important strategy in suicide prevention.

A 12-year National Study of Suicide by Jumping From Bridges in Norway.

PubMed

Sæheim, Aleksandra; Hestetun, Ingebjørg; Mork, Erlend; Nrugham, Latha; Mehlum, Lars

2017-01-01

Studies from several countries suggest that erecting fences on bridges more commonly used for suicide by jumping may be an effective way of reducing the risk of suicide by jumping from these bridges. Distribution of suicides by jumping off bridges has not yet been studied on a national level in any country. This study included all suicides by jumping from high places registered in the Norwegian Cause of Death Registry (COD) in the period 1999-2010 (n = 319). Combining data from the COD registry and information from police records, 71 cases of suicide by jumping off a bridge were identified involving 36 bridges. This form of suicide constituted approximately 1% of all suicides in Norway in the period 1999-2010. Almost half of these suicides were registered at only 6 bridges. Three Norwegian bridges were secured during the observation period of this study. Two bridges had barriers installed on the full length of the bridge with 11 suicides registered before barriers were installed, and none after. On the 1 bridge that was only partially secured, no change in numbers of suicides was observed after barriers were installed. One-third of jumps from bridges occurred over land. We found that although suicide by jumping off bridges was a relatively rare event, there is a potential for saving lives by installing physical barriers on bridges that are more commonly used for suicide by jumping.

Suicide in children and young adolescents: a 25-year database on suicides from Northern Finland.

PubMed

Lahti, Anniina; Harju, Aleksi; Hakko, Helinä; Riala, Kaisa; Räsänen, Pirkko

2014-11-01

Despite the large amount of research on adolescent suicidality, there are few detailed studies illustrating the characteristics of child and adolescent completed suicide. Our study presents the characteristics of child and adolescent suicides occurring over a period of 25 years within a large geographical area in Northern Finland, with a special focus on gender differences. The study sample included all 58 suicides among children and adolescents (<18 years) occurring in the province of Oulu in Finland between 1988 and 2012. The data is based on documents pertaining to establish the cause of death from forensic autopsy investigations. A register linkage to the data from the Finnish Hospital Discharge Register (FHDR) was also made. 79% of the suicide victims were male. Violent suicide methods predominated in both genders (males 98%, females 83%). While symptoms of mental illness were common, only a minority (15% of males and 17% of females) had a previous history of psychiatric hospitalization. 17% of females but none of the males had been hospitalized previously due to self-poisoning. A greater proportion of females than males had a history of self-cutting (33% vs. 7%) and previous suicide attempts (25% vs. 4%). 48% of males and 58% of females were under the influence of alcohol at the time of their suicide, and alcohol intoxication was related to suicides during the night. One fifth of the adolescents screened positive for substances other than alcohol. The results of this study indicate that there are similarities but also some differences in the characteristics of male and female suicides in adolescents. Copyright © 2014 Elsevier Ltd. All rights reserved.

Psychiatric in-patient care and suicide in England, 1997 to 2008: a longitudinal study.

PubMed

Kapur, N; Hunt, I M; Windfuhr, K; Rodway, C; Webb, R; Rahman, M S; Shaw, J; Appleby, L

2013-01-01

Psychiatric in-patients are at high risk of suicide. Recent reductions in bed numbers in many countries may have affected this risk but few studies have specifically investigated temporal trends. We aimed to explore trends in psychiatric in-patient suicide over time. A prospective study of all patients admitted to National Health Service (NHS) in-patient psychiatric care in England (1997-2008). Suicide rates were determined using National Confidential Inquiry and Hospital Episode Statistics (HES) data. Over the study period there were 1942 psychiatric in-patient suicides. Between the first 2 years of the study (1997, 1998) and the last 2 years (2007, 2008) the rate of in-patient suicide fell by nearly one-third from 2.45 to 1.68 per 100,000 bed days. This fall in rate was observed for males and females, across ethnicities and diagnoses. It was most marked for patients aged 15-44 years. Rates also fell for the most common suicide methods, particularly suicide by hanging on the ward (a 59% reduction). Although the number of post-discharge suicides fell, the rate of post-discharge suicide may have increased by 19%. The number of suicide deaths in those under the care of crisis resolution/home treatment teams has increased in recent years to approximately 160 annually. The rate of suicide among psychiatric in-patients in England has fallen considerably. Possible explanations include falling general population rates, changes in the at-risk population or improved in-patient safety. However, a transfer of risk to the period after discharge or other clinical settings such as crisis resolution teams cannot be ruled out.

Development and application of a Chinese webpage suicide information mining system (sims).

PubMed

Chen, Penglai; Chai, Jing; Zhang, Lu; Wang, Debin

2014-11-01

This study aims at designing and piloting a convenient Chinese webpage suicide information mining system (SIMS) to help search and filter required data from the internet and discover potential features and trends of suicide. SIMS utilizes Microsoft Visual Studio2008, SQL2008 and C# as development tools. It collects webpage data via popular search engines; cleans the data using trained models plus minimum manual help; translates the cleaned texts into quantitative data through models and supervised fuzzy recognition; analyzes and visualizes related variables by self-programmed algorithms. The SIMS developed comprises such functions as suicide news and blogs collection, data filtering, cleaning, extraction and translation, data analysis and presentation. SIMS-mediated mining of one-year webpage revealed that: peak months and hours of web-reported suicide events were June-July and 10-11 am respectively, and the lowest months and hours, September-October and 1-7 am; suicide reports came mostly from Soho, Tecent, Sina etc.; male suicide victims over counted female victims in most sub-regions but southwest China; homes, public places and rented houses were the top three places to commit suicide; poisoning, cutting vein and jumping from building were the most commonly used methods to commit suicide; love disputes, family disputes and mental diseases were the leading causes. SIMS provides a preliminary and supplementary means for monitoring and understanding suicide. It proposes useful aspects as well as tools for analyzing the features and trends of suicide using data derived from Chinese webpages. Yet given the intrinsic "dual nature" of internet-based suicide information and the tremendous difficulties experienced by ourselves and other researchers, there is still a long way to go for us to expand, refine and evaluate the system.

Comorbid psychiatric diagnoses in suicide attempt by charcoal burning: a 10-year study in a general hospital in Taiwan.

PubMed

Lin, Chemin; Yen, Tzung-Hai; Juang, Yeong-Yuh; Leong, Wa Cheong; Hung, Huei-Min; Ku, Chung-Hsuan; Lin, Ja-Liang; Lee, Shwu-Hua

2012-01-01

Over the last decade, charcoal burning has become a common method of suicide in Taiwan; however, the underlying psychiatric diagnoses and gender differences have yet to be examined. We conducted a retrospective chart review on inpatients after suicide attempt by charcoal burning during 2000-2010. The patients were referred to the psychiatric consultation team and diagnoses were made according to DSM-IV. We chose those who were admitted to the nephrology ward in the same period due to accidental carbon monoxide intoxication as controls. Demographic and laboratory data, psychiatric diagnoses and reasons for suicide were obtained and analyzed. Among seventy-three patients, major depressive disorder (49.3%) and adjustment disorder (41.1%) were most frequently diagnosed. Breaking-up, financial debt and physical/mental illnesses were the top three reasons for suicide (17.8% each). The male-to-female gender ratio was 1.5:1. Female patients had higher rates of major depressive disorders, while male patients presented more adjustment disorders comorbid with alcohol use disorders. There were gender differences in patients of suicide attempt by charcoal burning, in terms of demographic profiles and psychiatric diagnoses. Suicide risk assessment and prevention should be tailored by gender. Copyright © 2012 Elsevier Inc. All rights reserved.

Lesbian, Gay, Bisexual, and Transgender Hate Crimes and Suicidality Among a Population-Based Sample of Sexual-Minority Adolescents in Boston

PubMed Central

Hatzenbuehler, Mark L.

2014-01-01

Objectives. We examined whether past-year suicidality among sexual-minority adolescents was more common in neighborhoods with a higher prevalence of hate crimes targeting lesbian, gay, bisexual, and transgender (LGBT) individuals. Methods. Participants’ data came from a racially/ethnically diverse population-based sample of 9th- through 12th-grade public school students in Boston, Massachusetts (n = 1292). Of these, 108 (8.36%) reported a minority sexual orientation. We obtained data on LGBT hate crimes involving assaults or assaults with battery between 2005 and 2008 from the Boston Police Department and linked the data to the adolescent’s residential address. Results. Sexual-minority youths residing in neighborhoods with higher rates of LGBT assault hate crimes were significantly more likely to report suicidal ideation (P = .013) and suicide attempts (P = .006), than were those residing in neighborhoods with lower LGBT assault hate crime rates. We observed no relationships between overall neighborhood-level violent and property crimes and suicidality among sexual-minority adolescents (P > .05), providing evidence for specificity of the results to LGBT assault hate crimes. Conclusions. Neighborhood context (i.e., LGBT hate crimes) may contribute to sexual-orientation disparities in adolescent suicidality, highlighting potential targets for community-level suicide-prevention programs. PMID:24328619

Root Cause Analyses of Suicides of Mental Health Clients: Identifying Systematic Processes and Service-Level Prevention Strategies.

PubMed

Gillies, Donna; Chicop, David; O'Halloran, Paul

2015-01-01

The ability to predict imminent risk of suicide is limited, particularly among mental health clients. Root cause analysis (RCA) can be used by health services to identify service-wide approaches to suicide prevention. To (a) develop a standardized taxonomy for RCAs; (b) to quantitate service-related factors associated with suicides; and (c) to identify service-related suicide prevention strategies. The RCAs of all people who died by suicide within 1 week of contact with the mental health service over 5 years were thematically analyzed using a data collection tool. Data were derived from RCAs of all 64 people who died by suicide between 2008 and 2012. Major themes were categorized as individual, situational, and care-related factors. The most common factor was that clients had recently denied suicidality. Reliance on carers, recent changes in medication, communication problems, and problems in follow-through were also commonly identified. Given the difficulty in predicting suicide in people whose expressions of suicidal ideation change so rapidly, services may consider the use of strategies aimed at improving the individual, stressor, support, and care factors identified in this study.

Psychiatric disorders and clinical correlates of suicidal patients admitted to a psychiatric hospital in Tokyo

PubMed Central

2010-01-01

Background Patients admitted to a psychiatric hospital with suicidal behavior (SB) are considered to be especially at high risk of suicide. However, the number of studies that have addressed this patient population remains insufficient compared to that of studies on suicidal patients in emergency or medical settings. The purpose of this study is to seek features of a sample of newly admitted suicidal psychiatric patients in a metropolitan area of Japan. Method 155 suicidal patients consecutively admitted to a large psychiatric center during a 20-month period, admission styles of whom were mostly involuntary, were assessed using Structured Clinical Interviews for DSM-IV Axis I and II Disorders (SCID-I CV and SCID-II) and SB-related psychiatric measures. Associations of the psychiatric diagnoses and SB-related characteristics with gender and age were examined. Results The common DSM-IV axis I diagnoses were affective disorders 62%, anxiety disorders 56% and substance-related disorders 38%. 56% of the subjects were diagnosed as having borderline PD, and 87% of them, at least one type of personality disorder (PD). SB methods used prior to admission were self-cutting 41%, overdosing 32%, self-strangulation 15%, jumping from a height 12% and attempting traffic death 10%, the first two of which were frequent among young females. The median (range) of the total number of SBs in the lifetime history was 7 (1-141). Severity of depressive symptomatology, suicidal intent and other symptoms, proportions of the subjects who reported SB-preceding life events and life problems, and childhood and adolescent abuse were comparable to those of the previous studies conducted in medical or emergency service settings. Gender and age-relevant life-problems and life events were identified. Conclusions Features of the studied sample were the high prevalence of affective disorders, anxiety disorders and borderline PD, a variety of SB methods used prior to admission and frequent SB repetition in the lifetime history. Gender and age appeared to have an influence on SB method selection and SB-preceding processes. The findings have important implications for assessment and treatment of psychiatric suicidal patients. PMID:21144041

Neurobiological Risk Factors for Suicide Insights from Brain Imaging

PubMed Central

Cox Lippard, Elizabeth T.; Johnston, Jennifer A.Y.; Blumberg, Hilary P.

2014-01-01

Context This article reviews neuroimaging studies on neural circuitry associated with suicide-related thoughts and behaviors to identify areas of convergence in findings. Gaps in the literature for which additional research is needed are identified. Evidence acquisition A PubMed search was conducted and articles published prior to March 2014 were reviewed that compared individuals who made suicide attempts to those with similar diagnoses who had not made attempts or to healthy comparison subjects. Articles on adults with suicidal ideation and adolescents who had made attempts, or with suicidal ideation, were also included. Reviewed imaging modalities included structural magnetic resonance imaging, diffusion tensor imaging, single photon emission computerized tomography, positron emission tomography, and functional magnetic resonance imaging. Evidence synthesis Although many studies include small samples, and subject characteristics and imaging methods vary across studies, there were convergent findings involving the structure and function of frontal neural systems and the serotonergic system. Conclusions These initial neuroimaging studies of suicide behavior have provided promising results. Future neuroimaging efforts could be strengthened by more strategic use of common data elements, and a focus on suicide risk trajectories. At-risk subgroups defined by biopsychosocial risk factors and multidimensional assessment of suicidal thoughts and behaviors may provide a clearer picture of the neural circuitry associated with risk status—both current and lifetime. Also needed are studies investigating neural changes associated with interventions that are effective in risk reduction. PMID:25145733

Epidemiology of completed suicides in Singapore for 2001 and 2002.

PubMed

Loh, Marie; Tan, Chay Hoon; Sim, Kang; Lau, Gilbert; Mondry, Adrian; Leong, Jern-Yi; Tan, Ene-Choo

2007-01-01

This study provides an analysis of 640 completed suicide cases in Singapore for the years 2001 and 2002, compared to previous years and in relation to demographic and socioeconomic factors, as well as to the characteristics of a subgroup of suicide victims with prior psychiatric illness. There was little change in the suicide pattern over the 2 years studied compared to previous years. The sex ratio was constant at 1.5. Population-adjusted ratios were 1 for Chinese, 0.5 for Malays, and >1 for both Indians and other ethnic groups. Falling from heights ranked first in terms of method adopted for both years. A disproportionately higher number of suicides were recorded for the 25-34 and the > or =75-year-old age groups. A total of 47 (17.2%) in 2001 and 74 (20.2%) in 2002 of the cases had a history of prior psychiatric illness, with psychotic disorders being the most common diagnostic category. There was also a statistically significant correlation between unemployment and incidence rates. Although the overall rate of elderly suicides had gone down since the 1990s, prevention strategy should focus on the elderly as this rate is still about 3-4 times the national average.

Protective factors against suicide among young-old Chinese outpatients

PubMed Central

2014-01-01

Background Suicide is common among the elderly worldwide. However, no literature could be found on the beliefs/expectations that protect young-old people from attempting suicide. The purpose of this study was to explore young-old outpatients’ reasons for not killing themselves in Taiwan. Method Data for this qualitative descriptive study were extracted from a large research series. From the 83 elderly outpatients in the original sample, 31 were chosen for this study because they were young-old (65–74 years old) and from two randomly selected medical centers in northern Taiwan. Data on participants’ reasons for not killing themselves in unhappy situations were collected in individual interviews using a semi-structured guide and analyzed by content analysis. Results Analysis of interview data identified six major themes: satisfied with one’s life, suicide cannot resolve problems, fear of humiliating one’s children, religious beliefs, never thought about suicide, and living in harmony with nature. Conclusion These identified protective factors (reasons for living) could be added to suicide-prevention programs for the elderly. Our findings may also serve as a reference for geriatric researchers in western countries with increasing numbers of elderly ethnic minority immigrants. PMID:24739419

Risk profile of young people admitted to hospital for suicidal behaviour in Melbourne, Australia.

PubMed

Borschmann, Rohan; Stark, Patrick; Prakash, Chidambaram; Sawyer, Susan M

2018-05-20

Self-harm and suicidal behaviour is most prevalent during adolescence, but little is known about the risk profile of adolescents admitted to hospital for suicidal behaviour. Young people who self-harm are at an increased risk of mortality compared to those who do not self-harm; adolescents admitted to hospital for suicidal behaviour are particularly at risk. The aim of this study was to generate a risk profile of adolescents admitted to hospital with suicidal behaviour. We conducted a 12-month retrospective audit of adolescent admissions to the mental health inpatient unit at a tertiary children's hospital in Melbourne, Australia. Routinely collected data were used to generate a risk profile. We found that 212 of 271 (78.2%) admissions were due to suicidal behaviour. Of these, 107 (51%) adolescents were diagnosed with one or more mental disorders at discharge, most commonly major depressive disorder. Beyond known distal determinants of health risk, the proximal risk profile of these adolescents included factors relating to gender, substance use, prior mental health diagnoses and prior admission to hospital. Poor sleep was also a risk factor, with 159 (75%) reporting a recent history of sleeping problems. The very high proportion of admissions to the mental health inpatient unit due to suicidal behaviour reinforces the importance of finding effective methods of identification of the risk processes underpinning suicidal behaviours to reduce the unnecessary waste of young lives by suicide. © 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Exposure to, and searching for, information about suicide and self-harm on the Internet: Prevalence and predictors in a population based cohort of young adults

PubMed Central

Mars, Becky; Heron, Jon; Biddle, Lucy; Donovan, Jenny L.; Holley, Rachel; Piper, Martyn; Potokar, John; Wyllie, Clare; Gunnell, David

2015-01-01

Background There is concern over the potential impact of the Internet on self-harm and suicidal behaviour, particularly in young people. However, little is known about the prevalence and patterns of suicide/self-harm related Internet use in the general population. Methods Cross sectional study of 3946 of the 8525 participants in the Avon Longitudinal Study of Parents and Children (ALSPAC) who were sent a self-report questionnaire including questions on suicide/self-harm related Internet use and self-harm history at age 21 years. Results Suicide/self-harm related Internet use was reported by 22.5% (886/3946) of participants; 11.9% (470/3946) had come across sites/chatrooms discussing self-harm or suicide, 8.2% (323/3946) had searched for information about self-harm, 7.5% (296/3946) had searched for information about suicide and 9.1% (357/3946) had used the Internet to discuss self-harm or suicidal feelings. Suicide/self-harm related Internet use was particularly prevalent amongst those who had harmed with suicidal intent (70%, 174/248), and was strongly associated with the presence of suicidal thoughts, suicidal plans, and history of self-harm. Sites offering help, advice, or support were accessed by a larger proportion of the sample (8.2%, 323/3946) than sites offering information on how to hurt or kill yourself (3.1%, 123/3946). Most individuals (81%) who had accessed these potentially harmful sites had also accessed help sites. Limitations (i) There were differences between questionnaire responders and non-responders which could lead to selection bias and (ii) the data were cross-sectional, and we cannot conclude that associations are causal. Conclusions Suicide/self-harm related Internet use is common amongst young adults, particularly amongst those with suicidal thoughts and behaviour. Both harmful and helpful sites were accessed, highlighting that the Internet presents potential risks but also offers opportunities for suicide prevention. PMID:26150198

Building and Maintaining an Effective Campus-Wide Coalition for Suicide Prevention

ERIC Educational Resources Information Center

Kaslow, Nadine J.; Garcia-Williams, Amanda; Moffitt, Lauren; McLeod, Mark; Zesiger, Heather; Ammirati, Rachel; Berg, John P.; McIntosh, Belinda J.

2012-01-01

Preventing suicide is a commonly shared priority among college administrators, faculty, staff, students, and family members. Coalitions are popular health promotion mechanisms for solving community-wide problems and are valuable in campus-wide suicide prevention efforts. This article provides an example of an effective suicide prevention…

Characteristic Risk Factors Associated with Planned versus Impulsive Suicide Attempters.

PubMed

Kim, Jaeha; Lee, Kang-Sook; Kim, Dai Jin; Hong, Seung-Chul; Choi, Kyoung Ho; Oh, Youngmin; Wang, Sheng-Min; Lee, Hae-Kook; Kweon, Yong-Sil; Lee, Chung Tai; Lee, Kyoung-Uk

2015-12-31

The present study aimed to investigate predictors for planned suicide attempters. This study included 1,003 patients who attempted suicide and visited emergency department. They were divided into two groups, planned suicide attempters (SAs; n=133 [13.3%]) and impulsive SAs (n=870, [86.7%]), and the demographic variables, clinical characteristics, factors related to suicide, and psychiatric resources of the groups were compared. Major depressive disorder and substance use disorders were more common among planned SAs than among impulsive SAs. Additionally, the planned SAs were older, more likely to be divorced, separated or widowed, and more likely to have comorbid medical illnesses, severe depression, higher suicidality, and self-blaming tendencies than the impulsive SAs. Financial problems and physical illnesses were more common in planned SAs but interpersonal conflicts were more frequent in impulsive SAs. Planned SAs had fewer previous suicide attempts but these were more serious suicide attempts. The presence of the hope to die, a written will, and suicidal ideation of a repetitive, intense, and continuous nature were predictive of planned SAs. The present findings demonstrated that planned SAs had more severe psychopathology and medical illnesses than impulsive SAs. Therefore, screening for depression, substance use disorders, and suicidal plans among old and medically ill patients may be important for preventing suicide attempts.

Prevalence and comorbidity of common mental disorders and associations with suicidal ideation in the adult population.

PubMed

Veisani, Yousef; Mohamadian, Fathola; Delpisheh, Ali

2017-01-01

Little information exists on the association between comorbidities of mental disorders and suicidal ideation in developing countries. The current study examined the relationship between the presence of comorbid mental disorders and suicidal ideation in the adult population. This cross-sectional study was conducted using the cluster random sampling method in 3 steps. Data were collected from a household assets survey and the self-administered 28-item General Health Questionnaire as first step in screening, and the Persian version of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition - Text Revision was used in the second stage to determine the prevalence of mental disorders. Bivariate and multivariate analysis were used to investigate the associations between mental disorders and suicidal ideation. Of the 763 participants, 199 (26.1%) had 1 or more mental disorder. Forty-two (71.4%) subjects with comorbidities had a history of suicidal ideation, whereas 59 (7.7%) of all participants had a history of suicidal ideation. We found that major depressive disorder and obsessive-compulsive disorder were the most predictive of suicidal ideation in both sexes. The odds ratio for suicidal ideation associated with having 3 comorbid disorders was 2.70 (95% confidence interval [CI], 1.40 to 14.12) in males and 3.06 (95% CI, 1.25 to 15.22) in females. Consistent with pervious data, our results confirmed that mental disorders and comorbidities of mental disorders were important predictors of suicidal ideation. Our findings are very useful for applied intervention programs to reduce the suicide rate in regions in which it is high.

Suicide Method Runs in Families: A Birth Certificate Cohort Study of Adolescent Suicide in Taiwan

ERIC Educational Resources Information Center

Lu, Tsung-Hsueh; Chang, Wan-Ting; Lin, Jin-Jia; Li, Chung-Yi

2011-01-01

Suicide method used by adolescents was examined to determine if it was the same as that employed by their suicidal parents. Six hundred eighty adolescents completed suicide between 1997 and 2007, of whom 12 had parents who had previously died by suicide. The suicide method used by these adolescents was compared with that employed by their suicidal…

An assessment of suicide attempts by self-poisoning in the west of Iran.

PubMed

Najafi, Farid; Beiki, Omid; Ahmadijouybari, Tuoraj; Amini, Saeed; Moradinazar, Mehdi; Hatemi, Masoame; Moradi, Masoud

2014-10-01

Intentional self-poisoning that is widely used all over the world is one of the most common methods of suicide. This study aim was to determine the rate of attempted intentional self-poisoning and to identify high risk persons in the west of Iran (Kermanshah). A total of 3138 people (1279 M and 1859 F) studied. The average annual rate of suicide in Kermanshah was 153 persons per 100 000 people. The most number of attempted intentional self-poisoning (55.5%) were in the 20-29 year age group. The most popular toxic substances for self-poisoning were drugs (71%) and oil and fuels (15%), respectively. The most number of intentional self-poisoning suicides are attempted by drugs. By considering the high rate of intentional self-poisoning, low age of suicide attempts and also its high mortality rate in Kermanshah, it is necessary to stop the opportunity to buy over-the-counter (OTC) drugs, especially those being most misused. Copyright © 2014 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Celebrity suicide and its effect on further media reporting and portrayal of suicide: An exploratory study

PubMed Central

Harshe, Devavrat; Karia, Sagar; Harshe, Sneha; Shah, Nilesh; Harshe, Gurudas; De Sousa, Avinash

2016-01-01

Background: Suicide is a grave mental health problem in India, and suicide rates in India have risen over the past decades. Suicide reporting by the media is a common cause for spurts of suicides that may occur from time to time. The aim of the present study was to assess the change in trends in media reporting of suicide after a celebrity suicide. Methodology: Suicide by the renowned actor Robin Williams was selected as the reference case. The top three Indian daily newspapers published in English having the highest circulation as per the Registrar of Newspapers, Government of India report were selected to be scanned in the study. These were the Times of India – Mumbai edition, Mumbai Mirror, and the Daily News Analysis – Mumbai edition. The authors screened all news stories in the three newspapers within a 6-month period (3 months prior and 3 months post the date of the reference suicide case), and these news reports were evaluated as per the suicide reporting guidelines for media laid down by the Indian Psychiatric Society. The data were analyzed using Chi-square test and descriptive statistics where appropriate. Results: A total of 708 newspaper articles were identified on the basis of the guidelines mentioned above. Nearly 88% (n = 623) of the articles directly covered suicide while 4.09% (n = 29) focused on suicidal threats and 7.91% (n = 56) focused on parasuicide behavior. There was a significantly greater increase in the total number of articles printed after the celebrity suicide (n = 409) for all article types except teasers as compared to that before the celebrity suicide (n = 299). There was a significantly greater increase in front page news on suicide after the celebrity suicide (P = 0.0016), description of the method of suicide (P = 0.0221), and the mention of the suicide notes (P = 0.0002). Most articles after the celebrity suicide placed the blame on someone or the environment for the act (P = 0.0001). Conclusions: A change in media trend toward reporting suicide was noted post a celebrity suicide, and it is important that media follow guidelines stringently when reporting a serious problem like suicide. PMID:28197003

Review of fatal gunshot cases in the files of the Department of Forensic Medicine in Białystok, Poland, in the years 1964-2015.

PubMed

Ptaszyńska-Sarosiek, Iwona; Filimoniuk, Karolina; Cwalina, Urszula; Niemcunowicz-Janica, Anna

2016-01-01

Aim of the study was to assess gunshot fatalities on the basis of post-mortem examination reports collected at the Department of Forensic Medicine in the Medical University of Białystok. Material and methods: The research covered 87 gunshot fatalities occurring in the Podlasie district (north-eastern Poland) over the period from 1964 to 2015. The analysis included demographic data such as the victims' gender, age, place of residence and such data as time of year, circumstances of the event and causes of death. The study also investigated blood alcohol level in the victims. The results were analysed statistically using the Mann-Whitney and Kruskal-Wallis tests. Results: The majority of victims were young males, most of whom committed suicide. The most common cause of death among the suspected suicides was gunshot wounds in the skull area. The second most frequent gunshot wound location among non-suicides was the chest. The majority of male victims were intoxicated at the time of death. Conclusions: In the area of the city of Bialystok and its surroundings, there are approximately two gunshot fatalities per year. In most cases, the victims were urban-dwelling young males (aged 21-30) committing suicide. The most common cause of death among the suspected suicides was gunshot wounds in the skull area and the chest. The majority of male victims were intoxicated at the time of death.

Depression and Suicide Risk

MedlinePlus

... due to another medical disorder Relationship Between Depression & Suicide: 1. Depression is the psychiatric diagnosis most commonly associated with ... of patients with treated depression eventually die by suicide. xiv 4. Depression is present in at least 50 percent of ...

Adolescent Suicidal Behavior and Substance Use: Developmental Mechanisms

PubMed Central

Dawes, Michael A; Mathias, Charles W; Richard, Dawn M; Hill-Kapturczak, Nathalie; Dougherty, Donald M

2008-01-01

Adolescent suicidal behaviors and substance use are disturbingly common. Research suggests overlap of some of the etiological mechanisms for both adolescent suicidal behavior and substance use, yet clear understanding of the complex relations between these behaviors and their causal underpinnings is lacking. A growing body of evidence and a diathesis model (Mann et al. 1999; Mann, 2003) highlight the importance of impulse control as a proximal risk factor for adolescent suicidal and substance use behaviors. This literature review extends current theory on the relationships between adolescent suicidal behavior and substance use by: (1) examining how, when, and to what extent adolescent development is affected by poor impulse control, stressful life events, substance use behavior, and biological factors; (2) presenting proposed causal mechanisms by which these risk factors interact to increase risk for suicidal behaviors and substance use; and (3) proposing specific new hypotheses to extend the diathesis model to adolescents at risk for suicide and substance use. More specifically, new hypotheses are presented that predict bidirectional relationships between stressful life events and genetic markers of 5-HT dysregulation; substance use behavior and impulsivity; and substance use behavior and suicide attempts. The importance of distinguishing between different developmental trajectories of suicidal and substance use behaviors, and the effects of specific risk and protective mechanisms are discussed. Use of new statistical approaches that provide for the comparison of latent growth curves and latent class models is recommended to identify differences in developmental trajectories of suicidal behavior and substance use. Knowledge gained from these prospective longitudinal methods should lead to greater understanding on the timing, duration, and extent to which specific risk and protective factors influence the outcomes of suicidal behavior and substance use. In turn, findings from these studies should inform researchers who conduct future treatment and prevention studies. PMID:20651946

Loss of permanent employment and its association with suicidal ideation: a cohort study in South Korea.

PubMed

Yoon, Seohyun; Kim, Ja Young; Park, Jooyoung; Kim, Seung-Sup

2017-09-01

Objective Precarious employment is associated with worse mental health, but it is unclear whether changes in employment status are related to suicidal behaviors. This study examined the association between change in employment status and suicidal ideation among workers in South Korea. Methods To maximize power of the analysis, we combined data from the ongoing Korean Welfare Panel Study. We analyzed 3793 participants who were permanent workers at baseline (2011-2014) and who either: (i) maintained permanent employment; (ii) became a full-time precarious worker; (iii) became a part-time precarious worker; or (iv) became unemployed in the following year (2012-2015). Suicidal ideation was assessed annually by asking participants, "Have you ever seriously thought about dying by suicide in the past year?" Logistic regression was applied to examine associations between change in employment status and suicidal ideation, adjusting for potential confounders such as lifetime suicidal ideation and depressive symptoms at baseline. Results Participants who became part-time precarious workers were more likely to have suicidal ideation [odd ratio (OR) 2.37, 95% confidence interval (95% CI) 1.07-5.25, P=0.033] compared to those who remained permanent workers. In analysis restricted to workers who never previously thought about dying by suicide, suicidal ideation was more common among those who became either full-time (OR 2.33, 95% CI 1.09-4.99, P=0.029) or part-time (OR 3.94, 95% CI 1.46-10.64, P=0.007) precarious workers. Conclusions Our findings suggest that change in employment status from permanent to precarious employment may increase suicidal ideation among workers in South Korea.

Social media and suicide prevention: findings from a stakeholder survey

PubMed Central

ROBINSON, Jo; RODRIGUES, Maria; FISHER, Steve; BAILEY, Eleanor; HERRMAN, Helen

2015-01-01

Background Suicide is a leading cause of death, particularly among young adults. The rapid growth of social media and its heavy use by young adults presents new challenges and opportunities for suicide prevention. Social media sites are commonly used for communicating about suicide-related behavior with others, which raises the possibility of using social media to help prevent suicide. However, the use of social media varies widely between different suicide prevention advocates. The role this type of intervention should play in a community’s overall suicide prevention strategy remains a matter of debate. Aim Explore the ways in which stakeholders use social media for suicide prevention and assess their views about the potential utility of social media as a suicide prevention tool. Methods A 12-week stakeholder consultation that involved the online administration and completion of surveys by 10 individuals who conduct research about suicide and social media, 13 organizations that use social media for suicide prevention purposes, and 64 users of social media. Results Social media was seen as a useful means of delivering a range of suicide prevention activities. Respondents reported that the key benefits of social media were the opportunity to obtain emotional support from others, to express one’s feelings, to talk to others with similar problems, and to provide help to others. The social media site believed to hold most potential for delivering suicide prevention activities was Facebook. There were concerns about potential risks of social media, but respondents felt the potential benefits outweighed the risks. Conclusions Social media was recognized by different types of stakeholders as holding potential for delivering suicide prevention activities. More research is required to establish the efficacy and safety of potential social media-based interventions and ethical standards and protocols to ensure that such interventions are delivered safely need to be developed and implemented. PMID:25852253

Recent Suicidal Ideation among Patients in an Inner City Emergency Department

ERIC Educational Resources Information Center

Ilgen, Mark A.; Walton, Maureen A.; Cunningham, Rebecca M.; Barry, Kristen L.; Chermack, Steve T.; De Chavez, Peter; Blow, Frederic C.

2009-01-01

The rates and associated features of suicidal ideation among 5,641 patients seeking routine, nonsuicide related care in an inner-city emergency department were examined. Approximately 8% of patients seeking routine care in the emergency department reported some form of suicidal ideation within the past 2 weeks. Suicidal ideation was common in…

Suicide among Police in a Federal Force.

ERIC Educational Resources Information Center

Loo, Robert

1986-01-01

Reports the results of a study of suicide among 35 members of the Royal Canadian Mounted Police. The average annual rate (14.1 per 100,000) of suicide in this force was approximately one-half that of the comparable general population, and the most common means of suicide was by service revolver (77% of cases).

Genome-Wide Association Study of Suicide Attempts in Mood Disorder Patients

PubMed Central

Perlis, Roy H.; Huang, Jie; Purcell, Shaun; Fava, Maurizio; Rush, A. John; Sullivan, Patrick F.; Hamilton, Steven P.; McMahon, Francis J.; Schulze, Thomas; Potash, James B.; Zandi, Peter P.; Willour, Virginia L.; Penninx, Brenda W.; Boomsma, Dorret I.; Vogelzangs, Nicole; Middeldorp, Christel M.; Rietschel, Marcella; Nöthen, Markus; Cichon, Sven; Gurling, Hugh; Bass, Nick; McQuillin, Andrew; Hamshere, Marian; Craddock, Nick; Sklar, Pamela; Smoller, Jordan W.

2013-01-01

Objective Family and twin studies suggest that liability for suicide attempts is heritable and distinct from mood disorder susceptibility. The authors therefore examined the association between common genomewide variation and lifetime suicide attempts. Method The authors analyzed data on lifetime suicide attempts from genomewide association studies of bipolar I and II disorder as well as major depressive disorder. Bipolar disorder subjects were drawn from the Systematic Treatment Enhancement Program for Bipolar Disorder cohort, the Wellcome Trust Case Control Consortium bipolar cohort, and the University College London cohort. Replication was pursued in the NIMH Genetic Association Information Network bipolar disorder project and a German clinical cohort. Depression subjects were drawn from the Sequential Treatment Alternatives to Relieve Depression cohort, with replication in the Netherlands Study of Depression and Anxiety/Netherlands Twin Register depression cohort. Results Strongest evidence of association for suicide attempt in bipolar disorder was observed in a region without identified genes (rs1466846); five loci also showed suggestive evidence of association. In major depression, strongest evidence of association was observed for a single nucleotide polymorphism in ABI3BP, with six loci also showing suggestive association. Replication cohorts did not provide further support for these loci. However, meta-analysis incorporating approximately 8,700 mood disorder subjects identified four additional regions that met the threshold for suggestive association, including the locus containing the gene coding for protein kinase C-epsilon, previously implicated in models of mood and anxiety. Conclusions The results suggest that inherited risk for suicide among mood disorder patients is unlikely to be the result of individual common variants of large effect. They nonetheless provide suggestive evidence for multiple loci, which merit further investigation. PMID:21041247

A STUDY OF HOPELESSNESS, SUICIDAL INTENT AND DEPESSION IN CASES OF ATTEMPTED SUICIDE

PubMed Central

Jain, V.; Singh, H.; Gupta, S.C.; Kumar, S.

1999-01-01

The aim of the present study was to determine the severity and relationship of depression, hopelessness & sucide intent in individuals attempting suicides. Individuals admitted to a northern India hospital emergency services between 1st Jan. ′94 to 31st Dec. ′94 with suicide attempt were taken up for study and assessed with the help of different tools. 79 patients were screened for the study and 56 patients were included (33 male & 23 female). Majority of the sample was below 30 years of age (82.1%). Organophosphorus consumption and drug overdose was most common (75%) psychiatric illness was present in 57% cases, depression being most common 37.5% (p< 0.001) 22 subjects showed mild to moderate suicide intent (39.28%) & 16% subjects showed hopelessness score above 9. Variables taken up for the study have a highly significan correlation with each other i.e. suicidal intent, hopelessness and depression. PMID:21455374

Commentary: Homicide-suicide in older adults--cultural and contextual perspectives.

PubMed

Bell, Carl C; McBride, Dominica F

2010-01-01

The authors comment on "Domestic Homicide and Homicide-Suicide: The Older Offender" by Bourget et al., who learned that after a domestic homicide in Canada, the older offender frequently commits suicide. The authors comment on the ubiquity of single homicide-suicide across cultures, the incidence of single homicide-suicide in various cultures, the common patterns and differences in single homicide-suicides across cultures, ethnic and gender differences in single homicide-suicide within different cultures, characteristics of the phenomenon of mass murder followed by suicide and ethnic differences within this type of homicide-suicide, and differences in suicidal patterns in different cultures. Suicide and suicide preceded by homicide (single or multiple) are so rare, it is currently impossible to draw any substantive conclusions about the incidence of these phenomena in various contexts; however, ideas for consideration in addressing homicide-suicide are provided.

Decrease in Suicide Rates after a Change of Policy Reducing Access to Firearms in Adolescents: A Naturalistic Epidemiological Study

ERIC Educational Resources Information Center

Lubin, Gad; Werbeloff, Nomi; Halperin, Demian; Shmushkevitch, Mordechai; Weiser, Mark; Knobler, Haim Y.

2010-01-01

The use of firearms is a common means of suicide. We examined the effect of a policy change in the Israeli Defense Forces reducing adolescents' access to firearms on rates of suicide. Following the policy change, suicide rates decreased significantly by 40%. Most of this decrease was due to decrease in suicide using firearms over the weekend.…

Blurred Boundaries - A Qualitative Study of How Acts of Self-Harm and Attempted Suicide Are Defined by Mental Health Practitioners.

PubMed

James, Karen; Stewart, Duncan

2017-11-29

There is no commonly accepted definition of the term self-harm, and there is an ongoing debate about whether or not it should include acts of attempted suicide. The use of this language in clinical practice has not previously been explored. To investigate if, and how, practitioners distinguish between acts of self-harm and attempted suicide, and present any implications for practice. We conducted semistructured interviews with a random sample of 18 frontline practitioners from 10 mental health wards and completed a thematic analysis of interview data. Most participants described self-harm and attempted suicide as distinct behaviors. Characteristics of the act, disclosures of intent, and the level of distress observed were commonly used to differentiate between self-harm and attempted suicide. Very few participants believed that people who self-harm may also feel suicidal. Practitioners confidently described two different behaviors, yet self-harm and attempted suicide were often conflated, revealing the challenges and complexities associated with the separation of these acts in clinical practice. Clinicians working in other settings or disciplines may have different views. Participants' accounts may not be an accurate representation of what happens in practice. This study adds to a body of evidence which argues against the dichotomous separation of these behaviors into acts of suicidal and nonsuicidal self-harm.Our findings suggest there is no common understanding of the boundaries between self-harm and attempted suicide among frontline clinicians. The language currently used, and consequent practice, particularly with regard to risk assessment, is problematic. Efforts should be made to operationalize terms around suicidal behavior and to incorporate these into training for clinical staff.

Risk factors and study designs used in research of youths' suicide behaviour-an epidemiological discussion with focus on level of evidence.

PubMed

Christiansen, Erik; Larsen, Kim Juul; Agerbo, Esben; Bilenberg, Niels; Stenager, Elsebeth

2014-11-01

Abstract Introduction: Many different epidemiology study designs have been used to analyse risk factors for suicide behaviour. The purpose of this study was to obtain an insight into the current study design used in research on youths' risk factors for suicide behaviour and to rank the studies according to level of evidence (LoE). We searched PubMed and psycINFO in order to identify relevant individual studies. We included 36 studies of children and youth on suicidal behaviour and ideation-many rank low on LoE. For suicide, cohort design was often used, and mental illness (depression, substance abuse and severity of mental illness) was the most common risk factor. Cohort studies are ranked 2b, which is high according to LoE. For suicide attempts, survey was often used, and psychopathology, substance abuse and being exposed to suicidal behaviour were the most common risk factors. For suicidal ideation, survey was the only design used, and substance abuse and psychopathology the most common risk factors. Surveys are ranked 4, which are low according to LoE. Many risk factors were broad and unspecific, and standard definitions of outcome and exposure were rarely used. A good study of risk factors for suicidal behaviour would need a high LoE, as a high-powered longitudinal epidemiological study (cohort or case-control) of very specific risk factors. The factors would have high prevention potential, compared with more broad and unspecific risk factors, to which many people are exposed. We would recommend a cohort design (in high-risk populations) or a case-control design to identify risk factors, using clinical and/or register data instead of self-reported information, reporting adjusted estimates and using standard definition of suicidal outcome and risk factors.

What Are Reasons for the Large Gender Differences in the Lethality of Suicidal Acts? An Epidemiological Analysis in Four European Countries

PubMed Central

Heinrichs, Katherina; Székely, András; Tóth, Mónika Ditta; Coyne, James; Quintão, Sónia; Arensman, Ella; Coffey, Claire; Maxwell, Margaret; Värnik, Airi; van Audenhove, Chantal; McDaid, David; Sarchiapone, Marco; Schmidtke, Armin; Genz, Axel; Gusmão, Ricardo; Hegerl, Ulrich

2015-01-01

Background In Europe, men have lower rates of attempted suicide compared to women and at the same time a higher rate of completed suicides, indicating major gender differences in lethality of suicidal behaviour. The aim of this study was to analyse the extent to which these gender differences in lethality can be explained by factors such as choice of more lethal methods or lethality differences within the same suicide method or age. In addition, we explored gender differences in the intentionality of suicide attempts. Methods and Findings Methods. Design: Epidemiological study using a combination of self-report and official data. Setting: Mental health care services in four European countries: Germany, Hungary, Ireland, and Portugal. Data basis: Completed suicides derived from official statistics for each country (767 acts, 74.4% male) and assessed suicide attempts excluding habitual intentional self-harm (8,175 acts, 43.2% male). Main Outcome Measures and Data Analysis. We collected data on suicidal acts in eight regions of four European countries participating in the EU-funded “OSPI-Europe”-project (www.ospi-europe.com). We calculated method-specific lethality using the number of completed suicides per method * 100 / (number of completed suicides per method + number of attempted suicides per method). We tested gender differences in the distribution of suicidal acts for significance by using the χ2-test for two-by-two tables. We assessed the effect sizes with phi coefficients (φ). We identified predictors of lethality with a binary logistic regression analysis. Poisson regression analysis examined the contribution of choice of methods and method-specific lethality to gender differences in the lethality of suicidal acts. Findings Main Results Suicidal acts (fatal and non-fatal) were 3.4 times more lethal in men than in women (lethality 13.91% (regarding 4106 suicidal acts) versus 4.05% (regarding 4836 suicidal acts)), the difference being significant for the methods hanging, jumping, moving objects, sharp objects and poisoning by substances other than drugs. Median age at time of suicidal behaviour (35–44 years) did not differ between males and females. The overall gender difference in lethality of suicidal behaviour was explained by males choosing more lethal suicide methods (odds ratio (OR) = 2.03; 95% CI = 1.65 to 2.50; p < 0.000001) and additionally, but to a lesser degree, by a higher lethality of suicidal acts for males even within the same method (OR = 1.64; 95% CI = 1.32 to 2.02; p = 0.000005). Results of a regression analysis revealed neither age nor country differences were significant predictors for gender differences in the lethality of suicidal acts. The proportion of serious suicide attempts among all non-fatal suicidal acts with known intentionality (NFSAi) was significantly higher in men (57.1%; 1,207 of 2,115 NFSAi) than in women (48.6%; 1,508 of 3,100 NFSAi) (χ2 = 35.74; p < 0.000001). Main limitations of the study Due to restrictive data security regulations to ensure anonymity in Ireland, specific ages could not be provided because of the relatively low absolute numbers of suicide in the Irish intervention and control region. Therefore, analyses of the interaction between gender and age could only be conducted for three of the four countries. Attempted suicides were assessed for patients presenting to emergency departments or treated in hospitals. An unknown rate of attempted suicides remained undetected. This may have caused an overestimation of the lethality of certain methods. Moreover, the detection of attempted suicides and the registration of completed suicides might have differed across the four countries. Some suicides might be hidden and misclassified as undetermined deaths. Conclusions Men more often used highly lethal methods in suicidal behaviour, but there was also a higher method-specific lethality which together explained the large gender differences in the lethality of suicidal acts. Gender differences in the lethality of suicidal acts were fairly consistent across all four European countries examined. Males and females did not differ in age at time of suicidal behaviour. Suicide attempts by males were rated as being more serious independent of the method used, with the exceptions of attempted hanging, suggesting gender differences in intentionality associated with suicidal behaviour. These findings contribute to understanding of the spectrum of reasons for gender differences in the lethality of suicidal behaviour and should inform the development of gender specific strategies for suicide prevention. PMID:26147965

Death and suicide among former child and adolescent psychiatric patients

PubMed Central

Engqvist, Ulf; Rydelius, Per-Anders

2006-01-01

Background Increased mortality rates among previous child and adolescent psychiatry (CAP) patients have been found in Scandinavian studies up to the 1980s. The suicide risk in this group has been estimated to be almost five times higher than expected. This article addresses two questions: Do Swedish CAP patients continue to risk premature death and what kind of information related to psychiatric symptoms and/or behavior problems can predict later suicide? Methods Hospital files, Sweden's census databases (including immigration and emigration) and administrative databases (including the Swedish Hospital Discharge register and the Persons Convicted of Offences register), and the Cause of Death register were examined to determine the mortality rate in a group of 1,400 former CAP inpatients and outpatients over a period of 12–33 years. Observed and expected numbers of deceased were calculated with the prospective method and the standardized mortality ratio (SMR) method. The relative risk or the risk ratio (RR) is presented with 95% confidence intervals (CIs). Significance level tests were made using two-by-two tables and chi-square tests. The Cox proportional-hazards regression model was used for survival analysis. Results Twenty-four males and 14 females died. Compared with the general population, the standardized mortality ratio in this group of CAP patients was significantly higher in both sexes. Behavioral problems, school problems, and co-morbid alcohol or drug abuse and criminality (including alcohol-related crimes) were found to be important predictors. Thirty-two deaths were attributed to suicide, intoxication, drug overdose, or accident; one patient died of an alcohol abuse-related disorder, and five patients died of natural causes. Suicide was the most common cause of death, but only 2 of these 19 cases were initially admitted for attempted suicide. Conclusion We suggest that suicide and death prevention among CAP patients may not be a psychiatric issue per se but a future function of society's juvenile social-welfare investments and juvenile-delinquency prevention programs. PMID:17081290

Newspaper reporting and the emergence of charcoal burning suicide in Taiwan: A mixed methods approach.

PubMed

Chen, Ying-Yeh; Tsai, Chi-Wei; Biddle, Lucy; Niederkrotenthaler, Thomas; Wu, Kevin Chien-Chang; Gunnell, David

2016-03-15

It has been suggested that extensive media reporting of charcoal burning suicide was a key factor in the rapid spread of this novel method in many East Asian countries. But very few empirical studies have explored the relationship between media reporting and the emergence of this new method of suicide. We investigated the changing pattern of media reporting of charcoal burning suicides in Taiwan during 1998-2002 when this method of suicide increased most rapidly, assessing whether the characteristics of media reporting were associated with the changing incidence of suicide using this method. A mixed method approach, combining quantitative and qualitative analysis of newspaper content during 1998-2002 was used. We compared differences in reporting characteristics before and after the rapid increase in charcoal burning suicide. Point-biserial and Pearson correlation coefficients were calculated to quantify the associations between the media item content and changes in suicide rates. During the period when charcoal burning suicide increased rapidly, the number of reports per suicide was considerably higher than during the early stage (0.31 vs. 0.10). Detailed reporting of this new method was associated with a post-reporting increase in suicides using the method. Qualitative analysis of news items revealed that the content of reports of suicide by charcoal burning changed gradually; in the early stages of the epidemic (1999-2000) there was convergence in the terminology used to report charcoal burning deaths, later reports gave detailed descriptions of the setting in which the death occurred (2001) and finally the method was glamourized and widely publicized (2001-2002). Our analysis was restricted to newspaper reports and did not include TV or the Internet. Newspaper reporting was associated with the evolution and establishment of charcoal burning suicide. Working with media and close monitoring of changes in the incidence of suicide using a new method might help prevent a suicide epidemic such as charcoal burning suicide seen in Taiwan. Copyright © 2016 Elsevier B.V. All rights reserved.

Secondary combined suicide pact.

PubMed

Jayanth, S H; Girish Chandra, Y P; Hugar, Basappa S; Kainoor, Sunilkumar

2014-03-01

This article reports a combined suicide pact, where in a young couple; a 26 year old male and a 20 year old female committed suicide by using two methods. The couple had resorted to hanging and self-immolation to prevent failure of single method alone. In secondary combined suicides, several other methods of suicide are tried after the first method chosen has failed. It is primary combined suicide only when two or more methods are used simultaneously. Both types of combined suicide by one individual is well reported in the literature whereas the same by two persons together is rare. In this report, the deceased were disappointed lovers, poor and the family members were against their marriage. The investigation of scene, methods employed to commit suicide, autopsy findings and the interview with their relatives altogether suggested that it was a secondary combined suicide pact. Copyright © 2014 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

The Power of the Web: A Systematic Review of Studies of the Influence of the Internet on Self-Harm and Suicide in Young People

PubMed Central

Daine, Kate; Hawton, Keith; Singaravelu, Vinod; Stewart, Anne; Simkin, Sue; Montgomery, Paul

2013-01-01

Background There is concern that the internet is playing an increasing role in self-harm and suicide. In this study we systematically review and analyse research literature to determine whether there is evidence that the internet influences the risk of self-harm or suicide in young people. Methods An electronic literature search was conducted using the PsycINFO, MEDLINE, EMBASE, Scopus, and CINAHL databases. Articles of interest were those that included empirical data on the internet, self-harm or suicide, and young people. The articles were initially screened based on titles and abstracts, then by review of the full publications, after which those included in the review were subjected to data extraction, thematic analysis and quality rating. Results Youth who self-harm or are suicidal often make use of the internet. It is most commonly used for constructive reasons such as seeking support and coping strategies, but may exert a negative influence, normalising self-harm and potentially discouraging disclosure or professional help-seeking. The internet has created channels of communication that can be misused to ‘cyber-bully’ peers; both cyber-bullying and general internet use have been found to correlate with increased risk of self-harm, suicidal ideation, and depression. Correlations have also been found between internet exposure and violent methods of self-harm. Conclusions Internet use may exert both positive and negative effects on young people at risk of self-harm or suicide. Careful high quality research is needed to better understand how internet media may exert negative influences and should also focus on how the internet might be utilised to intervene with vulnerable young people. PMID:24204868

HPA axis hyperactivity and attempted suicide in young adult mood disorder inpatients.

PubMed

Jokinen, Jussi; Nordström, Peter

2009-07-01

Hyperactivity of the Hypothalamic-Pituitary-Adrenal (HPA) axis is a consistent finding in Major Depressive Disorder (MDD) and most prospective studies of HPA-axis function have found that non-suppressors in the dexamethasone suppression test (DST) are more likely to commit suicide during follow-up. The results of studies on HPA-axis function and attempted suicide are less consistent. Suicide attempts are more common among young people than the elderly, whereas suicide is more common among the elderly. The impact of age related changes in HPA-axis system activity in relation to suicidal behaviour across the lifecycle may be of importance. The aim of the present study was to investigate the DST results in 36 young adult (30 years or younger) inpatients with mood disorder, with (n=18) and without suicide attempt at the index episode. The DST non-suppressor rate was 25% among young mood disorder inpatients. DST non-suppression was associated with suicide attempt and post-dexamethasone serum cortisol at 11:00 p.m. was significantly higher in suicide attempters compared to non-attempters. The DST non-suppressor rate was 39% in young adult suicide attempters compared with 11% in non-attempters. The results add to previous evidence in support of the role of HPA axis hyperactivity and suicidal behaviour. The present findings motivate to include HPA axis measures in the assessment of depression in young adults.

Restrictions in Means for Suicide: An Effective Tool in Preventing Suicide: The Danish Experience

ERIC Educational Resources Information Center

Nordentoft, Merete; Qin, Ping; Helweg-Larsen, Karin

2007-01-01

Restriction of means for suicide is an important part of suicide preventive strategies in different countries. The effect on method-specific suicide rate and overall suicide rate of restrictions on availability of carbon monoxide, barbiturates, and dextropropoxyphene was examined. From 1970 to 2000, overall suicide mortality and method-specific…

[Suicide reporting in German print and online media for adolescents in Austria and possible effects on suicide prevalence].

PubMed

Eisenwort, Brigitte; Hermann, André; Till, Benedikt; Niederkrotenthaler, Thomas

2012-07-01

We analyzed the quality of suicide reporting in youth magazines and assessed potential copycat effects following media reports on suicide. We obtained suicide-related articles from five Austrian and German youth magazines published between 1996 and 2008. Reported sex, suicide (attempt) methods, suicide motives, the portrayal of suicide in a positive or negative light, accusations of blame and consistency with media recommendations for the reporting of suicide were analysed using qualitative content analysis. The suicide frequency among adolescents in Austria was compared 2 weeks before and after the publication of reports on suicide and suicide attempts. 59 articles were identified, most of which had been published in the magazine Bravo. There was an overrepresentation of suicide among girls and an underrepresentation of attempted suicide. The frequency of specific suicide and suicide attempt methods was consistent with epidemiological distributions of suicide methods. Fall from height was most frequently described for girls and hanging for boys. Regarding motives for suicide, factors like psychiatric diseases were underrepresented. Girls who died by suicide were often positively described in articles, but boys were more often negatively described. Parents were frequently blamed as being guilty of their child's suicidal behaviour, in particular when reporting on suicide attempts. Photos, suicide notes and details concerning method were frequently described. There was no indication of a Werther effect following reporting. The identified discrepancies between epidemiologic data regarding suicidal behaviour in adolescents and media reporting in youth media constitutes an important basis for suicide prevention in the community.

Depression and African Americans

MedlinePlus

... in daily life and can even lead to suicide. A common myth about depression is that it is “normal” for certain people ... making decisions Thoughts of death or suicide, or suicide attempts ... depression are with antidepressant medication, psychotherapy, or a combination ...

Suicide methods in children and adolescents.

PubMed

Kõlves, Kairi; de Leo, Diego

2017-02-01

There are notable differences in suicide methods between countries. The aim of this paper is to analyse and describe suicide methods in children and adolescents aged 10-19 years in different countries/territories worldwide. Suicide data by ICD-10 X codes were obtained from the WHO Mortality Database and population data from the World Bank. In total, 101 countries or territories, have data at least for 5 years in 2000-2009. Cluster analysis by suicide methods was performed for countries/territories with at least 10 suicide cases separately by gender (74 for males and 71 for females) in 2000-2009. The most frequent suicide method was hanging, followed by poisoning by pesticides for females and firearms for males. Cluster analyses of similarities in the country/territory level suicide method patterns by gender identified four clusters for both gender. Hanging and poisoning by pesticides defined the clusters of countries/territories by their suicide patterns in youth for both genders. In addition, a mixed method and a jumping from height cluster were identified for females and two mixed method clusters for males. A number of geographical similarities were observed. Overall, the patterns of suicide methods in children and adolescents reflect lethality, availability and acceptability of suicide means similarly to country specific patterns of all ages. Means restriction has very good potential in preventing youth suicides in different countries. It is also crucial to consider cognitive availability influenced by sensationalised media reporting and/or provision of technical details about specific methods.

The Need for and Acceptance of a Suicide Postvention Support Service for Australian Secondary Schools

ERIC Educational Resources Information Center

Rickwood, Debra; Telford, Nic; Kennedy, Vanessa; Bailey, Eleanor

2018-01-01

Suicide-related behaviours are relatively common among school-aged young people, and schools are an appropriate setting for activities that aim to prevent and assist recovery after suicide. headspace School Support is a specialist service that assists Australian secondary schools to be prepared for and recover from suicide. Through the responses…

Associations between Delinquency and Suicidal Behaviors in a Nationally Representative Sample of Adolescents

ERIC Educational Resources Information Center

Thompson, Martie P.; Kingree, J. B.; Ho, Ching-hua

2006-01-01

Suicide was the second leading cause of death for 14-17 years olds in 2002. Prior studies indicate that suicidal behaviors are especially common among juvenile delinquents, yet this association has not been examined in a national sample. The 2003 Youth Risk Behavior Surveillance System was used to examine associations between suicidal behaviors…

Personality Correlates of People Who Have Attempted Suicide and Those Who Have Seriously Considered It.

ERIC Educational Resources Information Center

Kaminsky, Sarah; Chrisler, Joan C.

Depression and low self-esteem are commonly considered to be at the root of suicidal ideation. Previous research has examined the correlations between a lack of purpose in life and depression, low self-esteem, substance abuse and suicidal thoughts. This study investigated personality differences among student groups who have attempted suicide.…

Psychache and Suicide Ideation among Men Who Are Homeless: A Test of Shneidman's Model

ERIC Educational Resources Information Center

Patterson, Allisha A.; Holden, Ronald R.

2012-01-01

Suicide ideation among the homeless is 10 times more common than in the general population. Cognitive theories of depression and hopelessness propose to explain suicidality; however, as yet, none of these fully account for the phenomenon. Shneidman has suggested a theory of psychache or unbearable psychological pain to explain suicidality. This…

An observational study of bullying as a contributing factor in youth suicide in Toronto.

PubMed

Sinyor, Mark; Schaffer, Ayal; Cheung, Amy H

2014-12-01

Bullying has been identified as a potential contributing factor in youth suicide. This issue has been highlighted in recent widely publicized media reports, worldwide, in which deceased youth were bullied. We report on an observational study conducted to determine the frequency of bullying as a contributing factor to youth suicide. Coroner records were reviewed for all suicide deaths in youth aged between 10 and 19 in the city of Toronto from 1998 to 2011. Data abstracted were recent stressors (including bullying), clinical variables, such as the presence of mental illness, demographics, and methods of suicide. Ninety-four youth suicides were included in the study. The mean age was 16.8 years, and 70.2% were male. Bullying was present in 6 deaths (6.4%), and there were no deaths where online or cyberbullying was detected. Bullying was the only identified contributing factor in fewer than 5 deaths. The most common stressors identified were conflict with parents (21.3%), romantic partner problems (17.0%), academic problems (10.6%), and criminal and (or) legal problems (10.6%). Any stressor or mental and (or) physical illness was detected in 78.7% of cases. Depression was detected in 40.4% of cases. Our study highlights the need to view suicide in youth as arising from a complex interplay of various biological, psychological, and social factors of which bullying is only one. It challenges simple cause-and-effect models that may suggest that suicide arises from anyone factor, such as bullying.

A test for mental capacity to request assisted suicide.

PubMed

Stewart, Cameron; Peisah, Carmelle; Draper, Brian

2011-01-01

The mental competence of people requesting aid-in-dying is a key issue for the how the law responds to cases of assisted suicide. A number of cases from around the common law world have highlighted the importance of competence in determining whether assistants should be prosecuted, and what they will be prosecuted for. Nevertheless, the law remains uncertain about how competence should be tested in these cases. This article proposes a test of competence that is based on the existing common law but which is tailored to cases of assisted suicide. The test will help doctors, other health professionals and lawyers determine whether the suicidal person was able to competently request assistance. Such knowledge will help to reduce some of the current uncertainty about criminal liability in cases of assisted suicide.

Recent cohort effects in suicide in Scotland: a legacy of the 1980s?

PubMed Central

Parkinson, Jane; Lewsey, James; Bouttell, Janet; McCartney, Gerry

2017-01-01

Background Mortality rates are higher in Scotland relative to England and Wales, even after accounting for deprivation. This ‘excess’ mortality is partly due to higher mortality from alcohol-related and drug-related deaths, violence and suicide (particularly in young adults). This study investigated whether cohort effects from exposure to neoliberal politics from the 1980s might explain the recent trends in suicide in Scotland. Methods We analysed suicide deaths data from 1974 to 2013 by sex and deprivation using shaded contour plots and intrinsic estimator regression modelling to identify and quantify relative age, period and cohort effects. Results Suicide was most common in young adults (aged around 25–40 years) living in deprived areas, with a younger peak in men. The peak age for suicide fell around 1990, especially for men for whom it dropped quickly from around 50 to 30 years. There was evidence of an increased risk of suicide for the cohort born between 1960 and 1980, especially among men living in the most deprived areas (of around 30%). The cohort at highest risk occurred earlier in the most deprived areas, 1965–1969 compared with 1970–1974. Conclusions The risk of suicide increased in Scotland for those born between 1960 and 1980, especially for men living in the most deprived areas, which resulted in a rise in age-standardised rates for suicide among young adults during the 1990s. This is consistent with the hypothesis that exposure to neoliberal politics created a delayed negative health impact. PMID:27485053

Suicidal ideation among students of a medical college in Western Nepal: a cross-sectional study.

PubMed

Menezes, Ritesh G; Subba, S H; Sathian, Brijesh; Kharoshah, Magdy A; Senthilkumaran, Subramanian; Pant, Sadip; Arun, M; Kundapur, Rashmi; Jain, Animesh; Lobo, Stany Wilfred; Ravi Shankar, P

2012-07-01

Many studies have been conducted in the developed countries to know the magnitude and factors influencing suicidal ideation among medical students, but such data are sparse in developing countries. This cross-sectional study was therefore conducted to find out the prevalence of suicidal ideation and factors influencing such ideation among students of a medical college in Western Nepal. A total of 206 students were selected using random sampling and questioned about their socio-demographic factors, other risk factors and suicidal ideation using a preformed validated questionnaire. The data were analyzed using SPSS for Windows Version 16.0 and the EPI Info 3.5.1 Windows Version. Descriptive statistics and testing of hypothesis were applied for the statistical methodology. The univariate and multivariate logistic regression methods were used to examine the association between different variables. Suicidal ideation in the last one year was present in nearly one tenth of the study population and in almost one fifth of them life-time suicidal ideation was present. Factors that were associated with suicidal ideation were primarily dissatisfaction with academic performance, being in the clinical semesters, having history of drug abuse and feeling neglected by parents. Most common reason reported for suicidal ideation was family related followed by self-related. Recognition of suicidal ideation among students and their associated factors can help in detecting it on time, making the right interventions and controlling the problem. Understanding the magnitude of the problem and their epidemiology via scientific study like this would be the first step in this process. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

An Analysis of Depression, Self-Harm, and Suicidal Ideation Content on Tumblr

PubMed Central

Cavazos-Rehg, Patricia A.; Krauss, Melissa J.; Sowles, Shaina J.; Connolly, Sarah; Rosas, Carlos; Bharadwaj, Meghana; Grucza, Richard; Bierut, Laura J.

2016-01-01

Background Social networking about depression can be indicative of self-reported depression and/or can normalize risk behaviors such as self-harm and suicidal ideation. Aim To gain a better understanding of the depression, self-harm, and suicidal content that is being shared on Tumblr. Method From April 16 to May 10, 2014, 17 popular depression-related Tumblr accounts were monitored for new posts and engagement with other Tumblr users. A total of 3,360 posts were randomly selected from all historical posts from these accounts and coded based on themes ascertained by the research team. Results The 17 Tumblr accounts posted a median number of 185 posts (range = 0–2,954). Content was engaged with (i.e., re-blogged or liked) a median number of 1,677,362 times (range = 0–122,186,504). Of the 3,360 randomly selected posts, 2,739 (82%) were related to depression, suicide, or self-harm. Common themes were self-loathing (412, 15%), loneliness/feeling unloved (405, 15%), self-harm (407, 15%), and suicide (372, 14%). Conclusion This study takes an important first step at better understanding the displayed depression-related references on Tumblr. The findings signal a need for suicide prevention efforts to intervene on Tumblr and use this platform in a strategic way, given the depression and suicidal content that was readily observed on Tumblr. PMID:27445014

Can Intoxication Status Be Used as a Prediction Tool for Manner of Death?: A Comparison of the Intoxication Status in Violent Suicides and Homicides.

PubMed

Molina, D Kimberley; Hargrove, Veronica M

2017-03-01

Determining the manner of death in medicolegal death investigations can be difficult. The investigator relies on many facets of death investigation, including the circumstances of death and autopsy examination. A study was designed to analyze whether the intoxication status of the decedent could be used as another tool in death investigations. The intoxication status of violent (nonoverdose or poisoning) suicides and homicides was retrospectively reviewed and compared. A total of 625 deaths were identified, including 366 suicides and 259 homicides. Age, sex, cause of death, and intoxication status, including the specific drugs present, were analyzed. Gunshot wounds were the most common cause of death in both groups, with hanging being the second most common cause in suicides and sharp force injuries in homicides. Analysis found that although the overall intoxication status for suicides versus homicides did not differ significantly, certain drugs were more prevalent in one group over the other. Specifically, illicit drugs, that is, heroin, cocaine, and methamphetamine, were more likely to be present in homicides, whereas antidepressants or antipsychotics, benzodiazepines, and zolpidem were more common in suicides.

Understanding and preventing military suicide.

PubMed

Bryan, Craig J; Jennings, Keith W; Jobes, David A; Bradley, John C

2012-01-01

The continual rise in the U.S. military's suicide rate since 2004 is one of the most vexing issues currently facing military leaders, mental health professionals, and suicide experts. Despite considerable efforts to address this problem, however, suicide rates have not decreased. The authors consider possible reasons for this frustrating reality, and question common assumptions and approaches to military suicide prevention. They further argue that suicide prevention efforts that more explicitly embrace the military culture and implement evidence-based strategies across the full spectrum of prevention and treatment could improve success. Several recommendations for augmenting current efforts to prevent military suicide are proposed.

Acute Alcohol Intoxication and Suicide Among U.S. Ethnic/Racial Groups: Findings from the National Violent Death Reporting System

PubMed Central

Caetano, Raul; Kaplan, Mark S.; Huguet, Nathalie; McFarland, Bentson H.; Conner, Kenneth; Giesbrecht, Norman; Nolte, Kurt B.

2012-01-01

Background To assess the prevalence and sociodemographic correlates of suicide involving acute alcohol intoxication among U.S. ethnic minorities. Methods Data were derived from the restricted 2003–2009 National Violent Death Reporting System (NVDRS). The study focused on the sociodemographic and toxicological information of 59,384 male and female suicide decedents for 16 states of the U.S. Acute alcohol intoxication was defined as having a blood alcohol content (BAC) ≥ 0.08 g/dl. Overall, 76% of decedents were tested for the presence of alcohol. Results The proportion of suicide decedents with a positive BAC ranged from 47% among American Indians/Alaska Natives (AIs/ANs) to 23% among Asians/Pacific Islanders (PIs). Average BAC was highest among AIs/ANs. Among those who were tested for BAC, the proportion of decedents legally intoxicated prior to suicide was: Blacks, 15%; AIs/ANs, 36%; Asians/PIs, 13%; Hispanics, 28%. Bivariate associations showed that most suicide decedents who were legally intoxicated were male, younger than 30 years of age, with a high school education, not married, non-veterans, lived in metropolitan areas, and used a firearm to complete suicide. However, with the exception of Whites, most of these associations became not statistically significant in multivariate analysis. Conclusions Alcohol use and legal intoxication prior to completing suicide are common among U.S. ethnic groups, especially among males and those who are younger than 30 years of age. The AI/AN group had the highest mean BAC, the highest rate of legal intoxication and decedents who were particularly young. Suicide prevention strategies should address alcohol use as a risk factor. Alcohol problems prevention strategies should focus on suicide as a consequence of alcohol use, especially among AI/AN youth and young adults. PMID:23384174

Decision-making competence and attempted suicide

PubMed Central

Szanto, Katalin; Bruine de Bruin, Wändi; Parker, Andrew M; Hallquist, Michael N; Vanyukov, Polina M; Dombrovski, Alexandre Y

2015-01-01

Objective The propensity of people vulnerable to suicide to make poor life decisions is increasingly well documented. Do they display an extreme degree of decision biases? The present study used a behavioral decision approach to examine the susceptibility of low-lethality and high-lethality suicide attempters to common decision biases, which may ultimately obscure alternative solutions and deterrents to suicide in a crisis. Method We assessed older and middle-aged individuals who made high-lethality (medically serious; N=31) and low-lethality suicide attempts (N=29). Comparison groups included suicide ideators (N=30), non-suicidal depressed (N=53), and psychiatrically healthy participants (N=28). Attempters, ideators, and non-suicidal depressed participants had unipolar non-psychotic major depression. Decision biases included sunk cost (inability to abort an action for which costs are irrecoverable), framing (responding to superficial features of how a problem is presented), under/overconfidence (appropriateness of confidence in knowledge), and inconsistent risk perception. Data were collected between June of 2010 and February of 2014. Results Both high- and low-lethality attempters were more susceptible to framing effects, as compared to the other groups included in this study (p≤ 0.05, ηp2 =.06). In contrast, low-lethality attempters were more susceptible to sunk costs than both the comparison groups and high-lethality attempters (p≤ 0.01, ηp2 =.09). These group differences remained after accounting for age, global cognitive performance, and impulsive traits. Premorbid IQ partially explained group differences in framing effects. Conclusion Suicide attempters’ failure to resist framing may reflect their inability to consider a decision from an objective standpoint in a crisis. Low-lethality attempters’ failure to resist sunk-cost may reflect their tendency to confuse past and future costs of their behavior, lowering their threshold for acting on suicidal thoughts. PMID:26717535

Characteristics of homicide followed by suicide incidents in multiple states, 2003–04

PubMed Central

Bossarte, R M; Simon, T R; Barker, L

2006-01-01

Objective To calculate the prevalence of homicide followed by suicide (homicide/suicide) and provide contextual information on the incidents and demographic information about the individuals involved using data from a surveillance system that is uniquely equipped to study homicide/suicide. Methods Data are from the National Violent Death Reporting System (NVDRS). This active state‐based surveillance system includes data from seven states for 2003 and 13 states for 2004. The incident‐level structure facilitates identification of homicide/suicide incidents. Results Within participating states, 65 homicide/suicide incidents (homicide rate  =  0.230/100 000) occurred in 2003 and 144 incidents (homicide rate  =  0.238/100 000) occurred in 2004. Most victims (58%) were a current or former intimate partner of the perpetrator. Among all male perpetrators of intimate partner homicide 30.6% were also suicides. A substantial proportion of the victims (13.7%) were the children of the perpetrator. Overall, most victims (74.6%) were female and most perpetrators were male (91.9%). A recent history of legal problems (25.3%), or financial problems (9.3%) was common among the perpetrators. Conclusions The results support earlier research documenting the importance of intimate partner violence (IPV) and situational stressors on homicide/suicide. These results suggest that efforts to provide assistance to families in crisis and enhance the safety of IPV victims are needed to reduce risk for homicide/suicide. The consistency of the results from the NVDRS with those from past studies and the comprehensive information available in the NVDRS highlight the promise of this system for studying homicide/suicide incidents and for evaluating the impact of prevention policies and programs. PMID:17170169

Suicide within 12 months of contact with mental health services: national clinical survey

PubMed Central

Appleby, Louis; Shaw, Jenny; Amos, Tim; McDonnell, Ros; Harris, Catherine; McCann, Kerry; Kiernan, Katy; Davies, Sue; Bickley, Harriet; Parsons, Rebecca

1999-01-01

Objective To describe the clinical circumstances in which psychiatric patients commit suicide. Design National clinical survey. Setting England and Wales. Subjects A two year sample of people who had committed suicide, in particular those who had been in contact with mental health services in the 12 months before death. Main outcome measures Proportion of suicides in people who had had recent contact with mental health services; proportion of suicides in inpatients; proportion of people committing suicide and timing of suicide within three months of hospital discharge; proportion receiving high priority under the care programme approach; proportion who were recently non-compliant and not attending. Results 10 040 suicides were notified to the study between April 1996 and March 1998, of whom 2370 (24%; 95% confidence interval 23% to 24%) had had contact with mental health services in the year before death. Data were obtained on 2177, a response rate of 92%. In general these subjects had broad social and clinical needs. Alcohol and drug misuse were common. 358 (16%; 15% to 18%) were psychiatric inpatients at the time of death, 21% (17% to 25%) of whom were under special observation. Difficulties in observing patients because of ward design and nursing shortages were both reported in around a quarter of inpatient suicides. 519 (24%; 22% to 26%) suicides occurred within three months of hospital discharge, the highest number occurring in the first week after discharge. 914 (43%; 40% to 44%) were in the highest priority category for community care. 488 (26% excluding people whose compliance was unknown; 24% to 28%) were non-compliant with drug treatment while 486 (28%; 26% to 30%) community patients had lost contact with services. Most people who committed suicide were thought to have been at no or low immediate risk at the final service contact. Mental health teams believed suicide could have been prevented in 423 (22%; 20% to 24%) cases. Conclusions Several suicide prevention measures in mental health services are implied by these findings, including measures to improve compliance and prevent loss of contact with services. Inpatient facilities should remove structural difficulties in observing patients and fixtures that can be used in hanging. Prevention of suicide after discharge may require earlier follow up in the community. Better suicide prevention in psychiatric patients is likely to need measures to improve the safety of mental health services as a whole, rather than specific measures for people known to be at high risk. Key messagesAround a quarter of people who commit suicide have been in contact with mental health services in the year before death—over 1000 cases annuallyOf these cases, 16% are psychiatric inpatients and 24% have been discharged from inpatient care in the previous three monthsProblems of observation caused by ward design and nursing shortages are common in cases of inpatient suicideSuicide in former inpatients occurs most commonly in the week after dischargeNon-compliance with treatment and loss of contact with services are common before suicide PMID:10231250

Seasonality in Violent and Nonviolent Methods of Suicide Attempts: A Cross-Sectional Study on Systematic Registry Data.

PubMed

Veisani, Yousef; Delpisheh, Ali; Sayehmiri, Kourosh; Moradi, Ghobad; Hassanzadeh, Jafar

2017-08-01

Little attention has been paid to seasonality in suicide in Iran. Time pattern in suicide deaths and suicide attempts for some related factors such as gender, mental disorders has been found. In present study, we focus on suicide methods and the association with seasonality and other putative covariates such as gender. Through a cross-sectional study, overall identified suicide attempts and suicide deaths in the province of Ilam from 1 January 2010 and 31 December 2014 were enrolled. We used Edwards' test for test of seasonality in suicide methods. Seasonal effect (peak/trough seasons) and (deaths/attempts suicide) was explored by ratio statistics, the null hypothesis being that the attempted suicides in each method group are evenly distributed over a year. More suicide attempts by hanging 29.4% and self-immolation 41.4% were observed in spring and differ by season pattern in both genders. The overall distribution of suicides by violent and non-violent methods was (males x2=6.3, P=0.041, females x2=7.7, P=0.021) and (males x2=44.5, P=0.001, females x2=104.7, P=0.001), respectively. The peak and trough seasons was observed in taking medications and self-poisoning for spring and winter. Suicide with alcohol was no differ by season pattern (x2=1.0, P=0.460). Suicide in Ilam illustrates a significant seasonality for both violent and non-violent methods of suicide, in both genders, the two peaks were observed in spring and autumn for violent suicides, and spring and summer in non-violent suicides.

Suicidal Behavior Among Female Sex Workers in Goa, India: The Silent Epidemic

PubMed Central

Wayal, Sonali; Cowan, Frances; Mabey, David; Copas, Andrew; Patel, Vikram

2009-01-01

Objectives. We sought to study suicidal behavior prevalence and its association with social and gender disadvantage, sex work, and health factors among female sex workers in Goa, India. Methods. Using respondent-driven sampling, we recruited 326 sex workers in Goa for an interviewer-administered questionnaire regarding self-harming behaviors, sociodemographics, sex work, gender disadvantage, and health. Participants were tested for sexually transmitted infections. We used multivariate analysis to define suicide attempt determinants. Results. Nineteen percent of sex workers in the sample reported attempted suicide in the past 3 months. Attempts were independently associated with intimate partner violence (adjusted odds ratio [AOR] = 2.70; 95% confidence interval [CI] = 1.38, 5.28), violence from others (AOR = 2.26; 95% CI = 1.15, 4.45), entrapment (AOR = 2.76; 95% CI = 1.11, 6.83), regular customers (AOR = 3.20; 95% CI = 1.61, 6.35), and worsening mental health (AOR = 1.05; 95% CI = 1.01, 1.11). Lower suicide attempt likelihood was associated with Kannad ethnicity, HIV prevention services, and having a child. Conclusions. Suicidal behaviors among sex workers were common and associated with gender disadvantage and poor mental health. India's widespread HIV-prevention programs for sex workers provide an opportunity for community-based interventions against gender-based violence and for mental health services delivery. PMID:19443819

Murder followed by suicide: a newspaper surveillance study using the New York Times Index.

PubMed

Warren-Gordon, Kiesha; Byers, Bryan D; Brodt, Stephen J; Wartak, Melissa; Biskupski, Brian

2010-11-01

Murder–suicide is a relatively uncommon event but as reported by the New York Times, it has occurred and continues to occur yearly. Previous research has indicated that those who commit murder–suicides tend to be men, are in or have been in an intimate relationship with the victim, victims tend to be women, and a firearm is most likely to be used. This study uses a newspaper surveillance methodology to examine such cases. Articles from the New York Times as found in the New York Times Index were coded, analyzed, and examined. The cases, 166 in total, support the findings from prior research. The trend data was examined by cross tabulations and chi-square analysis. The findings suggest that murder–suicides are rare events and when they occur they usually involve a male perpetrator and an intimate partner victim who is either a wife or girlfriend with the event occurring in a private home. A firearm is the most commonly used method for both murders and suicides, particularly if there was more than one murder victim. The authors conclude by suggesting that future research should focus on using the forthcoming data resource in the CDC’s National Violent Death Reporting System (NVDRS) to examine the occurrence of murder–suicide.

Mental health difficulties and suicidal behaviours among young migrants: multicentre study of European adolescents

PubMed Central

Corcoran, Paul; Keeley, Helen; Cannon, Mary; Carli, Vladimir; Wasserman, Camilla; Sarchiapone, Marco; Apter, Alan; Balazs, Judit; Banzer, Raphaela; Bobes, Julio; Brunner, Romuald; Cozman, Doina; Haring, Christian; Kaess, Michael; Kahn, Jean-Pierre; Kereszteny, Agnes; Bitenc, Ursa Mars; Nemes, Bogdan; Poštuvan, Vita; Sáiz, Pilar A.; Sisask, Merike; Tubiana, Alexandra; Värnik, Peeter; Hoven, Christina W.; Wasserman, Danuta

2017-01-01

Background Migration has been reported to be associated with higher prevalence of mental disorders and suicidal behaviour. Aims To examine the prevalence of emotional and behavioural difficulties, suicidal ideation and suicide attempts among migrant adolescents and their non-migrant peers. Method A school-based survey was completed by 11 057 European adolescents as part of the Saving and Empowering Young Lives in Europe (SEYLE) study. Results A previous suicide attempt was reported by 386 (3.6%) adolescents. Compared with non-migrants, first-generation migrants had an elevated prevalence of suicide attempts (odds ratio (OR) 2.08; 95% CI 1.32–3.26; P=0.001 for European migrants and OR 1.86; 95% CI 1.06–3.27; P=0.031 for non-European migrants) and significantly higher levels of peer difficulties. Highest levels of conduct and hyperactivity problems were found among migrants of non-European origin. Conclusions Appropriate mental health services and school-based supports are required to meet the complex needs of migrant adolescents. Declaration of interest None. Copyright and usage © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license. PMID:29234521

Attitudes towards suicidal behaviour in outpatient clinics among mental health professionals in Oslo

PubMed Central

2013-01-01

Background To investigate attitudes of professionals working in mental health care outpatient clinics in Child and Adolescent Psychiatry (CAP) (for children and adolescents aged 0–18 years) and District Psychiatric Centres (DPC) (for adults aged 18–67 years). Methods Professionals in four outpatient units in Oslo were enrolled (n = 229: 77%). The Understanding of Suicidal Patient scale (USP) (11 = positive to 55 = negative) and Attitudes Towards Suicide questionnaire (ATTS) (1 = totally disagree to 5 = totally agree) were used to assess professionals’ attitudes. Questions explored competence, religion, experiences of and views on suicidal behaviour and its treatment. Results All the professionals indicated positive attitudes (USP 18.7) and endorsed the view that suicide was preventable (ATTS 4.3). Professionals who had received supervision or were specialists had attitudes that were more positive. Professionals in CAP were less satisfied with available treatment. Psychiatric disorders were considered the most common cause of suicidal behaviour, and psychotherapy the most appropriate form of treatment. The professionals confirmed that patients with other disorders of comparable severity are followed up more systematically. Conclusions The professionals showed positive attitudes with minor differences between CAP and DPC. PMID:23510325

Psychiatric comorbidity and its impact on mortality in patients who attempted suicide by paraquat poisoning during 2000-2010.

PubMed

Lin, Chemin; Yen, Tzung-Hai; Juang, Yeong-Yuh; Lin, Ja-Liang; Lee, Shwu-Hua

2014-01-01

Paraquat poisoning is a lethal method of suicide used around the world. Although restricting its accessibility had been widely discussed, the underlying psychopathological mechanism of paraquat self-poisoning and its association with mortality have not yet been explicitly evaluated. We included all patients admitted to a tertiary general hospital in Taiwan between 2000 and 2010 following a suicide attempt by paraquat self-administration. Diagnoses were made upon psychiatric consultation based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. The risk of mortality was calculated by logistic regression with various psychiatric or medical covariates. The consultation-liaison psychiatry team assessed 157 patients who attempted suicide by paraquat poisoning. Mood disorders (54.0%), including dysthymic (26.7%) and major depressive disorders (24.7%), were the most common psychiatric diagnoses among the self-poisoning patients. Among those who attempted suicide, 87 patients (58.0%) died and dysthymic disorder (OR = 5.58, 95% CI: 1.13-27.69; p < 0.05) significantly increased the mortality risk after adjustment for relevant medical variables, including age, gender, severity index of paraquat poisoning (SIPP), and risk for respiratory failure. Awareness of comorbid psychiatric illnesses, especially dysthymic disorder, is vital in the prevention and treatment of suicide by paraquat poisoning.

Sexual orientation differences in treatment expectation, alliance, and outcome among patients at risk for suicide in a public psychiatric hospital.

PubMed

Plöderl, Martin; Kunrath, Sabine; Cramer, Robert J; Wang, Jen; Hauer, Larissa; Fartacek, Clemens

2017-05-15

Sexual minority (SM) individuals (gay, lesbian, bisexual, or otherwise nonheterosexual) are at increased risk for mental disorders and suicide and adequate mental healthcare may be life-saving. However, SM patients experience barriers in mental healthcare that have been attributed to the lack of SM-specific competencies and heterosexist attitudes and behaviors on the part of mental health professionals. Such barriers could have a negative impact on common treatment factors such as treatment expectancy or therapeutic alliance, culminating in poorer treatment outcomes for SM versus heterosexual patients. Actual empirical data from general psychiatric settings is lacking, however. Thus, comparing the treatment outcome of heterosexual and SM patients at risk for suicide was the primary aim of this study. The secondary aim was to compare treatment expectation and working alliance as two common factors. We report on 633 patients from a suicide prevention inpatient department within a public psychiatric hospital. Most patients were at risk for suicide due to a recent suicide attempt or warning signs for suicide, usually in the context of a severe psychiatric disorder. At least one indicator of SM status was reported by 21% of patients. We assessed the treatment outcome by calculating the quantitative change in suicide ideation, hopelessness, and depression. We also ran related treatment responder analyses. Treatment expectation and working alliance were the assessed common factors. Contrary to the primary hypothesis, SM and heterosexual patients were comparable in their improvement in suicide ideation, hopelessness, or depression, both quantitatively and in treatment responder analysis. Contrary to the secondary hypothesis, there were no significant sexual orientation differences in treatment expectation and working alliance. When adjusting for sociodemographics, diagnosis, and length of stay, some sexual orientation differences became significant, indicating that SM patients have better outcomes. These unexpected but positive findings may be due to common factors of therapy compensating for SM-specific competencies. It may also be due to actual presence of SM competencies - though unmeasured - in the department. Replication in other treatment settings and assessment of SM-specific competencies are needed, especially in the field of suicide prevention, before these findings can be generalized.

'No suicide contracts' in community crisis situations: a conceptual analysis.

PubMed

Farrow, T L

2003-04-01

'No suicide contracts' are commonly used in community crisis situations with suicidal people in New Zealand. These take the form of a 'guarantee of safety', along with a 'promise' to call specified persons if the suicidal ideation becomes unmanageable. This article describes the use of 'no suicide contracts' in community crisis situations, analyses the use of the tool within this context, and, in particular, argues that the theoretical base (transactional analysis) of the 'no suicide contract' is likely to be deleterious in the community crisis situation.

Suicidal behavior and assisted suicide in dementia.

PubMed

Draper, Brian M

2015-10-01

Concerns about suicide risk in people with dementia have been increasing in recent years along with a discourse about rational suicide and assisted suicide. A systematic narrative literature review of suicidal behavior and assisted suicide in persons with dementia. Most studies that have examined the spectrum of suicidal ideation, attempted suicide and suicide in dementia have methodological limitations but the overall suicide risk does not appear to be increased. When suicidal behavior does occur, common themes include the presence of psychiatric comorbidity, mainly depression; occurrence early in the dementia course with preserved insight and capacity; and an increased risk in younger people. The emerging discourse on rational and assisted suicide has been spurred by early and pre-symptomatic diagnosis and poses a number of ethical challenges for clinicians including the role of proxy decision-makers. Although dementia might not confer a significant overall risk for suicidal behavior, clinicians still need to consider the potential for suicide in vulnerable individuals particularly early in the dementia course.

The newsworthiness of suicide.

PubMed

Pirkis, Jane; Burgess, Philip; Blood, R Warwick; Francis, Catherine

2007-06-01

There is a paucity of studies examining which suicides are considered news-worthy. By combining data on media reports of individuals' suicides with routinely collected suicide data, it was found that 1% of Australian suicides were reported over a 1-year period. There was evidence of over-reporting of suicides by older people and females, and those involving dramatic methods. Reported suicides fell into three groups: suicides reported in a broader context; suicides by celebrities; and suicides involving unusual circumstances/methods. The data suggest a need for media professionals and suicide experts to work together to balance newsworthiness against the risk of copycat behavior.

Suicide in Elementary School-Aged Children and Early Adolescents.

PubMed

Sheftall, Arielle H; Asti, Lindsey; Horowitz, Lisa M; Felts, Adrienne; Fontanella, Cynthia A; Campo, John V; Bridge, Jeffrey A

2016-10-01

Suicide in elementary school-aged children is not well studied, despite a recent increase in the suicide rate among US black children. The objectives of this study were to describe characteristics and precipitating circumstances of suicide in elementary school-aged children relative to early adolescent decedents and identify potential within-group racial differences. We analyzed National Violent Death Reporting System (NVDRS) surveillance data capturing suicide deaths from 2003 to 2012 for 17 US states. Participants included all suicide decedents aged 5 to 14 years (N = 693). Age group comparisons (5-11 years and 12-14 years) were conducted by using the χ 2 test or Fisher's exact test, as appropriate. Compared with early adolescents who died by suicide, children who died by suicide were more commonly male, black, died by hanging/strangulation/suffocation, and died at home. Children who died by suicide more often experienced relationship problems with family members/friends (60.3% vs 46.0%; P = .02) and less often experienced boyfriend/girlfriend problems (0% vs 16.0%; P < .001) or left a suicide note (7.7% vs 30.2%; P < .001). Among suicide decedents with known mental health problems (n = 210), childhood decedents more often experienced attention-deficit disorder with or without hyperactivity (59.3% vs 29.0%; P = .002) and less often experienced depression/dysthymia (33.3% vs 65.6%; P = .001) compared with early adolescent decedents. These findings raise questions about impulsive responding to psychosocial adversity in younger suicide decedents, and they suggest a need for both common and developmentally-specific suicide prevention strategies during the elementary school-aged and early adolescent years. Further research should investigate factors associated with the recent increase in suicide rates among black children. Copyright © 2016 by the American Academy of Pediatrics.

[Suicide attempts among Chilean adolescents].

PubMed

Valdivia, Mario; Silva, Daniel; Sanhueza, Félix; Cova, Félix; Melipillán, Roberto

2015-03-01

Suicide mortality rates are increasing among teenagers. To study the prevalence and predictive factors of suicide attempts among Chilean adolescents. A random sample of 195 teenagers aged 16 ± 1 years (53% males) answered an anonymous survey about their demographic features, substance abuse, the Osaka suicidal ideation questionnaire, Smilksten familial Apgar. Beck hopelessness scale, Beck depression scale and Coppersmith self-esteem inventory. Twenty five percent of respondents had attempted suicide at least in one occasion during their lives. These attempts were significantly associated with female gender, absent parents, family dysfunction, drug abuse, smoking, low self-esteem, hopelessness, depression and recent suicidal ideation. A logistic regression analysis accepted female gender, smoking and recent suicidal ideation as significant independent predictors of suicide attempt. Suicide attempted is common among teenagers and its predictors are female sex, smoking and previous suicidal ideation.

Children at Risk: The Association between Perceived Weight Status and Suicidal Thoughts and Attempts in Middle School Youth

ERIC Educational Resources Information Center

Whetstone, Lauren M.; Morrissey, Susan L.; Cummings, Doyle M.

2007-01-01

Background: Suicide is one of the most common causes of death among young people. A report from the US Surgeon General called for strategies to prevent suicide, including increasing public awareness of suicide and risks factors, and enhancing research to understand risk and protective factors. Weight perception has been linked to depression and…

Characteristics and Co-Occurrence of Adolescent Non-Suicidal Self-Injury and Suicidal Behaviours in Pediatric Emergency Crisis Services

ERIC Educational Resources Information Center

Cloutier, Paula; Martin, Jodi; Kennedy, Allison; Nixon, Mary K.; Muehlenkamp, Jennifer J.

2010-01-01

During the potentially tumultuous adolescent period, non-suicidal self-injury (NSSI) and suicide attempts are relatively common, particularly amongst youth who present to mental health services. These phenomena frequently co-occur but their relationship is unclear. This study evaluated clinical data from 468 youth between the ages of 12 and 17…

Psychosocial Factors and Comorbidity Associated with Suicide Attempts: Findings in Patients with Bipolar Disorder.

PubMed

McGrady, Angele; Lynch, Denis; Rapport, Daniel

2017-01-01

Suicidal attempts occur more frequently in patients with bipolar disorder compared to other mood disorders. The goal of this study is to identify psychosocial factors and comorbidity associated with this serious and life-threatening behavior. Subjects were 121 patients evaluated and treated at a university outpatient psychiatric clinic. The patients' charts were examined to determine history of suicide attempts, demographic and psychosocial variables, and comorbid symptoms. Forty-one percent of the subjects had attempted suicide. Patients who were younger at onset of illness (p = 0.02) and those who had been abused (p = 0.003) were more likely to attempt suicide. Suicide attempts were also more common in subjects with a history of alcohol abuse (p = 0.003) and those with psychotic symptoms (p = 0.02). Based on the results of this study, it is recommended that increased emphasis be placed on the psychosocial history and comorbid symptoms in patients with bipolar disorder. While asking about previous suicide attempts is the most accurate way to predict suicidal behavior, age of onset, past abuse, and overuse of alcohol may also be helpful. Since suicidal behavior in patients with bipolar disorder is relatively common, intensified efforts to predict this behavior may be life-saving. © 2017 S. Karger AG, Basel.

Association between the accessibility to lethal methods and method-specific suicide rates: An ecological study in Taiwan.

PubMed

Lin, Jin-Jia; Lu, Tsung-Hsueh

2006-07-01

To examine the association between availability of lethal methods of suicide and method-specific suicide rates at the city/ county level in Taiwan. Age-adjusted and age-specific suicide rates of 23 cities/counties in Taiwan for the years 1999 to 2003 were calculated. Partial correlation coefficients were used to examine cross-sectional associations between independent variables, i.e., proportion of agricultural population and proportion of households living on the sixth floor or above, and suicide rates by different methods (poisoning by solids/liquids, jumping, and hanging) after adjusting for unemployment rates and prevalence of depression. The partial correlation coefficient was 0.77 (p < .001) for proportion of agricultural population with solids/liquids poisoning suicide rates. It was 0.73 (p < .001) for the proportion of households living on the sixth floor or above with suicide rates by jumping. Correlations between hanging suicide rates and proportion of agricultural population or between hanging suicide rates and proportion of households living on the sixth floor or above were not significant. The results showed strong positive associations between access to lethal methods and method-specific suicide rates. Controlling the availability of pesticides and fencing high buildings or installing window guards may be effective measures for suicide prevention.

Characterization of Chemical Suicides in the United States and Its Adverse Impact on Responders and Bystanders

PubMed Central

Anderson, Ayana R.

2016-01-01

Introduction A suicide trend that involves mixing household chemicals to produce hydrogen sulfide or hydrogen cyanide, commonly referred to as a detergent, hydrogen sulfide, or chemical suicide is a continuing problem in the United States (U.S.). Because there is not one database responsible for tracking chemical suicides, the actual number of incidents in the U.S. is unknown. To prevent morbidity and mortality associated with chemical suicides, it is important to characterize the incidents that have occurred in the U.S. Methods The author analyzed data from 2011–2013 from state health departments participating in the Agency for Toxic Substances and Disease Registry’s National Toxic Substance Incidents Program (NTSIP). NTSIP is a web-based chemical incident surveillance system that tracks the public health consequences (e.g., morbidity, mortality) from acute chemical releases. Reporting sources for NTSIP incidents typically include first responders, hospitals, state environmental agencies, and media outlets. To find chemical suicide incidents in NTSIP’s database, the author queried open text fields in the comment, synopsis, and contributing factors variables for potential incidents. Results Five of the nine states participating in NTSIP reported a total of 22 chemical suicide incidents or attempted suicides during 2011–2013. These states reported a total of 43 victims: 15 suicide victims who died, seven people who attempted suicide but survived, eight responders, and four employees working at a coroner’s office; the remainder were members of the general public. None of the injured responders reported receiving HazMat technician-level training, and none had documented appropriate personal protective equipment. Conclusion Chemical suicides produce lethal gases that can pose a threat to responders and bystanders. Describing the characteristics of these incidents can help raise awareness among responders and the public about the dangers of chemical suicides. Along with increased awareness, education is also needed on how to protect themselves. PMID:27833671

Suicide among police in a federal force.

PubMed

Loo, R

1986-01-01

Suicide among police has gained the attention of numerous police forces over the past two decades. The great variation in reported police suicide rates and caveats concerning such statistics are addressed. The paper reports the results of a study of suicide among members (n = 35) of the Royal Canadian Mounted Police (RMCP) between 1960 and 1983. The average annual rate (14.1 per 100,000) of suicide in this force was approximately half that of the comparable general population, and the most common means of suicide was by service revolver (77% of cases). Recommendations are made for suicide prevention and postvention actions in police forces. Finally, the need for reliable, long-term police suicide data bases is stressed.

Youth self-harm in low- and middle-income countries: Systematic review of the risk and protective factors.

PubMed

Aggarwal, Shilpa; Patton, George; Reavley, Nicola; Sreenivasan, Shreenivas A; Berk, Michael

2017-06-01

Self-harm (defined here as an act of intentionally causing harm to own self, irrespective of the type, motive or suicidal intent) is one of the strongest antecedents of suicide in youth. While there have been a number of studies of youth self-harm in low- and middle-income countries (LMICs), there is currently no systematic review of studies of prevalence rates and risk and protective factors. To systematically review the evidence relating to the prevalence rates and forms of self-harm in youth in LMICs and its relationship to family economic status, family functioning, relationship with the peer group, social relationships and academic performance. Electronic searches of three databases, MEDLINE, PsycINFO and Scopus, were performed. In total, 27 school-, community- and hospital-based studies evaluating self-harm in LMICs with youth focus (with participants between 12 and 25 years) were included. The self-harm was divided into suicidal and non-suicidal depending on the nature of self-harm. The 12-month prevalence rates of non-suicidal self-harm varied from 15.5% to 31.3%, and the range of suicidal behaviour rates was from 3.2% to 4.7%. Banging and hitting were the most common in the community-based studies, followed by cutting, scratching and wound picking. Self-poisoning with pesticides was most commonly reported in hospital-based studies. Risk factors for self-harm were family conflict, peer groups with members indulging in self-harm, truancy and school absenteeism. Protective factors were having an understanding family, having friends and higher school competence. Risk factors for suicidal thoughts and attempts were lack of close friends and history of suicide by a friend. The 12-month prevalence rates of youth self-harm in LMICs are comparable to high-income countries (HICs). The profile of risk and protective factors suggests that family-based interventions could be useful in treatment and prevention. Future studies should aim for greater consistency in assessment methods and the constructs under evaluation.

From chaos to calm: one jail system's struggle with suicide prevention.

PubMed

Hayes, L M

1997-01-01

This article profiles the suicide prevention practices at a large metropolitan jail, a facility that experienced nine inmate suicides in a recent 24-month period. The suicide rate in this facility was found to far exceed the rate for jails of comparable size as well as the national rate of jail suicides. The nine suicides are summarized and common features (including the issue of protective custody) of the deaths and systemic jail deficiencies are discussed. The process by which the jail system developed a suicide prevention program based upon the principles of staff training, identification/screening, communication, levels of supervision, housing, and intervention is offered.

Health practices, problems, and needs in a population of Micronesian adolescents.

PubMed

Mayer, P A; Bauman, K A

1986-09-01

Saipan, one of many islands of the Pacific Trust Territory, depends on the United States for its medical care. The limited resources on the island have resulted in little medical attention for adolescents. This study surveyed 519 Saipan adolescents to determine their health practices, problems, and needs. Although these teenagers rarely saw physicians, they commonly reported health problems such as headaches, abdominal pain, and dental cavities. In the psychosocial arena, their problems involved parents, girlfriends/boyfriends, school, and suicidal thoughts. The health topics found to be of most interest included sex education, jobs, suicide prevention, drugs, and birth control. The most popular methods for learning about these subjects were books, movies, films, and school classes. There were high reported incidences of drug and alcohol problems among boys, and thoughts about suicide in all respondents.

Relationship between Vehicle Emissions Laws and Incidence of Suicide by Motor Vehicle Exhaust Gas in Australia, 2001–06: An Ecological Analysis

PubMed Central

Studdert, David M.; Gurrin, Lyle C.; Jatkar, Uma; Pirkis, Jane

2010-01-01

Background Globally, suicide accounts for 5.2% of deaths among persons aged 15 to 44 years and its incidence is rising. In Australia, suicide rates peaked in 1997 and have been declining since. A substantial part of that decline stems from a plunge in suicides by one particular method: asphyxiation by motor vehicle exhaust gas (MVEG). Although MVEG remains the second most common method of suicide in Australia, its incidence decreased by nearly 70% in the decade to 2006. The extent to which this phenomenon has been driven by national laws in 1986 and 1999 that lowered permissible levels of carbon monoxide (CO) emissions is unknown. The objective of this ecological study was to test the relationship by investigating whether areas of Australia with fewer noxious vehicles per capita experienced lower rates of MVEG suicide. Methods and Findings We merged data on MVEG suicides in Australia (2001–06) with data on the number and age of vehicles in the national fleet, as well as socio-demographic data from the national census. Poisson regression was used to analyse the relationship between the incidence of suicide within two levels of geographical area—postcodes and statistical subdivisions (SSDs)—and the population density of pre-1986 and pre-1999 passenger vehicles in those areas. (There was a mean population of 8,302 persons per postcode in the study dataset and 87,413 persons per SSD.) The annual incidence of MVEG suicides nationwide decreased by 57% (from 2.6 per 100,000 in 2001 to 1.1 in 2006) during the study period; the population density of pre-1986 and pre-1999 vehicles decreased by 55% (from 14.2 per 100 persons in 2001 to 6.4 in 2006) and 26% (from 44.5 per 100 persons in 2001 to 32.9 in 2006), respectively. Area-level regression analysis showed that the suicide rates were significantly and positively correlated with the presence of older vehicles. A percentage point decrease in the population density of pre-1986 vehicles was associated with a 6% decrease (rate ratio [RR] = 1.06; 95% confidence interval [CI] 1.05–1.08) in the incidence of MVEG suicide within postcode areas; a percentage point decrease in the population density of pre-1999 vehicles was associated with a 3% decrease (RR = 1.03; 95% CI 1.02–1.04) in the incidence of MVEG suicide. Conclusions Areas of Australia with fewer vehicles predating stringent CO emission laws experience lower rates of MVEG suicide. Although those emission laws were introduced primarily for environmental reasons, countries that lack them may miss the benefits of a serendipitous suicide prevention strategy. Please see later in the article for the Editors' Summary PMID:20052278

Endocrinology and Suicide.

ERIC Educational Resources Information Center

Rich, Charles L

1986-01-01

Concludes that thyroid and adrenal gland disease unquestionably can produce severe mental disturbances. Most of these are "organic" in nature, but depressive symptoms are common as well. Cautions that a connection between these diseases and suicide has not been established. Advises treating all depressed, suicidal persons with the same…

Suicide by gassing in Hong Kong 2005-2013: Emerging trends and characteristics of suicide by helium inhalation.

PubMed

Chang, Shu-Sen; Cheng, Qijin; Lee, Esther S T; Yip, Paul S F

2016-03-01

Increased use of lethal suicide methods can have a profound impact on overall suicide incidence; the epidemic of suicide by barbecue charcoal gas poisoning in some East Asian countries is a recent example. There have been concerns about recent rises in suicide using gases in some Western countries. We investigated suicide by gassing in Hong Kong (2005-2013) using Coroner's files data. The characteristics were compared between suicide by helium inhalation, charcoal gas poisoning, and other methods. About one sixth (1407/8445, 16.7%) of all suicides used gases. Charcoal-burning suicides constituted the majority (97.5%) of them but showed a reduction over the 9-year period (-33%). Helium suicide was not recorded in 2005-2010 but increased from one in 2011 to three in 2012 and 11 in 2013, accounting for 1.2% of all suicides in 2013. Similar to the profile of charcoal-burning suicides, helium suicides were younger and more likely to have debt problem and less likely to receive psychiatric treatment than other suicides. Internet involvement related to the method was found in one third of cases of helium suicide. The small number of helium suicides (n=15) limits the power to examine their characteristics. Suicide by charcoal burning showed a downward trend whilst there was an alarming increase in helium suicide in Hong Kong. Public health measures to prevent an epidemic of helium suicide similar to that of charcoal-burning suicide may include close monitoring of trend, responsible media reporting, and restricting online information about and access to this method. Copyright © 2015 Elsevier B.V. All rights reserved.

Long-term trends of suicide by choice of method in Norway: a joinpoint regression analysis of data from 1969 to 2012.

PubMed

Puzo, Quirino; Qin, Ping; Mehlum, Lars

2016-03-11

Suicide mortality and the rates by specific methods in a population may change over time in response to concurrent changes in relevant factors in society. This study aimed to identify significant changing points in method-specific suicide mortality from 1969 to 2012 in Norway. Data on suicide mortality by specific methods and by sex and age were retrieved from the Norwegian Cause-of-Death Register. Long-term trends in age-standardized rates of suicide mortality were analyzed by using joinpoint regression analysis. The most frequently used suicide method in the total population was hanging, followed by poisoning and firearms. Men chose suicide by firearms more often than women, whereas poisoning and drowning were more frequently used by women. The joinpoint analysis revealed that the overall trend of suicide mortality significantly changed twice along the period of 1969 to 2012 for both sexes. The male age-standardized suicide rate increased by 3.1% per year until 1989, and decreased by 1.2% per year between 1994 and 2012. Among females the long-term suicide rate increased by 4.0% per year until 1988, decreased by 5.5% through 1995, and then stabilized. Both sexes experienced an upward trend for suicide by hanging during the 44-year observation period, with a particularly significant increase in 15-24 year old males. The most distinct change among men was seen for firearms after 1988 with a significant decrease through 2012 of around 5% per year. For women, significant reductions since 1985-88 were observed for suicide by drowning and poisoning. The present study demonstrates different time trends for different suicide methods with significant reductions in suicide by firearms, drowning and poisoning after the peak in the suicide rate in the late 1980s. Suicide by means of hanging continuously increased, but did not fully compensate for the reduced use of other methods. This lends some support for the effectiveness of method-specific suicide preventive measures, such as restrictions to the access to firearms, which had been implemented in Norway during the relevant time period.

Who uses firearms as a means of suicide? A population study exploring firearm accessibility and method choice

PubMed Central

Klieve, Helen; Sveticic, Jerneja; De Leo, Diego

2009-01-01

Background The 1996 Australian National Firearms Agreement introduced strict access limitations. However, reports on the effectiveness of the new legislation are conflicting. This study, accessing all cases of suicide 1997-2004, explores factors which may impact on the choice of firearms as a suicide method, including current licence possession and previous history of legal access. Methods Detailed information on all Queensland suicides (1997-2004) was obtained from the Queensland Suicide Register, with additional details of firearm licence history accessed from the Firearm Registry (Queensland Police Service). Cases were compared against licence history and method choice (firearms or other method). Odds ratios (OR) assessed the risk of firearms suicide and suicide by any method against licence history. A logistic regression was undertaken identifying factors significant in those most likely to use firearms in suicide. Results The rate of suicide using firearms in those with a current license (10.92 per 100,000) far exceeded the rate in those with no license history (1.03 per 100,000). Those with a license history had a far higher rate of suicide (30.41 per 100,000) compared to that of all suicides (15.39 per 100,000). Additionally, a history of firearms licence (current or present) was found to more than double the risk of suicide by any means (OR = 2.09, P < 0.001). The group with the highest risk of selecting firearms to suicide were older males from rural locations. Conclusion Accessibility and familiarity with firearms represent critical elements in determining the choice of method. Further licensing restrictions and the implementation of more stringent secure storage requirements are likely to reduce the overall familiarity with firearms in the community and contribute to reductions in rates of suicide. PMID:19778414

Department of Defense Suicide Event Report (DoDSER) Calendar Year 2014 Annual Report

DTIC Science & Technology

2015-07-16

diagnoses identified in suicide DoDSER reports included mood (n= 17, 28.3%), adjustment (n = 14, 23.3%) and anxiety (n = 13, 21.7%) disorders . For suicide ...n = 35, 27.3%) and substance abuse (n = 35, 27.3%) disorders . For suicide attempt DoDSER reports, the most common diagnoses identified were mood (n...diagnoses identified in suicide DoDSER reports included mood (n= 10, 17.2%), adjustment (n = 8, 13.8%) and substance abuse (n = 8, 13.8%) disorders . For

Prognosis after Adolescent Suicide Attempt: Mental Health, Psychiatric Treatment, and Suicide Attempts in a Nine-Year Follow-Up Study

ERIC Educational Resources Information Center

Groholt, Berit; Ekeberg, Oivind

2009-01-01

The prevalence of mental health and suicidal behavior was examined 8 to 10 years after an adolescent suicide attempt. Of 71 persons, 79% had at least one psychiatric disorder (mean 1.7) at follow-up, most commonly depression (46%), personality disorder (46%), and anxiety disorder (42%). The stability of diagnoses was moderate. The suicide…

Suicide by shooting is correlated to rate of gun licenses in Austrian counties.

PubMed

Etzersdorfer, Elmar; Kapusta, Nestor D; Sonneck, Gernot

2006-08-01

Shooting as method of suicide has increased considerably in Austria over recent decades and represented 23.5% of all suicides among men during the period 1990-2000. It is thought that the availability of guns could lead to their use in acts of suicide, and therefore we investigated the numbers of gun licenses (which constitutes ownership of guns and permission to carry a gun) in the nine Austrian counties and their correlation with suicides by shooting and other methods. We studied registered suicides, including the method used, between 1990 and 2000 in Austria and the numbers of gun licenses held in the nine counties of Austria in the same period. We found a strong correlation between the average gun license rate for the period 1990-2000 and suicides by shooting (r = 0.967), and only very weak correlation, and for some of the years under investigation a negative correlation, with other methods of committing suicide (r = 0.117) and the suicide rate in general (r = 0.383). As shooting as a method of suicide has increased in Austria in recent decades, and is a highly lethal method, the finding that the shooting suicide rate is related to the extent of gun ownership deserves attention, especially as there is evidence that restriction of gun ownership is an important factor in suicide prevention.

Motor Vehicle Exhaust Gas Suicide.

PubMed

Routley, Virginia

2007-01-01

In many motorized countries, inhalation of carbon monoxide from motor vehicle exhaust gas (MVEG) has been one of the leading methods of suicide. In some countries it remains so (e.g., Australia 16.0% of suicides in 2005). Relative to other methods it is a planned method and one often used by middle-aged males. The study provides a review of countermeasures aimed at restricting this method of suicide. The prevention measures identified were catalytic converters (introduced to reduce carbon monoxide for environmental reasons); in-cabin sensors; exhaust pipe modification; automatic idling stops; and helpline signage at suicide "hotspots." Catalytic converters are now in 90% of new vehicles worldwide and literature supports them being associated with a reduction in exhaust-gassing suicides. There remain, however, accounts of exhaust-gas fatalities in modern vehicles, whether accidentally or by suicide. These deaths and also crashes from fatigue could potentially be prevented by in-cabin multi-gas sensors, these having been developed to the prototype stage. Helpline signage at an exhaust-gassing suicide "hotspot" had some success in reducing suicides. The evidence on method substitution and whether a reduction in MVEG suicides causes a reduction in total suicides is inconsistent.

Suicidal Behavior in Long-Term Care Facilities.

ERIC Educational Resources Information Center

Osgood, Nancy J.; Brant, Barbara A.

1990-01-01

Surveyed administrators of 463 long-term care facilities concerning overt suicides and intentional life-threatening behaviors. Data revealed that White males were highest risk group. Refusal to eat, drink, or take medications were most common suicidal behaviors. Depression, loneliness, feelings of family rejection, and loss were significant…

Do Suicide Survivors Report Near-Death Experiences?

ERIC Educational Resources Information Center

Ring, Kenneth; Franklin, Stephen

1981-01-01

Interviewed persons (N=36) who had been close to death as a result of a suicide attempt to determine whether such persons report near-death experiences. Half related such experiences; these were more common for men. Found three patterns in suicide-related, near-death experiences. (Author/JAC)

A model to explain suicide by self-immolation among Iranian women: A grounded theory study.

PubMed

Khankeh, Hamid Reza; Hosseini, Seyed Ali; Rezaie, Leeba; Shakeri, Jalal; Schwebel, David C

2015-11-01

Self-immolation is a common method of suicide among Iranian women. There are several contributing motives for attempting self-immolation, and exploration of the process of self-immolation incidents will help interventionists and clinicians develop prevention programs. A grounded theory study using face-to-face, recorded interviews was conducted with surviving self-immolated patients (n=14), their close relatives (n=5), and medical staff (n=8) in Kermanshah, Iran. Data were analyzed using constant comparison in open, axial, and selective coding stages. A conceptual model was developed to explain the relationships among the main categories extracted through the grounded theory study. Family conflicts emerged as the core category. Cultural context of self-immolated patients offered a contextual condition. Other important categories linked to the core category were mental health problems, distinct characteristics of the suicidal method, and self-immolation as a threat. The role of mental health problems as a causal condition was detected in different levels of the self-immolation process. Finally, adverse consequences of self-immolation emerged as having important impact. The conceptual model, derived through grounded theory study, can guide design of prevention programs. The pivotal role of family conflicts should be emphasized in mental health interventions. The impact of adverse consequences of self-immolation on further suicidal processes necessitates post-suicide prevention programs. Further research to design specific interventions is recommended. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Risk factors for adult interpersonal violence in suicide attempters

PubMed Central

2014-01-01

Background Suicidal and violent behaviours are interlinked and share common biological underpinnings. In the present study we analysed the association between violent behaviour as a child, childhood trauma, adult psychiatric illness, and substance abuse in relation to interpersonal violence as an adult in suicide attempters with mood disorders. Methods A total of 161 suicide attempters were diagnosed with Structured Clinical Interviews and assessed with the Karolinska Interpersonal Violence Scale (KIVS) measuring exposure to violence and expressed violent behaviour in childhood (between 6-14 years of age) and during adult life (15 years or older). Ninety five healthy volunteers were used as a comparison group. A logistic regression analysis was conducted with the two KIVS subscales, expressed violent behaviour as a child and exposure to violence in childhood together with substance abuse, personality disorder diagnoses and age as possible predictors of adult interpersonal violence in suicide attempters. Results Violent behaviour as a child, age and substance abuse were significant predictors of adult interpersonal violence. ROC analysis for the prediction model for adult violence with the KIVS subscale expressed violence as a child gave an AUC of 0.79. Using two predictors: violent behaviour as a child and substance abuse diagnosis gave an AUC of 0.84. The optimal cut-off for the KIVS subscale expressed violence as a child was higher for male suicide attempters. Conclusions Violent behaviour in childhood and substance abuse are important risk factors for adult interpersonal violent behaviour in suicide attempters. PMID:25001499

The Impact of Media Reporting on the Emergence of Charcoal Burning Suicide in Taiwan

PubMed Central

Chen, Ying-Yeh; Chen, Feng; Gunnell, David; Yip, Paul S. F.

2013-01-01

We investigated the association of the intensity of newspaper reporting of charcoal burning suicide with the incidence of such deaths in Taiwan during 1998–2002. A counting process approach was used to estimate the incidence of suicides and intensity of news reporting. Conditional Poisson generalized linear autoregressive models were performed to assess the association of the intensity of newspaper reporting of charcoal burning and non-charcoal burning suicides with the actual number of charcoal burning and non-charcoal burning suicides the following day. We found that increases in the reporting of charcoal burning suicide were associated with increases in the incidence of charcoal burning suicide on the following day, with each reported charcoal burning news item being associated with a 16% increase in next day charcoal burning suicide (p<.0001). However, the reporting of other methods of suicide was not related to their incidence. We conclude that extensive media reporting of charcoal burning suicides appears to have contributed to the rapid rise in the incidence of the novel method in Taiwan during the initial stage of the suicide epidemic. Regulating media reporting of novel suicide methods may prevent an epidemic spread of such new methods. PMID:23383027

The Werther Effect of Two Celebrity Suicides: an Entertainer and a Politician

PubMed Central

Kim, Jae-Hyun; Park, Eun-Cheol; Nam, Jung-Mo; Park, SoHee; Cho, Jaelim; Kim, Sun-Jung; Choi, Jae-Woo; Cho, Eun

2013-01-01

Purpose Suicide is a major health problem in Korea. Extensive media exposure of celebrity suicide may induce imitative suicide, a phenomenon called the Werther effect. We examined the increased suicide risk following the suicides of an entertainer and a politician, and identified the relative suicide risks. Methods News articles about the celebrity suicides were obtained from three major newspapers and analysed for quantitative and qualitative features. Imitative suicide risk was investigated by applying a Poisson time series autoregression model with suicide mortality data from the National Statistics Office for 1.5 years before and 1.5 years after each celebrity’s suicide. The period with a significantly increased number of suicides immediately after the celebrity’s suicide determined the Werther effect band. The relative risk during this period was examined for different ages, genders, and suicide methods. Results News reports were more numerous and they contained more positive definitions about the entertainer’s suicide. The risk of suicide deaths rose markedly after both celebrity suicides. However, the Werther effect band was longer for the entertainer (6 weeks) than for the politician (4 weeks). The relative suicide risk was significant for almost all ages and both genders during that of both individuals. Use of the same suicide method was a prominent risk factor after both celebrity suicides. Conclusions Our results confirm the existence of imitative suicide behaviours, suggesting a facilitation effect of media reports. Guidelines for responsible media reporting need to be implemented to enhance public mental health in Korea. PMID:24386428

An analysis of secular trends in method-specific suicides in Japan, 1950-1975.

PubMed

Yoshioka, Eiji; Saijo, Yasuaki; Kawachi, Ichiro

2017-04-05

In Japan, a dramatic rise in suicide rates was observed in the 1950s, especially among the younger population, and then the rate decreased rapidly again in the 1960s. The aim of this study was to assess secular trends in method-specific suicides by gender and age in Japan between 1950 and 1975. We paid special attention to suicides by poisoning (solid and liquid substances), and their contribution to dramatic swings in the overall suicide rate in Japan during the 1950s and 1960s. Mortality and population data were obtained from the Vital Statistics of Japan and Statistics Bureau, Ministry of Internal Affairs and Communications in Japan, respectively. We calculated method-specific age-standardized suicide rates by gender and age group (15-29, 30-49, or 50+ years). The change in the suicide rate during the research period was larger in males than females in all age groups, and was more marked among people aged 15-29 years compared to those aged 30-49 years and 50 years or over. Poisoning by solid and liquid substances overwhelmingly contributed to the dramatic change in the overall suicide rates in males and females aged 15-49 years in the 1950s and 1960s. For the peak years of the rise in poisoning suicides, bromide was the most frequently used substance. Our results for the 1950s and 1960s in Japan illustrated how assessing secular trends in method-specific suicides by gender and age could provide a deeper understanding of the dramatic swings in overall suicide rate. Although rapid increases or decreases in suicide rates have been also observed in some countries or regions recently, trends in method-specific suicides have not been analyzed because of a lack of data on method-specific suicide in many countries. Our study illustrates how the collection and analysis of method-specific data can contribute to an understanding of dramatic shifts in national suicide rates.

Alcohol Policies and Suicide: A Review of the Literature

PubMed Central

Xuan, Ziming; Naimi, Timothy S.; Kaplan, Mark S.; Bagge, Courtney L.; Few, Lauren R.; Maisto, Stephen; Saitz, Richard; Freeman, Robert

2016-01-01

Both intoxication and chronic heavy alcohol use are associated with suicide. There is extensive population-level evidence linking per capita alcohol consumption with suicide. While alcohol policies can reduce excessive alcohol consumption, the relationship between alcohol policies and suicide warrants a critical review of the literature. This review summarizes the associations between various types of alcohol policies and suicide, both in the United States and internationally, as presented in English-language literature published between 1999 and 2014. Study designs, methodological challenges, and limitations in ascertaining the associations are discussed. Because of the substantial between-states variation in alcohol policies, U.S.-based studies contributed substantially to the literature. Repeated cross-sectional designs at both the ecological level and decedent level were common among U.S.-based studies. Non-U.S. studies often used time series data to evaluate pre-post comparisons of a hybrid set of policy changes. Although inconsistency remained, the published literature in general supported the protective effect of restrictive alcohol policies on reducing suicide as well as the decreased level of alcohol involvement among suicide decedents. Common limitations included measurement and selection bias, and a focus on effects of a limited number of alcohol policies without accounting for other alcohol policies. This review summarizes a number of studies that suggest restrictive alcohol policies may contribute to suicide prevention on a general population level, and to a reduction of alcohol involvement among suicide deaths. PMID:27618526

Characteristics of drug overdose in young suicide attempters.

PubMed

Kweon, Yong-Sil; Hwang, Sunyoung; Yeon, Bora; Choi, Kyoung Ho; Oh, Youngmin; Lee, Hae-Kook; Lee, Chung Tai; Lee, Kyoung-Uk

2012-12-01

Few studies have focused on the characteristic features of drug overdose in children and adolescents who have attempted suicide in Korea. The present study examined the characteristics of drug overdose in children and adolescents who visited the emergency room following drug ingestion for a suicide attempt. The medical records of 28 patients who were treated in the emergency room following a drug overdose from January 2008 to March 2011 were analyzed. Demographic and clinical variables related to the suicide attempts were examined. The mean age of the patients was 16.6±1.7 years (range 11-19 years), and 20 of the patients (71.4%) were female. Most of the patients (n=23, 82.1%) overdosed on a single drug; acetaminophen-containing analgesics were the most common (n=12, 42.9%). Depression was the most common psychiatric disorder (n=22, 78.6%), and interpersonal conflict was the most common precipitating factor of the suicide attempts (n=11, 39.3%). This was the first suicide attempt for approximately 80% of the patients. About one fourth of the patients (n=7, 25%) had follow-up visits at the psychiatric outpatient clinic. Early screening and psychiatric intervention for depression may be an important factor in preventing childhood and adolescent suicide attempts. Developing coping strategies to manage interpersonal conflicts may also be helpful. Moreover, policies restricting the amount and kind of drugs purchased by teenagers may be necessary to prevent drug overdose in this age group.

Suicide attempts and suicides in Bolivia from 2007 to 2012: pesticides are the preferred method - females try but males commit suicide!

PubMed

Jørs, Erik; Christoffersen, Mette; Veirum, Nikoline Høgsgaard; Aquilar, Guido Condarco; Morant, Rafael Cervantes; Konradsen, Flemming

2014-01-01

Suicide attempts and suicides constitute a significant burden on communities and health systems, especially in low income countries. However, many low income countries lack epidemiological information on which to base future preventive strategies. This study reports on gender and age profiles as well as the likely background and means used for suicide attempts and suicides in Bolivia. This study presents 1124 cases from four different sources of information: (i) emergency ward data with suicide attempts by poisoning from the year 2007, (ii) psychiatric ward data including suicide attempts from July 2011 to July 2012, (iii) newspaper articles reporting attempted suicides and suicides from 2009 to 2011, and (iv) the National Statistics on Crime reporting suicides from the years 2010-2011. Data on age was stratified into three age groups: adolescents aged 10-19 years, young adults aged 20-29 years, and older adults aged above 29 years. Data from the hospital wards and Crime Statistics were pooled to compare characteristics of suicide attempts with suicides concerning age and gender. Data on age, gender, methods used, and reasons were analyzed using IBM SPSS version 21. Hospital data showed that more females (403/657, 61%) than males (254/657, 39%) attempted suicide, and females attempted suicide at a younger age than males (p<0.05). In contrast to this, more males (208/293, 70.5%) than females (85/293, 29.5%) committed suicide, and furthermore it was most prevalent among young adults aged 20-29 years of both genders, as observed from the Crime Statistics. The dominant method was pesticide poisoning varying from 400 out of 657 (70.5%) of the hospital poisoning cases to 65 out of 172 (37.8%) of the newspaper cases. Newspaper data showed a higher mortality rate (65/77, 85.1%) among those using violent methods such as hanging and jumping compared to non-violent methods (43/84, 50.9%) such as ingesting chemicals and drugs (p<0.05). The reasons were related to interpersonal problems, economic problems, depression, and unwanted pregnancies. Many cases of suicide seemed to be hidden due to cultural and religious reasons. More females attempted suicide, whereas more males realized suicide. Suicide attempts were most numerous among adolescents in contrast to suicides being most prevalent in the older age groups. Self-poisoning with pesticides was the most popular method used. Access to potential suicide materials should be restricted and psychosocial interventions initiated to prevent suicides.

Relations between Suicidal Ideation, Depression, and Emotional Autonomy from Parents in Adolescence

ERIC Educational Resources Information Center

Pace, Ugo; Zappulla, Carla

2010-01-01

We examined the relations between depression, emotional autonomy quality-related constructs of separation and detachment, and suicidal ideation, focusing on the unique and common contribution that depression, separation and detachment made to suicidal ideation. We also examined gender differences. 403 adolescents, 196 boys and 207 girls, completed…

Interpersonal Precipitants and Suicide Attempts in Borderline Personality Disorder

ERIC Educational Resources Information Center

Brodsky, Beth S.; Groves, Shelly A.; Oquendo, Maria A.; Mann, J. John; Stanley, Barbara

2006-01-01

Borderline personality disorder (BPD) is often characterized by multiple low lethality suicide attempts triggered by seemingly minor incidents, and less commonly by high lethality attempts that are attributed to impulsiveness or comorbid major depression. The relationships among life events, impulsiveness, and type of suicidal behavior has hardly…

Loneliness, common mental disorders and suicidal behavior: Findings from a general population survey.

PubMed

Stickley, Andrew; Koyanagi, Ai

2016-06-01

Loneliness has been linked to an increased risk of engaging in suicidal behavior. To date, however, there has been comparatively little research on this in the general adult population, or on the role of common mental disorders (CMDs) in this association. The current study examined these associations using nationally representative data from England. Data came from the Adult Psychiatric Morbidity Survey 2007. Information was obtained from 7403 household residents aged ≥16 years on perceived loneliness and lifetime and past 12-month suicide ideation and attempts. The Clinical Interview Schedule Revised (CIS-R) was used to assess six forms of CMD. Logistic regression analysis was used to examine these associations. Loneliness was associated with suicidal behavior. Although adjusting for CMDs attenuated associations, higher levels of loneliness were still significantly associated with suicidal ideation and suicide attempts with odds ratios (OR) for those in the most severe loneliness category ranging from 3.45 (lifetime suicide attempt) to 17.37 (past 12-month suicide attempt). Further analyses showed that ORs for suicidal behavior were similar for individuals who were lonely without CMDs, and for those respondents with CMDs who were not lonely. Lonely individuals with CMDs had especially elevated odds for suicidal ideation. This study used cross-sectional data and a single-item measure to obtain information on loneliness. Loneliness is associated with suicidal behavior in the general adult population. This highlights the importance of efforts to reduce loneliness in order to mitigate its harmful effects on health and well-being. Copyright © 2016 Elsevier B.V. All rights reserved.

Ecological correlates of adolescent attempted suicide.

PubMed

Lester, D

1990-01-01

Rates of adolescent attempted suicide were correlated with social indicators over the electoral wards of Edinburgh (Scotland). Rates were found to be higher in wards where child neglect and misbehavior were more common. Rates of attempted suicide in the total population also were related to the housing pattern/social class of the wards. The importance of identifying similarities and differences in the patterns of suicidal behavior of adolescents and adults was noted.

Community Value Above Individualism: A Common Cultural Element in Modern Suicide Bombers

DTIC Science & Technology

2009-04-01

Japanese kamikaze raids. The Japanese conducted over 3,000 aerial suicide attacks in an organized manner during World War II with varying degrees of...definition. The kamikaze missions show that suicide missions do not require justification by religious means alone. Japanese culture morally justifies suicide...when facing an impossible situation. Most Japanese are followers of the Buddhist and Shinto religions, which teach the Confucian values of dutiful

Differential correlation of suicide and homicide rates according to geographical areas: A study with population-level data.

PubMed

Fountoulakis, Konstantinos N; Gonda, Xenia

2017-03-01

The current study investigated the relationship of suicide and homicide rates internationally. WHO database mortality data for 82 countries concerning suicide, homicides, and cancer and traffic accidents as controls were used. The analysis included Pearson correlation and multiple linear regression analysis. Worldwide homicidal rates explained 55.42%, 43.86% and 41.7% of male and 22.0%, 22.14% and 13.25% of female suicides for 2000, 2005 and 2010 respectively. In Europe there was a positive correlation between male suicide rates and all homicide rates including homicide rates in both genders, in male victims, and in female victims. In America there is no significant correlation. In Asia there is a significant correlation of male suicidal rates only with homicide rates of female victims. We observed marked and interesting differences in the pattern of association between Europe and the Americas. Overall the current paper suggests that at least in some human populations, suicidality and homicidality share common etiopathogenetic substrates and could be triggered by the same internal or external events or might develop based on common genetic background. Empirically it has been suggested that suicide is related to higher living standards while murder is related to poor quality of life and lower living standards. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Recent criminal offending and suicide attempts: a national sample.

PubMed

Cook, Thomas Bradley

2013-05-01

Few studies have assessed the risk of suicide and suicidal behavior among the community-residing population with recent criminal justice involvement despite evidence of high rates of suicide in jails and prisons. This study assessed the association between recent arrest history and a suicide attempt in the previous year including multiple arrests and specific offense categories using a national representative sample of adults. Data were derived from 2 years of the National Survey on Drug Use and Health (2008 and 2010), a nationally representative cross-sectional survey of non-institutionalized US adults. Suicide attempts in the previous year based on self-report were assessed in relation to recent arrest history while accounting for socio-demographic factors, mental and physical health status and substance use. Suicide attempts in the previous year are relatively common among those with recent arrests (2.3 %) compared to the general US population (0.4 %), with much higher prevalence among those with multiple recent arrests or charges (4.5 %). The prevalence of recent suicide attempts among those with multiple recent arrests was highest among adults aged 25-34 (5.7 %), with similar risks between men and women, and across racial and ethnic subgroups. There was no association between arrests prior to the most recent year and recent suicide attempts. Suicide attempts are common among the non-institutionalized population of US adults with recent criminal justice involvement. Suicide prevention efforts in the criminal justice system should extend to clients who remain in the community both during and immediately following periods of court-processing. Future research is needed to better identify case and client characteristics indicating the highest suicide risk.

Preventing recurrent suicidal behaviour.

PubMed Central

Links, P. S.; Balchand, K.; Dawe, I.; Watson, W. J.

1999-01-01

OBJECTIVE: To highlight recent empirical evidence for effective interventions that can guide family physicians in managing patients after suicide attempts. QUALITY OF EVIDENCE: Randomized control trials of psychosocial interventions for people after suicide attempts have provided some evidence for effective interventions. MAIN MESSAGE: Suicide attempts are more common than suicides; the number of attempts seen in a family practice is estimated to be 10 to 15 yearly. Up to two thirds of patients who take their lives by suicide have seen a family physician in the month before their death. Principles of care after a suicide attempt include actively engaging the patient, involving the family, restricting access to means of suicide, and developing intervention plans to deal with the psychopathology that has placed the patient at risk. CONCLUSIONS: Family physicians have a crucial role in preventing suicide through aftercare and ongoing monitoring of patients who have attempted suicide. PMID:10587773

Attitudes and Perceptions of Suicide and Suicide Prevention Messages for Asian Americans

PubMed Central

Thapa, Priyata; Sung, Yoonhee; Klingbeil, David A.; Lee, Chih-Yuan Steven; Klimes-Dougan, Bonnie

2015-01-01

Understanding the context of suicidal behaviors is critical for effective suicide prevention strategies. Although suicide is an important topic for Asian Americans, there is limited information about what Asian Americans’ attitudes are towards suicide and their perceptions about the effectiveness of prevention efforts. These questions are critical to examine to provide foundational knowledge for determining how best to intervene. In this study, Asian American (n = 87) and White (n = 87) participants completed self-report indexes on their knowledge of depression and suicide (e.g., estimates of suicide rates), coping attitudes (e.g., help-seeking) and suicide prevention attitudes (e.g., usefulness of PSAs). The results indicate that in comparison to Whites, Asian Americans perceived suicidal behavior to be more common, perceived a stronger link between depression and suicide, less frequently endorsed help-seeking strategies, and reported more concern or distress after viewing a suicide prevention PSA. These preliminary results also suggest the possibility of cultural differences in perceptions of suicide prevention messages. The implications of these findings are discussed with a focus on providing recommendations for exploring suicide prevention efforts for Asian Americans. PMID:26690227

Suicidal Behavior in Juvenile Delinquents: The Role of ADHD and Other Comorbid Psychiatric Disorders.

PubMed

Ruchkin, Vladislav; Koposov, Roman A; Koyanagi, Ai; Stickley, Andrew

2017-10-01

This study evaluated the role of psychiatric morbidity in relation to a history of suicidal behavior, with a particular focus on attention-deficit/hyperactivity disorder (ADHD). Suicidality and psychiatric diagnoses were assessed in 370 incarcerated male juvenile delinquents from Northern Russia using the semi-structured K-SADS-PL psychiatric interview. A lifetime history of suicidal ideation only (24.7 %) and suicidal ideation with suicide attempts (15.7 %) was common. Binary logistic regression analysis was used to assess the role of ADHD and other psychiatric disorders in suicidal ideation and suicide attempts. A history of suicidal ideation and of suicide attempts were associated with higher rates of psychiatric morbidity and with the number of comorbid psychiatric disorders. An ADHD diagnosis was associated with an increased risk for both suicidal ideation and for suicide attempts. The comorbidity of ADHD with drug dependence further increased the risk for suicidal ideation, while ADHD and alcohol dependence comorbidity increased the risk for suicide attempts. Our findings highlight the importance of adequately detecting and treating psychiatric disorders in vulnerable youths, especially when they are comorbid with ADHD.

The role of physical and mental health multimorbidity in suicidal ideation.

PubMed

Kavalidou, Katerina; Smith, Daniel J; O'Connor, Rory C

2017-02-01

Previous research has focused on the separate roles of mental illness and physical health conditions in suicide risk, with relatively few studies investigating the importance of physical and psychiatric disorder co-occurrence. We aimed to investigate whether suicidal ideation might be influenced by physical and mental ill-health multimorbidity. Data from the Adult Psychiatric Morbidity Survey of England were analysed. Participants who responded to the suicidal thoughts question were grouped into four distinct categories based on their health conditions (Common mental disorders (CMD) only, physical health conditions only, CMD/physical health multimorbidity and a control group with neither physical nor mental health conditions). Multinomial logistic regression analyses were conducted and odds ratios (OR) and 95% CIs are presented. In the fully adjusted model, both the multimorbidity and CMD-only groups were associated with higher levels of suicidal ideation relative to the control group. Secondary analyses of cross-sectional data. Although multimorbidity was associated with suicidal thoughts, it does not appear to elevate risk beyond the independent effects of common mental disorders or physical health problems. Primary care and mental health clinicians should consider assessment of suicidal ideation among patients with multimorbid physical/mental health conditions. Copyright © 2016 Elsevier B.V. All rights reserved.

Physician-Assisted Suicide and Euthanasia in the ICU: A Dialogue on Core Ethical Issues.

PubMed

Goligher, Ewan C; Ely, E Wesley; Sulmasy, Daniel P; Bakker, Jan; Raphael, John; Volandes, Angelo E; Patel, Bhavesh M; Payne, Kate; Hosie, Annmarie; Churchill, Larry; White, Douglas B; Downar, James

2017-02-01

Many patients are admitted to the ICU at or near the end of their lives. Consequently, the increasingly common debate regarding physician-assisted suicide and euthanasia holds implications for the practice of critical care medicine. The objective of this article is to explore core ethical issues related to physician-assisted suicide and euthanasia from the perspective of healthcare professionals and ethicists on both sides of the debate. We identified four issues highlighting the key areas of ethical tension central to evaluating physician-assisted suicide and euthanasia in medical practice: 1) the benefit or harm of death itself, 2) the relationship between physician-assisted suicide and euthanasia and withholding or withdrawing life support, 3) the morality of a physician deliberately causing death, and 4) the management of conscientious objection related to physician-assisted suicide and euthanasia in the critical care setting. We present areas of common ground and important unresolved differences. We reached differing positions on the first three core ethical questions and achieved unanimity on how critical care clinicians should manage conscientious objections related to physician-assisted suicide and euthanasia. The alternative positions presented in this article may serve to promote open and informed dialogue within the critical care community.

Copycat effects after media reports on suicide: a population-based ecologic study.

PubMed

Niederkrotenthaler, Thomas; Till, Benedikt; Kapusta, Nestor D; Voracek, Martin; Dervic, Kanita; Sonneck, Gernot

2009-10-01

This study aimed to investigate whether the risk of increased suicide occurrence after reports on suicide is associated with the social characteristics of the reported suicides and whether this varies with similarity between the reported suicides and suicides in the population. We collected reports on all 179 individual suicides named in the 13 largest Austrian nationwide newspapers from 1996 to 2006. Information on social status and sociodemographic characteristics of the reported suicides, on certainty of labelling the death as a suicide, and on the suicide methods applied were extracted from the articles. We conducted logistic regression analyses, with the increase of post-report suicides within 28 days after the reports as dependent variable. In model 1, the increase of suicides that matched the reported individual suicide with regard to age group, sex and suicide method was used as outcome variable. In model 2, the increase of suicides that were different from the reported suicide with regard to these characteristics was the outcome. In model 3, the post-report increase of total suicides was the dependent variable. Celebrity status of the reported suicide, age of the reported suicide between 30 and 64 years, and definitive labelling as a suicide were associated with an increased risk of a post-report increase of similar suicides; criminality (i.e. the individual was reported as suspected or convicted of crime) of the reported suicide was associated with a lower risk of a post-report increase. In dissimilar suicides, none of the variables was associated with a post-report increase of suicides. Celebrity status of the reported suicide was the only predictor of a post-report increase of total suicides. The findings support the hypothesis that social variables of reported suicides impact the risk of post-report copycat behaviour. Evidence of copycat effects seemed to be strongest in suicides that were similar to the respective model with regard to age group, sex, and suicide method.

Celebrity Suicides and Their Differential Influence on Suicides in the General Population: A National Population-Based Study in Korea

PubMed Central

Myung, Woojae; Won, Hong-Hee; Fava, Maurizio; Mischoulon, David; Yeung, Albert; Lee, Dongsoo; Kim, Doh Kwan

2015-01-01

Objective Although evidence suggests that there is an increase in suicide rates in the general population following celebrity suicide, the rates are heterogeneous across celebrities and countries. It is unclear which is the more vulnerable population according to the effect sizes of celebrity suicides to general population. Methods All suicide victims in the general population verified by the Korea National Statistical Office and suicides of celebrity in South Korea were included for 7 years from 2005 to 2011. Effect sizes were estimated by comparing rates of suicide in the population one month before and after each celebrity suicide. The associations between suicide victims and celebrities were examined. Results Among 94,845 suicide victims, 17,209 completed suicide within one month after 13 celebrity suicides. Multivariate logistic regression analyses revealed that suicide victims who died after celebrity suicide were significantly likely to be of age 20-39, female, and to die by hanging. These qualities were more strongly associated among those who followed celebrity suicide with intermediate and high effect sizes than lower. Younger suicide victims were significantly associated with higher effect size, female gender, white collar employment, unmarried status, higher education, death by hanging, and night-time death. Characteristics of celebrities were significantly associated with those of general population in hanging method and gender. Conclusion Individuals who commit suicide after a celebrity suicide are likely to be younger, female, and prefer hanging as method of suicide, which are more strongly associated in higher effect sizes of celebrity suicide. PMID:25866521

Biopsychosocial Causes of Suicide and Suicide Prevention Outcome Studies in Juvenile Detention Facilities: A Review.

PubMed

Joshi, Kshamta; Billick, Stephen Bates

2017-03-01

To identify various biopsychosocial risk factors associated with suicidality in juvenile detention facilities and the effectiveness of suicide prevention protocols currently in use. Medical literature searches were conducted using databases like Pub Med, Ovid, and Google Scholar to identify studies conducted in and outside of United States. The prevalence of suicide among youth imprisoned at detention facilities has risen. Psychiatric disorders are common among such population, making them vulnerable to suicidal tendencies. Suicide risk screening within first 24 h of admission to the detention facility has shown to lower the risk of suicide. Identification of high risk individuals and their further psychiatric assessment is advocated. Much of work with regards to screening tools and instruments is underway and further study is required to get a better understanding.

Has information on suicide methods provided via the Internet negatively impacted suicide rates?

PubMed Central

Mergl, Roland; Hegerl, Ulrich

2017-01-01

Suicide rates in Germany consistently decreased from 1991 to 2006, but this trend was reversed in 2007. Underlying this reversal were large increases in suicides due to gassing in females and in being overrun in males. During a similar time period (2005–2013), Asian and some Western countries have also observed abrupt increases in suicides due to certain gasses, and the availability of “how-to” information on the Internet about these painless methods of suicide is thought to play a role in their increased use. This study used data from the Federal Statistics Office of Germany to examine current trends in overall suicide mortality in Germany (2007–2015) as well by age, gender, and suicide methods. Also assessed was whether suicides via newly emergent methods are associated with the frequency of corresponding Internet searches using data from Google Trends. Joinpoint regression analyses indicated significant increases in the overall suicide rate (Average Annual Percentage Change (AAPC) = 2.37%) for females, but not males. The largest annual increases were observed in gassing self-intoxication suicides (AAPC = 13.93%), the majority of which involved carbon monoxide. The increase in gassing suicides was larger in females (500%), compared to males (164%). The frequency of suicides by gassing was significantly associated with Internet searches for “carbon monoxide poisoning” for both male and female subgroups, independent of age group. This study provides the updated suicide surveillance data that are necessary for suicide prevention activities. Results are congruent with the recent abrupt rises in carbon monoxide suicides in other countries. PMID:29284015

Has information on suicide methods provided via the Internet negatively impacted suicide rates?

PubMed

Paul, Elise; Mergl, Roland; Hegerl, Ulrich

2017-01-01

Suicide rates in Germany consistently decreased from 1991 to 2006, but this trend was reversed in 2007. Underlying this reversal were large increases in suicides due to gassing in females and in being overrun in males. During a similar time period (2005-2013), Asian and some Western countries have also observed abrupt increases in suicides due to certain gasses, and the availability of "how-to" information on the Internet about these painless methods of suicide is thought to play a role in their increased use. This study used data from the Federal Statistics Office of Germany to examine current trends in overall suicide mortality in Germany (2007-2015) as well by age, gender, and suicide methods. Also assessed was whether suicides via newly emergent methods are associated with the frequency of corresponding Internet searches using data from Google Trends. Joinpoint regression analyses indicated significant increases in the overall suicide rate (Average Annual Percentage Change (AAPC) = 2.37%) for females, but not males. The largest annual increases were observed in gassing self-intoxication suicides (AAPC = 13.93%), the majority of which involved carbon monoxide. The increase in gassing suicides was larger in females (500%), compared to males (164%). The frequency of suicides by gassing was significantly associated with Internet searches for "carbon monoxide poisoning" for both male and female subgroups, independent of age group. This study provides the updated suicide surveillance data that are necessary for suicide prevention activities. Results are congruent with the recent abrupt rises in carbon monoxide suicides in other countries.

Postmortem Presence of Drugs and Method of Violent Suicide

PubMed Central

Sheehan, Connor M.; Rogers, Richard G.; Boardman, Jason D.

2016-01-01

The link between substance use and suicide is well established. However, little research analyzes how substance use is related to the method of suicide. This paper analyzes how specific drugs are associated with method of suicide, a critical topic because drug use bears on the etiology of suicide and may lead to policies aimed at deterring suicide. We use the COVDRS and logistic regression to examine postmortem presence of drugs among 3,389 hanging and firearm suicides in Colorado from 2004–2009. Net of demographic controls, we find that opiates are positively associated with firearms (OR: 1.92, 95% L: 1.27, 95% U: 2.86]) while antidepressants are positively associated with hanging (OR: 1.45, 95% L: 1.04, 95% U: 2.03). For cocaine and opiates, the association between drug use and violent method vary by educational attainment. Importantly, knowledge of the presence and type of specific drug is strongly associated with the method of suicide. PMID:27239069

Gun availability and use of guns for suicide, homicide, and murder in Canada.

PubMed

Bridges, F Stephen; Kunselman, Julie C

2004-04-01

A reliability check of Lester's (2000b) 1970-1995 time series that examined associations between the availability of firearms and their use for homicide and suicide in Canada. For the period 1974 to 1999, the relative availability of firearms as measured by the rate of accidental death from firearms and the average of the percentages of suicides + homicides using firearms was positively associated with the rate of homicide by firearms but not negatively associated with the rate of homicide by all other methods, and positively associated with the rate of suicide by firearms and negatively associated with the rate of suicide by all other methods. Correlations for the homicide versus murder rates, homicide rate using guns versus murder rate using guns, and homicide rate by all other methods versus murder rate by all other methods were very similar. There was a decrease over time of total suicide and homicide rates and firearm suicide and homicide rates, and with a slight indication of substitution of other methods for suicide.

Impact of acute alcohol consumption on lethality of suicide methods.

PubMed

Park, C Hyung Keun; Yoo, Seong Ho; Lee, Jaewon; Cho, Sung Joon; Shin, Min-Sup; Kim, Eun Young; Kim, Se Hyun; Ham, Keunsoo; Ahn, Yong Min

2017-05-01

The influence of acute alcohol consumption on the factors related to suicide remains understudied. Thus, the present study investigated the relationship between blood alcohol content (BAC) and the lethality of suicide methods. Autopsy data on 315 South Korean suicide completers with a positive BAC were collected from a nationwide pool between May 2015 and November 2015, and the methods were dichotomised as suicide methods of low lethality (SMLL; drug/chemical overdose and sharp objects, n=67) and suicide methods of high lethality (SMHL; everything else, n=243). BAC at the time of autopsy and various suicide-related factors of these two groups were compared with logistic regression analyses. Compared to suicide completers with a BAC in the lowest range of 0.011-0.049%, suicide completers with a BAC in the range of 0.150-0.199% were more likely to use SMHL (odds ratio [OR]: 3.644, 95% confidence interval [CI]: 1.221-10.874). Additionally, the adoption of SMHL was significantly associated with the absence of a psychiatric illness (OR: 0.433, 95% CI: 0.222-0.843) and a younger age; the OR for high BAC among subjects in their 40s was 0.266 (95% CI: 0.083-0.856); in their 50s, 0.183 (95% CI: 0.055-0.615); and in their 60s, 0.057 (95% CI: 0.015-0.216). The relationship between BAC and suicide method lethality was represented by a bell-shaped pattern in which suicide methods of high lethality were more likely to be used by suicide completers with mid-range BAC levels. The increased impulsivity and impairments in particular executive functions, including planning and organization, associated with acute alcohol use may influence the selection of a particular suicide method based on its lethality. Copyright © 2017 Elsevier Inc. All rights reserved.

77 FR 27063 - Proposed Data Collections Submitted for Public Comment and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-08

... United States, homicide and suicide are the second and third leading causes of death, respectively, in... routinely collect standardized data about suicides, which are in fact much more common than homicides. The... part of one incident such as homicide-suicides. It also is a voluntary system in which some 10-20...

Death and suicide among former child and adolescent psychiatric patients.

PubMed

Engqvist, Ulf; Rydelius, Per-Anders

2006-11-02

Increased mortality rates among previous child and adolescent psychiatry (CAP) patients have been found in Scandinavian studies up to the 1980s. The suicide risk in this group has been estimated to be almost five times higher than expected. This article addresses two questions: Do Swedish CAP patients continue to risk premature death and what kind of information related to psychiatric symptoms and/or behavior problems can predict later suicide? Hospital files, Sweden's census databases (including immigration and emigration) and administrative databases (including the Swedish Hospital Discharge register and the Persons Convicted of Offences register), and the Cause of Death register were examined to determine the mortality rate in a group of 1,400 former CAP inpatients and outpatients over a period of 12-33 years. Observed and expected numbers of deceased were calculated with the prospective method and the standardized mortality ratio (SMR) method. The relative risk or the risk ratio (RR) is presented with 95% confidence intervals (CIs). Significance level tests were made using two-by-two tables and chi-square tests. The Cox proportional-hazards regression model was used for survival analysis. Twenty-four males and 14 females died. Compared with the general population, the standardized mortality ratio in this group of CAP patients was significantly higher in both sexes. Behavioral problems, school problems, and co-morbid alcohol or drug abuse and criminality (including alcohol-related crimes) were found to be important predictors. Thirty-two deaths were attributed to suicide, intoxication, drug overdose, or accident; one patient died of an alcohol abuse-related disorder, and five patients died of natural causes. Suicide was the most common cause of death, but only 2 of these 19 cases were initially admitted for attempted suicide. We suggest that suicide and death prevention among CAP patients may not be a psychiatric issue per se but a future function of society's juvenile social-welfare investments and juvenile-delinquency prevention programs.

Latina Adolescents Health Risk Behaviors and Suicidal Ideation and Suicide Attempts: Results from the National Youth Risk Behavior Survey 2001-2013.

PubMed

Price, James H; Khubchandani, Jagdish

2017-06-01

Suicidal ideation and suicide attempts are more common in Latina adolescents than White or African-American adolescents. Several health risk behaviors have been identified as being associated with Latina adolescent suicides. However, to date, no study has identified the consistency and stability of these risk behaviors over time. This study utilized the national Youth Risk Behaviors Survey from 2001 to 2013 to estimate the prevalence of suicidal ideation, suicide attempts, and health risk behaviors associated with suicidal behaviors in Latina adolescents. Our analysis found the prevalence of suicidal ideation and suicide attempts varied significantly over the 13-year study span, decreasing from 2001 to 2009 and increased from 2011 to 2013. The analyses found 11 health risk behaviors that were significantly associated with both suicidal ideation and suicide attempts that did not vary over time. The stability of these 11 health risk behaviors associated with suicidal behaviors could be useful to school personnel to identify early at risk Latina adolescents who may benefit from school and community mental health resources.

Suicide risk in youth with intellectual disabilities: the challenges of screening.

PubMed

Ludi, Erica; Ballard, Elizabeth D; Greenbaum, Rachel; Pao, Maryland; Bridge, Jeffrey; Reynolds, William; Horowitz, Lisa

2012-06-01

Children and adolescents with intellectual disabilities (IDs), often diagnosed with comorbid psychiatric disorders, are a vulnerable population who may be at risk for developing suicidal thoughts and behaviors. Previous research has demonstrated that direct suicide screening can rapidly and effectively detect suicide risk and facilitate further clinical evaluation and management. Currently, there are no measures that screen for suicide risk designed specifically for individuals with ID. A review of the literature was conducted to (1) estimate the prevalence of suicidal thoughts, behaviors, and deaths by suicide in children and adolescents with ID; (2) describe associations between youth with ID and suicide risk; and (3) identify the limitations of commonly used suicide screening measures developed for non-ID youth. The literature review confirms that suicide risk exists in this population; youth with ID think about, attempt, and die by suicide. Standardized suicide risk screening is challenged by the lack of measures developed for this population. A summary of the findings is followed by a discussion of the practical clinical considerations surrounding the assessment of suicide risk in youth with ID.

Intra- and extra-familial child homicide in Sweden 1992-2012: A population-based study.

PubMed

Hedlund, Jonatan; Masterman, Thomas; Sturup, Joakim

2016-04-01

Previous studies have shown decreasing child homicide rates in many countries - in Sweden mainly due to a drop in filicide-suicides. This study examines the rate of child homicides during 21 years, with the hypothesis that a decline might be attributable to a decrease in the number of depressive filicide offenders (as defined by a proxy measure). In addition, numerous characteristics of child homicide are presented. All homicide incidents involving 0-14-year-old victims in Sweden during 1992-2012 (n = 90) were identified in an autopsy database. Data from multiple registries, forensic psychiatric evaluations, police reports, verdicts and other sources were collected. Utilizing Poisson regression, we found a 4% annual decrease in child homicides, in accordance with prior studies, but no marked decrease regarding the depressive-offender proxy. Diagnoses from forensic psychiatric evaluations (n = 50) included substance misuse (8%), affective disorders (10%), autism-spectrum disorders (18%), psychotic disorders (28%) and personality disorders (30%). Prior violent offences were more common among offenders in filicides than filicide-suicides (17.8% vs. 6.9%); and about 20% of offenders in each group had previously received psychiatric inpatient care. Aggressive methods of filicide predominated among fathers. Highly lethal methods of filicide (firearms, fire) were more commonly followed by same-method suicide than less lethal methods. Interestingly, a third of the extra-familial offenders had an autism-spectrum disorder. Based on several findings, e.g., the low rate of substance misuse, the study concludes that non-traditional risk factors for violence must be highlighted by healthcare providers. Also, the occurrence of autism-spectrum disorders in the present study is a novel finding that warrants further investigation. Copyright © 2016 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Suicidal Ideation and Behavior in Youth in the Juvenile Justice System: A Review of the Literature

PubMed Central

Stokes, Marquita L.; McCoy, Kathleen P.; Abram, Karen M.; Byck, Gayle R.

2017-01-01

Suicide is prevalent among youth, especially those involved in the juvenile justice system. Although many studies have examined suicidal ideation and behavior in delinquent youth, prevalence rates vary widely. This paper reviews studies of suicidal ideation and behavior in youth in the juvenile justice system, focusing on the point of contact: incarceration status and stage of judicial processing. Suicidal ideation and behavior are prevalent, and increase with greater involvement in the juvenile justice system. Depression, sexual abuse, and trauma were the most commonly identified predictors of suicidal ideation and behavior. Prevalence rates of suicidal ideation and behavior vary by gender and race/ethnicity, indicating the need for gender-specific and culturally relevant interventions. PMID:26084946

Suicidal Ideation and Behavior in Youth in the Juvenile Justice System: A Review of the Literature.

PubMed

Stokes, Marquita L; McCoy, Kathleen P; Abram, Karen M; Byck, Gayle R; Teplin, Linda A

2015-07-01

Suicide is prevalent among youth, especially those involved in the juvenile justice system. Although many studies have examined suicidal ideation and behavior in delinquent youth, prevalence rates vary widely. This article reviews studies of suicidal ideation and behavior in youth in the juvenile justice system, focusing on the point of contact: incarceration status and stage of judicial processing. Suicidal ideation and behavior are prevalent and increase with greater involvement in the juvenile justice system. Depression, sexual abuse, and trauma were the most commonly identified predictors of suicidal ideation and behavior. Prevalence rates of suicidal ideation and behavior vary by gender and race/ethnicity, indicating the need for gender-specific and culturally relevant interventions. © The Author(s) 2015.

Low Vitamin D Status and Suicide: A Case-Control Study of Active Duty Military Service Members

PubMed Central

Umhau, John C.; George, David T.; Heaney, Robert P.; Lewis, Michael D.; Ursano, Robert J.; Heilig, Markus

2013-01-01

Objective Considering that epidemiological studies show that suicide rates in many countries are highest in the spring when vitamin D status is lowest, and that low vitamin D status can affect brain function, we sought to evaluate if a low level of 25-hydroxyvitamin D [25(OH)D] could be a predisposing factor for suicide. Method We conducted a prospective, nested, case-control study using serum samples stored in the Department of Defense Serum Repository. Participants were previously deployed active duty US military personnel (2002–2008) who had a recent archived serum sample available for analysis. Vitamin D status was estimated by measuring 25(OH) D levels in serum samples drawn within 24 months of the suicide. Each verified suicide case (n = 495) was matched to a control (n = 495) by rank, age and sex. We calculated odds ratio of suicide associated with categorical levels (octiles) of 25(OH) D, adjusted by season of serum collection. Findings More than 30% of all subjects had 25(OH)D values below 20 ng/mL. Although mean serum 25(OH)D concentrations did not differ between suicide cases and controls, risk estimates indicated that subjects in the lowest octile of season-adjusted 25(OH)D (<15.5 ng/mL) had the highest risk of suicide, with subjects in the subsequent higher octiles showing approximately the same level of decreased risk (combined odds ratio compared to lowest octile  = 0.49; 95% C.I.: 0.315–0.768). Conclusions Low vitamin D status is common in active duty service members. The lowest 25(OH)D levels are associated with an increased risk for suicide. Future studies could determine if additional sunlight exposure and vitamin D supplementation might reduce suicide by increasing 25(OH) D levels. PMID:23308099

Association of Poor Subjective Sleep Quality with Suicidal Ideation among Pregnant Peruvian Women

PubMed Central

Gelaye, Bizu; Barrios, Yasmin V.; Zhong, Qiu-Yue; Rondon, Marta B.; Borba, Christina P.C.; Sánchez, Sixto E.; Henderson, David C.; Williams, Michelle A.

2015-01-01

Objective To examine the independent and joint relationships of poor subjective sleep quality, and antepartum depression with suicidal ideation among pregnant women. Methods A cross-sectional study was conducted among 641 pregnant women attending prenatal care clinics in Lima, Peru. Antepartum depression and suicidal ideation were assessed using the Patient Health Questionnaire-9 (PHQ-9) scale. Antepartum subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Logistic regression procedures were performed to estimate odds ratios (aOR) and 95% confidence intervals (95% CI) adjusted for confounders. Results Overall, the prevalence of suicidal ideation in this cohort was 16.8% and poor subjective sleep quality was more common among women endorsing suicidal ideation as compared to their counterparts who did not (47.2%vs.24.8%, p<0.001). After adjustment for confounders including maternal depression, poor subjective sleep quality (defined using the recommended criteria of PSQI global score of >5vs. ≤5) was associated with a 1.7-fold increased odds of suicidal ideation (aOR=1.67; 95%CI 1.02–2.71). When assessed as a continuous variable, each 1-unit increase in the global PSQI score resulted in an 18% increase in odds for suicidal ideation, even after adjusting for depression (aOR=1.18; 95%CI 1.08–1.28). Women with both poor subjective sleep quality and depression had a 3.5-fold increased odds of suicidal ideation (aOR=3.48; 95%CI 1.96–6.18) as compared with those who had neither risk factor. Conclusion Poor subjective sleep quality was associated with increased odds of suicidal ideation. Replication of these findings may promote investments in studies designed to examine the efficacy of sleep-focused interventions to treat pregnant women with sleep disorders and suicidal ideation. PMID:25983188

Information sources used by the suicidal to inform choice of method.

PubMed

Biddle, Lucy; Gunnell, David; Owen-Smith, Amanda; Potokar, John; Longson, Damien; Hawton, Keith; Kapur, Nav; Donovan, Jenny

2012-02-01

Choice of suicide method strongly influences the outcome of an attempt. Public knowledge of possible methods is an important but less frequently considered aspect of the accessibility of suicide. This qualitative study explored the sources of information shaping the near-fatal suicide attempts of 22 individuals. Respondents were recruited from nine hospitals in England. Semi-structured interviews were conducted to gain detailed narratives of the planning of the suicide attempt. Interviews were recorded, transcribed, then subjected to thematic analysis utilising constant comparison techniques. Information sources discussed most frequently were television, news stories, the Internet, and previous self-harm. Others were professional resources, personal knowledge of others' attempts and information gleaned from healthcare professionals. Many respondents reported seeing media portrayals or reports of suicide, which had contributed to their awareness of suicide methods. Several provided examples of direct imitation. Some had deliberately sought information about methods when planning their attempt--mostly from the Internet. Past experience was used to identify 'best' methods and perfect implementation. The frequency with which sources of information are 'used' by particular groups and their relative import cannot be inferred from a qualitative sample. Near-fatal cases may differ from completed suicides. The media is an important contributor to the cognitive availability of suicide in society and could be used for prevention through carefully crafted portrayals of suicide designed to generate negative social perceptions of popular methods. Understanding of how sources of information can influence perceptions of suicide could inform the content of clinical conversations with patients. Copyright © 2011 Elsevier B.V. All rights reserved.

Youth Suicide Trends in Finland, 1969-2008

ERIC Educational Resources Information Center

Lahti, Anniina; Rasanen, Pirkko; Riala, Kaisa; Keranen, Sirpa; Hakko, Helina

2011-01-01

Background: There are only a few recent studies on secular trends in child and adolescent suicides. We examine here trends in rates and methods of suicide among young people in Finland, where suicide rates at these ages are among the highest in the world. Methods: The data, obtained from Statistics Finland, consisted of all suicides (n = 901)…

Information Accessibility of the Charcoal Burning Suicide Method in Mainland China

PubMed Central

Cheng, Qijin; Chang, Shu-Sen; Guo, Yingqi; Yip, Paul S. F.

2015-01-01

Background There has been a marked rise in suicide by charcoal burning (CB) in some East Asian countries but little is known about its incidence in mainland China. We examined media-reported CB suicides and the availability of online information about the method in mainland China. Methods We extracted and analyzed data for i) the characteristics and trends of fatal and nonfatal CB suicides reported by mainland Chinese newspapers (1998–2014); ii) trends and geographic variations in online searches using keywords relating to CB suicide (2011–2014); and iii) the content of Internet search results. Results 109 CB suicide attempts (89 fatal and 20 nonfatal) were reported by newspapers in 13 out of the 31 provinces or provincial-level-municipalities in mainland China. There were increasing trends in the incidence of reported CB suicides and in online searches using CB-related keywords. The province-level search intensities were correlated with CB suicide rates (Spearman’s correlation coefficient = 0.43 [95% confidence interval: 0.08–0.68]). Two-thirds of the web links retrieved using the search engine contained detailed information about the CB suicide method, of which 15% showed pro-suicide attitudes, and the majority (86%) did not encourage people to seek help. Limitations The incidence of CB suicide was based on newspaper reports and likely to be underestimated. Conclusions Mental health and suicide prevention professionals in mainland China should be alert to the increased use of this highly lethal suicide method. Better surveillance and intervention strategies need to be developed and implemented. PMID:26474297

Understanding Suicide Attempts Among Gay Men From Their Self-perceived Causes.

PubMed

Wang, Jen; Plöderl, Martin; Häusermann, Michael; Weiss, Mitchell G

2015-07-01

Gay men are at higher risk of suicidality. This paper describes the causes of suicide attempts as perceived by the men themselves and analyzes their impact on severity and recidivism. Mental health surveys conducted among gay men in Geneva, Switzerland, from two probability-based time-space samples in 2007 and 2011, were merged to yield a combined sample N = 762. Suicide ideation, plans, and attempts were assessed, and respondents who had ever attempted suicide answered open questions about perceived causes which were coded and categorized for analysis within the framework of cultural epidemiology. In all, 16.7% of the respondents reported a suicide attempt in their lifetime (59.5% of them with multiple attempts). At their latest attempt, over two thirds asserted intent to die, and half required medical assistance. There was a wide variety of perceived causes, with most individuals reporting multiple causes and many of the most common causes cited at both the first and most recent subsequent attempts. Social/inter-personal problems constitute the most prominent category. Problems with love/relationship and accepting one's homosexuality figure consistently among the top three causes. Whereas the former tend to be associated with weaker intent to die, the latter are associated with the strongest intent to die and reported at multiple attempts. Problems with family are among the most common perceived causes at first attempt but not at the most recent subsequent attempt. Nevertheless, they tend to be related to the strongest intent to die and the greatest medical severity of all the perceived causes. Ten percent of men attempting suicide cited depression as a cause. Although it tended to be associated with weaker intent to die, depression was most likely to be reported at multiple attempts. Respondent-driven assessment yielded both common and idiosyncratic causes of suicide and their distinct effects. Some of these perceived causes are not prominent in the current literature, yet they have important implications for understanding risk and preventing suicide among gay men.

Prevalence of suicidal behaviors in patients with major depressive disorder in China: A comprehensive meta-analysis.

PubMed

Dong, Min; Wang, Shi-Bin; Li, Yan; Xu, Dan-Dan; Ungvari, Gabor S; Ng, Chee H; Chow, Ines H I; Xiang, Yu-Tao

2018-01-01

Suicidal behaviors are common in major depressive disorder (MDD) and contribute significantly to premature death. The objective of this meta-analysis is to estimate the pooled prevalence of suicidal behaviors in patients with MDD in China. The relevant databases in English (PubMed, Embase, PsycINFO and Cochrane Library) and Chinese (Chinese National Knowledge Infrastructure, Wanfang and Chinese Biological Medical Literature) were systematically and independently searched from their inceptions until January 23, 2017. Original studies that reported the prevalence of suicidal behaviors including suicidal ideation (SI), suicide plan (SP), suicide attempt (SA) and completed suicide (CS) were included. Thirty three articles that met the inclusion criteria were analyzed. The pooled lifetime prevalence of SI, SP and SA were 53.1% (95% CI: 42.4-63.4%), 17.5% (95% CI: 5.8-42.3%) and 23.7% (95% CI: 19.9-28.0%), respectively. One-month prevalence of SI and SA were 27.7% (95% CI: 15.4-44.5%) and 20.3% (95% CI: 12.1-32.2%), respectively. The pooled prevalence of SA during hospitalization and after onset of MDD were 17.3% (95% CI: 12.4-23.7%) and 42.1% (95% CI: 26.1-60.0%), respectively. Subgroup analyses revealed significant differences in both lifetime prevalence of SI and SA between genders, and between outpatients and inpatients with MDD. Suicidal behaviors are common in MDD patients in China. Regular screening and effective intervention for suicidal behavior in MDD patients are warranted. Copyright © 2017 Elsevier B.V. All rights reserved.

Discovering the truth in attempted suicide.

PubMed

Michel, Konrad; Maltsberger, John T; Jobes, David A; Leenaars, Antoon A; Orbach, Israel; Stadler, Kathrin; Dey, Pascal; Young, Richard A; Valach, Ladislav

2002-01-01

The findings of an international workshop on improving clinical interactions between mental health workers and suicidal patients are reported. Expert clinician-researchers identified common contemporary problems in interviews of suicide attempters. Various videotaped interviews of suicide attempters were critically discussed in relation to expert experience and the existing literature in this area. The working group agreed that current mental health practice often does not take into account the subjective experience of patients attempting suicide, and that contemporary clinical assessments of suicidal behavior are more clinician-centered than patient-centered. The group concluded that clinicians should strive for a shared understanding of the patient's suicidality; and that interviewers should be more aware of the suicidal patient's inner experience of mental pain and loss of self-respect. Collaborative and narrative approaches to the suicidal patient are more promising, enhancing the clinician's ability to empathize and help the patient begin to reestablish a sense of mastery, thereby strengthening the clinical alliance.

Increase in assisted suicide in Switzerland: did the socioeconomic predictors change? Results from the Swiss National Cohort

PubMed Central

Steck, Nicole; Junker, Christoph

2018-01-01

Objective To determine whether the strong increase in assisted suicides in Switzerland since 2008 is linked to a shift in the socioeconomic factors associated with assisted suicide and its related diagnoses. Methods In a population-based longitudinal study, we investigated assisted suicides in Switzerland over the period 2003–2014. Two groups of younger (25–64 years) and older (65–94 years) persons were analysed separately and compared. We calculated crude rates and used Cox proportional hazard and logistic regression models to examine associations of assisted dying with gender, marital status, education, religion, neighbourhood socioeconomic status and other variables, and investigated trends over time. Results We identified 3941 assisted suicides among 6 237 997 Swiss residents, 80% of which occurred in the older age group. Crude rates of assisted suicide more than tripled during the study period from 3.60 to 11.21 per 100 000 person-years; the increase was more pronounced in the older age group. Cancer was the most common underlying diagnosis (41.8%), but the percentage dying assisted was highest among patients with diseases of the nervous system (5.25% in the younger and 1.23% in the older age group). The factors associated with assisted suicide did not change during the study period. Female gender, higher education, having no religious affiliation, no children and a Swiss passport, living in a neighbourhood with a higher socioeconomic index and living in the French-speaking part of Switzerland were associated with a higher rate. Conclusions The study results do not indicate any shift in socioeconomic factors associated with assisted suicide, but a more pronounced increase in incidence among the elderly. PMID:29666138

Patients admitted to hospital after suicide attempt with violent methods compared to patients with deliberate self-poisoning -a study of background variables, somatic and psychiatric health and suicidal behavior.

PubMed

Persett, Per Sverre; Grimholt, Tine K; Ekeberg, Oivind; Jacobsen, Dag; Myhren, Hilde

2018-01-24

In Norway, there are about 550 suicides recorded each year. The number of suicide attempts is 10-15 times higher. Suicide attempt is a major risk factor for suicide, in particular when violent methods are used. Suicide attempts with violent methods have hardly been studied in Norway. This study describes demographic, psychiatric and somatic health in patients admitted to somatic hospitals in Norway after suicide attempt by violent methods compared with suicide attempters using deliberate self-poisoning (DSP). Patients admitted to somatic hospital after suicide attempt aged > 18 years were included in a prospective cohort study, enrolled from December 2010 to April 2015. Demographics (gender, age, marital and living condition, educational and employment status), previous somatic and psychological health were registered. Patients who had used violent methods were compared with patients admitted after suicide attempt by DSP. The study included 80 patients with violent methods and 81 patients with DSP (mean age both groups 42 yrs.). Violent methods used were cutting (34%), jumping from heights (32%), hanging (14%), others (10%), shooting (7%) and drowning (4%). Patients with violent methods had more often psychosis than patients admitted with DSP (14% vs 4%, p <  0.05), less anxiety disorders (4% vs 19%, p <  0.01) and less affective disorders (21% vs. 36%, p <  0.05). There were no significant differences between the numbers of patients who received psychiatric treatment at the time of the suicide attempt (violent 55% versus DSP 48%) or reported previous suicide attempt, 58% in patients with violent methods and 47% in DSP. Patients with violent methods stayed longer in hospital (14.3 (mean 8.3-20.3) vs. 2.3 (mean 1.6-3.1) days, p <  0.001), stayed longer in intensive care unit (5 days vs. 0.5 days, p <  0.001) and were in need of longer mechanical ventilation (1.4 vs 0.1 days, p <  0.001). Patients with violent methods had more often psychosis, less anxiety disorders and affective disorders than patients with DSP. Psychiatric treatment before the attempt and previous suicide attempt was not significantly different between the groups and about half of the patients in both groups were in psychiatric treatment at the time of the suicide attempt.

Differentiating suicide decedents who died using firearms from those who died using other methods.

PubMed

Anestis, Michael D; Khazem, Lauren R; Anestis, Joye C

2017-06-01

Studies have documented a link between gun ownership and suicide, but little is known about characteristics of those most likely to use a gun in a suicide attempt rather than alternative methods. We examined which factors differentiate suicide decedents who died using a gun from those who died by other methods. We further examined whether such findings are consistent within the subcomponent of our larger sample comprised entirely of gun owning suicide decedents. Data reflect 267 suicide decedents, with data provided by individuals who identified as having lost someone to suicide (loss survivors). Within the full sample, a higher proportion of gun-owning and male suicide decedents died by firearm. Further, individuals who had previously discussed suicide or engaged in one or more non-lethal suicide attempts were less likely to die by suicide using a gun. Within the subsample of gun owning suicide decedents, a greater proportion of decedents who stored guns at home and in unsecure locations died from self-inflected gunshot wounds. These findings add clarity to the relationship between firearm ownership and death by suicide at the individual level. Furthermore, these findings are consistent with the notion that means safety implementation may represent a vital suicide prevention tool. Copyright © 2017. Published by Elsevier B.V.

An Aspect of the Capability for Suicide—Fearlessness of the Pain Involved in Dying—Amplifies the Association between Suicide Ideation and Attempts

PubMed Central

Smith, Phillip N.; Stanley, Ian H.; Joiner, Thomas E.; Sachs-Ericsson, Natalie J.; Van Orden, Kimberly A.

2016-01-01

The interpersonal theory of suicide posits that individuals who experience suicide ideation will only develop suicidal intent, and subsequently engage in suicidal behavior when they have concomitant fearlessness about death and tolerance for physical pain (i.e., the capability for suicide). Objective: The current studies examined the hypothesis that one aspect of the capability for suicide—fearlessness of the pain involved in dying—would amplify the positive association between current suicide ideation and a previous suicide attempt in two samples at high risk for experiencing suicide ideation and suicide attempts. Methods: Study 1 examined this relation using self-report methods in a sample of adults entering treatment in a mental health outpatient clinic. Study 2 utilized similar methods in a sample of adults admitted to inpatient psychiatry. Results: Both studies indicated that those individuals who reported suicide ideation were more likely than non-ideators to report having attempted suicide only if they also reported greater fearlessness of the pain involved in dying. Conclusions: The current findings support the theorized role of the capability for suicide in the transition from ideation to attempt and also support assessing the capability for suicide in risk assessment. PMID:26984289

Correlates of Non-suicidal Self-Injury and Suicide Attempts in Bulimic Spectrum Disorders

PubMed Central

Gómez-Expósito, Alexandra; Wolz, Ines; Fagundo, Ana B.; Granero, Roser; Steward, Trevor; Jiménez-Murcia, Susana; Agüera, Zaida; Fernández-Aranda, Fernando

2016-01-01

Objective: The aim of this study was to examine the implication of personality, impulsivity, and emotion regulation difficulties in patients with a bulimic-spectrum disorder (BSD) and suicide attempts (SA), BSD patients with non-suicidal self-injury (NSSI), and BSD patients without these behaviors. Method: One hundred and twenty-two female adult BSD patients were assessed using self-report questionnaires. Patients were clustered post-hoc into three groups depending on whether they presented BSD without NSSI or SA (BSD), BSD with lifetime NSSI (BSD + NSSI) or BSD with lifetime SA (BSD + SA). Results: The BSD + NSSI and BSD + SA groups presented more emotion regulation difficulties, more eating and general psychopathology, and increased reward dependence in comparison with the BSD group. In addition, BSD + SA patients specifically showed problems with impulse control, while also presenting higher impulsivity than both the BSD and BSD + NSSI groups. No differences in impulsivity between the BSD and BSD + NSSI groups were found. Conclusions: The results show that BSD + NSSI and BSD + SA share a common profile characterized by difficulties in emotion regulation and low reward dependence, but differ in impulsivity and cooperativeness. This suggests that self-injury, in patients without a history of suicide attempts (i.e., BSD + NSSI), may have a regulatory role rather than being due to impulsivity. PMID:27597836

Youth suicide in Canada: distinctions among boys and girls.

PubMed

Rhodes, Anne

2013-01-01

In Canada, boys account for almost three quarters of suicides among those aged 15-24 years. However, non-fatal suicide-related behaviours also onset in youth but are more common in girls. Thus far, there has been little empirical investigation of what produces this gender paradox. This report summarizes two recently published studies in which ICES tackles the issues of the potential impacts of misclassification of suicide and of help-seeking behaviour. Copyright © 2013 Longwoods Publishing.

[A cross-sectional study on suicide attempts in urban middle school students in Chengdu].

PubMed

Zhang, Zhi-qun; Guo, Lan-ting

2003-03-01

To study the prevalence and associated factors of suicide attempt in middle school students. Five middle schools in Chengdu were randomly sampled in the study. A total of 1393 students between the ages of 11 and 18 finished a self-administered questionnaire, Beck Depression Inventory (BDI), Adolescent Self-Rating Life Events Check List (ASLEC) and Egma Minnen av Bardodosnauppforstran (EMBU). Everyone who had suicide attempts was interviewed. Data were analysed by SPSS 8.0 (statistical package for the social science) program on computer. Thirty-six (2.6%) of the 1 393 students has the history of attempted suicide and the ratio of boys and girls was 1:2. Among the suicide attempters, 33.3% had recurrent events. The most common reason of suicide attempts in middle school stage was family conflicts (34.4%) with most common event as taking overdose tranquilizers or poisoning (50.0%). Risk factors of suicide attempt seemed to include hallucination, cigarette smoking, being bullied by peers, wanting to change sex, parents' remarriage, being female, father's refusal, being neglected in childhood and experiencing more events in the previous year. Protecting factor was found to have been family warmness. Suicide attempts were not uncommonly seen in middle school students. Clinicians and teaching staff should identify the risk factors and carry out intervention as early as possible.

Substances used in completed suicide by overdose in Toronto: an observational study of coroner's data.

PubMed

Sinyor, Mark; Howlett, Andrew; Cheung, Amy H; Schaffer, Ayal

2012-03-01

To identify the substances used by people who die from suicide by overdose in Toronto and to determine the correlates of specific categories of substances used. Coroner's records for all cases of suicide by overdose in Toronto, Ontario, during a 10-year period (1998 to 2007) were examined. Data collected included demographic data, all substances detected, and those determined by the coroner to have caused death. Logistic regression analyses were used to examine demographic and clinical factors associated with suicide by different drug types. There were 397 documented suicides by overdose (mean age 49.1 years, 50% female). Most substances detected were psychotropic prescription medications (n = 245), followed by other prescription medications (n = 143) and over-the-counter (OTC) medications (n = 83). More than one-half of all suicides by overdose were determined to have only one specific substance as the cause of death (n = 206). In suicides where only one class of substance was present in lethal amounts, OTC medication (n = 48), opioid analgesics (n = 44), and tricyclic antidepressants (n = 44) were most common. Suicides by overdose involved the use of different classes of substances, including psychotropic prescription medication, other prescription medications, as well as OTC medications. Physicians and pharmacists should be aware of commonly used prescription and OTC medications in overdose and exercise increased vigilance in prescribing or dispensing them to at-risk patients.

Combination of self-harm methods and fatal and non-fatal repetition: A cohort study.

PubMed

Birtwistle, Jacqueline; Kelley, Rachael; House, Allan; Owens, David

2017-08-15

Assessment and aftercare for people who self-harm needs to be related to an understanding of risks of adverse outcomes. We aimed to determine whether self-harm by a combination of methods and its early repetition are associated with adverse outcomes - especially non-fatal repetition and suicide. 10,829 consecutive general hospital attendances due to self-harm in one large English city were monitored, through scrutiny of Emergency Department attendances, over three years and followed up to determine the incidence of non-fatal repetition. Subsequent deaths, by any cause and by suicide, were determined from national statistical records. 6155 patients accounted for the 10,829 episodes: 72% by self-poisoning, 21% self-injury, and 746 episodes (7%) due to a combination of methods. After a combined-methods index episode, non-fatal repetition (P=0.001) and suicide (P=0.002) occurred sooner and more frequently than it did among those who had self-poisoned. Further hospital attendance due to self-harm within a month was associated with a 3.7-fold (95% CI 2.1-6.4) risk of subsequent suicide. The data exclude self-harm episodes that do not result in a hospital attendance. Index episodes in the study are not generally life-time first episodes so follow-up data are based on an arbitrary start-point. Both of these limitations are common to all studies of this kind. At psychosocial assessment and the making of aftercare arrangements, combined methods of self-harm or another recent episode should be considered 'red-flag' indicators for attention to care. Copyright © 2017. Published by Elsevier B.V.

Friendship Factors and Suicidality: Common and Unique Patterns in Mexican- and European-American Youth

PubMed Central

Winterrowd, Erin; Canetto, Silvia Sara; Chavez, Ernest L.

2010-01-01

Research suggests a link between friendships and suicidality among U.S. youth but this link has not been confirmed across ethnicities. This study examined the relationship between friendships and suicidality among Mexican- and European-American adolescents. Specifically, the role of friendship problems (i.e., social isolation, poor quality friendships) and problematic friends (i.e., friends who were disconnected from school, delinquent friends) was explored. Participants were 648 community youth. Friends’ school disconnection was related to Mexican-American girls’ suicidal ideation while friends’ delinquency was associated with European-American youth suicidal behavior. Friendship factors were no longer associated with suicidality after controlling for suicidality correlates such as depression. These findings indicate that the relationship between friendships and suicidality varies by gender and ethnicity. They also suggest a dominant role of depression. PMID:21309824

Impacts of Stress, Self-Efficacy, and Optimism on Suicide Ideation among Rehabilitation Patients with Acute Pesticide Poisoning

PubMed Central

Feng, Jun; Li, Shusheng; Chen, Huawen

2015-01-01

Background The high incidence of pesticide ingestion as a means to commit suicide is a critical public health problem. An important predictor of suicidal behavior is suicide ideation, which is related to stress. However, studies on how to defend against stress-induced suicidal thoughts are limited. Objective This study explores the impact of stress on suicidal ideation by investigating the mediating effect of self-efficacy and dispositional optimism. Methods Direct and indirect (via self-efficacy and dispositional optimism) effects of stress on suicidal ideation were investigated among 296 patients with acute pesticide poisoning from four general hospitals. For this purpose, structural equation modeling (SEM) and bootstrap method were used. Results Results obtained using SEM and bootstrap method show that stress has a direct effect on suicide ideation. Furthermore, self-efficacy and dispositional optimism partially weakened the relationship between stress and suicidal ideation. Conclusion The final model shows a significant relationship between stress and suicidal ideation through self-efficacy or dispositional optimism. The findings extended prior studies and provide enlightenment on how self-efficacy and optimism prevents stress-induced suicidal thoughts. PMID:25679994

Frequency and clinical features of patients who attempted suicide by charcoal burning in Japan.

PubMed

Kato, Koji; Akama, Fumiaki; Yamada, Keigo; Maehara, Mizuki; Kimoto, Keitaro; Kimoto, Kousuke; Takahashi, Yuki; Sato, Reiko; Onishi, Yuichi; Matsumoto, Hideo

2013-02-15

To date, the clinical features between patients in Japan who have attempted suicide by charcoal burning and those who have attempted suicide by other methods in the context of a mental disorder diagnosis as assessed by structured interviews have not been reported. We enrolled 647 consecutive patients who attempted suicide and were hospitalized for inpatient treatment. Psychiatric diagnoses, frequency of suicide attempts, and clinical features were compared between charcoal burning and other suicide methods. Twenty of the 647 patients (3.1%) had attempted suicide by charcoal burning. The ratio of men to women was significantly higher by this method compared with that of other methods. The proportion of patients with mood disorders was significantly higher in the charcoal burning group than that in the other methods group. The occurrence of a psychiatric history in patients in the charcoal burning group was significantly lower than that in the other methods group. The study sample was limited to a single hospital. The results demonstrate the clinical characteristics of patients who attempted suicide by charcoal burning. Therefore, it is necessary to identify the clinical features of patients who have attempted suicide by charcoal burning in Japan. Copyright © 2012 Elsevier B.V. All rights reserved.

Patterns and predictors of help-seeking contacts with health services and general practitioner detection of suicidality prior to suicide: a cohort analysis of suicides occurring over a two-year period.

PubMed

Leavey, Gerard; Rosato, Michael; Galway, Karen; Hughes, Lynette; Mallon, Sharon; Rondon, Janeet

2016-04-30

Contact with primary care and psychiatric services prior to suicide may be considerable, presenting opportunities for intervention. However, there is scant knowledge on the frequency, nature and determinants of contact. Retrospective cohort study-an analysis of deaths recorded as suicide by the Northern Ireland Coroner's Office linked with data from General Practice patient records over a 2 year period Eighty-seven per cent of suicides were in contact with General Practice services in the 12 months before suicide. The frequency of contact with services was considerable, particularly among patients with a common mental disorder or substance misuse problems. A diagnosis of psychiatric problems was absent in 40% of suicides. Excluding suicide attempts, the main predictors of a noted general practitioner concern for patient suicidality are male gender, frequency of consultations, diagnosis of mental illness and substance misuse. Despite widespread and frequent contact, a substantial proportion of suicidal people were undiagnosed and untreated for mental health problems. General Practitioner alertness to suicidality may be too narrowly focused.

The gap between suicide characteristics in the print media and in the population.

PubMed

Niederkrotenthaler, Thomas; Till, Benedikt; Herberth, Arno; Voracek, Martin; Kapusta, Nestor D; Etzersdorfer, Elmar; Strauss, Markus; Sonneck, Gernot

2009-08-01

Programmes to educate media professionals about suicide are increasingly established, but information about which suicide cases are most likely to be reported in the mass media is sparse. We applied binomial tests to compare frequencies of social characteristics of all domestic suicides in the 13 largest Austrian print media in 2005 with frequencies of suicide characteristics in the population. Additionally, each reported suicide case was linked to its respective entry in the suicide database. We performed a logistic regression analysis, with presence of an article as outcome, and sex of the suicide case, age, religious affiliation, family status, conduction of an autopsy and location of the suicide as explaining variables. Time of the year and federal state where the suicide happened was controlled for. Binomial tests showed that suicides involving murder or murder attempt were over-represented in the media. Reporting on mental disorders was under-represented. In the regression analysis, the likelihood of a report was negatively associated with the age of suicide cases. Foreign citizenship was a further predictor of a suicide report. The methods of drowning, jumping, shooting and rare methods were more likely to be reported than hanging, which is the most frequent suicide method in Austria. Suicide characteristics in the media are not representative of the population. The identified discrepancies provide a basis for tailor-made education of mass media professionals.

Victimization, Suicidal Ideation, and Alcohol Use From Age 13 to 15 Years: Support for the Self-Medication Model

PubMed Central

Marschall-Lévesque, Shawn; Castellanos-Ryan, Natalie; Parent, Sophie; Renaud, Johanne; Vitaro, Frank; Boivin, Michel; Tremblay, Richard E.; Séguin, Jean R.

2017-01-01

Purpose Recent years have seen increased coverage of adolescent victimization and suicide. Both adolescent peer victimization and substance use have been associated with suicidal ideation, with evidence suggesting that all three factors are interrelated. There are at least four models which can explain the associations between these factors (i.e., self-medication, secondary mental disorder, bidirectional, and common factor). However, none of them is being empirically supported as the dominant model because few longitudinal studies have explored the association between these factors. Methods The present study compared longitudinal paths of all four models simultaneously using a cross-lagged model. This was done using self-reported measures of peer victimization, suicidal ideation, and alcohol use at age 13, 14, and 15 years in a longitudinal sample of 238 adolescents. Results All three variables were moderately stable across time. Significant cross-lagged associations were found, showing that frequent peer victimization at age 13 years was associated with higher odds of having suicidal ideation at age 14 years (odds ratio, 1.82; p < .05). In turn, presence of suicidal ideation at age 14 years was significantly associated with higher alcohol use frequency at age 15 years (β = .13; p < .05). Conclusions Results support previous literature suggesting that peer victimization predates alcohol use and extends it by showing clear directionality between suicidal ideation and alcohol use over 1 year, supporting the self-medication model. Clarifying the empirical basis of these underlying models could allow for earlier prevention strategies, by targeting the risk factor that appears the earliest in the model. PMID:27914973

Family Functioning in Suicidal Inpatients With Intimate Partner Violence

PubMed Central

Heru, Alison M.; Stuart, Gregory L.; Recupero, Patricia Ryan

2007-01-01

Background: Intimate partner violence (IPV) is commonly bidirectional with both partners perpetrating and being victims of aggressive behaviors. In these couples, family dysfunction is reported across a broad range of family functions: communication, intimacy, problem solving, expression or control of anger, and designation of relationship roles. This study reports on the perceived family functioning of suicidal inpatients. Method: In this descriptive, cross-sectional study of adult suicidal inpatients, participants completed assessments of recent IPV and family functioning. Recruited patients were between 18 and 65 years of age and English fluent, had suicidal ideation, and were living with an intimate partner for at least the past 6 months. Intimate partner violence was assessed using the Conflict Tactics Scale-Revised, and family functioning was measured using the McMaster Family Assessment Device. The study was conducted from August 2004 through February 2005. Results: In 110 inpatients with suicidal ideation and IPV, family functioning was perceived as poor across many domains, although patients did report family strengths. Gender differences were not found in the overall prevalence of IPV, but when the sample was divided into good and poor family functioning, women with poorer family functioning reported more psychological abuse by a partner. For both genders, physical and psychological victimization was associated with poorer family functioning. Conclusion: Among psychiatric inpatients with suicidal ideation, IPV occurred in relationships characterized by general dysfunction. Poorer general family functioning was associated with the perception of victimization for both genders. The high prevalence of bidirectional IPV highlights the need for the development of couples treatment for this population of suicidal psychiatric inpatients. PMID:18185819

Young men's intimate partner violence and relationship functioning: long-term outcomes associated with suicide attempt and aggression in adolescence.

PubMed

Kerr, D C R; Capaldi, D M

2011-04-01

Longitudinal research supports that suicidal thoughts and behaviors in adolescence predict maladjustment in young adulthood. Prior research supports links between suicide attempt and aggression, perhaps because of a propensity for impulsive behavior in states of high negative affect that underlies both problems. Such vulnerability may increase risk for intimate partner violence and generally poor young adulthood relational adjustment. A total of 153 men participated in annual assessments from ages 10-32 years and with a romantic partner at three assessments from ages 18-25 years. Multi-method/multi-informant constructs were formed for parent/family risk factors, adolescent psychopathology (e.g. suicide-attempt history, mother-, father-, teacher- and self-reported physical aggression) and young adulthood relational distress (jealousy and low relationship satisfaction) and maladaptive relationship behavior (observed, self- and partner-reported physical and psychological aggression toward a partner, partner-reported injury, official domestic violence arrest records and relationship instability). Across informants, adolescent aggression was correlated with suicide-attempt history. With few exceptions, aggression and a suicide attempt in adolescence each predicted negative romantic relationship outcomes after controlling for measured confounds. Adolescent aggression predicted young adulthood aggression toward a partner, in part, via relationship dissatisfaction. Boys' aggression and suicide-attempt history in adolescence each predict poor relationship outcomes, including partner violence, in young adulthood. Findings are consistent with the theory of a trait-like vulnerability, such as impulsive aggression, that undermines adaptation across multiple domains in adolescence and young adulthood. Prevention and intervention approaches can target common causes of diverse public health problems.

Young men’s intimate partner violence and relationship functioning: Long-term outcomes associated with suicide attempt and aggression in adolescence

PubMed Central

Kerr, David C. R.; Capaldi, Deborah M.

2010-01-01

Background Longitudinal research supports that suicidal thoughts and behaviors in adolescence predict maladjustment in young adulthood. Prior research supports links between suicide attempt and aggression, perhaps because of a propensity for impulsive behavior in states of high negative affect that underlies both problems. Such vulnerability may increase risk for intimate partner violence and generally poor young adulthood relational adjustment. Method 153 men participated in annual assessments from ages 10 to 32 years and with a romantic partner at three assessments from ages 18 to 25 years. Multimethod/multi-informant constructs were formed for parent/family risk factors, adolescent psychopathology (e.g., suicide attempt history; mother-, father-, teacher-, and self-reported physical aggression), and young adulthood relational distress (jealousy and low relationship satisfaction) and maladaptive relationship behavior (observed, self-, and partner-reported physical and psychological aggression toward a partner, partner-reported injury, official domestic violence arrest records, and relationship instability). Results Across informants, adolescent aggression was correlated with suicide attempt history. With few exceptions, aggression and a suicide attempt in adolescence each predicted negative romantic relationship outcomes after controlling for measured confounds. Adolescent aggression predicted young adulthood aggression toward a partner, in part, via relationship dissatisfaction. Conclusions Boys’ aggression and suicide attempt history in adolescence each predict poor relationship outcomes, including partner violence, in young adulthood. Findings are consistent with the theory of a trait-like vulnerability, such as impulsive aggression, that undermines adaptation across multiple domains in adolescence and young adulthood. Prevention and intervention approaches can target common causes of diverse public health problems. PMID:20540815

Primary care contact prior to suicide in individuals with mental illness

PubMed Central

Pearson, Anna; Saini, Pooja; Da Cruz, Damian; Miles, Caroline; While, David; Swinson, Nicola; Williams, Alyson; Shaw, Jenny; Appleby, Louis; Kapur, Navneet

2009-01-01

Background Previous studies have reported differing rates of consultation with GPs prior to suicide. Patients with a psychiatric history have higher rates of consultation and consult closer to the time of their death. Aim To investigate the frequency and nature of general practice consultations in the year before suicide for patients in current, or recent, contact with secondary mental health services. Design of study Retrospective case-note study and semi-structured interviews. Setting General practices in the northwest of England. Method General practice data were obtained by a retrospective review of medical records (n = 247) and semi-structured interviews with GPs (n = 159). Results GP records were reviewed in 247 of the 286 cases (86%). Overall, 91% of individuals (n = 224) consulted their GP on at least one occasion in the year before death. The median number of consultations was 7 (interquartile range = 3–10). Interviews were carried out with GPs with regard to 159 patients. GPs reported concerns about their patient's safety in 43 (27%) cases, but only 16% of them thought that the suicide could have been prevented. Agreement between GPs and mental health teams regarding risk of suicide was poor. Both sets of clinicians rated moderate to high levels of risk in only 3% of cases for whom information was available (n = 139) (overall κ = 0.024). Conclusion Consultation prior to suicide is common but suicide prevention in primary care is challenging. Possible strategies might include examining the potential benefits of risk assessment and collaborative working between primary and secondary care. PMID:19861027

Prevention of: self harm in British South Asian women: study protocol of an exploratory RCT of culturally adapted manual assisted Problem Solving Training (C- MAP)

PubMed Central

2011-01-01

Background Suicide is a major public health problem worldwide. In the UK suicide is the second most common cause of death in people aged 15-24 years. Self harm is one of the commonest reasons for medical admission in the UK. In the year following a suicide attempt the risk of a repeat attempt or death by suicide may be up to 100 times greater than in people who have never attempted suicide. Research evidence shows increased risk of suicide and attempted suicide among British South Asian women. There are concerns about the current service provision and its appropriateness for this community due to the low numbers that get involved with the services. Both problem solving and interpersonal forms of psychotherapy are beneficial in the treatment of patients who self harm and could potentially be helpful in this ethnic group. The paper describes the trial protocol of adapting and evaluating a culturally appropriate psychological treatment for the adult British South Asian women who self harm. Methods We plan to test a culturally adapted Problem Solving Therapy (C- MAP) in British South Asian women who self harm. Eight sessions of problem solving each lasting approximately 50 minutes will be delivered over 3 months. The intervention will be assessed using a prospective rater blind randomized controlled design comparing with treatment as usual (TAU). Outcome assessments will be carried out at 3 and 6 months. A sub group of the participants will be invited for qualitative interviews. Discussion This study will test the feasibility and acceptability of the C- MAP in British South Asian women. We will be informed on whether a culturally adapted brief psychological intervention compared with treatment as usual for self-harm results in decreased hopelessness and suicidal ideation. This will also enable us to collect necessary information on recruitment, effect size, the optimal delivery method and acceptability of the intervention in preparation for a definitive RCT using repetition of self harm and cost effectiveness as primary outcome measures. Trial Registration Current Controlled Trials 08/H1013/6 PMID:21693027

Depression and risk of suicide in patients with obsessive-compulsive disorder: A hospital-based study

PubMed Central

Chaudhary, Rupesh Kumar; Kumar, Pankaj; Mishra, Bholeshwar Prasad

2016-01-01

Background: Obsessive Compulsive Disorder (OCD) is a chronic, distressing, anxiety disorder associated with significant functional impairment. Patient with OCD often suffer from one or more co-morbid disorders. Major depression has been the most common co-morbid syndrome. Comorbid Axis I disorders along with increased severity of comorbid depressive and anxiety symptoms, increased severity of obsessions, feelings of hopelessness and past history of suicide attempts have been associated with worsening levels of suicidality in OCD (Angelakis I, Gooding P., 2015). As per data Thirty-six percent of the patients of OCD report lifetime suicidal thoughts and 11% have a history of attempted suicide(Torres AR, Ramos-Cerqueira AT, et al, 2011). There is a reasonable probability that the patient of OCD have suicidal thoughts, plans or actually attempt suicide. Aim: To assess depression and suicidality in OCD patients. Method: This study was conducted on 50 patients diagnosed with OCD as per ICD 10 criteria, both outpatient & indoor, from department of psychiatry, Dayanand Medical College & Hospital, Ludhiana, Punjab, India. A socio-demographic proforma (containing demographic details), Hamilton Depression Rating & Scale, Columbia suicide severity rating scale (CSSRS) & Yale Brown Obsessive Compulsive Scale Symptom Checklist (YBOCS) were administered. Results: Mild depression was found out to be 40% whereas 16% were suffering from moderate depression and 10% and 14% had severe and very severe depression respectively. Suicidal ideation was found in 52 % of patients.16% of patients had history of actual attempt. Data showed that 70% of females had suicidal ideations. It was also found that in cases of severe and very severe depression associated with OCD all the patients had suicidal ideations as compared to 35% in mild and 87.5% in moderate depressive patients. It was found that 40% of severe depressive and 28.57% of very severe depressive patients had attempted suicide one or more times during the course of illness. Also suicidality was found to be maximum in those with symptoms of cleanliness and contamination (57%) followed by religious obsessions (45%), sexual obsessions (33%), repeated rituals (31%) and other obsessions like need to touch, ask (26%) respectively. Conclusion: OCD is associated with high risk not only depression but also of suicidal behavior. It is vital that patients of OCD undergo detailed assessment for suicide risk and associated depression. Aggressive treatment of depression may be warranted to modify the risk of suicide. Behavioral and cognitive techniques along with pharmacotherapy should be used to target co-existing depressive symptoms so as to decrease morbidity and mortality. PMID:28659695

Suicide means used by Chinese rural youths: a comparison between those with and without mental disorders.

PubMed

Zhang, Jie; Li, Ziyao

2011-06-01

Reports on Chinese rural youth suicide indicated patterns different from those of the West. Only about 30% to 70% young victims had had diagnoses of psychiatric illnesses (Phillips et al., Lancet 359:835-840, 2002; Xiao et al., Chin J Psychiatry 36:129-131, 2003), and more than 60% of them used pesticides as suicide means (Wang et al., Lancet 372:1765-1773, 2008). To prevent suicides in rural China, it is important to know the choice of means by Chinese young suicide victims with and without mental disorders. Data on suicide cases in China's rural areas gathered from a big psychological autopsy study were studied for demographic characteristics, suicide methods, and the presence of mental disorders. The findings in the suicide victims with and without mental disorders showed significant differences in suicide method selecting. Victims with mental disorders tended to select violent methods compared with those without mental disorders (31.4% vs. 16.2%). Hanging is method more likely chosen by the mentally disordered victims (13.3%) than those without a mental disorder (7.8%). Mental status affects the means choice among the Chinese rural young suicide victims. Among them, the female victims without mental disorders tended to act on impulsivity and used nonviolent means such as pesticide consumption for suicide. This study informs suicide prevention measures in both China and rest of the world.

Department of Defense Suicide Event Report (DoDSER) Calendar Year 2010 Annual Report

DTIC Science & Technology

2011-09-01

n = 69, 24.56%). Drug overdose was the most frequent method for suicide attempt (n = 496, 57.47%), followed by injury with a sharp or blunt object...who died by suicide were non-military issue firearm use and hanging. Suicide attempt methods were most often drug overdose , harming oneself with a...military issue firearm use. Suicide attempt methods were most often drug overdose and use of military issue firearm. Drug and alcohol use was less

Impact upon Therapy and the Therapist When Working with Suicidal Patients: Some Transference and Countertransference Aspects.

ERIC Educational Resources Information Center

Richards, Barbara M.

2000-01-01

Explores the experience of psychotherapists (N=100) working with suicidal patients. Findings indicate that suicidal patients can evoke intense feelings within the therapist. Commonly mentioned responses include feelings of hopelessness and helplessness and a sense of failure. Outlines measures vital to the support of therapists and discusses the…

Treating Iraq and Afghanistan War Veterans with PTSD Who Are at High Risk for Suicide

ERIC Educational Resources Information Center

Jakupcak, Matthew; Varra, Edward M.

2011-01-01

Iraq and Afghanistan War veterans diagnosed with psychiatric disorders commit suicide at a higher rate than the general population (Kang & Bullman, 2008). Posttraumatic stress disorder (PTSD) has been identified as a risk factor for suicide in veterans (Bullman & Kang, 1994) and is the most common mental disorder among Iraq and Afghanistan…

Suicidal Behavior and Associations with Quality of Life among HIV-Infected Patients in Ibadan, Nigeria.

PubMed

Oladeji, Bibilola Damilola; Taiwo, Babafemi; Mosuro, Olushola; Fayemiwo, Samuel A; Abiona, Taiwo; Fought, Angela J; Robertson, Kevin; Ogunniyi, Adesola; Adewole, Isaac F

Suicidality has rarely been studied in HIV-infected patients in sub-Saharan Africa. This study explored suicidal behavior in a clinic sample of people living with HIV, in Nigeria. Consecutive patients were interviewed using the Composite International Diagnostic Interview (CIDI-10.0) and the World Health Organization Quality of Life (WHO-QOL-HIV-BREF). Associations of suicidal behavior were explored using logistic regression models. In this sample of 828 patients (71% female, mean age 41.3 ± 10 years), prevalence of suicidal behaviors were 15.1%, 5.8%, and 3.9% for suicidal ideation, plans, and attempts, respectively. Women were more likely than men to report suicidal ideation (odds ratio 1.7; 95% confidence interval 1.05-2.64). Depression and/or anxiety disorder was associated with increased odds of all suicidal behaviors. Suicidal behavior was associated with significantly lower overall and domain scores on the WHO-QOL. Suicidal behaviors were common and significantly associated with the presence of mental disorders and lower quality of life.

Are elite cricketers more prone to suicide? A psychological autopsy study of Test cricketer suicides.

PubMed

Shah, Ajit; Sava-Shah, Shrenik; Wijeratne, Chanaka; Draper, Brian

2016-06-01

It has been hypothesised that the very nature of the game predisposes elite cricketers to higher rates of suicide. We aim to estimate the suicide rate of male Test cricketers and to determine the reasons for suicide. The suicide rate in male Test cricketers was determined. A psychological autopsy was conducted using published biographical data. Twenty suicides amongst 2794 male Test cricketers from 1877 to 2014 yielded a suicide rate of 715.4 per 100,000 for that period. Health, financial and relationship issues were prominent; depression and alcohol misuse were common. Most suicides in Test cricketers occurred post-retirement in mid to late life with similar correlates to those found in the general male population. The idiosyncrasies of cricket are unlikely to contribute to suicide; however, the post-retirement welfare of Test cricketers should remain a focus of concern and the greater supports available to contemporary Test cricketers needs to extend beyond retirement. © The Royal Australian and New Zealand College of Psychiatrists 2016.

Significant relationship between lifetime alcohol use disorders and suicide attempts in an Australian schizophrenia sample.

PubMed

McLean, Duncan; Gladman, Beverley; Mowry, Bryan

2012-02-01

Suicide and attempted suicide are common in individuals with schizophrenia, and evidence exists for a link between substance use disorders and suicidality in this disorder. However, alcohol has not been consistently implicated. We examined the relationship between substance use disorders and suicide attempts in schizophrenia. We recruited a schizophrenia sample in Australia (n = 821) for genetic analyses. We analysed demographic and clinical variables, including substance use disorders, and their relationship to suicide attempts using generalised equation modelling. A significant association was identified between lifetime alcohol abuse/dependence and suicide attempts (OR = 1.66; 95% CI, 1.23 to 2.24; p = 0.001) after adjustment for potential confounders, but not between cannabis abuse/dependence and suicide attempts, nor between other illicit drug abuse/dependence and suicide attempts. Polysubstance abuse/dependence was also not implicated. These results suggest that the presence of alcohol abuse/dependence may be a risk factor for suicide attempts in individuals with schizophrenia, independent of comorbid substance abuse/dependence.

Acute Pesticide Poisoning in Children: Hospital Review in Selected Hospitals of Tanzania.

PubMed

Lekei, Elikana; Ngowi, Aiwerasia V; London, Leslie

2017-01-01

Acute pesticide poisoning (APP) is a serious problem worldwide. Because the burden of childhood APP is unknown in Tanzania, this study describes the distribution, circumstances, and patterns of APP involving children under 18 years in Tanzania. A 12-month prospective study was conducted in 10 Tanzanian healthcare facilities in 2006 using a data collection tool for surveillance. Of 53 childhood poisoning cases identified, 56.6% were female. The most common poisoning circumstances were accidents (49.1%) and suicide (30.2%). The most vulnerable children were 16-17 years old (30.2%). Suicide was significantly more common in females (PRR females/males = 1.66; 95% CI = 1.03-2.68) and accidental cases were more common in children aged 10 years or younger. Suicide was concentrated in children over 10 years, comprising 53% of cases in this age group. Organophosphates (OPs), zinc phosphide, and endosulfan were common amongst reported poisoning agents. The annual APP incidence rate was 1.61/100,000. APP is common among children in this region of Tanzania. Prevention of suicide in older children should address mental health issues and control access to toxic pesticides. Prevention of accidents in younger children requires safer storage and hygiene measures. Diverse interventions are needed to reduce pesticide poisoning among children in Tanzania.

Acute Pesticide Poisoning in Children: Hospital Review in Selected Hospitals of Tanzania

PubMed Central

London, Leslie

2017-01-01

Background Acute pesticide poisoning (APP) is a serious problem worldwide. Because the burden of childhood APP is unknown in Tanzania, this study describes the distribution, circumstances, and patterns of APP involving children under 18 years in Tanzania. Methodology A 12-month prospective study was conducted in 10 Tanzanian healthcare facilities in 2006 using a data collection tool for surveillance. Results Of 53 childhood poisoning cases identified, 56.6% were female. The most common poisoning circumstances were accidents (49.1%) and suicide (30.2%). The most vulnerable children were 16-17 years old (30.2%). Suicide was significantly more common in females (PRR females/males = 1.66; 95% CI = 1.03–2.68) and accidental cases were more common in children aged 10 years or younger. Suicide was concentrated in children over 10 years, comprising 53% of cases in this age group. Organophosphates (OPs), zinc phosphide, and endosulfan were common amongst reported poisoning agents. The annual APP incidence rate was 1.61/100,000. Conclusion APP is common among children in this region of Tanzania. Prevention of suicide in older children should address mental health issues and control access to toxic pesticides. Prevention of accidents in younger children requires safer storage and hygiene measures. Diverse interventions are needed to reduce pesticide poisoning among children in Tanzania. PMID:29441090

The epidemiology of firearm suicide in the United States.

PubMed

Romero, Michael P; Wintemute, Garen J

2002-03-01

Little attention has been given to the role of firearms in suicide. In 1998, firearms were the leading method of committing suicide for both men and women, responsible for three times the number of suicides compared to the next leading method. Understanding the epidemiology of firearm suicide will increase awareness of firearm suicide as a major public health problem. Rates of firearm suicide have changed little over the past two decades and have consistently exceeded rates of firearm homicide. The firearm suicide rate among men is approximately six times that of women. While firearm suicide rates are highest among the elderly, the majority (66%) of firearm suicides are among persons under 55 years of age. Firearm suicide rates among women of all ages have dropped modestly, while rates among elderly men have risen considerably. Whites have roughly twice the rate of firearm suicide as do blacks and other race/ethnicity groups. Individual-level empirical studies have consistently indicated that keeping firearms in the home is associated with an increased risk of suicide. For suicide prevention to be effective, the availability and use of firearms in suicides must be addressed.

Turkish Imams' Experience with and Their Attitudes Toward Suicide and Suicidal Persons.

PubMed

Eskin, Mehmet

2017-06-01

This study investigated the experience with and attitudes toward suicide and suicidality in 70 consenting imams serving in mosques in the province of Aydin which is located at the southwest part of Turkey. A self-report questionnaire was used to collect the data. Attitudes of imams to suicide and suicidality were compared with attitudes of male university students. Only 4 imams (5.7 %) reported having had suicidal thoughts in past, and none reported having attempted suicide. Almost 50 % said that someone in communities they serve has commited suicide and nearly 40 % reported leading funeral ceremony for someone who committed suicide. Majority of imams (64.3 %) were of the opinion that a funeral ceremony should be arranged for people who suicide and 87.1 % were of the opinion that people who suicide can be buried in a common cemetery, but only 21.4 % said that someone who attempted suicide can be appointed as imam. Compared to male medical students, imams saw suicide as an unacceptable option and those engaging in suicidal behavior to be punished after death. But they displayed socially accepting and helping reactions to an imagined close friend who attempted suicide. Therefore, it was concluded that imams might exhibit preventive reactions to suicide when they offer counseling for persons from their congregations during times of suicidal crises.

Suicide by Jumping and Accessibility of Bridges: Results from a National Survey in Switzerland

ERIC Educational Resources Information Center

Reisch, Thomas; Schuster, Ursula; Michel, Konrad

2007-01-01

Rates of suicide by jumping show large regional differences. Barriers on bridges may prevent suicides but also may lead to a substitution of jumping site or method. The aim of our study was to compare suicide data from regions with and without suicide bridges and to estimate the effects on method and site substitution if bridges were to be…

An Observational Study of Suicide Death in Homeless and Precariously Housed People in Toronto.

PubMed

Sinyor, Mark; Kozloff, Nicole; Reis, Catherine; Schaffer, Ayal

2017-07-01

Homelessness has been identified as an important risk factor for suicide death, but there is limited research characterising homeless people who die by suicide. The goal of this study is to identify personal, clinical, and suicide method-related factors that distinguish homeless and precariously housed people who die from suicide from those who are not homeless at the time of suicide. Coroner records were reviewed for all suicide deaths in Toronto from 1998 to 2012. Data abstracted included housing status as well as other demographics, clinical variables such as the presence of mental illness, and suicide method. Of 3319 suicide deaths, 60 (1.8%) were homeless and 230 (6.9%) were precariously housed. Homeless and precariously housed people were each younger than nonhomeless people ( P < 0.0001). Compared with nonhomeless, homeless people were more likely to be male and less likely to be married, to have interpersonal conflict, or to leave a suicide note. Homeless people and precariously housed were more likely to have died by fall/jump than nonhomeless people (62%, 57%, and 29%, respectively). Homeless and precariously housed people are overrepresented among suicide deaths in a large urban center and differ demographically, clinically, and in their suicide method from nonhomeless people who die by suicide. Targeted suicide prevention strategies should aim to address factors specific to homeless people.

Method overtness, forensic autopsy, and the evidentiary suicide note: A multilevel National Violent Death Reporting System analysis.

PubMed

Rockett, Ian R H; Caine, Eric D; Stack, Steven; Connery, Hilary S; Nolte, Kurt B; Lilly, Christa L; Miller, Ted R; Nelson, Lewis S; Putnam, Sandra L; Nestadt, Paul S; Jia, Haomiao

2018-01-01

Higher prevalence of suicide notes could signify more conservatism in accounting and greater proneness to undercounting of suicide by method. We tested two hypotheses: (1) an evidentiary suicide note is more likely to accompany suicides by drug-intoxication and by other poisoning, as less violent and less forensically overt methods, than suicides by firearm and hanging/suffocation; and (2) performance of a forensic autopsy attenuates any observed association between overtness of method and the reported presence of a note. This multilevel (individual/county), multivariable analysis employed a generalized linear mixed model (GLMM). Representing the 17 states participating in the United States National Violent Death Reporting System throughout 2011-2013, the study population comprised registered suicides, aged 15 years and older. Decedents totaled 32,151. The outcome measure was relative odds of an authenticated suicide note. An authenticated suicide note was documented in 31% of the suicide cases. Inspection of the full multivariable model showed a suicide note was more likely to manifest among drug intoxication (adjusted odds ratio [OR], 1.70; 95% CI, 1.56, 1.85) and other poisoning suicides (OR, 2.12; 1.85, 2.42) than firearm suicides, the referent. Respective excesses were larger when there was no autopsy or autopsy status was unknown (OR, 1.86; 95% CI, 1.61, 2.14) and (OR, 2.25; 95% CI, 1.86, 2.72) relative to the comparisons with a forensic autopsy (OR, 1.62, 95% CI, 1.45, 1.82 and OR, 2.01; 95% CI, 1.66, 2.43). Hanging/suffocation suicides did not differ from the firearm referent given an autopsy. Suicide requires substantial affirmative evidence to establish manner of death, and affirmation of drug intoxication suicides appears to demand an especially high burden of proof. Findings and their implications argue for more stringent investigative standards, better training, and more resources to support comprehensive and accurate case ascertainment, as the foundation for developing evidence-based suicide prevention initiatives.

Self-harm.

PubMed

Skegg, Keren

The term self-harm is commonly used to describe a wide range of behaviours and intentions including attempted hanging, impulsive self-poisoning, and superficial cutting in response to intolerable tension. As with suicide, rates of self-harm vary greatly between countries. 5-9% of adolescents in western countries report having self-harmed within the previous year. Risk factors include socioeconomic disadvantage, and psychiatric illness--particularly depression, substance abuse, and anxiety disorders. Cultural aspects of some societies may protect against suicide and self-harm and explain some of the international variation in rates of these events. Risk of repetition of self-harm and of later suicide is high. More than 5% of people who have been seen at a hospital after self-harm will have committed suicide within 9 years. Assessment after self-harm includes careful consideration of the patient's intent and beliefs about the lethality of the method used. Strong suicidal intent, high lethality, precautions against being discovered, and psychiatric illness are indicators of high suicide risk. Management after self-harm includes forming a trusting relationship with the patient, jointly identifying problems, ensuring support is available in a crisis, and treating psychiatric illness vigorously. Family and friends may also provide support. Large-scale studies of treatments for specific subgroups of people who self-harm might help to identify more effective treatments than are currently available. Although risk factors for self-harm are well established, aspects that protect people from engaging in self-harm need to be further explored.

Assisted suicide by oxygen deprivation with helium at a Swiss right-to-die organisation.

PubMed

Ogden, Russel D; Hamilton, William K; Whitcher, Charles

2010-03-01

In Switzerland, right-to-die organisations assist their members with suicide by lethal drugs, usually barbiturates. One organisation, Dignitas, has experimented with oxygen deprivation as an alternative to sodium pentobarbital. To analyse the process of assisted suicide by oxygen deprivation with helium and a common face mask and reservoir bag. This study examined four cases of assisted suicide by oxygen deprivation using helium delivered via a face mask. Videos of the deaths were provided by the Zurich police. Dignitas provided protocol and consent information. One man and three women were assisted to death by oxygen deprivation. There was wide variation in the time to unconsciousness and the time to death, probably due to the poor mask fit. Swiss law prevented attendants from effectively managing the face mask apparatus. Purposeless movements of the extremities were disconcerting for Dignitas attendants, who are accustomed to assisting suicide with barbiturates. None of the dying individuals attempted self-rescue. The dying process of oxygen deprivation with helium is potentially quick and appears painless. It also bypasses the prescribing role of physicians, effectively demedicalising assisted suicide. Oxygen deprivation with a face mask is not acceptable because leaks are difficult to control and it may not eliminate rebreathing. These factors will extend time to unconsciousness and time to death. A hood method could reduce the problem of mask fit. With a hood, a flow rate of helium sufficient to provide continuous washout of expired gases would remedy problems observed with the mask.

Suicidal Behavior and Alcohol Abuse

PubMed Central

Pompili, Maurizio; Serafini, Gianluca; Innamorati, Marco; Dominici, Giovanni; Ferracuti, Stefano; Kotzalidis, Giorgio D.; Serra, Giulia; Girardi, Paolo; Janiri, Luigi; Tatarelli, Roberto; Sher, Leo; Lester, David

2010-01-01

Suicide is an escalating public health problem, and alcohol use has consistently been implicated in the precipitation of suicidal behavior. Alcohol abuse may lead to suicidality through disinhibition, impulsiveness and impaired judgment, but it may also be used as a means to ease the distress associated with committing an act of suicide. We reviewed evidence of the relationship between alcohol use and suicide through a search of MedLine and PsychInfo electronic databases. Multiple genetically-related intermediate phenotypes might influence the relationship between alcohol and suicide. Psychiatric disorders, including psychosis, mood disorders and anxiety disorders, as well as susceptibility to stress, might increase the risk of suicidal behavior, but may also have reciprocal influences with alcohol drinking patterns. Increased suicide risk may be heralded by social withdrawal, breakdown of social bonds, and social marginalization, which are common outcomes of untreated alcohol abuse and dependence. People with alcohol dependence or depression should be screened for other psychiatric symptoms and for suicidality. Programs for suicide prevention must take into account drinking habits and should reinforce healthy behavioral patterns. PMID:20617037

Suicide and sleep: Is it a bad thing to be awake when reason sleeps?

PubMed

Perlis, Michael L; Grandner, Michael A; Chakravorty, Subhajit; Bernert, Rebecca A; Brown, Gregory K; Thase, Michael E

2016-10-01

Suicide is the second leading cause of death, worldwide, for those between the ages of 24 and 44 y old. In 2013, more than 41,000 suicides occurred in the United States. These statistics underscore the need to 1) understand why people die by suicide and 2) identify risk factors that are potentially modifiable. While it has been posited that sleep disturbance may represent one such factor, systematic research in this arena did not begin until the 2000s. Since that time, sleep disturbance has been reliably identified as a risk factor for suicidal ideation, suicide attempts, and suicide. While insomnia, nightmares, and other sleep disorders have each been found to contribute to the risk for suicidal ideation and behavior, it is also possible that these factors share some common variance. One possibility is that sleep disturbance results in being awake at night, and being awake at night also confers risk. The hypothesis proffered here is that being awake when one is not biologically prepared to be so results in "hypofrontality" and diminished executive function, and that this represents a common pathway to suicidal ideation and behavior. Such a proposition is highly testable under a variety of possible protocols. The current review summarizes the extant literature on suicide rates by time-of-day, and discusses circadian, psychosocial, and neurocognitive explanations of risk. Such a focus promises to enhance our understanding of how sleep disturbance may confer risk, allows for the identification of future lines of research, and further justifies the need for interventions that promote good sleep continuity among at-risk individuals. Copyright © 2015 Elsevier Ltd. All rights reserved.

Suicide and sleep: Is it a bad thing to be awake when reason sleeps?

PubMed Central

Perlis, Michael L.; Grandner, Michael A.; Chakravorty, Subhajit; Bernert, Rebecca A.; Brown, Gregory K.; Thase, Michael E.

2016-01-01

Suicide is the second leading cause of death, worldwide, for those between the ages of 24 and 44 y old. In 2013, more than 41,000 suicides occurred in the United States. These statistics underscore the need to 1) understand why people die by suicide and 2) identify risk factors that are potentially modifiable. While it has been posited that sleep disturbance may represent one such factor, systematic research in this arena did not begin until the 2000s. Since that time, sleep disturbance has been reliably identified as a risk factor for suicidal ideation, suicide attempts, and suicide. While insomnia, nightmares, and other sleep disorders have each been found to contribute to the risk for suicidal ideation and behavior, it is also possible that these factors share some common variance. One possibility is that sleep disturbance results in being awake at night, and being awake at night also confers risk. The hypothesis proffered here is that being awake when one is not biologically prepared to be so results in “hypofrontality” and diminished executive function, and that this represents a common pathway to suicidal ideation and behavior. Such a proposition is highly testable under a variety of possible protocols. The current review summarizes the extant literature on suicide rates by time-of-day, and discusses circadian, psychosocial, and neuro-cognitive explanations of risk. Such a focus promises to enhance our understanding of how sleep disturbance may confer risk, allows for the identification of future lines of research, and further justifies the need for interventions that promote good sleep continuity among at-risk individuals. PMID:26706755

Effect of the First World War on suicide rates in Ireland: an investigation of the 1864-1921 suicide trends.

PubMed

Osman, Mugtaba; Parnell, Andrew C

2015-10-01

Since the proposition of the social integration theory by Émile Durkheim, macro-sociological changes have been speculated to affect suicide rates. This study investigates the effect of the First World War on Irish suicide rates. We applied an interrupted time series design of 1864-1921 annual Irish suicide rates. The 1864-1913 suicide rates exhibited a slow-rising trend with a sharp decline from the year 1914 onwards. The odds for death by suicide for males during the 1914-1918 period was 0.811 (95% CI 0.768-0.963). Irish rates of suicide were significantly reduced during the First World War, most notably for males. None. © 2015 The Royal College of Psychiatrists. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.

Friendship factors and suicidality: common and unique patterns in Mexican American and European American youth.

PubMed

Winterrowd, Erin; Canetto, Silvia Sara; Chavez, Ernest L

2011-02-01

Research suggests a link between friendships and suicidality among U.S. youth, but this link has not been confirmed across ethnicities. The relationship between friendships and suicidality among Mexican American and European American adolescents was examined in this study. Specifically, the role of friendship problems (i.e., social isolation, poor quality friendships) and problematic friends (i.e., friends who were disconnected from school, delinquent friends) was explored. Participants were 648 community youth. Friends' school disconnection was related to Mexican American girls' suicidal ideation, while friends' delinquency was associated with European American youth suicidal behavior. Friendship factors were no longer associated with suicidality after controlling for suicidality correlates such as depression. These findings indicate that the relationship between friendships and suicidality varies by gender and ethnicity. They also suggest a dominant role of depression. © 2011 The American Association of Suicidology.

Suicide amongst Cambridge University students 1970-1996.

PubMed

Collins, I P; Paykel, E S

2000-03-01

Anecdote, media coverage and earlier research suggest that the rate of suicide amongst students at Cambridge and Oxford Universities is unduly high. There is also a popular belief that student suicide is common at examination times. Student deaths at the University of Cambridge were identified using the University database. The cause of death was determined by reference to death certificates and coroners' inquest records. We identified 157 student deaths during academic years 1970-1996, of which 36 appeared to be suicides. The overall suicide rate was 11.3/100,000 person years at risk. Suicide rates were similar to those seen amongst 15- to 24-year-olds in the general population. There were non-significant trends for male postgraduates to be over-represented and first-year undergraduates under-represented. Examination times were not associated with excess suicide. Suicide rates in University of Cambridge students do not appear to be unduly high.

Correlations between interpersonal and cognitive difficulties: relationship to suicidal ideation in military suicide attempters.

PubMed

Shelef, L; Fruchter, E; Mann, J J; Yacobi, A

2014-10-01

Understanding suicidal ideation may help develop more effective suicide screening and intervention programs. The interpersonal and the cognitive-deficit theories seek to describe the factors leading to suicidal behavior. In the military setting it is common to find over- and under-reporting of suicidal ideation. This study sought to determine the relationship between these two models and determine to what degree their components can indirectly predict suicidal ideation. Suicide attempters (n=32) were compared with non-suicidal psychologically treated peers (n=38) and controls (n=33), matched for sex and age (mean 19.7years). Pearson's analysis was used to quantify the relationship between the variables from the two models and hierarchal regression analysis was used to determine the explanation of suicidal ideation variance by these variables. Suicide attempters have more difficulties in problem-solving, negative emotion regulation and burdensomeness compared with their peers (P<.001). These variables are all closely correlated with each other and to suicide ideation (r>±0.5; P<.001). Prior suicide attempt, loneliness and burdensomeness together explain 65% (P<.001) of the variance in suicidal ideation. Suicidal ideation is strongly correlated with components of interpersonal and cognitive difficulties. In addition to assessing current suicidal ideation, clinicians should assess past suicide attempt, loneliness and burdensomeness. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

An Aspect of the Capability for Suicide-Fearlessness of the Pain Involved in Dying-Amplifies the Association Between Suicide Ideation and Attempts.

PubMed

Smith, Phillip N; Stanley, Ian H; Joiner, Thomas E; Sachs-Ericsson, Natalie J; Van Orden, Kimberly A

2016-01-01

The interpersonal theory of suicide posits that individuals who experience suicide ideation will only develop suicidal intent, and subsequently engage in suicidal behavior when they have concomitant fearlessness about death and tolerance for physical pain (i.e., the capability for suicide). The current studies examined the hypothesis that one aspect of the capability for suicide-fearlessness of the pain involved in dying-would amplify the positive association between current suicide ideation and a previous suicide attempt in two samples at high risk for experiencing suicide ideation and suicide attempts. Study 1 examined this relation using self-report methods in a sample of adults entering treatment in a mental health outpatient clinic. Study 2 utilized similar methods in a sample of adults admitted to inpatient psychiatry. Both studies indicated that those individuals who reported suicide ideation were more likely than non-ideators to report having attempted suicide only if they also reported greater fearlessness of the pain involved in dying. The current findings support the theorized role of the capability for suicide in the transition from ideation to attempt and also support assessing the capability for suicide in risk assessment.

Why are suicide rates rising in young men but falling in the elderly?-- a time-series analysis of trends in England and Wales 1950-1998.

PubMed

Gunnell, David; Middleton, Nicos; Whitley, Elise; Dorling, Daniel; Frankel, Stephen

2003-08-01

Suicide rates doubled in males aged <45 in England and Wales between 1950 and 1998, in contrast rates declined in older males and females of all ages. Explanations for these divergent trends are largely speculative, but social changes are likely to have played an important role. We undertook a time-series analysis using routinely available age- and sex-specific suicide, social, economic and health data, focussing on the two age groups in which trends have diverged most-25-34 and 60+ year olds. Between 1950 and 1998 there were unfavourable trends in many of the risk factors for suicide: rises in divorce, unemployment and substance misuse and declines in births and marriage. Whilst economic prosperity has increased, so too has income inequality. Trends in suicide risk factors were generally similar in both age-sex groups, although the rises in divorce and markers of substance misuse were most marked in 25-34 year olds and young males experienced the lowest rise in antidepressant prescribing. Statistical modelling indicates that no single factor can be identified as underlying recent trends. The factors most consistently associated with the rises in young male suicide are increases in divorce, declines in marriage and increases in income inequality. These changes have had little effect on suicide in young females. This may be because the drugs commonly used in overdose-their favoured method of suicide-have become less toxic or because they are less affected by the factors underlying the rise in male suicide. In older people declines in suicide were associated with increases in gross domestic product, the size of the female workforce, marriage and the prescribing of antidepressants. Recent population trends in suicide appear to be associated with by a range of social and health related factors. It is possible that some of the patterns observed are due to declining levels of social integration, but such effects do not appear to have adversely influenced patterns in older generations.

Characteristics of Completed Suicides: Implications of Differences among Methods.

ERIC Educational Resources Information Center

Fischer, Ellen P.; And Others

1993-01-01

Compared characteristics of suicides by jumping to those of suicides by hanging, ingestion, or shooting. Method used was significantly associated with sociodemographics, occupation, and mental health status, even after adjustment for individual access to suicide means. Findings provide evidence for hypothesis that controlling access to agent of…

Disability pension due to common mental disorders and subsequent suicidal behaviour: a population-based prospective cohort study.

PubMed

Rahman, Syed Ghulam; Alexanderson, Kristina; Jokinen, Jussi; Mittendorfer-Rutz, Ellenor

2016-04-04

Adverse health outcomes, including suicide, in individuals on disability pension (DP) due to mental diagnoses have been reported. However, scientific knowledge on possible risk factors for suicidal behaviour (suicide attempt and suicide) in this group, such as age, gender, underlying DP diagnoses, comorbidity and DP duration and grade, is surprisingly sparse. This study aimed to investigate associations of different measures (main and secondary diagnoses, duration and grade) of DP due to common mental disorders (CMD) with subsequent suicidal behaviour, considering gender and age differences. Population-based prospective cohort study based on Swedish nationwide registers. A cohort of 46,515 individuals aged 19-64 years on DP due to CMD throughout 2005 was followed-up for 5 years. In relation to different measures of DP, univariate and multivariate HRs and 95% CIs for suicidal behaviour were estimated by Cox regression. All analyses were stratified by gender and age. During 2006-2010, 1036 (2.2%) individuals attempted and 207 (0.5%) completed suicide. Multivariate analyses showed that a main DP diagnosis of 'stress-related mental disorders' was associated with a lower risk of subsequent suicidal behaviour than 'depressive disorders' (HR range 0.4-0.7). Substance abuse or personality disorders as a secondary DP diagnosis predicted suicide attempt in all subgroups (HR range 1.4-2.3) and suicide in women and younger individuals (HR range 2.6-3.3). Full-time DP was associated with a higher risk of suicide attempt compared with part-time DP in women and both age groups (HR range 1.4-1.7). Depressive disorders as the main DP diagnosis and substance abuse or personality disorders as the secondary DP diagnosis were risk markers for subsequent suicidal behaviour in individuals on DP due to CMD. Particular attention should be paid to younger individuals on DP due to anxiety disorders because of the higher suicide risk. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Does Perceived Social Support Mediate or Moderate the Relationship between Victimisation and Suicidal Ideation among Chinese Adolescents?

ERIC Educational Resources Information Center

Liu, Xiaoqun; Chen, Gui; Hu, Peng; Guo, Guipin; Xiao, Shuiyuan

2017-01-01

Bullying is a common problem in school. Engagement in bullying has been known to have many adverse effects, even including suicide. Examining which factor will moderate or mediate the pathway from victimisation to suicidal ideation is needed to develop effective intervention initiatives. This study aimed to examine the mediator and moderator roles…

Strong Schools against Suicidality and Self-Injury: Evaluation of a Workshop for School Staff

ERIC Educational Resources Information Center

Groschwitz, Rebecca; Munz, Lara; Straub, Joana; Bohnacker, Isabelle; Plener, Paul L.

2017-01-01

Nonsuicidal self-injury (NSSI) and suicidality are common among adolescents. School staff are often the first adults to be confronted with those behaviors. However, previous studies have shown a lack of knowledge and confidence in dealing with self-harming behaviors. Objectives of this study were to evaluate a workshop on NSSI and suicidality in…

Nonfatal Suicidal Behavior among Chinese Women Who Have Been Physically Abused by Their Male Intimate Partners

ERIC Educational Resources Information Center

Wong, Susan P. Y.; Phillips, Michael R.

2009-01-01

Three hundred fifty-three women (median age = 32 years) admitted to the emergency rooms of nine general hospitals serving rural areas in China were interviewed for nonfatal suicidal behavior. Spousal conflict was the most commonly reported cause for their suicidal behavior and one third of respondents reported being victims of physical abuse by…

Soluble Interleukin 2 Receptor Levels, Temperament and Character in Formerly Depressed Suicide Attempters Compared with Normal Controls

ERIC Educational Resources Information Center

Rothenhausler, Hans-Bernd; Stepan, Alexandra; Kapfhammer, Hans-Peter

2006-01-01

An imbalance of the immune system and mixed personality profiles in suicide attempters have been reported. As suicidal behavior is common in patients with psychiatric disorders within the spectrum of depressive features, in this study we measured soluble interleukin-2 receptor concentrations in plasma (sIL-2R) and investigated temperament and…

[Gender differences in suicidal behavior].

PubMed

Vörös, Viktor; Osváth, Péter; Fekete, Sándor

2004-06-01

Gender-specific differences in suicidal behaviour have been analysed in a number of recent studies. According to these, several socioeconomic, demographic, psychiatric, familial, help-seeking differences can be identified in protective and risk factors between males and females. Gender is one of the most replicated predictors for suicide. In the framework of the WHO/EURO Multicentre Study on Suicidal Behaviour, more than fifty thousand suicide attempts have been registered so far. Until now data on more than 1200 monitored suicidal events have been collected in Pecs centre. In most countries male suicid rates are higher. In contrast to suicides, rates of suicide attempts are usually higher in females. Concerning the differences in methods, it is a recognised fact that males use violent methods of both suicide and attempted suicide more often than females. The summarised clinical impression suggests that compliance of male patients is poorer than that of females. According to our data, a typical male attempter is characterised as follows: unemployed, never married, lives alone. He tends to use violent methods; if he takes drugs, it is mostly meprobamate or carbamazepine. A lot of male attempters have alcohol problems or dependence. As for the females, we found high odds ratios in the following cases: divorced or widowed, economically inactive, depressive state in the anamnesis. Female attempters are mainly repeaters using the method of self-poisoning, mostly with benzodiazepines. As suicide is a multicausal phenomenon, its therapy and prevention should also be complex and gender differences should be taken into account in building up our helping strategies.

Burnt wives--a study of suicides.

PubMed

Kumar, Virendra

2003-02-01

Ritual self-immolation has long been practiced in India. Although in the past the practice has been related to the act of sati, it is currently more commonly associated with dowry disputes. In India, dowries are a continuing series of gifts endowed before and after the marriage. When dowry expectations are not met, the young bride may be killed or compelled to commit suicide, most frequently by burning. In a cohort of 152 burned wives, 32 (21%) were immolation suicides and these cases were analyzed from both epidemiological and medicolegal aspects. Suicide by burning amongst women is a major concern in India as it has become pervasive throughout all social strata and geographical areas. In this series, most women were from joint families (i.e. multigenerational groups of related individuals living under a single roof) and the suicides occurred 2-5 years after marriage. The majority of the affected wives were 21-25 years of age (69%) at the time of the suicide and sustained more than a 50% TBSA burn injury after dousing themselves with kerosene. Most died at the time of the incident or within the subsequent 24h, most commonly from shock.

Gender differences in suicide methods.

PubMed

Callanan, Valerie J; Davis, Mark S

2012-06-01

Gender differences in suicide completion rates have been attributed to the differences in lethality of suicide methods chosen by men and women, but few empirical studies have investigated factors other than demographic characteristics that might explain this differential. Data from the 621 suicides in Summit County, Ohio during 1997-2006 were disaggregated by gender to compare known correlates of suicide risk on three methods of suicide-firearm, hanging and drug poisoning. Compared to women, men who completed suicide with firearms were more likely to be married and committed the act at home. Unmarried men were likelier to hang themselves than married men, but unmarried women were less likely to hang themselves than married women. Men with a history of depression were more likely to suicide by hanging, but women with depression were half as likely to hang themselves compared to the women without a history of depression. Men with a history of substance abuse were more likely to suicide by poisoning than men without such history, but substance abuse history had no influence on women's use of poisoning to suicide. For both sexes, the odds of suicide by poisoning were significantly higher for those on psychiatric medications.

High and low suicidality in Europe: A fine-grained comparison of France and Spain within the ESEMeD surveys

PubMed Central

Kovess-Masfety, V.; Boyd, A.; Haro, J.M.; Bruffaerts, R.; Villagut, G.; Lépine, J.P.; Gasquet, I.; Alonso, J.

2015-01-01

Background Suicidality risk-factors between countries with similar economic and religious background have been rarely compared, especially within genders. Methods Lifetime prevalence of suicide ideation, plans, and attempts in the ESEMeD surveys were stratified on four separate groups: French women, Spanish women, French men, Spanish men. Outcome odds-ratios (OR) were modelled within each group using logistic regression including demographic characteristics, lifetime mood/anxiety disorders, parental bonding, marital status, and health service-use. Results Lifetime prevalence of suicide attempts was 3.4% in France (1.1% men, 5.4% women) and 1.5% in Spain (1.2% men, 1.7% women), with a significantly greater gender difference in France (p=0.001). Regarding risk-factors, French women reported suicide attempt more commonly with authoritarian mothers (OR=1.51; 95%CI=1.04–2.18), unlike Spanish women (OR=0.77; 95%CI=0.51–1.15) (p<0.001). Spanish men showed more than eight-times higher odds of suicide attempt with overprotecting mothers than French men (p=0.03). General practitioner-(GP)-use was significantly protective of suicide attempt among Spanish women (OR=0.08; 95%CI=0.02–0.35) with no effect in French women (OR=1.03; 95%CI=0.54–2.00) (p=0.01). No significant differences in the effect of marital status, any lifetime antidepressant use, mental disorders, or religiosity on suicide attempt were observed between France and Spain within gender-stratum. Limitations Parental bonding is retrospective and potentially influenced by mental state. Response rate was considerably lower in France than in Spain. Conclusions Suicidality risk-factors play different roles across genders between France and Spain. Parental bonding dimensions may be interpreted differently according to country, underlining cultural importance. As recommended by WHO, mental health decisions must involve GPs in conjunction with psychiatrists or psychologists. PMID:21621264

Suicide and the Internet: Changes in the accessibility of suicide-related information between 2007 and 2014.

PubMed

Biddle, Lucy; Derges, Jane; Mars, Becky; Heron, Jon; Donovan, Jenny L; Potokar, John; Piper, Martyn; Wyllie, Clare; Gunnell, David

2016-01-15

Following the ongoing concerns about cyber-suicide, we investigate changes between 2007 and 2014 in material likely to be accessed by suicidal individuals searching for methods of suicide. 12 search terms relating to suicide methods were applied to four search engines and the top ten hits from each were categorised and analysed for content. The frequency of each category of site across all searches, using particular search terms and engines, was counted. Key changes: growth of blogs and discussion forums (from 3% of hits, 2007 to 18.5% of hits, 2014); increase in hits linking to general information sites - especially factual sites that detail and evaluate suicide methods (from 9%, 2007 to 21.7%, 2014). Hits for dedicated suicide sites increased (from 19% to 23%), while formal help sites were less visible (from 13% to 6.5%). Overall, 54% of hits contained information about new high-lethality methods. We did not search for help sites so cannot assess the balance of suicide promoting versus preventing sites available online. Social media was beyond the scope of this study. Working with ISPs and search engines would help optimise support sites. Better site moderation and implementation of suicide reporting guidelines should be encouraged. Copyright © 2015 Elsevier B.V. All rights reserved.

The association between smoking and subsequent suicide-related outcomes in the National Comorbidity Survey panel sample

PubMed Central

Kessler, Ronald C.; Borges, Guilherme; Sampson, Nancy; Miller, Matthew; Nock, Matthew K.

2009-01-01

Controversy exists about whether the repeatedly-documented associations between smoking and subsequent suicide-related outcomes (SROs; ideation, plans, gestures, and attempts) are due to unmeasured common causes or to causal effects of smoking on SROs. We address this issue by examining associations of smoking with subsequent SROs with and without controls for potential explanatory variables in the National Comorbidity Survey (NCS) panel. The latter consists of 5001 people who participated in both the 199002 NCS and the 2001–03 NCS Follow-up Survey. Explanatory variables include socio-demographics, potential common causes (parental history of mental-substance disorders; other respondent childhood adversities) and potential mediators (respondent history of DSM-III-R mental-substance disorders). Small gross (i.e., without controls) prospective associations are found between history of early-onset nicotine dependence and both subsequent suicide ideation and, among ideators, subsequent suicide plans. None of the baseline smoking measures, though, predicts subsequent suicide gestures or attempts among ideators. The smoking-ideation association largely disappear, but the association of early-onset nicotine dependence with subsequent suicide plans persists (Odds-ratio = 3.0), after adjustment for control variables. However, the latter association is as strong with remitted as active nicotine dependence, arguing against a direct causal effect of nicotine dependence on suicide plans. Decomposition of the control variable effects, furthermore, suggests that these effects are due to common causes more than to mediators. These results refine our understanding of the ways in which smoking is associated with later SROs and for the most part argue against the view that these associations are due to causal effects of smoking. PMID:18645572

Who Leaves Suicide Notes? An Exploration of Victim Characteristics and Suicide Method of Completed Suicides in Queensland.

PubMed

Carpenter, Belinda; Bond, Christine; Tait, Gordon; Wilson, Moira; White, Kris

2016-01-01

The objective of this study is to address the question: are those who leave suicide notes representative of the larger population of those who commit suicide? The method involves an analysis of a full population of suicides by residents of Queensland, Australia for the full year of 2004, with the information drawn from Coronial files. Our overall results suggest that, and in support of previous research, the population who leaves suicide notes are remarkably similar to those who do not. Differences are identified in four areas: first, and in contrast to prior research, females are less likely to leave a suicide note; second, and in support of previous research, Aboriginal Australians are less likely to leave suicide notes; third, and in support of some previous research, those who use gas as a method of suicide are more likely to leave notes, while those who use a vehicle or a train are less likely to leave notes; finally, our findings lend support to research which finds that those with a diagnosed mental illness are less likely to leave notes. The discussion addresses some of the reasons these disparities may have occurred, and continues the debate over the degree to which suicide notes give insight into the larger suicide population.

Surfing for suicide methods and help: content analysis of websites retrieved with search engines in Austria and the United States.

PubMed

Till, Benedikt; Niederkrotenthaler, Thomas

2014-08-01

The Internet provides a variety of resources for individuals searching for suicide-related information. Structured content-analytic approaches to assess intercultural differences in web contents retrieved with method-related and help-related searches are scarce. We used the 2 most popular search engines (Google and Yahoo/Bing) to retrieve US-American and Austrian search results for the term suicide, method-related search terms (e.g., suicide methods, how to kill yourself, painless suicide, how to hang yourself), and help-related terms (e.g., suicidal thoughts, suicide help) on February 11, 2013. In total, 396 websites retrieved with US search engines and 335 websites from Austrian searches were analyzed with content analysis on the basis of current media guidelines for suicide reporting. We assessed the quality of websites and compared findings across search terms and between the United States and Austria. In both countries, protective outweighed harmful website characteristics by approximately 2:1. Websites retrieved with method-related search terms (e.g., how to hang yourself) contained more harmful (United States: P < .001, Austria: P < .05) and fewer protective characteristics (United States: P < .001, Austria: P < .001) compared to the term suicide. Help-related search terms (e.g., suicidal thoughts) yielded more websites with protective characteristics (United States: P = .07, Austria: P < .01). Websites retrieved with U.S. search engines generally had more protective characteristics (P < .001) than searches with Austrian search engines. Resources with harmful characteristics were better ranked than those with protective characteristics (United States: P < .01, Austria: P < .05). The quality of suicide-related websites obtained depends on the search terms used. Preventive efforts to improve the ranking of preventive web content, particularly regarding method-related search terms, seem necessary. © Copyright 2014 Physicians Postgraduate Press, Inc.

Religion as a risk factor for suicide attempt and suicide ideation among depressed patients

PubMed Central

Lawrence, Ryan E; Brent, David; Mann, J. John; Burke, Ainsley K.; Grunebaum, Michael F.; Galfalvy, Hanga C.; Oquendo, Maria A.

2016-01-01

We aimed to examine the relationship between religion and suicide attempt and ideation. 321 depressed patients were recruited from mood-disorder research studies at the New York State Psychiatric Institute. Participants were interviewed using the SCID, Columbia University Suicide History form, Scale for Suicide Ideation, and Reasons for Living Inventory. Participants were asked about their religious affiliation, importance of religion, and religious service attendance. We found that past suicide attempts were more common among depressed patients with a religious affiliation (OR 2.25, p=.007). Suicide ideation was greater among depressed patients who considered religion more important (Coeff. 1.18, p=.026), and those who attended services more frequently (Coeff. 1.99, p=.001). We conclude that the relationship between religion and suicide risk factors is complex, and can vary among different patient populations. Physicians should seek deeper understanding of the role of religion in an individual patient’s life in order to understand the person’s suicide risk factors more fully. PMID:26894320

Investigation of a Suicide Ideation Risk Profile in People With Co-occurring Depression and Substance Use Disorder.

PubMed

Handley, Tonelle E; Kay-Lambkin, Frances J; Baker, Amanda L; Lewin, Terry J; Kelly, Brian J; Inder, Kerry J; Attia, John R; Kavanagh, David J

2016-11-01

Disengagement from services is common before suicide, hence identifying factors at treatment presentation that predict future suicidality is important. This article explores risk profiles for suicidal ideation among treatment seekers with depression and substance misuse. Participants completed assessments at baseline and 6 months. Baseline demographics, psychiatric history, and current symptoms were entered into a decision tree to predict suicidal ideation at follow-up. Sixty-three percent of participants at baseline and 43.5% at follow-up reported suicidal ideation. Baseline ideation most salient when psychiatric illness began before adulthood, increasing the rate of follow-up ideation by 16%. Among those without baseline ideation, dysfunctional attitudes were the most important risk factor, increasing rates of suicidal ideation by 35%. These findings provide evidence of factors beyond initial diagnoses that increase the likelihood of suicidal ideation and are worthy of clinical attention. In particular, providing suicide prevention resources to those with high dysfunctional attitudes may be beneficial.

The foxconn suicides and their media prominence: is the werther effect applicable in china?

PubMed Central

2011-01-01

Background Media reporting of suicide and its relationship with actual suicide has rarely been investigated in Mainland China. The "Foxconn suicides" is a description referring to a string of suicides/attempts during 2010, all of which were related to a giant electrical manufacturing company, Foxconn. This study aimed to examine the clustering and copycat effects of the Foxconn suicides, and to investigate temporal patterns in how they were reported by the media in Mainland China, Hong Kong (HK), and Taiwan (TW). Methods Relevant articles were collected from representative newspapers published in three big cities in Mainland China (Beijing (BJ), Shenzhen (SZ), and Guangzhou (GZ)), HK, and TW, together with searching intensity data on the topic conducted using the Baidu search engine in Mainland China. The temporal clustering effects of the Foxconn suicides and their media prominence were assessed using the Kolmogorov-Smirnov test. The media reports of the Foxconn suicides' temporal patterns were explored using a nonparametric curve estimation method (that is, the local linear method). The potential mutual interactions between the Foxconn suicides and their media prominence were also examined, using logistic and Poisson regression methods. Results The results support a temporal clustering effect for the Foxconn suicides. The BJ-based newspapers' reporting and the occurrence of a Foxconn suicide/attempt are each found to be associated with an elevated chance of a further Foxconn suicide 3 days later. The occurrence of a Foxconn suicide also immediately influenced the intensity of both Baidu searching and newspaper reporting. Regional diversity in suicide reporting tempo-patterns within Mainland China, and similarities between HK and TW, are also demonstrated. Conclusions The Foxconn suicides were temporally clustered. Their occurrences were influenced by the reporting of BJ-based newspapers, and contagion within the company itself. Further suicide research and prevention work in China should consider its special media environment. PMID:22044598

Forging an Agenda for Suicide Prevention in the United States

PubMed Central

2013-01-01

Suicide prevention must be transformed by integrating injury prevention and mental health perspectives to develop a mosaic of common risk public health interventions that address the diversity of populations and individuals whose mortality and morbidity contribute to the burdens of suicide and attempted suicide. Emphasizing distal preventive interventions, strategies must focus on people and places—and on related interpersonal factors and social contexts—to alter the life trajectories of people before they become suicidal. Attention also must be paid to those in the middle years—the age with the greatest overall burden. We need scientific and social processes that define priorities and assess their potential for reducing what has been a steadily increasing rate of suicide during the past decade. PMID:23488515

Forging an agenda for suicide prevention in the United States.

PubMed

Caine, Eric D

2013-05-01

Suicide prevention must be transformed by integrating injury prevention and mental health perspectives to develop a mosaic of common risk public health interventions that address the diversity of populations and individuals whose mortality and morbidity contribute to the burdens of suicide and attempted suicide. Emphasizing distal preventive interventions, strategies must focus on people and places--and on related interpersonal factors and social contexts--to alter the life trajectories of people before they become suicidal. Attention also must be paid to those in the middle years--the age with the greatest overall burden. We need scientific and social processes that define priorities and assess their potential for reducing what has been a steadily increasing rate of suicide during the past decade.

Exposure to suicide is associated with increased risk for suicidal thoughts and behaviors among National Guard military personnel.

PubMed

Bryan, Craig J; Cerel, Julie; Bryan, AnnaBelle O

2017-08-01

Research suggests that individuals who know someone who died by suicide are at increased risk for posttraumatic stress disorder (PTSD), depression, and recent suicidal thoughts. Studies have not yet investigated the association of suicide exposure with suicide attempts, however, especially among high-risk subgroups of military personnel such as the National Guard. An anonymous online survey was completed by 971 military personnel assigned to the National Guard in Utah and Idaho. Weighted analyses were conducted to ensure demographic matching to the full population. Univariate and multivariate logistic regression was used to test the association of suicide exposure with psychiatric condition, suicide ideation, and suicide attempts. 65.4% of National Guard personnel reported knowing someone who had died by suicide. On average, participants knew 3.0 (SD=2.0) suicide decedents. Total number of known suicide decedents was associated with significantly increased risk for PTSD (OR=1.18, p=.008), depression (OR=1.19, p=.003), and suicide ideation (OR=2.48, p<.001), but not suicide attempt (OR=1.34, p=.472). Perceived closeness to the suicide decedent was associated with significantly increased risk for PTSD (OR=1.54, p<.001), depression (OR=1.36, p=.031), suicide ideation (OR=1.24, p=.039), and suicide attempt (OR=1.69, p=.026). The majority of participants who experienced suicidal thoughts and attempts after the suicide exposure had a previous history of suicide ideation. Suicide exposure is common among National Guard personnel, and is associated with increased risk for PTSD, depression, and suicidal thoughts and behaviors. Risk is highest for those personnel who know multiple suicide decedents and were closer to the suicide decedent. Copyright © 2017 Elsevier Inc. All rights reserved.

Nursing students’ attitude toward suicide prevention

PubMed Central

Nebhinani, Naresh; Mamta; Gaikwad, Achla D.; Tamphasana, L.

2013-01-01

Background: Preventing suicide depends upon different health professionals’ knowledge regarding suicide, attitude toward suicide attempters, skills to assess and manage suicidal risk. Objectives: This study was aimed to assess the attitude of nursing students toward suicide prevention. Materials and Methods: 308 nursing students were recruited from the two institutions through total enumeration method. Attitude toward suicide prevention scale was administered. Study design was cross-sectional. Results: Majority were single females, from urban locality, who were pursuing BSc Nursing with the mean age of 20 years. Only minority had previous exposure to suicide prevention programs or workshops. Nearly half of the subjects had positive attitude toward working with suicidal patients. Again half of the subjects considered unemployment and poverty as main causes of suicide and were quite hopeless about it and they also perceived that most of the suicidal people would not reveal their suicidal plans to others. Conclusions: Merely half of the students had positive attitude toward working with suicidal patients. Hence, there is strong need to organize more educational and training programs on suicide prevention so that these budding health professionals could be more equipped and trained to manage these suicidal patients. PMID:25013311

A systematic review of suicide prevention programs for military or veterans.

PubMed

Bagley, Steven C; Munjas, Brett; Shekelle, Paul

2010-06-01

Military personnel and veterans have important suicide risk factors. After a systematic review of the literature on suicide prevention, seven (five in the U.S.) studies of military personnel were identified containing interventions that may reduce the risk of suicide. The effectiveness of the individual components was not assessed, and problems in methodology or reporting of data were common. Overall, multifaceted interventions for active duty military personnel are supported by consistent evidence, although of very mixed quality, and in some cases during intervals of declines in suicide rates in the general population. There were insufficient studies of U.S. Veterans to reach conclusions.

The impact of indiscriminate media coverage of a celebrity suicide on a society with a high suicide rate: epidemiological findings on copycat suicides from South Korea.

PubMed

Ju Ji, Nam; Young Lee, Weon; Seok Noh, Maeng; Yip, Paul S F

2014-03-01

This study examines the extent to which the indiscriminate media coverage of the famous young actress Lee Eun-ju's suicide in 2005 affected suicides overall and in specific subgroups (by age, gender, and suicide method) in a suicide-prone society, South Korea. South Korea's 2003-2005 suicide data (n=34,237) were obtained from death certificate records of the National Statistical Office (NSO). Data was analyzed with Poisson time series auto-regression models. After adjusting for confounding factors (such as seasonal variation, calendar year, temperature, humidity, and unemployment rate), there was a significant increase in suicide (RR=1.40, 95%, CI=1.30-1.51, no. of excess mortalities=331; 95% CI=267-391) during the 4 weeks after Lee's suicide. This increase was more prominent in subgroups with similar characteristics to the celebrity. In particular, the relative risk of suicide during this period was the largest (5.24; 95% CI=3.31-8.29) in young women who used the same suicide method as the celebrity. Moreover, the incidence of these copycat suicides during the same time significantly increased in both genders and in all age subgroups among those who committed suicide using the same method as the celebrity (hanging). It is difficult to prove conclusively that the real motivation of the suicides was Lee's death. The findings from this study imply that, if the media indiscreetly reports the suicide of a celebrity in a suicide-prone society, the copycat effect can be far-reaching and very strong, particularly for vulnerable people. © 2013 Published by Elsevier B.V.

Suicides in Late Life

PubMed Central

Van Orden, Kimberly; Conwell, Yeates

2011-01-01

Suicide in late life is an enormous public health problem that will likely increase in severity as adults of the baby boom generation age. Data from psychological autopsy studies supplemented with recent studies of suicidal ideation and attempts point to a consistent set of risk factors for the spectrum of suicidal behaviors in late life (suicide ideation, attempts, and deaths). Clinicians should be vigilant for psychiatric illness (especially depression), physical illness, pain, functional impairment, and social disconnectedness. Recent advances in late-life suicide prevention have in common collaborative, multifaceted intervention designs. We suggest that one mechanism shared by all preventive interventions shown to reduce the incidence of late-life suicide is the promotion of connectedness. For the clinician working with older adults, our recommendation is to not only consider risk factors, such as depression, and implement appropriate treatments but to enhance social connectedness as well. PMID:21369952

Family support and other social factors precipitating suicidal ideation.

PubMed

Hirsch, J; Ellis, J B

1995-01-01

To examine the effects of family support and demographics on suicidal behavior, 385 subjects completed a demographic questionnaire and a Suicidal Ideation Questionnaire (SIQ). Sixteen percent described themselves as "serious" ideators, while 59% were seen as ideators, numbers consistent with past suicide research. Multiple regression analyses revealed that the type of caregiver a person reported having while growing up accounted for a significant amount of the variance on ideator status. Serious ideators were more common among single parent households. Although many demographic variables were assessed, only the primary caregiver a person had as a child impacted their status as a suicidal ideator. This suggests that suicidal behaviors may occur due to a complex interaction between social factors and childhood care. The influence of living in a single-parent home may contribute to whether or not a person considers suicide.

A Mixed Methods Approach to Identify Cognitive Warning Signs for Suicide Attempts.

PubMed

Adler, Abby; Bush, Ashley; Barg, Frances K; Weissinger, Guy; Beck, Aaron T; Brown, Gregory K

2016-01-01

This study used a mixed methods approach to examine pathways to suicidal behavior by identifying cognitive warning signs that occurred within 1 day of a suicide attempt. Transcripts of cognitive therapy sessions from 35 patients who attempted suicide were analyzed using a modified grounded theory approach. Cognitive themes emerging from these transcripts included: state hopelessness, focus on escape, suicide as a solution, fixation on suicide, and aloneness. Differences in demographic and baseline diagnostic and symptom data were explored in relation to each cognitive theme. We propose a potential conceptual model of cognitive warning signs for suicide attempts that requires further testing.

Social Representation of Cyberbullying and Adolescent Suicide: A Mixed-Method Analysis of News Stories.

PubMed

Young, Rachel; Subramanian, Roma; Miles, Stephanie; Hinnant, Amanda; Andsager, Julie L

2017-09-01

Cyberbullying has provoked public concern after well-publicized suicides of adolescents. This mixed-methods study investigates the social representation of these suicides. A content analysis of 184 U.S. newspaper articles on death by suicide associated with cyberbullying or aggression found that few articles adhered to guidelines suggested by the World Health Organization and the American Foundation for Suicide Prevention to protect against suicidal behavioral contagion. Few articles made reference to suicide or bullying prevention resources, and most suggested that the suicide had a single cause. Thematic analysis of a subset of articles found that individual deaths by suicide were used as cautionary tales to prompt attention to cyberbullying. This research suggests that newspaper coverage of these events veers from evidence-based guidelines and that more work is needed to determine how best to engage with journalists about the potential consequences of cyberbullying and suicide coverage.

National study of suicide method in violent criminal offenders.

PubMed

Webb, R T; Qin, P; Stevens, H; Shaw, J; Appleby, L; Mortensen, P B

2013-09-05

Gaining a greater knowledge of the mechanisms and means by which violent offenders die by suicide can inform tailored preventive strategies. Using interlinked national Danish registry data we constructed a nested case-control study dataset of all adult suicides during 1994-2006: N=9708 cases and N=188,134 age and gender matched living controls. Completely ascertained International Classification of Diseases 10th revision cause-specific mortality codes were examined, with all criminal charges since 1980, and covariate information on psychiatric treatment and socio-demographics. Self-poisonings were classified as 'nonviolent' suicide and all other methods as being 'violent' ones. Compared with the general population, risk among male and female violent offenders was strongly and significantly elevated for suicide by either a violent or a nonviolent method, although the relative risk was greater for nonviolent suicide. These patterns were also observed among nonviolent offenders, albeit with smaller effect sizes. Risk was especially raised for self-poisoning with narcotics & hallucinogens. We could only examine the full range of suicide methods in male violent offenders. In these men, hanging was the most frequently used method, although risk was markedly and significantly elevated virtually across the entire range of regularly used suicide methods. We lacked sufficient statistical power for undertaking a detailed profiling of specific suicide methods among female violent offenders. Our findings indicate that comprehensive and broadly-based preventive approaches are needed for tackling the markedly raised risk of suicide by both violent and nonviolent means in this population. Their high relative risk for self-poisoning by illicit or illegal drugs underlines the importance of access to means and of prevailing subculture. Copyright © 2013 Elsevier B.V. All rights reserved.

Celebrity suicides and their differential influence on suicides in the general population: a national population-based study in Korea.

PubMed

Myung, Woojae; Won, Hong-Hee; Fava, Maurizio; Mischoulon, David; Yeung, Albert; Lee, Dongsoo; Kim, Doh Kwan; Jeon, Hong Jin

2015-04-01

Although evidence suggests that there is an increase in suicide rates in the general population following celebrity suicide, the rates are heterogeneous across celebrities and countries. It is unclear which is the more vulnerable population according to the effect sizes of celebrity suicides to general population. All suicide victims in the general population verified by the Korea National Statistical Office and suicides of celebrity in South Korea were included for 7 years from 2005 to 2011. Effect sizes were estimated by comparing rates of suicide in the population one month before and after each celebrity suicide. The associations between suicide victims and celebrities were examined. Among 94,845 suicide victims, 17,209 completed suicide within one month after 13 celebrity suicides. Multivariate logistic regression analyses revealed that suicide victims who died after celebrity suicide were significantly likely to be of age 20-39, female, and to die by hanging. These qualities were more strongly associated among those who followed celebrity suicide with intermediate and high effect sizes than lower. Younger suicide victims were significantly associated with higher effect size, female gender, white collar employment, unmarried status, higher education, death by hanging, and night-time death. Characteristics of celebrities were significantly associated with those of general population in hanging method and gender. Individuals who commit suicide after a celebrity suicide are likely to be younger, female, and prefer hanging as method of suicide, which are more strongly associated in higher effect sizes of celebrity suicide.

Information-Seeking on the Internet.

PubMed

Singaravelu, Vinod; Stewart, Anne; Adams, Joanna; Simkin, Sue; Hawton, Keith

2015-01-01

The Internet is used by young people at risk of self-harm to communicate, find information, and obtain support. We aimed to identify and analyze websites potentially accessed by these young people. Six search terms, relating to self-harm/suicide and depression, were input into four search engines. Websites were analyzed for access, content/purpose, and tone. In all, 314 websites were included in the analysis. Most could be accessed without restriction. Sites accessed by self-harm/suicide search terms were mostly positive or preventive in tone, whereas sites accessed by the term ways to kill yourself tended to have a negative tone. Information about self-harm methods was common with specific advice on how to self-harm in 15.8% of sites, encouragement of self-harm in 7.0%, and evocative images of self-harm/suicide in 20.7%. Advice on how to get help was given in 56.1% of sites. Websites relating to suicide or self-harm are easily accessed. Many sites are potentially helpful. However, a significant proportion of sites are potentially harmful through normalizing or encouraging self-harm. Enquiry regarding Internet use should be routinely included while assessing young people at risk.

High-risk occupations for suicide.

PubMed

Roberts, S E; Jaremin, B; Lloyd, K

2013-06-01

High occupational suicide rates are often linked to easy occupational access to a method of suicide. This study aimed to compare suicide rates across all occupations in Britain, how they have changed over the past 30 years, and how they may vary by occupational socio-economic group. Method We used national occupational mortality statistics, census-based occupational populations and death inquiry files (for the years 1979-1980, 1982-1983 and 2001-2005). The main outcome measures were suicide rates per 100 000 population, percentage changes over time in suicide rates, standardized mortality ratios (SMRs) and proportional mortality ratios (PMRs). Several occupations with the highest suicide rates (per 100 000 population) during 1979-1980 and 1982-1983, including veterinarians (ranked first), pharmacists (fourth), dentists (sixth), doctors (tenth) and farmers (thirteenth), have easy occupational access to a method of suicide (pharmaceuticals or guns). By 2001-2005, there had been large significant reductions in suicide rates for each of these occupations, so that none ranked in the top 30 occupations. Occupations with significant increases over time in suicide rates were all manual occupations whereas occupations with suicide rates that decreased were mainly professional or non-manual. Variation in suicide rates that was explained by socio-economic group almost doubled over time from 11.4% in 1979-1980 and 1982-1983 to 20.7% in 2001-2005. Socio-economic forces now seem to be a major determinant of high occupational suicide rates in Britain. As the increases in suicide rates among manual occupations occurred during a period of economic prosperity, carefully targeted suicide prevention initiatives could be beneficial.

Sleep Disturbances and Suicide Risk in an 8-Year Longitudinal Study of Schizophrenia-Spectrum Disorders

PubMed Central

Li, Shirley Xin; Lam, Siu Ping; Zhang, Jihui; Yu, Mandy Wai Man; Chan, Joey Wing Yan; Chan, Cassandra Sheung Yan; Espie, Colin A.; Freeman, Daniel; Mason, Oliver; Wing, Yun-Kwok

2016-01-01

Study Objectives: Disrupted sleep is one of the prominent but often overlooked presenting symptoms in the clinical course of psychotic disorders. The aims of this study were to examine the prevalence of sleep disturbances, particularly insomnia and nightmares, and their prospective associations with the risk of suicide attempts in patients with schizophrenia-spectrum disorders. Methods: A naturalistic longitudinal study was conducted in outpatients diagnosed with schizophrenia-spectrum disorders recruited from the psychiatric outpatient clinic of a regional university-affiliated public hospital in Hong Kong. A detailed sleep questionnaire was completed by 388 patients at baseline in May–June 2006. Relevant clinical information was extracted from clinical case notes from June 2007–October 2014. Results: Prevalence of frequent insomnia and frequent nightmares was 19% and 9%, respectively. Baseline frequent insomnia was significantly associated with an increased incidence of suicide attempts during the follow-up period (adjusted hazard ratio = 4.63, 95% confidence interval 1.40–15.36, P < 0.05). Nightmare complaint alone did not predict the occurrence of suicide attempts, but the comorbidity of nightmares and insomnia was associated with the risk of suicide attempt over follow-up (adjusted HR = 11.10, 95% confidence interval: 1.68–73.43, P < 0.05). Conclusions: Sleep disturbances are common in patients with schizophrenia-spectrum disorders. The association between sleep disturbances and suicidal risk underscores the need for enhanced clinical attention and intervention on sleep disturbances in patients with schizophrenia. Citation: Li SX, Lam SP, Zhang J, Yu MW, Chan JW, Chan CS, Espie CA, Freeman D, Mason O, Wing YK. Sleep disturbances and suicide risk in an 8-year longitudinal study of schizophrenia-spectrum disorders. SLEEP 2016;39(6):1275–1282. PMID:27091530

The Incidence and Course of Depression in Bereaved Youth 21 Months After the Loss of a Parent to Suicide, Accident, or Sudden Natural Death

PubMed Central

Brent, David; Melhem, Nadine; Donohoe, M. Bertille; Walker, Monica

2009-01-01

Objective This study examined effects of bereavement 21 months after a parent’s death, particularly death by suicide. Method The participants were 176 offspring, ages 7–25, of parents who died by suicide, accident, or sudden natural death. They were assessed 9 and 21 months after the death, along with 168 nonbereaved subjects. Results Major depression and alcohol or substance abuse 21 months after the parent’s death were more common among bereaved youth than among comparison subjects. Offspring with parental suicide or accidental death had higher rates of depression than comparison subjects; those with parental suicide had higher rates of alcohol or substance abuse. Youth with parental suicide had a higher incidence of depression than those bereaved by sudden natural death. Bereavement and a past history of depression increased depression risk in the 9 months following the death, which increased depression risk between 9 and 21 months. Losing a mother, blaming others, low self-esteem, negative coping, and complicated grief were associated with depression in the second year. Conclusions Youth who lose a parent, especially through suicide, are vulnerable to depression and alcohol or substance abuse during the second year after the loss. Depression risk in the second year is mediated by the increased incidence of depression within the first 9 months. The most propitious time to prevent or attenuate depressive episodes in bereaved youth may be shortly after the parent’s death. Interventions that target complicated grief and blaming of others may also improve outcomes in symptomatic youth with parental bereavement. PMID:19411367

A Common Explanation for the Changing Age Distributions of Suicide and Homicide in the United States, 1930 to 2000

ERIC Educational Resources Information Center

O'Brien, Robert M.; Stockard, Jean

2006-01-01

A longstanding debate focuses on whether suicide and homicide rates walk hand in hand or whether they are reciprocally related. Much of the research on this issue investigates whether suicide or homicide predominates in certain geographic areas or whether they trend together over time. We theorize that the degree of social integration and social…

The association of trends in charcoal-burning suicide with Google search and newspaper reporting in Taiwan: a time series analysis.

PubMed

Chang, Shu-Sen; Kwok, Simon Sai Man; Cheng, Qijin; Yip, Paul S F; Chen, Ying-Yeh

2015-09-01

Some East/Southeast Asian countries have experienced a rapid increase in suicide by charcoal burning over the past decade. Media reporting and Internet use were thought to contribute to the epidemic. We investigated the association between method-specific suicide incidence and both Internet search volume and newspaper reporting in Taiwan. Weekly data for suicide, suicide-related Google search volume, and the number of articles reporting suicide in four major newspapers in Taiwan during 2008-2011 were obtained. Poisson autoregressive regression models were used to examine the associations between these variables. In the fully adjusted models, every 10 % increase in Google searches was associated with a 4.3 % [95 % confidence interval (CI) 1.1-7.6 %] increase in charcoal-burning suicide incidence in the same week, and a 3.8 % (95 % CI 0.4-7.2 %) increase in the following week. A one-article increase in the United Daily was associated with a 3.6 % (95 % CI 1.5-5.8 %) increase in charcoal-burning suicide in the same week. By contrast, non-charcoal-burning suicide was not associated with Google search volume, but was associated with the Apple Daily's reporting in the preceding week. We found that increased Internet searches for charcoal-burning suicide appeared to be associated with a subsequent increase in suicide by this method. The prevention of suicide using emerging methods may include monitoring and regulating online information that provides details of these methods as well as encouraging Internet service providers to provide help-seeking information.

Using the internet for suicide-related purposes: Contrasting findings from young people in the community and self-harm patients admitted to hospital.

PubMed

Biddle, Lucy; Derges, Jane; Goldsmith, Carlie; Donovan, Jenny L; Gunnell, David

2018-01-01

Despite accelerating interest in the impact of the internet on suicidal behaviour, empirical work has not captured detailed narratives from those who engaged in suicide-related internet use. This study explored the suicide-related online behaviour of two contrasting samples of distressed users, focusing on their purpose, methods and the main content viewed. In-depth interviews were conducted in the UK between 2014-2016 with i) young people in the community; and ii) self-harm patients presenting to hospital emergency departments. Data were analysed using methods of constant comparison. Suicide-related internet use varied according to the severity of suicidal feelings. In the young people sample, where severity was lower, use was characterised by disorganised browsing without clear purpose. A range of content was 'stumbled upon' including information about suicide methods. They also pursued opportunities to interact with others and explore online help. Self-harm patients were a higher severity group with a history of suicidal behaviour. Their use was purposeful and strategic, focused around 'researching' suicide methods to maximise effectiveness. They made specific choices about content viewed; many consulting factual content in preference to user generated accounts, while help content and communication was avoided. Findings indicate further action is necessary to improve online safety. Also, novel online help approaches are needed to engage individuals experiencing suicidal crisis. Awareness of the nature of suicide-related internet use and how this may reflect the status of an individual's suicidal thinking could be beneficial to clinicians to promote safety and indicate risk.

Suicide Prevention Public Service Announcements (PSAs): Examples from Around the World.

PubMed

Ftanou, Maria; Cox, Georgina; Nicholas, Angela; Spittal, Matthew J; Machlin, Anna; Robinson, Jo; Pirkis, Jane

2017-04-01

Media campaigns have received increased attention as an intervention for combating suicide. Suicide prevention campaigns involving public service announcements (PSAs) have not been well described and have been subject to minimal evaluation. This study aimed to identify suicide prevention PSAs from around the world and analyze and describe their content. We searched the Internet for short, English-language PSAs that had been screened as part of suicide prevention campaigns and identified 35. Most commonly, these PSAs focused on the general population and/or people who might be at risk of suicide, and had a particular emphasis on young people. Almost 60% promoted open discussion about suicide, around 50% indicated that the life of a suicidal person was important, about 40% acknowledged the suffering associated with suicidal thoughts and feelings, about 25% stressed that suicide is preventable, and about 20% focused on the devastating impact of suicide for those left behind. Most PSAs promoted some sort of support for people at risk of suicide, usually a helpline or website. Although these messages appeared appropriate and practical there is a lack of research on the impact that they may have on people with varying degrees of suicide risk. Further work is needed to ensure that they are consistent with theories of behavior change, and that they are having their desired impacts.

Comparative epidemiology of suicide in South Korea and Japan: effects of age, gender and suicide methods.

PubMed

Kim, Seong Yi; Kim, Myoung-Hee; Kawachi, Ichiro; Cho, Youngtae

2011-01-01

Suicide is one of the leading causes of mortality in both South Korea and Japan. The study aims to compare the descriptive epidemiology of suicide over the last two decades (1985-2006) and to explore the conditions associated with the different distribution of suicides in both countries. Age-standardized suicide rates were obtained from the OECD Health Data 2009. Age-specific suicide rates for the age groups were calculated from the WHO Mortality Database. Suicide methods were identified based on ICD-10. Through 1980-2000, Japan showed consistently higher suicide rates compared to Korea. However, from the mid-1990s, Korea showed an acute increase of suicides and finally surpassed Japan; the age-standardized suicide rate of Korea increased from 10.2 (per 100,000) in 1985 to 21.5 in 2006, while it slightly increased from 18.4 to 19.1 in Japan. The highest age-specific suicide rate was observed among Japanese men aged 45-64 years and Korean men aged over 64 years. The increase of elderly suicides among Korean women was notable. The gender ratio increased in Japan and decreased in Korea, respectively. The preferred suicide methods were hanging and pesticide poisoning in Korea and hanging in Japan. Because of the limited number of observations, hypothesis testing of specific risk factors was not possible. Age and gender distribution of suicide rates differed considerably between the two countries. Welfare protection throughout the life course in both countries, and pesticide regulation in Korea would be helpful in reducing the burden of suicide mortality in both countries, even if the social values could not be changed in a short time.

Characteristics of Youth with Combined Histories of Violent Behavior, Suicidal Ideation or Behavior, and Gun-Carrying

PubMed Central

Logan, Joseph E.; Vagi, Kevin J.; Gorman-Smith, Deborah

2015-01-01

Background Youth reporting combined histories of nonfatal violence, suicidal ideation/behavior, and gun-carrying (VSG) are at risk for perpetrating fatal interpersonal violence and self-harm. Aims We characterize these youth to inform prevention efforts. Methods We analyzed 2004 data from 3,931 7th, 9th, and 11–12th grade youth and compared VSG youth (n=66) to non-gun carrying youth who either had no histories of violence or suicidal thoughts/behavior (n=1,839), histories of violence (n=884), histories of suicidal thoughts/behaviors (n=552), or both (n=590). We compared groups based on demographic factors, risk factors (i.e., friends who engage in delinquency, peer-violence victimization, depressive symptoms, illicit substance use), and protective factors (i.e., school connectedness, parental care and supervision). Regression models identified factors associated with VSG youth. Results Illicit substance use and having friends who engage in delinquency were more common among VSG youth in all comparisons; almost all VSG youth had high-levels of these factors. Depressive symptoms were positively associated with VSG youth versus youth without either violent or suicide-related histories and youth with violent histories alone. School connectedness and parental supervision were negatively associated with VSG youth in most comparisons. Conclusions Family-focused and school-based interventions that increase connectedness while reducing delinquency and substance use might prevent these violent tendencies. PMID:27245809

Suicidal drug overdose in patients with systemic lupus erythematosus, a nationwide population-based case-control study.

PubMed

Tang, K T; Lin, C H; Chen, H H; Chen, Y H; Chen, D Y

2016-02-01

A four-fold increase of suicide mortality has been demonstrated in systemic lupus erythematosus (SLE) patients. Prior studies showed that the most common method of suicide attempts in SLE patients involves drug overdose. Therefore, we conducted a nationwide population-based case-control study to elucidate factors associated with drug overdose as suicide attempt in SLE patients. This study was based on the National Health Insurance Research Database in Taiwan. We identified all SLE patients from January 1, 2000 to December 31, 2010. Patients who had suicidal drug overdose (SDO) were selected as cases while age- and gender-matched patients who did not have SDO were selected as controls. The incidence rate of SDO in SLE patients was 291 cases per 100,000 person-years, higher than that in the general population (160 cases per 100,000 person-years). In a multivariate logistic regression analysis, we observed that SDO was associated with psychiatric disorders such as depressive disorders (odds ratio: 8.36, 95% confidence interval (CI): 5.60-12.48) and insomnia (odds ratio: 2.71, 95% CI: 1.73-4.25), and lower monthly income (odds ratios: 2.74 to 3.50) in SLE patients. SDO is associated with psychiatric disorders such as depressive disorders and insomnia, and lower monthly income in SLE patients. © The Author(s) 2015.

Self-reported barriers to professional help seeking among college students at elevated risk for suicide.

PubMed

Czyz, Ewa K; Horwitz, Adam G; Eisenberg, Daniel; Kramer, Anne; King, Cheryl A

2013-01-01

This study sought to describe self-reported barriers to professional help seeking among college students who are at elevated suicide risk and determine if these barriers vary by demographic and clinical characteristics. Participants were 165 non-treatment seekers recruited as part of a Web-based treatment linkage intervention for college students at elevated suicide risk (from September 2010 through December 2011). Data were collected using Web-based questionnaires. Two coders coded students' responses to an open-ended question about reasons for not seeking professional help. The most commonly reported barriers included perception that treatment is not needed (66%), lack of time (26.8%), and preference for self-management (18%). Stigma was mentioned by only 12% of students. There were notable differences based on gender, race, and severity of depression and alcohol abuse. Efforts aimed at reaching students at elevated risk for suicidal behavior should be particularly sensitive to these commonly described barriers.

The Significance of the Method Chosen for Suicide in Understanding the Psychodynamics of the Suicidal Individual.

ERIC Educational Resources Information Center

Leenaars, Antoon A.; Lester, David

1989-01-01

Compared suicide notes of individuals using active and passive methods for suicide for presence of 50 classifications regarding psychodynamics of perturbation, lethality, relations, self-cognitions, etc. Two sets of notes resembled each other closely, only difference being that active group more often cited rejection by significant other as…

Can We Really Prevent Suicide?

PubMed Central

Schwartz-Lifshitz, Maya; Zalsman, Gil; Giner, Lucas; Oquendo, Maria A.

2012-01-01

Every year, suicide is among the top 20 leading causes of death globally for all ages. Unfortunately, suicide is difficult to prevent, in large part because the prevalence of risk factors is high among the general population. In this review, clinical and psychological risk factors are examined and methods for suicide prevention are discussed. Prevention strategies found to be effective in suicide prevention include means restriction, responsible media coverage, and general public education, as well identification methods such as screening, gatekeeper training, and primary care physician education. Although the treatment for preventing suicide is difficult, follow-up that includes pharmacotherapy, psychotherapy, or both may be useful. However, prevention methods cannot be restricted to the individual. Community, social, and policy interventions will also be essential. PMID:22996297

Characteristics of overdose and non-overdose suicide attempts in a multi-ethnic Asian society.

PubMed

Mak, Kwok Kei; Ho, Cyrus S H; Zhang, Melvyn W B; Day, Jeffrey R; Ho, Roger C M

2013-10-01

Overdosing is an accessible method adopted by people attempting suicide in city settings. This study aimed to compare the trends and characteristics of people attempting suicide by drug overdose and by other methods in Singapore. This study examined the medical records of 628 patients who were admitted to a university hospital in Singapore, between January 2004 and December 2006. Patients were classified as overdose and non-overdose persons attempting suicide for comparisons of demographic and suicidal characteristics. Logistic regression was used to determine the odds ratios of various factors associated with self-perceived lethality of the suicide attempt. Patterns of monthly and weekly variations in the frequencies of suicide attempts were also analyzed. The percentages of Chinese people was higher in the non-overdose group (71.5% vs. 62.9%), while the percentages of Malay and Indian people were higher in the overdose group (31.6% vs. 18.5%). The female gender (OR=0.36, p=0.04) and admission of suicide intention (OR=7.11, p<0.001) were significantly associated with higher perceived lethality of the suicide method in the non-overdose group. Suicide attempts occurred more frequently between May and November, and on Tuesdays. Gender and ethnic differences between overdose and non-overdose people attempting suicide were found. Temporal variations of suicidal cases were also noted. Copyright © 2013 Elsevier B.V. All rights reserved.

[When a Suicide Attempt is Kid's Stuff].

PubMed

Vásquez-Rojas, Rafael; Quijano-Serrano, Margarita

2013-01-01

Attempted suicide in children and adolescents is a disturbing and painful issue for patients, their families and physicians. Current medical literature provides little information about minors who attempt suicide, possibly because there is under-reporting of this condition as a diagnosis, or maybe because it is sometimes considered as a way for the child to draw attention. To present the experience of the Department of Psychiatry (Universidad Nacional de Colombia) at the Hospital Infantil de La Misericordia, from 2003 to 2013. An observational retrospective study was conducted by reviewing 213 cases of children and adolescents treated for attempted suicide at the Hospital Infantil de La Misericordia from January 1, 2003 to October 31, 2013, and who received hospital or outpatient care in Child Psychiatry. A review was performed of the diagnosis, the number of suicide attempts, the peak months of consultation for this reason, and the methods selected, as well as a detailed description of the group of patients under 12 years old, and those managed with outpatient follow-up. The average patient is a female teenager who becomes intoxicated with drugs. Most often, patients do not return to outpatient follow-up. Those with follow-up have multiple psychopathologies and a high level of suffering. The most common methods, other than poisoning by drugs, are hanging and jumping from heights. Patients under 12 years old generally have their first attempt by drug poisoning. There is a predominance of anxiety disorder and depression, with a strong association with cognitive dysfunction, as a vulnerability factor. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Assessment of Psychiatrically Hospitalized Suicidal Adolescents: Self-Report Instruments as Predictors of Suicidal Thoughts and Behavior

ERIC Educational Resources Information Center

Huth-Bocks, Alissa C.; Kerr, David C. R.; Ivey, Asha Z.; Kramer, Anne C.; King, Cheryl A.

2007-01-01

Objective: The validity and clinical utility of the Reynolds Adolescent Depression Scale, Beck Hopelessness Scale, Suicidal Ideation Questionnaire-Junior, and Suicide Probability Scale (SPS) were examined longitudinally among suicidal adolescents. Method: Between 1998 and 2000, 289 psychiatrically hospitalized, suicidal youth, ages 12 to 17 years,…

Adolescent insomnia, suicide risk, and the interpersonal theory of suicide.

PubMed

Zullo, Lucas; Horton, Sarah; Eaddy, Michael; King, Jessica; Hughes, Jennifer; Diederich, Andrew; Kennard, Betsy; Emslie, Graham; Stewart, Sunita

2017-11-01

Although insomnia has been repeatedly linked with suicide ideation, the reason for the linkage is not clear. The Interpersonal Psychological Theory of Suicide (IPTS) proposes that three core variables (thwarted belongingness, perceived burdensomeness, and acquired capability) are the final common pathway for all risk factors for suicide ideation and behavior. Recent research has suggested that insomnia may be associated with suicide ideation independently of the IPTS. We examined cross-sectional data from 151 psychiatric inpatients (ages 12-17) to determine if the association between insomnia symptoms and a continuous measure of suicide risk (measured as increasingly severe ideation and plan) was explained by the framework of the IPTS. When all IPTS variables and depressive symptoms were included in the model, insomnia symptoms did not contribute unique variance to suicide risk. Perceived burdensomeness and depressive symptoms were found to explain the relationship between insomnia symptoms and suicide risk. Our findings suggest that improved sleep might reduce suicide risk, that management of interpersonal need cognitions might reduce risk in the presence of insomnia symptoms, and reinforce the independent role of depressive symptoms in suicide risk in clinical samples of adolescents. Copyright © 2017 Elsevier B.V. All rights reserved.

Method Choice in Nonfatal Self-Harm as a Predictor of Subsequent Episodes of Self-Harm and Suicide: Implications for Clinical Practice

PubMed Central

Hempstead, Katherine; Nguyen, Tuan; Barber, Catherine; Rosenberg-Wohl, Sarah; Azrael, Deborah

2013-01-01

Objectives. We examined time-varying and time-invariant characteristics of nonfatal intentional self-harm episodes in relation to subsequent episodes of self-harm and suicide. Methods. We conducted a follow-up cohort study through 2007 of 3600 patients discharged from hospitals in New Jersey with a primary diagnosis of intentional self-harm in 2003. We determined repetition of self-harm from hospital records and suicide from state registers. Results. Use of methods other than drug overdose and cutting in self-harm events, greater medical severity of nonfatal episodes, and a history of multiple self-harm episodes increased the risk of suicide. However, most suicides occurred without these risk factors. Most suicides took place without intervening episodes of self-harm, and most persons used a low-lethality method (drug overdose or cutting) in their index episode, but switched to a more lethal method in their fatal episode. Conclusions. Our findings suggest that preventing suicide among persons with a history of self-harm must account for the possibility that they will adopt methods with higher case-fatality ratios than they previously tried. PMID:23597351

Mobile Apps for Suicide Prevention: Review of Virtual Stores and Literature.

PubMed

de la Torre, Isabel; Castillo, Gema; Arambarri, Jon; López-Coronado, Miguel; Franco, Manuel A

2017-10-10

The best manner to prevent suicide is to recognize suicidal signs and signals, and know how to respond to them. We aim to study the existing mobile apps for suicide prevention in the literature and the most commonly used virtual stores. Two reviews were carried out. The first was done by searching the most commonly used commercial app stores, which are iTunes and Google Play. The second was a review of mobile health (mHealth) apps in published articles within the last 10 years in the following 7 scientific databases: Science Direct, Medline, PsycINFO, Embase, The Cochrane Library, IEEE Xplore, and Google Scholar. A total of 124 apps related to suicide were found in the cited virtual stores but only 20 apps were specifically designed for suicide prevention. All apps were free and most were designed for Android. Furthermore, 6 relevant papers were found in the indicated scientific databases; in these studies, some real experiences with physicians, caregivers, and families were described. The importance of these people in suicide prevention was indicated. The number of apps regarding suicide prevention is small, and there was little information available from literature searches, indicating that technology-based suicide prevention remains understudied. Many of the apps provided no interactive features. It is important to verify the accuracy of the results of different apps that are available on iOS and Android. The confidence generated by these apps can benefit end users, either by improving their health monitoring or simply to verify their body condition. ©Isabel de la Torre, Gema Castillo, Jon Arambarri, Miguel López-Coronado, Manuel A Franco. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 10.10.2017.

Designing Microblog Direct Messages to Engage Social Media Users With Suicide Ideation: Interview and Survey Study on Weibo

PubMed Central

Tan, Ziying; Liu, Xingyun; Liu, Xiaoqian; Cheng, Qijin

2017-01-01

Background While Web-based interventions can be efficacious, engaging a target population’s attention remains challenging. We argue that strategies to draw such a population’s attention should be tailored to meet its needs. Increasing user engagement in online suicide intervention development requires feedback from this group to prevent people who have suicide ideation from seeking treatment. Objective The goal of this study was to solicit feedback on the acceptability of the content of messaging from social media users with suicide ideation. To overcome the common concern of lack of engagement in online interventions and to ensure effective learning from the message, this research employs a customized design of both content and length of the message. Methods In study 1, 17 participants suffering from suicide ideation were recruited. The first (n=8) group conversed with a professional suicide intervention doctor about its attitudes and suggestions for a direct message intervention. To ensure the reliability and consistency of the result, an identical interview was conducted for the second group (n=9). Based on the collected data, questionnaires about this intervention were formed. Study 2 recruited 4222 microblog users with suicide ideation via the Internet. Results The results of the group interviews in study 1 yielded little difference regarding the interview results; this difference may relate to the 2 groups’ varied perceptions of direct message design. However, most participants reported that they would be most drawn to an intervention where they knew that the account was reliable. Out of 4222 microblog users, we received responses from 725 with completed questionnaires; 78.62% (570/725) participants were not opposed to online suicide intervention and they valued the link for extra suicide intervention information as long as the account appeared to be trustworthy. Their attitudes toward the intervention and the account were similar to those from study 1, and 3 important elements were found pertaining to the direct message: reliability of account name, brevity of the message, and details of the phone numbers of psychological intervention centers and psychological assessment. Conclusions This paper proposed strategies for engaging target populations in online suicide interventions. PMID:29233805

Gender differences of suicides in children and adolescents: Analysis of 167 suicides in a Mexican population from 2003 to 2013.

PubMed

Aguilar-Velázquez, Daniela Georgina; González-Castro, Thelma Beatriz; Tovilla-Zárate, Carlos Alfonso; Juárez-Rojop, Isela E; López-Narváez, Maria Lilia; Frésan, Ana; Hernández-Díaz, Yazmin; Guzmán-Priego, Crystell Guadalupe

2017-12-01

Suicide is the second cause of death in youth population. The aim of the present study was to analyze demographic characteristics and suicide methods used, as well as to identify gender differences among Mexican children and adolescents (aged 10-17 years) that committed suicide. Between January 2003 and December 2013, 167 suicides of children and adolescents between 10 and 17 years of age were documented by the Secretary of Health of the state of Tabasco, Mexico. All sociodemographic characteristics were compared according to gender. Our sample included 67.7% males and 32.3% females (male to female 2.1:1). The predominant marital status was single (89.6%) and hanging (93.7%) was the principal method of suicide used. Both female and male adolescents were predominantly students (50%); however, female adolescents were more frequently married (17%) and were housewives (26.4%). Our results identified that hanging is the principal suicide method used by children and adolescents in Mexican population; we also detected main gender differences in terms of poisoning/drug toxicity as the method used, occupation and marital status. These results should be taken into consideration when designing suicide prevention programs due to the differences found by gender. Copyright © 2017 Elsevier B.V. All rights reserved.

Factors influencing the suicide intervention skills of emergency medical services providers

PubMed Central

Lygnugaryte-Griksiene, Aidana; Leskauskas, Darius; Jasinskas, Nedas; Masiukiene, Agne

2017-01-01

ABSTRACT Background: Lithuania currently has the highest suicide rate in Europe and the fifth highest worldwide. Aims: To identify the factors that influence the suicide intervention skills of emergency medical services (EMS) providers (doctors, nurses, paramedics). Method: Two hundred and sixty-eight EMS providers participated in the research. The EMS providers were surveyed both prior to their training in suicide intervention and six months later. The questionnaire used for the survey assessed their socio-demographic characteristics, suicide intervention skills, attitudes towards suicide prevention, general mental health, strategies for coping with stress, and likelihood of burnout. Results: Better suicide intervention skills were more prevalent among EMS providers with a higher level of education, heavier workload, more positive attitudes towards suicide prevention, better methods of coping with stress, and those of a younger age. Six months after the non-continuous training in suicide intervention, the providers’ ability to assess suicide risk factors had improved, although there was no change in their suicide intervention skills. Conclusions: In order to improve the suicide intervention skills of EMS providers, particular attention should be paid to attitudes towards suicide prevention, skills for coping with stress, and continuous training in suicide intervention. Abbreviations: EMS: Emergency medical services; SIRI: Suicide intervention response inventory PMID:28235388

Self-mutilation and suicide attempts: relationships to bipolar disorder, borderline personality disorder, temperament and character.

PubMed

Joyce, Peter R; Light, Katrina J; Rowe, Sarah L; Cloninger, C Robert; Kennedy, Martin A

2010-03-01

Self-mutilation has traditionally been associated with borderline personality disorder, and seldom examined separately from suicide attempts. Clinical experience suggests that self-mutilation is common in bipolar disorder. A family study was conducted on the molecular genetics of depression and personality, in which the proband had been treated for depression. All probands and parents or siblings were interviewed with a structured interview and completed the Temperament and Character Inventory. Fourteen per cent of subjects interviewed reported a history of self-mutilation, mostly by wrist cutting. Self-mutilation was more common in bipolar I disorder subjects then in any other diagnostic groups. In multiple logistic regression self-mutilation was predicted by mood disorder diagnosis and harm avoidance, but not by borderline personality disorder. Furthermore, the relatives of non-bipolar depressed probands with self-mutilation had higher rates of bipolar I or II disorder and higher rates of self-mutilation. Sixteen per cent of subjects reported suicide attempts and these were most common in those with bipolar I disorder and in those with borderline personality disorder. On multiple logistic regression, however, only mood disorder diagnosis and harm avoidance predicted suicide attempts. Suicide attempts, unlike self-mutilation, were not familial. Self-mutilation and suicide attempts are only partially overlapping behaviours, although both are predicted by mood disorder diagnosis and harm avoidance. Self-mutilation has a particularly strong association with bipolar disorder. Clinicians need to think of bipolar disorder, not borderline personality disorder, when assessing an individual who has a history of self-mutilation.

A culture gap in the United States: Implications for policy on limiting access to firearms for suicidal persons.

PubMed

Marino, Elizabeth; Wolsko, Christopher; Keys, Susan G; Pennavaria, Laura

2016-09-01

Suicide is a critical public health problem worldwide. In the United States (US), firearm ownership is common, and firearms account for the majority of deaths by suicide. While suicide prevention strategies may include limiting access to firearms, the contentious nature of gun regulations in the US, particularly among members of rural communities, often gives rise to constitutional concerns and political polarization that could inhibit suicidal persons from seeking the help they need. We examine potential outcomes of public health strategies in the US that encourage limiting access to firearms for populations who both value firearm ownership and are vulnerable to suicide. Based on preliminary results from a firearm safety study, we argue that attempts to limit access to firearms among those at risk of suicide will only succeed when the most affected cultural groups are engaged in collaborative discussions.

Martyrs' last letters: are they the same as suicide notes?

PubMed

Leenaars, Antoon A; Ben Park, B C; Collins, Peter I; Wenckstern, Susanne; Leenaars, Lindsey

2010-05-01

Of the 800,000 suicides worldwide every year, a small number fall under Emile Durkheim's term of altruistic suicides. Study on martyrdom has been limited. There has to date, for example, been no systematic empirical study of martyr letters. We examined 33 letters of Korean self-immolators, compared with 33 suicide notes of a matched sample of more common suicides. An analysis of intrapsychic factors (suicide as unbearable pain, psychopathology) and interpersonal factors (suicide as murderous impulses and need to escape) revealed that, although one can use the same psychological characteristics or dynamics to understand the deaths, the state of mind of martyrs is more extreme, such that the pain is reported to be even more unbearable. Yet, there are differences, such as there was no ambivalence in the altruistic notes. It is concluded that intrapsychic and interpersonal characteristics are central in understanding martyrs, probably equal to community or societal factors. More forensic study is, however, warranted.

Classification of attempted suicide by cluster analysis: A study of 888 suicide attempters presenting to the emergency department.

PubMed

Kim, Hyeyoung; Kim, Bora; Kim, Se Hyun; Park, C Hyung Keun; Kim, Eun Young; Ahn, Yong Min

2018-08-01

It is essential to understand the latent structure of the population of suicide attempters for effective suicide prevention. The aim of this study was to identify subgroups among Korean suicide attempters in terms of the details of the suicide attempt. A total of 888 people who attempted suicide and were subsequently treated in the emergency rooms of 17 medical centers between May and November of 2013 were included in the analysis. The variables assessed included demographic characteristics, clinical information, and details of the suicide attempt assessed by the Suicide Intent Scale (SIS) and Columbia-Suicide Severity Rating Scale (C-SSRS). Cluster analysis was performed using the Ward method. Of the participants, 85.4% (n = 758) fell into a cluster characterized by less planning, low lethality methods, and ambivalence towards death ("impulsive"). The other cluster (n = 130) involved a more severe and well-planned attempt, used highly lethal methods, and took more precautions to avoid being interrupted ("planned"). The first cluster was dominated by women, while the second cluster was associated more with men, older age, and physical illness. We only included participants who visited the emergency department after their suicide attempt and had no missing values for SIS or C-SSRS. Cluster analysis extracted two distinct subgroups of Korean suicide attempters showing different patterns of suicidal behaviors. Understanding that a significant portion of suicide attempts occur impulsively calls for new prevention strategies tailored to differing subgroup profiles. Copyright © 2018 Elsevier B.V. All rights reserved.

Characterizing Suicide in Toronto: An Observational Study and Cluster Analysis

PubMed Central

Sinyor, Mark; Schaffer, Ayal; Streiner, David L

2014-01-01

Objective: To determine whether people who have died from suicide in a large epidemiologic sample form clusters based on demographic, clinical, and psychosocial factors. Method: We conducted a coroner’s chart review for 2886 people who died in Toronto, Ontario, from 1998 to 2010, and whose death was ruled as suicide by the Office of the Chief Coroner of Ontario. A cluster analysis using known suicide risk factors was performed to determine whether suicide deaths separate into distinct groups. Clusters were compared according to person- and suicide-specific factors. Results: Five clusters emerged. Cluster 1 had the highest proportion of females and nonviolent methods, and all had depression and a past suicide attempt. Cluster 2 had the highest proportion of people with a recent stressor and violent suicide methods, and all were married. Cluster 3 had mostly males between the ages of 20 and 64, and all had either experienced recent stressors, suffered from mental illness, or had a history of substance abuse. Cluster 4 had the youngest people and the highest proportion of deaths by jumping from height, few were married, and nearly one-half had bipolar disorder or schizophrenia. Cluster 5 had all unmarried people with no prior suicide attempts, and were the least likely to have an identified mental illness and most likely to leave a suicide note. Conclusions: People who die from suicide assort into different patterns of demographic, clinical, and death-specific characteristics. Identifying and studying subgroups of suicides may advance our understanding of the heterogeneous nature of suicide and help to inform development of more targeted suicide prevention strategies. PMID:24444321

Suicide and the 'Poison Complex': Toxic Relationalities, Child Development, and the Sri Lankan Self-Harm Epidemic.

PubMed

Widger, Tom

2015-01-01

Suicide prevention efforts in Asia have increasingly turned to 'quick win' means restriction, while more complicated cognitive restriction and psychosocial programs are limited. This article argues the development of cognitive restriction programs requires greater consideration of suicide methods as social practices, and of how suicide cognitive schemata form. To illustrate this, the article contributes an ethnographically grounded study of how self-poisoning becomes cognitively available in Sri Lanka. I argue the overwhelming preference for poison as a method of self-harm in the country is not simply reflective of its widespread availability, but rather how cognitive schemata of poison-a 'poison complex'-develops from early childhood and is a precondition for suicide schemata. Limiting cognitive availability thus requires an entirely novel approach to suicide prevention that draws back from its immediate object (methods and causes of self-harm) to engage the wider poison complex of which suicide is just one aspect.

[Homicide-suicide: Clinical review and psychological assumptions].

PubMed

Vandevoorde, J; Estano, N; Painset, G

2017-08-01

Suicide-homicide could be defined as a "suicidal" behaviour, which also includes the death of at least one other individual and sometimes up to hundreds. This literature review intends to highlight some characteristic features that might be found amongst the various types of suicide-homicide. It is a complex phenomenon which can occur in different situations, from a familial and somehow intimate setting (filicide, uxoricide, marital homicide…) to a public one (workplace shooting, school shooting), including a wide range of victims, from a single victim in marital cases of suicide-homicide to hundreds of victims in certain types, such as suicide by aircraft or warrior-like multi-homicids in terrorist acts. This literature review offers a combination of data emanating from scientific publications and case studies from our practices in an attempt to insulate some common factors. A thorough examination of the offenses unravels complex processes, ideations, M.O and peculiar cognitive impairments in which the familial suicide-homicide could be rooted. Mass murders might be caused also by a psychopathological alloy, made of Grandiose Self and sub-depressive and even paranoid ideations. Concerning the terrorism and multi-homicide-suicide, this is far more complex phenomenon and is defined by a group-process enrolment and ideological conviction. Beyond epidemiological studies, both descriptive and statistical, this paper's objective is to isolate a hypothesis about a psychopathological ground from which a criminological mechanism could emerge. Despite the lack of blatant psychosis, some traits might be identified in suicide-homicide cases - such as paranoid, psychopathic, narcissistic, melancholic - which can intertwine, potentiate one with another forming a distorted view of the world. The offense dynamic is possibly composed of preparatory behaviours, triggers, the use of death as a narcissistic support, identity choices… METHODS: The data were collected from scientific publications, personal cases, and open source. Despite the variety of behaviours included in this typology, we were able to identify a few mechanisms that could be found in two types of suicide-homicide [Private suicide-homicide (within the family circle) vs. Public space suicide-homicide (suicide by aircraft, school shooting…)]. Suicide-homicide phenomenon is the result of the interaction of societal, ideological, psychopathological and criminological elements which burst out in a lethal and paroxystic gesture. Psychiatrists and psychologists may have an important part to play in modelling a pattern to better understand it. Copyright © 2016 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Creating a Chinese suicide dictionary for identifying suicide risk on social media.

PubMed

Lv, Meizhen; Li, Ang; Liu, Tianli; Zhu, Tingshao

2015-01-01

Introduction. Suicide has become a serious worldwide epidemic. Early detection of individual suicide risk in population is important for reducing suicide rates. Traditional methods are ineffective in identifying suicide risk in time, suggesting a need for novel techniques. This paper proposes to detect suicide risk on social media using a Chinese suicide dictionary. Methods. To build the Chinese suicide dictionary, eight researchers were recruited to select initial words from 4,653 posts published on Sina Weibo (the largest social media service provider in China) and two Chinese sentiment dictionaries (HowNet and NTUSD). Then, another three researchers were recruited to filter out irrelevant words. Finally, remaining words were further expanded using a corpus-based method. After building the Chinese suicide dictionary, we tested its performance in identifying suicide risk on Weibo. First, we made a comparison of the performance in both detecting suicidal expression in Weibo posts and evaluating individual levels of suicide risk between the dictionary-based identifications and the expert ratings. Second, to differentiate between individuals with high and non-high scores on self-rating measure of suicide risk (Suicidal Possibility Scale, SPS), we built Support Vector Machines (SVM) models on the Chinese suicide dictionary and the Simplified Chinese Linguistic Inquiry and Word Count (SCLIWC) program, respectively. After that, we made a comparison of the classification performance between two types of SVM models. Results and Discussion. Dictionary-based identifications were significantly correlated with expert ratings in terms of both detecting suicidal expression (r = 0.507) and evaluating individual suicide risk (r = 0.455). For the differentiation between individuals with high and non-high scores on SPS, the Chinese suicide dictionary (t1: F 1 = 0.48; t2: F 1 = 0.56) produced a more accurate identification than SCLIWC (t1: F 1 = 0.41; t2: F 1 = 0.48) on different observation windows. Conclusions. This paper confirms that, using social media, it is possible to implement real-time monitoring individual suicide risk in population. Results of this study may be useful to improve Chinese suicide prevention programs and may be insightful for other countries.

Creating a Chinese suicide dictionary for identifying suicide risk on social media

PubMed Central

Liu, Tianli

2015-01-01

Introduction. Suicide has become a serious worldwide epidemic. Early detection of individual suicide risk in population is important for reducing suicide rates. Traditional methods are ineffective in identifying suicide risk in time, suggesting a need for novel techniques. This paper proposes to detect suicide risk on social media using a Chinese suicide dictionary. Methods. To build the Chinese suicide dictionary, eight researchers were recruited to select initial words from 4,653 posts published on Sina Weibo (the largest social media service provider in China) and two Chinese sentiment dictionaries (HowNet and NTUSD). Then, another three researchers were recruited to filter out irrelevant words. Finally, remaining words were further expanded using a corpus-based method. After building the Chinese suicide dictionary, we tested its performance in identifying suicide risk on Weibo. First, we made a comparison of the performance in both detecting suicidal expression in Weibo posts and evaluating individual levels of suicide risk between the dictionary-based identifications and the expert ratings. Second, to differentiate between individuals with high and non-high scores on self-rating measure of suicide risk (Suicidal Possibility Scale, SPS), we built Support Vector Machines (SVM) models on the Chinese suicide dictionary and the Simplified Chinese Linguistic Inquiry and Word Count (SCLIWC) program, respectively. After that, we made a comparison of the classification performance between two types of SVM models. Results and Discussion. Dictionary-based identifications were significantly correlated with expert ratings in terms of both detecting suicidal expression (r = 0.507) and evaluating individual suicide risk (r = 0.455). For the differentiation between individuals with high and non-high scores on SPS, the Chinese suicide dictionary (t1: F1 = 0.48; t2: F1 = 0.56) produced a more accurate identification than SCLIWC (t1: F1 = 0.41; t2: F1 = 0.48) on different observation windows. Conclusions. This paper confirms that, using social media, it is possible to implement real-time monitoring individual suicide risk in population. Results of this study may be useful to improve Chinese suicide prevention programs and may be insightful for other countries. PMID:26713232

The association of suicide-related Twitter use with suicidal behaviour: a cross-sectional study of young internet users in Japan.

PubMed

Sueki, Hajime

2015-01-01

Infodemiology studies for suicide prevention have become increasingly common in recent years. However, the association between Twitter use and suicide has only been partially clarified. This study examined the association between suicide-related tweets and suicidal behaviour to identify suicidal young people on the Internet. A cross-sectional survey was conducted using Internet survey panels (n=220,848) comprising users in their 20s, through a major Japanese Internet survey company. Final analyses included the data of 1000 participants. Of the participants (n=1000) used in the final analysis, 61.3% were women and the mean age was 24.9 years (SD=2.9, range=20-29). Logistic regression analyses showed that tweeting "want to die" and "want to commit suicide" was significantly related to suicidal ideation and behaviour. Lifetime suicide attempts, the most powerful predictor of future suicide out of all suicidal behaviours, were more strongly associated with tweeting "want to commit suicide" than tweeting "want to die". Having a Twitter account and tweeting daily were not associated with suicidal behaviour. An online panel survey has some inherent biases, such as coverage bias. Respondents were already registered as members of a particular Internet survey company in Japan, which limits the possibility of generalization. Twitter logs may be used to identify suicidal young Internet users. This study provides a basis for the early identification of individuals at high risk for suicide. Copyright © 2014 Elsevier B.V. All rights reserved.

Personal suicidality in reception and identification with suicidal film characters.

PubMed

Till, Benedikt; Vitouch, Peter; Herberth, Arno; Sonneck, Gernot; Niederkrotenthaler, Thomas

2013-04-01

The authors investigated the impact of suicidality on identity work during film exposure. Adults with low suicidality (n = 150) watched either It's My Party or The Fire Within, censored versions of these films not depicting the suicide, or the control film that concluded with a non-suicidal death. Baseline suicidality was measured with questionnaires before the movie. Identity work and identification with the protagonist were measured after the movie. Suicidality was directly associated with identity work during film dramas depicting suicide methods. The reception of suicide-related media content seems to partially depend on personal suicidality. Potential implications for suicide prevention are discussed.

Urban-Rural Differences in Suicide in the State of Maryland: The Role of Firearms.

PubMed

Nestadt, Paul S; Triplett, Patrick; Fowler, David R; Mojtabai, Ramin

2017-10-01

To assess whether the use of firearms explains rural-urban differences in suicide rates. We performed a retrospective analysis on all 6196 well-characterized adult suicides in Maryland from 2003 through 2015. We computed rate ratios by using census data and then stratified by sex, with adjustment for age and race. Suicide rates were higher in rural compared with urban counties. However, the higher rural suicide rates were limited to firearm suicides (incident rate ratio [IRR] = 1.66; 95% confidence interval [CI] = 1.20, 2.31). Nonfirearm suicide rates were not significantly higher in rural settings. Furthermore, 89% of firearm suicides occurred in men and the higher rural firearm suicide rate was limited to men (IRR = 1.36; 95% CI = 1.09, 1.69). Women were significantly less likely to complete suicide in rural areas (IRR = 0.63; 95% CI = 0.43, 0.94), regardless of method. Male firearm use drives the increased rate of suicide in rural areas. The opposite associations between urbanicity and suicide in men and women may be driven by the male preference for firearms as a method for committing suicide.

Media Roles in Suicide Prevention: A Systematic Review

PubMed Central

Sisask, Merike; Värnik, Airi

2012-01-01

The aim of the current systematic review was to monitor and provide an overview of the research performed about the roles of media in suicide prevention in order to find out possible effects media reporting on suicidal behaviours might have on actual suicidality (completed suicides, attempted suicides, suicidal ideation). The systematic review was performed following the principles of the PRISMA statement and includes 56 articles. Most of the studies support the idea that media reporting and suicidality are associated. However, there is a risk of reporting bias. More research is available about how irresponsible media reports can provoke suicidal behaviours (the ‘Werther effect’) and less about protective effect media can have (the ‘Papageno effect’). Strong modelling effect of media coverage on suicide is based on age and gender. Media reports are not representative of official suicide data and tend to exaggerate sensational suicides, for example dramatic and highly lethal suicide methods, which are rare in real life. Future studies have to encounter the challenges the global medium Internet will offer in terms of research methods, as it is difficult to define the circulation of news in the Internet either spatially or in time. However, online media can provide valuable innovative qualitative research material. PMID:22470283

Attempted Suicide Among Students and Young Adults in Montreal, Quebec, Canada: A Retrospective Cross-Sectional Study of Hospitalized and Nonhospitalized Suicide Attempts Based on Chart Review

PubMed Central

Rahme, Elham; Low, Nancy C. P.; Lamarre, Suzanne; Turecki, Gustavo; Bonin, Jean-Pierre; Daneau, Diane; Habel, Youssef; Yung, Emily C. C.; Morin, Suzanne; Szkrumelak, Nadia; Singh, Santokh; Renaud, Johanne; Lesage, Alain

2015-01-01

Objective We conducted a chart review to identify postsecondary students and nonstudents in the same age range who presented to the emergency department following a suicide attempt to (1) compare demographic characteristics and suicide risk factors and (2) determine factors associated with more serious attempts requiring hospitalizations. Method The study was conducted in 1 tertiary trauma hospital and 1 community hospital affiliated with McGill University, Montreal, Quebec, Canada, between January 1, 2009, and March 31, 2010. Charts of patients with potential suicide attempts were identified from medical records using ICD-10 codes that indicated traumatic injury, intentional self-harm, poisoning, and psychiatric or perception/cognition disorders and from the emergency department triage file using keywords that indicated suicidality or self-harm at presentation. Results In multivariable logistic regression models (odds ratio, 95% CI), students were younger (per 5-year increase: 0.22, 0.12–0.41), less likely to be born in Canada (0.17, 0.06–0.44), and more likely to use less violent methods (laceration, poisoning, other, multiple methods) versus more violent methods (collision, jump, fire burns, firearm, hanging) in their attempt. Fewer students had a history of substance abuse (0.12, 0.02–0.94) but were not different from nonstudents on history of other mental disorders. Less students attempted suicide in the winter/spring (January–April) versus fall (September–December) semester (0.32, 0.11–0.91). Students who attempted suicide were more likely to have family/social support. Those who attempted suicide in the previous year were more likely to require hospitalization for their current suicide attempt. Conclusions Knowledge of specific factors associated with suicide attempts in young people can help inform and guide suicide prevention efforts in both academic and community settings. Specific to the findings of this study regarding the method of suicide attempt used, for example, limiting access to dangerous substances or large quantities of medications may help prevent or reduce suicide attempts in this population. PMID:26835175

Characteristics and Proximal Outcomes of Calls Made to Suicide Crisis Hotlines in California.

PubMed

Ramchand, Rajeev; Jaycox, Lisa; Ebener, Pat; Gilbert, Mary Lou; Barnes-Proby, Dionne; Goutam, Prodyumna

2017-01-01

Suicide hotlines are commonly used to prevent suicides, although centers vary with respect to their management and operations. To describe variability across suicide prevention hotlines. Live monitoring of 241 calls was conducted at 10 suicide prevention hotlines in California. Call centers are similar with respect to caller characteristics and the concerns callers raise during their calls. The proportion of callers at risk for suicide varied from 3 to 57%. Compliance with asking about current suicide risk, past ideation, and past attempts also ranged considerably. Callers to centers that were part of the National Suicide Prevention Lifeline (NSPL) were more likely to experience reduced distress than callers to centers that were not part of the NSPL. Because callers do not generally choose the center or responder that will take their call, it is critical to promote quality across call centers and minimize the variability that currently exists. Accrediting bodies, funders, and crisis centers should require that centers continuously monitor calls to ensure and improve call quality.

Effect of the First World War on suicide rates in Ireland: an investigation of the 1864–1921 suicide trends

PubMed Central

Parnell, Andrew C.

2015-01-01

Summary Since the proposition of the social integration theory by Émile Durkheim, macro-sociological changes have been speculated to affect suicide rates. This study investigates the effect of the First World War on Irish suicide rates. We applied an interrupted time series design of 1864–1921 annual Irish suicide rates. The 1864–1913 suicide rates exhibited a slow-rising trend with a sharp decline from the year 1914 onwards. The odds for death by suicide for males during the 1914–1918 period was 0.811 (95% CI 0.768–0.963). Irish rates of suicide were significantly reduced during the First World War, most notably for males. Declaration of interest None. Copyright and usage © 2015 The Royal College of Psychiatrists. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence. PMID:27703742

Suicide attempts in children and adolescents: The place of clock genes and early rhythm dysfunction.

PubMed

Olliac, Bertrand; Ouss, Lisa; Charrier, Annaëlle

2016-11-01

Suicide remains one of the leading causes of death among young people, and suicidal ideation and behavior are relatively common in healthy and clinical populations. Suicide risk in childhood and adolescence is often approached from the perspective of nosographic categories to which predictive variables for suicidal acts are often linked. The cascading effects resulting from altered clock genes in a pediatric population could participate in biological rhythm abnormalities and the emergence of suicide attempts through impaired regulation of circadian rhythms and emotional states with neurodevelopmental effects. Also, early trauma and stressful life events can alter the expression of clock genes and contribute to the emergence of suicide attempts. Alteration of clock genes might lead to desynchronized and abnormal circadian rhythms impairing in turn the synchronization between external and internal rhythms and therefore the adaptation of the individual to his/her internal and external environment with the development of psychiatric disorders associated with increased risk for suicide attempts. Copyright © 2017 Elsevier Ltd. All rights reserved.

The prevalence and psychosocial correlates of suicide attempts among inpatient adolescent offspring of Croatian PTSD male war veterans.

PubMed

Boričević Maršanić, Vlatka; Margetić, Branka Aukst; Zečević, Iva; Herceg, Miroslav

2014-10-01

Despite evidence that children of male war veterans with combat-related posttraumatic stress disorder (PTSD) are at particularly high risk for behavior problems, very little is currently known about suicidal behaviors in this population of youth. This study aimed to examine the prevalence and psychosocial correlates of suicide attempts among psychiatrically hospitalized adolescent offspring of Croatian male PTSD veterans. Participants were psychiatric inpatients, ages 12-18 years. Self-report questionnaires assessed demographics, suicide attempts, psychopathology, parenting style, and family functioning. The prevalence of suicide attempts was 61.5% (65.2% for girls and 58.0% for boys). Internalizing symptoms, family dysfunction, lower levels of maternal and paternal care, and paternal overcontrol were significantly associated with suicide attempts. Our findings suggest that suicide attempts are common among inpatient adolescent offspring of male PTSD veterans and that interventions targeting both adolescent psychopathology and family relationships are needed for adolescents who have attempted suicide.

The relationship between deliberate self-harm behavior, body dissatisfaction, and suicide in adolescents: current concepts

PubMed Central

Greydanus, Donald E; Apple, Roger W

2011-01-01

Deliberate self-harm (DSH) is a common though often hidden condition in children and adolescents that may result in suicide. This discussion covers several aspects of DSH including its prevalence, etiology, and management. The relationships of DSH to body dissatisfaction and suicide are specifically considered. Even though most cases of DSH do not end in overt suicide, DSH reflects that potential underlying psychological pathophysiology, and likelihood of eventual death from self-murder, cannot always be predicted or prevented. It is important to take all acts of DSH as serious, and to offer comprehensive management to prevent future acts of DSH and potential suicide. PMID:21811385

When a patient commits suicide: an empirical study of psychoanalytic clinicians.

PubMed

Tillman, Jane G

2006-02-01

Twelve psychoanalysts/psychoanalytic psychotherapists who had a patient commit suicide while in treatment, or shortly after leaving treatment, were interviewed to gain a deeper understanding of the effects of patient suicide on the clinician. A phenomenological research interview was used to gather data, and a psychoanalytic lens was used to interpret the data, generating a descriptive account of the experience of having a patient commit suicide. Thematic analysis of the transcripts yielded eight common themes associated with the clinician's subjective experience of having a patient suicide. The eight themes may be broadly grouped into three general structures: I. Traumatic loss and grief; II. Interpersonal relationships; and III. Professional identity concerns.

The interface of the civil and criminal law of suicide at common law (1194-1845).

PubMed

Mendelson, Danuta; Freckelton, Ian

2013-01-01

Nowadays, suicide is considered essentially a private act, although what constitutes suicide for epidemiological and even clinical purposes in not wholly resolved. Historically, however, at common law, the act of self-killing was a felony with significant religious and legal consequences that impacted upon the deceased person as well as upon his or her whole family. This article identifies the influence of Christian theology, legal theory, and social and medical developments upon attitudes to the felony of self-murder and its definition. It focuses upon the start of more psychologically informed attitudes manifested in landmark court judgments involving exclusion clauses in English mid-nineteenth century insurance contracts. The article illustrates that the law in respect of socially controversial matters does not necessarily develops in a linear progression, nor does it accurately reflect public sentiments. More specifically, the article describes an ongoing definitional conundrum with suicide--whether it should be designated as committed by persons of significantly impaired mental state. The authors observe that in spite of reform to the criminal law of suicide, the civil law relating to suicide has continued to be characterised by ambivalence, ambiguity and significant vestiges of counter-therapeutic moralising. Copyright © 2013 Elsevier Ltd. All rights reserved.

Media representation of gender patterns of suicide in Taiwan.

PubMed

Chen, Ying-Yeh; Yip, Paul S F; Tsai, Chi-Wei; Fan, Hsiang-Fang

2012-01-01

Extensive media reporting of suicide events has been indicated as a contributing factor to the upsurge in suicide rates in Taiwan in the past decade. The study compares gender differences in sociodemographic profiles and method of suicide selectively reported in the newspapers and all suicide cases registered in official death records. It also identifies gender differences in media reports of suicides. Articles reporting suicide news from four major newspapers in Taiwan (China Times, United Daily, Liberty Times, and Apple Daily) in 2009 were retrieved and analyzed. Gender differences in sociodemographic profiles of suicides reported in the newspapers and official records of all suicide deaths were compared. Any gender differences in newspaper depictions of contributing factors of suicide and situations surrounding the suicidal acts were compared. Newspapers in Taiwan tended to overreport unusual methods of suicide among men and extended suicide among women. The reasons for suicide in men were more frequently portrayed as work-related or after legal problems, whereas in women suicide was more frequently framed as due to mental illness or relationship problems. The news media tended to underreport mental illness as a reason for suicide in men. The analysis was based solely on news reporting in the four major newspapers during the year 2009. Media representation of suicide generally follow societal-gendered assumptions of acceptable/unacceptable behaviors. Media professionals should be more careful and responsible in reporting suicide news and avoid any gender bias in their framing of suicide stories. Sensitive rather than sensational reporting should be promoted in order not to reinforce the myths of suicides in the community.

Self-injury and incontinence in psychogenic seizures.

PubMed

Peguero, E; Abou-Khalil, B; Fakhoury, T; Mathews, G

1995-06-01

Two patients who incurred significant injuries during psychogenic seizures prompted us to do a telephone survey of self-injury and incontinence in 102 consecutive patients diagnosed with psychogenic seizures by EEG-closed-circuit TV (EEG-CCTV) monitoring. Seventy-three patients (or a close family member or friend) were reached by telephone and responded to our survey. During typical attacks of psychogenic seizures, 40% reported injuries, 44% reporting tongue biting, and 44% reported urinary incontinence. Suicide attempts were reported by 32% and were more common in those with self-injury and urinary incontinence. We compared the results of patients with psychogenic seizures with those of 30 patients with refractory epilepsy documented by ictal recordings, using a similar telephone survey. Injuries of all types were more commonly reported by epilepsy patients. Burn injuries were reported only by patients with epilepsy. Suicide attempts were more commonly reported by the psychogenic seizure group. Self-injury and incontinence are commonly reported by psychogenic seizure patients. In view of their significant association with suicide attempts, they may indicate an underlying depression.

What Does Psychological Autopsy Study Tell Us about Charcoal Burning Suicide--A New and Contagious Method in Asia?

ERIC Educational Resources Information Center

Chan, Sandra S. M.; Chiu, Helen F. K.; Chen, Eric Y. H.; Chan, Wincy S. C.; Wong, Paul W. C.; Chan, Cecilia L. W.; Law, Y. W.; Yip, Paul S. F.

2009-01-01

Charcoal burning suicides in Hong Kong between 2002-2004 in the 15 to 59-year-old age group were investigated using the psychological autopsy method. The psychopathological profiles of charcoal burning suicides (N = 53) were compared against "other suicides" (N = 97). The two groups did not differ significantly in the prevalence of…

Risk factors of suicidal ideation among adolescents after Wenchuan earthquake in China.

PubMed

Ran, Mao-Sheng; Zhang, Zhen; Fan, Mei; Li, Rong-Hui; Li, Yuan-Hao; Ou, Guo Jing; Jiang, Zhe; Tong, Yu-Zhen; Fang, Ding-Zhi

2015-02-01

Suicidal ideation is a common phenomenon in survivors after disaster event. To identify the change of suicidal ideation, and to test hypotheses concerning the suicidal ideation, depression and PTSD symptoms among adolescent survivors after the 2008 Wenchuan earthquake in China. The suicidal ideation among high school students at 6, 12 and 18 months after the Wenchuan earthquake were investigated. Subjects included 737 student survivors in an affected high school. The PTSD Checklist-Civilian Version (PCL-C) and the Chinese Beck Depression Inventory (C-BDI) were used to measure the symptoms of PTSD and depression. The rates of suicidal ideation among the adolescent survivors at 6-, 12- and 18-month after the earthquake were 35.6%, 35.6% and 30.7% respectively. Depression symptoms in the 18-month follow-up, suicidal ideations at 6 and 12 months after the earthquake were the independent risk factors of suicidal ideation in the 18-month follow-up. Depression symptoms were the strongest predictor of suicidal ideation after earthquake. An increased rate of suicidal ideation after the earthquake may be mainly due to depression but not to PTSD symptoms. The disaster-related psychological sequelae and the risk factors of suicidal ideation, especially depression symptoms, should be considered in the mental health services and suicide prevention. Copyright © 2014 Elsevier B.V. All rights reserved.

Nonsuicidal self-injury and disordered eating: Differences in acquired capability and suicide attempt severity.

PubMed

Brausch, Amy M; Perkins, Natalie M

2018-05-21

Nonsuicidal self-injury (NSSI) and eating disorders are both strongly related to suicide behaviors, and both can be conceptualized as painful and provocative events that associate with acquired capability for suicide. Individuals who self-injure report greater acquired capability than those who do not engage in these behaviors, but results are mixed in eating disorder samples. Given that NSSI and disordered eating (DE) commonly co-occur, it is important to examine how acquired capability for suicide and suicide attempt severity may differ between individuals who engage in either, both, or neither of these behaviors. It was expected that individuals with both NSSI and DE would report the greatest acquired capability, assessed by fearlessness about death and fear about suicide, and suicide attempt severity, compared to NSSI only, DE only, and controls. In a sample of 1179 undergraduates, results indicated no differences on fearlessness about death, but the NSSI + DE group reported the lowest scores on fear of suicide and greatest suicide attempt severity compared to the other groups. Differences between fearlessness about death and fear about suicide are discussed, as well as the possible additive effect of engaging in both direct (NSSI) and indirect (DE) self-harm on fear about suicide and suicide risk. Copyright © 2018 Elsevier B.V. All rights reserved.

Suicide Attempt as a Risk Factor for Completed Suicide: Even More Lethal Than We Knew

PubMed Central

Bostwick, J. Michael; Pabbati, Chaitanya; Geske, Jennifer R.; McKean, Alastair J.

2017-01-01

Objective While suicide attempt history is considered to robustly predict completed suicide, previous studies have limited generalizability from using convenience samples of specific methods/treatment settings, disregarding previous attempts, or overlooking first-attempt deaths. Eliminating these biases should more accurately estimate suicide prevalence in attempters. Method This observational retrospective-prospective cohort study using the Rochester Epidemiology Project identified 1,490 (555 males/935 females) Olmsted County residents making index suicide attempts (first lifetime attempts reaching medical attention) between 01-01-1986 and 12-31-2007. The National Death Index identified suicides between enrollment and 12-31-2010 (follow-up 3-25 years). Medical records were queried for sex, age, method, and follow-up care for index attempt survivors. Coroner records yielded data on index attempt deaths. Results During the study period, 81/1490 enrollees (5.4%) died by suicide. Of the 81, 48 (59.3%) perished on index attempt; 27 of the surviving 33 index attempt survivors (81.8%) killed themselves within a year. Males were disproportionately represented: 62/81 (11.2% of men; 76.5% of suicides) vs 19/81 (2.0% of women, 23.5% of suicides). Of dead index attempters, 72.9% used guns, yielding an odds ratio for gunshot death vs all other methods of 140 [95%CI:60,325]. When adjusted for covariates, survivors given follow-up psychiatric appointments had significantly lower likelihood of subsequent suicide (OR=0.212[95%CI:0.089, 0.507]). Conclusions At 5.4%, completed suicide prevalence in this community cohort of suicide attempters was almost 59% higher than previously reported. An innovative aspect of this study explains the discrepancy: by including index attempt deaths—approximately 60% of total suicides—suicide prevalence more than doubled. We contend that counting both index and subsequent attempts deaths more accurately reflects prevalence. Our findings support suicide attempt as an even more lethal risk factor for completed suicide than previously thought. Research should focus on identifying risk factors for populations vulnerable to making first attempts and target risk reduction in those groups. PMID:27523496

Risk factors of suicide mortality among multiple attempters: A national registry study in Taiwan.

PubMed

Chen, I-Ming; Liao, Shih-Cheng; Lee, Ming-Been; Wu, Chia-Yi; Lin, Po-Hsien; Chen, Wei J

2016-05-01

Little is known about the risk factors of suicide mortality among multiple attempters. This study aims to investigate the predictors of suicidal mortality in a prospective cohort of attempters in Taiwan, focusing on the time interval and suicide method change between the last two nonfatal attempts. The representative data retrieved from the National Suicide Surveillance System (NSSS) was linked with National Mortality Database to identify the causes of death in multiple attempters during 2006-2008. Cox-proportional hazard models were applied to calculate the hazard ratios for the predictors of suicide. Among the 55,560 attempters, 6485 (11.7%) had survived attempts ranging from one to 11 times; 861 (1.5%) eventually died by suicide. Multiple attempters were characterized by female (OR = 1.56, p < 0.0001), nonrecipient of national aftercare service (OR = 1.62, p < 0.0001), and current contact with mental health services (OR = 3.17, p < 0.0001). Most multiple attempters who survived from hanging (68.1%) and gas poisoning (61.9%) chose the same method in the following fatal episode. Predictors of suicidal death were identified as male, older age (≥ 45 years), shorter interval and not maintaining methods of low lethality in the last two nonfatal attempts. Receipt of nationwide aftercare was associated with lower risk of suicide but the effect was insignificant. The time interval of the last two nonfatal attempts and alteration in the lethality of suicide method were significant factors for completed suicide. Risk assessment involving these two factors may be necessary for multiple attempters in different clinical settings. Effective strategies for suicide prevention emphasizing this high risk population should be developed in the future. Copyright © 2015. Published by Elsevier B.V.

Correlates of Attempted Suicide from the Emergency Room of 2 General Hospitals in Montreal, Canada

PubMed Central

Low, Nancy C. P.; Lamarre, Suzanne; Daneau, Diane; Habel, Youssef; Turecki, Gustavo; Bonin, Jean-Pierre; Morin, Suzanne; Szkrumelak, Nadia; Singh, Santokh; Lesage, Alain

2016-01-01

Introduction: The epidemiology of attempted suicide has not been well characterized because of lack of national data or an International Classification of Diseases (ICD) code for suicide attempts. We conducted a retrospective chart review in 2 adult general hospitals (tertiary and community) in Montreal, Canada, in 2009-2010 to 1) describe the characteristics of men and women who presented to the emergency department (ED) and/or were hospitalized following a suicide attempt, 2) identify factors associated with attempts requiring hospitalizations, and 3) validate the use of International Classification of Diseases, 10th Revision (ICD-10) codes for “intentional self-harm” as a method to detect suicide attempts from hospital abstract summary records. Method: All potential suicide attempts were identified from hospital abstract summary records and ED nursing triage file using ICD-10 codes and keywords suggestive of suicide attempts. All identified charts were examined, and those with confirmed suicide attempts were fully reviewed. Results: Of the 5746 identified charts, 369 were fully reviewed. Of these, 176 were for suicide attempters treated in the ED and 193 for hospitalized attempters, of whom 46% had an ICD-10 code for intentional self-harm. Poisoning (46%) was the most frequent method of suicide used. Half of attempters were younger than 34 years, 53% were female, and 75% had a history of mental disorders. Conclusion: About half of individuals who seek medical care for attempted suicide are admitted to hospital. About half of attempters use poisoning as a method of suicide, and a quarter do not have a history of mental disorders. Intentional self-harm codes capture only about half of hospitalized attempters.

Onset of common mental disorders and suicidal behavior following women's first exposure to gender based violence: a retrospective, population-based study.

PubMed

Rees, Susan; Steel, Zachary; Creamer, Mark; Teesson, Maree; Bryant, Richard; McFarlane, Alexander C; Mills, Katherine L; Slade, Tim; Carragher, Natacha; O'Donnell, Meaghan; Forbes, David; Silove, Derrick

2014-11-18

Women exposed to gender-based violence (GBV) experience a high rate of common mental disorders and suicidal behaviour ("mental disturbance"). Little is known however about the timing of onset of mental disturbance following first exposure to GBV amongst women with no prior mental disorder. The analysis was undertaken on the Australian National Mental Health and Wellbeing Survey dataset (N = 8841). We assessed lifetime prevalence and first onset of common mental disorder and suicidal behaviour (mental disturbance) and exposure to GBV and its first occurrence based on the Composite International Diagnostic Interview Version 3 (WMH-CIDI 3.0). We used the Kaplan-Meier method to derive cumulative incident curves for first onset mental disturbance. The two derived subgroups were women who experienced GBV without prior mental disturbance; and women never exposed to GBV stratified to match the former group on age and socio-economic status. For women with no prior mental disorder, the cumulative incidence curves showed a high incidence of all mental disturbances following first GBV, compared to women without exposure to GBV (all log rank tests <0.0001). Nearly two fifths (37%) of any lifetime mental disturbance had onset in the year following first GBV in women exposed to abuse. For these women, over half (57%) of cases of lifetime PTSD had onset in the same time interval. For GBV exposed women, half of all cases of mental disturbance (54%) and two thirds of cases of PTSD (66.9%) had onset in the five years following first abuse. In contrast, there was a low prevalence of onset of mental disturbance in the comparable imputed time to event period for women never exposed to GBV (for any mental disturbance, 1% in the first year, 12% in five years; for PTSD 3% in the first year, 7% in five years). Amongst women without prior mental disturbance, common mental disorders and suicidal behaviour have a high rate of onset in the one and five year intervals following exposure to GBV. There is a particularly high incidence of PTSD in the first year following GBV.

Suicide and depression in childhood and adolescence

PubMed Central

Garfinkel, B. D.; Golombek, H.

1974-01-01

Suicide and depression in children and adolescents are reviewed. The true incidence of suicide in the pediatric population is not known because of under-reporting; suicide is, however, considered as a leading cause of death in this age group. Suicide in young children often reflects an immature comprehension of the state of death, combined with a wish to alter an intolerable living situation or to punish individuals significant in his environment. At age 14 the incidence of suicide increases markedly. These acts of self-destruction reflect a developmental process that follows puberty. During this period the youth experiences an impoverishment of values and controls, as well as an intensification of emotions and needs, resulting in extreme disequilibrium. In the late adolescent, as in the adult, suicide occurs commonly in response to real or imagined loss. Specific guidelines are set out for the assessment and management of the depressed and suicidal youth. Community and medical measures of a prophylactic nature are recommended in the belief that the rising incidence of suicide can be halted through an intensification of efforts on the part of the medical profession. PMID:4599484

Religion as a Risk Factor for Suicide Attempt and Suicide Ideation Among Depressed Patients.

PubMed

Lawrence, Ryan E; Brent, David; Mann, J John; Burke, Ainsley K; Grunebaum, Michael F; Galfalvy, Hanga C; Oquendo, Maria A

2016-11-01

We aimed to examine the relationship between religion and suicide attempt and ideation. Three hundred twenty-one depressed patients were recruited from mood-disorder research studies at the New York State Psychiatric Institute. Participants were interviewed using the Structured Clinical Interview for DSM Disorders, Columbia University Suicide History form, Scale for Suicide Ideation, and Reasons for Living Inventory. Participants were asked about their religious affiliation, importance of religion, and religious service attendance. We found that past suicide attempts were more common among depressed patients with a religious affiliation (odds ratio, 2.25; p = 0.007). Suicide ideation was greater among depressed patients who considered religion more important (coefficient, 1.18; p = 0.026) and those who attended services more frequently (coefficient, 1.99; p = 0.001). We conclude that the relationship between religion and suicide risk factors is complex and can vary among different patient populations. Physicians should seek deeper understanding of the role of religion in an individual patient's life in order to understand the person's suicide risk factors more fully.

No association between serum cholesterol and death by suicide in patients with schizophrenia, bipolar affective disorder, or major depressive disorder.

PubMed

Park, Subin; Yi, Ki Kyoung; Na, Riji; Lim, Ahyoung; Hong, Jin Pyo

2013-12-05

Previous research on serum total cholesterol and suicidality has yielded conflicting results. Several studies have reported a link between low serum total cholesterol and suicidality, whereas others have failed to replicate these findings, particularly in patients with major affective disorders. These discordant findings may reflect the fact that studies often do not distinguish between patients with bipolar and unipolar depression; moreover, definitions and classification schemes for suicide attempts in the literature vary widely. Subjects were patients with one of the three major psychiatric disorders commonly associated with suicide: schizophrenia, bipolar affective disorder, and major depressive disorder (MDD). We compared serum lipid levels in patients who died by suicide (82 schizophrenia, 23 bipolar affective disorder, and 67 MDD) and non-suicide controls (200 schizophrenia, 49 bipolar affective disorder, and 175 MDD). Serum lipid profiles did not differ between patients who died by suicide and control patients in any diagnostic group. Our results do not support the use of biological indicators such as serum total cholesterol to predict suicide risk among patients with a major psychiatric disorder.

Restricting youth suicide: behavioral health patients in an urban pediatric emergency department.

PubMed

Rogers, Steven C; DiVietro, Susan; Borrup, Kevin; Brinkley, Ashika; Kaminer, Yifrah; Lapidus, Garry

2014-09-01

Suicide is the third leading cause of death among individuals age 10 years to 19 years in the United States. Adolescents with suicidal behaviors are often cared for in emergency departments (EDs)/trauma centers and are at an increased risk for subsequent suicide. Many institutions do not have standard procedures to prevent future self-harm. Lethal means restriction (LMR) counseling is an evidence-based suicide prevention strategy that informs families to restrict access to potentially fatal items and has demonstrated efficacy in preventing suicide. The objectives of this study were to examine suicidal behavior among behavioral health patients in a pediatric ED and to assess the use of LMR by hospital staff. A sample of 298 pediatric patients was randomly selected from the population of behavioral health patients treated at the ED from January 1 through December 31, 2012 (n = 2,294). Descriptive data include demographics (age, sex, race/ethnicity, etc,), chief complaint, current and past psychiatric history, primary diagnosis, disposition, alcohol/drug abuse, and documentation of any LMR counseling provided in the ED. Of the 298 patients, 52% were female, 47% were white, and 76% were in the custody of their parents. Behavior/out of control was the most common chief complaint (43%). The most common diagnoses were mood disorder (25%) and depression (20%). Thirty-four percent of the patients had suicidal ideation, 22% had a suicide plan, 32% had documented suicidal behavior, and 25% of the patients reported having access to lethal means. However, only 4% of the total patient population received any LMR counseling, and only 15% of those with access to lethal means had received LMR counseling. Providing a safe environment for adolescents at risk for suicidal behaviors should be a priority for all families/caretakers and should be encouraged by health care providers. The ED is a key point of entry into services for suicidal youth and presents an opportunity to implement effective secondary prevention strategies. The low rate of LMR counseling found in this study suggests a need for improved LMR counseling for all at-risk youth.

Long-Term Unemployment and Suicide: A Systematic Review and Meta-Analysis

PubMed Central

Milner, Allison; Page, Andrew; LaMontagne, Anthony D.

2013-01-01

Purpose There have been a number of reviews on the association+ between unemployment and suicide, but none have investigated how this relationship is influenced by duration of unemployment. Method A systematic review and meta-analysis was conducted of those studies that assessed duration of unemployment as a risk factor for suicide. Studies considered as eligible for inclusion were population-based cohort or case-control designs; population-based ecological designs, or hospital based clinical cohort or case-control designs published in the year 1980 or later. Results The review identified 16 eligible studies, out of a possible 10,358 articles resulting from a search of four databases: PubMed, Web of Knowledge, Scopus and Proquest. While all 16 studies measured unemployment duration in different ways, a common finding was that longer duration of unemployment was related to greater risk of suicide and suicide attempt. A random effects meta-analysis on a subsample of six cohort studies indicated that the pooled relative risk of suicide in relation to average follow-up time after unemployment was 1.70 (95% CI 1.22 to 2.18). However, results also suggested a possible habituation effect to unemployment over time, with the greatest risk of suicide occurring within five years of unemployment compared to the employed population (RR = 2.50, 95% CI 1.83 to 3.17). Relative risk appeared to decline in studies of those unemployed between 12 and 16 years compared to those currently employed (RR = 1.21, 95% CI 1.10 to 1.33). Conclusion Findings suggest that long-term unemployment is associated with greater incidence of suicide. Results of the meta-analysis suggest that risk is greatest in the first five years, and persists at a lower but elevated level up to 16 years after unemployment. These findings are limited by the paucity of data on this topic. PMID:23341881

CONTEMPORARY PRINCIPLES OF SUICIDE PREVENTION.

PubMed

Ljusic, Dragana; Ravanic, Dragan; Filipovic Danic, Snezana; Soldatovic, Ivan; Cvetkovic, Jovana; Stojanovic Tasic, Mirjana

2016-11-01

Suicide remains a significant public health problem worldwide. This study is aimed at analyzing and presenting contemporary methods in suicide prevention in the world as well as at identifying specific risk groups and risk factors in order to explain their importance. in suicide prevention. The literature search covered electronic databases PubMed, Web of Science and Scopus. In order to select the relevant articles, the authors searched for the combination of key-words which included the following medical subject heading terms (suicide or suicide ideation or attempted) and (prevention or risk factors) and (man or elders or mental disorders). Data analysis covered meta-analyses, systematic reviews and original scientific papers with different characteristics of suicide preventions, risk factors and risk groups. Worldwide evidence-based interventions for suicide prevention are divided in universal, selective and indicated interventions. Restricted approach to various methods of committing suicide as well as pharmacotherapy contributes to a lower suicide rate. Suicide risk factors can be categorized as proximal and distal. The following groups are at highest risk of committing suicide: males. older persons and persons with registered psychiatric disorders. There is a lot of evidence that suicide is preventable. It is known that only 28 coun tries in the world have national suicide prevention strategies and Serbia is not one of them.

The relationships of suicidal ideation with symptoms, neurocognitive function, and psychological factors in patients with first-episode psychosis.

PubMed

Chang, Wing Chung; Chen, Emily Sze Man; Hui, Christy Lai Ming; Chan, Sherry Kit Wa; Lee, Edwin Ho Ming; Chen, Eric Yu Hai

2014-08-01

Individuals with first-episode psychosis (FEP) have markedly elevated risk for suicide. Previous research on suicidality in early psychosis mainly focused on attempted and completed suicide. Data regarding risk factors for suicidal ideation, which is a common antecedent and predictor of suicide attempt, were limited. This study aimed to examine the prevalence of suicidal ideation and its relationships with clinical, neurocognitive and psychological factors in FEP patients. Eighty-nine Chinese patients aged 15 to 25years presenting with FEP to specialized early intervention service were recruited. A comprehensive set of assessments examining pre-treatment illness characteristics, symptom severity, neurocognitive function, and psychological factors were administered. Current suicidal ideation and history of suicide attempt were systematically evaluated. Approximately 42% of patients expressed suicidal ideation after service entry. Univariate regression analyses found that suicidal ideation was significantly associated with past suicide attempt, depressive symptoms, emotion expressivity, hopelessness, future expectation, attentional impulsiveness, internal and external locus of control, and the likelihood of endorsing fear of social approval and survival and coping beliefs as reasons for living. Final multivariate model showed that previous suicide attempt, depression, less severe diminished expression, greater degree of hopelessness and lower level of internal locus of control independently predicted suicidal ideation. Suicidal ideation was prevalent in FEP patients. Our findings implied that close monitoring and prompt intervention of those potentially modifiable risk factors for suicidal ideation including depression, hopelessness and perceived inadequate personal control may reduce suicide risk in the early course of psychotic illness. Copyright © 2014 Elsevier B.V. All rights reserved.

Suicide Risk Assessment and Prevention: A Systematic Review Focusing on Veterans.

PubMed

Nelson, Heidi D; Denneson, Lauren M; Low, Allison R; Bauer, Brian W; O'Neil, Maya; Kansagara, Devan; Teo, Alan R

2017-10-01

Suicide rates in veteran and military populations in the United States are high. This article reviews studies of the accuracy of methods to identify individuals at increased risk of suicide and the effectiveness and adverse effects of health care interventions relevant to U.S. veteran and military populations in reducing suicide and suicide attempts. Trials, observational studies, and systematic reviews relevant to U.S. veterans and military personnel were identified in searches of MEDLINE, PsycINFO, SocINDEX, and Cochrane databases (January 1, 2008, to September 11, 2015), on Web sites, and in reference lists. Investigators extracted and confirmed data and dual-rated risk of bias for included studies. Nineteen studies evaluated accuracy of risk assessment methods, including models using retrospective electronic records data and clinician- or patient-rated instruments. Most methods demonstrated sensitivity ≥80% or area-under-the-curve values ≥.70 in single studies, including two studies based on electronic records of veterans and military personnel, but specificity varied. Suicide rates were reduced in six of eight observational studies of population-level interventions. Only two of ten trials of individual-level psychotherapy reported statistically significant differences between treatment and usual care. Risk assessment methods have been shown to be sensitive predictors of suicide and suicide attempts, but the frequency of false positives limits their clinical utility. Research to refine these methods and examine clinical applications is needed. Studies of suicide prevention interventions are inconclusive; trials of population-level interventions and promising therapies are required to support their clinical use.

Suicidality in adolescents and adults with binge-eating disorder: Results from the national comorbidity survey replication and adolescent supplement.

PubMed

Forrest, Lauren N; Zuromski, Kelly L; Dodd, Dorian R; Smith, April R

2017-01-01

The relation between binge-eating disorder (BED) and suicidality (i.e., suicide ideation, plan, and/or attempt) has not been studied extensively, and it is unknown whether BED is uniquely associated with suicidality when adjusting for comorbid psychopathology. Moreover, the course of suicidality in BED has not been determined and it is unknown whether BED precedes suicidality or vice versa. A total of 10,123 adolescents and 2,980 adults from two nationally representative surveys were administered diagnostic interviews assessing psychopathology and suicidality, as well the retrospectively reported ages of onset. Among adults and adolescents, BED was associated with elevated odds of suicide ideation, plan, and attempt at a univariate level, but BED was not associated with elevated odds of suicidality when adjusting for comorbid psychopathology. Kaplan-Meier estimates of temporal patterns displayed that most adolescents experienced suicidality onset following BED onset, whereas most adults experienced suicidality onset prior to BED onset. BED, comorbid disorders, and suicidality share common factors and interrelations, and individuals with BED and comorbid disorders may be at particularly high risk for suicidal outcomes. The presence of BED in adolescence may serve as a marker for more severe symptomatology that precedes the occurrence of suicidality. Research is needed to understand how eating disorder symptoms, comorbid symptoms, and suicidality affect one another over time. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2017; 50:40-49). © 2016 Wiley Periodicals, Inc.

Impacts of stress, self-efficacy, and optimism on suicide ideation among rehabilitation patients with acute pesticide poisoning.

PubMed

Feng, Jun; Li, Shusheng; Chen, Huawen

2015-01-01

The high incidence of pesticide ingestion as a means to commit suicide is a critical public health problem. An important predictor of suicidal behavior is suicide ideation, which is related to stress. However, studies on how to defend against stress-induced suicidal thoughts are limited. This study explores the impact of stress on suicidal ideation by investigating the mediating effect of self-efficacy and dispositional optimism. Direct and indirect (via self-efficacy and dispositional optimism) effects of stress on suicidal ideation were investigated among 296 patients with acute pesticide poisoning from four general hospitals. For this purpose, structural equation modeling (SEM) and bootstrap method were used. Results obtained using SEM and bootstrap method show that stress has a direct effect on suicide ideation. Furthermore, self-efficacy and dispositional optimism partially weakened the relationship between stress and suicidal ideation. The final model shows a significant relationship between stress and suicidal ideation through self-efficacy or dispositional optimism. The findings extended prior studies and provide enlightenment on how self-efficacy and optimism prevents stress-induced suicidal thoughts.

Depression and Spinal Cord Injury

MedlinePlus

... or more. Thoughts of death are common in depression and the risk of suicide is higher while someone is depressed. Depression is ... psychologist, psychiatrist, or counselor who has experience treating depression. ... thoughts of death or suicide, contact your health care provider or a mental ...

Predicting Future Suicide Attempts Among Adolescent and Emerging Adult Psychiatric Emergency Patients

PubMed Central

Horwitz, Adam G.; Czyz, Ewa K.; King, Cheryl A.

2014-01-01

Objective The purpose of this study was to longitudinally examine specific characteristics of suicidal ideation in combination with histories of suicide attempts and non-suicidal self-injury (NSSI) to best evaluate risk for a future attempt among high-risk adolescents and emerging adults. Method Participants in this retrospective medical record review study were 473 (53% female; 69% Caucasian) consecutive patients, ages 15–24 years (M = 19.4 years) who presented for psychiatric emergency (PE) services during a 9-month period. These patients’ medical records, including a clinician-administered Columbia-Suicide Severity Rating Scale, were coded at the index visit and at future visits occurring within the next 18 months. Logistic regression models were used to predict suicide attempts during this period. Results SES, suicidal ideation severity (i.e., intent, method), suicidal ideation intensity (i.e., frequency, controllability), a lifetime history of suicide attempt, and a lifetime history of NSSI were significant independent predictors of a future suicide attempt. Suicidal ideation added incremental validity to the prediction of future suicide attempts above and beyond the influence of a past suicide attempt, whereas a lifetime history of NSSI did not. Sex moderated the relationship between the duration of suicidal thoughts and future attempts (predictive for males, but not females). Conclusions Results suggest value in incorporating both past behaviors and current thoughts into suicide risk formulation. Furthermore, suicidal ideation duration warrants additional examination as a potential critical factor for screening assessments evaluating suicide risk among high-risk samples, particularly for males. PMID:24871489

Patterns of Signs That Telephone Crisis Support Workers Associate with Suicide Risk in Telephone Crisis Line Callers.

PubMed

Hunt, Tara; Wilson, Coralie; Caputi, Peter; Wilson, Ian; Woodward, Alan

2018-01-30

Signs of suicide are commonly used in suicide intervention training to assist the identification of those at imminent risk for suicide. Signs of suicide may be particularly important to telephone crisis-line workers (TCWs), who have little background information to identify the presence of suicidality if the caller is unable or unwilling to express suicidal intent. Although signs of suicide are argued to be only meaningful as a pattern, there is a paucity of research that has examined whether TCWs use patterns of signs to decide whether a caller might be suicidal, and whether these are influenced by caller characteristics such as gender. The current study explored both possibilities. Data were collected using an online self-report survey in a Australian sample of 137 TCWs. Exploratory factor analysis uncovered three patterns of suicide signs that TCWs may use to identify if a caller might be at risk for suicide (mood, hopelessness, and anger), which were qualitatively different for male and female callers. These findings suggest that TCWs may recognise specific patterns of signs to identify suicide risk, which appear to be influenced to some extent by the callers' inferred gender. Implications for the training of telephone crisis workers and others including mental-health and medical professionals, as well as and future research in suicide prevention are discussed.

Patterns of Signs That Telephone Crisis Support Workers Associate with Suicide Risk in Telephone Crisis Line Callers

PubMed Central

Hunt, Tara; Caputi, Peter; Wilson, Ian; Woodward, Alan

2018-01-01

Signs of suicide are commonly used in suicide intervention training to assist the identification of those at imminent risk for suicide. Signs of suicide may be particularly important to telephone crisis-line workers (TCWs), who have little background information to identify the presence of suicidality if the caller is unable or unwilling to express suicidal intent. Although signs of suicide are argued to be only meaningful as a pattern, there is a paucity of research that has examined whether TCWs use patterns of signs to decide whether a caller might be suicidal, and whether these are influenced by caller characteristics such as gender. The current study explored both possibilities. Data were collected using an online self-report survey in a Australian sample of 137 TCWs. Exploratory factor analysis uncovered three patterns of suicide signs that TCWs may use to identify if a caller might be at risk for suicide (mood, hopelessness, and anger), which were qualitatively different for male and female callers. These findings suggest that TCWs may recognise specific patterns of signs to identify suicide risk, which appear to be influenced to some extent by the callers’ inferred gender. Implications for the training of telephone crisis workers and others including mental-health and medical professionals, as well as and future research in suicide prevention are discussed. PMID:29385780

Correlation Between Insight Level and Suicidal Behavior/Ideation in Bipolar Depression.

PubMed

de Assis da Silva, Rafael; Mograbi, Daniel C; Bifano, Jaqueline; Santana, Cristina M T; Cheniaux, Elie

2017-03-01

Suicide is a relatively common outcome along the course of bipolar disorder. Studies have shown a positive correlation between ideation or attempts of suicide and higher insight in schizophrenic patients. Nevertheless there are still few studies that evaluate the relationship between suicide and insight in mood disorders. Evaluate the relationship between insight and suicidal ideation or behavior in bipolar depression. A group of 165 bipolar patients were followed up along 1 year. Each patient's mood was assessed in every consultation according to DSM-IV-TR criteria. Suicidal ideation and behavior were prospectively assessed through item 3 of HAM-D whenever a major depressive episode was diagnosed. Insight was evaluated through the Insight Scale for Affective Disorders. A history of suicidal attempts was associated with worse insight in 60 patients with one episode of bipolar depression. The difference remained even when the supposed effect of depression over insight was controlled. No correlation between current suicidal ideation and insight level was found though. Our results suggest that a history of suicide attempts may correlate with higher impairment of insight in bipolar depression. No relationship was found between current suicidal ideation and insight.

Gender and racial differences for suicide attempters and ideators in a high-risk community corrections population.

PubMed

McCullumsmith, Cheryl B; Clark, C Brendan; Perkins, Adam; Fife, Jessaka; Cropsey, Karen L

2013-01-01

Community corrections populations are a high-risk group who carry multiple suicide risk factors. To identify factors correlated with historical suicide attempts and ideation among African-American men, African-American women, White men, and White women in a community corrections population. Self-report data from 18,753 enrollees in community corrections were analyzed. Multinomial logistic regression analyses were conducted to determine associations between historical suicidal ideation and attempts among the four demographic groups. Participants with historical suicide attempts tended to be younger, White, female, be taking psychotropic medication, have a history of physical or sexual abuse, and meet criteria for dependence on alcohol, amphetamines, cocaine, opioids, or sedatives. Five variables were commonly associated with suicide attempts for all four race/gender groups: younger age, being on disability or retirement, taking psychotropic medication, history of sexual or physical abuse, and cocaine dependence. Other demographic variables had race or gender specificities as risk factors for suicide attempts. Participants had high rates of historical suicide attempts with unique correlates differentiating attempters from ideators among different racial and gender groups. Cocaine dependence was universal predictor of suicide attempts, while other substance dependencies show specific racial and gender profiles associated with suicide attempts.

Changing Patterns in Methods of Suicide by Race and Sex.

ERIC Educational Resources Information Center

McIntosh, John L.; Santos, John F.

1982-01-01

Examined annual official national statistics for specific methods of suicide by sex and racial group from 1923 to 1978. Shifts were found in suicide methods employed, most notably for women and Asian Americans. Generally, firearm use increased among nearly all ethnic/racial-sex groups while the use of poisons declined. (JAC)

Where Do Youth Learn about Suicides on the Internet, and What Influence Does This Have on Suicidal Ideation?

ERIC Educational Resources Information Center

Dunlop, Sally M.; More, Eian; Romer, Daniel

2011-01-01

Background: Young people are susceptible to suicidal behavior as a result of learning about the suicidal behavior of others. This study was designed to determine whether Internet sites, such as online news and social networking websites, expose young people to suicide stories that might increase suicide ideation. Method: We reinterviewed 719 young…

Suicide Prevention: Critical Elements for Managing Suicidal Clients and Counselor Liability Without the Use of a No-Suicide Contract

ERIC Educational Resources Information Center

Lee, Jeane B.; Bartlett, Mary L.

2005-01-01

Despite its entrenchment as a standard of practice, no-suicide contracts fail to achieve their purpose as an effective part of treatment or as an effective method of inoculating counselors against potential lawsuits should a client commit suicide. Critical elements for managing suicidal clients and counselor liability without reliance on the…

Female Gender and Acne Disease Are Jointly and Independently Associated with the Risk of Major Depression and Suicide: A National Population-Based Study

PubMed Central

Yang, Yi-Chien; Tu, Hung-Pin; Chang, Wei-Chao; Fu, Hung-Chun; Ho, Ji-Chen; Chang, Wei-Pin; Chuang, Hung-Yi; Lee, Chih-Hung

2014-01-01

Acne is a common disease in adolescence with female preponderance. It could cause poor self-esteem and social phobia. Previous studies based on questionnaires from several thousands of adolescents showed that acne is associated with major depression and suicide. However, the gender- and age-specific risk of depression and suicide in patients with acne remain largely unknown. Using a database from the National Health Insurance, which included 98% of the population of Taiwan in 2006, we identified patients of acne, major depression, and suicide based on ICD-9-CM codes. Totally 47111 patients with acne were identified (16568 males and 30543 females) from 1 million subjects. The youths of 7–12 years had the highest prevalence of acne (14.39%). Major depression was more common in those with acne (0.77%) than controls (0.56% , P < 0.0001) regardless of gender. Multiple logistic regression showed an increased risk of major depression in women without acne (OR = 1.85, 95% CI 1.75–1.96). The risk is additive in women with acne (OR = 2.78, 95% CI 2.43–3.17). Similar additive risk of suicide was noticed in women with acne. In conclusion, acne and gender, independently and jointly, are associated with major depression and suicide. Special medical support should be warranted in females with acne for the risk of major depression and suicide. PMID:24678508

Female gender and acne disease are jointly and independently associated with the risk of major depression and suicide: a national population-based study.

PubMed

Yang, Yi-Chien; Tu, Hung-Pin; Hong, Chien-Hui; Chang, Wei-Chao; Fu, Hung-Chun; Ho, Ji-Chen; Chang, Wei-Pin; Chuang, Hung-Yi; Lee, Chih-Hung

2014-01-01

Acne is a common disease in adolescence with female preponderance. It could cause poor self-esteem and social phobia. Previous studies based on questionnaires from several thousands of adolescents showed that acne is associated with major depression and suicide. However, the gender- and age-specific risk of depression and suicide in patients with acne remain largely unknown. Using a database from the National Health Insurance, which included 98% of the population of Taiwan in 2006, we identified patients of acne, major depression, and suicide based on ICD-9-CM codes. Totally 47111 patients with acne were identified (16568 males and 30543 females) from 1 million subjects. The youths of 7-12 years had the highest prevalence of acne (14.39%). Major depression was more common in those with acne (0.77%) than controls (0.56% , P < 0.0001) regardless of gender. Multiple logistic regression showed an increased risk of major depression in women without acne (OR = 1.85, 95% CI 1.75-1.96). The risk is additive in women with acne (OR = 2.78, 95% CI 2.43-3.17). Similar additive risk of suicide was noticed in women with acne. In conclusion, acne and gender, independently and jointly, are associated with major depression and suicide. Special medical support should be warranted in females with acne for the risk of major depression and suicide.

Two perspectives on the needs of individuals bereaved by suicide.

PubMed

Gall, Terry Lynn; Henneberry, Jesse; Eyre, Melissa

2014-01-01

To qualitatively explore the needs of suicidally bereaved individuals, researchers interviewed 11 suicide bereaved individuals and 4 mental health workers. Common themes of bereaved persons included the suicide grief experience, coping, interpersonal domain, struggle with meaning, self-reflection, and moving forward. Mental health workers emphasized the nature of the helping relationship, the need to emotionally process the grief, the centrality of meaning making, importance of support groups, and the role of individual counseling. These 2 perspectives informed "best practices" for postvention (e.g., understanding the need for meaning-making while recognizing when to move on).

Suicides in Adolescents: Benefit/Harm Balance of Antidepressants

ERIC Educational Resources Information Center

Saz, Ulas Eylem; Arslan, Mehmet Tayyip; Egemen, Ayten

2007-01-01

Introduction: Depression is an important cause of suicide in adolescents. It has been speculated that antidepressants themselves can increase the risk of suicide. Method: Cases of adolescents admitted to the Ege University Pediatric Emergency Department in Turkey due to suicide attempt were assessed. Results: Nine of 13 suicide attempts during…

Suicide on railroad rights-of-way: a psychological autopsy study.

PubMed

Berman, Alan L; Sundararaman, Ramya; Price, Andrea; Au, Josephine S

2014-12-01

Findings from 55 psychological autopsies of decedents who perished on U.S. railroad rights-of-way between October 1, 2007, and September 30, 2010 are reported. Described are distal, proximal, and contextual factors of risk; understandings of why these suicides occurred on railroad rights-of-way; and opportunities for prevention of similar suicides. International comparisons of suicides on railroad rights-of-way are made to highlight distinct findings regarding U.S. cases. Decedents studied exhibited considerable predisposing risk for suicide, with a high prevalence of severe mental disorders and substance abuse. In addition, a number of acute risk factors were commonly observed, notably suicide ideation, hopelessness, anxiety, and anger. In the context of that acute risk, associated situational variables and a relative absence of protective factors are described. © 2014 The American Association of Suicidology.

Innovative Surveillance and Risk Reduction Systems for Family Maltreatment, Suicidality, and Substance Problems in USAF

DTIC Science & Technology

2005-03-01

prevention, spouse 13 abuse, child abuse , suicide, alcohol, drug abuse 16. PRICE CODE 17. SECURITY CLASSIFICA TION 18. SECURITY CLASSIFICA TION 19...cohesion 9 Triple P Command) • Spouse emotional 0 Depressive 9 Common Sense Parenting abuse symptomatology * Child abuse & neglect e Relationship...and secretive problems Partner Physical Prescr. Illicit Child Abuse Abuse Partner Emo. Abuse Alcohol Drug Drug Suicid- c3-to- Problems Misuse Use ality