[Suicidal Behaviour and Associated Factors in Colombia. Results from the 2015 National Mental Health Survey].

PubMed

Arenas, Alvaro; Gómez-Restrepo, Carlos; Rondón, Martin

2016-12-01

Suicidal behaviour leads to a significant cause of mortality in the world. It is important to know the factors associated with this behaviour in order to design public health policies that may decrease its incidence. Describe the results of the Colombian National Survey of Mental Health related to suicidal behaviour in adults. It was observed that 5.5% (95% CI, 4.5-6.7) of men and 7.6% (95% CI, 6.6-8.7) of women had suicidal thoughts. A suicide plan was reported in 2.7% of women (95% CI, 2.1-3.0), and attempted suicide observed in 1.9% of men (95% CI, 1.4-2.5) and 3.3% of women (95% CI, 2.6-4.1). The region with the highest frequency of suicidal ideation was Bogotá, with 10.3% (95% CI, 7.6-13.8) and was the lowest in the Atlantic region with 3.8% (95% CI, 3.0-4.8). It was found that the presence of any mental illness, especially depressive, anxiety disorders and borderline personality traits, as well as people who have been displaced by violence at least once in life, are associated with serious suicidal ideation. No differences were found in suicidal ideation as regards poverty or problems arising from alcohol consumption. Suicidal behaviour is common in the Colombian adult population, which warrants the design and implementation of interventions in the most vulnerable groups in order to reduce this risk. Copyright © 2016. Publicado por Elsevier España.

Cognitive Behavioural Suicide Prevention for Male Prisoners: Case examples

PubMed Central

Pratt, Daniel; Gooding, Patricia; Awenat, Yvonne; Eccles, Steve; Tarrier, Nicholas

2015-01-01

Suicide is a serious public health problem but a problem that is preventable. This complex and challenging problem is particularly prevalent amongst prisoners; associated with a five-fold increase in risk compared to the general community. Being in prison can lead people to experience fear, distrust, lack of control, isolation, and shame, which is often experienced as overwhelming and intolerable with some choosing suicide as a way to escape. Few effective psychological interventions exist to prevent suicide although cognitive behaviour therapies appear to offer some promise. Offering cognitive behaviour suicide prevention (CBSP) therapy to high risk prisoners may help to reduce the likelihood of preventable self-inflicted deaths. In this paper we present three cases drawn from a randomised controlled trial designed to investigate the feasibility of CBSP for male prisoners. Implications of the current findings for future research and clinical practice are considered. PMID:27713616

Measures of frequency used in cohorts studies to evaluate the suicidal behaviour in young people (12-26 years): A systematic review.

PubMed

Lagares-Franco, Carolina; Almenara-Barrios, José; O'Ferrall-González, Cristina; Castellvi-Obiols, Pere; Gabilondo, Andrea; Blasco-Cubedo, María Jesús; Miranda-Mendizábal, Andrea; Parés-Badell, Oleguer; Piqueras, José Antonio; Roca, Miquel; Rodríguez-Jiménez, Tíscar; Rodríguez-Marín, Jesús; Soto-Sanz, Victoria; Vilagut-Saiz, Gemma; Alonso, Jordi

2017-12-12

A priority for the WHO by 2020 is to have reduced the rates of suicide; they indicate difficulties in giving precise estimations due to a wide variety of factors, which include aspects related to the statistical measurements themselves of suicidal behaviour. The proportion of deaths from suicide is 8.5% among young people between 15-29 years of age. To review the methodology used to express the frequency of suicidal behaviour in young people and to describe the methodological characteristics of the studies reviewed. A systematic review of longitudinal studies registered on PROSPERO. The extracted information included the following: year of publication, journal, population size, sample, country, design, age, percentage of men, follow-up time and losses, suicidal behaviour, risk factors, ethical aspects, fundamentally, evaluating the measures of frequency used. Eighty-two articles were selected from 37,793 documents. None of the studies define the measure of frequency used for suicidal behaviour, there are currently up to 9 different ways of measuring it. The populations are students or the general population (66%), birth cohorts (16%) and specific groups. Follow-up was from 24 weeks to 30 years. Only 24.1% of the studies took ethical aspects into consideration. Researchers must make an effort to reach an agreement on the measures of frequency used in suicidal behaviour studies, as the methodological and terminological variability currently used impedes making any comparisons between different studies or understanding the real dimension of the problem. Copyright © 2017 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

Suicidal Imagery in a Previously Depressed Community Sample

PubMed Central

Crane, Catherine; Shah, Dhruvi; Barnhofer, Thorsten; Holmes, Emily A.

2015-01-01

This study sought to replicate previous findings of vivid suicide-related imagery in previously suicidal patients in a community sample of adults with a history of depression. Twenty-seven participants were interviewed regarding suicidal imagery. Seventeen participants reported prior suicidal ideation or behaviour in the clinical assessment, and the vast majority of these also reported experiencing suicide-related imagery when at their most depressed and despairing, in many cases in the form of flash-forwards to imagined future suicidal acts. Interestingly, five of the 10 participants who did not report suicidal ideation or behaviour in the clinical interview also described prominent imagery related to themes of death and suicide, but in several cases, these images were associated with meanings that seemed to act to reduce the likelihood of subsequent suicidal acts. Severity of prior suicidality was associated with lower levels of imagery-related distress and higher levels of imagery-related comfort. These findings support the idea that suicide-related imagery is an important component in the phenomenology of depression and despair and hint at potentially important differences in the meaning associated with such imagery between those individuals who report experiencing suicidal ideation or behaviour when depressed and those who do not. The findings are consistent with Joiner’s model of acquired capability for suicide through habituation to pain and fear of suicide and suggest that it may be useful to tackle such imagery directly in the treatment of suicidal patients. PMID:21254309

What Interrupts Suicide Attempts in Men: A Qualitative Study

PubMed Central

Player, Michael J.; Proudfoot, Judy; Fogarty, Andrea; Whittle, Erin; Spurrier, Michael; Shand, Fiona; Christensen, Helen; Hadzi-Pavlovic, Dusan; Wilhelm, Kay

2015-01-01

Despite higher rates of suicide in men, there is a dearth of research examining the perspectives and experiences of males at risk of suicide, particularly in terms of understanding how interventions can be tailored to men’s specific needs. The current study aimed to examine factors assisting, complicating or inhibiting interventions for men at risk, as well as outlining the roles of family, friends and others in male suicide prevention. Thirty-five male suicide survivors completed one-to-one interviews, and forty-seven family and friends of male suicide survivors participated in eight focus groups. Thematic analysis revealed five major themes: (1) development of suicidal behaviours tends to follow a common path associated with specific types of risk factors (disrupted mood, unhelpful stoic beliefs and values, avoidant coping strategies, stressors), (2) men at risk of suicide tend to systematically misinterpret changes in their behaviour and thinking, (3) understanding mood and behavioural changes in men enables identification of opportunities to interrupt suicide progression, (4) distraction, provision of practical and emotional supports, along with professional intervention may effectively interrupt acute risk of harm, and (5) suicidal ideation may be reduced through provision of practical help to manage crises, and helping men to focus on obligations and their role within families. Findings suggest that interventions for men at risk of suicidal behaviours need to be tailored to specific risk indicators, developmental factors, care needs and individuals’ preferences. To our knowledge this is the first qualitative study to explore the experiences of both suicidal men and their family/friends after a suicide attempt, with the view to improve understanding of the processes which are effective in interrupting suicide and better inform interventions for men at risk. PMID:26090794

Socio-economic and psychological correlates of suicidality among Hong Kong working-age adults: results from a population-based survey.

PubMed

Liu, Ka Y; Chen, Eric Y H; Chan, Cecilia L W; Lee, Dominic T S; Law, Y W; Conwell, Yeates; Yip, Paul S F

2006-12-01

The global toll of suicide is estimated to be one million lives per year, which exceeded the number of deaths by homicide and war combined. A key step to suicide prevention is to prevent less serious suicidal behaviour to preclude more lethal outcomes. Although 61% of the world's suicides take place in Asia and the suicide rates among middle age groups have been increasing since the economic crisis in many Asian countries, population-based studies of suicidal behaviour among working-age adults in non-western communities are scarce. Data from a population-based survey with 2015 participants were used to estimate the prevalence of suicidal ideation and behaviour among the working-age population in Hong Kong, and to study the associated socio-economic and psychological correlates. We focused particularly on potential modulating factors between life-event-related factors and suicidal ideation. Six per cent of the Hong Kong population aged 20-59 years considered suicide in the past year, while 1.4% attempted suicide. Hopelessness, reasons for living, and reluctance to seek help from family and friends had direct association with past-year suicidal ideation. Reasons for living were found to moderate the effect of perceived stress on suicidal ideation. Suicidality is a multi-faceted problem that calls for a multi-sectored, multi-layered approach to prevention. Prevention programmes can work on modulating factors such as reasons for living to reduce suicidal risk in working-age adults.

Problem-solving counseling as a therapeutic tool on youth suicidal behavior in the suburban population in Sri Lanka.

PubMed

Perera, E A Ramani; Kathriarachchi, Samudra T

2011-01-01

Suicidal behaviour among youth is a major public health concern in Sri Lanka. Prevention of youth suicides using effective, feasible and culturally acceptable methods is invaluable in this regard, however research in this area is grossly lacking. This study aimed at determining the effectiveness of problem solving counselling as a therapeutic intervention in prevention of youth suicidal behaviour in Sri Lanka. This control trial study was based on hospital admissions with suicidal attempts in a sub-urban hospital in Sri Lanka. The study was carried out at Base Hospital Homagama. A sample of 124 was recruited using convenience sampling method and divided into two groups, experimental and control. Control group was offered routine care and experimental group received four sessions of problem solving counselling over one month. Outcome of both groups was measured, six months after the initial screening, using the visual analogue scale. Individualized outcome measures on problem solving counselling showed that problem solving ability among the subjects in the experimental group had improved after four counselling sessions and suicidal behaviour has been reduced. The results are statistically significant. This Study confirms that problem solving counselling is an effective therapeutic tool in management of youth suicidal behaviour in hospital setting in a developing country.

Suicide death and hospital-treated suicidal behaviour in asylum seekers in the Netherlands: a national registry-based study

PubMed Central

2011-01-01

Background Several suicide and suicidal behaviour risk factors are highly prevalent in asylum seekers, but there is little insight into the suicide death rate and the suicidal behaviour incidence in this population. The main objective of this study is to assess the burden of suicide and hospital-treated non-fatal suicidal behaviour in asylum seekers in the Netherlands and to identify factors that could guide prevention. Methods We obtained data on cases of suicide and suicidal behaviour from all asylum seeker reception centres in the Netherlands (period 2002-2007, age 15+). The suicide death rates in this population and in subgroups by sex, age and region of origin were compared with the rate in the Dutch population; the rates of hospital-treated suicidal behaviour were compared with that in the population of The Hague using indirect age group standardization. Results The study included 35 suicide deaths and 290 cases of hospital-treated suicidal behaviour. The suicide death rate and the incidence of hospital-treated suicidal behaviour differed between subgroups by sex and region of origin. For male asylum seekers, the suicide death rate was higher than that of the Dutch population (N = 32; RR = 2.0, 95%CI 1.37-2.83). No difference was found between suicide mortality in female asylum seekers and in the female general population of the Netherlands (N = 3; RR = 0.73; 95%CI 0.15-2.07). The incidence of hospital-treated suicidal behaviour was high in comparison with the population of The Hague for males and females from Europe and the Middle East/South West Asia, and low for males and females from Africa. Health professionals knew about mental health problems prior to the suicidal behaviour for 80% of the hospital-treated suicidal behaviour cases in asylum seekers. Conclusions In this study the suicide death rate was higher in male asylum seekers than in males in the reference population. The incidence of hospital-treated suicidal behaviour was higher in several subgroups of asylum seekers than that in the reference population. We conclude that measures to prevent suicide and suicidal behaviour among asylum seekers in the Netherlands are indicated. PMID:21693002

Suicidal behaviours among adolescents in northern Nova Scotia.

PubMed

Wang, JianLi; Hughes, Jean; Murphy, Gail Tomblin; Rigby, Janet A; Langille, Donald B

2003-01-01

To estimate the 12-month prevalence of suicidal behaviours by gender and to investigate the gender-specific factors associated with suicidal behaviours and to describe health service utilization by suicidal adolescents. This was a cross-sectional study. The baseline data of the Adolescent Health Study conducted in northern Nova Scotia were used. Female students were more likely to report suicidal behaviours than male students (p < 0.005). There was no gender difference in injurious suicide attempts. Depression was the strongest risk factor for suicidal behaviours in the two genders (p < 0.005). Female students who reported drug use and living in a non-intact family were at higher risk of suicide attempts. Low self-esteem was positively associated with suicidal ideation and suicide planning among male students. Suicidal girls were more likely to seek professional help for emotional disturbance than boys. Family doctors were the most frequently contacted professional by suicidal adolescents. Some factors associated with suicidal behaviours among adolescents may be gender specific. Suicidal behaviours have been considered a depressive symptom. Most suicidal students, however, had not contacted a health professional for an emotional problem in this population. This presents challenges for prevention of suicidal behaviours among adolescents.

Prevention of suicidal behaviour among army personnel: a qualitative study.

PubMed

Crawford, M J; Sharpe, D; Rutter, D; Weaver, T

2009-09-01

To examine the context of suicidal behaviour among soldiers in the United Kingdom and identify factors that could reduce the risk of such behaviour. A series of in-depth interviews with service providers involved in treating soldiers following deliberate self harm. Their responses were compared with those of a small sub-sample of soldiers who presented to Army medical services following self harm. We interviewed 21 service providers with a range of experience and professional backgrounds and 10 soldiers. Service providers told us that the rarity of suicide among soldiers together with lower levels of mental illness amongst those who end their lives made suicide prevention in the Army a difficult task. However they highlighted concerns about recruitment and retention of young soldiers, and stated that stigmatisation of mental illness in the Army sometimes prevented those with suicidal ideation seeking help. They also highlighted the role of alcohol use in precipitating self-harm. Soldiers who had self-harmed told us that they struggled to balance the demands of work and family life and described harming themselves impulsively often while intoxicated with alcohol. Soldiers look to sources of support outside the Army, and see commanding officers, rather than healthcare professionals, as helping resolve their problems. Neither service providers nor soldiers mentioned helplines and other 'independent' sources of confidential advice and support which are available to soldiers serving with the British Army. Our findings highlight problems associated with efforts to reduce suicide among soldiers but suggest that these should focus continuing to try to reduce stigmatisation of mental distress and specifically on the role of commanding officers. Greater efforts should also be made to publicise existing sources of help and reduce levels of alcohol misuse.

Gender differences in suicidal behaviour in patients with first-episode psychosis.

PubMed

Austad, Gudrun; Joa, Inge; Johannessen, Jan Olav; Larsen, Tor Ketil

2015-08-01

Prior research shows contradictory gender patterns in suicidal behaviour among patients with first-episode psychosis. The aim of this study was to investigate gender differences in the prevalence of suicidal behaviour (suicidal ideation, suicide plans and suicide attempts) and to delineate risk factors for suicidal behaviour among consecutively included male and female patients with first-episode psychosis in the TIPS II early detection study. Patients with first-episode psychosis (n = 246) from a hospital catchment area with a system for early detection were assessed and compared on baseline sociodemographical and clinical variables according to gender. Current (past 1 month) and lifetime prevalence of suicidal behaviour were assessed. Current and lifetime rates of suicidal behaviour were high (50.8% and 65.9%, respectively) and higher among females (lifetime: 78.3 %, past month: 64.2 %) versus males (lifetime: 56.4 %, past month: 40.7 %). Depressive symptoms and female gender were associated with both lifetime and current risk for suicidal behaviour. Lifetime prevalence was also associated with a longer duration of untreated psychosis and young age after controlling for other risk factors. Suicidal behaviour was frequent among patients with first-episode psychosis, with a higher prevalence of suicidal behaviour in females. Depressive symptoms and female gender were significantly associated with suicidal behaviour. © 2013 Wiley Publishing Asia Pty Ltd.

Problem—solving counseling as a therapeutic tool on youth suicidal behavior in the suburban population in Sri Lanka

PubMed Central

Perera, E. A. Ramani; Kathriarachchi, Samudra T.

2011-01-01

Background: Suicidal behaviour among youth is a major public health concern in Sri Lanka. Prevention of youth suicides using effective, feasible and culturally acceptable methods is invaluable in this regard, however research in this area is grossly lacking. Objective: This study aimed at determining the effectiveness of problem solving counselling as a therapeutic intervention in prevention of youth suicidal behaviour in Sri Lanka. Setting and design: This control trial study was based on hospital admissions with suicidal attempts in a sub-urban hospital in Sri Lanka. The study was carried out at Base Hospital Homagama. Materials and Methods: A sample of 124 was recruited using convenience sampling method and divided into two groups, experimental and control. Control group was offered routine care and experimental group received four sessions of problem solving counselling over one month. Outcome of both groups was measured, six months after the initial screening, using the visual analogue scale. Results: Individualized outcome measures on problem solving counselling showed that problem solving ability among the subjects in the experimental group had improved after four counselling sessions and suicidal behaviour has been reduced. The results are statistically significant. Conclusion: This Study confirms that problem solving counselling is an effective therapeutic tool in management of youth suicidal behaviour in hospital setting in a developing country. PMID:21431005

Household Survey of Pesticide Practice, Deliberate Self-Harm, and Suicide in the Sundarban Region of West Bengal, India

PubMed Central

Banerjee, Sohini; Chowdhury, Arabinda Narayan; Schelling, Esther; Weiss, Mitchell G.

2013-01-01

The toxicological impact and intentional ingestion of pesticides are major public health concerns globally. This study aimed to estimate the extent of deliberate self-harm (DSH) and suicides (suicidal behaviour) and document pesticide practices in Namkhana block of the Sundarban region, India. A cross-sectional study was conducted in 1680 households (21 villages) following a mixed random and cluster design sampling. The survey questionnaire (Household Information on Pesticide Use and DSH) was developed by the research team to elicit qualitative and quantitative information. The Kappa statistic and McNemar's test were used to assess the level of agreement and association between respondents' and investigators' opinions about safe storage of pesticides. Over five years, 1680 households reported 181 incidents of suicidal behaviour. Conflict with family members was the most frequently reported reason for suicidal behaviour (53.6%). The Kappa statistic indicated poor agreement between respondents and investigators about safe storage of pesticides. The pesticide-related annual DSH rate was 158.1 (95% CI 126.2–195.5), and for suicide it was 73.4 (95% CI 52.2–100.3) per 100,000. Unsafe pesticide practice and psychosocial stressors are related to the high rates of suicidal behaviour. An intersectoral approach involving the local governments, agricultural department and the health sector would help to reduce the magnitude of this public health problem. PMID:24224181

Direct versus indirect psychosocial and behavioural interventions to prevent suicide and suicide attempts: a systematic review and meta-analysis.

PubMed

Meerwijk, Esther L; Parekh, Amrita; Oquendo, Maria A; Allen, I Elaine; Franck, Linda S; Lee, Kathryn A

2016-06-01

Psychosocial and behavioural interventions that address suicidal thoughts and behaviour during treatment (direct interventions) might be more effective in preventing suicide and suicide attempts than indirect interventions that address symptoms associated with suicidal behaviour only (eg, hopelessness, depression, anxiety, quality of life). To test this hypothesis, we did a systematic review and meta-analysis of psychosocial and behavioural interventions aimed at preventing suicide and suicide attempts. For this systematic review and meta-analysis, we searched MEDLINE and PsycINFO from inception to Dec 25, 2015, for randomised controlled trials that reported suicides or suicide attempts as an outcome, irrespective of participants' diagnoses or the publication language. We excluded studies with pharmacological or device-based interventions, those that targeted communities or clinicians, primary prevention trials, and trials that reported events of non-suicidal self-injury as suicide attempts. Trials that had no suicides or suicide attempts in both groups were also excluded. Data were extracted by one investigator and independently verified by a second investigator. We used random-effects models of the odds ratio (OR) based on a pooled measure of suicides and the number of individuals who attempted suicide, immediately post-treatment and at longer-term follow-up. Of 2024 unique abstracts screened, 53 articles met eligibility criteria and reported on 44 studies; 31 studies provided post-treatment data with 6658 intervention group participants and 6711 control group participants at baseline, and 29 studies provided follow-up data. The post-treatment difference between direct interventions and indirect interventions did not reach statistical significance at the 0·05 level (OR 0·62 [95% CI 0·45-0·87] vs 0·93 [0·77-1·12], p=0·06) and represented a large effect size (Cohen's d=0·77). At longer-term follow-up, the difference was not significant (OR 0·65 [0·46-0·91] vs 0·82 [0·70-0·96], p=0·25) but still represented a medium effect size (Cohen's d=0·47). These effect sizes emphasise the clinical importance of direct interventions. Post-hoc subgroup and sensitivity analyses showed that our results are robust and unlikely to be notably affected by between-study heterogeneity or publication bias. Psychosocial and behavioural interventions that directly address suicidal thoughts and behaviour are effective immediately post-treatment and long term, whereas treatments indirectly addressing these components are only effective long term. Moreover, although the differences shown between direct and indirect strategies were non-significant, the difference in favour of direct interventions represented a large post-treatment improvement and medium improvement at longer-term follow-up. On the basis of these findings, clinicians working with patients at risk of suicide should address suicidal thoughts and behaviours with the patient directly. Although direct interventions are effective, they are not sufficient, and additional efforts are needed to further reduce death by suicide and suicide attempts. Continued patient contact might be necessary to retain long-term effectiveness. National Institute of Nursing Research. Copyright © 2016 Elsevier Ltd. All rights reserved.

Suicidal ideation, deliberate self-harm behaviour and suicide attempts among adolescent outpatients with depressive mood disorders and comorbid axis I disorders.

PubMed

Tuisku, Virpi; Pelkonen, Mirjami; Karlsson, Linnea; Kiviruusu, Olli; Holi, Matti; Ruuttu, Titta; Punamäki, Raija-Leena; Marttunen, Mauri

2006-06-01

We aimed to analyse and compare prevalence and associated clinical features of suicidal ideation, self-harm behaviour with no suicidal intent and suicide attempts among adolescent outpatients with depressive mood disorders with or without comorbidity. A sample of 218 consecutive adolescent outpatients aged 13-19 years with depressive mood disorders was interviewed using K-SADS-PL for DSM-IV Axis I diagnoses. They filled out self-report questionnaires assessing depressive and anxiety symptoms. Suicidal behaviour was assessed by K-SADS-PL suicidality items. Half of the subjects reported suicidal ideation or behaviour. There was no difference in prevalence of suicidal behaviour between non-comorbid and comorbid mood disorder groups. Multivariate logistic regression analyses produced the following associations: (1) suicidal ideation with self-reported depressive symptoms and poor psychosocial functioning, (2) deliberate self-harm behaviour with younger age and poor psychosocial functioning, and (3) suicide attempts with self-reported depressive symptoms and poor psychosocial functioning. Depressed mood disorders, whether comorbid or not, are associated with suicidal ideation and suicide attempts. Diagnostic assessment should be supplemented by self-report methods when assessing suicidal behaviour in depressed adolescents.

Trends in suicidal behaviour in Dutch general practice 1983–2013: a retrospective observational study

PubMed Central

Hooiveld, Mariette; Korevaar, Joke C; Donker, Gé A

2016-01-01

Objectives To analyse trends in suicidal behaviour as reported by the Dutch sentinel general practices from 1983 to 2013. Second, to examine the relationship between suicidal behaviour and several patient characteristics. Finally, to compare the relationship between suicidal behaviour and patient characteristics before (1983–2007) and after (2008–2013) the start of the crisis. Setting 40 general practices in the Netherlands during the period 1983–2013. Participants Patients with an ICPC code of P77 (suicide attempt). Primary and secondary outcomes Primary outcomes were age-adjusted and gender-specific trends in reported suicides (342) and suicide attempts (1614). Secondary outcomes were the relationship between suicidal behaviour and age, household composition, history of depression, recognition of suicide ideation, treatment before the suicidal behaviour and contact within the past month before suicidal behaviour for the period 1983–2013. Additionally, separate frequencies for the periods 1983–2007 and 2008–2013 were presented. Results Join-point analyses revealed a significant rise in male suicides from 2008 (b=0.32, SE=0.1, p=0.008), and an increase in male suicide attempts since 2009 (b=0.19, SE=0.04, p<0.001). Female suicidal behaviour showed a steady decrease from 1989 to 2013(b=−0.03, SE=0.007, p<0.0001 for female suicide, b=−0.02, SE=0.002, p<0.001 for female attempts). Before 2007, a history of depression was reported in 65% (168/257) of the suicides. After the start of the recession, a depression was recognised in 44% (22/50) of the patients who died by suicide. Conclusions Since 2008, there was a rise in the male suicide rate while female suicide behaviour has continued to decline. General practitioners less often reported a history of depression within patients who died due to suicide after 2007 than before. Training in the early recognition of suicide ideation in depressive patients might improve suicide prevention in primary care. PMID:27165647

Neurobiology of suicidal behaviour.

PubMed

Pjevac, Milica; Pregelj, Peter

2012-10-01

It is known that suicidal behaviour has multiple causes. If triggers could be mainly attributed to environmental factors, predisposition could be associated with early stressors on one side such as childhood adversities and genetic predisposition. No convincing animal model of suicide has been produced to date. The study of endophenotypes has been proposed as a good strategy to overcome the methodological difficulties. However, research in suicidal behaviours using endophenotypes entrails important methodological problems. Further, serotoninergic system was studied in patients with suicidal behaviour primary due to its involvement of serotonin in impulsive-aggressive behaviour, which has been shown to be a major risk factor in suicidal behaviour. Not only on the level of neurotransmitters but also the regulation of neurotropic factors could be impaired in suicide victims. Multiple lines of evidence including studies of levels of BDNF in blood cells and plasma of suicidal patients, postmortem brain studies in suicidal subjects with or without depression, and genetic association studies linking BDNF to suicide suggest that suicidal behaviour may be associated with a decrease in BDNF functioning. It seems that especially specific gene variants regulating the serotoninergic system and other neuronal systems involved in stress response are associated with suicidal behaviour. Most genetic studies on suicidal behaviour have considered a small set of functional polymorphisms relevant mostly to monoaminergic neurotransmission. However, genes and epigenetic mechanisms involved in regulation of other factors such as BDNF seem to be even more relevant for further research.

Plasma apolipoprotein E and severity of suicidal behaviour.

PubMed

Asellus, Peter; Nordström, Peter; Nordström, Anna-Lena; Jokinen, Jussi

2016-01-15

There is evidence for association between low cholesterol levels and suicidal behaviour. Since apolipoprotein E (ApoE) is involved in the cholesterol metabolism in both the periphery and in the central nervous system; it may be of particular interest in the neurobiology of suicidal behaviour. Furthermore, hypothalamic-pituitary-adrenal (HPA) axis function, one of the main biological systems implicated in both suicidal behaviour and early-life adversity, affect ApoE levels. Very few studies have assessed plasma ApoE in relation to suicidal behaviour. The purpose of this study was to investigate levels of ApoE in plasma in relation to the severity of suicidal behaviour and life-time adversity in the form of exposure to interpersonal violence in suicide attempters. A total of 100 suicide attempters (67 women and 33 men) were enroled in the study. Information on earlier suicide attempts and age at onset of suicidal behaviour was gathered using the Karolinska Suicide History Interview. The Karolinska Interpersonal Violence Scale was used to assess exposure to interpersonal violence. Plasma ApoE was measured by immunonephelometry according to accredited routines. Patients with at least one earlier suicide attempt had significantly higher ApoE levels compared to suicide attempters debuting with suicidal behaviour at inclusion in the study. A higher number of earlier suicide attempts was significantly correlated with higher plasma ApoE levels. Age at onset was significantly negatively correlated with ApoE after adjusting for age. ApoE showed a significant positive correlation with exposure to interpersonal violence as a child in male suicide attempters. Our findings indicate that ApoE may be related to stress and trauma and the temporal severity of suicidal behaviour. Copyright © 2015 Elsevier B.V. All rights reserved.

[Suicidal behaviour among prisoners: prevalence and association with psychological distress in Flemish prisons].

PubMed

Favril, L; Vander Laenen, F; Audenaert, K

Internationally, the prevalence of suicidal behaviour (suicidal ideation, suicide plan and attempted suicide) is significantly elevated among prisoners compared to the community at large. To estimate the prevalence of suicidal behaviour among prisoners in the Flanders region of Belgium, to identify differences according to gender and custodial status, and to examine the association of recent suicidal ideation and suicide plan with psychological distress. We performed a cross-sectional survey using a representative sample of 1,326 prisoners, randomly selected from 15 Flemish prisons. During their lifetime, an estimated 44.4% of prisoners in Flanders reported suicidal ideation, 30.2% made a suicide plan, and one-fifth (21.8%) attempted suicide at least once. Past-year suicidal ideation in prison was endorsed by one-fourth (24.9%) of all prisoners, and 14.3% made a recent suicidal plan during their current incarceration. Approximately one in ten prisoners (9.5%) attempted suicide while in prison. Recent suicidal ideation and suicide plan were significantly associated with high levels of psychological distress. Generally, female prisoners reported significant higher levels of suicidal behaviour than men, while differences according to custodial status were less unequivocal. Corroborating international research findings, high rates of suicidal behaviour were identified among prisoners in Flanders, compared to the general population. Not only is suicidal behaviour a significant risk factor for suicide, it is also important in its own right as an indicator of profound psychological distress. Suicidal behaviour should therefore be an important target for prevention and intervention in this at-risk population.

A structural test of the Integrated Motivational-Volitional model of suicidal behaviour.

PubMed

Dhingra, Katie; Boduszek, Daniel; O'Connor, Rory C

2016-05-30

Suicidal behaviours are highly complex, multi-determined phenomena. Despite this, historically research has tended to focus on bivariate associations between atheoretical demographic and/or psychiatric factors and suicidal behaviour. The aim of this study was to empirically test the Integrated Motivational-Volitional model of suicidal behaviour using structural equation modelling. Healthy adults (N=1809) completed anonymous self-report surveys. The fit of the proposed model was good, and explained 79% of variance in defeat, 83% of variance in entrapment, 61% of variance in suicidal ideation, and 27% of variance in suicide attempts. All proposed paths were significant except for those between goal re-engagement and two factors of suicide resilience (Internal Protective and External Protective) and suicidal ideation; and impulsivity and discomfort intolerance and suicide attempts. These findings represent a preliminary step towards greater clarification of the mechanisms driving suicidal behaviour, and support the utility of basing future research on the Integrated Motivational-Volitional model of suicidal behaviour. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Prevalence of suicidal behaviour & associated factors among tuberculosis patients in public primary care in South Africa.

PubMed

Peltzer, Karl; Louw, Julia

2013-01-01

In spite of the high prevalence of tuberculosis worldwide, there are only a few studies on its psychiatric complications such as suicidal behaviour. We undertook this study to assess the prevalence of suicidal behaviour and its associated factors among tuberculosis patients in public primary care in South Africa. In a cross-sectional survey conducted in three provinces of South Africa new TB and new re-treatment patients were assessed within one month of anti-tuberculosis treatment. The sample included 4900 (54.5% men and women 45.5%) consecutively selected tuberculosis patients from 42 public primary care clinics in three districts in South Africa. A total of 322 patients (9.0%) reported suicidal ideation and 131 (3.1%) had a history of a suicide attempt. In multivariate analysis female gender [Odds Ratio (OR)= 0.56, Confidence Interval (CI)= 0.43-0.74], psychological distress (OR=2.36, CI=1.04-2.29), post-traumatic stress disorders (PTSD) (OR=4.98, CI=3.76-6.59), harmful alcohol use (OR=1.97, CI=1.25-3.09) and being a TB re-treatment patient (OR=1.76, CI=1.32-2.34) were associated with suicidal ideation, and psychological distress (OR=3.27, CI=1.51-7.10), PTSD symptoms (OR=4.48, CI=3.04-6.61) and harmful alcohol use (OR=3.01, CI=1.83-4.95) were associated with a suicide attempt. Our findings suggest that co-morbid illnesses of psychological distress, PTSD and harmful alcohol use and HIV infection should be assessed in TB patients under TB control programmes to prevent suicidal behaviour. Clinicians should be aware about suicidality in tuberculosis patients to reduce mortality.

Prevalence of suicidal behaviour & associated factors among tuberculosis patients in public primary care in South Africa

PubMed Central

Peltzer, Karl; Louw, Julia

2013-01-01

Background & objectives: In spite of the high prevalence of tuberculosis worldwide, there are only a few studies on its psychiatric complications such as suicidal behaviour. We undertook this study to assess the prevalence of suicidal behaviour and its associated factors among tuberculosis patients in public primary care in South Africa. Methods: In a cross-sectional survey conducted in three provinces of South Africa new TB and new re-treatment patients were assessed within one month of anti-tuberculosis treatment. The sample included 4900 (54.5% men and women 45.5%) consecutively selected tuberculosis patients from 42 public primary care clinics in three districts in South Africa. Results: A total of 322 patients (9.0%) reported suicidal ideation and 131 (3.1%) had a history of a suicide attempt. In multivariate analysis female gender [Odds Ratio (OR)= 0.56, Confidence Interval (CI)= 0.43-0.74], psychological distress (OR=2.36, CI=1.04-2.29), post-traumatic stress disorders (PTSD) (OR=4.98, CI=3.76-6.59), harmful alcohol use (OR=1.97, CI=1.25-3.09) and being a TB re-treatment patient (OR=1.76, CI=1.32-2.34) were associated with suicidal ideation, and psychological distress (OR=3.27, CI=1.51-7.10), PTSD symptoms (OR=4.48, CI=3.04-6.61) and harmful alcohol use (OR=3.01, CI=1.83-4.95) were associated with a suicide attempt. Interpretation & conclusions: Our findings suggest that co-morbid illnesses of psychological distress, PTSD and harmful alcohol use and HIV infection should be assessed in TB patients under TB control programmes to prevent suicidal behaviour. Clinicians should be aware about suicidality in tuberculosis patients to reduce mortality. PMID:24056595

Protective Factors Against Depression and Suicidal Behaviour in Adolescence

PubMed Central

Breton, Jean-Jacques; Labelle, Réal; Berthiaume, Claude; Royer, Chantal; St-Georges, Marie; Ricard, Dominique; Abadie, Pascale; Gérardin, Priscille; Cohen, David; Guilé, Jean-Marc

2015-01-01

Objectives: To examine whether protective factors in the Protection for Adolescent Depression Study (PADS) moderate the impact of stressful events on depression and suicidal behaviour in the community and a clinical setting; and to study the influence of sex. Method: Participants were 283 adolescents from the community and 119 from a mood disorder clinic in Montreal. The participants were evaluated on 6 instruments measuring individual risk and protective factors. Descriptive analyses and univariate and multiple logistic regression models were carried out. Results: Risk factors predicted higher levels of depression and presence of suicidal behaviour, and protective factors predicted lower levels of depression and absence of suicidal behaviour, as expected under the vulnerability-resilience stress model. Several sex differences were observed in terms of the predictive power of risk factors (for example, hopelessness among girls and keep to themselves among boys) and protective factors (for example, focusing on the positive among girls and self-discovery among boys). Conclusions: Findings from the PADS suggest that protective factors moderate the impact of stress on depression and suicidal behaviour. Developing protection appears important in the presence of chronic conditions, such as depressive disorders, to reduce the likelihood of further episodes. The influence of sex makes it all the more relevant to target different factors for boys and girls to increase protection and decrease risk in prevention and intervention programs. PMID:25886672

Self-reported suicide attempts and associated risk and protective factors among secondary school students in New Zealand.

PubMed

Fleming, Theresa M; Merry, Sally N; Robinson, Elizabeth M; Denny, Simon J; Watson, Peter D

2007-03-01

To examine associations between individual, family, school and community characteristics and rates of suicide attempts in a national population sample of New Zealand secondary school students. A total of 9570 randomly selected 9- to 13-year-old students from 114 schools were surveyed, using the New Zealand Adolescent Health Survey. This is a 523-item anonymous self-report comprehensive questionnaire delivered by Multi-Media Computer-Assisted Self-Interviewing. Multivariate analyses were used to examine correlates of self-reported suicide attempts within the last 12 months. In total, 739 participants (4.7% of males and 10.5% of females) reported having made a suicide attempt within the last 12 months. Depressive symptoms, alcohol abuse, -having a friend or family member attempt suicide, family violence and non-heterosexual attractions were independently associated with increased rates of suicide attempts while parents caring, other family members caring, teachers being fair and feeling safe at school were independently associated with decreased rates of suicide attempts. Caring friendships, attending worship frequently, possible sexual abuse and anxiety symptoms were not independently associated with suicide attempts. Risk and protective factors operated in the same way for male and female students and for those with and without other suicide predictors. New Zealand secondary school students, particularly female students, report high rates of suicide attempts. Risk of suicide attempts is lower in students reporting caring home and fair, safe school environments and this effect remains once depression is taken into account. This study confirms the importance of depression, substance use, problem behaviour, negative life events, exposure to suicide behaviour by others and the significance of sexual orientation in suicidal behaviour among school students and provides evidence of the importance of the family and school environments in reducing risk among this group.

Trends in suicidal behaviour in Dutch general practice 1983-2013: a retrospective observational study.

PubMed

de Beurs, Derek P; Hooiveld, Mariette; Kerkhof, Ad J F M; Korevaar, Joke C; Donker, Gé A

2016-05-10

To analyse trends in suicidal behaviour as reported by the Dutch sentinel general practices from 1983 to 2013. Second, to examine the relationship between suicidal behaviour and several patient characteristics. Finally, to compare the relationship between suicidal behaviour and patient characteristics before (1983-2007) and after (2008-2013) the start of the crisis. 40 general practices in the Netherlands during the period 1983-2013. Patients with an ICPC code of P77 (suicide attempt). Primary outcomes were age-adjusted and gender-specific trends in reported suicides (342) and suicide attempts (1614). Secondary outcomes were the relationship between suicidal behaviour and age, household composition, history of depression, recognition of suicide ideation, treatment before the suicidal behaviour and contact within the past month before suicidal behaviour for the period 1983-2013. Additionally, separate frequencies for the periods 1983-2007 and 2008-2013 were presented. Join-point analyses revealed a significant rise in male suicides from 2008 (b=0.32, SE=0.1, p=0.008), and an increase in male suicide attempts since 2009 (b=0.19, SE=0.04, p<0.001). Female suicidal behaviour showed a steady decrease from 1989 to 2013(b=-0.03, SE=0.007, p<0.0001 for female suicide, b=-0.02, SE=0.002, p<0.001 for female attempts). Before 2007, a history of depression was reported in 65% (168/257) of the suicides. After the start of the recession, a depression was recognised in 44% (22/50) of the patients who died by suicide. Since 2008, there was a rise in the male suicide rate while female suicide behaviour has continued to decline. General practitioners less often reported a history of depression within patients who died due to suicide after 2007 than before. Training in the early recognition of suicide ideation in depressive patients might improve suicide prevention in primary care. 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/

A Novel Therapy for People Who Attempt Suicide and Why We Need New Models of Suicide

PubMed Central

Michel, Konrad; Valach, Ladislav; Gysin-Maillart, Anja

2017-01-01

This paper presents a model of suicidal behaviour based on suicide as a goal-directed action, and its implications. An action theoretical model has guided the authors in the development of a brief therapy for individuals who attempt suicide (ASSIP—Attempted Suicide Short Intervention Program). Key elements are an early therapeutic alliance, narrative interviewing, psychoeducation, a joint case conceptualization, safety planning, and regular letters over 24 months. In a randomized controlled trial, ASSIP was highly effective in reducing the risk of suicide reattempts. The therapeutic elements in this treatment are described and possible implications for future directions in clinical suicide prevention discussed. PMID:28257071

Natural disasters and suicidal behaviours: a systematic literature review.

PubMed

Kõlves, Kairi; Kõlves, Keili E; De Leo, Diego

2013-03-20

Various consequences including suicidal behaviours can arise in the aftermath of natural disasters. The aim of the present review was to systematically analyse the existing literature on the potential impact of natural disasters on suicidal behaviours. A systematic search of English-language articles indexed in electronic databases was conducted. The current review covers 42 papers containing empirical analyses of the relationship between natural disasters and suicidal behaviours. In total, 19 papers analysed suicide mortality and 23 non-fatal suicidal behaviours. The effects of earthquakes on suicidal behaviours are the most frequently studied among natural disasters (n=20), followed by hurricanes (n=11). Further, there were four papers about tsunamis, three about floods, three about heat waves and drought, and one investigating the effects of multiple natural disasters. The studies show different directions in suicide mortality following natural disasters. Nevertheless, there seems to be a drop in non-fatal suicidal behaviours in the initial post-disaster period, which has been referred to as the 'honeymoon' phase. A delayed increase in suicidal behaviours has been reported in some studies. However, other factors increasing the risk of suicidal behaviours after natural disasters have been reported, such as previous and current mental health problems. Furthermore, contributing factors, such as economic conditions, should also be considered. The exclusion of non-English articles. In light of the various methodological limitations observed, there is a need for further studies using proper designs. Mental health and suicidal behaviours should continue to be monitored for several years after the disaster. Copyright © 2012 Elsevier B.V. All rights reserved.

[Suicidal behaviour and attempted suicide occurring during assessment by the outreach psychiatric emergency service].

PubMed

de Winter, R F P; de Groot, M H; van Dassen, M; Deen, M L; de Beurs, D P

The outreach emergency psychiatric service plays an important role in recognising, arranging interventions and preventing suicide and suicidal behaviour. However, little is known about the assessments that members of the emergency team make when faced with patients showing suicidal behaviour.
AIM: To describe the relationships that are revealed between patient characteristics, suicidal thoughts and attempted suicide during assessments made by the emergency psychiatric service in The Hague.
METHOD: The emergency service kept a detailed record of 14,705 consultations. We compared the characteristics of patients who had suicidal thoughts with those of patients who had no such thoughts and we also compared the characteristics of patients who had attempted to commit suicide with those of patients who had not. We drew these comparisons by using logistic regression models, adjusting for clustering.
RESULTS: 32.2% of the patients showed signs of suicidal behaviour and 9.2 % appeared likely to attempt suicide. Suicidal behaviour occurred most often in patients with depression. Suicidal patients were more often admitted to hospital than were non-suicidal patients and they were more likely to have been referred by a general practitioner or a general hospital. Medication was the most frequent means employed in attempts to commit suicide.
CONCLUSION: In about one third of the consultations of the outreach emergency psychiatric service, the patient showed suicidal behaviour. The actions and the policy of the emergency psychiatric service with regard to suicidal behaviour were diverse and dependent on factors that could change over the course of time.

Patterns of suicidal behaviour in a metro subway system: a study of 306 cases injured by the Munich subway, 1980-1999.

PubMed

Ladwig, Karl-Heinz; Baumert, Jens J

2004-09-01

As a basis for preventive strategies to reduce subway suicides, an investigation was undertaken to determine if there was a distinct pattern of subway suicidal behaviour. Data were taken from the Municipal Munich Subway System case registry (southern Germany) for all suicidal incidents on the track: purposely inflicted; date, time and location of incident, sex of victim, outcome. The analysis covered a 20 year observation period between 1980 and 1999, for which the Munich Municipal Office for Statistics also provided data of all deaths due to suicides within the city area of Munich. Suicide mortality was classified by the International Classification of Diseases, Ninth revision (codes E950-E959). A total of 306 incidents were documented with an annual mean of 16.5 cases. Case fatality was 66% (n=202). It was highest in winter and in higher aged groups. No significant time trend for incidences was observed. Median age of suicide attempters was 38 years. Most incidences (24.2%) were recorded for persons aged 20-29 years. The male: female ratio was 1.15 : 1. The peak time of day for incidences in women was during the late morning hours while significantly more men committed subway suicides during evening hours (p=0.001). No consistent seasonal variation was observed. In comparison to average suicide attempters, subjects committing subway suicides are markedly younger and they follow to a lesser extent established seasonal or circadian time patterns. More women are involved in subway suicides than would be expected. However, similarities to reports on behavioural patterns of subway suicides in other communities are striking.

Educational interventions for general practitioners to identify and manage depression as a suicide risk factor in young people: a systematic review and meta-analysis protocol.

PubMed

Tait, Lynda; Michail, Maria

2014-12-15

Suicide is a major public health problem and globally is the second leading cause of death in young adults. Globally, there are 164,000 suicides per year in young people under 25 years. Depression is a strong risk factor for suicide. Evidence shows that 45% of those completing suicide, including young adults, contact their general practitioner rather than a mental health professional in the month before their death. Further evidence indicates that risk factors or early warning signs of suicide in young people go undetected and untreated by general practitioners. Healthcare-based suicide prevention interventions targeted at general practitioners are designed to increase identification of at-risk young people. The rationale of this type of intervention is that early identification and improved clinical management of at-risk individuals will reduce morbidity and mortality. This systematic review will synthesise evidence on the effectiveness of education interventions for general practitioners in identifying and managing depression as a suicide risk factor in young people. We shall conduct a systematic review and meta-analysis following the Cochrane Handbook for Systematic Reviews of Interventions guidelines and conform to the reporting guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement recommendations. Electronic databases will be systematically searched for randomised controlled trials and quasi-experimental studies investigating the effectiveness of interventions for general practitioners in identifying and managing depression as a suicide risk factor in young people in comparison to any other intervention, no intervention, usual care or waiting list. Grey literature will be searched by screening trial registers. Only studies published in English will be included. No date restrictions will be applied. Two authors will independently screen titles and abstracts of potential studies. The primary outcome is identification and management of depression. Secondary outcomes are suicidal ideation, suicide attempts, deliberate self-harm, knowledge of suicide risk factors and suicide-related behaviours, attitudes towards suicide risk and suicide-related behaviours, confidence in dealing with suicide risk factors and suicide-related behaviour. Our study will inform the development of future education interventions and provide feasibility and acceptability evidence, to help general practitioners identify and manage suicidal behaviour in young people. PROSPERO registration number: CRD42014009110.

What bridges the gap between self-harm and suicidality? The role of forgiveness, resilience and attachment.

PubMed

Nagra, Gurmokh S; Lin, Ashleigh; Upthegrove, Rachel

2016-07-30

Self-harm is the most robust risk for completed suicide. There is a lack of understanding of why some people who self-harm escalate to suicidal behaviour when others do not. Psychological factors such as attachment, self-forgiveness and self-appraisal may be important. To determine whether factors from the Interpersonal Theory and Schematic Appraisals models are useful to identify suicidal behaviour in populations that self-harm. Specifically we investigate whether resilience factors of secure attachment, self-forgiveness and positive self-appraisals significantly influence suicidality in people who self-harm. A cross-sectional online study of 323 participants recruited from self-harm support forum. Validated self-report measures were used to assess appraisals, relationships, self-forgiveness, attachment style, suicidality and self-harm. Emotion coping and support seeking self-appraisals and self-forgiveness were negatively associated with suicidality in participants with a history of self-harm. Dismissing attachment was positively associated with suicidality. The perceived ability to cope with emotions, the perceived ability to gain support and self-forgiveness may protect against suicide in people who self-harm. Conversely the presence of dismissing attachment may increase the risk of suicidality. Findings provide therapeutic targets to reduce risk of suicidality in this high risk group. Copyright © 2016. Published by Elsevier Ireland Ltd.

Review of health and risk-behaviours, mental health problems and suicidal behaviours in young Europeans on the basis of the results from the EU-funded Saving and Empowering Young Lives in Europe (SEYLE) study.

PubMed

Wasserman, Danuta

2016-12-23

An estimated 800 000 suicide deaths occur worldwide. The global suicide rate is 11.4 per 100 000 population; 15.0/100 000 for males and 8.0/100 000 for females. Globally, suicide is the second leading cause of death in 15-29 year olds. In a collaborative effort to reduce the high rates of suicide and mental health problems among youth across Europe, the European Union 7th Framework funded the Saving and Empowering Young Lives in Europe (SEYLE) project. SEYLE is a randomized controlled trial (RCT) aimed to promote mental health and healthy lifestyles, while preventing psychopathology and suicidal behaviours among adolescents. The epidemiological data on 11,110 pupils in the age group 14-16 years, with a mean age of 14.8 years (SD ± 0.8), who were recruited from 168 schools across 10 European Union countries: Austria, Estonia, France, Germany, Hungary, Ireland, Italy, Romania, Slovenia and Spain, with Sweden as the coordinating centre showed the following prevalences: alcohol use (13.4%), smoking (30.9%), physical inactivity (32.8%), pathological Internet use (4.4%) and sleeping on average 7.7 hours per night. In terms of reproductive health, the prevalence of sexual debut was 18.8% for the total sample. Pupils aged .16 years had a higher prevalence (38%) of sexual debut compared to those aged .15 years (13.2%). Males had a higher prevalence (21.3%) than females (16.9%). Three clusters of adolescents were identified: 57.8% with low frequency of all risk-behaviours; 13.2% with high frequency of all risk behaviours; and 29% so-called 'invisible' risk group, which did not show any striking externalised riskbehaviours, but scored positive for high use of Internet/TV/videogames, sedentary behaviour and reduced sleep. When comparing pupils in the "invisible" risk group with those in the high-risk group, similar prevalence rates of anxiety (8% vs. 9.2%), subthreshold depression (33.2% vs. 34%), depression (13.4% vs. 14.7%) and suicidal thoughts (42.2% vs. 44%) were observed. Pupils meeting the criteria of depression and subthreshold depression were 10.5% and 32%, respectively. Prevalence rates for anxiety and subthreshold anxiety was 5.8% and 29.2%, respectively. Lifetime prevalence of deliberate self-injurious behaviours (D-SIB) was 27.6%, with higher rates reported for occasional D-SIB (19.7%) compared to repetitive D-SIB (7.8%). Suicidal ideation was present in approximately one third of the sample (32.3%). More than four percent (4.2%) of the sample reported attempting suicide during their lifetime, with a significantly higher prevalence among girls (5.1% vs. 3.0%, p<0.05). In comparing the effectiveness of the three active SEYLE interventions, based on three specific preventive strategies directed towards teachers and school staff, professionals and pupils in comparison to a control group, the intervention empowering pupils, called the Youth Aware of Mental Health (YAM) showed significant results in preventing new cases of suicide attempts, severe suicidal ideation with plans and depression. More than a 50% reduction of incident cases of suicide attempts (OR: 0.45 [0.24 - 0.85]; p=0.014), and of incident cases of severe suicidal ideation and plans (OR: 0.50 [0.27 - 0.92]; p=0.025), as well as a significant reduction by 30% of incident cases with moderate to severe depression (OR: 0.71 [0.52- 0.97]; p=0.031) was observed.

Serotonergic modulation of suicidal behaviour: integrating preclinical data with clinical practice and psychotherapy.

PubMed

Boulougouris, Vasileios; Malogiannis, Ioannis; Lockwood, George; Zervas, Iannis; Di Giovanni, Giuseppe

2013-10-01

Many studies have provided important information regarding the anatomy, development and functional organization of the 5-HT system and the alterations in this system that are present within the brain of the suicidal patient. There is also a growing interest in genetic factors associated with suicide, since these may lead to the emergence of personality traits that prove to be long-term predictors of suicidal behaviour. This review will focus on presenting the scientific literature on the role of the serotonergic system in suicidal behaviour as well as dysfunctional attitudes and personality traits associated with the suicidal patient. The association of the serotonin transporter gene, the 5-HT2 receptors and its metabolite 5-hydroxyindoleacetic acid with suicidal behaviour and animal models that may capture the complexity of suicidal behaviour will be discussed. Finally, the relationship between neurobiological models and psychotherapeutic interventions for suicide prevention will be considered with a focus on Schema Therapy (an approach that has shown particular promise in the treatment of suicidal individuals with personality disorders), aiming to invite the reader to integrate some aspects of the neurobiology of human suicidal behaviour into a model of suicide that can be used in a clinical encounter.

Network Analysis: A Novel Approach to Understand Suicidal Behaviour

PubMed Central

de Beurs, Derek

2017-01-01

Although suicide is a major public health issue worldwide, we understand little of the onset and development of suicidal behaviour. Suicidal behaviour is argued to be the end result of the complex interaction between psychological, social and biological factors. Epidemiological studies resulted in a range of risk factors for suicidal behaviour, but we do not yet understand how their interaction increases the risk for suicidal behaviour. A new approach called network analysis can help us better understand this process as it allows us to visualize and quantify the complex association between many different symptoms or risk factors. A network analysis of data containing information on suicidal patients can help us understand how risk factors interact and how their interaction is related to suicidal thoughts and behaviour. A network perspective has been successfully applied to the field of depression and psychosis, but not yet to the field of suicidology. In this theoretical article, I will introduce the concept of network analysis to the field of suicide prevention, and offer directions for future applications and studies.

Suicidal and self-harm behaviour associated with adolescent attention deficit hyperactivity disorder-a study in the Northern Finland Birth Cohort 1986.

PubMed

Hurtig, Tuula; Taanila, Anja; Moilanen, Irma; Nordström, Tanja; Ebeling, Hanna

2012-10-01

Suicidal behaviour, i.e. suicidal ideation and suicidal acts, as well as self-harm behaviour, are relatively common among adolescents. Depression and/or female gender seem to be risk factors for suicidal behaviour. However, the role of attention deficit hyperactivity disorder (ADHD) in these behaviours is still unclear. To study the effect of ADHD on suicidal or self-harm behaviour in adolescents from a general population sample. The sample was derived from a population-based Northern Finland Birth Cohort 1986 (n = 9432). Based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children, Present and Lifetime Version (Kiddie-SADS-PL) interview performed in a subpopulation (n = 457), the associations between suicidal behaviour and deliberate self-harm (DSH) and the diagnosis of ADHD were studied. Compared with adolescents without ADHD (n = 169), those with ADHD (n = 104) had more suicidal ideation (57% vs. 28%, P < 0.001) and DSH (69% vs. 32%, P < 0.001). In binary logistic models, the effect of ADHD on suicidal ideation remained strong (OR = 6.1) after controlling for several other predictors. Other contributing factors in suicidal behaviour included female gender, childhood emotional and behavioural problems, concurrent depression and anxiety, and, specifically in DSH, behavioural disorder, substance abuse and strains in family relations. ADHD is a risk factor for suicidal ideation and DSH. These findings in a general population sample speak for a need to target mental health interventions at children and adolescents with relevant symptoms of ADHD.

The longitudinal association between psychotic experiences, depression and suicidal behaviour in a population sample of adolescents.

PubMed

Sullivan, Sarah A; Lewis, Glyn; Gunnell, David; Cannon, Mary; Mars, Becky; Zammit, Stan

2015-12-01

Whilst psychotic experiences are associated with suicidal behaviour in a number of studies the value of psychotic experiences for the prediction of suicidal behaviour and the role of depressive symptoms in this relationship is not clear. We examined the association between psychotic experiences and subsequent suicidal behaviour and examine the role of depressive symptoms in this relationship. Psychotic experiences and depressive symptoms at age 12 and 16 years, and suicidal behaviour at age 16 years were assessed in participants (prospective analysis n = 3171; cross-sectional analysis n = 3952) from a population-based cohort. Psychotic experiences (OR 1.75 95 % CI 1.20, 2.54) and depression (OR 3.97 95 % CI 2.56, 6.15) at 12 years were independently associated with suicidal behaviour at 16 years after adjustment for confounding. There was no evidence that the relationship between psychotic experiences and suicidal behaviour was stronger in participants who were also depressive. A ROC analysis showed that adding information on psychotic experiences to measures of depressive symptoms had hardly any effect on improving prediction of suicidal behaviour (AUC increased from 0.64 to 0.65). Whereas adding a measure of depressive symptoms to the measure of psychotic experiences improved prediction substantially (AUC 0.56-0.65). Psychotic experiences and depression are independently associated with suicidal behaviour although the association with depression is substantially stronger. Psychotic experiences alone are not a strong predictor of later suicidal behaviour and add little to predicting the risk of suicidal behaviour over and above the information provided by depressive symptoms.

Factors associated with suicidal thoughts in a large community study of older adults.

PubMed

Almeida, Osvaldo P; Draper, Brian; Snowdon, John; Lautenschlager, Nicola T; Pirkis, Jane; Byrne, Gerard; Sim, Moira; Stocks, Nigel; Flicker, Leon; Pfaff, Jon J

2012-12-01

Thoughts about death and self-harm in old age have been commonly associated with the presence of depression, but other risk factors may also be important. To determine the independent association between suicidal ideation in later life and demographic, lifestyle, socioeconomic, psychiatric and medical factors. A cross-sectional study was conducted of a community-derived sample of 21 290 adults aged 60-101 years enrolled from Australian primary care practices. We considered that participants endorsing any of the four items of the Depressive Symptom Inventory -Suicidality Subscale were experiencing suicidal thoughts. We used standard procedures to collect demographic, lifestyle, psychosocial and clinical data. Anxiety and depressive symptoms were assessed with the Hospital Anxiety and Depression Scale. The 2-week prevalence of suicidal ideation was 4.8%. Male gender, higher education, current smoking, living alone, poor social support, no religious practice, financial strain, childhood physical abuse, history of suicide in the family, past depression, current anxiety, depression or comorbid anxiety and depression, past suicide attempt, pain, poor self-perceived health and current use of antidepressants were independently associated with suicidal ideation. Poor social support was associated with a population attributable fraction of 38.0%, followed by history of depression (23.6%), concurrent anxiety and depression (19.7%), prevalent anxiety (15.1%), pain (13.7%) and no religious practice (11.4%). Prevalent and past mood disorders seem to be valid targets for indicated interventions designed to reduce suicidal thoughts and behaviour. However, our data indicate that social disconnectedness and stress account for a larger proportion of cases than mood disorders. Should these associations prove to be causal, then interventions that succeeded in addressing these issues would contribute the most to reducing suicidal ideation and, possibly, suicidal behaviour in later life.

Clinical assessment and crisis intervention for the suicidal bipolar disorder patient.

PubMed

Saunders, Kate E A; Hawton, Keith

2013-08-01

Suicidal behaviour is common in people suffering with bipolar disorder, and suicide is a leading cause of death in this group. Our aim in this review is to provide an overview of key assessment and management strategies, highlight research findings relevant to suicide prevention, and identify important areas for future research. We reviewed the published literature regarding the risk factors for and management of suicida\\l behaviour in individuals with bipolar disorder using the Pubmed and PsychINFO databases. Where available, we focused our search on systematic reviews. Suicide is usually associated with a depressive phase, although mixed affective states also convey increased risk. All individuals with bipolar disorder should have an up-to-date crisis management plan which outlines the action to be taken should suicidal behaviour emerge. Timely clinical assessment is essential in ensuring that those at high risk are identified. This should include mental state examination, consideration of risk factors, and evaluation of issues such as access to means, preparatory acts before suicide, and also protective factors. While pharmacological approaches are the mainstay of management, less specific measures, such as the removal of access to means, are also important in ensuring safety in the acute situation. Intensifying the clinical support of both patients and relatives, and the sharing of risk information with other health agencies are essential in management. Specific psychological treatments are likely to be helpful in preventing crises, although the evidence base is limited. The aetiology of suicidal behaviour in bipolar disorder is multifactorial and requires proactive crisis planning and management. A range of issues need to be addressed in the assessment of at-risk patients. Determining the efficacy of interventions specific to reducing suicidality in bipolar disorder should be a research priority. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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.

Suicidal behaviour in adolescents and young adults with ASD: findings from a systematic review.

PubMed

Hannon, Geraldine; Taylor, Emily P

2013-12-01

Suicide is a major problem in Western society. However we have very little understanding of suicidal behaviour among individuals with autism spectrum disorders. The purpose of this review is to synthesise primary research on suicidal behaviour among adolescents and young adults with autism spectrum disorders in order to estimate prevalence and to identify and critically evaluate risk factors for suicidal behaviour in this population. Four primary research studies were identified for this review following a comprehensive literature search. The available research provides little empirical evidence for the processes underlying suicidal behaviour in adolescents and young adults with autism. © 2013.

Employing crisis postcards with case management in Kaohsiung, Taiwan: 6-month outcomes of a randomised controlled trial for suicide attempters.

PubMed

Chen, Wei-Jen; Ho, Chi-Kung; Shyu, Shi-Sen; Chen, Cheng-Chung; Lin, Guei-Ging; Chou, Li-Shiu; Fang, Yun-Ju; Yeh, Pin-Yang; Chung, Tieh-Chi; Chou, Frank Huang-Chih

2013-07-17

Suicide attempts constitute a serious clinical problem and have important implications for healthcare resources. The aim of the present study was to evaluate the effectiveness of case management using crisis postcards over a 6-month follow-up period. A randomised controlled trial was conducted in Kaohsiung, Taiwan. Prevention of further suicide attempts was compared between two groups with and without the postcard intervention. The intervention group consisted of 373 participants (139 males, 234 females; age: 39.8 ± 14.0 yrs.). The control group consisted of 388 participants (113 males, 275 females; age: 40.0 ± 16.0 yrs.). A survival analysis was used to test the effectiveness of the crisis postcard intervention for the prevention of suicide reattempts. Per-protocol and intention-to-treat analyses were conducted. The intention-to-treat analysis indicated that the crisis postcard had no effect (hazard ratio = 0.84; 95% CI = 0.56 - 1.29), whereas the per-protocol analysis showed a strong benefit for the crisis postcard (hazard ratio = 0.39; 95% CI = 0.21 - 0.72). Although the results of the present study indicated that the postcard intervention did not reduce subsequent suicide behaviour, our study provides an alteration to the postcard intervention. Further studies need to be conducted to clarify whether this type of intervention can reduce subsequent suicidal behaviour, with a particular focus on reducing the rate of loss to follow-up.

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.

Birth order: self-injurious and suicidal behaviour among adolescents.

PubMed

Kirkcaldy, Bruce; Richardson-Vejlgaard, Randall; Siefen, Georg

2009-01-01

A sample of 2553 children and adolescents in a psychiatry clinic in Germany were assessed using a structured interview inventory that included history of self-injurious behaviour, suicidal intent and socially disruptive and threatening behaviour, and diverse socio-demographic variables (the basis documentation or 'Ba-Do'). Birth order was associated with both suicidal and self-injurious behaviour, middle children being most likely to exhibit such behaviour. Females were more than twice as likely to have self-injured than males. Comparisons of birth order groups within gender found no significant differences in suicidal behaviour between birth positions for males, however among females, middle children were much more likely to have attempted suicide. Conversely, there was no difference in self-injurious behaviour among birth positions in females, but among males, middle children were significantly more likely to have self-injured than firstborns, only children or lastborns. The number of siblings in the family was significantly correlated with both suicidal history (r = 0.12, p < 0.001) and self-injurious behaviour (r = 0.10, p < 0.001). The risk of suicidal behaviour was highest for those with four or more siblings.

Suicidality in first episode psychosis is associated with insight and negative beliefs about psychosis.

PubMed

Barrett, Elizabeth A; Sundet, Kjetil; Faerden, Ann; Agartz, Ingrid; Bratlien, Unni; Romm, Kristin Lie; Mork, Erlend; Rossberg, Jan Ivar; Steen, Nils Eiel; Andreassen, Ole A; Melle, Ingrid

2010-11-01

Suicidal behaviour is prevalent in psychotic disorders. Insight has been found to be associated with increased risk for suicidal behaviour, but not consistently. A possible explanation for this is that insight has different consequences for patients depending on their beliefs about psychosis. The present study investigated whether a relationship between insight, negative beliefs about psychosis and suicidality was mediated by depressive symptoms, and if negative beliefs about psychosis moderated the relationship between insight and suicidality in patients with a first episode of psychosis (FEP). One hundred ninety-four FEP-patients were assessed with a clinical interview for diagnosis, symptoms, functioning, substance use, suicidality, insight, and beliefs about psychosis. Nearly 46% of the patients were currently suicidal. Depressive symptoms, having a schizophrenia spectrum disorder, insight, and beliefs about negative outcomes for psychosis were independently associated with current suicidality; contradicting a mediating effect of depressive symptoms. Negative beliefs about psychosis did not moderate the effect of insight on current suicidality. The results indicate that more depressive symptoms, higher insight, and negative beliefs about psychosis increase the risk for suicidality in FEP-patients. The findings imply that monitoring insight should be part of assessing the suicide risk in patients with FEP, and that treating depression and counteracting negative beliefs about psychosis may possibly reduce the risk for suicidality. Copyright © 2010 Elsevier B.V. All rights reserved.

[Transcultural aspects of suicidal behaviour].

PubMed

Calliess, I T; Machleidt, W; Ziegenbein, M; Haltenhof, H

2007-11-01

Due to increasing immigration in Germany the German Mental Health Care System today has to deal in a growing number with the assessment of the level of psychic functioning and the capability of self control in patients of different ethnic origin. For clinicians this is a challenge, since suicidal behaviour in terms of its frequency, meaning, motives and manner is very much dependent on the cultural context in which it occurs. Moreover, the general attitude of an individual towards suicide is embedded in the culture of origin of the immigrant. Until now there has been only little systematic research on the influence of culture on suicidal behaviour. In this review the traditions of suicidal behaviour in different cultures in their religious and historical dimensions will be reflected. The historical and cultural roots of suicidal behaviour will be put in context to a categorization of the different variants of suicide, such as institutionalized suicide versus individualized suicide. Psychodynamic aspects of suicidal ideation will be highlighted in cross-cultural perspective with a distinction between a. the wish to die, b. the wish to kill and c. the wish to be killed. It will be shown that there can be differentiated between accepted and non-accepted suicide. With respect to epidemiology there will be discussed the impact of culture on the suicide rates across cultures. The influence of culture on the psychopathology of suicidal behaviour will be summed up systematically. These aspects are of high relevance for the understanding and assessment of suicidal crisis in immigrants, since the suicidal patient even today - although subconsciously - is influenced by the deep rooted traditions of suicidal behaviour in his culture of origin.

The suicidal process: age of onset and severity of suicidal behaviour.

PubMed

Thompson, Angus H; Dewa, Carolyn S; Phare, Stephanie

2012-08-01

The concept of the suicidal process implies a progression from behaviour of relatively low intent to completed suicide. Evidence from the literature has given rise to the speculation that the age of onset of an early form of the suicidal process may be associated with the ultimate seriousness of suicidal behaviour. This study was designed to test the hypothesis that early onset of the first stage of the suicidal process, a wish to die, is associated with increases in the ultimate position along the suicidal process dimension. Questions on the appearance and timing of suicidal process components (a death wish, ideation, plan, or attempt) were embedded in a telephone survey on mental health and addictions in the workforce. Records of those that had experienced suicidal behaviour were examined for the effects on the age of onset of the first death wish as a function of the level of severity of suicidal behaviour, gender, and depression. The findings showed that increases in suicidal intent were associated with lowered age of the first death wish. This pattern held true for depressed and non-depressed persons alike. The results support the notion that the early onset of a supposed precursor of suicidal behaviour, a death wish in this case, adds to its ability to portend more serious problem levels in later stages of life. Furthermore, mood operates independently in its association with the timing of such suicidal behaviour, suggesting that the effect of a relatively youthful appearance of a wish to die cannot be explained by early onset depression.

Association between BDNF levels and suicidal behaviour: a systematic review and meta-analysis.

PubMed

Eisen, Rebecca B; Perera, Stefan; Banfield, Laura; Anglin, Rebecca; Minuzzi, Luciano; Samaan, Zainab

2015-12-30

Suicidal behaviour is a complex phenomenon with a multitude of risk factors. Brain-derived neurotrophic factor (BDNF), a protein crucial to nervous system function, may be involved in suicide risk. The objective of this systematic review is to evaluate and summarize the literature examining the relationship between BDNF levels and suicidal behaviour. A predefined search strategy was used to search MEDLINE, EMBASE, PsychINFO, and CINAHL from inception to December 2015. Studies were included if they investigated the association between BDNF levels and suicidal behaviours (including completed suicide, attempted suicide, or suicidal ideation) by comparing BDNF levels in groups with and without suicidal behaviour. Only the following observational studies were included: case-control and cohort studies. Both clinical- and community-based samples were included. Screening, data extraction, and risk of bias assessment were conducted in duplicate. Six-hundred thirty-one articles were screened, and 14 were included in the review. Three studies that assessed serum BDNF levels in individuals with suicide attempts and controls were combined in a meta-analysis that showed no significant association between serum BDNF and suicide attempts. The remaining 11 studies were not eligible for the meta-analysis and provided inconsistent findings regarding associations between BDNF and suicidal behaviour. The findings of the meta-analysis indicate that there is no significant association between serum BDNF and attempted suicide. The qualitative review of the literature did not provide consistent support for an association between BDNF levels and suicidal behaviour. The evidence has significant methodological limitations. PROSPERO CRD42015015871.

[Trends in suicidal behaviour in Dutch general practice, 1983-2013].

PubMed

de Beurs, D P; Hooiveld, M; Kerkhof, A J F M; Korevaar, J C; Donker, G A

2016-01-01

We investigated trends in suicidal behaviour as reported by Dutch general practices from 1983 to 2013. Also, we analysed the relationship with patient characteristics and with the financial crisis of 2008. Retrospective observational study. We estimated age-adjusted and gender-specific trends in suicides (342) and attempted suicides (1614), as registered in 1983-2013 under ICPC code P77 by 40 Dutch general practices participating in the NIVEL Primary Care Database sentinel station. Secondary outcomes, on the basis of supplementary questions in the GP Information System (Huisartsen Informatie Systeem), were the relationship between suicidal behaviour, earlier treatments and patient characteristics. Also, we analysed separate frequencies for the periods 1983-2007 and 2008-2013. Join-point analyses revealed a significant rise in male suicides from 2008 (b = 0.32, SE = 0.1, p = 0.008), and an increase in male suicide attempts since 2009 (b = 0.19, SE = 0.04, p < 0.001). Female suicidal behaviour showed a steady decrease in 1989-2013: b = -0.03, SE = 0.007, p < 0.0001 for female suicide, b = -0.02, SE = 0.002, p < 0.001 for female attempts. Almost half of the suicidal patients had visited their GP one month before the event. In 31% of these patients, the GP had recognized suicidal behaviour. Since 2008, there was a rise in the male suicide rate while female suicide behaviour has continued to decline. Training in the early recognition of suicide ideation in depressive patients might improve suicide prevention in primary care.

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

Disentangling depression and anxiety in relation to neuroticism, extraversion, suicide, and self-harm among adult psychiatric inpatients with serious mental illness.

PubMed

Subica, Andrew M; Allen, Jon G; Frueh, B Christopher; Elhai, Jon D; Fowler, J Christopher

2016-11-01

Little is known about depression-anxiety comorbidity and its association with personality traits and suicide/self-harm in adult psychiatric inpatients with serious mental illness (SMI), impacting clinical assessment and treatment. This study sought to determine the symptom structure of depression-anxiety comorbidity and its relation to neuroticism, extraversion, and suicide/self-harm behaviour in this high-risk population. Nine hundred and sixty-two adults receiving inpatient care at a private psychiatric hospital completed questionnaires at admission. Confirmatory factor analyses compared a bifactor solution specifying a general distress factor and two specific depression and anxiety factors against unidimensional and correlated factors solutions. The bifactor solutions' factors were subsequently correlated with neuroticism and extraversion subscales and pre-hospitalization suicide/self-harm behaviours. The bifactor model rendered superior fit to sample data and a robust general factor - accounting for 77.61% of common item variance - providing the first evidence for a tripartite structure of depression and anxiety among adult inpatients. The bifactor solution-outputted independent general distress, depression, and anxiety factors positively correlated with neuroticism, the personality dimension corresponding to trait negative affectivity. The general distress and depression factors associated with recent self-harm, but factors showed no associations with prior suicidal behaviour. In adult psychiatric inpatients, general distress substantially underlies comorbid depression and anxiety symptom variation and may contribute to recent incidence of self-harm. Transdiagnostic assessments and interventions targeting general distress may temper depression, anxiety, and self-harm in adult inpatients. Clinical implications Depression-anxiety comorbidity symptomology in adult psychiatric inpatients is primarily composed of general distress. General distress and specific depression are associated with recent self-harm but not suicidal behaviour. Assessing and treating general distress rather than depression or anxiety specifically may best mitigate comorbid depression and anxiety, and reduce self-harm behaviour in this clinical population. Cautions and limitations The large sample lacked ethnocultural diversity, and data were cross-sectional. The use of brief self-report measures to assess depression and anxiety may have reduced measurement range. © 2015 The British Psychological Society.

Non-fatal suicidal behaviour in rural Ethiopia: a cross-sectional facility- and population-based study.

PubMed

Fekadu, Abebaw; Medhin, Girmay; Selamu, Medhin; Shiferaw, Tsion; Hailemariam, Maji; Rathod, Sujit D; Jordans, Mark; Teferra, Solomon; Lund, Crick; Breuer, Erica; Prince, Martin; Giorgis, Tedla W; Alem, Atalay; Hanlon, Charlotte

2016-03-22

Injury related to self-harm is one of the leading causes of global disease burden. As a formative work for a programme to implement comprehensive mental healthcare in a rural district in Ethiopia, we determined the 12-month prevalence of non-fatal suicidal behaviour as well as factors associated with this behaviour to understand the potential burden of the behaviour in the district. Population-based (n = 1485) and facility-based (n = 1014) cross-sectional surveys of adults, using standardised, interview-based measures for suicidality (items on suicide from the Composite International Diagnostic Interview), depressive symptoms (the Patient Health Questionnaire) and alcohol use disorders (Alcohol Use Disorder Investigation Test; AUDIT). The overall 12-month prevalence of non-fatal suicidal behaviour, consisting of suicidal ideation, plan and attempt, was 7.9 % (95 % Confidence Interval (CI) = 6.8 % to 8.9 %). The prevalence was significantly higher in the facility sample (10.3 %) compared with the community sample (6.3 %). The 12-month prevalence of suicide attempt was 4.4 % (95 % CI = 3.6 % to 5.3 %), non-significantly higher among the facility sample (5.4 %) compared with the community sample (3.8 %). Over half of those with suicidal ideation (56.4 %) transitioned from suicidal ideation to suicide attempt. Younger age, harmful use of alcohol and higher depression scores were associated significantly with increased non-fatal suicidal behaviours. The only factor associated with transition from suicidal ideation to suicide attempt was high depression score. Only 10.5 % of the sample with suicidal ideation had received any treatment for their suicidal behaviour: 10.8 % of the community sample and 10.2 % of the facility sample. Although help seeking increased with progression from ideation to attempt, there was no statistically significant difference between the groups. Non-fatal suicidal behaviour is an important public health problem in this rural district. A more in-depth understanding of the context of the occurrence of the behaviour, improving access to care and targeting depression and alcohol use disorder are important next steps. The role of other psychosocial factors should also be explored to assist the provision of holistic care.

The meanings of suicidal behaviour to psychology students in Ghana: a qualitative approach.

PubMed

Osafo, Joseph; Hjelmeland, Heidi; Akotia, Charity S; Knizek, Birthe Loa

2011-11-01

The objective of this study was to examine psychology students' attitudes toward suicidal behaviour and the meanings they assign to the act. In-depth interviews were conducted with 15 final year psychology students at a university in Ghana. Interpretative Phenomenological Analysis (IPA) was used to analyze the data. The results indicated that the students had a generalized negative attitude toward suicide. Religious beliefs and family harmony are cultural contexts influencing the interpretation of suicidal behaviour as breach of divine and communal moralities. The implications of these meanings of suicidal behaviour for suicide prevention in Ghana are discussed.

Is introversion a risk factor for suicidal behaviour in depression?

PubMed

Roy, A

1998-11-01

Personality is an important determinant of suicidal behaviour. However, it has been studied little in relation to suicidal behaviour in depression. Depressed patients who had attempted suicide (N = 41) were compared with depressed patients who had never attempted suicide (N = 56) and normal controls (N = 56) for their scores on three personality questionnaires. Introversion was the only personality dimension where the post hoc test showed a different pattern between the two groups of depressed patients in their relation to controls. In particular, only depressed patients who had attempted suicide had significantly lower introversion scores than controls. The personality dimension of introversion may be a risk factor for suicidal behaviour in depression.

[Antidepressants do prevent suicide, at least pending something better...].

PubMed

Courtet, Philippe; Olié, Émilie

2014-01-01

Suicide is a major public health problem worldwide, with about 1.5 million deaths each year France ranks 7th in the EU Patients with depression account for the majority of completed suicides. As most of these individuals are not adequately treated, it is conceivable that better treatment of depression would reduce suicide mortality. However, the last ten years have seen a controversy over a possible suicidogenic effect of antidepressants. Here we summarize data from the different types of studies that have cast a shadow over these drugs which can save lives when used effectively to treat depression. Better knowledge of the pathophysiology of "suicidal behaviour disorder" should identify therapeutic targets for innovative agents capable of preventing suicide.

[Preliminary study of the characteristics of attempted suicide in the province of Granada].

PubMed

Martín, Y Mejías; Caro, M P García; Rio-Valle, J Schmidt; Rufián, A Quero; Sánchez, B Gorlat

2011-01-01

Suicides account for a number of deaths that is higher than other traumatic deaths in Spain. Non-fatal suicidal behaviour occurs in a greater proportion than such behaviour with a deadly outcome. There are many causes for this behaviour and it is important to become familiar with them if it is to be prevented. The aim of this article is to describe the characteristics of non-mortal suicidal behaviour in the province of Granada. A retrospective descriptive study of the characteristics of non-mortal suicidal behaviour in Granada during the years 2008 and 2009, according to the database of the Provincial 061 Service in Granada. The sample includes the demands made to this service in which the literal reason for the alert included the terms: suicide, self-harm or the threat of suicide. The statistical analysis was done with the SPSS 15.0 program. We analyzed the variable non-mortal suicidal behaviour with respect to the independent variables: sex, age, month, day of the week, time slot, health district, resolution of the demand (assigned priority) and further attempts. In total we analyzed 535 demands typified as intentional self-injury by unspecified means. Statistically significant differences were found when comparing the data for the two years with respect to the month chosen, and in the relationship between age range and time slot of the suicide attempts. Despite its limitations, the characterization of suicidal behaviour in our province offers essential information, and could be useful in designing and developing a program of psychosocial intervention for the prevention of suicidal behaviour adjusted to the specific profiles of our population.

Books reconsidered: Emile Durkheim, Le Suicide.

PubMed

Robertson, Michael

2006-12-01

To reappraise Emile Durkheim's taxonomy of suicide in Le Suicide in the light of recent experience. While Durkheim's scientific method and argument are fundamentally flawed, some of his concepts have instrumental value in attempting to understand the complex origins of suicidal behaviour. Durkheim's baseless dismissal of mental illness as a key determinant of suicidal behaviour weakens his thesis significantly. However, his conceptualization of anomic, egoistic and altruistic suicide provides a means of comprehending recent trends in suicidal behaviour in the former Soviet states and a possible window into the psyche of the suicides of religious and political extremists.

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.

Total sleep time as a predictor of suicidal behaviour.

PubMed

Michaels, Matthew S; Balthrop, Tia; Nadorff, Michael R; Joiner, Thomas E

2017-12-01

Insomnia symptoms are a known predictor of suicide; however, less is known about the relationship between hypersomnia and suicide, and how total sleep time may better account for suicidal ideation compared with subjective reports of insomnia symptoms. In the present secondary data analysis, a squared term confirmed the importance of both short and long total sleep time on suicidal behaviour. Total sleep time had a significant positive direct effect on suicidal behaviour (b = 0.20, SE = 0.08, P < 0.05), significant negative direct effects on insomnia symptoms (b = -1.67, SE = 0.13, P < 0.0001) and on depressive symptoms (b = -1.76, SE = 0.29, P < 0.0001). Depression had a significant positive effect on suicidal behaviour (b = 0.17, SE = 0.01, P < 0.0001), and significantly mediated the relationship between total sleep time and suicidal behaviour, but insomnia symptoms did not. Total sleep time squared had a significant positive relationship with suicidal behaviour (b = 0.02, SE = 0.01, P < 0.05), significant negative direct effects on insomnia symptoms (b = -0.12, SE = 0.01, P < 0.0001) and on depressive symptoms (b = -0.12, SE = 0.02, P < 0.0001). Depression had a significant positive effect on suicidal behaviour (b = 0.17, SE = 0.01, P < 0.0001), and significantly mediated the relationship between total sleep time and suicidal behaviour. These results suggest the importance of assessing for total sleep time in clinical settings with regard to suicide risk. © 2017 European Sleep Research Society.

[Recognition, care and prevention of suicidal behaviour in adults].

PubMed

Rihmer, Zoltán; Németh, Attila; Kurimay, Tamás; Perczel-Forintos, Dóra; Purebl, György; Döme, Péter

2017-01-01

Suicide is a major public health problem everywhere in the world and in the WHO European Region suicide accounts for over 120,000 deaths per year. 1. Recognition and diagnosis: An underlying psychiatric disorder is present in up to 90% of people who completed suicide. Comorbidity with depression, anxiety, substance abuse and personality disorders is high. In order to achieve successful prevention of suicidality, adequate diagnostic procedures and appropriate treatment for the underlying disorder are essential. 2. Treatment and care: Acute intervention should start immediately in order to keep the patient alive. Existing evidence supports the efficacy of pharmacological treatment and cognitive behavioural therapy (including dialectical behavior therapy and problem-solving therapy) in preventing suicidal behaviour. Some other psychological treatments are promising, but the supporting evidence is currently insufficient. Studies show that antidepressant and mood stabilizer treatments decrease the risk for suicidality among responders in mood disorder patients. However, the risk of suicidal behaviour in depressed patients treated with antidepressants exists during the first 10-14 days of treatment, which requires careful monitoring. Short-term supplementary medication with anxiolytics and hypnotics in the case of anxiety and insomnia is recommended. Treatment with antidepressants of children and adolescents should only be given under supervision of a specialist. Long-term treatment with lithium has been shown to be very effective in preventing both suicide and attempted suicide in patients with unipolar and bipolar depression. Treatment with clozapine is effective in reducing suicidal behaviour in patients with schizophrenia. Other atypical antipsychotics are promising but more evidence is required. 3. Family and social support: The suicidal person should always be motivated to involve family in the treatment. Psychosocial treatment and support is recommended, as the majority of suicidal patients have problems with relationships, work, school and lack functioning social networks. 4. A secure home, public and hospital environment, without access to suicidal means is a necessary strategy in suicide prevention. Each treatment option, prescription of medication and discharge of the patient from hospital should be carefully evaluated against the involved risks. 5. Education of treatment team: Training of general practitioners is effective in the prevention of suicide. It improves treatment of depression and anxiety, quality of the provided care and attitudes towards suicide. Continuous training including discussions about ethical and legal issues is necessary for psychiatrists and other mental health professionals. Multidisciplinary treatment teams including psychiatrist and other professionals such as psychologist, social worker, and occupational therapist are always preferable, as integration of pharmacological, psychological and social rehabilitation is recommended especially for patients with chronic suicidality. 6. Public aspects: Not only the health care workers are responsible for suicide prevention. All members of our society (including community/political leaders as well as religious and civil organizations) have their own task with more or less competence and responsibility.

Lifetime mental disorders and suicidal behaviour in South Africa.

PubMed

Khasakhala, L; Sorsdahl, K R; Harder, V S; Williams, D R; Stein, D J; Ndetei, D M

2011-05-01

There is relatively little data on the relationship between lifetime mental disorders and suicidal behaviour in low and middle income countries. This study examines the relationship between lifetime mental disorders, and subsequent suicide ideation, plans, and suicide attempts in South Africa. A national survey of 4185 South African adults was conducted using the World Health Organization Composite International Diagnostic Interview (CIDI) to generate psychiatric diagnoses and suicidal behaviour. Bivariate, multivariate and discrete-time survival analyses were employed to investigate the associations between mental disorders and subsequent suicide ideation, plans, and attempts. Sixty-one percent of people who seriously considered killing themselves at some point in their lifetime reported having a prior DSM-IV disorder. Mental disorders predict the onset of suicidal ideation, but have weaker effects in predicting suicide plans or attempts. After controlling for comorbid mental disorders, PTSD was the strongest predictor of suicidal ideation and attempts. There is a relationship between number of mental disorders and suicidal behaviour, with comorbidity having significantly sub-additive effects. Consistent with data from the developed world, mental disorders are strong predictors of suicidal behaviour, and these associations are more often explained by the prediction of ideation, rather than the prediction of attempts amongst ideators. This suggests some universality of the relevant mechanisms underlying the genesis of suicidal thoughts, and the progression to suicide attempts.

ASSOCIATIONS BETWEEN TRAUMATIC EVENTS AND SUICIDAL BEHAVIOUR IN SOUTH AFRICA

PubMed Central

Sorsdahl, Katherine; Stein, Dan J.; Williams, David R.; Nock, Matthew K.

2011-01-01

Research conducted predominantly in the developed world suggests that there is an association between trauma exposure and suicidal behaviour. However, there are limited data available investigating whether specific traumas are uniquely predictive of suicidal behaviour, or the extent to which traumatic events predict the progression from suicide ideation to plans and attempts. A national survey was conducted with 4351 adult South Africans between 2002 and 2004 as part of the WHO World Mental Health Surveys. Data on trauma exposure and subsequent suicidal behaviour were collected. Bivariate and multivariate survival models tested the relationship between the type and number of traumatic events and lifetime suicidal behaviour. A range of traumatic events are associated with lifetime suicide ideation and attempt; however, after controlling for all traumatic events in a multivariate model, only sexual violence (OR=4.7, CI 2.3-9.4) and having witnessed violence (OR=1.8, 1.1-2.9) remained significant predictors of life-time suicide attempts. Disaggregation of the associations between traumatic events and suicide attempts indicates that they are largely due to traumatic events predicting suicide ideation rather than to the progression from suicide ideation to attempt. This paper highlights the importance of traumatic life events in the occurrence of suicidal thoughts and behaviours and provides important information about the nature of this association. Future research is needed to better understand how and why such experiences increase the risk of suicidal outcomes. PMID:22134450

Suicidal tendencies and attitude towards freedom to choose suicide among Lithuanian schoolchildren: results from three cross-sectional studies in 1994, 1998, and 2002.

PubMed

Zemaitiene, Nida; Zaborskis, Apolinaras

2005-08-11

Suicidal behaviour is increasingly becoming a phenomenon associated with young people and an important public health issue in Lithuania. However, there are very few studies evaluating impact of young peoples' attitudes towards suicide to their suicidal behaviour. A better understanding of the relations among the variables associated with suicidal ideation and threats in the normal population of adolescents may eventually result in a better understanding of the more serious forms of adolescent suicidal behaviour. The aim of the present study was to evaluate prevalence of suicidal tendencies among Lithuanian schoolchildren and to estimate its association with an attitude towards suicide in 1994-2002. Three country representative samples of schoolchildren, aged 11, 13 and 15, were surveyed in 1994 (n = 5,428), 1998 (n = 4,513), and 2002 (n = 5,645) anonymously in conformity with the methodology of the World Health Organization Cross--National study on Health Behaviour in School-aged Children (HBSC). About one third of respondents reported about suicidal ideation, plans or attempts to commit suicide. In the study period of eight years, the percentage of adolescents who reported sometime suicidal ideation decreased but the percentage of adolescents who declared serious suicidal behaviour remained on the same high level (8.1%, 9.8% and 8.4% correspondingly in 1994, 1998 and 2002). Moreover, the number of suicidal attempts changed from 1.0% in 1994 to 1.8% in the year 1998 and to 1,7% in the year 2002. The schoolchildren's attitude towards suicide became more agreeable: 36.6%, 41.9% and 62.5% of respondents, correspondingly in 1994, 1998 and 2002, answered that they agree with a person's freedom to make a choice between life and suicide. A multiple logistic regression analysis with low level of suicidality and high level of suicidality versus non suicidal behaviour as dependent variables for gender, age, year of the survey and attitude towards freedom to choose suicide as independent variables approved a significant association between studied covariates over the entire study period. Suicidal tendencies are quite frequent among Lithuanian adolescents. An increasing number of schoolchildren are expressing an agreeable attitude towards suicide. The approving attitude towards suicide among adolescents correlates with suicidal ideation and behaviour.

Seasonal variation of seclusion incidents from violent and suicidal acts in forensic psychiatric patients.

PubMed

Paavola, Paula; Tiihonen, Jari

2010-01-01

A seasonal variation in violence and suicidal behaviour has been reported in several studies with partially congruent results. Most of forensic psychiatric patients have a history of severe violent behaviour that often continues in spite of regular treatment. In the forensic psychiatric hospital environment aggressive and suicidal acts are often sudden and unpredictable. For reasons of safety, rapid and intensive coercive measures, such as seclusion and restraint, are necessary in the treatment of such patients. To examine whether these involuntary seclusions have a seasonal pattern, possibly similar than the reported seasonal variation in violence and suicidal behaviour. By investigating the possibility of a seasonal variation of seclusion incidents from violent and suicidal acts, it may become possible to improve the management of forensic psychiatric patients. The hospital files of all secluded patients at Niuvanniemi Hospital from 1 January 1996 to 31 December 2002 were examined. In total, 385 patients (324 male and 61 female) were identified as being secluded at least once in 1930 different incidents (1476 from male and 454 from female patients). Seasonal decomposition and linear regression with dummy month variables were used to examine the possibility of annual variations for seclusions. The seasonal variation of involuntary seclusion incidents was statistically significant. According to the linear regression model, most of the seclusion incidents, affecting many different patients, began in July and August, and were concentrated throughout the fall until November. The sum of all seclusion days was lowest in January and highest between July and November (difference +31% to +37%). These findings are mainly in agreement with results from other studies on seasonal variation and violent behaviour. The allocation of staff for late summer and fall might enhance the management of forensic psychiatric patients, thus leading to possible decreases in seclusion incidents. The factors affecting violent, aggressive and suicidal behaviours are complex and more investigation is needed to understand, identify, intervene and effectively reduce such behaviours. Copyright 2009. Published by Elsevier Ltd.

The development of a screening tool for the early identification of risk for suicidal behaviour among students in a developing country

PubMed Central

Vawda, Naseema B. M.; Milburn, Norweeta G.; Steyn, Renier; Zhang, Muyu

2016-01-01

Objective Adolescent suicidal behaviour is a public health concern in South Africa. The purpose of this manuscript is to report on the development of a screening tool for teachers to identify South African students who are most at risk for suicidal behaviour. This need is addressed within the context of the limited number of mental health professionals available to provide screening and care services in South Africa. Method Grade 8 students participated by completing sociodemographic questionnaires and self-report psychometric instruments. A screening tool for suicidal behaviour was developed using a four phase approach. Results Twelve factors for high risk suicidal behaviour were identified and included in the screening tool. While further research is needed to validate the screening tool, the findings provide a useful preliminary starting point for teachers to refer students at high risk for suicidal behaviour to mental health services for treatment. Conclusion This screening tool is based on factors that were identified as being associated with suicidal behaviour from local research on South African adolescents. The tool contributes to research on adolescent mental health, particularly suicidal behaviour, in developing low and middle income countries like South Africa, with the aim of creating African prevention and intervention programmes. PMID:28459269

Staff experiences and perceptions of working with in-patients who are suicidal: qualitative analysis

PubMed Central

Awenat, Yvonne; Peters, Sarah; Shaw-Nunez, Emma; Gooding, Patricia; Pratt, Daniel; Haddock, Gillian

2017-01-01

Background Suicidal behaviour is frequent in psychiatric in-patients and much staff time and resources are devoted to assessing and managing suicide risk. However, little is known about staff experiences of working with in-patients who are suicidal. Aims To investigate staff experiences of working with in-patients who are suicidal. Method Qualitative study guided by thematic analysis of semi-structured interviews with mental health staff with experience of psychiatric in-patient care. Results Twenty staff participated. All had encountered in-patient suicide deaths or attempts. Three key themes were identified: (a) experiences of suicidality, (b) conceptualising suicidality and (c) talking about suicide. Conclusions Suicidal behaviour in psychiatric wards has a large impact on staff feelings, practice and behaviour. Staff felt inadequately equipped to deal with such behaviours, with detrimental consequences for patients and themselves. Organisational support is lacking. Training and support should extend beyond risk assessment to improving staff skills in developing therapeutic interactions with in-patients who are suicidal. PMID:28642259

The meaning of suicidal behaviour from the perspective of senior nursing undergraduate students.

PubMed

Vedana, Kelly G G; Pereira, Camila C M; Dos Santos, José Carlos; Ventura, Carla; Moraes, Sabrina M; Miasso, Adriana I; Zanetti, Ana Carolina G; Borges, Tatiana L

2018-06-01

The meaning ascribed to suicidal behaviours may influence the quality of the care provided to people at risk of suicide. Such a phenomenon has yet to be properly investigated amongst nursing undergraduate students, the aim of this study being to gain an understanding of the meanings of suicidal behaviour for a particular group of nurses. The study, which utilized grounded theory, was conducted in Brazil in 2016-2017 with 30 undergraduate students. The findings indicated that suicidal behaviour, classified according to the individual beliefs and judgements of the participants, presented a significant barrier to the delivery of care and was complex and multifaceted care phenomenon. Participants were often reluctant to discuss the topic, seemingly wanting to distance themselves from the care of persons exhibiting suicidal behaviour, and to avoid professional engagements relating to suicide prevention. Significant work is required in raising both an awareness and knowledge of suicidal behaviour befitting the promotion of tolerance, emotional competency, resilience, and empathy amongst nursing students. © 2017 Australian College of Mental Health Nurses Inc.

Risk of non-fatal suicide ideation and behaviour in recent onset schizophrenia--the influence of clinical, social, self-esteem and demographic factors.

PubMed

Tarrier, Nicholas; Barrowclough, Christine; Andrews, Bernice; Gregg, Lynsey

2004-11-01

Suicide rates amongst schizophrenic patients are high. There are disadvantages in investigating successfully completed suicides which make suicidal ideation and previous attempts important proxy measures of suicidal risk. The aim of this study was to investigate factors associated with these risk measures. Fifty-nine patients suffering recent onset schizophrenia were assessed for suicidal ideation and history, and a range of demographic, clinical, social (including relatives' Expressed Emotion) and self-esteem measures. Univariate comparisons were made between those with and without suicide ideation and previous attempts. Path analysis was conducted to identify factors directly or indirectly associated with a composite scale of risk (low, medium or high). Approximately 25% of the sample reported a current desire to kill themselves and 47% had made one or more previous attempts. There were numerous significant univariate differences between those with or without ideation or history. Path analysis indicated that greater hopelessness (OR 1.22) and longer duration of illness (OR 1.13) increased risk. Hopelessness was associated with higher negative self-evaluation and social isolation. Negative self-evaluation was associated with more relatives' criticism which was associated with more negative symptoms. Being a male, unmarried and unemployed were all significantly associated with an increase in negative symptoms. Social isolation was associated with being unemployed, older, more positive symptoms and longer illness duration. Duration of illness was not itself predicted by any other variables. Non-fatal suicide ideation and behaviour are significantly associated with an array of demographic, clinical, interpersonal and psychological factors. To reduce risk of suicide, these factors need to be assessed and methods developed to reduce their influence.

"We Went Out to Explore, But Gained Nothing But Illness": Immigration Expectations, Reality, Risk and Resilience in Chinese-Canadian Women with a History of Suicide-Related Behaviour.

PubMed

Zaheer, Juveria; Eynan, Rahel; Lam, June S H; Grundland, Michael; Links, Paul S

2018-01-30

Suicide is a complex and tragic outcome driven by biological, psychological, social and cultural factors. Women of Chinese descent and women who have immigrated to other countries have higher rates of suicidal ideation and behaviour, and immigration-related stress may contribute. To understand the experiences of immigration and their relationship with distress and suicide-related behaviour in Chinese women who have immigrated to Canada. 10 semi-structured qualitative interviews with Chinese women who have immigrated to Toronto, Canada and have a history of suicide-related behaviour were completed and analyzed using a constructivist grounded theory methodology. Immigration-related and acculturation stress stemmed from unmet expectations and harsh realities. These repeated experiences resulted in hopelessness, helplessness, and alienation, which are risk factors for suicide and suicide-related behaviour. However, immigration-related support can also increase hope, self-efficacy and connectedness to foster recovery and resilience. This is the first qualitative study focusing on immigration experiences and its relationship to suicide-related behaviour in Chinese immigrant women. Knowledge of immigration and acculturation stressors can a) help identify and support women at risk for suicide and b) form a target for social intervention for all immigrant women, regardless of suicide risk.

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.

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.

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.

Trends from the surveillance of suicidal behaviour by the Belgian Network of Sentinel General Practices over two decades: a retrospective observational study.

PubMed

Boffin, Nicole; Moreels, Sarah; Van Casteren, Viviane

2015-11-27

First, we describe trends in characteristics of suicidal events using new (2011-2012) and previous (1993-1995, 2000-2001 and 2007-2008) data reported by the Belgian Network of Sentinel General Practices (SGP); second, we examine patient age-related trends in on-site attendance of sentinel general practitioners (GPs) as first professional caregivers following suicidal behaviour; third, we investigate the accuracy of suicide incidence estimates derived from the SGP data. Retrospective observational study. General practices from the nationwide representative Belgian Network of SGP. Patient gender and age, suicide methods, whether the patient was new, whether the GP was the first caregiver on-site, and the outcome of the suicidal behaviour (fatal or not) were recorded on standard registration forms. The accuracy of suicide incidence estimates was tested against suicide mortality data. Over the four time periods, 1671 suicidal events were reported: 275 suicides, 1287 suicide attempts and 109 events of suicidal behaviour of unknown outcome. In 2011-2012, sentinel GPs' on-site attendance following the suicidal behaviour of patients <65 years had continued to decrease (from 71% in 1993-1995 to 58% in 2000-2001, 39% in 2007-2008 and 25% in 2011-2012). In 2011-2012, it had also decreased steeply in the population ≥65 years (from 70% in 1993-1995, 76% in 2000-2001 and 79% in 2007-2008 to 35% in 2011-2012). No significant differences were found between the SGP-based suicide incidence estimates for 2011-2012 and the available suicide mortality rates for people <65 and ≥65 years. GPs' on-site attendance as first professional caregivers following suicidal behaviour continues to decline since 2011-2012 also in the population ≥65 years. Unawareness of patients' suicidal behaviour endangers both care for surviving patients and the completeness of SGP surveillance data. Yet, the incidence of suicide for 2011-2012 was estimated accurately by the SGP. 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/

Suicide in India.

PubMed

Aggarwal, Shilpa

2015-06-01

The current report reviews the data from the series Accidental Death and Suicide in India published by India's National Crime Records Bureau (NCRB) reporting official suicide rates based on police reports over the period of 10 years from 2004 to 2013. A reference to wider literature is made to present a comprehensive picture. Suicide in India is more prevalent in young, is likely to involve hanging and ingestion of pesticides and is related to social and economic causes. Reducing alcohol consumption, unemployment, poverty, social inequities, domestic violence and improving social justice are essential to reduce suicide in India. NCRB data might underreport suicide. Discrepancy in farmers' suicide rate between reports suggests that this might be overrepresented in NCRB data. An integrated suicide prevention programme with a multidimensional approach is needed. Mental health care bill and the recent launch of first national mental health policy are welcome measures. Decriminalization of suicide is likely to positively influence mental health practice and policy in India. Nationally representative studies investigating fatal and non-fatal suicidal behaviours, evaluation of models of service delivery for the vulnerable population, investigating suicide following different treatment services and effects of decriminalization of suicide on suicide rates should be the focus of future research. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Impact of some types of mass gatherings on current suicide risk in an urban population: statistical and negative binominal regression analysis of time series.

PubMed

Usenko, Vasiliy S; Svirin, Sergey N; Shchekaturov, Yan N; Ponarin, Eduard D

2014-04-04

Many studies have investigated the impact of a wide range of social events on suicide-related behaviour. However, these studies have predominantly examined national events. The aim of this study is to provide a statistical evaluation of the relationship between mass gatherings in some relatively small urban sub-populations and the general suicide rates of a major city. The data were gathered in the Ukrainian city of Dnipropetrovsk, with a population of 1 million people, in 2005-2010. Suicide attempts, suicides, and the total amount of suicide-related behaviours were registered daily for each sex. Bivariate and multivariate statistical analysis, including negative binomial regression, were applied to assess the risk of suicide-related behaviour in the city's general population for 7 days before and after 427 mass gatherings, such as concerts, football games, and non-regular mass events organized by the Orthodox Church and new religious movements. The bivariate and multivariate statistical analyses found significant changes in some suicide-related behaviour rates in the city's population after certain kinds of mass gatherings. In particular, we observed an increased relative risk (RR) of male suicide-related behaviour after a home defeat of the local football team (RR = 1.32, p = 0.047; regression coefficient beta = 0.371, p = 0.002), and an increased risk of male suicides (RR = 1.29, p = 0.006; beta =0.255, p = 0.002), male suicide-related behaviour (RR = 1.25, p = 0.019; beta =0.251, p < 0.001), and total suicide-related behaviour (RR = 1.23 p < 0.001; beta =0.187, p < 0.001) after events organized by the new religious movements. Although football games and mass events organized by new religious movements involved a relatively small part of an urban population (1.6 and 0.3%, respectively), we observed a significant increase of the some suicide-related behaviour rates in the whole population. It is likely that the observed effect on suicide-related behaviour is related to one's personal presence at the event rather than to its broadcast. Our findings can be explained largely in terms of Gabennesch's theory of the 'broken-promises effect' with regard to intra- and interpersonal conflict and, in terms of crowd behaviour effects.

Influence of Sex on Suicidal Phenotypes in Affective Disorder Patients with Traumatic Childhood Experiences

PubMed Central

Carlberg, Laura; Swoboda, Patrick; Ludwig, Birgit; Koller, Romina; Kapusta, Nestor D.; Aigner, Martin; Haslacher, Helmuth; Schmöger, Michaela; Kasper, Siegfried; Schosser, Alexandra

2015-01-01

Objectives In the current study, we aimed to investigate the impact of childhood trauma on suicidal behaviour phenotypes in a group of patients with diagnosed affective disorder (unipolar or bipolar affective disorder). Patients and Methods Patients with and without a history of childhood abuse, measured by Childhood Trauma Questionnaire (CTQ), were assessed to explore risks for suicidal behaviour (including suicide attempt, self-harm and non-suicidal self-injury). The tested sample consisted of 258 patients (111 males and 147 females, in-patients and out-patients at the Department of Psychiatry and Psychotherapy, Medical University of Vienna and University Hospital Tulln, Lower Austria). Psychiatric diagnoses were derived from the SCAN (Schedules for Clinical Assessment in Neuropsychiatry) interview. In addition, patients were administered the Lifetime Parasuicidal Count (LPC), Suicidal Behaviour Questionnaire (SBQ-R), and Viennese Suicide Risk Assessment Scale (VISURIAS) questionnaires. Results In contrast to male suicide attempters, female suicide attempters showed both significantly higher total CTQ scores (p<0.001), and higher CTQ subscores (emotional, physical and sexual abuse, as well as emotional and physical neglect) in comparison to the non-suicidal control group. Besides, females with a history of self-harming behaviour (including suicidal intention) and Non-Suicidal-Self Injury (NSSI) had significantly higher CTQ total scores (p<0.001) than the control group. Conclusion These findings suggest gender differences in suicidal behaviour after being exposed to childhood trauma. PMID:26366559

Suicidal behaviour and psychosocial problems in veterinary surgeons: a systematic review.

PubMed

Platt, Belinda; Hawton, Keith; Simkin, Sue; Mellanby, Richard J

2012-02-01

Rates of suicide are elevated among veterinary surgeons in several countries, yet little is known about contributory factors. We have conducted a systematic review of studies investigating suicidal behaviour and psychosocial problems in veterinary surgeons. A systematic search of the international research literature was performed in May 2008. Data from 52 studies of non-fatal suicidal behaviour, mental health difficulties, stress and burnout, occupational difficulties, and psychological characteristics of veterinary surgeons were extracted by two independent reviewers and analysed. Studies were rated for quality and greater emphasis placed on findings from higher quality studies. The majority of studies were of stress and occupational difficulties experienced by veterinary surgeons. Occupational stressors included managerial aspects of the job, long working hours, heavy workload, poor work-life balance, difficult client relations, and performing euthanasia. Few studies investigated suicidal behaviour or mental health difficulties in the profession. Some studies suggested that young and female veterinarians are at greatest risk of negative outcomes such as suicidal thoughts, mental health difficulties, and job dissatisfaction. The review highlights the difficulties faced by veterinary surgeons that may contribute to poor mental wellbeing and suicidal behaviour. Future research might include further examination of the influence of euthanasia on attitudes towards suicide and more direct examination of the impact that occupational risk factors might have on suicidal behaviour. Suggestions about the review's implications for suicide prevention in this group are also made.

Suicide and the selfish gene.

PubMed

Satora, Leszek

2005-01-01

The application of an evolutionary perspective to human behaviour generates philosophical, political and scientific controversy. Modern human symbolic consciousness is not the cumulation of the long trend that natural selection would predict. The new archaeological data suggested the anatomical and behavioural innovation has been episodic and rare separated by long periods of stagnate. New behavioural mode and the new skeletal structure of modem human arose as an incidental exaptation. Additionally the genetic basis dysfunction connected with suicide behaviour and growing statistic suicide among teenager is contradictory to the theory that our behaviour are programmed in any detail by selfish genes. In this cases genetically determined suicidal behaviour should be rapidly eliminated by natural selection.

Genetic Vulnerability as a Distal Risk Factor for Suicidal Behaviour: Historical Perspective and Current Knowledge

PubMed Central

ANDRIESSEN, Karl; VIDETIC-PASKA, Alja

2015-01-01

Introduction Suicide is a multidimensional problem. Observations of family history of suicide suggest the existence of a genetic vulnerability to suicidal behaviour. Aim Starting with a historical perspective, the article reviews current knowledge of a genetic vulnerability to suicidal behaviour, distinct from the genetic vulnerability to psychiatric disorders, focused on clinical and population-based studies, and findings from recent molecular genetics association studies. Method The review includes peer-reviewed research articles and review papers from the professional literature in English language, retrieved from PubMed/Medline and PsycINFO. Results The research literature confirms a existence of a genetic vulnerability to suicidal behaviour. Even though the results of individual studies are difficult to compare, genetic influences could explain up to half of the variance of the occurrence of suicide. Conclusion Genetic vulnerability could be a distal risk factor for suicide, which helps us to understand the occurrence of suicide among vulnerable people. Ethical implications of such vulnerability are highlighted. PMID:27646732

Suicide and related health risk behaviours among school learners in South Africa: results from the 2002 and 2008 national youth risk behaviour surveys

PubMed Central

2013-01-01

Background Attempted and completed suicide constitute a major public health problem among young people world-wide, including South Africa (SA). Suicide attempt and completed suicide increase during the adolescent period. One in 5 adolescents considers attempting suicide, but statistics are frequently unreliable. Methods Data for this study were derived from the 2002 and 2008 South African Youth Risk Behaviour Surveys (YRBS). The study population comprised grades 8, 9, 10 and 11 students in governmental schools in the nine provinces of SA (N = 10,699 in 2002 and 10,270 in 2008). Key outcome measures were suicide ideation and suicide attempts. Results Of the total sample, 18% of the students in 2002 and 19% in 2008 reported to have seriously considered and/or made a plan to commit suicide during the past six months (Suicide ideation), whereas 18.5% of students in 2002 and 21.8% in 2008 reported that they had attempted suicide at least 1 time during the past six months. On both suicide measures girls have higher prevalence scores than boys, and older school learners score higher than younger learners. In addition, 32% of the learners reported feelings of sadness or hopelessness. These feelings contributed significantly to the explanation of suicide ideation and suicide attempt next to being the victim or actor in violent acts and illegal substance use. Conclusion The prevalence of suicide ideation and suicide attempts among South African adolescents is high and seems to be influenced by a wide spectrum of factors at the demographic, psychological and behavioural level. Hence, more research is needed to determine the behavioural and psychological determinants of suicide among youngsters in order to develop comprehensive intervention strategies for suicide prevention and care. PMID:24093214

Suicide and related health risk behaviours among school learners in South Africa: results from the 2002 and 2008 national youth risk behaviour surveys.

PubMed

Shilubane, Hilda N; Ruiter, Robert A C; van den Borne, Bart; Sewpaul, Ronel; James, Shamagonam; Reddy, Priscilla S

2013-10-04

Attempted and completed suicide constitute a major public health problem among young people world-wide, including South Africa (SA). Suicide attempt and completed suicide increase during the adolescent period. One in 5 adolescents considers attempting suicide, but statistics are frequently unreliable. Data for this study were derived from the 2002 and 2008 South African Youth Risk Behaviour Surveys (YRBS). The study population comprised grades 8, 9, 10 and 11 students in governmental schools in the nine provinces of SA (N = 10,699 in 2002 and 10,270 in 2008). Key outcome measures were suicide ideation and suicide attempts. Of the total sample, 18% of the students in 2002 and 19% in 2008 reported to have seriously considered and/or made a plan to commit suicide during the past six months (Suicide ideation), whereas 18.5% of students in 2002 and 21.8% in 2008 reported that they had attempted suicide at least 1 time during the past six months. On both suicide measures girls have higher prevalence scores than boys, and older school learners score higher than younger learners. In addition, 32% of the learners reported feelings of sadness or hopelessness. These feelings contributed significantly to the explanation of suicide ideation and suicide attempt next to being the victim or actor in violent acts and illegal substance use. The prevalence of suicide ideation and suicide attempts among South African adolescents is high and seems to be influenced by a wide spectrum of factors at the demographic, psychological and behavioural level. Hence, more research is needed to determine the behavioural and psychological determinants of suicide among youngsters in order to develop comprehensive intervention strategies for suicide prevention and care.

Effect of exercise augmentation of cognitive behavioural therapy for the treatment of suicidal ideation and depression.

PubMed

Abdollahi, Abbas; LeBouthillier, Daniel M; Najafi, Mahmoud; Asmundson, Gordon J G; Hosseinian, Simin; Shahidi, Shahriar; Carlbring, Per; Kalhori, Atefeh; Sadeghi, Hassan; Jalili, Marzieh

2017-09-01

Suicidal ideation and depression are prevalent and costly conditions that reduce quality of life. This study was designed to determine the efficacy of exercise as an adjunct to cognitive behavioural therapy (CBT) for suicidal ideation and depression among depressed individuals. In a randomized clinical trial, 54 mildly to moderately depressed patients (54% female, mean age=48.25) were assigned to a combined CBT and exercise group or to a CBT only group. Both groups received one weekly session of therapy for 12 weeks, while the combined group also completed exercise three times weekly over the same period. Self-reported suicidal ideation, depression, and activities of daily living were measured at the beginning and the end of treatment. Multilevel modelling revealed greater improvements in suicidal ideation, depression, and activities of daily living in the combined CBT and exercise group, compared to the CBT only group. No follow-up data were collected, so the long-term effects (i.e., maintenance of gains) is unclear. The findings revealed that exercise adjunct to CBT effectively decreases both depressive symptoms and suicidal ideation in mildly to moderately depressed individuals. Copyright © 2017 Elsevier B.V. All rights reserved.

Trauma characteristics, post-traumatic symptoms, psychiatric disorders and suicidal behaviours: Results from the 2007 Australian National Survey of Mental Health and Wellbeing.

PubMed

Afzali, Mohammad H; Sunderland, Matthew; Batterham, Philip J; Carragher, Natacha; Slade, Tim

2017-11-01

The current study examined whether trauma characteristics such as the type and number of traumatic events were associated with three suicidal behaviours (i.e. ideation, plan and attempt) after adjusting for sociodemographic factors, post-traumatic symptoms and history of psychiatric disorders. Data came from the 2007 Australian National Survey of Mental Health and Wellbeing ( N = 8841). Respondents were asked about exposure to 28 traumatic events that occurred during their lifetime. Suicidal behaviours were measured using three statements about whether the person ever seriously thought about or planned or attempted suicide. Sexual violence and exposure to multiple traumatic events were particularly associated with suicidal behaviours. The presence of the emotional numbing symptom cluster and co-occurrence of three psychiatric disorders (major depressive disorder, alcohol use disorder and substance use disorder) also increased the odds of suicidal behaviours. Analysis of age of onset revealed that the mean age of traumatic exposure was earlier than the age at which suicidal behaviours emerged. The current study is the first to demonstrate that sexual violence and exposure to multiple traumatic events are associated with suicidal behaviours in a representative sample of Australian adults. The results underline the potential benefits of thorough assessment of trauma history, post-traumatic symptoms and history of psychiatric disorders and their additive contribution in suicide risk among trauma victims. These findings can be used by clinicians and researchers for early intervention programmes.

Behaviour patterns preceding a railway suicide: Explorative study of German Federal Police officers' experiences

PubMed Central

2011-01-01

Background Constant high-level numbers of railway suicides indicate that prevention strategies against railway suicides are urgently needed. The main question of the present study was whether pre-crash railway suicide behaviour can be identified, using German Federal Police officers experience with suicidal events in railway related environments. Methods To collect information on pre-crash railway suicide behaviour, a questionnaire was used and made available on the German Federal Police intranet. A total of 202 subjects (mean age: 41 years, sex: 84.9% male) were included in the analysis. Multivariate logistic regression analyses were performed to predict the prevention of suicide (first model) or demand for counselling (second model) as outcomes. Sex, age, years of service, number of experienced suicides, suicides personally observed, information on suicides obtained from witnesses and finally either counselling/debriefing (first model) or whether officers had prevented a suicide (second model) were used as predictors. Results A considerable proportion of police officers reported behavioural patterns preceding a suicide. Half of them observed the dropping or leaving behind of personal belongings or the avoidance of eye contact, more than a third erratic gesture, mimic or movement. Erratic communication patterns and general confusion were each reported by about one quarter. One fifth indicated the influence of alcohol. Less frequently observed behaviour was aimlessly wandering (14.3%) and out of the ordinary clothing (4%). About one third of all railway suicide victims committed suicide in stations. Of those, 70% had chosen an eminent spot. The multivariate logistic regression model using prevented suicides as the outcome identified the number of suicides experienced, counselling/debriefing and having personally observed a suicide as variables with significant impact. The model using counselling/debriefing as the outcome identified age and having prevented a suicide as variables with a significant association. Conclusions Our results provide evidence that railway suicides are preceded by identifiable behavioural patterns. This emphasizes the importance of educational efforts, taking into account the knowledge and skills of experienced police officers. PMID:21816069

Association between childhood adversities and long-term suicidality among South Africans from the results of the South African Stress and Health study: a cross-sectional study.

PubMed

Bruwer, Belinda; Govender, Ravi; Bishop, Melanie; Williams, David R; Stein, Dan J; Seedat, Soraya

2014-06-11

Suicide and suicidal behaviours are significant public health problems and a leading cause of death worldwide and in South Africa. We examined the association between childhood adversities and suicidal behaviour over the life course. A national probability sample of 4351 South African adult participants (aged 18 years and older) in the South African Stress and Health (SASH) study was interviewed as part of the World Mental Health Surveys initiative. Respondents provided sociodemographic and diagnostic information, as well as an account of suicide-related thoughts and behaviours. Suicidality or suicidal behaviour were defined as were defined as suicide attempts and suicidal ideation in the total sample, and suicide plans and attempts among ideators. Childhood adversities included physical abuse, sexual abuse, parental death, parental divorce, other parental loss, family violence, physical illness and financial adversity. The association between suicidality and childhood adversities was examined using discrete-time survival models. More than a third of the respondents with suicidal behaviour experienced at least one childhood adversity, with physical abuse, parental death and parental divorce being the most prevalent adversities. Physical abuse, sexual abuse and parental divorce were identified as significant risk markers for lifetime suicide attempts, while physical abuse and parental divorce were significantly correlated with suicidal ideation. Two or more childhood adversities were associated with a twofold higher risk of lifetime suicide attempts. Sexual abuse (OR 9.3), parental divorce (OR 3.1) and childhood physical abuse (OR 2.2) had the strongest associations with lifetime suicide attempts. The effect of childhood adversities on suicidal tendencies varied over the life course. For example, sexual abuse was significantly associated with suicide attempts during childhood and teen years, but not during young and later adulthood. Childhood adversities, especially sexual abuse, physical abuse and parental divorce, are important risk factors for the onset and persistence of suicidal behaviour, with this risk being greatest in childhood and adolescence. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Psychosocial Characteristics and Social Networks of Suicidal Prisoners: Towards a Model of Suicidal Behaviour in Detention

PubMed Central

Rivlin, Adrienne; Hawton, Keith; Marzano, Lisa; Fazel, Seena

2013-01-01

Prisoners are at increased risk of suicide. Investigation of both individual and environmental risk factors may assist in developing suicide prevention policies for prisoners and other high-risk populations. We conducted a matched case-control interview study with 60 male prisoners who had made near-lethal suicide attempts in prison (cases) and 60 male prisoners who had not (controls). We compared levels of depression, hopelessness, self-esteem, impulsivity, aggression, hostility, childhood abuse, life events (including events occurring in prison), social support, and social networks in univariate and multivariate models. A range of psychosocial factors was associated with near-lethal self-harm in prisoners. Compared with controls, cases reported higher levels of depression, hopelessness, impulsivity, and aggression, and lower levels of self-esteem and social support (all p values <0.001). Adverse life events and criminal history factors were also associated with near-lethal self-harm, especially having a prior prison spell and having been bullied in prison, both of which remained significant in multivariate analyses. The findings support a model of suicidal behaviour in prisoners that incorporates imported vulnerability factors, clinical factors, and prison experiences, and underscores their interaction. Strategies to reduce self-harm and suicide in prisoners should include attention to such factors. PMID:23922671

Engaging families in the management of adolescent self-harm.

PubMed

Aggarwal, Shilpa; Patton, George

2018-02-01

Adolescent self-harm is an emerging public health challenge. It is associated with later psychiatric and substance use disorders, unemployment and suicide. Family interventions have been effective in a range of adolescent mental health problems and for that reason were reviewed for their effectiveness in the management of adolescent self-harm. The search identified 10 randomised and 2 non-randomised controlled trial conducted in the high-income countries. For the most part the evidence is of low quality. The interventions were classified as brief single session, intermediate-level and intensive family interventions depending on the intensity and duration of treatment. Brief interventions did not reduce adolescent self-harm. Intermediate interventions such as the Resourceful Adolescent Parent Programme, Safe Alternatives for Teens and Youth Programme and attachment-based family treatment were effective in reducing suicidal behaviour (effect size 0.72), suicide attempts (P=0.01) and suicidal ideations (effect size 0.95), respectively in the short-term with an absence of long-term follow-up data. Intensive adolescent interventions such as dialectical behaviour therapy and mentalisation-based therapy reduced suicidal ideation (effect size 0.89) and self-harm (56% vs 83%, P=0.01), respectively. The persistence of effects beyond the intervention end point is not known in many interventions. Early involvement of the family, an evaluation of the risks at the end of an acute crisis episode and a stepped-care model taking into account level of suicide risk and resources available to an adolescent and her/his family are likely to promote better outcomes in adolescents who self-harm. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Impact of some types of mass gatherings on current suicide risk in an urban population: statistical and negative binominal regression analysis of time series

PubMed Central

2014-01-01

Background Many studies have investigated the impact of a wide range of social events on suicide-related behaviour. However, these studies have predominantly examined national events. The aim of this study is to provide a statistical evaluation of the relationship between mass gatherings in some relatively small urban sub-populations and the general suicide rates of a major city. Methods The data were gathered in the Ukrainian city of Dnipropetrovsk, with a population of 1 million people, in 2005–2010. Suicide attempts, suicides, and the total amount of suicide-related behaviours were registered daily for each sex. Bivariate and multivariate statistical analysis, including negative binomial regression, were applied to assess the risk of suicide-related behaviour in the city’s general population for 7 days before and after 427 mass gatherings, such as concerts, football games, and non-regular mass events organized by the Orthodox Church and new religious movements. Results The bivariate and multivariate statistical analyses found significant changes in some suicide-related behaviour rates in the city’s population after certain kinds of mass gatherings. In particular, we observed an increased relative risk (RR) of male suicide-related behaviour after a home defeat of the local football team (RR = 1.32, p = 0.047; regression coefficient beta = 0.371, p = 0.002), and an increased risk of male suicides (RR = 1.29, p = 0.006; beta =0.255, p = 0.002), male suicide-related behaviour (RR = 1.25, p = 0.019; beta =0.251, p < 0.001), and total suicide-related behaviour (RR = 1.23 p < 0.001; beta =0.187, p < 0.001) after events organized by the new religious movements. Conclusions Although football games and mass events organized by new religious movements involved a relatively small part of an urban population (1.6 and 0.3%, respectively), we observed a significant increase of the some suicide-related behaviour rates in the whole population. It is likely that the observed effect on suicide-related behaviour is related to one’s personal presence at the event rather than to its broadcast. Our findings can be explained largely in terms of Gabennesch’s theory of the ‘broken-promises effect’ with regard to intra- and interpersonal conflict and, in terms of crowd behaviour effects. PMID:24708574

Prevalence and familial predictors of suicidal behaviour among adolescents in Lithuania: a cross-sectional survey 2014.

PubMed

Zaborskis, Apolinaras; Sirvyte, Dainora; Zemaitiene, Nida

2016-07-12

In the past decades Lithuania has been experiencing a very high suicide rate among young people and there are scarce data on the role of the family in shaping these people suicidal behaviour. This study investigated the prevalence of suicidal ideation and attempts, as well as their association with a range of familial factors in a representative sample of Lithuanian adolescents. Study subjects (N = 3572) were adolescents aged 13- and 15-years from the schools in Lithuania who were surveyed in Spring 2014 according to the methodology of the cross-national Health Behaviour in School-aged Children (HBSC). A standard HBSC international questionnaire was translated into Lithuanian and used anonymously to obtain information about suicidal behaviour (stopped doing activities, considered suicide, planned suicide, and suicide attempts) and family life (family structure, quality of communication in family, parental monitoring and bonding, parenting style, family time, etc.). Logistic regression was used to assess association between suicidal behaviours and familial variables. Forty three percents of surveyed adolescents reported presence of emotions that stopped doing activities during the last 12 months, 23.8 % seriously considered attempting suicide, 13.7 % made a suicide plan, 13.2 % attempted suicide, and 4.1 % needed treatment because of suicide attempt in the previous year. Adolescents from non-intact families reported more suicidal ideation (OR ranged from 1.32 to 1.35, P < 0.05) and more suicide attempts (OR = 1.70, 95 % CI 1.38-2.09, P < 0.001). Among adolescents from intact families, some manisfestations of suicidal behaviour were significantly associated with low satisfaction in family relationships, low father's and mother's emotional support, low mother's monitoring, low school-related parental support, authoritarian-repressive father's parenting style and permissive-neglectful mother's parenting style, but rare family time together and rare electronic media communication with parents were inversely associated with suicidal behaviour. The boys, 15-year-olds and adolescents who indicated often activities together with their families were more likely than their counterparts to report suicide attempts treated by a doctor or nurse. The young people of Lithuania are at particular risk for suicides. A non-intact family structure and weak family functioning are significant predictors of suicidal ideation and attempts among adolescents of Lithuania. It is essential to consider family life practices in planning intervention programs for prevention of suicides among adolescents.

Practitioners' experiences of adolescent suicidal behaviour in peer groups.

PubMed

Briggs, S; Slater, T; Bowley, J

2017-06-01

WHAT IS KNOWN ON THE SUBJECT?: Group suicidal behaviour can be devastating for all concerned. There is an absence of research on adolescent suicidal group behaviour. The perspectives of practitioners' experiences of these groups are largely lacking from research literature. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Practitioners work regularly with suicidal behaviour in adolescent peer groups. Practitioners identify peer relationships in groups as complex, including elements that are both suicide encouraging and preventing. Practitioners identify a range of ways in which young people become involved in suicidal behaviour in groups, including indirectly through risk taking and care-seeking as well as directly suicidal or self-harming. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Assessments of young people should routinely include a focus on the qualities of peer relations, including those in the online/digital realm. Assessments and interventions need to consider the complexity of group relationships and roles, and the multiplicity of factors that can contribute to suicidal behaviour in groups. Interventions that sustain therapeutic connectedness are helpful for taking dynamic/fluctuating risks into account. Introduction Group suicidal behaviour by young people can have harmful effects; it may be increasing, influenced by online media and reported increasing self-harm rates; new knowledge and understanding to inform interventions is required. Aim To explore how practitioners experience group suicidal behaviour amongst adolescents, how they assess risks/needs, and how these insights inform understanding about these groups. Method Ten practitioners, including Mental Health Nurses, were interviewed in one multidisciplinary CAMHS, in England. Data analysis was by Thematic Analysis (Braun & Clarke 2006). Results Participants described frequently working with suicidal groups. Roles in groups include suicide encouraging and preventing. Practitioners identify risky and protective connections between young people, online and offline. Clinical tensions include living with suicidal risks, emotional and positional challenges, and getting to grips with digital media. Discussion Peer groups appear to have a larger role in adolescent suicide than recognized to date. Practitioners need to assess young people's roles in groups, their diverse motivations and to understand constantly changing digital media. Implications for practice Assessments of suicide risk for young people should routinely include focus on peer relations including the online/digital realm. Maintaining relationships with vulnerable young people facilitates managing fluctuating risks and understanding different group dynamics. © 2017 John Wiley & Sons Ltd.

Immigration and suicidality in the young.

PubMed

Bursztein Lipsicas, Cendrine; Henrik Mäkinen, Ilkka

2010-05-01

Little research has focused on the relation of immigration and suicidal behaviour in youth. Nevertheless, the impact of migration on the mental health of youth is an issue of increasing societal importance. This review aimed to present studies on the prevalence of suicidal behaviour in immigrant youth in various countries and to provide possible explanations for suicidal behaviour in immigrant youth, especially regarding acculturation. The review included a literature search to locate articles on the subject of suicidal behaviour in immigrant youth in the context of acculturation. Studies on suicidal behaviour in culturally diverse youth are few and most of the existing research does not differentiate ethnic minorities from immigrants. Studies on epidemiology and on specific risk factors were found regarding various immigrant youth including Hispanics in the United States, Asians in North America and Europe, as well as comparative studies between different immigrant groups in specific countries. The relation between immigration status and suicidal behaviours in youth appears to vary by ethnicity and country of settlement. Time spent in the new country as well as intergenerational communication and conflicts with parents have, in many of the studies, been related to suicidality in immigrant youth. Summing up, there is a clear and urgent need to further pursue the work in this field, to develop targeted public health interventions as well as psychosocial treatment for preventing suicide in these youth.

Perception of Mattering and Suicide Ideation in the Australian Working Population: Evidence from a Cross-Sectional Survey.

PubMed

Milner, A; Page, K M; LaMontagne, A D

2016-07-01

Thoughts about suicide are a risk factor for suicide deaths and attempts and are associated with a range of mental health outcomes. While there is considerable knowledge about risk factors for suicide ideation, there is little known about protective factors. The current study sought to understand the role of perceived mattering to others as a protective factor for suicide in a working sample of Australians using a cross-sectional research design. Logistic regression analysis indicated that people with a higher perception that they mattered had lower odds of suicide ideation than those with lower reported mattering, after controlling for psychological distress, demographic and relationship variables. These results indicate the importance of further research and intervention studies on mattering as a lever for reducing suicidality. Understanding more about protective factors for suicide ideation is important as this may prevent future adverse mental health and behavioural outcomes.

A systematic review of physical illness, functional disability, and suicidal behaviour among older adults.

PubMed

Fässberg, Madeleine Mellqvist; Cheung, Gary; Canetto, Silvia Sara; Erlangsen, Annette; Lapierre, Sylvie; Lindner, Reinhard; Draper, Brian; Gallo, Joseph J; Wong, Christine; Wu, Jing; Duberstein, Paul; Wærn, Margda

2016-01-01

To conduct a systematic review of studies that examined associations between physical illness/functional disability and suicidal behaviour (including ideation, nonfatal and fatal suicidal behaviour) among individuals aged 65 and older. Articles published through November 2014 were identified through electronic searches using the ERIC, Google Scholar, PsycINFO, PubMed, and Scopus databases. Search terms used were suicid* or death wishes or deliberate self-harm. Studies about suicidal behaviour in individuals aged 65 and older with physical illness/functional disabilities were included in the review. Sixty-five articles (across 61 independent samples) met inclusion criteria. Results from 59 quantitative studies conducted in four continents suggest that suicidal behaviour is associated with functional disability and numerous specific conditions including malignant diseases, neurological disorders, pain, COPD, liver disease, male genital disorders, and arthritis/arthrosis. Six qualitative studies from three continents contextualized these findings, providing insights into the subjective experiences of suicidal individuals. Implications for interventions and future research are discussed. Functional disability, as well as a number of specific physical illnesses, was shown to be associated with suicidal behaviour in older adults. We need to learn more about what at-risk, physically ill patients want, and need, to inform prevention efforts for older adults.

A systematic review of physical illness, functional disability, and suicidal behaviour among older adults

PubMed Central

Fässberg, Madeleine Mellqvist; Cheung, Gary; Canetto, Silvia Sara; Erlangsen, Annette; Lapierre, Sylvie; Lindner, Reinhard; Draper, Brian; Gallo, Joseph J.; Wong, Christine; Wu, Jing; Duberstein, Paul; Wærn, Margda

2016-01-01

Objectives: To conduct a systematic review of studies that examined associations between physical illness/functional disability and suicidal behaviour (including ideation, nonfatal and fatal suicidal behaviour) among individuals aged 65 and older. Method: Articles published through November 2014 were identified through electronic searches using the ERIC, Google Scholar, PsycINFO, PubMed, and Scopus databases. Search terms used were suicid* or death wishes or deliberate self-harm. Studies about suicidal behaviour in individuals aged 65 and older with physical illness/functional disabilities were included in the review. Results: Sixty-five articles (across 61 independent samples) met inclusion criteria. Results from 59 quantitative studies conducted in four continents suggest that suicidal behaviour is associated with functional disability and numerous specific conditions including malignant diseases, neurological disorders, pain, COPD, liver disease, male genital disorders, and arthritis/arthrosis. Six qualitative studies from three continents contextualized these findings, providing insights into the subjective experiences of suicidal individuals. Implications for interventions and future research are discussed. Conclusion: Functional disability, as well as a number of specific physical illnesses, was shown to be associated with suicidal behaviour in older adults. We need to learn more about what at-risk, physically ill patients want, and need, to inform prevention efforts for older adults. PMID:26381843

Mediating role of borderline personality disorder traits in the effects of childhood maltreatment on suicidal behaviour among mood disorder patients.

PubMed

Aaltonen, K I; Rosenström, T; Baryshnikov, I; Karpov, B; Melartin, T; Suominen, K; Heikkinen, M; Näätänen, P; Koivisto, M; Joffe, G; Isometsä, E

2017-07-01

Substantial evidence supports an association between childhood maltreatment and suicidal behaviour. However, few studies have examined factors mediating this relationship among patients with unipolar or bipolar mood disorders. Depressive disorder and bipolar disorder (ICD-10-DCR) patients (n=287) from the Helsinki University Psychiatric Consortium (HUPC) Study were surveyed on self-reported childhood experiences, current depressive symptoms, borderline personality disorder traits, and lifetime suicidal behaviour. Psychiatric records served to complement the information on suicide attempts. We examined by formal mediation analyses whether (1) the effect of childhood maltreatment on suicidal behaviour is mediated through borderline personality disorder traits and (2) the mediation effect differs between lifetime suicidal ideation and lifetime suicide attempts. The impact of childhood maltreatment in multivariate models on either lifetime suicidal ideation or lifetime suicide attempts showed comparable total effects. In formal mediation analyses, borderline personality disorder traits mediated all of the total effect of childhood maltreatment on lifetime suicide attempts, but only one fifth of the total effect on lifetime suicidal ideation. The mediation effect was stronger for lifetime suicide attempts than for lifetime suicidal ideation (P=0.002) and independent of current depressive symptoms. The mechanisms of the effect of childhood maltreatment on suicidal ideation versus suicide attempts may diverge among psychiatric patients with mood disorders. Borderline personality disorder traits may contribute to these mechanisms, although the influence appears considerably stronger for suicide attempts than for suicidal ideation. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Toward suicide prevention.

PubMed

Rao, V A

1999-10-01

Suicide is an important mode of death. There are many psychiatrically ill patients in therapy running different degree of suicide risk. The risk of death by suicide is with almost all psychiatric illnesses, but it is found more with depressive disease, schizophrenia and personality disorder. Many studies have reported higher incidences of suicide attempts and suicide among alcoholics, which is often precipitated by family crises. Drug problems, low threshold for tolerance of day to day frustration, unemployement and poor parenting are major causes for youth suicide.There is biological evidence of suicidal behaviour. Fall in the level of serotonin and 5-HIAA in the CSF and in hind brain is found in subjects dying from suicide. Researchers have found decreased melatonin level in depression and suicide attempters. Long term therapy with antidepressants (Tricyclics), mood stabilizers (lithium and valproate) and new SSRIs prevent relapses and lessen suicide. It was concluded that general hospital doctors are in position of reducing suicide rates. Education of physician in detection of depression and suicide prevention will result in decline in number of suicides. The important measures include limiting the ability of methods of self-harm, antidepressants, paracetamol and insecticides.

TOWARD SUICIDE PREVENTION

PubMed Central

Rao, Venkoba A.

1999-01-01

Suicide is an important mode of death. There are many psychiatrically ill patients in therapy running different degree of suicide risk. The risk of death by suicide is with almost all psychiatric illnesses, but it is found more with depressive disease, schizophrenia and personality disorder. Many studies have reported higher incidences of suicide attempts and suicide among alcoholics, which is often precipitated by family crises. Drug problems, low threshold for tolerance of day to day frustration, unemployement and poor parenting are major causes for youth suicide. There is biological evidence of suicidal behaviour. Fall in the level of serotonin and 5-HIAA in the CSF and in hind brain is found in subjects dying from suicide. Researchers have found decreased melatonin level in depression and suicide attempters. Long term therapy with antidepressants (Tricyclics), mood stabilizers (lithium and valproate) and new SSRIs prevent relapses and lessen suicide. It was concluded that general hospital doctors are in position of reducing suicide rates. Education of physician in detection of depression and suicide prevention will result in decline in number of suicides. The important measures include limiting the ability of methods of self-harm, antidepressants, paracetamol and insecticides. PMID:21430799

Youth Perceptions of Suicide and Help-Seeking: "They'd Think I Was Weak or "Mental""

ERIC Educational Resources Information Center

Curtis, Cate

2010-01-01

Youth suicide is an issue of international concern and the college population may have a considerably higher rate of suicidal behaviour than the general population, yet seeking help for suicidality is uncommon. This research sought to understand college students' knowledge of suicidal behaviour and attitudes to help-seeking, in a New Zealand…

Severity of suicidal intent, method and behaviour antecedent to an act of self-harm: a cross sectional study of survivors of self-harm referred to a tertiary hospital in Mysore, south India.

PubMed

Krishna, Murali; Rajendra, Rajagopal; Majgi, Sumanth M; Heggere, Narendra; Parimoo, Shruti; Robinson, Catherine; Poole, Rob

2014-12-01

Rates of self harm are high in south India, but little is known about the relationship between antecedent behaviour, suicidal intent and method. Aims: To identify clinical, social and behavioural antecedents preceding an act of self-harm. 200 participants, consecutively presenting with deliberate self harm to a hospital in south India,were interviewed. Socio-demographic and clinical characteristics were recorded, together with behaviours preceding self-harm. The Pierce Suicidal Intent Scale and Mini International Neuropsychiatric Inventory were administered. Pesticide poisoning was the most common method, especially amongst men, in rural areas, and amongst professionals. No particular antecedent behaviour or activity appears to be associated with higher levels of suicidal intent. Absenteeism from work was the most commonly reported change of behaviour in the month preceding an act of self-harm. Unskilled labourers and professionals had significantly greater suicidal intent (adjusted for age, gender and method) than skilled labourers and the unemployed. There were no differences in suicidal intent between different methods. Rural dwellers had significantly greater suicidal intent compared to urban dwellers, irrespective of the method. Major Depressive Disorder was associated with significantly greater suicidal intent compared with other diagnoses and no diagnosis. Amongst people who harm themselves in south India, professionals and unskilled labourers, rural residents, and people with current major depressive disorder have higher levels of suicidal intent. Severity of suicidal intent does not appear to influence choice of method of self-harm. Behaviours predictive of self-harm in the west may not be relevant in south India.

Factors Influencing Suicide Behaviours in Immigrant and Ethno-Cultural Minority Groups: A Systematic Review.

PubMed

Lai, Daniel W L; Li, Lun; Daoust, Gabrielle D

2017-06-01

This paper reviews recent literature on factors influencing suicide behaviours, including thoughts, plans, and attempts, in immigrant and ethno-cultural minority groups, to inform a more comprehensive understanding of suicide behaviours in increasingly culturally diverse populations. Thirty-three studies published between 2002 and 2013 were identified through digital databases searches and included in this review. Analysis of study findings focused on impacts of ethno-cultural identity and acculturation, other cultural and immigration influences, and family and community supports on suicide behaviours. Policy, practice, and research recommendations are identified, to inform relevant suicide prevention efforts and enhance mental health supports for immigrant and ethno-cultural minority populations.

[Clinical significance of suicidal behaviour in delusional disorder: a 44 case-series descriptive study].

PubMed

González-Rodríguez, Alexandre; Molina-Andreu, Oriol; Penadés Rubio, Rafael; Catalán Campos, Rosa; Bernardo Arroyo, Miguel

2014-04-07

Suicidal behaviour in delusional disorder (DD) has been poorly studied. This study aimed to describe the prevalence of clinically significant depression, suicidal ideation and behaviour in these patients, and to relate them with psychotic or depressive symptoms. A cross-sectional study including 44 outpatients with DD (DSM-IV-TR) was conducted. Demographic and clinical data, as well as scores in clinical assessment scales: Positive and Negative Syndrome Scale (PANSS), Personal and Social Performance Scale, Hamilton Depression Rating Scale (17-item version) and Columbia Suicide Severity Rating Scale, were recorded. The sample was divided into 2 groups according to presence or absence of comorbid depression (CD). Fifteen patients (34.1%) had CD, 14 (31.8%) suicidal ideation and 7 (15.9%) suicidal behaviour in the previous 2 years. Patients with CD had an earlier age at onset and for a first psychiatric appointment, and had higher scores on the PANSS general subscale (p=0,043) and in intensity of suicidal ideation (p=0,001). In our sample, patients with DD and CD have more frequently suicidal ideation and behaviour than those without CD. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Prevalence of suicidal behaviour following traumatic brain injury: Longitudinal follow-up data from the NIDRR Traumatic Brain Injury Model Systems.

PubMed

Fisher, Lauren B; Pedrelli, Paola; Iverson, Grant L; Bergquist, Thomas F; Bombardier, Charles H; Hammond, Flora M; Hart, Tessa; Ketchum, Jessica M; Giacino, Joseph; Zafonte, Ross

2016-01-01

This study utilized the Traumatic Brain Injury Model Systems (TBIMS) National Database to examine the prevalence of depression and suicidal behaviour in a large cohort of patients who sustained moderate-to-severe TBI. Participants presented to a TBIMS acute care hospital within 72 hours of injury and received acute care and comprehensive rehabilitation in a TBIMS designated brain injury inpatient rehabilitation programme. Depression and suicidal ideation were measured with the Patient Health Questionnaire (PHQ-9). Self-reported suicide attempts during the past year were recorded at each follow-up examination, at 1, 2, 3, 10, 15 and 20 years post-injury. Throughout the 20 years of follow-up, rates of depression ranged from 24.8-28.1%, suicidal ideation ranged from 7.0-10.1% and suicide attempts (past year) ranged from 0.8-1.7%. Participants who endorsed depression and/or suicidal behaviour at year 1 demonstrated consistently elevated rates of depression and suicidal behaviour 5 years after TBI. Compared to the general population, individuals with TBI are at greater risk for depression and suicidal behaviour many years after TBI. The significant psychiatric symptoms evidenced by individuals with TBI highlight the need for routine screening and mental health treatment in this population.

Sexual orientation and suicidal behaviour in adolescents and young adults: systematic review and meta-analysis.

PubMed

Miranda-Mendizábal, A; Castellví, P; Parés-Badell, O; Almenara, J; Alonso, I; Blasco, M J; Cebrià, A; Gabilondo, A; Gili, M; Lagares, C; Piqueras, J A; Roca, M; Rodríguez-Marín, J; Rodríguez-Jiménez, T; Soto-Sanz, V; Vilagut, G; Alonso, J

2017-08-01

Background Research suggests that lesbian, gay and bisexual (LGB) adolescents have a higher risk of suicidal behaviours than their heterosexual peers, but little is known about specific risk factors. Aims To assess sexual orientation as a risk factor for suicidal behaviours, and to identify other risk factors among LGB adolescents and young adults. Method A systematic search was made of six databases up to June 2015, including a grey literature search. Population-based longitudinal studies considering non-clinical populations aged 12-26 years and assessing being LGB as a risk factor for suicidal behaviour compared with being heterosexual, or evaluating risk factors for suicidal behaviour within LGB populations, were included. Random effect models were used in meta-analysis. Results Sexual orientation was significantly associated with suicide attempts in adolescents and youths (OR = 2.26, 95% CI 1.60-3.20). Gay or bisexual men were more likely to report suicide attempts compared with heterosexual men (OR = 2.21, 95% CI 1.21-4.04). Based on two studies, a non-significant positive association was found between depression and suicide attempts in LGB groups. Conclusions Sexual orientation is associated with a higher risk of suicide attempt in young people. Further research is needed to assess completed suicide, and specific risk factors affecting the LGB population. © The Royal College of Psychiatrists 2017.

Influences on loneliness, depression, sexual-risk behaviour and suicidal ideation among Thai transgender youth.

PubMed

Yadegarfard, Mohammadrasool; Ho, Robert; Bahramabadian, Fatemeh

2013-01-01

This study examined the influence of age, education level and number of sex partners on levels of loneliness, depression, suicidal ideation and sexual-risk behaviour in Thai male-to-female transgender youth. A total of 190 participants filled in the study's questionnaire, designed to tap the primary variables of age, level of education, number of sex partners, loneliness, depression, suicidal ideation and sexual-risk behaviour. Results reveal that level of education has a significant influence on depression and loneliness, the number of sex partners has a significant influence on sexual-risk behaviour and suicidal ideation and age has a significant influence on sexual-risk behaviour and suicidal ideation. Participants with higher levels of education reported more loneliness than participants who did not graduate from high school. In addition, participants who did not graduate from high school reported more depression than participants with some university credit. Furthermore, participants aged 15 to 19 years, compared with those of 20 to 25 years, reported higher level of sexual-risk behaviour and higher levels of suicidal ideation.

Suicidal ideation and behaviour among community and health care seeking populations in five low- and middle-income countries: a cross-sectional study.

PubMed

Jordans, M; Rathod, S; Fekadu, A; Medhin, G; Kigozi, F; Kohrt, B; Luitel, N; Petersen, I; Shidhaye, R; Ssebunnya, J; Patel, V; Lund, C

2017-02-16

Aims Suicidal behaviour is an under-reported and hidden cause of death in most low- and middle-income countries (LMIC) due to lack of national systematic reporting for cause-specific mortality, high levels of stigma and religious or cultural sanctions. The lack of information on non-fatal suicidal behaviour (ideation, plans and attempts) in LMIC is a major barrier to design and implementation of prevention strategies. This study aims to determine the prevalence of non-fatal suicidal behaviour within community- and health facility-based populations in LMIC. Twelve-month prevalence of suicidal ideation, plans and attempts were established through community samples (n = 6689) and primary care attendees (n = 6470) from districts in Ethiopia, Uganda, South Africa, India and Nepal using the Composite International Diagnostic Interview suicidality module. Participants were also screened for depression and alcohol use disorder. We found that one out of ten persons (10.3%) presenting at primary care facilities reported suicidal ideation within the past year, and 1 out of 45 (2.2%) reported attempting suicide in the same period. The range of suicidal ideation was 3.5-11.1% in community samples and 5.0-14.8% in health facility samples. A higher proportion of facility attendees reported suicidal ideation than community residents (10.3 and 8.1%, respectively). Adults in the South African facilities were most likely to endorse suicidal ideation (14.8%), planning (9.5%) and attempts (7.4%). Risk profiles associated with suicidal behaviour (i.e. being female, younger age, current mental disorders and lower educational and economic status) were highly consistent across countries. The high prevalence of suicidal ideation in primary care points towards important opportunities to implement suicide risk reduction initiatives. Evidence-supported strategies including screening and treatment of depression in primary care can be implemented through the World Health Organization's mental health Global Action Programme suicide prevention and depression treatment guidelines. Suicidal ideation and behaviours in the community sample will require detection strategies to identify at risks persons not presenting to health facilities.

Employment status, inflation and suicidal behaviour: an analysis of a stratified sample in Italy.

PubMed

Solano, Paola; Pizzorno, Enrico; Gallina, Anna M; Mattei, Chiara; Gabrielli, Filippo; Kayman, Joshua

2012-09-01

There is abundant empirical evidence of a surplus risk of suicide among the unemployed, although few studies have investigated the influence of economic downturns on suicidal behaviours in an employment status-stratified sample. We investigated how economic inflation affected suicidal behaviours according to employment status in Italy from 2001 to 2008. Data concerning economically active people were provided by the Italian Institute for Statistical Analysis and by the International Monetary Fund. The association between inflation and completed versus attempted suicide with respect to employment status was investigated in every year and quarter-year of the study time frame. We considered three occupational categories: employed, unemployed who were previously employed and unemployed who had never worked. The unemployed are at higher suicide risk than the employed. Among the PE, a significant association between inflation and suicide attempt was found, whereas no association was reported concerning completed suicides. No association was found between completed and attempted suicides among the employed, the NE and inflation. Completed suicide in females is significantly associated with unemployment in every quarter-year. The reported vulnerability to suicidal behaviours among the PE as inflation rises underlines the need of effective support strategies for both genders in times of economic downturns.

Suicide attempt by hanging in preadolescent children: a case series.

PubMed

Omigbodun, O O; Adejumo, O A; Babalola, O O

2008-10-01

Suicide is now among the five top causes of death in youth worldwide. However, during the preadolescent period, suicidal behaviour is rare and difficult to define because the cognitive level of young children limits their ability to plan and understand the consequences or the finality of suicide. There is virtually no information about preadolescent suicidal behaviour in Nigeria. To illustrate the presentation and psychosocial issues associated with preadolescent suicidal attempt using the 'hanging' method in Nigeria. Three case scenarios of suicide attempt by hanging in preadolescents seen at the University College Hospital, Ibadan between 2005 and 2006 were interviewed in detail along with mental state and physical examination. Family and individual therapies were embarked upon. Types of psychopathology found in the preadolescents include depressive symptoms, conduct and oppositional defiant disorder and impulse control problems. Stressful life events such as family disruption, physical abuse, and bullying at school were factors associated with suicidal behaviour. The influence of the media in providing information about 'hanging' as a method of suicide was evident. Therapy yield varying results. High risk parameters for suicide in children should be known to all health professionals. The importance of intervention strategies particularly media education, monitoring systems and further research on suicidal behaviour in this environment is apparent.

'This place is making me more depressed': The organisation of care for suicide attempters in a South African hospital.

PubMed

Bantjes, Jason; Nel, Annemi; Louw, Kerry-Ann; Frenkel, Louise; Benjamin, Ereshia; Lewis, Ian

2017-09-01

People who attend hospital following a suicide attempt represent a well-delineated high-risk group of patients who may be amenable to targeted interventions to reduce the risk of suicidal behaviour. Little is, however, known about how hospitals in South Africa respond to suicide attempters, what quality of care these patients receive or what possibilities exist for hospital-based suicide prevention interventions. We describe an ethnographic study conducted at a large hospital in South Africa to investigate the impact of current procedures and practices on the care received by those who attempt suicide. Findings suggest that the organisation of care within the hospital is a significant barrier to patients receiving optimal care and represents a lost opportunity for suicide prevention. Findings highlight the mismatch between the needs of suicide attempters and current services and call attention to the need for greater psychological input as well as hospital-based suicide prevention interventions that can be offered to patients without necessitating admissions.

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

Effects of life satisfaction and psychache on risk for suicidal behaviour: a cross-sectional study based on data from Chinese undergraduates

PubMed Central

You, Zhiqi; Song, Juanjuan; Wu, Caizhi; Qin, Ping; Zhou, Zongkui

2014-01-01

Objectives To examine predictive power of psychache and life satisfaction on risks for suicidal ideation and suicide attempt among young people. Design A cross-sectional study. Setting Data were collected from an online survey in Wuhan, China. Participants 5988 university students from six universities were selected by a stratified cluster sampling method. Primary and secondary outcome measures Suicidal ideation and suicide attempt at some point of the students’ lifetime were the outcomes of interest. Results Students with suicidal ideation or attempted suicide reported a lower level of life satisfaction and high degree of psychache than counterparts without suicidal ideation or attempt. Regression analyses indicated that life satisfaction and psychache were significantly associated with the risk of suicidal ideation and the risk of suicidal attempt. Though psychache showed a relatively stronger predictive power than life satisfaction, the effect of the two factors remained significant when they were individually adjusted for personal demographic characteristics. However, when the two factors were included in the model simultaneously to adjust for each other, psychache could fully explain the association between life satisfaction and suicidal attempt. Life satisfaction remained to contribute unique variance in the statistical prediction of suicidal ideation. Conclusions Psychache and life satisfaction both have a significant predictive power on risk for suicidal behaviour, and life satisfaction could relieve the predictive power of psychache when suicidal behaviour is just starting. Shneidman's theory that psychache is the pre-eminent psychological cause of suicide is perhaps applicable only to a more serious form of suicidal behaviour. PMID:24657883

Cultural aspects of suicide.

PubMed

Maharajh, Hari D; Abdool, Petal S

2005-09-08

Undefined cultural factors cannot be dismissed and significantly contribute to the worldwide incidence of death by suicide. Culture is an all embracing term and defines the relationship of an individual to his environment. This study seeks to investigate the effect of culture on suicide both regionally and internationally. Culture-bound syndrome with suicidal behaviours specific to a particular culture or geographical region are discussed. Opinions are divided as to the status of religious martyrs. The law itself is silent on many aspects of suicidal behaviour and despite decriminalization of suicide as self-murder, the latter remains on the statutes of many developing countries. The Caribbean region is of concern due to its steady rise in mean suicide rate, especially in Trinidad and Tobago where socio-cultural factors are instrumental in influencing suicidal behaviour. These include transgenerational cultural conflicts, psycho-social problems, media exposure, unemployment, social distress, religion and family structure. The methods used are attributed to accessibility and lethality. Ingestion of poisonous substances is most popular followed by hanging. The gender differences seen with regard to suicidality can also be attributed to gender related psychopathology and psychosocial differences in help-seeking behaviour. These are influenced by the cultural environment to which the individual is exposed. Culture provides coping strategies to individuals; as civilization advances many of these coping mechanisms are lost unclothing the genetic predisposition of vulnerable groups. In the management of suicidal behaviour, a system of therapeutic re-culturation is needed with an emphasis on relevant culture- based therapies.

Behaviour of implanted arsenic during rapid thermal annealing of Ti on Si

NASA Astrophysics Data System (ADS)

Ponpon, J. P.; Saulnier, A.; Stuck, R.

1987-11-01

The reaction during rapid thermal annealing of the Ti-Si couple with arsenic implanted either into titanium or into silicon has been investigated from the point of view of suicide formation kinetics and impurity redistribution. In contrast with similar experiments on other refractory metals, tungsten for example, the reaction is not blocked by the presence of arsenic but a temperature and dose dependent impurity effect leading to a lowering of the growth rate of the disilicide phase is observed. This has been attributed to arsenic segregation in the grain boundaries of the growing suicide which reduces the transport of silicon via easy diffusion paths towards the unreacted metal or a metal rich suicide phase. Arsenic, when present in the metal, has been found to produce the same effects as oxygen at the early beginning of the annealing. However, after the reaction has started the respective behaviour and influence of arsenic and oxygen become completely different.

The influence of psychosocial variables on adolescent suicidal ideation.

PubMed

George, Ancel; van den Berg, Henriette S

2012-07-01

Increased rates of suicide among adolescents aged 15-24 years have led to suicides becoming the third leading cause of death in the Unites States. South African statistics show an equally worrying trend as suicide constitutes 11.5% of the total deaths for the age group 11-20 years (Stark et al. 2010). A national youth risk behaviour survey done in South Africa has re-emphasised the need for concern, as adolescent suicidal behaviour increased between 2002 and 2008 (Reddy et al. 2010). The objective was to investigate the influence of risk and protective factors (psychosocial and individual factors) on suicidal ideation. The Integrated Stress and Coping Process model was used as guiding theory for the inclusion of personal and contextual stressors and resources including coping strategies as potential risk and protective factors, in their relationship to suicidal ideation. A purposive, stratified sampling technique was used to study 381 adolescents in the Northern Cape Province. The instruments used were a suicidal ideation questionnaire; a biographical questionnaire; a self-esteem scale; and a survey examining stressors and resources relevant to adolescents. Suicidal ideation was significantly higher in the South African sample than in an American sample. Avoidant coping strategies (denial, emotional venting and restraint coping), negative life events and stressful romantic relationships contributed to higher levels of suicidal ideation while self-esteem and adaptive coping (acceptance and seeking social support for instrumental reasons) reduced these levels. A lack of self-esteem, ineffective coping and particular stressors contributed significantly to the vulnerability of adolescents. Future studies should explore a wider range of dispositional factors that influence effective coping and adjustment in addressing adolescent suicidal ideation.

Association between HTR2C gene variants and suicidal behaviour: a protocol for the systematic review and meta-analysis of genetic studies.

PubMed

Thelma Beatriz, González-Castro; Isela, Juárez-Rojop; Alma, Genis; María Lilia, López-Narváez; Carlos Alfonso, Tovilla-Zárate

2014-09-04

Suicide is an important public health problem and one of the most common causes of death throughout the world. Suicidal behaviour is complex, and its causes are multifactorial. Case-control studies have reported an association between an alteration of the serotonin system and suicidal behaviour. Recently, it has been suggested that the 5-HTRC2 serotonin receptor gene is involved in the pathogenesis of suicidal behaviour. To evaluate the role of the 5-HTR2C gene in suicidal behaviour, we will perform a systematic review and a meta-analysis of worldwide reports that have investigated the association between the serotonin system and suicidal behaviour. This analysis will be reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. Studies deemed fit for inclusion in the systematic review will be scored for methodological quality using the Newcastle-Ottawa Assessment Scale (NOS). The inclusion criteria will be to present independent data, to be case-control studies and to be published in journal peer reviews. To generate more accurate analyses, we will grade the reports using the GRADES scale procedures. This study will describe the association between the HTR2C gene and suicidal behaviour. The results will be reported in a peer-reviewed publication and in scientific presentations in Mexico and throughout the world. PROSPERO CRD42014009213. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Cognitive-behavioural suicide prevention for male prisoners: a pilot randomized controlled trial.

PubMed

Pratt, D; Tarrier, N; Dunn, G; Awenat, Y; Shaw, J; Ulph, F; Gooding, P

2015-12-01

Prisoners have an exceptional risk of suicide. Cognitive-behavioural therapy for suicidal behaviour has been shown to offer considerable potential, but has yet to be formally evaluated within prisons. This study investigated the feasibility of delivering and evaluating a novel, manualized cognitive-behavioural suicide prevention (CBSP) therapy for suicidal male prisoners. A pilot randomized controlled trial of CBSP in addition to treatment as usual (CBSP; n = 31) compared with treatment as usual (TAU; n = 31) alone was conducted in a male prison in England. The primary outcome was self-injurious behaviour occurring within the past 6 months. Secondary outcomes were dimensions of suicidal ideation, psychiatric symptomatology, personality dysfunction and psychological determinants of suicide, including depression and hopelessness. The trial was prospectively registered (number ISRCTN59909209). Relative to TAU, participants receiving CBSP therapy achieved a significantly greater reduction in suicidal behaviours with a moderate treatment effect [Cohen's d = -0.72, 95% confidence interval -1.71 to 0.09; baseline mean TAU: 1.39 (S.D. = 3.28) v. CBSP: 1.06 (S.D. = 2.10), 6 months mean TAU: 1.48 (S.D. = 3.23) v. CBSP: 0.58 (S.D. = 1.52)]. Significant improvements were achieved on measures of psychiatric symptomatology and personality dysfunction. Improvements on psychological determinants of suicide were non-significant. More than half of the participants in the CBSP group achieved a clinically significant recovery by the end of therapy, compared with a quarter of the TAU group. The delivery and evaluation of CBSP therapy within a prison is feasible. CBSP therapy offers significant promise in the prevention of prison suicide and an adequately powered randomized controlled trial is warranted.

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.

Can CCTV identify people in public transit stations who are at risk of attempting suicide? An analysis of CCTV video recordings of attempters and a comparative investigation.

PubMed

Mishara, Brian L; Bardon, Cécile; Dupont, Serge

2016-12-15

Suicides incur in all public transit systems which do not completely impede access to tracks. We conducted two studies to determine if we can reliably identify in stations people at risk of suicide in order to intervene in a timely manner. The first study analysed all CCTV recordings of suicide attempters in Montreal underground stations over 2 years to identify behaviours indicating suicide risk. The second study verified the potential of using those behaviours to discriminate attempters from other passengers in real time. First study: Trained observers watched CCTV video recordings of 60 attempters, with 2-3 independent observers coding seven easily observable behaviours and five behaviours requiring interpretation (e.g. "strange behaviours," "anxious behaviour"). Second study: We randomly mixed 63 five-minute CCTV recordings before an attempt with 56 recordings from the same cameras at the same time of day, and day of week, but when no suicide attempt was to occur. Thirty-three undergraduate students after only 10 min of instructions watched the recordings and indicated if they observed each of 13 behaviours identified in the First Study. First study: Fifty (83%) of attempters had easily observable behaviours potentially indicative of an impending attempt, and 37 (61%) had two or more of these behaviours. Forty-five (75%) had at least one behaviours requiring interpretation. Twenty-two witnesses attempted to intervene to stop the attempt, and 75% of attempters had behaviours indicating possible ambivalence (e.g. waiting for several trains to pass; trying to get out of the path of the train). Second study: Two behaviours, leaving an object on the platform and pacing back and forth from the yellow line (just before the edge of the platform), could identify 24% of attempters with no false positives. The other target behaviours were also present in non-attempters. However, having two or more of these behaviours indicated a likelihood of being at risk of attempting suicide. We conclude that real time observations of CCTV monitors, automated computer monitoring of CCTV signals, and/or training of drivers and transit personnel on behavioural indications of suicide risk, may identify attempters with few false positives, and potentially save lives.

[Depression, deliberate self-harm and suicidal behaviour in adolescents engaging in risky and pathological internet use].

PubMed

Fischer, Gloria; Brunner, Romuald; Parzer, Peter; Klug, Katja; Durkee, Tony; Carli, Vladimi; Wasserman, Danuta; Vonderlin, Eva; Resch, Franz; Kaess, Michael

2012-01-01

To investigate associations between risky and pathologic internet use with depression, deliberate self-harm and suicidal behaviour among a representative sample of German adolescents. A total of 1,435 students (48% boys, 52% girls) from the area of Heidelberg/Germany were recruited during the SEYLE study, a European school-based intervention study and completed an assessment of different questionnaires, including the Young Diagnostic Questionnaire for the assessment of risky and pathological internet use, the Beck Depression Inventory, the Deliberate Self Harm Inventory, and the Paykel Suicide Scale. 80.7% of the students reported regular, 14.5% risky, and 4.8% pathological internet use. The risky and the pathological internet users showed significant higher rates of depression, deliberate self-harm and suicidal behaviour compared to students with regular internet use. Remarkably, there were no significant differences of levels of depression and suicidal behaviour between risky and pathological users. These results suggest that not only pathologic internet use but also risky internet use is associated with symptoms of depression, self-harm and suicidal behaviour. Therefore, more attention should be paid to adolescents with risky internet use for the early recognition of depression, self-harm and suicidality in adolescence.

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/

School Performance and Gender Differences in Suicidal Behaviour--A 30-Year Follow-Up of a Stockholm Cohort Born in 1953

ERIC Educational Resources Information Center

Rojas, Yerko

2013-01-01

Astonishingly little is known about the relationship between high educational achievements and suicidal behaviour among women. This is remarkable given that a woman breaking into traditionally male-dominant spheres is a well established example of social-role marginality. The current study combines fatal and non-fatal suicidal behaviour and…

Coping strategies, mental health and HIV status: Predictors of suicidal behaviour among PWIDs.

PubMed

Akram, Bushra; Ilyas, Mubeen

2017-04-01

To understand suicidal behaviour among people who inject drugs. This correlational, cross-sectional study was conducted in two Pakistani cities of Gujrat and Jhelum from October 2015 to March 2016, and comprised male injecting-drug users aged18-60 years. Multistage systematic random sampling method was used. Urdu-translated versions of the brief cope inventory, mental health status scale and suicidal behaviour questionnaire (revised) were administered. SPSS 16 was used for data analysis. Of the 200 participants, 83(41.5%) were aged 26-32 years. The prevalence of human immunodeficiency virus was in 94(47%) cases. Suicidal behaviour was positively associated with psychological distress and human immunodeficiency virus status (p<0.05), whereas it was negatively associated with mental health, psychological well-being and coping strategies (p<0.05). Regression analysis showed mental health index and psychological well-being were negative predictors, whereas psychological distress and human immunodeficiency virus status were positive predictors of suicidal behaviour among the participants (p<0.05). The level of stress led people who inject drugs towards suicidal behaviour. However, the level of stress varied according to the severity of human immunodeficiency virus and poor mental health.

Suicidal behaviour and lipid levels in unipolar and bipolar depression.

PubMed

Ainiyet, Babajohn; Rybakowski, Janusz K

2014-10-01

Evidence for a possible association between a low level of cholesterol and increased suicidal behaviour has accumulated in the recent 3 decades. The present study investigates whether lipid levels can make state-dependent markers of suicidal behaviour in Polish patients with mood disorder recently admitted to a psychiatric hospital owing to an acute depressive episode. The study was conducted on 223 patients (73 male and 150 female) with unipolar (n=171) and bipolar (n=52) depression. They were interviewed to assess any occurrence of suicidal thoughts, suicidal tendencies and/or suicidal attempts during the 3 months before admission. Laboratory measurements [total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, triglycerides and total lipids] were obtained within 24-72 h after hospital admission. Suicidal thoughts, tendencies, and attempts were associated with low total cholesterol, LDL cholesterol, and total lipids in both male and female patients, in both diagnostic categories. Triglycerides were significantly lower in male and female patients with suicidal thoughts compared with their non-suicidal counterparts. No association with suicidality was found with HDL cholesterol. The results of our study support a majority of research showing the association in depressed patients between suicidal behaviour and low levels of total and LDL cholesterol. In addition, the data suggest a similar association with low total lipids, and in some instances, with low triglycerides.

A systematic review of suicide prevention interventions targeting indigenous peoples in Australia, United States, Canada and New Zealand

PubMed Central

2013-01-01

Background Indigenous peoples of Australia, Canada, United States and New Zealand experience disproportionately high rates of suicide. As such, the methodological quality of evaluations of suicide prevention interventions targeting these Indigenous populations should be rigorously examined, in order to determine the extent to which they are effective for reducing rates of Indigenous suicide and suicidal behaviours. This systematic review aims to: 1) identify published evaluations of suicide prevention interventions targeting Indigenous peoples in Australia, Canada, United States and New Zealand; 2) critique their methodological quality; and 3) describe their main characteristics. Methods A systematic search of 17 electronic databases and 13 websites for the period 1981–2012 (inclusive) was undertaken. The reference lists of reviews of suicide prevention interventions were hand-searched for additional relevant studies not identified by the electronic and web search. The methodological quality of evaluations of suicide prevention interventions was assessed using a standardised assessment tool. Results Nine evaluations of suicide prevention interventions were identified: five targeting Native Americans; three targeting Aboriginal Australians; and one First Nation Canadians. The main intervention strategies employed included: Community Prevention, Gatekeeper Training, and Education. Only three of the nine evaluations measured changes in rates of suicide or suicidal behaviour, all of which reported significant improvements. The methodological quality of evaluations was variable. Particular problems included weak study designs, reliance on self-report measures, highly variable consent and follow-up rates, and the absence of economic or cost analyses. Conclusions There is an urgent need for an increase in the number of evaluations of preventive interventions targeting reductions in Indigenous suicide using methodologically rigorous study designs across geographically and culturally diverse Indigenous populations. Combining and tailoring best evidence and culturally-specific individual strategies into one coherent suicide prevention program for delivery to whole Indigenous communities and/or population groups at high risk of suicide offers considerable promise. PMID:23663493

Violence against women is strongly associated with suicide attempts: evidence from the WHO multi-country study on women's health and domestic violence against women.

PubMed

Devries, Karen; Watts, Charlotte; Yoshihama, Mieko; Kiss, Ligia; Schraiber, Lilia Blima; Deyessa, Negussie; Heise, Lori; Durand, Julia; Mbwambo, Jessie; Jansen, Henrica; Berhane, Yemane; Ellsberg, Mary; Garcia-Moreno, Claudia

2011-07-01

Suicidal behaviours are one of the most important contributors to the global burden of disease among women, but little is known about prevalence and modifiable risk factors in low and middle income countries. We use data from the WHO multi-country study on women's health and domestic violence against women to examine the prevalence of suicidal thoughts and attempts, and relationships between suicide attempts and mental health status, child sexual abuse, partner violence and other variables. Population representative cross-sectional household surveys were conducted from 2000-2003 in 13 provincial (more rural) and city (urban) sites in Brazil, Ethiopia, Japan, Namibia, Peru, Samoa, Serbia, Thailand and Tanzania. 20967 women aged 15-49 years participated. Prevalence of lifetime suicide attempts, lifetime suicidal thoughts, and suicidal thoughts in the past four weeks were calculated, and multivariate logistic regression models were fit to examine factors associated with suicide attempts in each site. Prevalence of lifetime suicide attempts ranged from 0.8% (Tanzania) to 12.0% (Peru city); lifetime thoughts of suicide from 7.2% (Tanzania province) to 29.0% (Peru province), and thoughts in the past four weeks from 1.9% (Serbia) to 13.6% (Peru province). 25-50% of women with suicidal thoughts in the past four weeks had also visited a health worker in that time. The most consistent risk factors for suicide attempts after adjusting for probable common mental health disorders were: intimate partner violence, non-partner physical violence, ever being divorced, separated or widowed, childhood sexual abuse and having a mother who had experienced intimate partner violence. Mental health policies and services must recognise the consistent relationship between violence and suicidality in women in low and middle income countries. Training health sector workers to recognize and respond to the consequences of violence may substantially reduce the health burden associated with suicidal behaviour. Copyright © 2011 Elsevier Ltd. All rights reserved.

A systematic review of suicide prevention interventions targeting indigenous peoples in Australia, United States, Canada and New Zealand.

PubMed

Clifford, Anton C; Doran, Christopher M; Tsey, Komla

2013-05-13

Indigenous peoples of Australia, Canada, United States and New Zealand experience disproportionately high rates of suicide. As such, the methodological quality of evaluations of suicide prevention interventions targeting these Indigenous populations should be rigorously examined, in order to determine the extent to which they are effective for reducing rates of Indigenous suicide and suicidal behaviours. This systematic review aims to: 1) identify published evaluations of suicide prevention interventions targeting Indigenous peoples in Australia, Canada, United States and New Zealand; 2) critique their methodological quality; and 3) describe their main characteristics. A systematic search of 17 electronic databases and 13 websites for the period 1981-2012 (inclusive) was undertaken. The reference lists of reviews of suicide prevention interventions were hand-searched for additional relevant studies not identified by the electronic and web search. The methodological quality of evaluations of suicide prevention interventions was assessed using a standardised assessment tool. Nine evaluations of suicide prevention interventions were identified: five targeting Native Americans; three targeting Aboriginal Australians; and one First Nation Canadians. The main intervention strategies employed included: Community Prevention, Gatekeeper Training, and Education. Only three of the nine evaluations measured changes in rates of suicide or suicidal behaviour, all of which reported significant improvements. The methodological quality of evaluations was variable. Particular problems included weak study designs, reliance on self-report measures, highly variable consent and follow-up rates, and the absence of economic or cost analyses. There is an urgent need for an increase in the number of evaluations of preventive interventions targeting reductions in Indigenous suicide using methodologically rigorous study designs across geographically and culturally diverse Indigenous populations. Combining and tailoring best evidence and culturally-specific individual strategies into one coherent suicide prevention program for delivery to whole Indigenous communities and/or population groups at high risk of suicide offers considerable promise.

Substance use and suicidal ideation and behaviour in low- and middle-income countries: a systematic review.

PubMed

Breet, Elsie; Goldstone, Daniel; Bantjes, Jason

2018-04-24

Understanding relationships between substance use and suicidal ideation and behaviour (SIB) has important public health implications for suicide prevention in low- and middle-income countries (LMICs), where 75% of suicides occur. This systematic review explored the associations between substance use and SIB in LMICs. We searched five databases using a combination of keywords for substance use, SIB and LMICs to identify English-written quantitative studies published between January 2006 and February 2016. Data were extracted to provide an overview of what is known about the topic, highlight gaps in the literature, and explore the implications of current knowledge for suicide prevention. Studies included in the review were assessed for methodological quality using the Scottish Intercollegiate Guidelines Network checklist. Analysis of included studies (N = 108) demonstrated a consistent positive association between substance use and SIB across all substances (i.e. alcohol, tobacco, cannabis, illicit drugs, non-medical use of prescription drugs), all substance use dimensions (i.e. intoxication, use, and pathological use) and all SIB dimensions (i.e. suicidal ideation, non-fatal suicidal behaviour, and suicide). Most of the available research evidence comes from upper-middle-income countries, only 22% comes from lower-middle-income and low-income countries. Most studies focused on alcohol and tobacco, while neglecting substances such as cannabis, opioids, sedatives, stimulants, misuse of prescription medication, inhalants, and hallucinogens. Most of the studies employed a cross-sectional design, were conducted within a risk-factor paradigm, and provided little information about the potential interaction between variables. Public health suicide prevention policy and research in LMICs should take account of the fact that: substance use is a potentially modifiable risk factor; assessment and management of substance use is integral to the care of at-risk patients; reducing consumption and hazardous use of substances in LMICs is important for suicide prevention; and research needs to be expanded to include more theory driven research that focuses on all substance use dimensions and SIB dimensions, while employing more sophisticated statistical methods.

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

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.

Differences and similarities of risk factors for suicidal ideation and attempts among patients with depressive or bipolar disorders.

PubMed

Aaltonen, Kari; Näätänen, Petri; Heikkinen, Martti; Koivisto, Maaria; Baryshnikov, Ilya; Karpov, Boris; Oksanen, Jorma; Melartin, Tarja; Suominen, Kirsi; Joffe, Grigori; Paunio, Tiina; Isometsä, Erkki

2016-03-15

Substantial literature exists on risk factors for suicidal behaviour. However, their comparative strength, independence and specificity for either suicidal ideation or suicide attempt(s) remain unclear. The Helsinki University Psychiatric Consortium (HUPC) Study surveyed 287 psychiatric care patients with ICD-10-DCR depressive or bipolar disorders about lifetime suicidal behaviour, developmental history and attachment style, personality and psychological traits, current and lifetime symptom profiles, and life events. Psychiatric records were used to confirm diagnosis and complement information on suicide attempts. Multinomial regression models predicting lifetime suicidal ideation and single or repeated suicide attempts were generated. Overall, 21.6% patients had no lifetime suicidal behaviour, 33.8% had lifetime suicide ideation without attempts, and 17.1% had a single and 27.5% repeated suicide attempts. In univariate analyses, lifetime suicidal behaviour was associated with numerous factors. In multivariate models, suicidal ideation was independently predicted by younger age, severe depressive disorder, bipolar disorder type II/nos, hopelessness, and childhood physical abuse. Repeated suicide attempts were independently predicted by younger age, female sex, severe depressive disorder with or without psychotic symptoms, bipolar disorder type II/nos, alcohol use disorder, borderline personality disorder traits, and childhood physical abuse. Cross-sectional and retrospective study design, utilization of clinical diagnoses, and relatively low response rate. Risk factors for suicidal ideation and attempts may diverge both qualitatively and in terms of dose response. When effects of risk factors from multiple domains are concurrently examined, proximal clinical characteristics remain the most robust. All risk factors cluster into the group of repeated attempters. Copyright © 2015 Elsevier B.V. All rights reserved.

DSM-IV Axis II personality disorders and suicide and attempted suicide in China.

PubMed

Tong, Yongsheng; Phillips, Michael R; Conner, Kenneth R

2016-10-01

There are meagre data on Axis II personality disorders and suicidal behaviour in China. To describe the prevalence of Axis II personality disorders in suicides and suicide attempts in China and to estimate risk for these outcomes associated with personality disorders. People who died by suicide (n = 151), people who attempted suicide (n = 118) and living community controls (n = 140) were randomly sampled from four Chinese counties and studied using the Structured Clinical Interviews for DSM-IV-TR Axis I Disorders (SCID-I) and Axis II Personality Disorders (SCID-II). We also determined the prevalence of subthreshold versions of ten DSM-IV personality disorders. Axis II personality disorders were present in 7% of the suicide group, 6% of the suicide attempt group and 1% of the control group. Threshold and subthreshold personality disorders had adjusted odds ratios (point estimates) in the range of 2.7-8.0 for suicide and for suicide attempts. Axis II personality disorders may confer increased risk for suicidal behaviour in China, but their low prevalence in the community and among people with suicidal behaviour suggests that other personality constructs such as select dimensional traits may be a more fruitful avenue for understanding and preventing suicide in China. © The Royal College of Psychiatrists 2016.

HPT axis, CSF monoamine metabolites, suicide intent and depression severity in male suicide attempters.

PubMed

Jokinen, Jussi; Samuelsson, Mats; Nordström, Anna-Lena; Nordström, Peter

2008-11-01

A lower thyroid-stimulating hormone (TSH) response to thyrotropin-releasing hormone (TRH) in depressed women has been associated with violent suicide attempts, suicidal intent, higher lethality and suicide risk. The cerebrospinal fluid (CSF) 5-hydroxyindoleacetic acid (5-HIAA) and homovanillic acid (HVA) levels are related to suicidal behaviour. We studied the HPT axis function in twelve male suicide attempters and eight healthy volunteers submitted to lumbar puncture and to TRH test. Suicidal behaviour and depression severity were assessed. There was no association between deltamaxTSH and violent suicidality or subsequent suicide. The deltamaxTSH correlated with CSF HVA in suicide attempters. The plasma T3 showed a negative correlation with the Beck Suicide Intent Scale and the Montgomery Asberg Depression rating scale. Dopaminergic regulatory mechanisms on the thyroid hormone activity may be altered in male suicide attempters.

Workplace bullying and the association with suicidal ideation/thoughts and behaviour: a systematic review.

PubMed

Leach, Liana S; Poyser, Carmel; Butterworth, Peter

2017-01-01

The established links between workplace bullying and poor mental health provide a prima facie reason to expect that workplace bullying increases the risk of suicidal ideation (thoughts) and behaviours. Until now, there has been no systematic summary of the available evidence. This systematic review summarises published studies reporting data on workplace bullying and suicidal ideation, or behaviour. The review sought to ascertain the nature of this association and highlight future research directions. 5 electronic databases were searched. 2 reviewers independently selected the articles for inclusion, and extracted information about study characteristics (sample, recruitment method, assessment and measures) and data reporting the association of workplace bullying with suicidal ideation and behaviour. 12 studies were included in the final review-8 reported estimates of a positive association between workplace bullying and suicidal ideation, and a further 4 provided descriptive information about the prevalence of suicidal ideation in targets of bullying. Only 1 non-representative cross-sectional study examined the association between workplace bullying and suicidal behaviour. The results show an absence of high-quality epidemiological studies (eg, prospective cohort studies, which controlled for workplace characteristics and baseline psychiatric morbidity). While the available literature (predominantly cross-sectional) suggests that there is a positive association between workplace bullying and suicidal ideation, the low quality of studies prevents ruling out alternative explanations. Further longitudinal, population-based research, adjusting for potential covariates (within and outside the workplace), is needed to determine the level of risk that workplace bullying independently contributes to suicidal ideation and behaviour. 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/.

A population study of the association between sleep disturbance and suicidal behaviour in people with mental illness.

PubMed

Stubbs, Brendon; Wu, Yu-Tzu; Prina, A Matthew; Leng, Yue; Cosco, Theodore D

2016-11-01

Limited representative research has considered the relationship between sleep disturbance and suicidal behaviour among people with mental illness. We investigated the relationship between sleep disturbance and suicidal behaviour across Part II interview of the National Comorbidity Survey Replication (NCSR). The associations between sleep disturbance and suicidal behaviour (thoughts, plans and attempts) were investigated using logistic and multinomial logistic regressions and stratified across six mental disorder groups (depression, anxiety, substance use disorders (SUD), eating disorders (ED), bipolar disorders (BD) and early life disorders). From 5701 participants (mean age 43.4 years 58% women), people with any mental disorder experiencing sleep disturbance were at increased odds of suicidal thoughts (odds ratio (OR): 2.5; 95% CI: 1.7, 3.6) and suicidal plans and attempts (OR: 5.7; 95% CI: 2.7, 11.9) adjusting for age, sex and income. People with BD (OR: 8.9; 95 CI: 2.1, 38.1), early life disorders (OR 6.98, 95% ci 2.48, 19.67), depression (OR 1.88, 95% CI 1.14, 3.11), anxiety (OR 1.90, 95% CI 1.28, 2.85) and SUD (2.60, 95% CI 1.23, 5.49) but not ED, were at increased odds of suicidal thoughts in the presence of sleep disturbance. Adjusting for anti-depressant intake attenuated the effect sizes by up to 20% but the associations remained significant. In conclusion, sleep disturbance is a potential risk factor for suicidal behaviours in people with mental illness. Monitoring and management of sleep disturbance in clinical practice might be an important strategy to mitigate suicidal behaviours in people with mental illness. Copyright © 2016 Elsevier Ltd. All rights reserved.

Attitudes towards suicidal behaviour and associated factors among nursing professionals: A quantitative study.

PubMed

Giacchero Vedana, K G; Magrini, D F; Zanetti, A C G; Miasso, A I; Borges, T L; Dos Santos, M A

2017-11-01

WHAT IS KNOWN ON THE SUBJECT?: Self-confident health professionals with positive and understanding attitudes can take better care of people with suicidal behaviour, but the factors associated with these attitudes are not known. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: The majority of nursing professionals had no experience or training in mental health or suicide. They were less self-confident and had more negative attitudes. Nurses and nursing assistants who worked before in mental health services were more understanding with people with suicidal behaviour. Nurses and nursing assistants who were working in prehospital services were less self-confident to taking care of people with suicidal behaviour. Some members of the nursing team had already seriously considered committing suicide. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The practicing, support and training in mental health may improve the nurses' attitudes and emotional competencies. It is important to know why few nurses had suicide-related training, despite the relevance of this issue. Training in mental health or suicide need to include attitudinal and emotional competencies. It is important to offer emotional support to emergency nursing professionals. Background The attitudes towards suicide of emergency nurses may affect the care provided. However, the factors associated with these attitudes remain unclear. Objective To investigate attitudes towards suicidal behaviour and associated factors among nursing professionals working in emergency settings. Methods A cross-sectional observational study including 28 nurses and 118 who were nursing assistants employed at two emergency services in Brazil was conducted. Data were collected in 2015 using a self-administered sociodemographic questionnaire and the Suicide Behavior Attitude Questionnaire (SBAQ). Results The majority of participants reported having no experience or training in mental health or suicide. They reported more negative feelings towards the patient and a lower self-perception of professional competence regarding suicidal behaviours, and these attitudes seemed to reinforce each other. Nurses who worked in mental health services reported less moralistic/judgemental attitudes. Working in prehospital services was associated with having a lower self-perception of professional competence. There were professionals who reported thinking seriously about committing suicide. Conclusion When combined with support and training, practicing mental health nursing may serve as an opportunity to develop favourable attitudes and emotional competences, and these issues need to be addressed in suicide education strategies. © 2017 John Wiley & Sons Ltd.

Main predictors for repetition of suicidal behaviour among women referred to a single public sector tertiary care hospital in Iran.

PubMed

Mostafazadeh, Babak; Farzaneh, Esmaeil

2017-09-01

To assess the main predictors for repetition of suicidal behaviour among women. This cross-sectional study was conducted at Loghman Hakim Hospital, Tehran, Iran, in 2014, and comprised women patients. The patients were divided into two groups, i.e. women repeating suicide and women without repeating suicide. Data was collected through a checklist and then analysed with SPSS 20. Of the 300 women, 121(40.3%) repeated suicide and 179(59.7%) did not. The overall mean age was 26.9±9.1 years (range: 14-80 years). High prevalence of psychological drug usage, alcohol use, history of self-mutilation (self-harm), psychotic disturbances, sexual relationships, as well as smoking and opium addition was revealed as major factors in repeated suicidal behaviour in women when compared with other women. The result of multivariate logistic regression model showed two factors of self-mutilation (odds ratio =2.692, p=0.002) and underlying psychotic disorders (odds ratio = 2.780, p<0.001) as main predictors of suicide in women. In this regard, demographic characteristics could not predict repeating suicidal attempts (p>0.05). The presence of underlying psychotic disorders and self-mutilation were main predictors for repetition of suicidal behaviour.

SIAM (Suicide intervention assisted by messages): the development of a post-acute crisis text messaging outreach for suicide prevention.

PubMed

Berrouiguet, Sofian; Alavi, Zarrin; Vaiva, Guillaume; Courtet, Philippe; Baca-García, Enrique; Vidailhet, Pierre; Gravey, Michel; Guillodo, Elise; Brandt, Sara; Walter, Michel

2014-11-18

Suicidal behaviour and deliberate self-harm are common among adults. Research indicates that maintaining contact either via letter or postcard with at-risk adults following discharge from care services can reduce reattempt risk. Feasibility trials demonstrated that intervention through text message was also effective in preventing suicide repetition amongst suicide attempters. The aim of the current study is to investigate the effect of text message intervention versus traditional treatment on reducing the risk of suicide attempt repetition among adults after self-harm. The study will be a 2-year multicentric randomized controlled trial conducted by the Brest University Hospital, France. Participants will be adults discharged after self-harm, from emergency services or after a short hospitalization. Participants will be recruited over a 12-month period. The intervention is comprised of an SMS that will be sent at h48, D7, D15 and monthly. The text message enquires about the patients' well-being and includes information regarding individual sources of help and evidence-based self help strategies. Participants will be assessed at the baseline, month 6 and 13. As primary endpoint, we will assess the number of patients who reattempt suicide in each group at 6 months. As secondary endpoints, we will assess the number of patients who reattempt suicide at 13 month, the number of suicide attempts in the intervention and control groups at 6 and 13 month, the number of death by suicide in the intervention and control groups at month 6 and 13. In both groups, suicidal ideations, will be assessed at the baseline, month 6 and 13. Medical costs and satisfaction will be assessed at month 13. This paper describes the design and deployment of a trial SIAM; an easily reproducible intervention that aims to reduce suicide risk in adults after self-harm. It utilizes several characteristics of interventions that have shown a significant reduction in the number of suicide reattempts. We propose to assess its efficacy in reducing suicide reattempt in the suicide attempter (SA) population. The study was registered on Clinical Trials Registry (clinicaltrials.gov): NCT02106949, registered on 06 June 2014.

Assessing suicidal youth with antisocial, borderline, or narcissistic personality disorder.

PubMed

Links, Paul S; Gould, Brent; Ratnayake, Ruwan

2003-06-01

This paper has 3 objectives. First, we review the epidemiologic evidence for the association between suicidal behaviour and suicide in individuals diagnosed with antisocial, borderline, or narcissistic personality disorder. Second, we examine whether any potentially modifiable risk factors are associated with these diagnoses, based on existing empirical evidence. Last, we discuss clinical approaches to assessing youth with antisocial, borderline, or narcissistic personality disorder presenting at risk for suicide. We reviewed the English-language literature for the last 12 years (from January 1, 1991, to December 31, 2002), using as search terms the names of the 3 disorders, as well as the key words suicide, suicidal behaviour, youth, and adolescents. Patients with antisocial or borderline personality disorder are likely to be at increased risk for suicidal behaviour when they demonstrate such comorbid disorders as major depressive episodes or substance abuse disorders, when they experience recent negative life events, or when they have a history of childhood sexual abuse. For patients with antisocial personality disorder, the risk of violence has to be judged in addition to the risk of suicide or self-harm. For patients with borderline personality disorder, interventions are determined by differentiating acute-on-chronic from chronic risk of suicidal behaviour. Finally, patients with narcissistic personality disorder can be at high risk for suicide during periods when they are not suffering from clinical depression. These episodes can seem to be unpredictable.

International note: association between perceived resilience and health risk behaviours in homeless youth.

PubMed

Oppong Asante, Kwaku; Meyer-Weitz, Anna

2015-02-01

Homeless youth are regarded as an extremely high risk group, susceptible to suicidal ideation substance abuse, and high rates of mental illness. While there exists a substantial body of knowledge regarding resilience of homeless youth, few studies has examined the relationship between perceived resilience and health risk behaviours. The present study describes the findings from a quantitative examination of street-related demographics, resilience, suicidal ideation, substance abuse, sexual risk behaviours and violent related behaviours among 227 homeless youth. The findings revealed that perceived resilience was negatively related to suicidal ideation, substance abuse and violence. Suicidal ideation was positively related to both substance abuse and violence, whilst violence and substance abuse were positively correlated. Multiple regressions showed that perceived resilience served as a protective factor for suicidal ideation and having multiple sexual lifetime partners, suggesting that youth with lower level of perceived resilience were more likely to engage in various health risks behaviours. Copyright © 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Temperament and character personality profile and affective temperaments in self-poisoning nonlethal suicide attempters.

PubMed

Ardani, Amir Rezaei; Naghibzadeh, Bahram; Farid Hosseini, Farhad; Asadpour, Zahra; Khabazianzadeh, Fatemeh

2015-09-30

Involvement of personality traits in susceptibility to suicidal behaviour has attracted considerable research interest over the past decades. This study was motivated by reports that emotionality may play a potentially confounding role in the association between the personality profile and suicidal behaviour. We assessed the association between personality traits, as measured using the Temperament and Character Inventory (TCI), and suicidal behaviour, while controlling for the effects of Affective Temperaments, measured using the Temperament Evaluation of the Memphis, Pisa, Paris and San Diego auto-questionnaire (TEMPS-A) in a sample of 140 consecutive self-poisoning nonlethal suicide (SNS) attempters admitted to the Emergency Toxicology Clinic, comparing them with a sample of 140 age and sex matched healthy controls. After controlling for Affective Temperaments, the temperament dimension of Novelty Seeking (NS) and the character dimensions of Self-directedness and Self-transcendence remained significantly associated with SNS attempts. NS, in particular, was most consistently and uniquely associated with suicidal behaviour. The present study conveys the difficulty in disentangling the personality profile of SNS attempters from their emotionality. We conclude that the risk associated with certain personality traits is often entirely mediated by Affective Temperaments and few dimensions independently contribute to the risk of self-poisoning nonlethal suicidal behaviour. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Trends in hospital admissions involving suicidal behaviour in the Northern Territory, 2001-2013.

PubMed

Leckning, Bernard A; Li, Shu Qin; Cunningham, Teresa; Guthridge, Steven; Robinson, Gary; Nagel, Tricia; Silburn, Sven

2016-06-01

To investigate trends in hospital admissions involving suicidal behaviour in the Northern Territory (NT) resident population over the period 2001-2013. Estimates of age-standardised rates and average changes in the annual rate of hospital admissions involving suicidal behaviour were calculated by socio-demographic characteristics and types of suicidal behaviour. Overall rates for Indigenous admissions were 2.7 times higher than non-Indigenous admissions and had increased by almost twice as much. While male and female rates of admission were similar for both Indigenous and non-Indigenous residents, the average annual change in rates was greater for Indigenous females (13.4%) compared to males (8.8%) and for non-Indigenous males (7.7%) compared to females (5.2%). Younger and middle-aged Indigenous admissions experienced increasing rates of admissions, whilst trends were similar across age groups for non-Indigenous admissions. Admissions with a diagnosis of suicidal ideation increased the most across all groups. Trends in intentional self-harm admissions differed according to Indigenous status and sex. There have been substantial increases in hospital admissions involving suicidal behaviour in the NT, most markedly for Indigenous residents. Indigenous females and youth appear to be at increasing risk. The steep increase in suicidal ideation across all groups warrants further investigation. © The Royal Australian and New Zealand College of Psychiatrists 2016.

[Perceived satisfaction and usefulness of suicide prevention information for patients and relatives].

PubMed

Triñanes, Y; Senra-Rivera, C; Seoane-Pesqueira, G; González-García, A; Álvarez-Ariza, M; de-Las-Heras-Liñero, E; Atienza, G

2014-01-01

To assess the satisfaction of persons with suicidal behaviour and their relatives using patient information material included in the Clinical Practice Guidelines on Prevention and Treatment of Suicidal Behaviour. The sample was made up of 57 patients with suicidal ideation or behaviour, and 52 relatives. The participants were recruited through a suicide prevention programme (Programa de intervención intensiva en conducta suicida [PII] - Suicidal Behaviour Intensive Intervention Programme) and a family association (Federación de Asociaciones de Familiares y Personas con enfermedad mental de Galicia [FEAFES] - Galician Federation of Associations of Relatives and Persons with mental diseases). An ad-hoc questionnaire was designed to ascertain the degree of perceived satisfaction and usefulness of using the information included in the guidelines. The descriptive data of the sample is presented, along with an exploratory factorial analysis of the questionnaire that yielded two dimensions, i.e., format and usefulness. Patients scored significantly lower than the relatives in two dimensions; nevertheless, no significant differences were found between the two groups in the level of general satisfaction. The socio-demographic variables did not influence the results. Similarly, no differences were observed between patients with and without history of suicidal behaviour. Participants stressed that Primary Care was the setting best suited for dissemination of this type of information. In general, both patients and relatives displayed a high level of satisfaction with the patient information material assessed. Furnishing information of this type to patients with suicidal ideation and/or behaviour could act as a preventive-educational tool. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

Victims of bullying in childhood and suicide attempts in adulthood.

PubMed

Meltzer, H; Vostanis, P; Ford, T; Bebbington, P; Dennis, M S

2011-11-01

To examine whether self-reported exposure to bullying during childhood is associated with suicide attempts over the life course, and if so, what mechanisms could account for this relationship. A random probability sample comprising 7461 respondents was interviewed for the 2007 survey of psychiatric morbidity of adults in Great Britain. Survey respondents were asked about suicidal attempts and whether they were bullied in childhood. Recall of being bullied in childhood decreased with age from 25% of 16-24-year-olds to 4% among those 75 or over with few differences in the proportions between men and women. Bullying co-occurred with several victimisation experiences including sexual abuse and severe beatings and with running away from home. Even after controlling for lifetime factors known to increase the risk of suicidal behaviour, adults who reported bullying in childhood were still more than twice as likely as other adults to attempt suicide later in life. Being the victim of bullying involves the experience of suffering a defeat and humiliation that in turn could lead to entrapment, hopelessness, depression and suicidal behaviour. Bullying is already known to be associated with substantial distress and other negative consequences and this further evidence of a strong correlation with the risk of suicide in later life should increase further the motivation of society, services and citizens to act decisively to reduce bullying in childhood. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

The impact of fiscal austerity on suicide: on the empirics of a modern Greek tragedy.

PubMed

Antonakakis, Nikolaos; Collins, Alan

2014-07-01

Suicide rates in Greece (and other European countries) have been on a remarkable upward trend following the global recession of 2008 and the European sovereign debt crisis of 2009. However, recent investigations of the impact on Greek suicide rates from the 2008 financial crisis have restricted themselves to simple descriptive or correlation analyses. Controlling for various socio-economic effects, this study presents a statistically robust model to explain the influence on realised suicidality of the application of fiscal austerity measures and variations in macroeconomic performance over the period 1968-2011. The responsiveness of suicide to levels of fiscal austerity is established as a means of providing policy guidance on the extent of suicide behaviour associated with different fiscal austerity measures. The results suggest (i) significant age and gender specificity in these effects on suicide rates and that (ii) remittances have suicide-reducing effects on the youth and female population. These empirical regularities potentially offer some guidance on the demographic targeting of suicide prevention measures and the case for 'economic' migration. Copyright © 2014 Elsevier Ltd. All rights reserved.

Young Male Prisoners in a Young Offenders' Institution: Their Contact with Suicidal Behaviour by Others

ERIC Educational Resources Information Center

Hales, H.; Davison, S.; Misch, P.; Taylor, P. J.

2003-01-01

Prison suicide rates are increasing. The impact of witnessing a suicide or how many people do so is unknown. The aim of this study was to find how many young people detained in a Young Offenders' Institution (YOI) have had contact with another's suicide attempt and to test for association between this and own self-harming behaviour. A…

Suicide in young men.

PubMed

Pitman, Alexandra; Krysinska, Karolina; Osborn, David; King, Michael

2012-06-23

Suicide is second to only accidental death as the leading cause of mortality in young men across the world. Although suicide rates for young men have fallen in some high-income and middle-income countries since the 1990s, wider mortality measures indicate that rates remain high in specific regions, ethnic groups, and socioeconomic groups within those nations where rates have fallen, and that young men account for a substantial proportion of the economic cost of suicide. High-lethality methods of suicide are preferred by young men: hanging and firearms in high-income countries, pesticide poisoning in the Indian subcontinent, and charcoal-burning in east Asia. Risk factors for young men include psychiatric illness, substance misuse, lower socioeconomic status, rural residence, and single marital status. Population-level factors include unemployment, social deprivation, and media reporting of suicide. Few interventions to reduce suicides in young men have been assessed. Efforts to change help-seeking behaviour and to restrict access to frequently used methods hold the most promise. Copyright © 2012 Elsevier Ltd. All rights reserved.

Prevalence and social determinants of suicidal behaviours among college youth in India.

PubMed

Nath, Yogini; Paris, Joel; Thombs, Brett; Kirmayer, Laurence

2012-07-01

Little is known about the prevalence of and factors associated with suicide ideation and suicide attempts among college youth in India. The aims were to estimate the prevalence of suicidal behaviours among Indian college students and identify potential risk factors for suicide ideation and attempts. The study surveyed 1,817 undergraduate college students aged 18-24 years in Ahmedabad, Gujarat, with a questionnaire that assessed suicidal behaviours as well as stressful situations and life events. Logistic regression analysis was used to assess risk factors. The prevalence of lifetime suicide ideation and lifetime suicide attempts was 11.7% and 4.0%, respectively. Suicide ideation was predicted by female gender, odds ratio (OR) = 1.41, 95% CI 1.01, 1.97, economic stress, OR = 1.17, 95% CI 1.11, 1.24, stress due to life events involving religious violence in the community, OR = 1.43, 95% CI 1.15, 1.78, and life events involving caste conflicts or caste discrimination, OR = 1.28, 95% CI 1.13, 1.46. Female gender and caste-related life events were not significantly associated with suicide attempts but economic stress and stressful experience of religious conflict continued to be significantly associated with lifetime suicide attempt, OR = 1.19, 95% CI 1.08, 1.31, and OR = 1.58, 95% CI 1.14, 2.17, respectively. In this sample, college students from low socioeconomic classes who faced economic difficulties, and students who experienced distress as a result of caste discrimination or caste conflict, and communal unrest, were at a higher risk for suicidal behaviour.

Understanding the role of sleep in suicide risk: qualitative interview study

PubMed Central

Kyle, Simon D; Pratt, Daniel; Peters, Sarah

2016-01-01

Objective Sleep problems are associated with increased risk of suicide, independent of depression. This analysis explores narrative accounts of the role of sleep in relation to suicidal thoughts and behaviours. Design Qualitative study, based on in-depth semistructured interviews which were analysed with an inductive, latent thematic analysis. Participants A maximum variation sample of 18 people with experience of a major depressive episode, and suicidal thoughts and behaviours. Setting Primary care, North West England. Results Respondents emphasised the importance of sleep for recovery and management of their mental well-being. Moreover, three inter-related pathways were identified, whereby beliefs about sleep contributed to suicidal thoughts and behaviours. First, being awake during the biological night heightened risk of suicidal behaviours, as this was perceived to be an opportune time for a suicide attempt due to the decreased chances that a friend of family member would intervene during a suicide attempt. Additionally, the reduction in available support at night added to suicide risk. Second, failure to achieve good sleep was perceived to make life harder through contributing to core features of depression, such as negative thinking, attention difficulties and inactivity. Third, sleep acted as an alternative to suicide, by providing an escape from problems, including mental health problems, in waking life. However, this desire to sleep to escape was associated with excessive daytime sleeping, which subsequently may reinforce disturbed sleeping patterns. Conclusions Sleep problems should be an important treatment target when working with suicidal clients. More broadly, night-time service provision should be considered when developing suicide prevention initiatives. PMID:27550652

Risk and protective factors for suicidal ideation and behaviour in Rwandan children

PubMed Central

Ng, Lauren C.; Kirk, Catherine M.; Kanyanganzi, Frederick; Fawzi, Mary C. Smith; Sezibera, Vincent; Shema, Evelyne; Bizimana, Justin I.; Cyamatare, Felix R.; Betancourt, Theresa S.

2015-01-01

Background Suicide is a leading cause of death for young people. Children living in sub-Saharan Africa, where HIV rates are disproportionately high, may be at increased risk. Aims To identify predictors, including HIV status, of suicidal ideation and behaviour in Rwandan children aged 10–17. Method Matched case–control study of 683 HIV-positive, HIV-affected (seronegative children with an HIV-positive caregiver), and unaffected children and their caregivers. Results Over 20% of HIV-positive and affected children engaged in suicidal behaviour in the previous 6 months, compared with 13% of unaffected children. Children were at increased risk if they met criteria for depression, were at high-risk for conduct disorder, reported poor parenting or had caregivers with mental health problems. Conclusions Policies and programmes that address mental health concerns and support positive parenting may prevent suicidal ideation and behaviour in children at increased risk related to HIV. PMID:26045350

Area-level socioeconomic disadvantage and suicidal behaviour in Europe: A systematic review.

PubMed

Cairns, Joanne-Marie; Graham, Eva; Bambra, Clare

2017-11-01

The relationship between adverse individual socio-economic circumstances and suicidal behaviour is well established. However, the impact of adverse collective circumstances - such as the socio-economic context where people live - is less well understood. This systematic review explores the extent to which area-level socioeconomic disadvantage is associated with inequalities in suicidal behaviour and self-harm in Europe. We performed a systematic review (in MEDLINE, Embase, PsycINFO, EconLit and Social Sciences Citation Index) from 2005 to 2015. Observational studies were included if they were based in Europe and had a primary suicidal behaviour and self-harm outcome, compared at least two areas, included an area-level measure of socio-economic disadvantage and were published in the English language. The review followed The Joanna Briggs Institute guidelines for quality appraisal. We identified 27 studies (30 papers) from 14 different European countries. There was a significant association (in 25/27 studies, all of which were rated as of medium or high quality) between socioeconomic disadvantage and suicidal behaviour (and self-harm), particularly for men, and this was a consistent finding across a variety of European countries. Socio-economic disadvantage was found to have an independent effect in several studies whilst others found evidence of mediating contextual and compositional factors. There is strong evidence of an association between suicidal behaviours (and self-harm) and area-level socio-economic disadvantage in Europe, particularly for men. Suicide prevention strategies should take this into account. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Calls due to suicidal behaviour made to the prehospital, emergency department in Málaga: characteristics and associated factors].

PubMed

Jiménez-Hernández, M; Castro-Zamudio, S; Guzmán Parra, J; Martínez-García, A I; Guillén-Benítez, C; Moreno-Küstner, B

2017-12-29

Suicidal behaviour (fatal and non-fatal) has become a serious public health problem in many countries. The aim of the study was to describe the differential characteristics of emergency calls due to suicidal behaviour made to the Emergency Coordinating Centre (CCUE) in the province of Málaga, in comparison with calls due to physical or psychiatric problems. Retrospective observational study of the calls recorded in the database of the Public Company for Emergency Health during one year. Multivariate logistic regression analyses were carried out including age, gender and the following variables related with the demand: hours of the day, type of day (working days or bank holidays), months of the year and trimesters, number of resources mobilized and types of resolution. The analyses were carried out on 163,331 calls, of which 1,380 calls were due to suicidal behaviour (0.8%), 9,951 for psychiatric reasons (6.1%) and 152,000 for physical reasons (93%). The emergency calls for suicidal behaviour were mainly made by females, between 31-60 years, in the evening and at night, and required transfer to hospital and more than one mobilized resource. Calls due to completed suicide were more frequently made by older men. Calls due to suicidal tendencies predominated over those due to attempted or threatened suicide during the first trimester of the year, while the opposite was the case during the third trimester. The results indicated differential characteristics of suicide calls that are potentially relevant for prevention in spite of the limitations of the present study.

Psychosocial influences on prisoner suicide: a case-control study of near-lethal self-harm in women prisoners.

PubMed

Marzano, Lisa; Hawton, Keith; Rivlin, Adrienne; Fazel, Seena

2011-03-01

We examined the psychosocial influences on female prisoner suicide by carrying out a study of near-lethal self-harm. We interviewed 60 women prisoners who had recently engaged in near-lethal self-harm (cases) and 60 others who had never carried out near-lethal acts in prison (controls) from all closed female prison establishments in England and Wales, using mixed quantitative and qualitative methods. We gathered information on socio-demographic and criminological variables, life events and childhood trauma, exposure to suicidal behaviour, contributory and precipitating factors for near-lethal self-harm, social support and psychological characteristics. While socio-demographic factors were only modestly associated with near-lethal self-harm, being on remand, in single cell accommodation, and reporting negative experiences of imprisonment were strong correlates. Recent life events and past trauma, including different forms of childhood abuse, were also significantly associated with near-lethal self-harm, as were a family history of suicide and high scores on measures of depression, aggression, impulsivity and hostility, and low levels of self-esteem and social support. Our findings underline the importance of both individual and prison-related factors for suicide in custody, and hence the need for a comprehensive approach to suicide prevention in women's prisons. Given the multiple needs of female prisoners at-risk of self-harm and suicide, complex psychosocial interventions are likely to be required, including interventions for abused and bereaved women, and initiatives to improve staff-prisoner relationships and reduce bullying. The findings of this research may provide insights into factors leading to suicidal behaviour in other forensic and institutional settings, such as detention centres and psychiatric hospitals, and may assist in developing suicide prevention policies for prisoners and other at-risk populations. Copyright © 2011 Elsevier Ltd. All rights reserved.

Violent suicidal behaviour in bipolar disorder is associated with nitric oxide synthase 3 gene polymorphism.

PubMed

Oliveira, J; Debnath, M; Etain, B; Bennabi, M; Hamdani, N; Lajnef, M; Bengoufa, D; Fortier, C; Boukouaci, W; Bellivier, F; Kahn, J-P; Henry, C; Charron, D; Krishnamoorthy, R; Leboyer, M; Tamouza, R

2015-09-01

Given the importance of nitric oxide system in oxidative stress, inflammation, neurotransmission and cerebrovascular tone regulation, we postulated its potential dysfunction in bipolar disorder (BD) and suicide. By simultaneously analysing variants of three isoforms of nitric oxide synthase (NOS) genes, we explored interindividual genetic liability to suicidal behaviour in BD. A total of 536 patients with BD (DSM-IV) and 160 healthy controls were genotyped for functionally relevant NOS1, NOS2 and NOS3 polymorphisms. History of suicidal behaviour and violent suicide attempt was documented for 511 patients with BD. Chi-squared test was used to perform genetic association analyses and logistic regression to test for gene-gene interactions. NOS3 rs1799983 T homozygous state was associated with violent suicide attempts (26.4% vs. 10.8%, in patients and controls, P = 0.002, corrected P (Pc) = 0.004, OR: 2.96, 95% CI = 1.33-6.34), and this association was restricted to the early-onset BD subgroup (37.9% vs. 10.8%, in early-onset BD and controls, P = 0.0003, Pc = 0.0006 OR: 5.05, 95% CI: 1.95-12.45), while we found no association with BD per se and no gene-gene interactions. Our results bring further evidence for the potential involvement of endothelial NOS gene variants in susceptibility to suicidal behaviour. Future exploration of this pathway on larger cohort of suicidal behaviour is warranted. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Exposure to suicide behaviour and individual risk of self-harm: Findings from a nationally representative New Zealand high school survey.

PubMed

Chan, Song; Denny, Simon; Fleming, Theresa; Fortune, Sarah; Peiris-John, Roshini; Dyson, Ben

2018-04-01

To examine whether there is an association between students self-reported suicide attempts and non-suicidal self-injury and exposure to suicidal behaviour among friends, family members or within school communities. A cross-sectional analysis of a nationally representative health and well-being survey of 8500 New Zealand high school students conducted from March through November 2012. Students' self-reported suicide attempts and repeated non-suicidal self-injury was examined in relation to student reports of self-harming behaviour among friends and family as well as data from school administrators of completed suicides within the school community. Almost 1 in 20 (4.5%) students reported a suicide attempt in the last 12 months and 7.9% reported repeated non-suicidal self-injury in the last 12 months. The risk of both suicide attempts and repeated non-suicidal self-injury was highest among females, students from homes with economic deprivation and among students reporting an episode of low mood in the previous 12 months. Students exposed to suicide attempts or completed suicide among friends and/or family members were at increased risk of reporting attempted suicide and repeated non-suicidal self-injury in the last year. There was no association between completed suicide in school community and students self-reported suicide attempts or repeated non-suicidal self-injury. Low mood and exposure to suicide attempts of friends and family members are associated with suicide attempts and repeated non-suicidal self-injury in New Zealand high school students. This research highlights importance of supporting adolescents with low mood and exposed to suicide of friends and family.

Suicide and suicidal behaviour

PubMed Central

Turecki, Gustavo; Brent, David A.

2017-01-01

Summary Suicide is a complex public health problem of global dimension. Suicidal behaviour (SB) shows marked differences between genders, age groups, geographic regions and socio-political realities, and variably associates with different risk factors, underscoring likely etiological heterogeneity. Although there is no effective algorithm to predict suicide in clinical practice, improved recognition and understanding of clinical, psychological, sociological, and biological factors may facilitate the detection of high-risk individuals and assist in treatment selection. Psychotherapeutic, pharmacological, or neuromodulatory treatments of mental disorders can often prevent SB; additionally, regular follow-up of suicide attempters by mental health services is key to prevent future SB. PMID:26385066

Suicide and poverty in low-income and middle-income countries: a systematic review.

PubMed

Iemmi, Valentina; Bantjes, Jason; Coast, Ernestina; Channer, Kerrie; Leone, Tiziana; McDaid, David; Palfreyman, Alexis; Stephens, Bevan; Lund, Crick

2016-08-01

Suicide is the 15th leading cause of death worldwide, with over 75% of suicides occurring in low-income and middle-income countries. Nonetheless, evidence on the association between suicide and poverty in low-income and middle-income countries is scarce. We did a systematic review to understand the association between suicidal ideations and behaviours and economic poverty in low-income and middle-income countries. We included studies testing the association between suicidal ideations and behaviours and economic poverty in low-income and middle-income countries using bivariate or multivariate analysis and published in English between January, 2004, and April, 2014. We identified 37 studies meeting these inclusion criteria. In 18 studies reporting the association between completed suicide and poverty, 31 associations were explored. The majority reported a positive association. Of the 20 studies reporting on the relationship between non-fatal suicidal ideations and behaviours and poverty, 36 associations were explored. Again, almost all studies reported a positive association. However, when considering each poverty dimension separately, we found substantial variations. These findings show a consistent trend at the individual level indicating that poverty, particularly in the form of worse economic status, diminished wealth, and unemployment is associated with suicidal ideations and behaviours. At the country level, there are insufficient data to draw clear conclusions. Available data show a potential benefit in addressing economic poverty within suicide prevention strategies, with particular attention to both chronic poverty and acute economic events. Copyright © 2016 Elsevier Ltd. All rights reserved.

Personality traits as an endophenotype in genetic studies on suicidality in bipolar disorder.

PubMed

Pawlak, J; Dmitrzak-Węglarz, M; Maciukiewicz, M; Kapelski, P; Czerski, P; Leszczyńska-Rodziewicz, A; Zaremba, D; Hauser, J

2017-04-01

Introduction The influence of personality traits on suicidal behaviour risk has been well documented. Personality traits and suicidal behaviour are partially genetically determined and personality has been described as an endophenotype of suicidal behaviour. The aim of this study was to investigate a possible association between personality traits with suicidal behaviour and selected serotonergic gene polymorphisms. In the study we included 156 patients meeting DSM-IV criteria for bipolar disorder (BP) and 93 healthy controls. The personality dimensions were assessed using the Temperament and Character Inventory (TCI). We genotyped two selected polymorphisms of the tryptophan hydroxylase 1 (TPH1) gene (rs1800532 218A>C and rs1799913 779A>C) and polymorphism in the promoter region of serotonin transporter gene (5-HTTLPR, rs25531) related to serotoninergic neurotransmission. Multiple poisson regression, logistic regression and Kruskal-Wallis tests were applied. We found numerous differences between the BP patients and the control group in terms of their TCI dimensions/subdimensions. Significant differences were found between patients with, and without, suicidal attempts in fatigability and asthenia (Ha4), as well as in harm avoidance (Ha). We also found that the interactions between TCI subdimensions (the interaction of disordiness (Ns4) and spiritual acceptance (St3), disordiness (Ns4) and integrated conscience (C5), extravagance (Ns3) and resourcefulness (Sd3)) were significantly contributing for suicidal behaviour risk. We found association between all studied genetic polymorphisms and several TCI dimensions and subdimensions. Our results confirm that personality traits are partially determined by genes. Both personality traits and the interactions between temperament and character traits, may be helpful in predicting suicidal behaviour.

"I just couldn't step out of the circle. I was trapped": Patterns of endurance and distress in Chinese-Canadian women with a history of suicidal behaviour.

PubMed

Zaheer, Juveria; Shera, Wes; Tsang, A Ka Tat; Law, Samuel; Fung, Wai Lun Alan; Eynan, Rahel; Lam, June; Zheng, Xiaoqian; Pozi, Liu; Links, Paul S

2016-07-01

Recent studies have highlighted higher rates of suicidal ideation and behaviour and associated themes of gender role stress in Chinese women residing in North America. However, qualitative studies, which privilege their voices in the discourse of suicide prevention and provide insight into their experiences, are lacking. To gain an understanding of the life histories, patterns of distress and constructions of suicide of Chinese-Canadian women with a history of suicidal behaviour. Ten women were recruited from four mental health programs in Toronto, Canada and participated in qualitative interviewing and analysis informed by constructivist grounded theory. Chinese-Canadian women describe experiencing "stress" or "pressure" leading to the exacerbation of depressive symptoms. Stress and pressure are managed through a coping strategy of endurance, informed by the cultural conception of "ren". Cultural influences contribute to the manifestation of stress and pressure as somatic symptoms and sleeplessness. Finally, the women describe feeling unable to endure through worsening distress, reaching a "breaking point"; suicidal behaviour is constructed as a strategy to disrupt this cycle. This study challenges the binary notion that suicidal behaviour is either a consequence of mental illness or a reaction to interpersonal stress. Rather, the women describe an ingrained pattern of enduring through psychosocial problems without acknowledging worsening anxiety, depressive and physical symptoms. The pattern of endurance also prevents early treatment of these difficulties, resulting in the intensification of symptoms until a breaking point is reached. Knowledge of these patterns and coping strategies can allow for earlier identification and intervention for women at risk to prevent the worsening of distress leading to suicidal thoughts and behaviour. Copyright © 2016 Elsevier Ltd. All rights reserved.

[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.

Differences in emotion modulation using cognitive reappraisal in individuals with and without suicidal ideation: An ERP study.

PubMed

Kudinova, Anastacia Y; Owens, Max; Burkhouse, Katie L; Barretto, Kenneth M; Bonanno, George A; Gibb, Brandon E

2016-08-01

Difficulties in emotion regulation have been associated with increased suicidal thoughts and behaviours. The majority of studies have examined self-reported use of emotion regulation strategies. In contrast, the current study focused on a direct measure of individuals' ability to use a specific emotion regulation strategy, cognitive reappraisal, using the late positive potential (LPP), an event-related potential component that reflects attention to emotional stimuli. Specifically, the cognitive reappraisal ability of 33 undergraduate students was assessed via an image-viewing task during which the participants had to passively view, increase or reduce their emotions in response to looking at neutral, positive or dysphoric images. We found that participants with a history of suicidal ideation (SI) had significantly higher LPP when asked to reduce negative emotion in response to dysphoric images, compared to individuals with no history of SI. These findings suggest that difficulties with using cognitive reappraisal, specifically to decrease negative affect, might be linked to suicide risk.

Hostility and childhood sexual abuse as predictors of suicidal behaviour in Borderline Personality Disorder.

PubMed

Ferraz, Liliana; Portella, Maria J; Vállez, Mónica; Gutiérrez, Fernando; Martín-Blanco, Ana; Martín-Santos, Rocío; Subirà, Susana

2013-12-30

Impulsivity is a multidimensional construct and has been previously associated with suicidal behaviour in borderline personality disorder (BPD). This study examined the associations between suicidal behaviour and impulsivity-related personality traits, as well as history of childhood sexual abuse, in 76 patients diagnosed with BPD using both the Structured Interview for Diagnostic and Statistical Manual of Mental Disorders III (DSM-III) Axis-II diagnoses and the self-personality questionnaire. Impulsivity-related traits were measured using the Barratt Impulsiveness Scale-11 (BIS-11), the Buss-Durkee Hostility Inventory (BDHI) and the Temperament and Character Inventory-Revised (TCI-R). We found that hostility and childhood sexual abuse, but not impulsivity or other temperament traits, significantly predicted the presence, number and severity of previous suicide attempts. Hostility traits and childhood sexual abuse showed an impact on suicide attempts in BPD. Our results support previous findings indicating that high levels of hostility and having suffered sexual abuse during childhood lead to an increased risk for suicidal behaviour in BPD. © 2013 Elsevier Ireland Ltd. All rights reserved.

Understanding the role of sleep in suicide risk: qualitative interview study.

PubMed

Littlewood, Donna L; Gooding, Patricia; Kyle, Simon D; Pratt, Daniel; Peters, Sarah

2016-08-22

Sleep problems are associated with increased risk of suicide, independent of depression. This analysis explores narrative accounts of the role of sleep in relation to suicidal thoughts and behaviours. Qualitative study, based on in-depth semistructured interviews which were analysed with an inductive, latent thematic analysis. A maximum variation sample of 18 people with experience of a major depressive episode, and suicidal thoughts and behaviours. Primary care, North West England. Respondents emphasised the importance of sleep for recovery and management of their mental well-being. Moreover, three inter-related pathways were identified, whereby beliefs about sleep contributed to suicidal thoughts and behaviours. First, being awake during the biological night heightened risk of suicidal behaviours, as this was perceived to be an opportune time for a suicide attempt due to the decreased chances that a friend of family member would intervene during a suicide attempt. Additionally, the reduction in available support at night added to suicide risk. Second, failure to achieve good sleep was perceived to make life harder through contributing to core features of depression, such as negative thinking, attention difficulties and inactivity. Third, sleep acted as an alternative to suicide, by providing an escape from problems, including mental health problems, in waking life. However, this desire to sleep to escape was associated with excessive daytime sleeping, which subsequently may reinforce disturbed sleeping patterns. Sleep problems should be an important treatment target when working with suicidal clients. More broadly, night-time service provision should be considered when developing suicide prevention initiatives. 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/

The epidemiology of suicide on the London Underground.

PubMed

O'Donnell, I; Farmer, R D

1994-02-01

A database containing details of every incident of suicidal behaviour on the London Underground railway system between 1940 and 1990 was assembled from the records of London Underground Ltd and the British Transport Police. The total number of cases was 3240. The mean annual number of suicidal acts on the London Underground system increased from 36.1 (1940-1949) to 94.1 (1980-1989). There were significantly fewer incidents on Sundays than on the other days of the week and the daily rate was highest in the spring. 64% of incidents involved males and the peak age group for both sexes was 25-34 yr. Suicide verdicts were returned for a greater proportion of women than men. Overall case fatality was 55%. However, case fatality rates differed between stations, environmental factors appearing to influence survival. Possible strategies to prevent railway suicides and reduce the lethality of this method are discussed.

Influence of Religion on Attitude Towards Suicide: An Indian Perspective.

PubMed

Thimmaiah, Rohini; Poreddi, Vijayalakshmi; Ramu, Rajalakshmi; Selvi, Sugavana; Math, Suresh Bada

2016-12-01

This cross-sectional survey was aimed to compare attitudes towards suicide and suicidal behaviour among randomly selected sample (N = 172) belonged to Hindu and Muslim religions. Data were collected through face-to-face interview. Hindus differed from Muslims regarding suicidal attempts among family (χ (2) = 12.356, p < .002) and community members (χ (2) = 20.425, p < .000). Our study also showed that suicidal behaviours were comparatively low among Muslim participants than Hindus. Further, Muslims hold more negative attitudes towards suicide than Hindus. An enhanced understanding of attitudes towards suicide among general population may be crucial to plan educational, intervention and prevention programs.

Suicidal behaviours: Prevalence estimates from the second Australian Child and Adolescent Survey of Mental Health and Wellbeing.

PubMed

Zubrick, Stephen R; Hafekost, Jennifer; Johnson, Sarah E; Lawrence, David; Saw, Suzy; Sawyer, Michael; Ainley, John; Buckingham, William J

2016-09-01

To (1) estimate the lifetime and 12-month prevalence of suicidal behaviours in Australian young people aged 12-17 years, (2) describe their co-morbidity with mental illness and (3) describe the co-variation of these estimates with social and demographic variables. A national random sample of children aged 4-17 years was recruited in 2013-2014. The response rate to the survey was 55% with 6310 parents and carers of eligible households participating. In addition, of the 2967 young people aged 11-17 years in these households, 89% (2653) of the 12- to 17-year-olds completed a self-report questionnaire that included questions about suicidal behaviour. In any 12-month period, about 2.4% or 41,400 young people would have made a suicide attempt. About 7.5% of 12- to 17-year-olds report having suicidal ideation, 5.2% making a plan and less than 1% (0.6%) receiving medical treatment for an attempt. The presence of a mental disorder shows the largest significant association with lifetime and 12-month suicidal behaviour, along with age, gender, sole parent family status and poor family functioning. Of young people with a major depressive disorder, 19.7% reported making a suicide attempt within the previous 12 months. There are also significant elevations in the proportions of young people reporting suicidal behaviour who have anxiety and conduct disorders. Mental disorders should be a leading intervention point for suicide prevention both in the primary health sector and in the mental health sector specifically. The associations examined here also suggest that efforts to assist sole parent and/or dysfunctional families would be worthy areas in which to target these efforts. © The Royal Australian and New Zealand College of Psychiatrists 2016.

Personality trait risk factors for attempted suicide among young women with eating disorders.

PubMed

Youssef, G; Plancherel, B; Laget, J; Corcos, M; Flament, M F; Halfon, O

2004-05-01

- Clinical observations and a review of the literature led us to hypothesize that certain personality and character traits could provide improved understanding, and thus improved prevention, of suicidal behaviour among young women with eating disorders. - The clinical group consisted of 152 women aged between 18 and 24 years, with DSM-IV anorexia nervosa/restrictive type (AN-R = 66), anorexia nervosa/purging type (AN-P = 37), bulimia nervosa/non-purging type (BN-NP = 9), or bulimia nervosa/purging type (BN-P = 40). The control group consisted of 140 subjects. The assessment measures were the Minnesota Multiphasic Personality Inventory-second version (MMPI-2) scales and subscales, the Beck Depression Inventory (BDI) used to control for current depressive symptoms, plus a specific questionnaire concerning suicide attempts. - Suicide attempts were most frequent in subjects with purging behaviour (30.0% for BN-P and 29.7% for AN-P). Those attempting suicide among subjects with eating disorders were mostly students (67.8%). For women with AN-R the scales for 'Depression' and 'Antisocial practices' represented significant suicidal risk, for women with AN-P the scales for 'Hysteria', 'Psychopathic deviate', 'Shyness/Self-consciousness', 'Antisocial Practices', 'Obsessiveness' and 'Low self-esteem' were risk indicators and for women with BN-P the 'Psychasthenia', 'Anger' and 'Fears' scales were risk indicators. - This study provides interesting results concerning the personality traits of young women with both eating disorders and suicidal behaviour. Students and those with purging behaviour are most at risk. Young women should be given more attention with regard to the risk of suicide attempts if they: (a). have AN-R with a tendency to self-punishment and antisocial conduct, (b). have AN-P with multiple physical complaints, are not at ease in social situations and have antisocial behaviour, or (c). if they have BN-P and tend to be easily angered with obsessive behaviour and phobic worries. The MMPI-2 is an interesting assessment method for the study of traits indicating a risk of suicidal behaviour in young subjects, after controlling for current depressive pathology.

What characterizes substance abusers who commit suicide attempts? Factors related to Axis I disorders and patterns of substance use disorders. A study of treatment-seeking substance abusers in Norway.

PubMed

Landheim, A S; Bakken, K; Vaglum, P

2006-01-01

The frequency of suicide attempts and clinical characteristics of attempters among poly-substance abusers and alcoholics were examined. A consecutive sample (n = 260) of in- and outpatients from two Norwegian counties were assessed by Composite International Diagnostic Interview (Axis I disorders), Millon's Clinical Multiaxial Inventory (Axis II disorders) and the Norwegian National Client Assessment Form. When analysing the association between suicide attempters and the range of predictor variables, logistic regression analysis was conducted. Almost half (47%) of the sample reported lifetime suicide attempts; significantly more frequently in poly-substance abusers (58%) than alcoholics (38%). A substance use disorder with duration of >or=15 years and an early onset (<18 years of age) were independently associated with being a suicide attempter after controlling for Axis I disorders. In addition, eating disorders, agoraphobia and major depression were strongly and independently associated with being a suicide attempter. Attempts at preventing suicidal behaviour should not ignore the suicide risk among poly-substance abusers. In addition, prevention of suicidal behaviour demands a treatment programme focusing concomitantly on both addictive behaviour and comorbid psychiatric disorders. Copyright 2006 S. Karger AG, Basel.

Decision-making performance of depressed patients within 72 h following a suicide attempt.

PubMed

Hegedűs, Klára M; Szkaliczki, Andrea; Gál, Bernadett I; Andó, Bálint; Janka, Zoltán; Álmos, Péter Z

2018-08-01

The significance of decision-making in suicidal behaviour is often highlighted; however, the performance of persons in suicide crisis is unknown. This study aimed to explore the comprehensive decision-making profile of depressed patients following a suicide attempt. Decision-making was measured by reward- ("ABCD") and punishment- ("EFGH") sensitive versions of the Iowa Gambling Task (IGT) in 59 medication-free depressed patients within 72 h after a suicide attempt and in 46 healthy control subjects. Severity of depressive symptoms was assessed in the patient group by the Hamilton Depression Rating Scale. Performance of the two groups differed significantly on the IGT ABCD, while a trend towards significant differences was seen on the IGT EFGH. Severity of depressive symptoms did not affect the depressed participants' decision-making performance. Subjects were not matched for years of education. Administration of the IGT ABCD and IGT EFGH was not counterbalanced. Methods of suicide attempts and history of previous attempts were not collected. Individuals with a recent suicide attempt showed decision-making dysfunction on both IGT versions. However, on the EFGH, the overall difference between groups was not significant, depressed participants' performance remained poor during all blocks. Their behaviour reflected a focus on best immediate possible outcomes, not regarding future adverse consequences. This could be a result of psychological and cognitive alterations which modulate suicidal behaviour independent from mood. Further longitudinal studies should verify this possibility. Investigation of state-dependent neuropsychological characteristics of suicidal behaviour might be essential for detecting acute suicidal crisis. Copyright © 2018 Elsevier B.V. All rights reserved.

Suicidal Ideation and Attempts in Adolescents: Associations with Depression and Six Domains of Self-Esteem

ERIC Educational Resources Information Center

Wild, Lauren G.; Flisher, Alan J.; Lombard, Carl

2004-01-01

This study aimed to disentangle the influence of depression and self-esteem on suicidal behaviour in adolescence. Grades 8 and 11 students in Cape Town, South Africa (n=939) completed questionnaires assessing suicidal ideation and behaviour, depression, and self-esteem with respect to family, peers, school, sports/athletics, body image and global…

Suicidal behaviour in the ancient Greek and Roman world.

PubMed

Lykouras, L; Poulakou-Rebelakou, E; Tsiamis, C; Ploumpidis, D

2013-12-01

We attempt to present and analyze suicidal behaviour in the ancient Greek and Roman world. Drawing information from ancient Greek and Latin sources (History, Philosophy, Medicine, Literature, Visual Arts) we aim to point out psychological and social aspects of suicidal behaviour in antiquity. The shocking exposition of suicides reveals the zeitgeist of each era and illustrates the prevailing concepts. Social and legal reactions appear ambivalent, as they can oscillate from acceptance and interpretation of the act to punishment. In the history of these attitudes, we can observe continuities and breaches, reserving a special place in cases of mental disease. The delayed emergence of a generally accepted term for the voluntary exit from life (the term suicidium established during the 17th century), is connected to reactions triggered by the act of suicide than to the frequency and the extent of the phenomenon. The social environment of the person, who voluntary ends his life usually dictates the behaviour and historical evidence confirms the phenomenon. Copyright © 2013 Elsevier B.V. All rights reserved.

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.

Relationship between tinnitus and suicidal behaviour in Korean men and women: a cross-sectional study.

PubMed

Seo, J H; Kang, J M; Hwang, S H; Han, K D; Joo, Y H

2016-06-01

This study investigated the prevalence of suicidal ideation and behaviour in a representative sample of South Koreans with or without tinnitus. A cross-sectional study. Based on data from the 2010 to 2012 Korean National Health and Nutrition Examination Survey (KNHANES). The study included 17 446 Korean individuals. Participants provided demographic, socio-economic and behavioural information, as well as responses to questionnaires assessing the presence and severity of tinnitus, mental health status regarding stress, depression, and suicidal ideation and attempts. In the univariate analysis, the Rao-Scott chi-square test and logistic regression analysis were used to test the association between tinnitus and risk factors. Simple and multiple linear regression analyses were used to examine the association between tinnitus and mental status. A total of 20.9% and 1.2% of participants with tinnitus, and 12.2% and 0.6% of those without, reported suicidal ideation and attempts, respectively (P < 0.0001 and P = 0.001). Participants reporting suicide attempts showed a higher proportion of severe annoying (6.0%) and irritating (11.8%) tinnitus than those with suicidal ideation (1.4% and 10.2%, respectively). Risks for experiencing tinnitus were significantly associated with suicidal ideation and attempts after adjusting for confounding variables. This study has important implications for enhanced screening and evaluation of mental health status and suicidal ideation/behaviour among tinnitus patients. © 2015 John Wiley & Sons Ltd.

Why Suicide? The Analysis of Motives for Self-Harm.

PubMed

Abbas, Mohammed J; Mohanna, Mostafa A; Diab, Tarig A; Chikoore, Millicent; Wang, Michael

2018-03-01

There is a gap in understanding the meaning and motives behind suicidal behaviour. Using the Ideal Type methodology, Jean Baechler systematically examined the internal logic of suicidal and self-harming behaviours. He developed a typology of eleven typical meanings/motives: Flight, Grief, Self-punishment, Vengeance, Crime, Blackmail, Appeal, Sacrifice, Transfiguration, Ordeal and Game. To develop and validate a standardized instrument to measure the motives/meanings of suicidal and self-harming behaviours, using Baechler's typology. We developed a self-fill Likert questionnaire (Ideal Typical Meaning Questionnaire, ITMQ) covering ten of Baechler's eleven types. The questionnaire was completed by 147 patients within four weeks of attempting suicide or self-harm. The Death Attitude Profile-Revised (DAP-R) questionnaire was used to examine the concurrent validity of the Flight and the Transfiguration types and to explore the association between suicidal/self-harming motives and views about death. The final 25-item ITMQ has an eight-factor structure (Appeal/Blackmail, Ordeal/Game, Vengeance, Self-punishment, Sacrifice, Flight, Grief and Transfiguration) supporting Baechler's theory. The types have adequate reliability. Correlations with the DAP-R gave some support for the concurrent validity of the Flight and Transfiguration types. The ITMQ is a measure of suicidal and self-harming motives/meanings based on a sound conceptual framework and could significantly contribute to the understanding of suicidal and self-harming behaviour in research and clinical settings.

Metasynthesis of Youth Suicidal Behaviours: Perspectives of Youth, Parents, and Health Care Professionals

PubMed Central

Lachal, Jonathan; Orri, Massimiliano; Sibeoni, Jordan; Moro, Marie Rose; Revah-Levy, Anne

2015-01-01

Background Youth suicide is a major public health issue throughout the world. Numerous theoretical models have been proposed to improve our understanding of suicidal behaviours, but medical science has struggled to integrate all the complex aspects of this question. The aim of this review is to synthesise the views of suicidal adolescents and young adults, their parents, and their healthcare professionals on the topics of suicidal behaviour and management of those who have attempted suicide, in order to propose new pathways of care, closer to the issues and expectations of each group. Methods and Findings This systematic review of qualitative studies — Medline, PsycInfo, Embase, CINAHL, and SSCI from 1990 to 2014 — concerning suicide attempts by young people used thematic synthesis to develop categories inductively from the themes identified in the studies. The synthesis included 44 studies from 16 countries: 31 interviewed the youth, 7 their parents, and 6 the healthcare professionals. The results are organised around three superordinate themes: the individual experience, that is, the individual burden and suffering related to suicide attempts in all three groups; the relational experience, which describes the importance of relationships with others at all stages of the process of suicidal behaviour; and the social and cultural experience, or how the group and society accept or reject young people in distress and their families and how that affects the suicidal process and its management. Conclusion The violence of the message of a suicidal act and the fears associated with death lead to incomprehension and interfere with the capacity for empathy of both family members and professionals. The issue in treatment is to be able to witness this violence so that the patient feels understood and heard, and thus to limit recurrences. PMID:26001066

Assessment of Suicidal Behavior in a Psychiatric Emergency Room in Lisbon.

PubMed

Marques, João Gama; Guerreiro, Diogo Frasquilho; Sampaio, Daniel

2015-01-01

Some studies alerted for the burden of suicidal attempters at emergency rooms. In this study we characterized the suicidal patients admitted to a Portuguese emergency room. For three years, all patients assessed by the first author after suicidal behaviour were included. Suicidal intentionality was evaluated with the Pierce Suicide Intent Scale. Clinical records were searched for follow-up status and satisfaction level was assessed through telephone call. From 120 included patients 70.8% were female, with mean age of 42.35 years. Pierce Suicide Intent Scale suicidal intentionality was low in 30.1%, medium in 59.3%, and high in 10.6% of the sample. The most important predictors of Pierce Suicide Intent Scale intentionality were male gender (p < 0.001), family history of suicide (p < 0.01), divorced or widowed marital status (p < 0.013), and severe mental illness (p < 0.015). In 41.6% of the patients the follow-up status was unknown. Regarding satisfaction, only 19.5% gave a valid answer: 2.7% 'mildly satisfied', 4.4% 'moderately satisfied', and 12.5% 'very satisfied'. The Pierce Suicide Intent Scale is useful on suicidal behavior assessment at emergency rooms. Highly intentional suicidal behaviour is related to male sex, social problems and personal and familial psychiatric history. The quality of administrative records on this psychiatric emergency room setting are still unacceptable. The most important variables correlated with higher suicidal intentionality are the same described in other countries. Of the reachable patients, one fifth was satisfied with provided follow-up. We still need studies for better understanding of suicidal behaviour observed on this Portuguese emergency room.

Suicidal behaviour in Te Rau Hinengaro: the New Zealand Mental Health Survey.

PubMed

Beautrais, Annette L; Wells, J Elisabeth; McGee, Magnus A; Oakley Browne, Mark A

2006-10-01

To describe prevalence and correlates of suicidal behaviour in the New Zealand population aged 16 years and over. Data are from Te Rau Hinengaro: The New Zealand Mental Health Survey, a nationally representative household survey conducted from October 2003 to December 2004 in a sample of 12,992 participants aged 16 years and over to study prevalences and correlates of mental disorders assessed using the World Mental Health Composite International Diagnostic Interview. Lifetime and 12 month prevalences and onset distributions for suicidal ideation, plans and attempts, and sociodemographic and mental disorder correlates of these behaviours were examined. Lifetime prevalences were 15.7% for suicidal ideation, 5.5% for suicide plan and 4.5% for suicide attempt, and were consistently significantly higher in females than in males. Twelve-month prevalences were 3.2% for ideation, 1.0% for plan and 0.4% for attempt. Risk of ideation in the past 12 months was higher in females, younger people, people with lower educational qualifications, and people with low household income. Risk of making a plan or attempt was higher in younger people and in people with low household income. After adjustment for sociodemographic factors, there were no ethnic differences in ideation, although Māori and Pacific people had elevated risks of plans and attempts compared with non-Māori non-Pacific people. Individuals with a mental disorder had elevated risks of ideation (11.8%), plan (4.1%) and attempt (1.6%) compared with those without mental disorder. Risks of suicidal ideation, plan and attempt were associated with mood disorder, substance use disorder and anxiety disorder. Major depression was the specific disorder most strongly associated with suicidal ideation, plan and attempt. Less than half of those who reported suicidal behaviours within the past 12 months had made visits to health professionals within that period. Less than one-third of those who had made attempts had received treatment from a psychiatrist. Risks of making a suicide plan or attempt were associated with mental disorder and sociodemographic disadvantage. Most people with suicidal behaviours had not seen a health professional for mental health problems during the time that they were suicidal.

How do young people in Cambodia perceive the impact of societal attitudes, media and religion on suicidal behaviour?

PubMed

Jegannathan, Bhoomikumar; Kullgren, Gunnar; Dahlblom, Kjerstin

2016-03-01

Young people in low and middle income countries (LMICs) in societal transitions with rapidly changing norms face an increased risk of suicide. This study explores how young people in Cambodia understand the impact on suicidal behaviour from societal attitudes, media and religion. Focus group discussions were held with school students from a suburban area. Thematic analysis was used to interpret the data. Participants perceived the prevailing suicide-stigmatizing societal attitudes, the double-edged media and suicide-ambiguity in Buddhist religion as challenging. Globalization was recognized as contradicting with traditional Cambodian norms and values. Suicide prevention programmes should take into consideration the complex picture of suicide that young people are exposed to. © The Author(s) 2015.

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.

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

Suicidal Ideation and Behaviour among Young People Leaving Care: Case-File Survey

ERIC Educational Resources Information Center

Hamilton, David J.; Taylor, Brian J.; Killick, Campbell; Bickerstaff, David

2015-01-01

Self-harming and suicide amongst adolescents are reported to be increasing in Europe and internationally. For young people in state care, this aspect of mental well-being is of particular concern. The aim of this study was to establish the incidence of suicidal ideation and behaviour amongst young people (age 16-21 years) leaving state care in one…

Childhood physical abuse, non-suicidal self-harm and attempted suicide amongst regular injecting drug users.

PubMed

Darke, Shane; Torok, Michelle

2013-12-01

Childhood physical abuse (CPA), non-suicidal self-harm and attempted suicide are all highly prevalent amongst injecting drug users (IDU). This paper reported on the association of CPA with self-harm and attempted suicide. Cross-sectional study, with 300 IDU administered a structured interview examining the prevalence of CPA, non-suicidal self-harm and suicide attempts. CPA was reported by 74.3%, and severe CPA by 40.3%. A history of non-suicidal self-harm was reported by 23.7%, and 25.7% had attempted suicide. Non-suicidal self-harm preceded the suicide attempt in 83.3% of cases where both had occurred. Independent correlates of non-suicidal self-harm were: female gender (OR 3.62), avoided home due to conflict (OR 2.28) and more extensive polydrug use (OR 1.32). Independent correlates of attempted suicide were: severe CPA (OR 3.18), frequent CPA (OR 2.54), avoided home due to conflict (OR 3.95), female gender (OR 2.99), a positive screen for Conduct Disorder (OR 3.53), and more extensive polydrug use (OR 1.52). Those presenting to treatment agencies are highly likely to have a history of CPA, that may still influence their behaviours. Screening for histories of CPA and non-suicidal self-harm appears warranted when determining suicide risk for this population. At the population level, reductions in the rate of CPA, could possibly reduce the rate of subsequent suicidality. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Maoa and Maob polymorphisms and personality traits in suicide attempters and healthy controls: a preliminary study.

PubMed

Balestri, Martina; Calati, Raffaella; Serretti, Alessandro; Hartmann, Annette M; Konte, Bettina; Friedl, Marion; Giegling, Ina; Rujescu, Dan

2017-03-01

Serotonergic neurotransmission dysfunctions have been well documented in patients with suicidal behaviour. We investigated monoamine oxidase A (MAOA: rs2064070, rs6323, rs909525) and B (MAOB: rs1799836, rs2311013, rs2205655) genetic modulation of personality traits (Temperament and Character Inventory, TCI) as endophenotype for suicidal behaviour. 108 suicide attempters and 286 healthy controls of German origin were screened. Among females, allelic analyses revealed associations between MAOA rs6323 A allele and higher Harm Avoidance in suicide attempters and MAOB rs2205655 A allele and higher Cooperativeness scores in healthy controls. Among males, MAOA rs909525 A allele was associated with higher Reward Dependence in suicide attempters. Multivariate analyses controlling for age and educational level mainly confirmed results. Case-control analyses in this subsample do not differ from our previously reported one. Despite of the small sample size, a possible involvement of these genes in the modulation of personality traits closely related to suicidal behaviour cannot be excluded. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

The association between electrodermal activity (EDA), depression and suicidal behaviour: A systematic review and narrative synthesis.

PubMed

Sarchiapone, Marco; Gramaglia, Carla; Iosue, Miriam; Carli, Vladimir; Mandelli, Laura; Serretti, Alessandro; Marangon, Debora; Zeppegno, Patrizia

2018-01-25

Electrodermal activity (EDA) and other peripheral autonomic electrical parameters have been used as indicators of emotional states, including depressive states and suicidal state. We aimed to review EDA research systematically, focusing on EDA's usefulness as a biomarker for depression and suicidal behaviour. We searched MEDLINE, Scopus, Cochrane Library, and Web of Science databases, following PRISMA guidelines. The initial screening of articles was based on titles and abstracts; then the full text was reviewed. A preliminary synthesis of findings was developed using tables, thematic analysis and quality ratings. 1287 articles were screened and 77 relevant studies were identified and included in the systematic review. The studies were fairly consistent in maintaining that hypoactive electrodermal response is an established feature of patients affected by depression. There is also preliminary evidence that monitoring EDA may help to differentiate the phases of mood disorders. A few studies provided evidence that EDA can be used to differentiate acutely suicidal subjects from depressed patients who are not severely suicidal. Although EDA has been shown to be a valid, sensitive marker of suicidal ideation, suicide attempts and violent suicidal behaviour, it also seems to be influenced to some extent by antidepressant treatment. Most of the studies summarised in this review are quite outdated and employed a variety of designs and methods to evaluate EDA. This limits the generalisability of the results and makes it difficult to draw clear conclusions about the role of EDA in real-world settings. Electrodermal hypoactivity seems to be a reliable feature of depression and a valid marker of suicidal risk. Nevertheless, the potential utility of EDA in diagnosis, prevention, and treatment planning for depression and suicidal behaviour, should be thoroughly studied.

Factors Associated with Suicidal Thought and Help-Seeking Behaviour in Transition-Aged Youth versus Adults.

PubMed

MacKinnon, Nathalie; Colman, Ian

2016-12-01

Suicide is a leading cause of death for transition-aged youth (TAY), and yet few studies examine correlates of suicidal ideation specifically in this age demographic (age 18-24 years). The transition to adulthood is a unique context, marked by novel stressors (e.g., joining the workforce) and increased independence, which may influence risk factors for suicidal ideation. This study examined correlates of suicidal ideation in TAY and adults and contrasted profiles across age. We used 4 biannual cycles (2005, 2007, 2009, 2011) of the Canadian Community Health Survey, a population-based cross-sectional survey on health. We used logistic regression to assess the association between suicidal ideation and depression, distress, alcohol use, smoking, exercise, sedentary behaviour, chronic illness, restrictions to daily living, perceived physical and mental health, and perceived social support independently in both TAY ( n = 4427) and adults ( n = 14,452). We subsequently assessed possible interactions with age (18-24 v. 25-44 years) and sex and differences in help-seeking behaviour in a combined model. TAY exhibited higher rates of suicidal ideation than adults did ( P < 0.001). Numerous factors were associated with suicidal ideation in TAY. Notably, alcohol abstinence was associated with decreased suicidal ideation in TAY but not for adults. Moreover, when depressed, TAY were significantly less likely to have received professional mental health help than adults (odds ratio = 0.64, 95% CI, 0.43 to 0.94). Suicidal ideation is more prevalent in TAY than adults, and its consequences may be aggravated by poor treatment-seeking behaviour in at-risk (i.e. depressed) individuals. These different risk profiles substantiate the recent shift toward clinical interventions focusing on transition-aged youth, rather than traditional child (<18 years) and adult (>18 years) services.

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.

Understanding boys': thinking through boys, masculinity and suicide.

PubMed

Mac An Ghaill, Mairtin; Haywood, Chris

2012-02-01

In the UK, the media are reporting increasing rates of childhood suicide, while highlighting that increasing numbers of pre-adolescent boys (in relation to girls) are diagnosed as mentally ill. In response, academic, professional and political commentators are explaining this as a consequence of gender. One way of doing this has been to apply adult defined understandings of men and masculinities to the attitudes and behaviours of pre-adolescent boys. As a consequence, explanations of these trends point to either 'too much' masculinity, such as an inability to express feelings and seek help, or 'not enough' masculinity that results in isolation and rejection from significant others, such as peer groups. Using a discourse analysis of semi-structured interviews with 28 children aged 9-13 (12 male, 16 females) and 12 school staff at a school in North East England, this article questions the viability of using normative models of masculinity as an explanatory tool for explaining boys' behaviours and suggests that researchers in the field of gender and suicide consider how boys' genders may be constituted differently. We develop this argument in three ways. First, it is argued that studies that use masculinity tend to reduce the formation of gender to the articulation of power across and between men and other men and women. Second, we argue that approaches to understanding boys' behaviours are simplistically grafting masculinity as a conceptual frame onto boy's attitudes and behaviours. In response, we suggest that it is important to re-think how we gender younger boys. The final section focuses specifically on the ways that boys engage in friendships. The significance of this section is that we need to question how notions of communication, integration and isolation, key features of suicide behaviours, are framed through the local production of friendships. Copyright © 2010 Elsevier Ltd. All rights reserved.

Subcortical brain structure and suicidal behaviour in major depressive disorder: a meta-analysis from the ENIGMA-MDD working group.

PubMed

Rentería, M E; Schmaal, L; Hibar, D P; Couvy-Duchesne, B; Strike, L T; Mills, N T; de Zubicaray, G I; McMahon, K L; Medland, S E; Gillespie, N A; Hatton, S N; Lagopoulos, J; Veltman, D J; van der Wee, N; van Erp, T G M; Wittfeld, K; Grabe, H J; Block, A; Hegenscheid, K; Völzke, H; Veer, I M; Walter, H; Schnell, K; Schramm, E; Normann, C; Schoepf, D; Konrad, C; Zurowski, B; Godlewska, B R; Cowen, P J; Penninx, B W J H; Jahanshad, N; Thompson, P M; Wright, M J; Martin, N G; Christensen, H; Hickie, I B

2017-05-02

The aetiology of suicidal behaviour is complex, and knowledge about its neurobiological mechanisms is limited. Neuroimaging methods provide a noninvasive approach to explore the neural correlates of suicide vulnerability in vivo. The ENIGMA-MDD Working Group is an international collaboration evaluating neuroimaging and clinical data from thousands of individuals collected by research groups from around the world. Here we present analyses in a subset sample (n=3097) for whom suicidality data were available. Prevalence of suicidal symptoms among major depressive disorder (MDD) cases ranged between 29 and 69% across cohorts. We compared mean subcortical grey matter volumes, lateral ventricle volumes and total intracranial volume (ICV) in MDD patients with suicidal symptoms (N=451) vs healthy controls (N=1996) or MDD patients with no suicidal symptoms (N=650). MDD patients reporting suicidal plans or attempts showed a smaller ICV (P=4.12 × 10 -3 ) or a 2.87% smaller volume compared with controls (Cohen's d=-0.284). In addition, we observed a nonsignificant trend in which MDD cases with suicidal symptoms had smaller subcortical volumes and larger ventricular volumes compared with controls. Finally, no significant differences (P=0.28-0.97) were found between MDD patients with and those without suicidal symptoms for any of the brain volume measures. This is by far the largest neuroimaging meta-analysis of suicidal behaviour in MDD to date. Our results did not replicate previous reports of association between subcortical brain structure and suicidality and highlight the need for collecting better-powered imaging samples and using improved suicidality assessment instruments.

Family characteristics of suicides in Cameron Highlands: a controlled study.

PubMed

Maniam, T

1994-09-01

Cameron Highlands has one of the highest suicide rates in the world, especially among Indians. Forty Indian families (19 suicides; 21 controls) were studied to compare family characteristics such as income, overcrowding, birth order of index cases of suicide, family history of suicidal behaviour or mental illness, marital disharmony, presence of alcohol abuse, availability of, and knowledge about, weedicides/insecticides, talk/threat of suicide among family members and experience of significant losses in the past year. Controls were matched for age, sex and educational level with the index cases of suicide. A significant difference was only found for one of the above factors, namely increased experience of significant losses in the past year in the family of index cases of suicide. More than 75% in both groups had alcohol related problems. About equal proportions in each group had a family history of suicidal behaviour and mental illness. There was more marital disharmony in families of suicides but this failed to reach significance. These results and methodological limitations of this study are discussed.

Frequency and preventative interventions for non-suicidal self-injury and suicidal behaviour in primary school-age children: a scoping review protocol.

PubMed

Bem, Danai; Connor, Charlotte; Palmer, Colin; Channa, Sunita; Birchwood, Max

2017-07-10

Non-suicidal self-injury (NSSI) and suicidal behaviour have been witnessed in children as young as 6-7 years of age, but while there are many reviews of preventative interventions for NSSI and suicide in adolescents, few have explored its prevalence in younger children and the potential impact of preventative interventions at this stage of life. NSSI and suicidal behaviour are an increasing concern in schools but school-based programmes can improve knowledge, attitudes and help-seeking behaviours and help prevent escalation of NSSI and later suicide. This scoping review will aim to explore the nature and extent of the evidence on the magnitude of NSSI and suicidal behaviour in primary school children, and to examine whether there are any primary school-based interventions available for the prevention of this phenomenon in 5 to 11-year-olds. A scoping review will be conducted using established methodology by Arksey and O'Malley and the Joanna Briggs Institute. Multiple bibliographic and indexing databases and grey literature will be searched using a combination of text words and index terms relating to NSSI, suicide, primary schools, frequency and intervention. Two reviewers will independently screen eligible studies for study selection and extract relevant data from included studies. A narrative summary of evidence will be conducted for all included studies with results presented in tables and/or diagrams. Inductive content analysis will be used to understand any narrative findings within the included studies. Ethical approval is not required for this scoping review. The results of this review will be disseminated though publication in a peer-reviewed journal and presented at relevant conferences. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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

Attitudes toward suicidal behaviour among professionals at mental health outpatient clinics in Stavropol, Russia and Oslo, Norway.

PubMed

Norheim, Astrid Berge; Grimholt, Tine K; Loskutova, Ekaterina; Ekeberg, Oivind

2016-07-27

Attitudes toward suicidal behaviour can be essential regarding whether patients seek or are offered help. Patients with suicidal behaviour are increasingly treated by mental health outpatient clinics. Our aim was to study attitudes among professionals at outpatient clinics in Stavropol, Russia and Oslo, Norway. Three hundred and forty-eight (82 %) professionals anonymously completed a questionnaire about attitudes. Professionals at outpatient clinics in Stavropol (n = 119; 94 %) and Oslo (n = 229; 77 %) were enrolled in the study. The Understanding Suicidal Patients (USP) scale (11 = positive to 55 = negative) and the Attitudes Towards Suicide Scale (ATTS) (1 = totally disagree, 5 = totally agree) were used. Questions about religious background, perceived competence and experiences of and views on suicidal behaviour and treatment (0 = totally disagree, 4 = totally agree) were examined. All groups reported positive attitudes, with significant differences between Stavropol and Oslo (USP score, 21.8 vs 18.7; p < 0.001). Professionals from Stavropol vs. Oslo reported significantly less experience with suicidal patients, courses in suicide prevention (15 % vs 79 %) guidelines in suicidal prevention (23 % vs 90 %), interest for suicide prevention (2.0 vs 2.7; p < 0.001), and agreed more with the ATTS factors: avoidance of communication on suicide (3.1 vs 2.3; p < 0.001), suicide is acceptable (2.9 vs 2.6; p = 002), suicide is understandable (2.9 vs 2.7; p = 0.012) and (to a lesser extent) suicide can be prevented (4.2 vs 4.5; p < 0.001). In both cities, psychiatric disorders (3.4) were considered as the most important cause of suicide. Use of alcohol (2.2 vs 2.8; p < 0.001) was considered less important in Stavropol. Psychotherapy was considered significant more important in Stavropol than Oslo (3.6 vs 3.4; p = 0.001). Professionals reported positive attitudes towards helping suicidal patients, with significant differences between cities. A need for further education was reported in both cities, but education was less integrated in mental health care in Stavropol than it was in Oslo. In both cities, psychiatric disorders were considered the major reasons for suicide, and psychotherapy was the most important treatment measure.

Volumetric analysis of the hypothalamus, amygdala and hippocampus in non-suicidal and suicidal mood disorder patients--a post-mortem study.

PubMed

Bielau, Hendrik; Brisch, Ralf; Gos, Tomasz; Dobrowolny, Henrik; Baumann, Bruno; Mawrin, Christian; Kreutzmann, Peter; Bernstein, Hans-Gert; Bogerts, Bernhard; Steiner, Johann

2013-11-01

In recent years, the hypothalamus, amygdala and hippocampus have attracted increased interest with regard to the effects of stress on neurobiological systems in individuals with depression and suicidal behaviour. A large body of evidence indicates that these subcortical regions are involved in the pathogenetic mechanisms of mood disorders and suicide. The current neuroimaging techniques inadequately resolve the structural components of small and complex brain structures. In previous studies, our group was able to demonstrate a structural and neuronal pathology in mood disorders. However, the impact of suicide remains unclear. In the current study we used volumetric measurements of serial postmortem sections with combined Nissl-myelin staining to investigate the hypothalamus, amygdala and hippocampus in suicide victims with mood disorders (n = 11), non-suicidal mood disorder patients (n = 9) and control subjects (n = 23). Comparisons between the groups by using an ANCOVA showed a significant overall difference for the hypothalamus (p = 0.001) with reduced volumes in non-suicidal patients compared to suicide victims (p = 0.018) and controls (p = 0.006). To our surprise, the volumes between the suicide victims and controls did not differ significantly. For the amygdala and hippocampus no volume changes between the groups could be detected (all p values were n. s.). In conclusion our data suggest a structural hypothalamic pathology in non-suicidal mood disorder patients. The detected differences between suicidal and non-suicidal patients suggest that suicidal performances might be related to the degree of structural deficits.

The molecular bases of the suicidal brain

PubMed Central

Turecki, Gustavo

2017-01-01

Suicide ranks among the leading causes of death around the world, and takes a heavy emotional and public health toll on most societies. Both distal and proximal factors contribute to suicidal behaviour. Distal factors — such as familial and genetic predisposition, as well as early-life adversity — increase the lifetime risk of suicide. They alter responses to stress and other processes through epigenetic modification of genes and associated changes in gene expression, and through the regulation of emotional and behavioural traits. Proximal factors associate with the precipitation of a suicidal event and include alterations in key neurotransmitter systems, inflammatory changes and glial dysfunction in the brain. This Review explores the key molecular changes associated with suicidality, and presents some promising avenues for future research. PMID:25354482

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 in deaf populations: a literature review.

PubMed

Turner, Oliver; Windfuhr, Kirsten; Kapur, Navneet

2007-10-08

Studies have found that deaf individuals have higher rates of psychiatric disorder than those who are hearing, while at the same time encountering difficulties in accessing mental health services. These factors might increase the risk of suicide. However, the burden of suicidal behaviour in deaf people is currently unknown. The aim of the present review was to provide a summary of literature on suicidal behaviour with specific reference to deaf individuals. The objectives of the review were to establish the incidence and prevalence of suicidal behaviour in deaf populations; describe risk factors for suicidal behaviour in deaf populations; describe approaches to intervention and suicide prevention that have been used in deaf populations. A number of electronic databases (e.g. Medline, PsycINFO, CINAHL, EMBASE, Dissertation Abstracts International, Web of Science, ComDisDome, ASSIA, Education Sage Full Text, Google Scholar, and the grey literature databases FADE and SIGLE) were explored using a combination of key words and medical subject headings as search terms. Reference lists of papers were also searched. The Science and Social Sciences Citation Index electronic databases were used to identify studies that had cited key papers. We also contacted experts and organisations with an interest in the field. Very few studies focussed specifically on suicide in deaf populations. Those studies that were included (n = 13) generally involved small and unrepresentative samples. There were limited data on the rate of suicidal behaviour in deaf people. One study reported evidence of hearing impairment in 0.2% of all suicide deaths. Another found that individuals with tinnitus seen in specialist clinics had an elevated rate of suicide compared to the general population. The rates of attempted suicide in deaf school and college students during the previous year ranged from 1.7% to 18%, with lifetime rates as high as 30%. Little evidence was found to suggest that risk factors for suicide in deaf people differed systematically from those in the general population. However, studies did report higher levels of depression and higher levels of perceived risk among deaf individuals than hearing control groups. No firm evidence was found regarding the effectiveness of suicide prevention strategies in deaf people, but suggested strategies include developing specific screening tools, training clinical staff, promoting deaf awareness, increasing the availability of specialist mental health services for deaf people. There is a significant gap in our understanding of suicide in deaf populations. Clinicians should be aware of the possible association between suicide and deafness. Specialist mental health services should be readily accessible to deaf individuals and specific preventative strategies may be of benefit. However, further research using a variety of study designs is needed to increase our understanding of this issue.

Impulsive-aggressive behaviours and completed suicide across the life cycle: a predisposition for younger age of suicide.

PubMed

McGirr, A; Renaud, J; Bureau, A; Seguin, M; Lesage, A; Turecki, G

2008-03-01

It is unclear whether the association between impulsive-aggressive behaviours and suicide exists across different ages. Via psychological autopsy, we examined a total of 645 subjects aged 11-87 years who died by suicide. Proxy-based interviews were conducted using the SCID-I & SCID-II or K-SADS interviews and a series of behavioural and personality-trait assessments. Secondarily, 246 living controls were similarly assessed. Higher levels of impulsivity, lifetime history of aggression, and novelty seeking were associated with younger age of death by suicide, while increasing levels of harm avoidance were associated with increasing age of suicide. This effect was observed after accounting for age-related psychopathology (current and lifetime depressive disorders, lifetime anxiety disorders, current and lifetime substance abuse disorders, psychotic disorders and cluster B personality disorders). Age effects were not due to the characteristics of informants, and such effects were not observed among living controls. When directly controlling for major psychopathology, the interaction between age, levels of impulsivity, aggression and novelty seeking predicted suicide status while controlling for the independent contributions of age and these traits. Higher levels of impulsive-aggressive traits play a greater role in suicide occurring among younger individuals, with decreasing importance with increasing age.

The impact of migration and culture on suicide attempts of children and adolescents living in Istanbul.

PubMed

Akkaya-Kalayci, Türkan; Popow, Christian; Winkler, Dietmar; Bingöl, R Hülya; Demir, Türkay; Özlü, Zeliha

2015-03-01

Suicidal attempts are steadily increasing in societies with rapid urbanisation and dramatic social changes in places like Istanbul. Stress related to internal migration may increase suicidal behaviour. We investigated the impact of internal migration and culture on suicide attempts among youth in Istanbul. We retrospectively analysed the records of 210 children and adolescents, aged 6-18 years, who presented at the Emergency Outpatient Clinic of the Department of Pediatrics at Cerrahpaşa Medical School in Istanbul because of suicide attempts between January 2008 and December 2010. The majority of patients (78.95%, N = 165) had a background of internal migration, mostly (65%, N = 136) originating from regions with large cultural differences compared with that of Istanbul. Noticeably, more migrants than non-migrants (18.8% vs. 6.8%) and more patients originating from regions with large cultural differences chose high-risk methods for suicide attempts (20.7% vs. 8.1%). Internal migration can be considered a serious risk factor for suicidal behaviour. Furthermore, the degree of cultural differences between the area of origin and the new environment can be of vital importance. Healthcare measures should, therefore, focus on internal migration as a risk factor for youth suicidal behaviour and provide assistance for appropriate resettlement and integration in countries with increased mobility.

Temperament and character personality profile in relation to suicidal ideation and suicide attempts in major depressed patients.

PubMed

Conrad, Rupert; Walz, Frank; Geiser, Franziska; Imbierowicz, Katrin; Liedtke, Reinhard; Wegener, Ingo

2009-12-30

To prevent suicidal behaviour, it is important to better understand those personality traits associated with suicidal ideation and suicide attempts. A sample of 394 consecutive major depressed outpatients admitted to Bonn University Hospital was subdivided into three groups: Lifetime suicide attempters (N=32; 8.1%), suicide ideators (N=133) and patients without suicide ideation (N=229). Psychodiagnostic measures embraced the Temperament and Character Inventory (TCI), the Symptom Checklist-90-R and the Hamilton Depression Rating Scale. Suicide attempters and ideators showed higher scores on emotional distress and depression. Analysis of covariance (covariates: age, gender, depression) revealed that suicide attempters score higher on the temperament dimension harm avoidance compared with non-attempters. Suicide ideators could be distinguished from non-ideators by character dimensions in terms of lower self-directedness and higher self-transcendence. Our findings suggest that high harm avoidance is a personality trait associated with suicide attempt in major depression, whereas low self-directedness and high self-transcendence are related to suicidal ideation. As temperament dimensions represent the "emotional core" and character dimensions the "cognitive core" of personality, we discuss whether Cloninger's psychobiological model might be helpful to distinguish between non-suicide ideators, patients who do think about suicide, and patients initiating suicidal behaviour.

Important Variables When Screening for Students at Suicidal Risk: Findings from the French Cohort of the SEYLE Study.

PubMed

Kahn, Jean-Pierre; Tubiana, Alexandra; Cohen, Renaud F; Carli, Vladimir; Wasserman, Camilla; Hoven, Christina; Sarchiapone, Marco; Wasserman, Danuta

2015-09-30

Due to early detection of mental ill-health being an important suicide preventive strategy, the multi-centre EU funded "Saving and Empowering Young Lives in Europe" (SEYLE) study compared three school-based mental health promotion programs to a control group. In France, 1007 students with a mean age of 15.2 years were recruited from 20 randomly assigned schools. This paper explores the French results of the SEYLE's two-stage screening program (ProfScreen) and of the cross-program suicidal emergency procedure. Two-hundred-thirty-five ProfScreen students were screened using 13 psychopathological and risk behaviour scales. Students considered at risk because of a positive finding on one or more scales were offered a clinical interview and, if necessary, referred for treatment. A procedure for suicidal students (emergency cases) was set up to detect emergencies in the whole cohort (n = 1007). Emergency cases were offered the same clinical interview as the ProfScreen students. The interviewers documented their reasons for referrals in a short report. 16,2% of the ProfScreen students (38/235) were referred to treatment and 2,7% of the emergency cases (27/1007) were also referred to treatment due to high suicidal risk. Frequent symptoms in those students referred for evaluation were depression, alcohol misuse, non-suicidal self-injuries (NSSI), and suicidal behaviours. According to the multivariate regression analysis of ProfScreen, the results show that the best predictors for treatment referral were NSSI (OR 2.85), alcohol misuse (OR 2.80), and depressive symptoms (OR 1.13). Analysis of the proportion for each scale of students referred to treatment showed that poor social relationships (60%), anxiety (50%), and suicidal behaviours (50%) generated the highest rate of referrals. Qualitative analysis of clinician's motivations to refer a student to mental health services revealed that depressive symptoms (51%), anxiety (38%), suicidal behaviours (40%), and negative life events (35%) were the main reasons for referrals. Thus, not only the classical psychopathological symptoms, such as depression, anxiety, and suicidal behaviours, but also negative life events and poor social relationships (especially isolation) motivate referrals for treatment.

Important Variables When Screening for Students at Suicidal Risk: Findings from the French Cohort of the SEYLE Study

PubMed Central

Kahn, Jean-Pierre; Tubiana, Alexandra; Cohen, Renaud F.; Carli, Vladimir; Wasserman, Camilla; Hoven, Christina; Sarchiapone, Marco; Wasserman, Danuta

2015-01-01

Due to early detection of mental ill-health being an important suicide preventive strategy, the multi-centre EU funded “Saving and Empowering Young Lives in Europe” (SEYLE) study compared three school-based mental health promotion programs to a control group. In France, 1007 students with a mean age of 15.2 years were recruited from 20 randomly assigned schools. This paper explores the French results of the SEYLE’s two-stage screening program (ProfScreen) and of the cross-program suicidal emergency procedure. Two-hundred-thirty-five ProfScreen students were screened using 13 psychopathological and risk behaviour scales. Students considered at risk because of a positive finding on one or more scales were offered a clinical interview and, if necessary, referred for treatment. A procedure for suicidal students (emergency cases) was set up to detect emergencies in the whole cohort (n = 1007). Emergency cases were offered the same clinical interview as the ProfScreen students. The interviewers documented their reasons for referrals in a short report. 16,2% of the ProfScreen students (38/235) were referred to treatment and 2,7% of the emergency cases (27/1007) were also referred to treatment due to high suicidal risk. Frequent symptoms in those students referred for evaluation were depression, alcohol misuse, non-suicidal self-injuries (NSSI), and suicidal behaviours. According to the multivariate regression analysis of ProfScreen, the results show that the best predictors for treatment referral were NSSI (OR 2.85), alcohol misuse (OR 2.80), and depressive symptoms (OR 1.13). Analysis of the proportion for each scale of students referred to treatment showed that poor social relationships (60%), anxiety (50%), and suicidal behaviours (50%) generated the highest rate of referrals. Qualitative analysis of clinician’s motivations to refer a student to mental health services revealed that depressive symptoms (51%), anxiety (38%), suicidal behaviours (40%), and negative life events (35%) were the main reasons for referrals. Thus, not only the classical psychopathological symptoms, such as depression, anxiety, and suicidal behaviours, but also negative life events and poor social relationships (especially isolation) motivate referrals for treatment. PMID:26437422

Effects of the Dutch Skills for Life Program on the Health Behavior, Bullying, and Suicidal Ideation of Secondary School Students

ERIC Educational Resources Information Center

Fekkes, M.; van de Sande, M. C. E.; Gravesteijn, J. C.; Pannebakker, F. D.; Buijs, G. J.; Diekstra, R. F. W.; Kocken, P. L.

2016-01-01

Purpose: The purpose of this paper is to evaluate the effects of the Dutch "Skills for Life" programme on students' health behaviours, bullying behaviour and suicidal ideation. Design/methodology/approach: The effectiveness of the "Skills for Life" programme on health behaviour outcomes was evaluated at three points in time in…

Non-suicidal self-injury: clinical presentation, assessment and management.

PubMed

Dhingra, Katie; Ali, Parveen

2016-09-28

Non-suicidal self-injury is a common behaviour in adolescents and young adults, and may be associated with mental health disorders, risk of suicidal behaviour (ideation and attempts), and a need for clinical services. Nurses, in particular those working in emergency departments and mental health settings, have a crucial role in the assessment, treatment and care of individuals who have self-injured. It is essential for nurses to assess an individual's risk of more serious harm or accidental death, regardless of intent. It is also important to understand the variations in non-suicidal self-injurious behaviour in terms of its presentation, features and functions, to provide appropriate person-centred care. Nurses should assist individuals in identifying the triggers or cues for their behaviour, exploring treatment options, and monitoring their behaviour and risk in the long term. This article describes the profile of people who self-injure, and the issues related to assessment and management of such patients presenting in emergency departments. A description of who self-injures and why, and how people self-injure; developmental aspects of these behaviours, including short and long-term outcomes; and the available treatments is presented.

Anger as a predictor of psychological distress and self-harm ideation in inmates: a structured self-assessment diary study.

PubMed

Humber, Naomi; Emsley, Richard; Pratt, Daniel; Tarrier, Nicholas

2013-11-30

Suicidal ideation and behaviour are common among inmates. Anger is found at exaggerated levels and has been associated with suicidal ideation and behaviour in inmate samples suggesting its possible salience in the prediction of suicide. The study investigated relationships between anger, psychological distress, and self-harm/suicidal ideation among inmates. The principles of Ecological Momentary Assessment were considered and a structured self-assessment diary was utilised to examine relationships between the variables of interest. Participants completed a structured self-assessment diary for six consecutive days which included momentary ratings of items describing psychological states of concurrent affects, thoughts, and appraisals related to anger, psychological distress, and self-harm/suicidal ideation. Psychometric assessment measures were also conducted. Temporal associations between predictors and outcomes were investigated. Multilevel modelling analyses were performed. Increased anger was significantly associated with concurrent high levels of self-harm ideation in inmates, when controlling for depression and hopelessness. Temporal analyses also revealed that anger at one time point did not predict suicidal ideation at the next time point. Elucidating the temporal nature of the relationship between anger, psychological distress, and self-harm/suicidal ideation has advanced understanding of the mechanisms of suicidal behaviour, by demonstrating an increased risk of suicide when a male inmate is angry. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

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

Associations of School Connectedness With Adolescent Suicidality: Gender Differences and the Role of Risk of Depression

PubMed Central

Langille, Donald B; Asbridge, Mark; Cragg, Amber; Rasic, Daniel

2015-01-01

Objective: Previous studies have not examined associations of school connectedness with adolescent suicidal behaviours stratified by gender, while including a measure of depression. We analyzed survey data to determine whether there are independent protective associations of higher school connectedness with suicidal behaviours in Canadian adolescents, while controlling for potential confounders, including risk of depression; and whether such associations differ by gender. Method: Using data from a stratified cluster sample of randomly selected classes of students in schools in 3 of Canada’s Atlantic provinces, we used multiple logistic regression to examine whether associations of risk of depression, measured using the 12-item Center for Epidemiologic Studies–Depression scale, lessened protective associations of higher school connectedness with suicidal behaviours in grades 10 and 12 students, while stratifying by gender. Results: After adjusting for risk of depression, higher school connectedness was independently associated with decreased suicidal ideation in both genders and with suicidal attempt in females. In males, higher connectedness was no longer protective for suicide attempt when risk of depression was included in the model. Conclusions: School connectedness, which is felt to have positive influences on many types of adolescent behaviour, appears to also be both directly and indirectly protective for suicidality. These effects may occur through different pathways in females and males. Given the protection it offers both genders, including those at risk and not at risk of depression, increasing school connectedness should be considered as a universal adolescent mental health strategy. Studies that examine school connectedness should include analyses that examine potential differences between males and females. PMID:26175323

Subcortical brain structure and suicidal behaviour in major depressive disorder: a meta-analysis from the ENIGMA-MDD working group

PubMed Central

Rentería, M E; Schmaal, L; Hibar, D P; Couvy-Duchesne, B; Strike, L T; Mills, N T; de Zubicaray, G I; McMahon, K L; Medland, S E; Gillespie, N A; Hatton, S N; Lagopoulos, J; Veltman, D J; van der Wee, N; van Erp, T G M; Wittfeld, K; Grabe, H J; Block, A; Hegenscheid, K; Völzke, H; Veer, I M; Walter, H; Schnell, K; Schramm, E; Normann, C; Schoepf, D; Konrad, C; Zurowski, B; Godlewska, B R; Cowen, P J; Penninx, B W J H; Jahanshad, N; Thompson, P M; Wright, M J; Martin, N G; Christensen, H; Hickie, I B

2017-01-01

The aetiology of suicidal behaviour is complex, and knowledge about its neurobiological mechanisms is limited. Neuroimaging methods provide a noninvasive approach to explore the neural correlates of suicide vulnerability in vivo. The ENIGMA-MDD Working Group is an international collaboration evaluating neuroimaging and clinical data from thousands of individuals collected by research groups from around the world. Here we present analyses in a subset sample (n=3097) for whom suicidality data were available. Prevalence of suicidal symptoms among major depressive disorder (MDD) cases ranged between 29 and 69% across cohorts. We compared mean subcortical grey matter volumes, lateral ventricle volumes and total intracranial volume (ICV) in MDD patients with suicidal symptoms (N=451) vs healthy controls (N=1996) or MDD patients with no suicidal symptoms (N=650). MDD patients reporting suicidal plans or attempts showed a smaller ICV (P=4.12 × 10−3) or a 2.87% smaller volume compared with controls (Cohen’s d=−0.284). In addition, we observed a nonsignificant trend in which MDD cases with suicidal symptoms had smaller subcortical volumes and larger ventricular volumes compared with controls. Finally, no significant differences (P=0.28–0.97) were found between MDD patients with and those without suicidal symptoms for any of the brain volume measures. This is by far the largest neuroimaging meta-analysis of suicidal behaviour in MDD to date. Our results did not replicate previous reports of association between subcortical brain structure and suicidality and highlight the need for collecting better-powered imaging samples and using improved suicidality assessment instruments. PMID:28463239

IQ and adolescent self-harm behaviours in the ALSPAC birth cohort.

PubMed

Chang, Shu-Sen; Chen, Ying-Yeh; Heron, Jon; Kidger, Judi; Lewis, Glyn; Gunnell, David

2014-01-01

Low IQ is associated with an increased risk of suicide and suicide attempt in adults, but less is known about the relationship between IQ and aspects of suicidal/self-harm behaviours in adolescence. We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a population-based prospective UK cohort. Binomial and multinomial logistic regression models were used to examine the association of IQ measured at age 8 with suicide-related outcomes amongst 4810 adolescents aged 16-17 years. There was some evidence that associations differed in boys and girls (p values for interaction ranged between 0.06 and 0.25). In boys higher IQ was associated with increased risk of suicidal thoughts (adjusted odds ratio per 10 point increase in IQ score=1.14, 95% Confidence Interval [CI] 1.01-1.28) and suicidal plans (1.15, 95% CI 0.93-1.43), although statistical evidence for the latter association was limited. There was also evidence for an association with non-suicidal self-harm (1.24, 95% CI 1.08-1.45) but not suicidal self-harm (1.04, 95% CI 0.86-1.25). In girls higher IQ was associated with increased risk of non-suicidal self-harm (1.11, 95% CI 1.02-1.22) but not suicidal thoughts, suicidal plans or suicidal self-harm. Loss to follow up and questionnaire non-response may have led to selection bias. In contrast to previous studies of IQ-suicide associations in adults, we found that higher IQ was associated with an increased risk of non-suicidal self-harm in male and female adolescents and suicidal thoughts in males. Associations of IQ with self-harm differed for self-harm with and without suicidal intent, suggesting that the aetiology of these behaviours may differ. © 2013 Elsevier B.V. All rights reserved.

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.

Perceived competence and attitudes towards patients with suicidal behaviour: a survey of general practitioners, psychiatrists and internists

PubMed Central

2014-01-01

Background Competence and attitudes to suicidal behaviour among physicians are important to provide high-quality care for a large patient group. The aim was to study different physicians’ attitudes towards suicidal behaviour and their perceived competence to care for suicidal patients. Methods A random selection (n = 750) of all registered General Practitioners, Psychiatrists and Internists in Norway received a questionnaire. The response rate was 40%. The Understanding of Suicidal Patients Scale (USP; scores < 23 = positive attitude) and items about suicide in case of incurable illness from the Attitudes Towards Suicide Questionnaire were used. Five-point Likert scales were used to measure self-perceived competence, level of commitment, empathy and irritation felt towards patients with somatic and psychiatric diagnoses. Questions about training were included. Results The physicians held positive attitudes towards suicide attempters (USP = 20.3, 95% CI: 19.6–20.9). Internists and males were significantly less positive. There were no significant differences in the physicians in their attitudes toward suicide in case of incurable illness according to specialty. The physicians were most irritated and less committed to substance misuse patients. Self perceived competence was relatively high. Forty-three percent had participated in courses about suicide assessment and treatment. Conclusions The physicians reported positive attitudes and relatively high competence. They were least committed to treat patients with substance misuse. None of the professional groups thought that patients with incurable illness should be given help to commit suicide. Further customized education with focus on substance misuse might be useful. PMID:24886154

Perceived competence and attitudes towards patients with suicidal behaviour: a survey of general practitioners, psychiatrists and internists.

PubMed

Grimholt, Tine K; Haavet, Ole R; Jacobsen, Dag; Sandvik, Leiv; Ekeberg, Oivind

2014-05-08

Competence and attitudes to suicidal behaviour among physicians are important to provide high-quality care for a large patient group. The aim was to study different physicians' attitudes towards suicidal behaviour and their perceived competence to care for suicidal patients. A random selection (n = 750) of all registered General Practitioners, Psychiatrists and Internists in Norway received a questionnaire. The response rate was 40%. The Understanding of Suicidal Patients Scale (USP; scores < 23 = positive attitude) and items about suicide in case of incurable illness from the Attitudes Towards Suicide Questionnaire were used. Five-point Likert scales were used to measure self-perceived competence, level of commitment, empathy and irritation felt towards patients with somatic and psychiatric diagnoses. Questions about training were included. The physicians held positive attitudes towards suicide attempters (USP = 20.3, 95% CI: 19.6-20.9). Internists and males were significantly less positive. There were no significant differences in the physicians in their attitudes toward suicide in case of incurable illness according to specialty. The physicians were most irritated and less committed to substance misuse patients. Self perceived competence was relatively high. Forty-three percent had participated in courses about suicide assessment and treatment. The physicians reported positive attitudes and relatively high competence. They were least committed to treat patients with substance misuse. None of the professional groups thought that patients with incurable illness should be given help to commit suicide. Further customized education with focus on substance misuse might be useful.

Contact with child and adolescent psychiatric services among self-harming and suicidal adolescents in the general population: a cross sectional study.

PubMed

Tørmoen, Anita J; Rossow, Ingeborg; Mork, Erlend; Mehlum, Lars

2014-01-01

Studies have shown that adolescents with a history of both suicide attempts and non-suicidal self-harm report more mental health problems and other psychosocial problems than adolescents who report only one or none of these types of self-harm. The current study aimed to examine the use of child and adolescent psychiatric services by adolescents with both suicide attempts and non-suicidal self-harm, compared to other adolescents, and to assess the psychosocial variables that characterize adolescents with both suicide attempts and non-suicidal self-harm who report contact. Data on lifetime self-harm, contact with child and adolescent psychiatric services, and various psychosocial risk factors were collected in a cross-sectional sample (response rate = 92.7%) of 11,440 adolescents aged 14-17 years who participated in a school survey in Oslo, Norway. Adolescents who reported any self-harm were more likely than other adolescents to have used child and adolescent psychiatric services, with a particularly elevated likelihood among those with both suicide attempts and non-suicidal self-harm (OR = 9.3). This finding remained significant even when controlling for psychosocial variables. In adolescents with both suicide attempts and non-suicidal self-harm, symptoms of depression, eating problems, and the use of illicit drugs were associated with a higher likelihood of contact with child and adolescent psychiatric services, whereas a non-Western immigrant background was associated with a lower likelihood. In this study, adolescents who reported self-harm were significantly more likely than other adolescents to have used child and adolescent psychiatric services, and adolescents who reported a history of both suicide attempts and non-suicidal self-harm were more likely to have used such services, even after controlling for other psychosocial risk factors. In this high-risk subsample, various psychosocial problems increased the probability of contact with child and adolescent psychiatric services, naturally reflecting the core tasks of the services, confirming that they represents an important area for interventions that aim to reduce self-harming behaviour. Such interventions should include systematic screening for early recognition of self-harming behaviours, and treatment programmes tailored to the needs of teenagers with a positive screen. Possible barriers to receive mental health services for adolescents with immigrant backgrounds should be further explored.

Contact with child and adolescent psychiatric services among self-harming and suicidal adolescents in the general population: a cross sectional study

PubMed Central

2014-01-01

Background Studies have shown that adolescents with a history of both suicide attempts and non-suicidal self-harm report more mental health problems and other psychosocial problems than adolescents who report only one or none of these types of self-harm. The current study aimed to examine the use of child and adolescent psychiatric services by adolescents with both suicide attempts and non-suicidal self-harm, compared to other adolescents, and to assess the psychosocial variables that characterize adolescents with both suicide attempts and non-suicidal self-harm who report contact. Methods Data on lifetime self-harm, contact with child and adolescent psychiatric services, and various psychosocial risk factors were collected in a cross-sectional sample (response rate = 92.7%) of 11,440 adolescents aged 14–17 years who participated in a school survey in Oslo, Norway. Results Adolescents who reported any self-harm were more likely than other adolescents to have used child and adolescent psychiatric services, with a particularly elevated likelihood among those with both suicide attempts and non-suicidal self-harm (OR = 9.3). This finding remained significant even when controlling for psychosocial variables. In adolescents with both suicide attempts and non–suicidal self-harm, symptoms of depression, eating problems, and the use of illicit drugs were associated with a higher likelihood of contact with child and adolescent psychiatric services, whereas a non-Western immigrant background was associated with a lower likelihood. Conclusions In this study, adolescents who reported self-harm were significantly more likely than other adolescents to have used child and adolescent psychiatric services, and adolescents who reported a history of both suicide attempts and non-suicidal self-harm were more likely to have used such services, even after controlling for other psychosocial risk factors. In this high-risk subsample, various psychosocial problems increased the probability of contact with child and adolescent psychiatric services, naturally reflecting the core tasks of the services, confirming that they represents an important area for interventions that aim to reduce self-harming behaviour. Such interventions should include systematic screening for early recognition of self-harming behaviours, and treatment programmes tailored to the needs of teenagers with a positive screen. Possible barriers to receive mental health services for adolescents with immigrant backgrounds should be further explored. PMID:24742154

A randomized trial of brief dialectical behaviour therapy skills training in suicidal patients suffering from borderline disorder.

PubMed

McMain, Shelley F; Guimond, Tim; Barnhart, Ryan; Habinski, Liat; Streiner, David L

2017-02-01

Evidence-based therapies for borderline personality disorder (BPD) are lengthy and scarce. Data on brief interventions are limited, and their role in the treatment of BPD is unclear. Our aim was therefore to evaluate the clinical effectiveness of brief dialectical behaviour therapy (DBT) skills training as an adjunctive intervention for high suicide risk in patients with BPD. Eighty-four out-patients were randomized to 20 weeks of DBT skills (n = 42) or a waitlist (WL; n = 42). The primary outcome was frequency of suicidal or non-suicidal self-injurious (NSSI) episodes. Assessments were conducted at baseline 10, 20 and 32 weeks. DBT participants showed greater reductions than the WL participants on suicidal and NSSI behaviours between baseline and 32 weeks (P < 0.0001). DBT participants showed greater improvements than controls on measures of anger, distress tolerance and emotion regulation at 32 weeks. This abbreviated intervention is a viable option that may be a useful adjunctive intervention for the treatment of high-risk behaviour associated with the acute phase of BPD. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Internet Pathways in Suicidality: A Review of the Evidence

PubMed Central

Durkee, Tony; Hadlaczky, Gergo; Westerlund, Michael; Carli, Vladimir

2011-01-01

The general aim of this study was to review the scientific literature concerning the Internet and suicidality and to examine the different pathways by which suicidal risks and prevention efforts are facilitated through the Internet. An online literature search was conducted using the MEDLINE and Google Scholar databases. The main themes that were investigated included pathological Internet use and suicidality, pro-suicide websites, suicide pacts on the Internet, and suicide prevention via the Internet. Articles were screened based on the titles and abstracts reporting on the themes of interest. Thereafter, articles were selected based on scientific relevance of the study, and included for full text assessment. The results illustrated that specific Internet pathways increased the risk for suicidal behaviours, particularly in adolescents and young people. Several studies found significant correlations between pathological Internet use and suicidal ideation and non-suicidal self-injury. Pro-suicide websites and online suicide pacts were observed as high-risk factors for facilitating suicidal behaviours, particularly among isolated and susceptible individuals. Conversely, the evidence also showed that the Internet could be an effective tool for suicide prevention, especially for socially-isolated and vulnerable individuals, who might otherwise be unreachable. It is this paradox that accentuates the need for further research in this field. PMID:22073021

Comorbid psychiatric disorders in female adolescents with first-onset anorexia nervosa.

PubMed

Bühren, K; Schwarte, R; Fluck, F; Timmesfeld, N; Krei, M; Egberts, K; Pfeiffer, E; Fleischhaker, C; Wewetzer, C; Herpertz-Dahlmann, B

2014-01-01

Patients with anorexia nervosa (AN) exhibit high rates of psychiatric comorbidity. To disentangle the effects of duration of illness on comorbid psychiatric symptoms, we investigated the rates of comorbid psychiatric disorders, suicidality and self-harm behaviour in adolescent patients with a first onset of AN. In adolescent females (n = 148) with a first onset of AN, body mass index, psychiatric comorbidity (according to DSM-IV), depressive symptoms, suicidality and self-injurious behaviour were assessed. Seventy patients (47.3%) met the criteria for at least one comorbid psychiatric disorder. The binge-purging subtype was associated with increased rates of psychiatric comorbidity, suicidality and self-injurious behaviour. The severity of eating disorder-specific psychopathology influenced current psychiatric comorbidity and suicidal ideation. Prevalence rates of comorbid psychiatric disorders and suicidal ideation are considerably lower among adolescents with AN compared with adults. An early and careful assessment, along with adequate treatment of the eating disorder, might prevent the development of severe psychiatric comorbidities. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.

[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.

The burden of living with and caring for a suicidal family member.

PubMed

McLaughlin, Columba; McGowan, Iain; O'Neill, Siobhan; Kernohan, George

2014-10-01

The family has a primary role in caring for family members who are suicidal and in the prevention of future suicide. However, the impact that suicidal behaviour has on these family members is poorly understood. To explore the lived experiences of participants who cared for suicidal family members. Eighteen participants were interviewed using a short topic guide. Responses were digitally recorded and transcripts were analysed using thematic analysis. One overarching theme: "Hard work for the whole family" and four sub-themes: (i) Family burden, (ii) competing pressures, (iii) secrecy and shame and (iv) helplessness and guilt. Caring for a suicidal family member may be euphemistically summarised as "hard work" that impacts heavily on the day-to-day tasks of other family members. Participants spent much time worrying and ruminating about the risk of suicide in their family member. Mental health care professionals ought to acknowledge and address the impact that suicidal behaviour has on family carers.

5HT-2C receptor polymorphism in suicide victims. Association studies in German and Slavic populations.

PubMed

Stefulj, Jasminka; Büttner, Andreas; Kubat, Milovan; Zill, Peter; Balija, Melita; Eisenmenger, Wolfgang; Bondy, Brigitta; Jernej, Branimir

2004-08-01

Sustainable observations suggest that suicidal behaviour by itself may have biological correlates, among which those related to the serotonergic synapse hold the key position. Based on the association of suicide and serotonergic dysfunction, it was proposed that genetic mechanisms affecting suicidal behaviour could be related to the alterations of the genes encoding the elements of 5HT synapse. The present study tested the association of the polymorphism in the serotonin 2C (5HT-2C) receptor coding region (Cys23Ser) with suicide commitment. Study was based on two independent samples, one of German (284 suicide victims versus 297 controls) and other of Slavic/Croatian (118 suicide victims versus 275 controls) ethnicity. No significant differences in allele or genotype frequencies between victims and controls were demonstrated. Results did not provide supporting evidence for the potential involvement of the investigated variants of 5HT-2C receptor in the susceptibility to suicide.

Suicidal ideation and attempts in adolescents: associations with depression and six domains of self-esteem.

PubMed

Wild, Lauren G; Flisher, Alan J; Lombard, Carl

2004-12-01

This study aimed to disentangle the influence of depression and self-esteem on suicidal behaviour in adolescence. Grades 8 and 11 students in Cape Town, South Africa (n = 939) completed questionnaires assessing suicidal ideation and behaviour, depression, and self-esteem with respect to family, peers, school, sports/athletics, body image and global self-worth. Data were analysed using a series of multinomial logistic regression models adjusted for gender, grade, race and the sampling strategy. Results indicated that depression and low self-esteem in the family context were independently associated with suicide ideation and attempts. Moreover, low family self-esteem significantly differentiated suicide attempters from ideators. Screening for depression and low self-esteem in the family context is discussed as a possible strategy for helping to identify adolescents at risk for suicide attempts.

Insight and suicidality in psychosis: A cross-sectional study.

PubMed

Massons, Carmen; Lopez-Morinigo, Javier-David; Pousa, Esther; Ruiz, Ada; Ochoa, Susana; Usall, Judith; Nieto, Lourdes; Cobo, Jesus; David, Anthony S; Dutta, Rina

2017-06-01

We aimed to test whether specific insight dimensions are associated with suicidality in patients with psychotic disorders. 143 patients with schizophrenia spectrum disorders were recruited. Suicidality was assessed by item 8 of the Calgary Depression Scale for Schizophrenia (CDSS). Insight was measured by the Scale of Unawareness of Mental Disorder (SUMD) and the Markova and Berrios Insight Scale. Bivariate analyses and multivariable logistic regression models were conducted. Those subjects aware of having a mental illness and its social consequences had higher scores on suicidality than those with poor insight. Awareness of the need for treatment was not linked with suicidality. The Markova and Berrios Insight scale total score and two specific domains (awareness of "disturbed thinking and loss of control over the situation" and "having a vague feeling that something is wrong") were related to suicidality. However, no insight dimensions survived the multivariable regression model, which found depression and previous suicidal behaviour to predict suicidality. Suicidality in psychosis was linked with some insight dimensions: awareness of mental illness and awareness of social consequences, but not compliance. Depression and previous suicidal behaviour mediated the associations with insight; thus, predicting suicidality. Copyright © 2017. Published by Elsevier B.V.

The 'European Alliance Against Depression (EAAD)': a multifaceted, community-based action programme against depression and suicidality.

PubMed

Hegerl, Ulrich; Wittmann, Meike; Arensman, Ella; Van Audenhove, Chantal; Bouleau, Jean-Hervé; Van Der Feltz-Cornelis, Christina; Gusmao, Ricardo; Kopp, Maria; Löhr, Cordula; Maxwell, Margaret; Meise, Ulrich; Mirjanic, Milan; Oskarsson, Högni; Sola, Victor Perez; Pull, Charles; Pycha, Roger; Ricka, Regula; Tuulari, Jyrki; Värnik, Airi; Pfeiffer-Gerschel, Tim

2008-01-01

Action programmes fostering partnerships and bringing together regional and national authorities to promote the care of depressed patients are urgently needed. In 2001 the 'Nuremberg Alliance Against Depression' was initiated as a community-based model project within the large-scale 'German Research Network on Depression and Suicidality' (Kompetenznetz 'Depression, Suizidalität'). The 'Nuremberg Alliance Against Depression' was an action programme, conducted in the city of Nuremberg (500,000 inhabitants) in 2001/2002, addressing four intervention levels (Hegerl et al. Psychol Med 2006;36:1225). Based on the positive results of the Nuremberg project (a significant reduction of suicidal behaviour by more than 20%) 18 international partners representing 16 different European countries established the 'European Alliance Against Depression' (EAAD) in 2004. Based on the four-level approach of the Nuremberg project, all regional partners initiated respective regional intervention programmes addressing depression and suicidality. Evaluation of the activities takes place on regional and international levels. This paper gives a brief overview of the background for and experiences with the EAAD. It describes the components of the programme, provides the rationale for the intervention and outlines the current status of the project. The aim of the paper is to disseminate information about the programme's potential to reduce suicidal behaviour and to provide examples of how European community-based 'best practice' models for improving the care of depressed patients and suicidal persons can be implemented using a bottom-up approach. EAAD is mentioned by the European commission as a best practice example within the Green Paper 'Improving the mental health of the population: Towards a strategy on mental health for the European Union' (European Commission 2005).

Coping and suicide risk in high risk psychiatric patients.

PubMed

Ambrus, Livia; Sunnqvist, Charlotta; Asp, Marie; Westling, Sofie; Westrin, Åsa

2017-12-20

A dysfunctional use of coping strategies has repeatedly been linked to suicidal behaviour in non-psychiatric populations. However, data regarding association between coping strategies and suicidal behaviour in psychiatric populations are limited. The aim of the study was to investigate the possible relationship between self-reported suicide risk, suicidal ideation and coping strategies in three psychiatric cohorts. Three cohorts of psychiatric patients were involved in the study; recent suicide attempters (n = 55), suicide attempters at follow-up 12 years after a suicide attempt (n = 38) and patients with ongoing depression without attempted suicide (n = 72). Patients filled in the self-rating version of The Suicide Assessment Scale (SUAS-S) from which items no. 17-20 addressing current suicidal ideation were extracted. To investigate coping strategies, the Coping Orientation of Problem Experience Inventory (COPE) was used. In all cohorts, regression analyses showed that only avoidant coping was significantly correlated with the scores of SUAS-S adjusted for covariates. The items no. 17-20 correlated significantly to avoidant coping but not with other coping strategies in all cohorts. The results of this study indicate that among coping strategies only avoidant coping may be associated with suicide risk in psychiatric patients independently of history of attempted suicide.

Attitudes towards suicide among medical students: comparison between Madras (India) and Vienna (Austria).

PubMed

Etzersdorfer, E; Vijayakumar, L; Schöny, W; Grausgruber, A; Sonneck, G

1998-03-01

Attitudes towards suicide among medical students in Madras (India) and Vienna (Austria) were compared using the SUIATT questionnaire by Diekstra and Kerkhof (1989). Results show a very restrictive attitude in Madras, rejecting the right to commit suicide, nearly always judging suicide as a cowardly act, and rejecting the idea of assisted suicide. On the other hand, in Vienna a more permissive attitude was found. It is interpreted that the Indian pattern comes close to a "medical" or "disease model", with stronger emphasis on mental illness, impulsiveness and emotional aspects, whereas the Viennese pattern reflects a "theoretical", "rational model", concentrating on cognitive factors and minimizing the influence of mental illness, emotional difficulties and restrictions related to suicidal behaviour. This pattern may be influenced by the public discussion on assisted suicide and the right to die in Europe in the last decade. Possible relations to the risk for actual suicidal behaviour are discussed using respective answers concerning previous suicidal ideation and suicide attempts. The answers concerning suicidal ideation seem to be strongly influenced by the different attitude patterns: only 16.8% reported previous suicidal ideation in Madras, compared to 51.5% in Vienna, whereas the percentage of reported suicide attempts is equal in both centres (5.9%:4.9%).

A cross-ethnic comparison on incidence of suicide.

PubMed

Liu, I C; Liao, S F; Lee, W C; Kao, C Y; Jenkins, R; Cheng, A T A

2011-06-01

Suicide rates vary widely across nations and ethnic groups. This study aims to explore potential factors contributing to inter-ethnic differences in suicide rates. Study subjects came from a case-control psychological autopsy study conducted in Taiwan, including 116 consecutive suicides from two aboriginal groups and Taiwanese Han; 113 of them each matched with two living controls. Gender-, age- and method-specific suicide rates, population attributable fraction (PAF) of suicide for five major risk factors, help-seeking before suicide and emergency medical aid after suicide were compared between the three ethnic groups. One aboriginal group (the Atayal) had significantly higher adjusted rate ratios (RR) of suicide than the other aboriginal group (the Ami) [RR 0.20, 95% confidence intervals (CI) 0.12-0.34] and the Han (RR 0.26, 95% CI 0.16-0.40). Such differences can be explained by higher PAFs of suicide for three major risk factors (substance dependence, PAF 47.6%, 95% CI 25.5-64.2; emotionally unstable personality disorder, PAF 52.7%, 95% CI 32.8-69.0; family history of suicidal behaviour, PAF 43.5%, 95% CI 23.2-60.2) in this group than in the other two groups. This higher suicide rate was substantially reduced from 68.2/100 000 per year to 9.1/100 000 per year, comparable with the other two groups, after stepwise removal of the effects of these three risk factors. Suicide rates by self-poisoning were also significantly higher in this group than in the other two groups. Higher rates of specific risk factors and use of highly lethal pesticides for suicide contributed to the higher suicide rate in one ethnic group in Taiwan. These findings have implications for developing ethnicity-relevant suicide prevention strategies.

Does the environment affect suicide rates in Spain? A spatiotemporal analysis.

PubMed

Santurtún, Maite; Santurtún, Ana; Zarrabeitia, María T

2017-06-05

Suicide is an important public health problem, it represents one of the major causes of unnatural death, and there are many factors that affect the risk of suicidal behaviour. The present study analyzes the temporal and spatial variations of mortality by suicide in Spain and its relationship with gross domestic product (GDP) per capita. A retrospective study was performed, in which deaths by suicide, sex and age group in 50 Spanish provinces between 2000 and 2012 were analyzed. The annual trend of suicide mortality was assessed using Kendall's tau-b correlation coefficient. Seasonality and monthly and weekly behaviour were evaluated by performing the ANOVA test and the Bonferroni adjustment. Finally, the relationship between GDP per capita and suicide was studied. Between 2000 and 2012, 42,905adult people died by suicide in Spain. The annual average incidence rate was 95 suicides per million population. The regions located in the south and in the northwest of the country registered the highest per capita mortality rates. There is a decreasing trend in mortality by suicide over the period studied (CC=-.744; P=.0004) in adults over the age of 64, and a seasonal behaviour was identified with summer maximum and autumn minimum values (f=.504; P<.0001). The regions with the highest GDP per capita showed the lowest mortality by suicide (r=-.645; P<.0001) and the relationship is stronger among older age groups. Mortality by suicide does not follow a homogenous geographical distribution in Spain. Mortality in men was higher than in women. Over the period of study, there has been a decrease in mortality by suicide in Spain in adults over the age of 64. The seasonal cycle of suicides and the inverse relationship with GDP per capita found in this study, provide information which may be used as a tool for developing prevention and intervention strategies. Copyright © 2017 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

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.

Effect of sex and age on the association between suicidal behaviour and obesity in Korean adults: a cross-sectional nationwide study.

PubMed

Kim, Dae-Kwon; Song, Hyun Jin; Lee, Eui-Kyung; Kwon, Jin-Won

2016-06-02

To examine the hypothesis that the relationship between obesity and the risk of suicidal behaviour would differ according to sex and age. Data from the 2007-2012 Korean National Health and Nutrition Examination Survey (KNHANES) were used. 36 211 adults with body mass index (BMI) data were included and the mean age was 49.6 years. BMI. Suicide ideation and attempts. A cross-sectional study was performed. Multiple logistic regressions after controlling for socioeconomic variables and concomitant diseases were applied to see the relationship between obesity level and suicidal ideation or attempt. Women with severe obesity had the highest prevalence of suicide attempts and ideation, whereas among males, underweight men had the highest prevalence. After adjustment, obese men had a lower OR for suicide ideation (OR=0.87, 95% CI 0.76 to 1.00). Among women, the ORs of severely obese and underweight women were 1.27 (95% CI 1.06 to 1.52) and 1.24 (95% CI 1.06 to 1.45), respectively. When grouped by age category, the ORs for suicide ideation in severely obese women aged 18 to <30 years or attempts in severely obese women aged 30 to <50 years were 2.30 (95% CI 1.36 to 3.89) and 3.07 (95% CI 1.50 to 6.31), respectively. However, overweight and obese women aged more than 50 years exhibited significantly less ORs of suicide ideation, when compared with counterparts of normal weight. The association between obesity and suicidal behaviour exhibited a different pattern by sex and age in South Korea. In particular, severely obese young women had a substantial risk of suicidal behaviour. Our study results highlighted the importance of obesity management in the prevention of suicide among young women, and may be helpful for the drafting of the health agenda in Asian countries with an obesity prevalence and culture similar to those in Korea. 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/

Effect of sex and age on the association between suicidal behaviour and obesity in Korean adults: a cross-sectional nationwide study

PubMed Central

Kim, Dae-Kwon; Song, Hyun Jin; Lee, Eui-Kyung; Kwon, Jin-Won

2016-01-01

Objectives To examine the hypothesis that the relationship between obesity and the risk of suicidal behaviour would differ according to sex and age. Setting Data from the 2007–2012 Korean National Health and Nutrition Examination Survey (KNHANES) were used. Participants 36 211 adults with body mass index (BMI) data were included and the mean age was 49.6 years. Independent variable BMI. Primary and secondary outcome measures Suicide ideation and attempts. Design and analysis A cross-sectional study was performed. Multiple logistic regressions after controlling for socioeconomic variables and concomitant diseases were applied to see the relationship between obesity level and suicidal ideation or attempt. Results Women with severe obesity had the highest prevalence of suicide attempts and ideation, whereas among males, underweight men had the highest prevalence. After adjustment, obese men had a lower OR for suicide ideation (OR=0.87, 95% CI 0.76 to 1.00). Among women, the ORs of severely obese and underweight women were 1.27 (95% CI 1.06 to 1.52) and 1.24 (95% CI 1.06 to 1.45), respectively. When grouped by age category, the ORs for suicide ideation in severely obese women aged 18 to <30 years or attempts in severely obese women aged 30 to <50 years were 2.30 (95% CI 1.36 to 3.89) and 3.07 (95% CI 1.50 to 6.31), respectively. However, overweight and obese women aged more than 50 years exhibited significantly less ORs of suicide ideation, when compared with counterparts of normal weight. Conclusions The association between obesity and suicidal behaviour exhibited a different pattern by sex and age in South Korea. In particular, severely obese young women had a substantial risk of suicidal behaviour. Our study results highlighted the importance of obesity management in the prevention of suicide among young women, and may be helpful for the drafting of the health agenda in Asian countries with an obesity prevalence and culture similar to those in Korea. PMID:27256086

The strategic function of attempted suicide.

PubMed

Katschnig, H; Steinert, H

1975-01-01

Attempting suicide is regarded as a strategy for getting out of emotionally troublesome situations. This strategy is a bodily and risky 'cry for help', but also a cry for help with almost certain success as the bodily self-damage forces significant others to show indulgent behaviour. As this indulgent behaviour has the actual function to relieve significant others from feelings of guilt and from real social pressures, it very often diminishes with time, so that the effect of the 'attempted suicide strategy' proves to be very short. The relation between this concept and some epidemiological findings is discussed and the consequences of this approach for the management of attempted suicides are pointed out.

[Study on high-risk behaviour and suicide associated risk factors related to HIV/AIDS among gay or bisexual men].

PubMed

Chen, Hong-quan; Li, Yang; Zhang, Bei-chuan; Li, Xiu-fang

2011-10-01

Characteristics on AIDS high-risk behaviors in gay or bisexual men with suicide ideas were explored and analyzed. A cross-sectional survey was conducted with the snowball sampling method adopted. Subjects with suicide ideas were collected from responses to the valid questionnaires and subjects with no suicide ideas were collected from the age comparable men. The overall rate of gays or bisexuals with suicide ideas was 20.2% in this survey. The attitude for homogeneity and marital status among the unmarried was more than that among the comparable group (P < 0.05). The rate of AIDS high-risk behaviors as same-sex sexual harassment, bleeding during sexual intercourse in the last year, coitus with unfamiliar same-sex partners in cities, suffering from adult same-sex sexual abuse before the age of 16, having had sexual abuse and abusive behavior, having had active or passive anal kiss, having had active or passive coitus with fingers, alcohol consumption weekly at least once or more, hurt by gays because of attitude and/or same-sex sexual activity and hurt by heterosexual men because of attitude and/or same-sex sexual activity were significantly higher in gays and bisexual men with suicide ideas than those without (P < 0.05). Data from multivariate logistic regression models suggested that harm from gays (Waldχ(2) = 6.637, P = 0.010) and heterosexual men (Waldχ(2) = 5.835, P = 0.016) due to attitude on homosexual activity appear to be the risk factors causing the suicide ideas. Reducing the social discrimination and harm towards gays and bisexual men could reduce the occurrence of the suicide ideas and have a positive effect on curbing the prevalence of AIDS.

[Psychological femininity and masculinity, self-appeal, attachment styles, coping styles and strategies of self-presentation among women with suicide attempts].

PubMed

Mandal, Eugenia; Zalewska, Karolina

2010-01-01

The aim of this study was to diagnose particular personality characteristics of women with suicide attempts: psychological femininity and masculinity, self-appeal, attachment styles, self-presentation strategies and coping styles. A group of 35 adult women who attempted suicide and the control group (35 women) were submitted to a research. The following measures were used: Inventory of Gender Identity (IPP), Strategies of Self-presentation Questionnaire (KSA), Attachment Style Test, Sense of Self-Appeal Scale (SPWA), Coping Inventory of Stressful Situations (CISS). Female suicide-attempters had a lower index of psychological masculinity and a lower sense of self-appeal than women in the control group. They were characterised by an avoidant attachment style, used a strategy of self-depreciation in self-presentation and an emotion-oriented style of coping. The predictors of risk of suicide behaviours that mainly showed: avoidant-attachment style and strategy of self-depreciation in self-presentation. Parasuicides were characterised by lower self-esteem and weak interpersonal skills, which reduced their ways of coping in difficult situations.

Cost-Effectiveness of Classroom-Based Cognitive Behaviour Therapy in Reducing Symptoms of Depression in Adolescents: A Trial-Based Analysis

ERIC Educational Resources Information Center

Anderson, Rob; Ukoumunne, Obioha C.; Sayal, Kapil; Phillips, Rhiannon; Taylor, John A.; Spears, Melissa; Araya, Ricardo; Lewis, Glyn; Millings, Abigail; Montgomery, Alan A.; Stallard, Paul

2014-01-01

Background: A substantial minority of adolescents suffer from depression and it is associated with increased risk of suicide, social and educational impairment, and mental health problems in adulthood. A recently conducted randomized controlled trial in England evaluated the effectiveness of a manualized universally delivered age-appropriate CBT…

CSF 5-HIAA and exposure to and expression of interpersonal violence in suicide attempters.

PubMed

Moberg, T; Nordström, P; Forslund, K; Kristiansson, M; Asberg, M; Jokinen, J

2011-07-01

Serotonin is implicated in impaired impulse control, aggression and suicidal behaviour. Low cerebrospinal fluid (CSF) concentrations of the serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA) have been found in violent suicide attempters, suicide victims and in violent offenders. CSF 5-HIAA concentrations have both genetic and environmental determinants. Childhood trauma may have an effect on central monoamine function as an adult. The aim of this study was to assess the relationship of CSF 5-HIAA and the exposure to and the expression of violence in childhood and during adult life measured with the Karolinska Interpersonal Violence Scale (KIVS). 42 medication free suicide attempters underwent lumbar puncture and were assessed with the Karolinska Interpersonal Violence Scale (KIVS) to assess history of childhood exposure to violence and lifetime expressed violent behaviour. In women, but not in men, CSF 5-HIAA showed a significant negative correlation to exposure to violence during childhood. Furthermore, suicide attempters with low CSF 5-HIAA were more prone to commit violent acts as an adult if exposed to violence as a child compared to suicide attempters with high CSF 5-HIAA. In the non-traumatized group, CSF 5-HIAA showed a significant negative correlation to expressed violent behaviour in childhood. Although central serotonergic function has important genetic determinants, exposure to childhood trauma may also affect serotonergic function. Low serotonergic function may facilitate impaired aggression control in traumatized suicide attempters. Copyright © 2011 Elsevier B.V. All rights reserved.

Parasuicide online: Can suicide websites trigger suicidal behaviour in predisposed adolescents?

PubMed

Becker, K; Mayer, M; Nagenborg, M; El-Faddagh, M; Schmidt, M H

2004-01-01

The present case report describes a 17-year-old female who explicitly visited suicide web forums, where she researched reliable suicide methods, contacted an anonymous user and purchased substances for the implementation of suicide. The risk of Internet use by vulnerable youth is discussed. Psychiatric exploration should include questions of manner and frequency of media use. The application of media guidelines for suicide prevention is demanded for websites, as are accessible self-help sites for suicidal persons targeted to youthful users.

Community-Based Suicide Prevention Research in Remote On-Reserve First Nations Communities

ERIC Educational Resources Information Center

Isaak, Corinne A.; Campeau, Mike; Katz, Laurence Y.; Enns, Murray W.; Elias, Brenda; Sareen, Jitender

2010-01-01

Suicide is a complex problem linked to genetic, environmental, psychological and community factors. For the Aboriginal population more specifically, loss of culture, history of traumatic events, individual, family and community factors may also play a role in suicidal behaviour. Of particular concern is the high rate of suicide among Canadian…

COHORT EFFECTS OF SUICIDE MORTALITY ARE SEX SPECIFIC IN THE RAPIDLY DEVELOPED HONG KONG CHINESE POPULATION, 1976-2010.

PubMed

Chung, Roger Y; Yip, Benjamin H K; Chan, Sandra S M; Wong, Samuel Y S

2016-06-01

To examine temporal variations of age, period, and cohort on suicide mortality rate in Hong Kong (HK) from 1976 to 2010, and speculate the macroenvironmental mechanisms of the observed trends. Poisson age-period-cohort modeling was used to delineate the effects of age, period, and cohort on suicide mortality. Analysis by sex was also conducted to examine if gender difference exists for suicidal behaviours. Age-cohort model provides the best fit to the mortality data, implying that the cohort effect is likely to explain more of the contributions to HK's suicide mortality pattern than the period effect. Risk of suicide mortality increases nonlinearly with age and accelerates after age 65-69 for both sexes. Moreover, the cohort effects differ between the sexes-risk of mortality increases continually for men born after 1961, but no change is observed for women since the 1941 cohort. With increased risk of suicide mortality in younger cohorts and the age effect of suicide mortality, we may see future increase in suicide mortality as these younger cohorts age. Further studies are needed to clarify plausible associations between broader sociohistorical changes in the population impacting psychological risk factors and suicidal behaviour to better inform suicide prevention strategies. © 2015 Wiley Periodicals, Inc.

Suicide: rationality and responsibility for life.

PubMed

Ho, Angela Onkay

2014-03-01

Death by suicide is widely held as an undesirable outcome. Most Western countries place emphasis on patient autonomy, a concept of controversy in relation to suicide. This paper explores the tensions between patients' rights and many societies' overarching desire to prevent suicide, while clarifying the relations between mental disorders, mental capacity, and rational suicide. A literature search was conducted using search terms of suicide and ethics in the PubMed and LexisNexis Academic databases. Article titles and abstracts were reviewed and deemed relevant if the paper addressed topics of rational suicide, patient autonomy or rights, or responsibility for life. Further articles were found from reference lists and by suggestion from preliminary reviewers of this paper. Suicidal behaviour in a person cannot be reliably predicted, yet various associations and organizations have developed standards of care for managing patients exhibiting suicidal behaviour. The responsibility for preventing suicide tends to be placed on the treating clinician. In cases where a person is capable of making treatment decisions--uninfluenced by any mental disorder--there is growing interest in the concept of rational suicide. There is much debate about whether suicide can ever be rational. Designating suicide as an undesirable event that should never occur raises the debate of who is responsible for one's life and runs the risk of erroneously attributing blame for suicide. While upholding patient rights of autonomy in psychiatric care is laudable, cases of suicidality warrant a delicate consideration of clinical judgment, duty of care, and legal obligations.

Suicide: Rationality and Responsibility for Life

PubMed Central

Ho, Angela Onkay

2014-01-01

Objectives: Death by suicide is widely held as an undesirable outcome. Most Western countries place emphasis on patient autonomy, a concept of controversy in relation to suicide. This paper explores the tensions between patients’ rights and many societies’ overarching desire to prevent suicide, while clarifying the relations between mental disorders, mental capacity, and rational suicide. Methods: A literature search was conducted using search terms of suicide and ethics in the PubMed and LexisNexis Academic databases. Article titles and abstracts were reviewed and deemed relevant if the paper addressed topics of rational suicide, patient autonomy or rights, or responsibility for life. Further articles were found from reference lists and by suggestion from preliminary reviewers of this paper. Results: Suicidal behaviour in a person cannot be reliably predicted, yet various associations and organizations have developed standards of care for managing patients exhibiting suicidal behaviour. The responsibility for preventing suicide tends to be placed on the treating clinician. In cases where a person is capable of making treatment decisions—uninfluenced by any mental disorder—there is growing interest in the concept of rational suicide. Conclusions: There is much debate about whether suicide can ever be rational. Designating suicide as an undesirable event that should never occur raises the debate of who is responsible for one’s life and runs the risk of erroneously attributing blame for suicide. While upholding patient rights of autonomy in psychiatric care is laudable, cases of suicidality warrant a delicate consideration of clinical judgment, duty of care, and legal obligations. PMID:24881162

Assessment of depression and suicidal behaviour among medical students in Portugal

PubMed Central

Faravelli, Carlo; Figueira, Maria Luísa

2016-01-01

Objectives To examine depression and suicidal behaviour and associated factors in a sample of medical students in Portugal. Methods We conducted a cross-sectional study design of 456 native Portuguese medical students from the 4th and 5th year at the University of Lisbon. Participants answered a self-report survey including questions on demographic and clinical variables. Statistical analyses were conducted using the chi-square test, with a Monte Carlo simulation when appropriate. Results Depression among medical students was 6.1% (n=28) and suicidal behaviour 3.9% (n=18). Higher depression scores were noted in female medical students (χ2=4.870,df=2,p=0.027), students who lived alone (χ2=8.491,df=3,p=0.037), those with poor physical health (χ2=48.269,df=2,p<0.001), with poor economic status (χ2=8.579,df=2,p=0.014), students with a psychiatric diagnosis (χ2=44.846,df=1,p=0.009), students with a family history of psychiatric disorders (χ2=5.284,df=1,p=0.022) and students with high levels of anxiety (χ2=104.8, df=3, p<0.001).  Depression scores were also higher in students with suicidal ideation (χ2=85.0,df=1,p<0.001), suicidal plan (χ2=47.9,df=1,p<0.001) and suicidal attempt (χ2=19.2,df=1,p<0.001). Suicidal behaviour was higher in medical students who lived alone (χ2=16.936,df=3,p=0.001), who had poor physical health (χ2=18,929,df=2,p=0.001), poor economic status (χ2=9.181,df=2,p=0.01), who are/were in psychopharmacology treatment (χ2=30.108,df =1,p<0.001), and who had high alcohol use (χ2=7.547,df=2,p=0.023), severe depression (χ2=88.875,df=3,p<0.001) and high anxiety levels (χ2=50.343,df=3,p<0.001). The results also revealed that there were no differences between students in the 4th and 5th years of medical school regarding rate of depression and suicidal behaviour. Conclusions Since depression and suicidal behaviour are mental health problems affecting a significant proportion of medical students, medical schools should implement programs that promote mental health wellness, physical health and economic status between other factors. PMID:27794561

Assessment of depression and suicidal behaviour among medical students in Portugal.

PubMed

Coentre, Ricardo; Faravelli, Carlo; Figueira, Maria Luísa

2016-10-29

To examine depression and suicidal behaviour and associated factors in a sample of medical students in Portugal. We conducted a cross-sectional study design of 456 native Portuguese medical students from the 4 th and 5 th year at the University of Lisbon. Participants answered a self-report survey including questions on demographic and clinical variables. Statistical analyses were conducted using the chi-square test, with a Monte Carlo simulation when appropriate. Depression among medical students was 6.1% (n=28) and suicidal behaviour 3.9% (n=18). Higher depression scores were noted in female medical students (χ 2 =4.870,df=2,p=0.027), students who lived alone (χ 2 =8.491,df=3,p=0.037), those with poor physical health (χ 2 =48.269,df=2,p<0.001), with poor economic status (χ 2 =8.579,df=2,p=0.014), students with a psychiatric diagnosis (χ 2 =44.846,df=1,p=0.009), students with a family history of psychiatric disorders (χ 2 =5.284,df=1,p=0.022) and students with high levels of anxiety (χ 2 =104.8, df=3, p<0.001).  Depression scores were also higher in students with suicidal ideation (χ 2 =85.0,df=1,p<0.001), suicidal plan (χ 2 =47.9,df=1,p<0.001) and suicidal attempt (χ 2 =19.2,df=1,p<0.001). Suicidal behaviour was higher in medical students who lived alone (χ 2 =16.936,df=3,p=0.001), who had poor physical health (χ 2 =18,929,df=2,p=0.001), poor economic status (χ 2 =9.181,df=2,p=0.01), who are/were in psychopharmacology treatment (χ 2 =30.108,df =1,p<0.001), and who had high alcohol use (χ 2 =7.547,df=2,p=0.023), severe depression (χ 2 =88.875,df=3,p<0.001) and high anxiety levels (χ 2 =50.343,df=3,p<0.001). The results also revealed that there were no differences between students in the 4 th and 5 th years of medical school regarding rate of depression and suicidal behaviour. Since depression and suicidal behaviour are mental health problems affecting a significant proportion of medical students, medical schools should implement programs that promote mental health wellness, physical health and economic status between other factors.

[Anorexia and borderline personality disorder : bonds pathology].

PubMed

Cayn, Delphine; Pham-Scottez, Alexandra

Comorbidity with a borderline personality disorder is far from rare in patients suffering from eating disorders. Clinically, this presents as chronic instability in many areas: interpersonal relationships, self-image, emotions, mood and acting out. Treatment is mainly based on a containing and reassuring therapeutic framework. A care plan may be put in place that incorporates reducing impulsive harmful, eating and self-harming behaviours. Dialectical behaviour therapy is intended in particular to prevent suicide risk in borderline personality disorder patients. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Sex, gender role orientation, gender role attitudes and suicidal thoughts in three generations. A general population study.

PubMed

Hunt, Kate; Sweeting, Helen; Keoghan, Margaret; Platt, Stephen

2006-08-01

Suicide and other suicidal behaviours are markedly (though differently) patterned by gender. The increase in young male suicide rates in many countries has heightened interest in whether suicidal behaviours and ideation (thoughts) are related to masculinity. Relatively little research has explored the relationship between gender role attitudes and orientation and suicidal behaviours and ideation. Most research in this area has been conducted with young people. We investigated whether gender role orientation (masculinity and femininity scores) and gender role attitudes were related to the reporting of serious suicidal thoughts in three generations (early adulthood, and early and late middle age) in a community sample. Subjects (653 men and women aged around 23 years, 754 aged around 43 years, 722 aged around 63 years) completed home interviews with nurses as part of an ongoing longitudinal community-based study of social factors and health. These included measures of suicidal ideation (thoughts), attitudes to traditional gender roles, and a validated measure of gender role orientation (masculinity and femininity scores). The prevalence of serious suicidal thoughts was higher in early adulthood (10% men, 15% women) than in early (4% men, 8% women) and late (6% men, 5% women) middle age. In early adulthood only sex was significantly related to suicidal thoughts, with women at higher risk (adjusted OR 1.74, 95% CI 1.01-3.00). In early middle age masculinity scores were negatively related to suicidal thoughts (adjusted OR for each unit increase in score 0.65: 95% CI 0.46-0.93), and more traditional views on gender roles were positively associated with suicidal thoughts (adjusted OR 1.48: 95% CI 1.07-2.04). In late middle age trends were in the same direction as in early middle age, but were not statistically significant. Femininity scores were unrelated to serious suicidal thoughts at any age. The high rates of suicidal thoughts amongst men and women in early adulthood point to the importance of understanding mental health problems at this age. The results raise a number of questions and suggest that suicide researchers should pay more attention to gender roles and attitudes in older adults.

Knowledge, Self-Confidence and Attitudes towards Suicidal Patients at Emergency and Psychiatric Departments: A Randomised Controlled Trial of the Effects of an Educational Poster Campaign.

PubMed

van Landschoot, Renate; Portzky, Gwendolyn; van Heeringen, Kees

2017-03-14

Educational posters are used to enhance knowledge, attitudes and self-confidence of patients. Little is known on their effectiveness for educating health care professionals. As these professionals may play an important role in suicide prevention, the effects of a poster and accompanying evaluation and triage guide on knowledge, self-confidence and attitudes regarding suicidal thoughts and behaviours, were studied in a multicentre cluster randomised controlled trial, involving staff from 39 emergency and 38 psychiatric departments throughout Flanders ( n = 1171). Structured self-report questionnaires assessed the knowledge, confidence and beliefs regarding suicidal behaviour management, and attitudes. Data were analysed through a Solomon four-group design, with random assignment to the different conditions. Baseline scores for knowledge and provider confidence were high. The poster and accompanying evaluation and triage guide did not have an effect on knowledge about suicide and self-confidence in suicidal behaviour management. However, the poster campaign appeared to be beneficial for attitudes towards suicidal patients, but only among staff from mental health departments that were assigned to the un-pretested condition. Given the limited effects of the poster campaign in the studied population with a relatively high baseline knowledge, the evaluation of this poster as part of a multimodal educational programme in a more heterogeneous sample of health care professionals is recommended.

Knowledge, Self-Confidence and Attitudes towards Suicidal Patients at Emergency and Psychiatric Departments: A Randomised Controlled Trial of the Effects of an Educational Poster Campaign

PubMed Central

van Landschoot, Renate; Portzky, Gwendolyn; van Heeringen, Kees

2017-01-01

Educational posters are used to enhance knowledge, attitudes and self-confidence of patients. Little is known on their effectiveness for educating health care professionals. As these professionals may play an important role in suicide prevention, the effects of a poster and accompanying evaluation and triage guide on knowledge, self-confidence and attitudes regarding suicidal thoughts and behaviours, were studied in a multicentre cluster randomised controlled trial, involving staff from 39 emergency and 38 psychiatric departments throughout Flanders (n = 1171). Structured self-report questionnaires assessed the knowledge, confidence and beliefs regarding suicidal behaviour management, and attitudes. Data were analysed through a Solomon four-group design, with random assignment to the different conditions. Baseline scores for knowledge and provider confidence were high. The poster and accompanying evaluation and triage guide did not have an effect on knowledge about suicide and self-confidence in suicidal behaviour management. However, the poster campaign appeared to be beneficial for attitudes towards suicidal patients, but only among staff from mental health departments that were assigned to the un-pretested condition. Given the limited effects of the poster campaign in the studied population with a relatively high baseline knowledge, the evaluation of this poster as part of a multimodal educational programme in a more heterogeneous sample of health care professionals is recommended. PMID:28335446

Household composition and suicidal behaviour in the adult population of Belgium.

PubMed

Gisle, Lydia; Van Oyen, Herman

2013-07-01

We aimed to estimate the prevalence of suicidal behaviours, i.e. ideation and attempt, in the adult population of Belgium, and to explore their association with household composition. Data of 4,459 adults (25-64 years) from the 2004 Belgian Health Interview Survey were used for analyses. Bivariate and multivariate logistic regressions were used to calculate the odds of engaging in suicidal behaviours according to household type, further controlling for age, sex, income, employment status and social support. Lifetime prevalence of ideation and attempts was 14 and 4.7 %, respectively. Current prevalence of ideation was 4.0 % and past year prevalence of attempts was 0.5 %. Compared to other household compositions, living alone (A) and as lone parent (P) increased the odds of lifetime and current suicidal thoughts (ORA 2.3, 95 % CI 1.7-2.9 and ORP 3.8, 95 % CI 1.9-7.7) and lifetime attempts (ORA 2.3, 95 % CI 1.4-3.6 and ORP 4.5, 95 % CI 2.4-8.5). When controlling for confounders, single person and single parent households still presented increased adjusted-odds of lifetime and current suicidal thoughts (a-ORA 1.8, 95 % CI 1.1-2.9 and a-ORP 2.3, 95 % CI 1.0-5.5). The likelihood of ever attempted suicide was also higher among single parent households (a-ORP 4.5, 95 % CI 2.4-8.5) after adjustment, but not among those living alone (a-ORA 1.4, 95 % CI 0.8-2.8). Living alone or as lone parent place adults at higher risk for suicide behaviour, and this is only partly explained by lower socio-economic status or poor perceived support.

Tensions in perspectives on suicide prevention between men who have attempted suicide and their support networks: Secondary analysis of qualitative data.

PubMed

Fogarty, Andrea S; Spurrier, Michael; Player, Michael J; Wilhelm, Kay; Whittle, Erin L; Shand, Fiona; Christensen, Helen; Proudfoot, Judith

2018-02-01

Men generally have higher rates of suicide, despite fewer overt indicators of risk. Differences in presentation and response suggest a need to better understand why suicide prevention is less effective for men. To explore the views of at-risk men, friends and family about the tensions inherent in suicide prevention and to consider how prevention may be improved. Secondary analysis of qualitative interview and focus group data, using thematic analysis techniques, alongside bracketing, construction and contextualisation. A total of 35 men who had recently made a suicide attempt participated in interviews, and 47 family and friends of men who had made a suicide attempt took part in focus groups. Participants recounted their experiences with men's suicide attempts and associated interventions, and suggested ways in which suicide prevention may be improved. Five tensions in perspectives emerged between men and their support networks, which complicated effective management of suicide risk: (i) respecting privacy vs monitoring risk, (ii) differentiating normal vs risky behaviour changes, (iii) familiarity vs anonymity in personal information disclosure, (iv) maintaining autonomy vs imposing constraints to limit risk, and (v) perceived need for vs failures of external support services. Tension between the different perspectives increased systemic stress, compounding problems and risk, thereby decreasing the effectiveness of detection of and interventions for men at risk of suicide. Suggested solutions included improving risk communication, reducing reliance on single source supports and increasing intervention flexibility in response to individual needs. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Disentangling dysthymia from major depressive disorder in suicide attempters' suicidality, comorbidity and symptomatology.

PubMed

Holmstrand, Cecilia; Engström, Gunnar; Träskman-Bendz, Lil

2008-01-01

Dysthymia and major depressive disorder (MDD) are both risk diagnoses for suicidal behaviour. The aim of the present study was to identify clinical differences between these disorders, with a special reference to dysthymia. We studied suicidal behaviour, comorbidity and psychiatric symptoms of inpatient suicide attempters with dysthymia and MDD. We used DSM III-R diagnostics, the Suicide Assessment Scale (SUAS) and the Comprehensive Psychopathological Rating Scale (CPRS), part of which is the Montgomery and Asberg Depression Rating Scale (MADRS). Suicide mortality, number of repeated suicide attempts, method of suicide attempt and comorbidity of Axis I did not differ between the groups. Dysthymia patients, however, suffered more than MDD patients from DSM-III-R Axis II diagnoses (above all cluster B). There was no significant difference in Axis III comorbidity. Total SUAS, CPRS and MADRS scores did not differ significantly between the groups. When studying separate SUAS and CPRS items in a multivariate analysis, the CPRS items "aches and pains", "increased speech flow", increased "agitation" and "less tendency to worrying over trifles" as well as young age remained independently associated with dysthymia. Dysthymia patients, who later committed suicide, more often reported increased "aches and pains" than those who did not commit suicide. In this small sample of suicide attempters, we conclude that dysthymia suicide attempters, more often than MDD patients, have a comorbidity with personality disorders, which combined with a picture of aches and pains, could be factors explaining their suicidality.

Safety First: The Role of Trust and School Safety in Non-Suicidal Self-Injury

ERIC Educational Resources Information Center

Noble, Rick Nelson; Sornberger, Michael J.; Toste, Jessica R.; Heath, Nancy L.; McLouth, Rusty

2011-01-01

Non-suicidal self-injury (NSSI) has become very prominent among adolescents in middle and high school settings. However, little research has evaluated the role of the school environment in the behaviour. This study examined whether indices of school trust and perceived safety were predictive of NSSI behaviour. Results indicate that these variables…

Factors predicting recovery from suicide in attempted suicide patients.

PubMed

Sun, Fan-Ko; Lu, Chu-Yun; Tseng, Yun Shan; Chiang, Chun-Ying

2017-12-01

The aim of this study was to explore the factors predicting suicide recovery and to provide guidance for healthcare professionals when caring for individuals who have attempted suicide. The high rate of suicide is a global health problem. Suicide prevention has become an important issue in contemporary mental health. Most suicide research has focused on suicidal prevention and care. There is a lack of research on the factors predicting suicidal recovery. A cross-sectional design was adopted. A correlational study with a purposive sample of 160 individuals from a suicide prevention centre in southern Taiwan was conducted. The questionnaires included the Brief Symptom Rating Scale-5, Suicidal Recovery Assessment Scale and Beck Hopelessness Scale. Descriptive statistics and linear regressions were used for the analysis. The mean age of the participants was 40.2 years. Many participants were striving to make changes to create a more stable and fulfilling life, had an improved recovery from suicide and had a good ability to adapt or solve problems. The linear regression showed that the Beck Hopelessness Scale scores (ß = -.551, p < .001) and Brief Symptom Rating Scale-5 (ß = -.218, p = .003) and past suicidal behaviour (ß = -.145, p = .008) were significant predictors of individuals' recovery from suicide. They accounted for 57.1% of the variance. Suicidal individuals who have a lower level of hopelessness, a better ability to cope with their mental condition and fewer past suicidal behaviours may better recover from suicide attempts. The nurses could use the results of this study to predict recovery from suicide in patients with attempted suicide. © 2017 John Wiley & Sons Ltd.

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

Cigarette smoking and suicide attempts in psychiatric outpatients in Hungary.

PubMed

Rihmer, Zoltán; Döme, Péter; Gonda, Xénia; Kiss, Huba G; Kovács, Dénes; Seregi, Krisztina; Teleki, Zsófia

2007-06-01

Epidemiological and clinical studies have found a significant association between smoking and suicidal behaviour. 334 outpatients with DSM-IV diagnosis of unipolar major depression, bipolar (I+II) disorder, schizophrenia, schizoaffective disorder and pure panic disorder were interviewed regarding to their smoking habits and previous suicide attempts. With the exception of panic disorder patients, the rate of prior suicide attempt(s) was much higher among current and lifetime smokers than among never smokers in all diagnostic groups, but the difference was statistically significant only for lifetime smoker unipolar depressives and for current and lifetime smoker schizophrenics. Age, social class and alcohol/caffeine consumption was not controlled and dependent vs nondependent smokers were not distinguished. The findings support previous results on the strong relationship between smoking and suicidal behaviour in psychiatric (particularly major depressive and schizophrenic) patients.

Religion and the risk of suicide: longitudinal study of over 1 million people.

PubMed

O'Reilly, Dermot; Rosato, Michael

2015-06-01

Durkheim's seminal historical study demonstrated that religious affiliation reduces suicide risk, but it is unclear whether this protective effect persists in modern, more secular societies. To examine suicide risk according to Christian religious affiliation and by inference to examine underlying mechanisms for suicide risk. If church attendance is important, risk should be lowest for Roman Catholics and highest for those with no religion; if religiosity is important, then 'conservative' Christians should fare best. A 9-year study followed 1 106 104 people aged 16-74 years at the 2001 UK census, using Cox proportional hazards models adjusted for census-based cohort attributes. In fully adjusted models analysing 1119 cases of suicide, Roman Catholics, Protestants and those professing no religion recorded similar risks. The risk associated with conservative Christians was lower than that for Catholics (HR = 0.71, 95% CI 0.52-0.97). The relationship between religious affiliation and suicide established by Durkheim may not pertain in societies where suicide rates are highest at younger ages. Risks are similar for those with and without a religious affiliation, and Catholics (who traditionally are characterised by higher levels of church attendance) do not demonstrate lower risk of suicide. However, religious affiliation is a poor measure of religiosity, except for a small group of conservative Christians, although their lower risk of suicide may be attributable to factors such as lower risk behaviour and alcohol consumption. © The Royal College of Psychiatrists 2015.

Suicide attempts and risk of suicide in patients with fibromyalgia: a survey in Spanish patients.

PubMed

Calandre, Elena P; Vilchez, Juan S; Molina-Barea, Rocío; Tovar, Maria Isabel; Garcia-Leiva, Juan M; Hidalgo, Javier; Rodriguez-Lopez, Carmen Maria; Rico-Villademoros, Fernando

2011-10-01

Depression, chronic pain and sleep disturbances frequently co-exist in FM and have shown to be independently related with suicidal behaviours. The present survey was performed to evaluate the prevalence of previous suicide attempts in patients with FM and its potential relationship with sociodemographic and clinical characteristics of the disease. A concise survey was sent to patients of seven associations of patients with FM. In addition to the inquiry concerning the number, if any, and characteristics of suicide attempts, the survey included questions about sociodemographic and clinical data of patients as well as the revised FM impact questionnaire (FIQR) and the Plutchik suicide risk scale. One hundred and eighty patients answered the survey. Thirty (16.7%) of them reported one to three previous suicide attempts. Drug poisoning was the most frequently employed method for suicide attempt (70%). No relevant differences were found between suicide attempters and non-attempters in relation to age, education and marital status, but a significant difference was found in relation to employment status. Plutchik's scale scores, both in suicide attempters and non-attempters, were higher than those found in the literature. FIQR scores were significantly higher in suicide attempters than in non-attempters. A high-positive correlation was found between FIQR and Plutchik suicide risk scale scores. Pain, poor sleep quality, anxiety and depression were positively correlated with suicide risk. FM is associated with an increased risk of suicide and suicide attempts. Suicidal behaviour seems to be related with the global severity of the disease.

Suicidal Behaviour in Mood Disorders—Who, When, and Why?

PubMed Central

Isometsä, Erkki

2014-01-01

Objective: About one-half to two-thirds of all suicides are by people who suffer from mood disorders; preventing suicides among those who suffer from them is thus central for suicide prevention. Understanding factors underlying suicide risk is necessary for rational preventive decisions. Method: The literature on risk factors for completed and attempted suicide among subjects with depressive and bipolar disorders (BDs) was reviewed. Results: Lifetime risk of completed suicide among psychiatric patients with mood disorders is likely between 5% and 6%, with BDs, and possibly somewhat higher risk than patients with major depressive disorder. Longitudinal and psychological autopsy studies indicate suicidal acts usually take place during major depressive episodes (MDEs) or mixed illness episodes. Incidence of suicide attempts is about 20- to 40-fold, compared with euthymia, during these episodes, and duration of these high-risk states is therefore an important determinant of overall risk. Substance use and cluster B personality disorders also markedly increase risk of suicidal acts during mood episodes. Other major risk factors include hopelessness and presence of impulsive–aggressive traits. Both childhood adversity and recent adverse life events are likely to increase risk of suicide attempts, and suicidal acts are predicted by poor perceived social support. Understanding suicidal thinking and decision making is necessary for advancing treatment and prevention. Conclusion: Among subjects with mood disorders, suicidal acts usually occur during MDEs or mixed episodes concurrent with comorbid disorders. Nevertheless, illness factors can only in part explain suicidal behaviour. Illness factors, difficulty controlling impulsive and aggressive responses, plus predisposing early exposures and life situations result in a process of suicidal thinking, planning, and acts. PMID:24881160

Suicidal behaviour in mood disorders--who, when, and why?

PubMed

Isometsä, Erkki

2014-03-01

About one-half to two-thirds of all suicides are by people who suffer from mood disorders; preventing suicides among those who suffer from them is thus central for suicide prevention. Understanding factors underlying suicide risk is necessary for rational preventive decisions. The literature on risk factors for completed and attempted suicide among subjects with depressive and bipolar disorders (BDs) was reviewed. Lifetime risk of completed suicide among psychiatric patients with mood disorders is likely between 5% and 6%, with BDs, and possibly somewhat higher risk than patients with major depressive disorder. Longitudinal and psychological autopsy studies indicate suicidal acts usually take place during major depressive episodes (MDEs) or mixed illness episodes. Incidence of suicide attempts is about 20- to 40-fold, compared with euthymia, during these episodes, and duration of these high-risk states is therefore an important determinant of overall risk. Substance use and cluster B personality disorders also markedly increase risk of suicidal acts during mood episodes. Other major risk factors include hopelessness and presence of impulsive-aggressive traits. Both childhood adversity and recent adverse life events are likely to increase risk of suicide attempts, and suicidal acts are predicted by poor perceived social support. Understanding suicidal thinking and decision making is necessary for advancing treatment and prevention. Among subjects with mood disorders, suicidal acts usually occur during MDEs or mixed episodes concurrent with comorbid disorders. Nevertheless, illness factors can only in part explain suicidal behaviour. Illness factors, difficulty controlling impulsive and aggressive responses, plus predisposing early exposures and life situations result in a process of suicidal thinking, planning, and acts.

Contact & connect--an intervention to reduce depression stigma and symptoms in construction workers: protocol for a randomised controlled trial.

PubMed

Milner, Allison; Witt, Katrina; Burnside, Lewis; Wilson, Caitlyn; LaMontagne, Anthony D

2015-10-16

Males employed in the construction industry have high rates of suicide. Although reasons underpinning this risk are multifaceted, poor help-seeking and stigma are represent major contributors. Males in the construction industry are also exposed to other risk factors for mental ill health and suicide, including unemployment. Sigma-reducing interventions that are accessible and attractive to recently unemployed males in the construction industry could therefore improve help-seeking, and address depression and suicidal behaviour in this population. Contact&Connect will use a parallel individual randomized design to evaluate the effectiveness of a multimedia-based intervention aimed at reducing stigma. The intervention consists of a package of 12 brief contact interventions (BCIs) delivered over a six month period. BCIs will direct participants to informational programs and microsites. Content will address three major themes: debunking depression myths and stereotypes, normalisation, and empowerment. Target enrollment is 630 (315 in each arm), each to be followed for 12 months. Eligible participants will be males, between 30 and 64 years, unemployed at the time of recruitment, registered with Incolink (a social welfare trustee company for unemployed members of the construction industry), and own a smart phone with enabled internet connectivity. At present, there are no programs that have been shown to be effective in reducing stigma in the blue-collar male population. Contact&Connect promises to provide a tailored, efficient, and scalable approach to reducing stigma, depressive symptoms and suicidality among unemployed males. Australian New Zealand Clinical Trials Register ACTRN12615000792527 (date of registration: 30 July, 2015).

System Constraints on Efficacious Teacher Behaviours in School-Based Suicide Prevention Initiatives; A Qualitative Study of Teacher Views and Experiences

ERIC Educational Resources Information Center

McConnellogue, Sheila; Storey, Lesley

2017-01-01

International concern about youth suicide has led to a growing consensus that schools are a potentially important location for suicide prevention efforts. The present study investigated the experiences and perceptions of teachers regarding a role in youth suicide prevention through semi-structured interviews which were analysed using…

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…

Adolescents' Self-Reported Suicide Attempts, Self-Harm Thoughts and Their Correlates across 17 European Countries

ERIC Educational Resources Information Center

Kokkevi, A.; Rotsika, V.; Arapaki, A.; Richardson, C.

2012-01-01

Background: Suicide is a leading cause of death among adolescents in Europe. Self-harm thoughts and behaviours are documented precursors of completed suicide. It is therefore of great importance to investigate the prevalence of suicide thoughts and attempts and their correlates, with the aim of preventing this major life-threatening public health…

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

Impact of religious feast days on youth suicide attempts in Istanbul, Turkey.

PubMed

Akkaya-Kalayci, Türkan; Popow, Christian; Waldhör, Thomas; Özlü-Erkilic, Zeliha

2015-01-01

Suicidal behaviour is related to psychosocial and biological factors. Although suicide is strictly forbidden by the Islamic faith, there are non-confirmed observations of increased suicidality on religious feast days. The objective of the present study was to find out if suicide attempts of youths living in Istanbul increase on religious feast days compared to ordinary and non-religious holidays. We retrospectively analyzed all suicide attempts (N = 2,232) of young people up to 25 years of age seeking support at various hospitals in Istanbul in 2010. The main hypothesis was that the number of suicide attempts would increase during religious feast days. The number of suicide attempts was higher on religious feast days and non-religious holidays except for New Year's Day and International Labour Day than the daily average number of the actual months. Like on ordinary days, more female than male youth (84.9% vs. 15.1%) attempted suicide on feast days. We speculate that changes of the daily rhythm and increased family interaction on feast days and non-religious holidays could lead to unexpected confrontations and disputes instead of the expected positive family climate. This "Broken-Promise Effect" and changes of the daily rhythm could contribute to the observed increased suicidal behaviour.

Initial Findings from a Novel School-Based Program, EMPATHY, Which May Help Reduce Depression and Suicidality in Youth.

PubMed

Silverstone, Peter H; Bercov, Marni; Suen, Victoria Y M; Allen, Andrea; Cribben, Ivor; Goodrick, Jodi; Henry, Stu; Pryce, Catherine; Langstraat, Pieter; Rittenbach, Katherine; Chakraborty, Samprita; Engels, Rutger C; McCabe, Christopher

2015-01-01

We describe initial pilot findings from a novel school-based approach to reduce youth depression and suicidality, the Empowering a Multimodal Pathway Towards Healthy Youth (EMPATHY) program. Here we present the findings from the pilot cohort of 3,244 youth aged 11-18 (Grades 6-12). They were screened for depression, suicidality, anxiety, use of drugs, alcohol, or tobacco (DAT), quality-of-life, and self-esteem. Additionally, all students in Grades 7 and 8 (mean ages 12.3 and 13.3 respectively) also received an 8-session cognitive-behavioural therapy (CBT) based program designed to increase resiliency to depression. Following screening there were rapid interventions for the 125 students (3.9%) who were identified as being actively suicidal, as well as for another 378 students (11.7%) who were felt to be at higher-risk of self-harm based on a combination of scores from all the scales. The intervention consisted of an interview with the student and their family followed by offering a guided internet-based CBT program. Results from the 2,790 students who completed scales at both baseline and 12-week follow-up showed significant decreases in depression and suicidality. Importantly, there was a marked decrease in the number of students who were actively suicidal (from n=125 at baseline to n=30 at 12-weeks). Of the 503 students offered the CBT program 163 (32%) took part, and this group had significantly lower depression scores compared to those who didn't take part. There were no improvements in self-esteem, quality-of-life, or the number of students using DAT. Only 60 students (2% of total screened) required external referral during the 24-weeks following study initiation. These results suggest that a multimodal school-based program may provide an effective and pragmatic approach to help reduce youth depression and suicidality. Further research is required to determine longer-term efficacy, reproducibility, and key program elements. ClinicalTrials.gov NCT02169960.

Influence of therapist competence and quantity of cognitive behavioural therapy on suicidal behaviour and inpatient hospitalisation in a randomised controlled trial in borderline personality disorder: Further analyses of treatment effects in the BOSCOT study

PubMed Central

Norrie, John; Davidson, Kate; Tata, Philip; Gumley, Andrew

2013-01-01

Objectives We investigated the treatment effects reported from a high-quality randomized controlled trial of cognitive behavioural therapy (CBT) for 106 people with borderline personality disorder attending community-based clinics in the UK National Health Service – the BOSCOT trial. Specifically, we examined whether the amount of therapy and therapist competence had an impact on our primary outcome, the number of suicidal acts†, using instrumental variables regression modelling. Design Randomized controlled trial. Participants from across three sites (London, Glasgow, and Ayrshire/Arran) were randomized equally to CBT for personality disorders (CBTpd) plus Treatment as Usual or to Treatment as Usual. Treatment as Usual varied between sites and individuals, but was consistent with routine treatment in the UK National Health Service at the time. CBTpd comprised an average 16 sessions (range 0–35) over 12 months. Method We used instrumental variable regression modelling to estimate the impact of quantity and quality of therapy received (recording activities and behaviours that took place after randomization) on number of suicidal acts and inpatient psychiatric hospitalization. Results A total of 101 participants provided full outcome data at 2 years post randomization. The previously reported intention-to-treat (ITT) results showed on average a reduction of 0.91 (95% confidence interval 0.15–1.67) suicidal acts over 2 years for those randomized to CBT. By incorporating the influence of quantity of therapy and therapist competence, we show that this estimate of the effect of CBTpd could be approximately two to three times greater for those receiving the right amount of therapy from a competent therapist. Conclusions Trials should routinely control for and collect data on both quantity of therapy and therapist competence, which can be used, via instrumental variable regression modelling, to estimate treatment effects for optimal delivery of therapy. Such estimates complement rather than replace the ITT results, which are properly the principal analysis results from such trials. Practitioner points Assessing the impact of the quantity and quality of therapy (competence of therapists) is complex. More competent therapists, trained in CBTpd, may significantly reduce the number of suicidal act in patients with borderline personality disorder. PMID:23420622

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.

An exploration of integrated data on the social dynamics of suicide among women.

PubMed

Mallon, Sharon; Galway, Karen; Hughes, Lynette; Rondón-Sulbarán, Janeet; Leavey, Gerard

2016-05-01

The gender-based nature of suicide-related behaviour is largely accepted. However, studies that report exclusively on female suicides are rare. Here we demonstrate how female suicide has effectively been 'othered' and appears incidental in studies which compare female and male behaviour. We highlight how recent studies of suicide have tended to be dominated by male-only approaches, which increasingly link issues of masculinity with male death by suicide. Drawing on data collected from the general practitioner and coroner's office, we then apply the sociological autopsy approach to a cohort of 78 deaths recorded as suicides in the UK between 2007 and 2009. By focusing on females in isolation from males, we demonstrate that, as in male-only suicide studies, it is similarly possible to draw out issues associated with the feminine identity, which can be linked to death by suicide. We find that bereavement, sexual violence and motherhood could all be linked to the lives and help-seeking of the females who died. In closing, we suggest that a reorientation towards sociological analytic approaches of female suicide may help to produce further reductions in the rate of female death by suicide. A Virtual Abstract of this paper can be found at: https://www.youtube.com/watch?v=a0w9KKMFdIQ. © 2016 Foundation for the Sociology of Health & Illness.

Childhood Suicidal Behaviour.

ERIC Educational Resources Information Center

Kosky, R.

1983-01-01

A total of 20 children under 14 years of age who were admitted to a hospital following suicide attempts were compared with 50 psychiatrically ill, nonsuicidal inpatients of similar age. Suicidal behavior was associated with the male sex, personal experiences of significant loss, academic underachievement, marital disintegration among parents, and…

Aboriginal Suicidal Behaviour Research: From Risk Factors to Culturally-Sensitive Interventions

PubMed Central

Katz, Laurence Y.; Elias, Brenda; O’Neil, John; Enns, Murray; Cox, Brian J.; Belik, Shay-Lee; Sareen, Jitender

2006-01-01

Introduction There is a significant amount of research demonstrating that the rate of completed suicide among Aboriginal populations is much higher than in the general population. Unfortunately, there is a paucity of research evaluating the risk factors for completed suicide and suicidal behavior in this population. There is an even greater shortage of research on evidence-based interventions for suicidal behaviour. Method A literature review was conducted to facilitate the development of an approach to the study of this complex problem. Results An approach to developing a research program that informs each step of the process with evidence from the previous steps was developed. The study of risk factors and interventions is described. Conclusions Research into the risk factors and evidence-based interventions for Aboriginal suicidal behavior are required. A programmatic approach is described in detail in this paper. It is hoped this informed approach would systematically address this important public health issue that afflicts a significant proportion of the Canadian population. PMID:18392204

Associations between emotional intelligence, depression and suicide risk in nursing students.

PubMed

Aradilla-Herrero, Amor; Tomás-Sábado, Joaquín; Gómez-Benito, Juana

2014-04-01

The most important factor which predisposes young people to suicide is depression, although protective factors such as self-esteem, emotional adaptation and social support may reduce the probability of suicidal ideation and suicide attempts. Several studies have indicated an elevated risk of suicide for health-related professions. Little is known, however, about the relationship between perceived emotional intelligence and suicide risk among nursing students. The main goals were to determine the prevalence of suicide risk in a sample of nursing students, to examine the relationship between suicide risk and perceived emotional intelligence, depression, trait anxiety and self-esteem, and to identify any gender differences in relation to these variables. Cross-sectional study of nursing students (n=93) who completed self-report measures of perceived emotional intelligence (Trait Meta-Mood Scale, which evaluates three dimensions: emotional attention, clarity and repair), suicide risk (Plutchik Suicide Risk Scale), self-esteem (Rosenberg Self-esteem Scale), depression (Zung Self-Rating Depression Scale) and anxiety (Trait scale of the State-Trait Anxiety Inventory). Linear regression analysis confirmed that depression and emotional attention are significant predictors of suicidal ideation. Moreover, suicide risk showed a significant negative association with self-esteem and with emotional clarity and repair. Gender differences were only observed in relation to depression, on which women scored significantly higher. Overall, 14% of the students were considered to present a substantial suicide risk. The findings suggest that interventions to prevent suicidal ideation among nursing students should include strategies to detect mood disorders (especially depression) and to improve emotional coping skills. In line with previous research the results indicate that high scores on emotional attention are linked to heightened emotional susceptibility and an increased risk of suicide. The identification and prevention of factors associated with suicidal behaviour in nursing students should be regarded as a priority. © 2013.

Ethnocultural Aspects of Suicide in Young People: A Systematic Literature Review Part 1--Rates and Methods of Youth Suicide

ERIC Educational Resources Information Center

Colucci, Erminia; Martin, Graham

2007-01-01

The study of ethnocultural aspects of suicidal behaviour is, at the moment, still a neglected area. The relatively few studies available are mainly on adults; young people usually are not examined separately. The authors reviewed 82 publications on youth suicide that have addressed, to different degrees, the ethnicity/culture of the population…

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…

Trends in suicidality among sexual minority and heterosexual students in a Canadian population-based cohort study

PubMed Central

Peter, Tracey; Edkins, Tamara; Watson, Ryan; Adjei, Jones; Homma, Yuko; Saewyc, Elizabeth

2017-01-01

Objectives Despite evidence from numerous studies that document disparities in suicidality for sexual minorities, few have investigated whether or not these trends have improved over time, which is the objective of the current study. Methods Using school-based population data over a 15-year period (1998 to 2013), multivariate logistic regressions were used to calculate age-adjusted odds ratios separately by gender. Interactions were included to test widening or narrowing disparities within orientation groups, which makes this one of the first studies to test whether gaps in disparities between heterosexual and sexual minorities have widened or narrowed over time. Results Results show that sexual minority youth are persistently at a greater risk for suicidal behaviour, a trend that has continued particularly for bisexual youth of both sexes. Results also suggest that the gap in suicidal behaviour is widening among some female sexual orientation groups, yet narrowing for other male sexual orientation groups. Conclusions These findings have important public health implications, especially since we see decreases in suicidal behaviour for heterosexual adolescents, but not in the same way for many sexual minority youth, despite advances in social acceptance of gay, lesbian, and bisexual issues in North America. PMID:29326961

School-based suicide prevention programmes: the SEYLE cluster-randomised, controlled trial.

PubMed

Wasserman, Danuta; Hoven, Christina W; Wasserman, Camilla; Wall, Melanie; Eisenberg, Ruth; Hadlaczky, Gergö; Kelleher, Ian; Sarchiapone, Marco; Apter, Alan; Balazs, Judit; Bobes, Julio; Brunner, Romuald; Corcoran, Paul; Cosman, Doina; Guillemin, Francis; Haring, Christian; Iosue, Miriam; Kaess, Michael; Kahn, Jean-Pierre; Keeley, Helen; Musa, George J; Nemes, Bogdan; Postuvan, Vita; Saiz, Pilar; Reiter-Theil, Stella; Varnik, Airi; Varnik, Peeter; Carli, Vladimir

2015-04-18

Suicidal behaviours in adolescents are a major public health problem and evidence-based prevention programmes are greatly needed. We aimed to investigate the efficacy of school-based preventive interventions of suicidal behaviours. The Saving and Empowering Young Lives in Europe (SEYLE) study is a multicentre, cluster-randomised controlled trial. The SEYLE sample consisted of 11,110 adolescent pupils, median age 15 years (IQR 14-15), recruited from 168 schools in ten European Union countries. We randomly assigned the schools to one of three interventions or a control group. The interventions were: (1) Question, Persuade, and Refer (QPR), a gatekeeper training module targeting teachers and other school personnel, (2) the Youth Aware of Mental Health Programme (YAM) targeting pupils, and (3) screening by professionals (ProfScreen) with referral of at-risk pupils. Each school was randomly assigned by random number generator to participate in one intervention (or control) group only and was unaware of the interventions undertaken in the other three trial groups. The primary outcome measure was the number of suicide attempt(s) made by 3 month and 12 month follow-up. Analysis included all pupils with data available at each timepoint, excluding those who had ever attempted suicide or who had shown severe suicidal ideation during the 2 weeks before baseline. This study is registered with the German Clinical Trials Registry, number DRKS00000214. Between Nov 1, 2009, and Dec 14, 2010, 168 schools (11,110 pupils) were randomly assigned to interventions (40 schools [2692 pupils] to QPR, 45 [2721] YAM, 43 [2764] ProfScreen, and 40 [2933] control). No significant differences between intervention groups and the control group were recorded at the 3 month follow-up. At the 12 month follow-up, YAM was associated with a significant reduction of incident suicide attempts (odds ratios [OR] 0·45, 95% CI 0·24-0·85; p=0·014) and severe suicidal ideation (0·50, 0·27-0·92; p=0·025), compared with the control group. 14 pupils (0·70%) reported incident suicide attempts at the 12 month follow-up in the YAM versus 34 (1·51%) in the control group, and 15 pupils (0·75%) reported incident severe suicidal ideation in the YAM group versus 31 (1·37%) in the control group. No participants completed suicide during the study period. YAM was effective in reducing the number of suicide attempts and severe suicidal ideation in school-based adolescents. These findings underline the benefit of this universal suicide preventive intervention in schools. Coordination Theme 1 (Health) of the European Union Seventh Framework Programme. Copyright © 2015 Elsevier Ltd. All rights reserved.

[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.

[Investigation of the association between arsenic levels in drinking water and suicide rate of Hungarian settlements between 2005 and 2011. A preliminary study].

PubMed

Rihmer, Zoltán; Hal, Melinda; Kapitány, Balázs; Gonda, Xénia; Vargha, Márta; Döme, Péter

2016-01-01

Both suicidal behaviour and consumption of arsenic-contaminated drinking-water represent major public health problems. Previous epidemiological and animal studies showed that high arsenic intake may also be associated with the elevated risk for depression. Since untreated depression is the most powerful risk factor for suicidal behaviour, we postulated that the consumption of arsenic-contaminated tap drinking-water may also be related to suicide. Based on the level of arsenic in their drinking water Hungarian settlements with more then 500 inhabitants (n=1639) were divided into four groups. Then average age-standardized suicide rates of the four groups were compared. We found that the higher is the arsenic level in the drinking water the higher is the suicide rate of the settlements. In addition to the practical consequences of our preliminary results (e.g. in the suicide prevention) they also suggest that high level of arsenic in drinking water might contribute, at least in part, to the well-known and stable in time regional differences in suicide mortality of Hungary since the highest arsenic levels in drinking water have been found in counties with traditionally high suicide rates, such as Bacs-Kiskun, Csongrad, Bekes and Hajdu- Bihar.

The role of impulsivity in self-mutilators, suicide ideators and suicide attempters - a study of 1265 male incarcerated individuals.

PubMed

Carli, Vladimir; Jovanović, Nikolina; Podlesek, Anja; Roy, Alec; Rihmer, Zoltan; Maggi, Stefania; Marusic, Dragan; Cesaro, Caterina; Marusic, Andrej; Sarchiapone, Marco

2010-06-01

We explored differences between high and low-impulsive incarcerated individuals in the context of lifetime self-mutilation, suicide ideation and suicide attempt. A total of 1265 males detained in Italian penitentiary institutions were studied between January 2006 and December 2008. The study raters were specifically trained to discriminate between suicide attempters, ideators and self-mutilators. Participants completed the Barratt Impulsivity Scale, Childhood Trauma Questionnaire (CTQ), Eysenck Personality Questionnaire (EPQ), Connor-Davidson Resilience Scale (CD-RISC), Brown-Goodwin Assessment for Lifetime History of Aggression (BGLHA) and Buss and Durkee Hostility Inventory (BDHI). Based on BIS 7 total score distribution, two extreme quarters - high-impulsive group (n=306) and low-impulsive group (n=285) - were compared. Over 42% of participants had lifetime suicide ideation, 13% attempted suicide and 17% were self-mutilators. High-impulsive subjects were younger, more often single and with more prominent psychoticism, extraversion, aggression, hostility and resilience capacity. They were more frequently diagnosed with substance use disorders and engaged in self-mutilating behaviour. There was no difference in the rate of suicide attempts between the two groups. Although high-impulsive subjects were more prone to suicidal behaviour, it was not predicted by higher impulsivity when other psychological variables were accounted for. Copyright 2010 Elsevier B.V. All rights reserved.

Pronounced prefronto-temporal cortical thinning in schizophrenia: Neuroanatomical correlate of suicidal behavior?

PubMed

Besteher, Bianca; Wagner, Gerd; Koch, Kathrin; Schachtzabel, Claudia; Reichenbach, Jürgen R; Schlösser, Ralf; Sauer, Heinrich; Schultz, C Christoph

2016-10-01

Schizophrenia is characterized by increased mortality for which suicidality is the decisive factor. An analysis of cortical thickness and folding to further elucidate neuroanatomical correlates of suicidality in schizophrenia has not yet been performed. We searched for relevant brain regions with such differences between patients with suicide-attempts, patients without any suicidal thoughts and healthy controls. 37 schizophrenia patients (14 suicide-attempters and 23 non-suicidal) and 50 age- and gender-matched healthy controls were included. Suicidality was documented through clinical interview and chart review. All participants underwent T1-weighted MRI scans. Whole brain node-by-node cortical thickness and folding were estimated (FreeSurfer Software) and compared. Additionally a three group comparison for prefrontal regions-of-interest was performed in SPSS using a multifactorial GLM. Compared with the healthy controls patients showed a typical pattern of cortical thinning in prefronto-temporal regions and altered cortical folding in the right medial temporal cortex. Patients with suicidal behavior compared with non-suicidal patients demonstrated pronounced (p<0.05) cortical thinning in the right DLPFC and the superior temporal cortex. Comparing cortical thickness in suicidal patients with non-suicidal patients significant (p<0.05) cortical thinning was additionally found in the right superior and middle temporal, temporopolar and insular cortex. Our findings extend the evidence for neuroanatomical underpinnings of suicidal behaviour in schizophrenia. We identified cortical thinning in a network strongly involved in regulation of impulsivity, emotions and planning of behaviour in suicide attempters, which might lead to neuronal dysregulation in this network and consequently to a higher risk of suicidal behavior. Copyright © 2016 Elsevier B.V. All rights reserved.

Protective associations of importance of religion and frequency of service attendance with depression risk, suicidal behaviours and substance use in adolescents in Nova Scotia, Canada.

PubMed

Rasic, Daniel; Kisely, Steve; Langille, Donald B

2011-08-01

We examined relationships of measures of personal importance of religion and frequency of attendance at religious services with risk of depression and risk behaviours in high school students in Cape Breton, Canada. We examined the impact of confounding and explanatory factors on these relationships. Data were drawn from self-report surveys of adolescents aged 15-19 (N=1615) at three high schools in May, 2006. We used logistic regression to assess associations of religious importance and religious service attendance with risk of depression, suicidal behaviour, binge drinking and frequent marijuana use, controlling in multivariate models for sociodemographic factors, family structure and social capital. Among females, higher personal importance of religion was associated with decreased odds of depression, suicidal ideation, drinking and marijuana use, while more religious attendance was protective for substance use behaviours and suicidal ideation. In males, both measures of religiosity were associated with decreased substance use. In multivariate models, religious importance had weak protective effects for depression and suicidal thinking in females, which were respectively modified by social trust and substance use. Attendance was protective for suicidal thinking in females, and was modified by depression. These associations were not seen in males. Attendance was consistently associated with less substance use in females, while importance was not. Importance was consistently protective for marijuana use and attendance was protective for binge drinking in males. This was a cross-sectional self-report survey and causality cannot be inferred. Protective associations of measures of religiosity are seen in Canadian adolescents, as they are elsewhere. Copyright © 2011 Elsevier B.V. All rights reserved.

Association of TPH1 with suicidal behaviour and psychiatric disorders in the Chinese population

PubMed Central

Liu, X; Li, H; Qin, W; He, G; Li, D; Shen, Y; Shen, J; Gu, N; Feng, G; He, L

2006-01-01

Tryptophan hydroxylase (TPH), the rate limiting enzyme in serotonin biosynthesis, is one of the most important regulating factors in the serotonergic system. Recently, polymorphisms of the TPH gene have been identified as being associated with suicide, but the evidence is inconsistent. To investigate the role in suicide of one of the isoforms, TPH1, we examined the association of five single nucleotide polymorphisms (SNPs) in the promoter region and in intron 7 of the TPH1 gene based on a sample from the Chinese population of 810 subjects, of whom 329 had made no suicide attempts (NSA), 297 had made suicide attempts (SA), and 184 were healthy subjects (HS). In this study, we observed statistically significant differences between NSA and HS subjects in allele distributions on one marker, −6526A (p = 0.0329; odds ratio (OR) 1.36; 95% confidence interval (CI) 1.01 to 1.81). No significant difference in genotype distribution or allele frequencies of other polymorphisms was found between the suicide victims and the controls. The overall haplotype frequency was significantly different between cases and healthy controls (p = 0.000024 NSA v HS; p<0.000001, SA v HS; p<0.000001, cases v HS). We found the haplotype TCAAA of −7180/−7065/−6526/218/779 to be strongly associated with suicidal behaviour and psychiatric disorders (p = 0.00243; OR = 1.62; 95% CI 1.17 to 2.24 and p = 0.018; OR = 1.41; 95% CI 1.05 to 1.91), which suggests an association of TPH1 with suicidal behaviour and indicates that TPH1 may play a significant role in the aetiology of psychiatric disorders in the Han Chinese population. PMID:16467214

Adolescent suicidal behaviours in 32 low- and middle-income countries

PubMed Central

Gariépy, Geneviève; Sentenac, Mariane; Elgar, Frank J

2016-01-01

Abstract Objective To estimate prevalence of suicidal ideation and suicidal ideation with a plan in each surveyed country and to examine cross-national differences in associated risk factors. Methods We analysed data of students aged 13–17 years who participated in the 2003–2012 Global School-based Health Surveys in 32 countries, of which 29 are low- and middle-income. We used random effects meta-analysis to generate regional and overall pooled estimates. Multivariable logistic regression was used to estimate risk ratios for the associated risk factors. Population attributable fractions were estimated based on adjusted risk ratios and the prevalence of the determinants within each exposure level. Findings Across all countries, the pooled 12-month prevalence of suicide ideation were 16.2% (95% confidence interval, CI: 15.6 to 16.7) among females and 12.2% (95% CI: 11.7 to 12.7) among males and ideation with a plan were 8.3% (95% CI: 7.9 to 8.7) among females and 5.8% (95% CI: 5.5 to 6.1) among males. Suicide ideation in the WHO Region of the Americas was higher in females than males, with an estimated prevalence ratio of 1.70 (95% CI: 1.60 to 1.81), while this ratio was 1.04 (95% CI: 0.98 to 1.10) in the WHO African Region. Factors associated with suicidal ideation in most countries included experiences of bullying and physical violence, loneliness, limited parental support and alcohol and tobacco use. Conclusion The prevalence of adolescent suicidal behaviours varies across countries, yet a consistent set of risk factors of suicidal behaviours emerged across all regions and most countries. PMID:27147764

Social problem solving, autobiographical memory, trauma, and depression in women with borderline personality disorder and a history of suicide attempts.

PubMed

Maurex, Liselotte; Lekander, Mats; Nilsonne, Asa; Andersson, Eva E; Asberg, Marie; Ohman, Arne

2010-09-01

The primary aim of this study was to compare the retrieval of autobiographical memory and the social problem-solving performance of individuals with borderline personality disorder (BPD) and a history of suicide attempts, with and without concurrent diagnoses of depression and/or post-traumatic stress disorder (PTSD), to that of controls. Additionally, the relationships between autobiographical memory, social problem-solving skills, and various clinical characteristics were examined in the BPD group. Individuals with BPD who had made at least two suicide attempts were compared to controls with regard to specificity of autobiographical memory and social problem-solving skills. Autobiographical memory specificity and social problem-solving skills were further studied in the BPD group by comparing depressed participants to non-depressed participants; and autobiographical memory specificity was also studied by comparing participants with and without PTSD. A total of 47 women with a diagnosis of BPD and 30 controls completed the Autobiographical Memory Test, assessing memory specificity, and the means-end problem solving-procedure, measuring social problem-solving skills. The prevalence of suicidal/self-injurious behaviour, and the exposure to violence, was also assessed in the BPD group. Compared to controls, participants with BPD showed reduced specificity of autobiographical memory, irrespective of either concurrent depression, previous depression, or concurrent PTSD. The depressed BPD group displayed poor problem-solving skills. Further, an association between unspecific memory and poor problem-solving was displayed in the BPD group. Our results confirmed that reduced specificity of autobiographical memory is an important characteristic of BPD individuals with a history of suicide attempt, independent of depression, or PTSD. Reduced specificity of autobiographical memory was further related to poor social problem-solving capacity in the BPD group.

Which thoughts can kill a boxer? naive theories about cognitive and emotional antecedents of suicide.

PubMed

Spörrle, Matthias; Försterling, Friedrich

2007-12-01

We investigated naive theories regarding the association among beliefs, emotions and behaviours to test Rational Emotive Behaviour Therapy's (REBT) assumption that rational cognitions and adaptive emotions lead to functional behaviours whereas irrational cognitions and maladaptive emotions trigger dysfunctional reactions. We applied an experimental between-subjects design. Participants read newspaper articles about the defeat of a boxer. In one condition, the authentic article informed participants that he committed suicide and in the other, a fictitious article about the same defeat described the athlete as successfully continuing his career. Different question formats were employed to assess participants' assumptions about the stimulus person's defeat-related cognitions and emotions: rating scales, sentence completion and free responses. Participants assumed significantly more irrational beliefs (e.g. I absolutely have to win) on the side of the boxer in the suicide scenario than in the non-suicide version. This finding was obtained by directive and non-directive assessment methods. Additionally, participants expected the suicidal stimulus person to be experiencing maladaptive emotions (e.g. depression, guilt) whereas a successful resumption of his career lead to expectations of adaptive affects (e.g. sadness, concern). Ratings of the functionality revealed that sadness, fear, annoyance and concern were expected to be more functional than depression, anxiety, rage and guilt. The results show that naive psychological theories about the antecedents of dysfunctional behaviour are in accordance with theoretical assumptions of REBT: Irrational beliefs are viewed to be connected with maladaptive emotions and to result in dysfunctional behaviour, and adaptive emotions are thought to be of higher functional value than their maladaptive counterparts. The use of different question formats and a between-subject design excluded that results are due to methodological artifacts or contrast effects.

Re-development of mental health first aid guidelines for suicidal ideation and behaviour: a Delphi study.

PubMed

Ross, Anna M; Kelly, Claire M; Jorm, Anthony F

2014-09-13

Suicide continues to be a leading cause of death globally. Friends and family are considered best positioned to provide initial assistance if someone is suicidal. Expert consensus guidelines on how to do this were published in 2008. Re-developing these guidelines is necessary to ensure they contain the most current recommended helping actions and remain consistent with the suicide prevention literature. The Delphi consensus method was used to determine the importance of including helping statements in the guidelines. These statements describe helping actions a member of the public can take, and information they should have, to help someone who is experiencing suicidal thoughts. Systematic searches of the available suicide prevention literature were carried out to find helping statements. Two expert panels, comprising 41 suicide prevention professionals and 35 consumer advocates respectively, rated each statement. Statements were accepted for inclusion in the guidelines if they were endorsed by at least 80% of each panel. Out of 436 statements, 164 were endorsed as appropriate helping actions in providing assistance to someone experiencing suicidal thoughts or engaging in suicidal behaviour. These statements were used to form the re-developed guidelines. The re-development of the guidelines has resulted in more comprehensive guidance than the earlier version, with the endorsement of 164 helping actions, compared to 30 previously. These guidelines will form the basis of a suicide prevention course aimed at educating members of the public on providing first aid to someone who is experiencing suicidal thoughts.

Validation of the Beck Hopelessness Scale in patients with suicide risk.

PubMed

Rueda-Jaimes, German Eduardo; Castro-Rueda, Vanessa Alexandra; Rangel-Martínez-Villalba, Andrés Mauricio; Moreno-Quijano, Catalina; Martinez-Salazar, Gustavo Adolfo; Camacho, Paul Anthony

Only a few scales have been validated in Spanish for the assessment of suicide risk, and none of them have achieved predictive validity. To determine the validity and reliability of the Beck Hopelessness Scale in patients with suicide risk attending the specialist clinic. The Beck Hopelessness Scale, reasons for living inventory, and the suicide behaviour questionnaire were applied in patients with suicide risk attending the psychiatric clinic and the emergency department. A new assessment was made 30 days later to determine the predictive validity of suicide or suicide attempt. The evaluation included a total of 244 patients, with a mean age of 30.7±13.2 years, and the majority were women. The internal consistency was .9 (Kuder-Richardson formula 20). Four dimensions were found which accounted for 50% of the variance. It was positively correlated with the suicidal behaviour questionnaire (Spearman .48, P<.001), number of suicide attempts (Spearman .25, P<.001), severity of suicide risk (Spearman .23, P<.001). The correlation with the reasons for living inventory was negative (Spearman -.52, P<.001). With a cut-off ≥12, the negative predictive value was 98.4% (95% CI: 94.2-99.8), and the positive predictive value was 14.8% (95% CI: 6.6-27.1). The Beck Hopelessness Scale in Colombian patients with suicidality shows results similar to the original version, with adequate reliability and moderate concurrent and predictive validity. Copyright © 2016 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

Addressing hopelessness in people with suicidal ideation: building upon the therapeutic relationship utilizing a cognitive behavioural approach.

PubMed

Collins, S; Cutcliffe, J R

2003-04-01

This article reports on how the therapeutic relationship can be enhanced by utilizing a cognitive behavioural approach when dealing with hopelessness in suicidal people. A rationale is presented regarding why this topic is deemed important. Following a brief overview of the concept of hope, the theoretical and empirical literature relating to hopelessness are examined. This literature indicates that, given the inextricable link between suicide and a sense of pervasive hopelessness, it is necessary for the practitioner to understand the methods and theoretical underpinnings of hope inspiration. Two case studies, drawn from clinical practice, are described in order to elucidate the key elements/interventions (which include the therapeutic relationship and specific cognitive behavioural techniques that the nurse therapist may utilize when attempting to ameliorate the client's sense of hopelessness). These key elements/interventions are further elaborated upon. Whilst cognitive behavioural techniques are shown to be beneficial when dealing with hopelessness, it is advocated that the therapeutic relationship is a prerequisite for successful therapy.

Adverse childhood experiences and associations with health-harming behaviours in young adults: surveys in eight eastern European countries.

PubMed

Bellis, Mark A; Hughes, Karen; Leckenby, Nicola; Jones, Lisa; Baban, Adriana; Kachaeva, Margarita; Povilaitis, Robertas; Pudule, Iveta; Qirjako, Gentiana; Ulukol, Betül; Raleva, Marija; Terzic, Natasa

2014-09-01

To evaluate the association between adverse childhood experiences - e.g. abuse, neglect, domestic violence and parental separation, substance use, mental illness or incarceration - and the health of young adults in eight eastern European countries. Between 2010 and 2013, adverse childhood experience surveys were undertaken in Albania, Latvia, Lithuania, Montenegro, Romania, the Russian Federation, The former Yugoslav Republic of Macedonia and Turkey. There were 10,696 respondents - 59.7% female - aged 18-25 years. Multivariate modelling was used to investigate the relationships between adverse childhood experiences and health-harming behaviours in early adulthood including substance use, physical inactivity and attempted suicide. Over half of the respondents reported at least one adverse childhood experience. Having one adverse childhood experience increased the probability of having other adverse childhood experiences. The number of adverse childhood experiences was positively correlated with subsequent reports of health-harming behaviours. Compared with those who reported no adverse experiences, respondents who reported at least four adverse childhood experiences were at significantly increased risk of many health-harming behaviours, with odds ratios varying from 1.68 (95% confidence interval, CI: 1.32-2.15) - for physical inactivity - to 48.53 (95% CI: 31.98-76.65) - for attempted suicide. Modelling indicated that prevention of adverse childhood experiences would substantially reduce the occurrence of many health-harming behaviours within the study population. Our results indicate that individuals who do not develop health-harming behaviours are more likely to have experienced safe, nurturing childhoods. Evidence-based programmes to improve parenting and support child development need large-scale deployment in eastern European.

Mental Health Risk Factors for Suicides in the US Army, 2007-8

DTIC Science & Technology

2012-03-07

Levin A. Military brass address suicide crisis and strategies to cure it. Psychiatr News 2009;44:10. 6. Black SA, ed. Brief to the U.S. Army Suicide... schizophrenia . Br J Psychiatry 2000;177:212e17. 19. Conner KR, Cox C, Duberstein PR, et al. Violence, alcohol, and completed suicide: a caseecontrol...study. Am J Psychiatry 2001;158:1701e5. 20. de Hert M, Peuskens J. Psychiatric aspects of suicidal behaviour: schizophrenia . In: Hawton K, Van Heerigen K

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

Suicidal ideation and behaviour among persons seeking HIV testing in peri-urban areas of Cape Town, South Africa: a lost opportunity for suicide prevention.

PubMed

Bantjes, Jason; Kagee, Ashraf; Saal, Wylene

2017-07-01

Suicidal ideation and behaviour (SIB) are among the psychiatric sequela of HIV/AIDS. Few studies have however examined the prevalence and correlates of SIB among persons seeking HIV testing. We set out to document the prevalence and correlates of SIB among people seeking HIV testing in peri-urban areas of Cape Town, South Africa (SA). A cross-sectional research design was used to recruit a sample (n = 500) of individuals seeking HIV testing. Self-report measures were used to assess two-week prevalence of SIB as well as life-time prevalence of suicide attempt. A structured clinical interview was used to assess common mental disorders (CMDs). Regression analysis was used to determine if CMD and socio-demographic variables predicted suicidal ideation. The mean age of the sample was 36 years, 51.6% were female and 46.6% were unemployed. The two-week prevalence of suicidal ideation was 24.27% while the two-week prevalence of suicide attempt and suicide plans was 2.8%. Suicidal ideation was not associated with age, gender, employment status, family income or household food insecurity. CMDs were significantly associated with suicidal ideation; individuals with depressive disorders were approximately 5.5 times more likely to report suicidal ideation, while those with generalised anxiety disorder, trauma-related disorders and alcohol use disorder were approximately 7, 4.7 and 2.8 times more likely to report suicidal ideation, respectively. Results suggest that persons seeking HIV testing may be a well-delineated group of persons at risk of suicide in this region of SA. Contact with the health care system during HIV testing provides an opportunity for targeted suicide prevention interventions in what appears to be a high risk group.

Suicidal Behaviour Among Adolescents and Young Adults with Self-Reported Chronic Illness.

PubMed

Ferro, Mark A; Rhodes, Anne E; Kimber, Melissa; Duncan, Laura; Boyle, Michael H; Georgiades, Katholiki; Gonzalez, Andrea; MacMillan, Harriet L

2017-12-01

The aims of this study were to estimate the: (1) 12-mo prevalence of suicidal thoughts, plans, and attempts in a population sample of adolescents and young adults with and without chronic illness; (2) associations among chronic illness and suicidal thoughts and behaviour (STB); and, (3) moderating roles of mood and substance use disorder on this association. Individuals were aged 15 to 30 y ( n = 5,248) from the Canadian Community Health Survey-Mental Health. Twelve-month STB and psychiatric disorder were measured using the World Health Organization Composite International Diagnostic Interview 3.0. Multinomial logistic regression examined associations between chronic illness and STB, adjusting for relevant sociodemographic and health characteristics. Product term interactions among chronic illness, mood, and substance use disorders were included in the regression models to examine potential moderating effects. Prevalence of suicidal thoughts, plans, and attempts was higher in individuals with chronic illness ( P < 0.01 for all). After adjustment, chronic illness increased the odds for suicidal thoughts [OR = 1.28 (1.01 to 1.64)], plans [OR = 2.34 (1.22 to 4.39)], and attempts [OR = 4.63 (1.52 to 14.34)]. In the presence v. absence of a mood disorder, the odds for suicidal thoughts were higher among individuals with chronic illness [OR = 1.89 (1.06 to 5.28)]. Suicidal thoughts and behaviours are common among adolescents and young adults with chronic illness, particularly among those with comorbid mood disorders. Health professionals should routinely ask about STB during assessments of their adolescent and young adult patients.

Incidence, medical and socio-behavioural predictors of psychiatric events in an 11-year follow-up of HIV-infected patients on antiretroviral therapy.

PubMed

Protopopescu, Camelia; Raffi, François; Brunet-François, Cécile; Salmon, Dominique; Verdon, Renaud; Reboud, Philippe; Carrieri, Maria Patrizia; Leport, Catherine; Spire, Bruno; Michel, Laurent

2012-01-01

Psychiatric disorders are relatively common among HIV-infected patients. However, there are few studies about their potential risk factors. This analysis aimed to measure the incidence of severe psychiatric events (PE) among patients receiving combination antiretroviral therapy (cART) of the French APROCO-COPILOTE (ANRS CO8) cohort, and to identify the medical and socio-behavioural correlates of their first episode of depression, suicide or suicide attempt (D/S/SA). APROCO-COPILOTE is a cohort of patients started on a protease inhibitor regimen between 1997 and 1999, with prospective medical standardized records and self-administered questionnaires collecting socio-demographic and socio-behavioural data. This analysis included all 11-year follow-up visits for 1,095 patients having completed baseline self-administered questionnaires. A proportional hazard Cox model was used to identify the correlates of a first D/S/SA event. The overall prevalence of severe PE remained low: 50 patients experienced 67 events (incidence rate [95% CI] =1.04 [0.82, 1.32] per 100 person-years). Depression (n=16), suicides (n=5) and suicide attempts (n=14) were the most frequently diagnosed PE (0.54 [0.39, 0.76] per 100 person-years) among 25 patients. Multivariate results showed that unemployment, unstable housing, detectable viral load and smoking more than 20 cigarettes/day were independently associated with D/S/SA. Although the incidence of severe PE remained relatively low among the patients of APROCO-COPILOTE cohort, this study's results underline a clinically important problem in HIV-infected patients receiving cART. Furthermore, our findings not only emphasize the importance of comprehensive care, especially for socially vulnerable patients, but may also help future studies designed to assess the effectiveness of interventions in reducing the risk of PE during cART.

Antecedents and sex/gender differences in youth suicidal behavior

PubMed Central

Rhodes, Anne E; Boyle, Michael H; Bridge, Jeffrey A; Sinyor, Mark; Links, Paul S; Tonmyr, Lil; Skinner, Robin; Bethell, Jennifer M; Carlisle, Corine; Goodday, Sarah; Hottes, Travis Salway; Newton, Amanda; Bennett, Kathryn; Sundar, Purnima; Cheung, Amy H; Szatmari, Peter

2014-01-01

Suicide is the second leading cause of death in youth globally; however, there is uncertainty about how best to intervene. Suicide rates are typically higher in males than females, while the converse is true for suicide attempts. We review this “gender paradox” in youth, and in particular, the age-dependency of these sex/gender differences and the developmental mechanisms that may explain them. Epidemiologic, genetic, neurodevelopmental and psychopathological research have identified suicidal behaviour risks arising from genetic vulnerabilities and sex/gender differences in early adverse environments, neurodevelopment, mental disorder and their complex interconnections. Further, evolving sex-/gender-defined social expectations and norms have been thought to influence suicide risk. In particular, how youth perceive and cope with threats and losses (including conforming to others’ or one’s own expectations of sex/gender identity) and adapt to pain (through substance use and help-seeking behaviours). Taken together, considering brain plasticity over the lifespan, these proposed antecedents to youth suicide highlight the importance of interventions that alter early environment(s) (e.g., childhood maltreatment) and/or one’s ability to adapt to them. Further, such interventions may have more enduring protective effects, for the individual and for future generations, if implemented in youth. PMID:25540727

Suicidal ideation and its determinants in Korean adults: The role of physical activity and functional limitations.

PubMed

Park, S M

2015-01-01

The recognition of suicide as a major public health problem has suggested the need to identify risk factors that have implications for preventive intervention. In the suicidal process, suicidal ideation is a key stage in the pathway leading to eventual suicide. This study investigated the influence of physical activity and functional limitations on suicidal ideation among young and middle-aged adults in a high suicidal society. Data for the current study were obtained from the Fourth Korea National Health and Nutrition Examination Survey 2007-2009 (KNHANES), a cross-sectional study conducted by the Korea Centers for Disease Control and Prevention. The survey conducted face-to-face interviews with young adults (n = 2326) and middle-aged adults (n = 3396). Using multivariate logistic regression analysis, the relationship of physical activity and functional limitations with suicidal ideation in young and middle-aged adults was assessed. A notable outcome was that the absence of a regular walking was correlated with increased suicidal ideation in middle-aged women. The other major finding was that young women and middle-aged adults with functional limitations had a high rate of suicidal thoughts. Multiple intervention approaches, including informational, social and behavioural approaches, are needed to promote regular walking in middle-aged women. For instance, mass media campaigns, community walking groups and individually adapted health behaviour modification may provide opportunities for positive intervention. Additionally, another important public health implication from these findings is the need for a suicide-intervention support system that includes screening for suicide risk in healthcare settings, especially among young women with physical limitations.

HIV infection and mental health: suicidal behaviour--systematic review.

PubMed

Catalan, Jose; Harding, Richard; Sibley, Elissa; Clucas, Claudine; Croome, Natasha; Sherr, Lorraine

2011-10-01

Suicide has long been associated with serious illness generally and HIV specifically. New treatments have affected prognosis in HIV positively, but it is unclear how they impact on suicidal burden (thoughts, self-harm and completions). This review examines all published suicide and HIV data for a definitive account of (1) prevalence of HIV-related suicidality, (2) measurement within studies and (3) effectiveness of interventions. Standard systematic research methods were used to gather quality published papers on HIV and suicide, searching published databases according to quality inclusion criteria. From the search, 332 papers were generated and hand searched resulting in 66 studies for analysis. Of these, 75% were American/European, but there was representation from developing countries. The breakdown of papers provided 12, which measured completed suicides (death records), five reporting suicide as a cause of attrition. Deliberate self-harm was measured in 21, using 22 instruments; 16 studies measured suicidal ideation using 14 instruments, suicidal thoughts were measured in 17, using 15 instruments. Navigating the diverse range of studies clearly points to a high-suicidal burden among people with HIV. The overview shows that autopsy studies reveal 9.4% of deceased HIV+ individuals had committed suicide; 2.4% HIV+ study participants commit suicide; approximately 20% of HIV+ people studied had deliberately harmed themselves; 26.9% reported suicidal ideation, 28.5% during the past week and 6.5% reported ideation as a side effect to medication; 22.2% had a suicide plan; 19.7% were generally "suicidal" (11.7% of people with AIDS, 15.3% at other stages of HIV); 23.1% reported thoughts of ending their own life; and 14.4% expressed a desire for death. Only three studies recruited over 70% female participants (39 studies recruited over 70% men), and six focussed on injecting drug users. Only three studies looked at interventions - predominantly indirect. Our detailed data suggest that all aspects of suicide are elevated and urgently require routine monitoring and tracking as a standard component of clinical care. There is scant evidence of direct interventions to reduce any aspect of suicidality, which needs urgent redress.

Examining the Needs of Paediatric Nurses Caring for Children and Young People Presenting with Self-Harm/Suicidal Behaviour on General Paediatric Wards: Findings from a Small-Scale Study

ERIC Educational Resources Information Center

Fisher, Gemma; Foster, Celeste

2016-01-01

This article reports on the process and findings from a small-scale qualitative research study. The study intended to develop an evidence-based care plan/pathway for children and young people in paediatric inpatient settings presenting with self-harm/suicidal behaviour. The article includes a critical review of unanticipated challenges of…

Does the Suicide Assessment Scale predict risk of repetition? A prospective study of suicide attempters at a hospital emergency department.

PubMed

Waern, M; Sjöström, N; Marlow, T; Hetta, J

2010-11-01

To determine whether the modified version of the Suicide Assessment Scale (SUAS) can be utilised to predict risk of repeat suicidal behaviour. Hundred and sixty-five patients aged 18 to 68 years who were admitted to emergency wards after a suicide attempt were interviewed. Follow-up interviews (n=96) were carried out after 2 months. Associations between SUAS scores and repeat attempt (fatal/non-fatal) during the following 3 years were analysed and the instrument's ability to predict repetition was assessed. High SUAS score (>30) was associated with repetition. The ability of the SUAS to correctly predict repeat suicidal behaviour in the entire study group was low (AUC=0.65, 95% CI=0.56-0.74) but better for those (n=42) who reported ongoing psychiatric treatment at follow-up (AUC=0.78, 95% CI 0.63-0.94). Among the latter group, all with baseline SUAS scores >30 made repeats. The modified SUAS performed well as a screening instrument in psychiatric patients. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

The role of serotonergic system at the interface of aggression and suicide

PubMed Central

Bortolato, Marco; Pivac, Nela; Seler, Dorotea Muck; Perkovic, Matea Nikolac; Pessia, Mauro; Di Giovanni, Giuseppe

2013-01-01

Alterations in serotonin (5-HT) neurochemistry have been implicated in the aetiology of all major neuropsychiatric disorders, ranging from schizophrenia to mood and anxiety-spectrum disorders. This review will focus on the mulifaceted implications of 5-HT-ergic dysfunctions in the pathophysiology of aggressive and suicidal behaviours. After a brief overview of the anatomical distribution of the 5-HT-ergic system in the key brain areas that govern aggression and suicidal behaviours, the implication of 5-HT markers (5-HT receptors, transporter as well as synthetic and metabolic enzymes) in these conditions is discussed. In this regard, particular emphasis is placed on the integration of pharmacological and genetic evidence from animal studies with the findings of human experimental and genetic association studies. Traditional views postulated an inverse relationship between 5-HT and aggression and suicidal behaviours; however, ample evidence has shown that this perspective may be overly simplistic, and that such pathological manifestations may reflect alterations in 5-HT homeostasis due to the interaction of genetic, environmental and gender-related factors, particularly during early critical developmental stages. The development of animal models that may capture the complexity of such interactions promises to afford a powerful tool to elucidate the pathophysiology of impulsive aggression and suicidability, and find new effective therapies for these conditions. PMID:23333677

Patterns of suicidal ideation and behavior in Northern Ireland and associations with conflict related trauma.

PubMed

O'Neill, Siobhan; Ferry, Finola; Murphy, Sam; Corry, Colette; Bolton, David; Devine, Barney; Ennis, Edel; Bunting, Brendan

2014-01-01

In this study, data from the World Mental Health Survey's Northern Ireland (NI) Study of Health and Stress (NISHS) was used to assess the associations between conflict- and non-conflict-related traumatic events and suicidal behaviour, controlling for age and gender and the effects of mental disorders in NI. DSM mental disorders and suicidal ideation, plans and attempts were assessed using the Composite International Diagnostic Interview (CIDI) in a multi-stage, clustered area probability household sample (N = 4,340, response rate 68.4%). The traumatic event categories were based on event types listed in the PTSD section of the CIDI. Suicidal ideation and attempts were more common in women than men, however, rates of suicide plans were similar for both genders. People with mood, anxiety and substance disorders were significantly more likely than those without to endorse suicidal ideation, plan or attempt. The highest odds ratios for all suicidal behaviors were for people with any mental disorder. However, the odds of seriously considering suicide were significantly higher for people with conflict and non-conflict-related traumatic events compared with people who had not experienced a traumatic event. The odds of having a suicide plan remain significantly higher for people with conflict-related traumatic events compared to those with only non-conflict-related events and no traumatic events. Finally, the odds of suicide attempt were significantly higher for people who have only non-conflict-related traumatic events compared with the other two categories. The results suggest that traumatic events associated with the NI conflict may be associated with suicidal ideation and plans, and this effect appears to be in addition to that explained by the presence of mental disorders. The reduced rates of suicide attempts among people who have had a conflict-related traumatic event may reflect a higher rate of single, fatal suicide attempts in this population.

Patterns of Suicidal Ideation and Behavior in Northern Ireland and Associations with Conflict Related Trauma

PubMed Central

O'Neill, Siobhan; Ferry, Finola; Murphy, Sam; Corry, Colette; Bolton, David; Devine, Barney; Ennis, Edel; Bunting, Brendan

2014-01-01

In this study, data from the World Mental Health Survey's Northern Ireland (NI) Study of Health and Stress (NISHS) was used to assess the associations between conflict- and non-conflict–related traumatic events and suicidal behaviour, controlling for age and gender and the effects of mental disorders in NI. DSM mental disorders and suicidal ideation, plans and attempts were assessed using the Composite International Diagnostic Interview (CIDI) in a multi-stage, clustered area probability household sample (N = 4,340, response rate 68.4%). The traumatic event categories were based on event types listed in the PTSD section of the CIDI. Suicidal ideation and attempts were more common in women than men, however, rates of suicide plans were similar for both genders. People with mood, anxiety and substance disorders were significantly more likely than those without to endorse suicidal ideation, plan or attempt. The highest odds ratios for all suicidal behaviors were for people with any mental disorder. However, the odds of seriously considering suicide were significantly higher for people with conflict and non-conflict–related traumatic events compared with people who had not experienced a traumatic event. The odds of having a suicide plan remain significantly higher for people with conflict-related traumatic events compared to those with only non-conflict–related events and no traumatic events. Finally, the odds of suicide attempt were significantly higher for people who have only non-conflict–related traumatic events compared with the other two categories. The results suggest that traumatic events associated with the NI conflict may be associated with suicidal ideation and plans, and this effect appears to be in addition to that explained by the presence of mental disorders. The reduced rates of suicide attempts among people who have had a conflict-related traumatic event may reflect a higher rate of single, fatal suicide attempts in this population. PMID:24646627

"You feel like you can't live anymore": suicide from the perspectives of Canadian men who experience depression.

PubMed

Oliffe, John L; Ogrodniczuk, John S; Bottorff, Joan L; Johnson, Joy L; Hoyak, Kristy

2012-02-01

Severe depression is a known risk factor for suicide, yet worldwide men's suicide rates continue to outnumber reported rates of men's depression. While acknowledging that the pathways to suicide are diverse, and being mindful of the complex challenges inherent to studying suicide, we interviewed men who experienced depression as a means to better understanding the processes they used to counter and contemplate suicide. This novel qualitative study provides insights on how masculine roles, identities and relations mediate depression-related suicidal ideation in a cohort of 38 men in Canada, ranging in age from 24 to 50 years-old. Constant comparative analyses yielded the core category of reconciling despair in which men responded to severe depression and suicidal ideation by following two pathways. To counter suicide actions, connecting with family, peers and health care professionals and/or drawing on religious and moral beliefs were important interim steps for quelling thoughts about suicide and eventually dislocating depression from self-harm. This pathway revealed how connecting with family through masculine protector and father roles enabled men to avoid suicide while positioning help-seeking as a wise, rational action in re-establishing self-control. The other pathway, contemplating escape, rendered men socially isolated and the overuse of alcohol and other drugs were often employed to relieve emotional, mental and physical pain. Rather than providing respite, these risky practices were the gateway to men's heightened vulnerability for nonfatal suicidal behaviour. Men on this pathway embodied solitary and/or risk taker identities synonymous with masculine ideals but juxtaposed nonfatal suicidal behaviours as feminine terrain. Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved.

Systematic review of research on railway and urban transit system suicides.

PubMed

Mishara, Brian L; Bardon, Cécile

2016-03-15

We critically review research on railway suicides to inform suicide prevention initiatives and future studies, including who is at risk and why, and behaviours at track locations. Literature was identified from Scopus, Web of Science, Google Scholar and our documentation centre, and contacting 71 railway companies, resulting in 716 articles and eight unpublished reports, with 94 having empirical data on 55 unique studies. Research quality was critically assessed. The quality of studies varies greatly with frequent shortcomings: no justification of sample size, lacking information on the reliability and validity of measures, no explanation nor theoretical understanding of findings. Railway suicides resemble closely people who use other methods, although they tend to be younger. As with other suicide methods, mental health problems are likely to be present. Railway suicide attempters usually die, but most urban transportation systems attempters survive. Railway suicides are rarely impulsive; people usually go to the railway for the purpose of killing themselves. Hotspots have been the focus of some prevention measures. We know little about why people choose railway suicide, but studies of survivors suggest they often thought they would have an immediate, certain and painless death. Media reports on railway suicides can increase their incidence. Most research focuses on the incidence and characteristics of events and attempters. Research has not shown that railway suicides are different from suicides by other means. Better quality research is needed, particularly studies that investigate why people use railways to kill themselves and how railway suicides can be effectively prevented, as well as more evaluations of prevention programmes. Because of significant variations by country and region in characteristics of railway suicides, prevention programmes should conduct a local assessment of the characteristics of attempters and incidents. We need more research on indicators of suicide risk in attempters on railway property, and studies of how suicidal people on railway property are prevented from suicide. Changing beliefs and attitudes about railway suicides, reducing media reports, offering help onsite, controlling access at hotspots and better staff training in mental health facilities near tracks are promising prevention strategies. However, local specificities must be considered in planning prevention strategies. Copyright © 2016 Elsevier B.V. All rights reserved.

Working with women prisoners who seriously harm themselves: ratings of staff expressed emotion (EE).

PubMed

Moore, Estelle; Andargachew, Sara; Taylor, Pamela J

2011-02-01

Prison staff are repeatedly exposed to prisoners' suicidal behaviours; this may impair their capacity to care. Expressed emotion (EE), as a descriptor of the 'emotional climate' between people, has been associated with challenging behaviour in closed environments, but not previously applied to working alliances in a prison. To investigate the feasibility of rating EE between staff and suicidal women in prison; to test the hypothesis that most such staff-inmate alliances would be rated high EE. All regular staff on two small UK prison units with high suicidal behaviour rates were invited to participate. An audiotaped five-minute speech sample (FMSS) about work with one nominated suicidal prisoner was embedded in a longer research interview, then rated by two trained raters, independent of the interview process and the prison. Seven prison officers and 8 clinically qualified staff completed interviews; 3 refused, but 17 others were not interviewed, reasons including not having worked long enough with any one such prisoner. Participants and non-participants had similar relevant backgrounds. Contrary to our hypothesis, EE ratings were generally 'low'. As predicted, critical comments were directed at high frequency oppositional behaviour. EE assessments with prison staff are feasible, but our sample was small and turnover of prisoners high, so the study needs replication. Attributions about problem behaviour to illness, and/or traumatic life experience, tend to confirm generally supportive working relationships in this sample. Copyright © 2010 John Wiley & Sons, Ltd.

THE CHALLENGES OF SCHOOL-BASED YOUTH SUICIDE PREVENTION: EXPERIENCES AND PERCEPTIONS OF MENTAL HEALTH PROFESSIONALS IN SOUTH AFRICAN SCHOOLS.

PubMed

Woolf, Maryke; Bantjes, Jason; Kagee, Ashraf

2015-01-01

Youth suicidal behaviour poses a significant public health concern. Mental health care professionals working in schools have an important role to play in youth suicide prevention initiatives, although little is known of the experiences of this group of professionals in the developing world. The aim of this study was to explore the experiences of mental health professionals working in South African schools and document their insights, attitudes and beliefs regarding youth suicidal behaviour. In-depth semi-structured interviews were conducted with seven school-based mental health care professionals and data were analysed using Thematic Analysis. Participants reported that they relied on a reactive strategy by responding to youths who were in crisis. They were challenged by a lack of support from faculty staff, lack of access to resources, and heavy caseloads. Findings highlight the need for a proactive and collaborative approach to suicide prevention among mental health care professionals, teachers and parents in South African schools and improved training and supervision.

Correlates of self-harm and suicide attempts in justice-involved young people.

PubMed

Shepherd, Stephane; Spivak, Benjamin; Borschmann, Rohan; Kinner, Stuart A; Hachtel, Henning

2018-01-01

The purpose of this study was to ascertain the prevalence and correlates of self-harm among young people in detention in Australia. The sample included 215 (177 male; 38 female) young people who were in youth detention in the state of Victoria, Australia. Participants were administered a series of questionnaires related to self-harm, mental health, socio-environmental experiences and behaviours. Overall, one-third (33%) of the sample reported previous self-harm and 12% reported at least one suicide attempt. In a multivariate logistic regression analysis, a history of childhood trauma, contact with mental health services, and low educational interest significantly increased the likelihood of self-harm. Young people who reported a suicide attempt scored significantly higher on the measure of childhood trauma than did youth who had engaged in non-suicidal self-harm. Findings demonstrate a strong connection between childhood traumatic experiences and suicidal behaviours for youth in detention. Trauma histories and mental health concerns must be considered when identifying youth at increased risk of self-harm.

Correlates of self-harm and suicide attempts in justice-involved young people

PubMed Central

Spivak, Benjamin; Borschmann, Rohan; Kinner, Stuart A.; Hachtel, Henning

2018-01-01

The purpose of this study was to ascertain the prevalence and correlates of self-harm among young people in detention in Australia. The sample included 215 (177 male; 38 female) young people who were in youth detention in the state of Victoria, Australia. Participants were administered a series of questionnaires related to self-harm, mental health, socio-environmental experiences and behaviours. Overall, one-third (33%) of the sample reported previous self-harm and 12% reported at least one suicide attempt. In a multivariate logistic regression analysis, a history of childhood trauma, contact with mental health services, and low educational interest significantly increased the likelihood of self-harm. Young people who reported a suicide attempt scored significantly higher on the measure of childhood trauma than did youth who had engaged in non-suicidal self-harm. Findings demonstrate a strong connection between childhood traumatic experiences and suicidal behaviours for youth in detention. Trauma histories and mental health concerns must be considered when identifying youth at increased risk of self-harm. PMID:29447289

THE CHALLENGES OF SCHOOL-BASED YOUTH SUICIDE PREVENTION: EXPERIENCES AND PERCEPTIONS OF MENTAL HEALTH PROFESSIONALS IN SOUTH AFRICAN SCHOOLS

PubMed Central

Woolf, Maryke; Bantjes, Jason; Kagee, Ashraf

2016-01-01

Youth suicidal behaviour poses a significant public health concern. Mental health care professionals working in schools have an important role to play in youth suicide prevention initiatives, although little is known of the experiences of this group of professionals in the developing world. The aim of this study was to explore the experiences of mental health professionals working in South African schools and document their insights, attitudes and beliefs regarding youth suicidal behaviour. In-depth semi-structured interviews were conducted with seven school-based mental health care professionals and data were analysed using Thematic Analysis. Participants reported that they relied on a reactive strategy by responding to youths who were in crisis. They were challenged by a lack of support from faculty staff, lack of access to resources, and heavy caseloads. Findings highlight the need for a proactive and collaborative approach to suicide prevention among mental health care professionals, teachers and parents in South African schools and improved training and supervision. PMID:27990493

Development of mental health first aid guidelines for suicidal ideation and behaviour: A Delphi study

PubMed Central

Kelly, Claire M; Jorm, Anthony F; Kitchener, Betty A; Langlands, Robyn L

2008-01-01

Background Suicide is a statistically rare event, but devastating to those left behind and one of the worst possible outcomes associated with mental illness. Although a friend, family member or co-worker may be the first person to notice that a person is highly distressed, few have the knowledge and skills required to assist. Simple guidelines may help such a person to encourage a suicidal individual to seek professional help or decide against suicide. Methods This research was conducted using the Delphi methodology, a method of reaching consensus in a panel of experts. Experts recruited to the panels included 22 professionals, 10 people who had been suicidal in the past and 6 carers of people who had been suicidal in the past. Statements about how to assist someone who is thinking about suicide were sourced through a systematic search of both professional and lay literature. The guidelines were written using the items most consistently endorsed by all three panels. Results Of 114 statements presented to the panels, 30 were accepted. These statements were used to develop the guidelines appended to this paper. Conclusion There are a number of actions which are considered to be useful for members of the public when they encounter someone who is experiencing suicidal thoughts or engaging in suicidal behaviour. These guidelines will be useful in revision of curricula of mental health first aid and suicide intervention training programs. They can also be used by members of the public who want immediate information about how to assist a suicidal person. PMID:18366657

Social media and suicide prevention: a systematic review.

PubMed

Robinson, Jo; Cox, Georgina; Bailey, Eleanor; Hetrick, Sarah; Rodrigues, Maria; Fisher, Steve; Herrman, Helen

2016-04-01

Social media platforms are commonly used for the expression of suicidal thoughts and feelings, particularly by young people. Despite this, little is known about the ways in which social media can be used for suicide prevention. The aim of this study was to conduct a systematic review to identify current evidence pertaining to the ways in which social media are currently used as a tool for suicide prevention. Medline, PsycInfo, Embase, CINHAL and the Cochrane Library were searched for articles published between 1991 and April 2014. English language articles with a focus on suicide-related behaviour and social media were included. No exclusion was placed on study design. Thirty studies were included; 4 described the development of social media sites designed for suicide prevention, 6 examined the potential of social media in terms of its ability to reach or identify people at risk of suicide, 15 examined the ways in which people used social media for suicide prevention-related purposes, and 5 examined the experiences of people who had used social media sites for suicide prevention purposes. No intervention studies were identified. Social media platforms can reach large numbers of otherwise hard-to-engage individuals, may allow others to intervene following an expression of suicidal ideation online, and provide an anonymous, accessible and non-judgmental forum for sharing experiences. Challenges include difficulties controlling user behaviour and accurately assessing risk, issues relating to privacy and confidentiality and the possibility of contagion. Social media appears to hold significant potential for suicide prevention; however, additional research into its safety and efficacy is required. © 2015 Wiley Publishing Asia Pty Ltd.

Correlates of firesetting in a community sample of young adolescents.

PubMed

Martin, Graham; Bergen, Helen A; Richardson, Angela S; Roeger, Leigh; Allison, Stephen

2004-03-01

To investigate relationships between firesetting, antisocial behaviour, individual, family and parenting factors in a large community sample of adolescents. A cross-sectional study of students (n = 2596) aged 13 years on average, from 27 schools in South Australia with a questionnaire on firesetting, antisocial behaviour (adapted 21-item Self Report Delinquency Scale), risk-taking, drug use, suicidality, physical and sexual abuse, depressive symptomatology, hopelessness, anxiety, locus of control, self-esteem, family functioning (McMaster Family Assessment Device) and parenting style (Influential Relationships Questionnaire). Data analysis included chi2, anova and logistic regression. Large significant differences are found between firesetters and non-firesetters on all measures. Among adolescents with serious levels of antisocial behaviour (7+ acts included in diagnostic guidelines for DSM-IV conduct disorder), firesetters differ from non-firesetters in reporting more extreme antisocial behaviour (10+ acts), extreme drug use, suicidal behaviour, and perceived failure at school. Gender differences are apparent. A study limitation is the single item assessment of firesetting. Self-report firesetting is strongly associated with extreme antisocial behaviour in young community adolescents, in support of existing evidence from incarcerated delinquent and psychiatric populations. Early detection of community firesetters demands further assessment and intervention. Clinicians should consider its coexistence with serious drug use and high risk-taking (especially in girls), and suicidality, sexual and physical abuse (in boys).

Initial Findings from a Novel School-Based Program, EMPATHY, Which May Help Reduce Depression and Suicidality in Youth

PubMed Central

Silverstone, Peter H.; Bercov, Marni; Suen, Victoria Y. M.; Allen, Andrea; Cribben, Ivor; Goodrick, Jodi; Henry, Stu; Pryce, Catherine; Langstraat, Pieter; Rittenbach, Katherine; Chakraborty, Samprita; Engels, Rutger C.; McCabe, Christopher

2015-01-01

We describe initial pilot findings from a novel school-based approach to reduce youth depression and suicidality, the Empowering a Multimodal Pathway Towards Healthy Youth (EMPATHY) program. Here we present the findings from the pilot cohort of 3,244 youth aged 11–18 (Grades 6-12). They were screened for depression, suicidality, anxiety, use of drugs, alcohol, or tobacco (DAT), quality-of-life, and self-esteem. Additionally, all students in Grades 7 and 8 (mean ages 12.3 and 13.3 respectively) also received an 8-session cognitive-behavioural therapy (CBT) based program designed to increase resiliency to depression. Following screening there were rapid interventions for the 125 students (3.9%) who were identified as being actively suicidal, as well as for another 378 students (11.7%) who were felt to be at higher-risk of self-harm based on a combination of scores from all the scales. The intervention consisted of an interview with the student and their family followed by offering a guided internet-based CBT program. Results from the 2,790 students who completed scales at both baseline and 12-week follow-up showed significant decreases in depression and suicidality. Importantly, there was a marked decrease in the number of students who were actively suicidal (from n=125 at baseline to n=30 at 12-weeks). Of the 503 students offered the CBT program 163 (32%) took part, and this group had significantly lower depression scores compared to those who didn’t take part. There were no improvements in self-esteem, quality-of-life, or the number of students using DAT. Only 60 students (2% of total screened) required external referral during the 24-weeks following study initiation. These results suggest that a multimodal school-based program may provide an effective and pragmatic approach to help reduce youth depression and suicidality. Further research is required to determine longer-term efficacy, reproducibility, and key program elements. Trial Registration ClinicalTrials.gov NCT02169960 PMID:25974146

Suicide Attempts among Indigenous Sami Adolescents and Majority Peers in Arctic Norway: Prevalence and Associated Risk Factors

ERIC Educational Resources Information Center

Silviken, Anne; Kvernmo, Siv

2007-01-01

The prevalence of suicide attempts and associated risk factors such as sociodemographic conditions, emotional/behavioural problems and parent-child relationships were examined among 591 indigenous Sami and 2100 majority adolescents in Arctic Norway. There were no significant ethnic differences in prevalence of suicide attempts. In both ethnic…

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

High school students' knowledge and experience with a peer who committed or attempted suicide: a focus group study.

PubMed

Shilubane, Hilda N; Ruiter, Robert A C; Bos, Arjan E R; Reddy, Priscilla S; van den Borne, Bart

2014-10-18

Suicide is a major public health problem for adolescents in South Africa, and also affects those associated with them. Peers become more important during adolescence and can be a significant source of social support. Because peers may be the first to notice psychological problems among each other, the present study's objectives were to assess students' knowledge about suicide, perceived risk factors, signs of poor mental health in adolescents who committed suicide, students' awareness of available mental health care and resources, and beliefs about prevention. This qualitative study used focus group discussions to elicit the thoughts and feelings of high school students who had a peer who committed or attempted suicide. Peers and class mates of suicide attempters and suicide completers were identified with the help of a social worker and school management and were invited to participate. All focus group discussions were audio taped and analyzed. A total of 56 adolescents (13-19 years of age) from Limpopo schools in South Africa participated in six focus group discussions. The data were analyzed by NVivo version 8, using an inductive approach. Participants reported to be affected by the suicide attempt or completed suicide. They felt guilty about their failure to identify and prevent the suicide and displayed little knowledge of warning signs for suicidal behaviour. They identified several risk factors for the suicide of their peers, such as poor relationship issues, teenage pregnancy, punishment, and attention seeking behaviour. Resources for students with mental health problems and survivors of suicide attempts were not perceived to be available at schools and elsewhere. School-based suicide prevention programs based on theory and evidence are necessary. Such interventions should also focus on detection of mental health problems by peers. Counseling services for students with mental health problems and suicide survivors should be available and made known to students at risk and peers.

[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.

Suicidality in schizophrenic patients with and without obsessive-compulsive disorder.

PubMed

Sevincok, Levent; Akoglu, Aybars; Kokcu, Filiz

2007-02-01

This report examines the suicidal behaviour in subjects with schizophrenia who have (N=24) and do not have comorbid Obsessive-Compulsive Disorder (OCD) (N=33). The patients with OCD-schizophrenia were more likely to have a previous history of suicidal attempts, and ideations. The number of previous suicidal attempts were significantly higher in patients with OCD-schizophrenia than in patients with non-OCD schizophrenia. The patients with a history of previous suicide attempts were more likely to have a comorbid diagnosis of OCD. Compulsive symptoms were significant predictors of suicide attempt among patients with schizophrenia. Our preliminary findings may suggest that obsessive-compulsive symptoms may account for the emergence of suicidality in patients with OCD-schizophrenia.

[Suicide under the influence of "magic mushrooms"].

PubMed

Müller, Katja; Püschel, Klaus; Iwersen-Bergmann, Stefanie

2013-01-01

Psilocybin/psilocin from so-called psychoactive mushrooms causes hallucinogenic effects. Especially for people with mental or psychiatric disorders ingestion of magic mushrooms may result in horror trips combined with the intention of self-destruction and suicidal thoughts. Automutilation after consumption of hallucinogenic mushrooms has already been described. Our case report demonstrates the suicide of a man by self-inflicted cut and stab injuries. A causal connection between suicidal behaviour and previous ingestion of psychoactive mushrooms is discussed.

Preventing Suicide: A Neglected Social Work Research Agenda

PubMed Central

Joe, Sean; Niedermeier, Danielle

2009-01-01

Summary Social workers encounter suicidal clients; however, little is known about social work’s empirical knowledge base for suicide assessment and treatment. In the first comprehensive study of social work’s contribution to the suicide literature, the authors conducted systematic electronic and manual searches for suicide research published in peer-reviewed journals by social work investigators for the period 1980–2006, with the purpose of ascertaining the state of clinical knowledge related to suicide risk factors and effective treatments. These findings reveal that despite recent increases to the study of suicide by social work researchers, they have contributed limited evidenced-based knowledge in the last twenty-six years on the treatment or prevention of suicide or suicide-related behaviours. The article outlines the risk factors for suicide and discusses the implications for clinical social work practice and research. PMID:19924271

Do schools differ in suicide risk? The influence of school and neighbourhood on attempted suicide, suicidal ideation and self-harm among secondary school pupils.

PubMed

Young, Robert; Sweeting, Helen; Ellaway, Anne

2011-11-17

Rates of suicide and poor mental health are high in environments (neighbourhoods and institutions) where individuals have only weak social ties, feel socially disconnected and experience anomie - a mismatch between individual and community norms and values. Young people spend much of their time within the school environment, but the influence of school context (school connectedness, ethos and contextual factors such as school size or denomination) on suicide-risk is understudied. Our aim is to explore if school context is associated with rates of attempted suicide and suicide-risk at age 15 and self-harm at age 19, adjusting for confounders. A longitudinal school-based survey of 1698 young people surveyed when aged 11, (primary school), 15 (secondary school) and in early adulthood (age 19). Participants provided data about attempted suicide and suicide-risk at age 15 and deliberate self-harm at 19. In addition, data were collected about mental health at age 11, social background (gender, religion, etc.), and at age 15, perception of local area (e.g. neighbourhood cohesion, safety/civility and facilities), school connectedness (school engagement, involvement, etc.) and school context (size, denomination, etc.). A dummy variable was created indicating a religious 'mismatch', where pupils held a different faith from their school denomination. Data were analysed using multilevel logistic regression. After adjustment for confounders, pupils attempted suicide, suicide-risk and self-harm were all more likely among pupils with low school engagement (15-18% increase in odds for each SD change in engagement). While holding Catholic religious beliefs was protective, attending a Catholic school was a risk factor for suicidal behaviours. This pattern was explained by religious 'mismatch': pupils of a different religion from their school were approximately 2-4 times more likely to attempt suicide, be a suicide-risk or self-harm. With several caveats, we found support for the importance of school context for suicidality and self-harm. School policies promoting school connectedness are uncontroversial. Devising a policy to reduce risks to pupils holding a different faith from that of their school may be more problematic.

Do schools differ in suicide risk? the influence of school and neighbourhood on attempted suicide, suicidal ideation and self-harm among secondary school pupils

PubMed Central

2011-01-01

Background Rates of suicide and poor mental health are high in environments (neighbourhoods and institutions) where individuals have only weak social ties, feel socially disconnected and experience anomie - a mismatch between individual and community norms and values. Young people spend much of their time within the school environment, but the influence of school context (school connectedness, ethos and contextual factors such as school size or denomination) on suicide-risk is understudied. Our aim is to explore if school context is associated with rates of attempted suicide and suicide-risk at age 15 and self-harm at age 19, adjusting for confounders. Methods A longitudinal school-based survey of 1698 young people surveyed when aged 11, (primary school), 15 (secondary school) and in early adulthood (age 19). Participants provided data about attempted suicide and suicide-risk at age 15 and deliberate self-harm at 19. In addition, data were collected about mental health at age 11, social background (gender, religion, etc.), and at age 15, perception of local area (e.g. neighbourhood cohesion, safety/civility and facilities), school connectedness (school engagement, involvement, etc.) and school context (size, denomination, etc.). A dummy variable was created indicating a religious 'mismatch', where pupils held a different faith from their school denomination. Data were analysed using multilevel logistic regression. Results After adjustment for confounders, pupils attempted suicide, suicide-risk and self-harm were all more likely among pupils with low school engagement (15-18% increase in odds for each SD change in engagement). While holding Catholic religious beliefs was protective, attending a Catholic school was a risk factor for suicidal behaviours. This pattern was explained by religious 'mismatch': pupils of a different religion from their school were approximately 2-4 times more likely to attempt suicide, be a suicide-risk or self-harm. Conclusions With several caveats, we found support for the importance of school context for suicidality and self-harm. School policies promoting school connectedness are uncontroversial. Devising a policy to reduce risks to pupils holding a different faith from that of their school may be more problematic. PMID:22093491

A preliminary benefit-risk assessment of varenicline in smoking cessation.

PubMed

Cahill, Kate; Stead, Lindsay; Lancaster, Tim

2009-01-01

Varenicline is a recently developed medication for smoking cessation, which has been available on prescription since 2006. It is a selective nicotinic acetylcholine receptor partial agonist, and is designed to reduce withdrawal symptoms and to lessen the rewards of continued smoking. Our objective in this article is to assess the efficacy of varenicline as an aid to smoking cessation and to weigh the potential benefits against the possible risks. We identified ten randomized controlled trials and one cohort study with historical controls. In total there were 7999 participants, 5112 of whom received varenicline. Eight of the trials compared varenicline with placebo for cessation, two compared it with nicotine replacement therapy and one tested extended use for relapse prevention. Three of the varenicline/placebo trials also included a bupropion arm. The recommended dosage of varenicline 1 mg twice daily more than doubled the chances of quitting at 6 months or longer, with a relative risk (RR) compared with placebo of 2.38 (95% CI 2.00, 2.84). It also outperformed bupropion (RR 1.52 [95% CI 1.22, 1.88]) and nicotine replacement (RR 1.31 [95% CI 1.01, 1.71]). A reduced dosage regimen of 1 mg daily also increased cessation (RR 1.88 [95% CI 1.35, 2.60]). In the trials, varenicline significantly reduced craving and other withdrawal symptoms. The most frequent adverse event was nausea, occurring in 30-40% of varenicline users. However, this was generally reported at mild to moderate levels, diminished over time and was associated with attributable discontinuation rates of between 0.6% and 7.6%. Other commonly occurring adverse events included insomnia, abnormal dreams and headache. Serious adverse events were rare, with no treatment-related deaths during the treatment or follow-up phases. Postmarketing surveillance has raised new questions about the safety of varenicline. In February 2008, the US FDA issued a public health advisory note, reporting a possible association between varenicline and an increased risk of behaviour change, agitation, depressed mood, and suicidal ideation and behaviour. They have required the manufacturers to revise the labelling of varenicline and the Summary of Product Characteristics, and to issue a medication guide. It is arguable that much of the reported behavioural and mood changes may be associated with nicotine withdrawal, although some effects occurred in people who continued to smoke while taking the medication. In view of the potential, if unproven, risk that varenicline may be associated with serious neuropsychiatric adverse outcomes, patients attempting to quit smoking with varenicline, and their families and caregivers, should be alerted about the need to monitor for neuropsychiatric symptoms, including changes in behaviour, agitation, depressed mood, suicidal ideation and suicidal behaviour, and to report such symptoms immediately to the patient's healthcare provider.

Adverse childhood experiences and associations with health-harming behaviours in young adults: surveys in eight eastern European countries

PubMed Central

Hughes, Karen; Leckenby, Nicola; Jones, Lisa; Baban, Adriana; Kachaeva, Margarita; Povilaitis, Robertas; Pudule, Iveta; Qirjako, Gentiana; Ulukol, Betül; Raleva, Marija; Terzic, Natasa

2014-01-01

Abstract Objective To evaluate the association between adverse childhood experiences – e.g. abuse, neglect, domestic violence and parental separation, substance use, mental illness or incarceration – and the health of young adults in eight eastern European countries. Methods Between 2010 and 2013, adverse childhood experience surveys were undertaken in Albania, Latvia, Lithuania, Montenegro, Romania, the Russian Federation, The former Yugoslav Republic of Macedonia and Turkey. There were 10 696 respondents – 59.7% female – aged 18–25 years. Multivariate modelling was used to investigate the relationships between adverse childhood experiences and health-harming behaviours in early adulthood including substance use, physical inactivity and attempted suicide. Findings Over half of the respondents reported at least one adverse childhood experience. Having one adverse childhood experience increased the probability of having other adverse childhood experiences. The number of adverse childhood experiences was positively correlated with subsequent reports of health-harming behaviours. Compared with those who reported no adverse experiences, respondents who reported at least four adverse childhood experiences were at significantly increased risk of many health-harming behaviours, with odds ratios varying from 1.68 (95% confidence interval, CI: 1.32–2.15) – for physical inactivity – to 48.53 (95% CI: 31.98–76.65) – for attempted suicide. Modelling indicated that prevention of adverse childhood experiences would substantially reduce the occurrence of many health-harming behaviours within the study population. Conclusion Our results indicate that individuals who do not develop health-harming behaviours are more likely to have experienced safe, nurturing childhoods. Evidence-based programmes to improve parenting and support child development need large-scale deployment in eastern European. PMID:25378755

Suicides and suicide ideation in the Bible: an empirical survey.

PubMed

Koch, H J

2005-09-01

The aim of this review is to summarize all data on suicidal behaviour reported in the Bible and to discuss basic implications for medical ethical positions. All books of the Jerusalem Bible, including the apocrypha accepted in the Catholic canon, were searched for all cases of suicide, attempted suicide and suicidal ideation clearly identifiable as such. The Bible including the apocrypha reports about 10 completed suicides and 11 cases of suicide attempt or ideation. The Bible considers human life as a divine gift but suicide per se is neither condemned nor approved. Those suffering from suicidal thoughts are treated with respect and support is offered. Theological teaching on suicide was influenced for centuries by the biased negative opinion of the early fathers of the church and scholastic savants, but these opinions are not substantiated by a thorough reading of the Bible. Copyright (c) 2005 Blackwell Munksgaard

Prevention of suicide and attempted suicide in Denmark. Epidemiological studies of suicide and intervention studies in selected risk groups.

PubMed

Nordentoft, Merete

2007-11-01

The suicide rates in Denmark have been declining during the last two decades. The decline was relatively larger among women than among men. All age groups experienced a decline except the very young with stable rates and the very old with increasing rates. The Universal, Selective, Indicated (USI) model recommended by Institute of Medicine was used as a framework for the thesis. Universal preventive interventions are directed toward the entire population; selective interventions are directed toward individuals who are at greater risk for suicidal behaviour; and indicated preventions are targeted at individuals who have already begun self-destructive behaviour. At the universal level, a review was carried out to highlight the association between availability of methods for suicide and suicide rate. There were mostly studies of firearms, and the conclusion of the review was that there was clear indication of restricted access to lethal means was associated with decline in suicide with that specific method, and in many cases also with overall suicide mortality. Restricting access is especially important for methods with high case fatality rate. Our own study indicated a beneficial effect on suicide rates of restrictions in access to barbiturates, dextropropoxyphen, domestic gas and car exhaust with high content of carbon monoxide. Although a range of other factors in the society might also be of importance, it was concluded that restrictions in access to dangerous means for suicide were likely to play an important role in reducing suicide rates in Denmark, especially for women. At the selective level, there are several important risk groups such as psychiatric patients, persons with alcohol and drug abuse, persons with newly diagnosed severe physical illness, all who previously attempted suicide, and groups of homeless, institutionalized, prisoners and other socially excluded persons. The thesis focused on homeless persons and psychiatric patients, especially patients with schizophrenia and related disorders. The thesis contains a review of the risk of suicide in homeless. In all the studies included, increased suicide mortality was found, and in the studies that evaluated suicide risk in different age groups, the excess suicide mortality was most dominant in younger age groups. Our own study revealed an increased risk of suicide, and in univariate analysis, significant predictors for suicide were found to be associated with shortest stay in hostel less than 11 days and more than one stay during one year. The thesis also contains a review of the risk of suicide in first-episode patients with schizophrenia, and it was concluded on the basis of the identified studies that long-term risk of suicide was not 10 percent as previously accepted, but lower. Risk factors for suicide among patients with schizophrenia were evaluated in case control studies, in nested case control studies, and in prospective studies. The following risk factors were the most important and frequently observed predictors: male gender, young age, short duration of illness, many admissions during last year, current inpatient, short time since discharge, previous and recent suicide attempt, co-morbid depression, drug abuse, poor compliance with medication, poor adherence to treatment, high IQ, and suicidal ideations. The results of analyses of psychotic symptoms as risk factor for suicide were contradictory, but a recent meta-analysis concluded that both hallucinations and delusions seemed to be protective; however, there was a non-significant tendency that command hallucinations were associated with higher suicide risk. Prevention of suicide in schizophrenia must especially focus on improving assessment of risk of suicide during inpatient treatment and the first week after discharge, and special attention must be paid to patients with one or more of the identified risk factors. There is a need for large randomised clinical trials evaluating the effect on suicide and suicide attempt of psychosocial and pharmacological treatment in schizophrenia. In our own study, we did not find any effect of integrated treatment on attempted suicide, but there was an effect on hopelessness and a trend toward lower prevalence of depression among patients in the integrated treatment. There were four suicides and one probable suicide (drowning) in standard treatment and one suicide in integrated treatment at two-year follow-up, but the study did not have sufficient power to detect these differences in proportion to who committed suicide; more than one thousand patients should have been in each treatment condition in order for these differences in proportion to be significant. At the indicated prevention level, a literature review was carried out regarding risk of suicide attempt and suicide in short-term, medium-term and long-term follow-up of persons who attempted suicide. It was concluded that the risk of repetition in short- and medium-term follow-up studies was approximately 16 percent, with lower risk among "first-evers" compared to repeaters. There was a large variation in repetition rate. The proportion who committed suicide in medium-term follow-up studies was 2.8 percent and in long-term follow-up studies was 3.5 percent (weighted mean) with clearly higher proportions in the Nordic studies than in the studies from UK. Risk factors for attempted suicide were previous suicide attempt, alcohol and drug abuse, depression, schizophrenia, previous inpatient treatment, self-discharge before evaluation, sociopathy, unemployment, frequent change of address, hostility, and living alone. Several of the predictors are overlapping and most of them were already identified in early studies of factors predictive of repetition of suicide attempt. Predictors of suicide were male gender, increasing age, previous suicide attempt, serious suicide attempt, alcohol and substance abuse, somatic disease, mental illness, and planning of suicide attempt, high suicidal intent score, violent suicide attempt or suicide attempt with severe lethality, and ongoing or previous psychiatric treatment. In our follow-up study from Bispebjerg Hospital, we found that the risk of suicide during a ten-year follow-up period among patients admitted in 1980 after self-poisoning was 30 times greater than in the general population. We also found increased mortality by all other causes of death. Predictors of suicide were several previous suicide attempts, living alone and increasing age. There are not many randomised clinical trials of psychosocial interventions aiming to reduce risk of repetition among suicide attempters. A Cochrane review concluded that evidence was lacking to indicate the most effective forms of treatment for deliberate self-harm patients. A recent randomised controlled trial showed a positive influence of cognitive behavioural therapy on repetition rate. Our own quasi-experimental study of effectiveness of two weeks' inpatient treatment in a special unit of young persons who had severe suicidal thoughts or who had attempted suicide showed that risk of repetition was reduced in the intervention group, and that the intervention group obtained a significantly greater improvement in Beck's Depression Inventory, Hopelessness Scale, Rosenberg Self-Esteem Scale and CAGE-score. The study of emergency outreach indicates that there are many persons in the community that experience a suicidal crisis, and that this group is an important target group for psychiatric emergency outreach. In our study of registration and referral practice in Copenhagen Hospital Cooperation, we conclude that not all suicide attempts were registered as such in the National Patient Register - in fact, only 37 percent. It must be concluded that the quality of the Danish Patient Register must be improved with regard to registration of suicide attempt. We found that psychiatric evaluation was planned in relation to almost all suicide attempts, but that it must be recommended to pay attention to escorting patients to psychiatric emergency in order to ensure that the patient actually attends the planned consultation. We found that patients who were referred after psychiatric evaluation to psychiatric treatment at outpatient facilities only received the planned treatment in approximately two-thirds of the cases; therefore, like Hawton et al. [Hawton et al., 1998; Hawton et al., 1999], we recommend that outpatient facilities adopt an assertive approach to patients who have attempted suicide. Danish suicide research is strong, primarily due to the possibilities for linking complete national registers providing detailed data and large sample sizes for suicide research, which is so far unique for the Nordic countries. This, combined with skilful use of epidemiological methods, had resulted in a remarkable series of papers highlighting risk of suicide in different risk groups, risk factors and protective factors. This activity must continue. In this work it is important to be aware of limitations in naturalistic studies such as the risk of interchanging cause and effect and the necessity to carry out control for confounders. Meta-analysis is a strong tool for summing up results of previous research. Meta-analyses can be used in reporting the evidence for effectiveness of interventions, but also for determining risk or identifying risk factors. A meta-analysis of risk factors of repetition of suicide attempt has not been carried out, and the quality of the identified studies did not allow a formal meta-analysis. Large randomised clinical trials examining the effectiveness of interventions on reducing rate of suicide attempt and suicide should have high priority. Suicide is a major public health problem and should be given high priority with regard to prevention and research. (ABSTRACT TRUNCATED)

Sleep problems and suicide associated with mood instability in the Adult Psychiatric Morbidity Survey, 2007

PubMed Central

McDonald, Keltie C; Saunders, Kate EA; Geddes, John R

2018-01-01

Objective Mood instability is common in the general population. Mood instability is a precursor to mental illness and associated with a range of negative health outcomes. Sleep disturbance appears to be closely linked with mood instability. This study assesses the association between mood instability and sleep disturbance and the link with suicidal ideation and behaviour in a general population sample in England. Method The Adult Psychiatric Morbidity Survey, 2007 collected detailed information about mental health symptoms and correlates in a representative sample of adult household residents living in England (n = 7303). Mood instability was assessed using the Structured Clinical Interview for DSM-IV Axis-II. Sleep problems were defined as sleeping more than usual or less than usual during the past month. Other dependent variables included medication use and suicidal ideation and behaviour (response rate 57%). Generalized linear modelling was used to estimate the prevalence of mood instability and sleep problems. Logistic regression was used to estimate odds ratios. All estimates were weighted. Results The prevalence of mood instability was 14.7% (95% confidence interval [13.6%, 15.7%]). Sleep problems occurred in 69.8% (95% confidence interval: [66.6%, 73.1%]) of those with mood instability versus 37.6% (95% confidence interval: [36.2%, 39.1%]) of those without mood instability. The use of sedating and non-sedating medications did not influence the association. Sleep problems were significantly associated with suicidal ideation and behaviour even after adjusting for mood instability. Conclusion Sleep problems are highly prevalent in the general population, particularly among those with mood instability. Sleep problems are strongly associated with suicidal ideation and behaviour. Treatments that target risk and maintenance factors that transcend diagnostic boundaries, such as therapies that target sleep disturbance, may be particularly valuable for preventing and addressing complications related to mood instability such as suicide. PMID:28095702

The Werther effect reconsidered in light of psychological vulnerabilities: results of a pilot study.

PubMed

Pouliot, Louise; Mishara, Brian L; Labelle, Réal

2011-11-01

Findings from three decades of epidemiological studies suggest that media diffusion of stories about suicide is related to increases in suicidal behaviours in the population exposed to the media reports. However, we still know little about the psychological processes and personal vulnerabilities that prompt some people to engage in suicidal behaviours after exposure to media presentations of suicides. This cross-sectional study explored the possible impact of exposure to film suicide in normal young people. Undergraduates from a university (mean age 23 years) completed a questionnaire on exposure to suicide portrayal in fictional films, in which assessment of negative emotional and cognitive reactions resulting from exposure, as well as emotional reactivity, dissociation, thought suppression, and suicidal tendencies were made. Of the 101 participants, 70% reported being distressed by the portrayal of a suicide in a fictional film. Among those, 33% stated they felt distressed about the portrayal for several days to several weeks. The majority of the affected participants (71%) indicated having been mentally preoccupied for some time by the portrayal and experienced intrusive memories (68%). Emotional reactivity and dissociation tendencies were significant predictors of the negative reactions to the suicide film they viewed. Participants who reported that the idea had crossed their mind to imitate the suicidal protagonist in the film were 3.45 times more likely to be suicidal and tended to present higher dissociation and thought suppression propensities compared to those who did not report these thoughts. The results showing possible influences of suicide portrayal in fictional film on suicide related cognitions were based on a survey methodology. Results suggest that fictional suicide portrayals in the media may have a deleterious impact on viewers, and such impacts do not appear to be limited to people having a clinical profile of mental disorders, as previously assumed by researchers in the field. Copyright © 2011 Elsevier B.V. All rights reserved.

Suicidal behaviour characteristics and factors associated with mortality in the hospital setting.

PubMed

Sendra-Gutiérrez, Juan Manuel; Esteban-Vasallo, María; Domínguez-Berjón, M Felicitas

2016-04-29

Suicide is a major public health problem worldwide, and an approach is necessary due to its high potential for prevention. This paper examines the main characteristics of people admitted to hospitals in the Community of Madrid (Spain) with suicidal behaviour, and the factors associated with their hospital mortality. A study was conducted on patients with E950-E959 codes of suicide and self-inflicted injuries of the International Classification of Diseases, Ninth Revision, Clinical Modification, contained in any diagnostic field of the minimum basic data set at hospital discharge between 2003 and 2013. Sociodemographic, clinical and health care variables were assessed by uni- and multivariate logistic regression analysis in the evaluation of factors associated with hospital mortality. Hospital suicidal behaviour predominates in women (58.7%) and in middle-age. Hospital mortality is 2.2% (1.6% in women and 3.2% in men), increasing with age. Mental disorders are detected 3-4 times more in secondary diagnoses. The main primary diagnosis (>74%) is poisoning with substances, with lower mortality (∼1%) than injury by hanging and jumping from high places (≥12%), which have the highest numbers. Other factors associated with increased mortality include different medical comorbidities and severity of the injury, while length of stay and mental disorders are protective factors. Type of hospital, poisoning, and Charlson index are associated differently with mortality in men and women. Hospitalised suicidal acts show a low mortality, mainly related to comorbidities and the severity of injuries. Copyright © 2016 SEP y SEPB. Published by Elsevier España. All rights reserved.

[Association between suicidal behaviour and cyclothymic temperament in patients with recurrent depressive disorder].

PubMed

Mechri, Anwar; Kerkeni, Neila; Hassine, Rym; Khalfaoui, Sana; Touati, Imen; Bacha, Miloud

2013-01-01

Suicidal behaviour is a major health problem, particularly among patients with depressive disorders. To determine the frequency of suicidal behavior among sample of patients with recurrent depressive disorder and to explore the relationship between suicidal behavior and cyclothymic temperament in these patients. This was a cross-sectional study bearing on 98 patients (43 men and 55 women, mean age of 46.8 ± 9.9 years) followed for recurrent depressive disorder according to the criteria of DSM-IV recruited during partial or complete recovery interval. Information about suicidal behavior was collected from medical records. Cyclothymic temperament (CT) was assessed using the cyclothymic subscale (21 items). Patients who had scores above the threshold score of 10 and were considered as cyclothymic (CT+ group) and other patients were considered non-cyclothymic (CT- group). History of suicide attempts were reported in 22.4% of patients. The mean number of previous suicide attempts was significantly higher among patients in the TC+ group (0.7 ± 1.4) versus 0.2 ± 0.6 for patients in the TC- group (p=0.01). Recurrent thoughts of death and suicide attempts in the last depressive episode, were significantly higher in the CT+ group, with a 57.5% versus 24.6% in the CT- group, (p=0.001) and 33.3% versus 10.7% in the TC- group (p=0.006). A multivariate analysis retained the TC as an independent factor associated with suicidal behavior, with two other factors: the young age of patients and the frequency of previous hospitalizations. Our findings the frequency of suicidal behavior and suggest the involvement of CT in the increased risk of suicide among patients with recurrent depressive disorder.

Suicidal ideation in a community-derived sample of Spanish adolescents.

PubMed

Fonseca-Pedrero, Eduardo; Inchausti, Félix; Pérez-Gutiérrez, Laura; Aritio Solana, Rebeca; Ortuño-Sierra, Javier; Sánchez-García, M ª Ángeles; Lucas-Molina, Beatriz; Domínguez, César; Foncea, David; Espinosa, Virginia; Gorría, Ana; Urbiola-Merina, Elena; Fernández, Marta; Merina Díaz, Carmen; Gutiérrez, Carmen; Aures, Marta; Campos, María S; Domínguez-Garrido, Elena; Pérez de Albéniz Iturriaga, Alicia

Suicide is a current public health problem and among the main causes of mortality in adolescents and young adults. The main goal of this study was to analyse suicidal ideation in a representative sample of Spanish adolescents. Specifically, the prevalence rates of suicide ideation, the psychometric properties of the Paykel Suicide Scale (PSS) scores, and the socio-emotional adjustment of adolescents at risk for suicide were analysed. The sample consisted of 1,664 participants (M=16.12 years, SD=1.36, range 14-19 years), selected by stratified sampling by clusters. The instruments used were the PSS, the Strengths and Difficulties Questionnaire, the Personal Wellbeing Index-School Children, and the Oviedo Infrequency Scale. The results showed that 4.1% of the sample indicated that they had tried to commit suicide in the previous year. Statistically significant differences were found according to gender but not according to age in the PSS mean scores. The analysis of the internal structure of the PSS showed that the one-dimensional model presented excellent goodness of fit indexes. This model showed measurement invariance across gender. The reliability of the scores, estimated with ordinal alpha, was 0.93. Participants who reported suicide ideation showed poorer mental health status and lower life satisfaction compared to the non-suicide ideation group. Suicidal ideation is present during adolescence and is associated with poor subjective well-being and increased emotional and behavioural problems. PSS seems to show adequate psychometric behaviour to assess suicidal ideation in adolescents. These findings have clear implications, both in health and education systems, to improve the promotion of emotional well-being and prevention of psychological and psychiatric problems in this sector of the population. Copyright © 2017 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

Investigating the feasibility of an enhanced contact intervention in self-harm and suicidal behaviour: a protocol for a randomised controlled trial delivering a Social support and Wellbeing Intervention following Self Harm (SWISH).

PubMed

Ahmed, Nilufar; John, Ann; Islam, Saiful; Jones, Richard; Anderson, Pippa; Davies, Charlotte; Khanom, Ashra; Harris, Shaun; Huxley, Peter

2016-09-14

Self-harm is a strong predictor for suicide. Risks for repeat behaviour are heightened in the aftermath of an index episode. There is no consensus on the most effective type of intervention to reduce repetition. Treatment options for patients who do not require secondary mental health services include no support, discharge to general practitioner or referral to primary care mental health support services. The aim of this study is to assess whether it is feasible to deliver a brief intervention after an episode and whether this can reduce depressive symptoms and increase the sense of well-being for patients who self-harm. This is a non-blinded parallel group randomised clinical trial. 120 patients presenting with self-harm and/or suicidal ideation to mental health services over a 12-month period who are not referred to secondary services will be randomised to either intervention plus treatment as usual (TAU), or control (TAU only). Patients are assessed at baseline, 4 and 12 weeks with standardised measures to collect data on depression, well-being and service use. Primary outcome is depression scores and secondary outcomes are well-being scores and use of services. The findings will indicate whether a rapid response brief intervention is feasible and can reduce depression and increase well-being among patients who self-harm and do not require secondary services. Ethical approval was granted by the UK National Health Service (NHS) Ethics Committee process (REC 6: 14/WA/0074). The findings of the trial will be disseminated through presentations to the participating Health Board and partners, peer-reviewed journals and national and international conferences. ISRCTN76914248; Pre-results. 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/

Characteristics of suicide notes of children and young adolescents: an examination of the notes from suicide victims 15 years and younger.

PubMed

Freuchen, Anne; Grøholt, Berit

2015-04-01

By analysing the suicide notes from suicide victims 15 years and younger, we attempt to gain insight into the process leading to youth suicide and explore the characteristics of the note writers. During a psychological autopsy on 42 youths, we were entrusted with 23 suicide notes in which we explored the themes and compared the note writers to the non-note writers. The key messages were as follows: explain the reason for suicide, declare love and give instructions. The note writers had showed suicidal behaviour more frequently than non-note writers. In the notes from youth suicide victims they present themselves as fully responsible and without confusion or overwhelming despair. The notes are likely equally informative as the notes of older victims. © The Author(s) 2013.

Crafting safe and effective suicide prevention media messages: outcomes from a workshop in Australia.

PubMed

Ftanou, Maria; Skehan, Jaelea; Krysinska, Karolina; Bryant, Marc; Spittal, Matthew J; Pirkis, Jane

2018-01-01

Suicide and suicide-related behaviours are major public health concerns in Australia and worldwide. One universal intervention that has received an increased focus as a means of preventing suicide is the use of media campaigns. There is, however, a lack of understanding of the kinds of campaign messages that are safe and effective. The current paper aims to expand on this knowledge. The study objectives were to: (1) explore what suicide prevention experts consider to be essential characteristics of effective and safe suicide media campaigns; (2) develop suicide prevention media messages; and (3) explore the impact that these messages might have on different audiences. We conducted a workshop in July 2015 which was attended by 21 experts (professionals with knowledge about suicide prevention and/or media campaigns, and people with a lived experience of suicide). The experts were split into three groups, and each group developed a suicide prevention message for one of the following target audiences: people at risk of suicide; family and peers of people at risk of suicide; and people bereaved by suicide. The three groups generally agreed that these messages had to include two key characteristics: (1) validate or reflect the target group's issues and needs; and (2) promote help-seeking behaviours. They noted, however, that messages that might have a positive impact for one target audience might inadvertently have a negative impact for other target audiences. In particular, they were concerned that messages designed for family and peers about being supportive and looking for warning signs might leave those who had been bereaved by suicide feeling isolated, guilty or traumatised. Workshop participants highlighted that gaps exist in relation to the use of appropriate language, were unsure of how to create destigmatising messages without normalising or sensationalising suicide and commented on the lack of evaluative evidence for the efficacy of media campaigns. Developing suicide prevention messages is complex and target and non-target audiences may interpret these messages differently to the way they were intended and the impact of such messaging may be detrimental. Caution needs to be applied when developing suicide prevention messages.

The prevalence of depressive symptoms among adolescents in Nairobi public secondary schools: association with perceived maladaptive parental behaviour.

PubMed

Khasakhala, L I; Ndetei, D M; Mutiso, V; Mbwayo, A W; Mathai, M

2012-03-01

Depression in adolescents is a matter of concern because of its high prevalence, potential recurrence and impairment of functioning in the affected individual. The study sought to determine the prevalence of depressive symptoms among adolescents in Nairobi (Kenya) public secondary schools; make a comparison between day and boarding students; and identify associated factors in this population. A random sample of school going adolescents was taken from a stratified sample of 17 secondary schools out of the 49 public secondary schools in Nairobi province. The sample was stratified to take into account geographical distribution, day and boarding schools, boys only, girls only and mixed (co-education) schools in the capital city of Kenya. Self administered instruments (EMBU and CDI) were used to measure perceived parental behaviour and levels of depression in a total of 1,276 students excluding those who had no living parent. The prevalence of clinically significant depressive symptoms was 26.4%. The occurrence was higher in girls than it was in boys p<0.001. Students in boarding schools had more clinically significant depressive symptoms compared to day students (p=0.01). More girls exhibited suicidal behaviour than boys (p<0.001). There was a significant correlation between depressive symptoms and suicidal behaviour (p<0.001). CDI scores correlated positively with age (p<0.001) with an increase in CDI score with unit increase in age among students 14-17 years old, perceived rejecting maternal parenting behaviour (p<0.001), perceived no emotional attachment paternal behaviour (p<0.001), perceived no emotional attachment maternal behaviour (p<0.001), and perceived under protective paternal behaviour (p=0.005). Perceived maladaptive parental behaviours are substantially associated with the development of depressive symptoms and suicidal behaviour in children.

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

Depression, Suicidal Behaviour, and Mental Disorders in Older Aboriginal Australians

PubMed Central

Shen, Yu-Tang; Radford, Kylie; Daylight, Gail; Cumming, Robert; Broe, Tony G. A.; Draper, Brian

2018-01-01

Aboriginal Australians experience higher levels of psychological distress, which may develop from the long-term sequelae of social determinants and adversities in early and mid-life. There is little evidence available on the impact of these on the mental health of older Aboriginal Australians. This study enrolled 336 Aboriginal Australian participants over 60 years from 5 major urban and regional areas in NSW, utilizing a structured interview on social determinants, and life-time history of physical and mental conditions; current psychosocial determinants and mental health. Univariate and multivariate analyses were utilized to examine the link between these determinants and current depressive scores and suicidality. There was a high rate of life-time depression (33.3%), current late-life depression (18.1%), and suicidal ideation (11.1%). Risk factors strongly associated with late-life depression included sleep disturbances, a history of suicidal behaviour, suicidal ideation in late-life and living in a regional location. This study supports certain historical and psychosocial factors predicting later depression in old age, and highlights areas to target for prevention strategies. PMID:29510527

Depression, Suicidal Behaviour, and Mental Disorders in Older Aboriginal Australians.

PubMed

Shen, Yu-Tang; Radford, Kylie; Daylight, Gail; Cumming, Robert; Broe, Tony G A; Draper, Brian

2018-03-04

Aboriginal Australians experience higher levels of psychological distress, which may develop from the long-term sequelae of social determinants and adversities in early and mid-life. There is little evidence available on the impact of these on the mental health of older Aboriginal Australians. This study enrolled 336 Aboriginal Australian participants over 60 years from 5 major urban and regional areas in NSW, utilizing a structured interview on social determinants, and life-time history of physical and mental conditions; current psychosocial determinants and mental health. Univariate and multivariate analyses were utilized to examine the link between these determinants and current depressive scores and suicidality. There was a high rate of life-time depression (33.3%), current late-life depression (18.1%), and suicidal ideation (11.1%). Risk factors strongly associated with late-life depression included sleep disturbances, a history of suicidal behaviour, suicidal ideation in late-life and living in a regional location. This study supports certain historical and psychosocial factors predicting later depression in old age, and highlights areas to target for prevention strategies.

Why does Scotland have a higher suicide rate than England? An area-level investigation of health and social factors.

PubMed

Mok, Pearl L H; Leyland, Alastair H; Kapur, Navneet; Windfuhr, Kirsten; Appleby, Louis; Platt, Stephen; Webb, Roger T

2013-01-01

Up until the mid-late 2000s, the national suicide rate in Scotland was the highest among all the UK countries, but the reasons for this phenomenon are poorly understood. In a multilevel study of suicide risk in Scotland and England during 2001-2006, the authors examined a range of social, cultural and health-related factors at small area level: postcode sector and Health Board in Scotland and ward and Primary Care Organisation in England. Scotland's national suicide rate was 79% higher than in England (rate ratio 1.79, 95% CI 1.62 to 1.98), with younger male and female Scots aged 15-44 years having double the risk compared with their English peers. Overall, 57% of the excess suicide risk in Scotland was explained by a range of area-level measures, including prescriptions for psychotropic drugs, alcohol and drug use, socioeconomic deprivation, social fragmentation, and other health-related indices. The use of psychotropic drugs, acting as a proxy measure for mental ill health, was the variable most strongly associated with the between-country differences in suicide risk. Alcohol misuse also made an important contribution to the differentials. Overall, the contribution of socioeconomic deprivation and social fragmentation was relatively small. Any attempt to reverse the divergent trend in suicide between Scotland and England will require initiatives to prevent and treat mental ill health and to tackle alcohol and drug misuse. Differences in prescribing rates, however, may also be explained by differences in illness behaviour or the availability of psychosocial interventions, and addressing these may also reduce Scotland's excess risk.

Analysis of Suicidal Behaviour in Israeli Veterans and Terror Victims with Post-Traumatic Stress Disorder by Using the Computerised Gottschalk-Gleser Scales

ERIC Educational Resources Information Center

Galor, Sharon; Hentschel, Uwe

2009-01-01

The primary objective of this study was to identify the vulnerability factors for suicide attempts in an Israeli sample, with the help of the Gottschalk-Gleser content analysis scales. The respondents were divided into four groups: suicide attempters; controls; post-traumatic stress disorder and depressed patients who did not report suicidal…

Psychotic experiences and risk of self-injurious behaviour in the general population: a systematic review and meta-analysis.

PubMed

Honings, S; Drukker, M; Groen, R; van Os, J

2016-01-01

Recent studies suggest that psychotic experiences (PE) in the general population are associated with an increased risk of self-injurious behaviour. Both the magnitude of this association and the level of adjustment for confounders vary among studies. A meta-analysis was performed to integrate the available evidence. The influence of possible confounders, including variably defined depression, was assessed. A systematic review and meta-analysis was conducted including general population studies reporting on the risk of self-injurious behaviour in individuals with PE. Studies were identified by a systematic search strategy in Pubmed, PsycINFO and Embase. Reported effect sizes were extracted and meta-analytically pooled. The risk of self-injurious behaviour was 3.20 times higher in individuals with PE compared with those without. Subanalyses showed that PE were associated with self-harm, suicidal ideation as well as suicidal attempts. All studies had scope for considerable residual confounding; effect sizes adjusted for depression were significantly smaller than effect sizes unadjusted for depression. In the longitudinal studies, adjustment for psychopathology resulted in a 74% reduction in excess risk. PE are associated with self-injurious behaviour, suggesting they have potential as passive markers of suicidality. However, the association is confounded and several methodological issues remain, particularly how to separate PE from the full range of connected psychopathology in determining any specific association with self-injurious behaviour. Given evidence that PE represent an indicator of severity of non-psychotic psychopathology, the association between PE and self-injurious behaviour probably reflects a greater likelihood of self-injurious behaviour in more severe states of mental distress.

Autopsy audit of intentional burns inflicted by self or by others in north India-5 year snapshot.

PubMed

Kumar, Sachil; Verma, Anoop K; Singh, Uma Shankar; Singh, Raghvendra

2015-10-01

The incidence of suicide and homicide is on the increase worldwide, including India. One million people die annually due to suicides and homicides alone. Thus this study had been undertaken to find out the material and social causes of burn and to assess the socio-demographic characteristics between suicide and homicide. This retrospective study was carried out on 1393 fatal burn cases (2008-2012) who were autopsied at the mortuary of King George's Medical University, Lucknow, India. Data retrieved include: age, sex, type of family, marital status, place of incidence, psychological status and burn size (TBSA). The results were presented in Mean ± SD and percentages and analyzed with SPSS 16.0. Out of the total 1369 cases of burns, 536 cases (38.5%) were homicidal deaths in comparison to 857 cases (61.5%) of suicidal deaths. Female predominance was seen in both suicidal and homicidal deaths with peak age 30-39 years in suicides in contrast to 40-49 years in homicides. At younger age ≤19 years, the victims of suicide is almost similar to the victims of homicide; but at extremes of ages below 10 years and above 60 years, homicides were relatively more common than suicides. Married victims were predominant in the homicidal group (66.6%). There is no quite difference at the place where burn occurs. Depression and anxiety disorders were the most frequent psychiatric co-morbidities associated with suicidal behaviours. Patients from suicidal group suffered significantly larger burns than from homicidal group. Hence, this study was planned with a purpose to know the magnitude and the socio-cultural factors of the problem of burns to more clearly understand the dynamics surrounding these deaths, so that a sound prevention programme could be suggested, planned and implemented for reducing the incidence of fatal burns. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Communication and interpretation of emotional distress within the friendships of young Irish men prior to suicide: a qualitative study.

PubMed

Sweeney, Lorna; Owens, Christabel; Malone, Kevin

2015-03-01

The potential for young men in crisis to be supported by their lay networks is an important issue for suicide prevention, due to the under-utilisation of healthcare services by this population. Central to the provision of lay support is the capability of social networks to recognise and respond effectively to young men's psychological distress and suicide risk. The aim of this qualitative study was to explore young men's narratives of peer suicide, in order to identify how they interpreted and responded to behavioural changes and indications of distress from their friend before suicide. In-depth qualitative interviews were conducted during 2009/10 with 15 Irish males (aged 19-30 years) who had experienced the death by suicide of a male friend in the preceding 5 years. The data were analysed using a thematic approach. Through the analysis of the participants' stories and experiences, we identified several features of young male friendships and social interactions that could be addressed to strengthen the support available to young men in crisis. These included the reluctance of young men to discuss emotional or personal issues within male friendships; the tendency to reveal worries and emotion only within the context of alcohol consumption; the tendency of friends to respond in a dismissive or disapproving way to communication of suicidal thoughts; the difficulty of knowing how to interpret a friend's inconsistent or ambiguous behaviour prior to suicide; and beliefs about the sort of person who takes their own life. Community-based suicide prevention initiatives must enhance the potential of young male social networks to support young men in crisis, through specific provisions for developing openness in communication and responsiveness, and improved education about suicide risk. © 2014 John Wiley & Sons Ltd.

Religiosity as a protective factor against suicidal behaviour.

PubMed

Burshtein, S; Dohrenwend, B P; Levav, I; Werbeloff, N; Davidson, M; Weiser, M

2016-06-01

Data suggest that adherence to religious beliefs is associated with lower rates of suicide. A number of mediating factors have been hypothesized to explain this association, including enhanced social support, less substance abuse, and lower rates of psychopathology. We utilized data from a two-phase population-based, epidemiological study of mental disorders among young Jewish Israel born in a 10-year birth-cohort conducted in the 1980s. This study included data on religiosity and suicidal behaviour. Twenty-five years thereafter, mortality data were obtained from a national vital statistics registry. Rates of suicidal ideation were similar among secular, partially observant, and religious subjects (9.4%, 6.7%, and 6.2%, respectively; adjusted OR for linear trend: 0.80, 95% CI: 0.58-1.09). Rates of suicide attempts were significantly lower among religious subjects (2.4%, 2.5%, and 0.4% for secular, partially observant, and religious, respectively; adjusted OR for linear trend: 0.62, 95% CI: 0.43-0.88). Of the 4914 subjects, eight died by suicide: Seven of them were secular and one was partially observant (χ(2) = 2.52, P = 0.09). There were no differences in social functioning or rates of psychopathology among the study groups. Religiosity has a protective effect against suicide attempts, which is independent of social functioning, psychopathology, and substance use. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Estimating the impact of alcohol policies on youth suicides.

PubMed

Markowitz, Sara; Chatterji, Pinka; Kaestner, Robert

2003-03-01

Alcohol consumption has been identified as one of the most important risk factors for youth suicide. Previous research has shown a strong, empirical link between alcohol use and suicide. If alcohol use is a contributing factor in determining suicidal behaviors, then policies designed to reduce the alcohol consumption may succeed in reducing youth suicides as well. This paper looks at the role of alcohol-related policies in reducing completed suicides by American youths and young adults. This hypothesis comes from two well established relationships: i) the observed correlation between alcohol consumption and incidents of suicide, and ii) the negative relationship between the full price of alcohol and consumption. The alcohol policies examined are excise taxes on beer, measures of alcohol availability, and drunk driving laws. Data on completed suicides for each state in the United States are analyzed for the period 1976-1999. Negative binomial regressions are used to estimate a reduced form model of youth suicide. Suicides are analyzed by gender and age groups (ages 10-14, 15-19 and 20-24). The results indicate that increases in the excise tax on beer are associated with a reduced number of male suicides. This tax, however, has no impact on female suicides. Suicides by males ages 20-24 are positively related to the availability of alcohol, and negatively related to the presence of a 0.08 BAC (blood alcohol concentration) law and a zero tolerance law for drunk driving. Female suicides are not impacted by the availability of alcohol, although the drunk driving laws may impact suicides by teenage females. Policies designed to reduce alcohol consumption may have the unintended benefit of reducing suicides, particularly among young males. While this research shows that alcohol policies may be successful in reducing male suicides, such policies have little impact on female suicides. Future research should explore other potential types of policies and programs to reduce female suicides. Also, illegal drug use has been linked to suicides in a similar manner as alcohol consumption. Future research should consider the role of illegal drug consumption and related policies in determining youth suicides.

Dialectical Behaviour Therapy: Description, Research and Future Directions

ERIC Educational Resources Information Center

Swales, Michaela A.

2009-01-01

Dialectical Behaviour Therapy (DBT) is a cognitive behavioural treatment initially developed for adult women with a diagnosis of borderline personality disorder (BPD) and a history of chronic suicidal behaviour (Linehan, 1993a; 1993b). DBT was the first treatment for BPD to demonstrate its efficacy in a randomised controlled trial (Linehan ,…

Indo-Canadian Collaboration for Suicide Prevention: Training Needs Assessment for Healthcare Professionals in India.

PubMed

Shah, Ravi; Eynan, Rahel; Srivastava, Amresh; Reiss, Leanna; Sathyanarayana Rao, T S; Parkar, Shubhangi; Dutt, Lakshman; Kadam, Kranti; Links, Paul S

2016-07-01

The main purpose of the study was to conduct a comprehensive needs assessment of primary healthcare professionals in order to develop a training program aimed at enhancing competencies in suicide risk assessment and management. A total of 144 primary healthcare professionals (physicians = 46; primary care workers = 98) completed the needs assessment questionnaire. The majority of healthcare professionals rated their level of comfort and competence in assessing, treating, and referring suicidal patients as medium or high. However, their knowledge about suicide, risk factors for suicide, asking about suicidal behaviour, and helping a suicidal patient was rated low or medium. Overall, the scarcity of qualified healthcare professionals and the existing gaps in core competencies for suicide risk assessment and management was identified. Development of innovative and effective competencies-based suicide specific training for primary care providers in India is urgently required.

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

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

2015-10-01

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. 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. 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. (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. 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. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

Varenicline and suicidal behaviour: a cohort study based on data from the General Practice Research Database

PubMed Central

Irvine, D; Wise, L; Davies, C; Martin, R M

2009-01-01

Objective To determine whether varenicline, a recently licensed smoking cessation product, is associated with an increased risk of suicide and suicidal behaviour compared with alternative treatments bupropion and nicotine replacement therapy. Design Cohort study nested within the General Practice Research Database. Setting Primary care in the United Kingdom. Participants 80 660 men and women aged 18-95 years were prescribed a new course of a smoking cessation product between 1 September 2006 and 31 May 2008; the initial drugs prescribed during follow-up were nicotine replacement products (n=63 265), varenicline (n=10 973), and bupropion (n=6422). Main outcome measures Primary outcomes were fatal and non-fatal self harm, secondary outcomes were suicidal thoughts and depression, all investigated with Cox’s proportional hazards models. Results There was no clear evidence that varenicline was associated with an increased risk of fatal (n=2) or non-fatal (n=166) self harm, although a twofold increased risk cannot be ruled out on the basis of the upper limit of the 95% confidence interval. Compared with nicotine replacement products, the hazard ratio for self harm among people prescribed varenicline was 1.12 (95% CI 0.67 to 1.88), and it was 1.17 (0.59 to 2.32) for people prescribed bupropion. There was no evidence that varenicline was associated with an increased risk of depression (n=2244) (hazard ratio 0.88 (0.77 to1.00)) or suicidal thoughts (n=37) (1.43 (0.53 to 3.85)). Conclusion Although a twofold increased risk of self harm with varenicline cannot be ruled out, these findings provide some reassurance concerning its association with suicidal behaviour. PMID:19797344

Associations between time in bed and suicidal thoughts, plans and attempts in Korean adolescents

PubMed Central

Kim, Jae-Hyun; Park, Eun-Cheol; Lee, Sang Gyu; Yoo, Ki-Bong

2015-01-01

Objectives To examine the hypothesis that respondents with any of three specific sleep patterns would have a higher likelihood of suicidality than those without reports of these patterns in Korean adolescents. Setting Data from the 2011–2013 Korea Youth Risk Behavior Web-based Survey were used. Participants 191 642 subjects were included. The survey's target population was students in grades 7 through 12 in South Korea. Independent variable Sleep time. Primary and secondary outcome measures Suicidal thoughts, plans and attempts. Results The odds of suicidal thoughts in subjects with very short or long time in bed were 1.487-fold higher (95% CI 1.219 to 1.815) or 0.611-fold lower (95% CI 0.460 to 0.811), respectively, than for subjects with 7 h/day in bed; the odds were similar for suicidal plans. The odds of suicidal thoughts in subjects with early or late awakening times were 1.231-fold higher (95% CI 1.050 to 1.442) or 1.528-fold lower (95% CI 1.000 to 2.334), respectively, than for subjects with 7 h/day in bed; these odds were lower for suicidal plans and attempts. The odds of suicidal thoughts in subjects with early bedtime were 1.748-fold higher (95% CI 1.302 to 2.346), the odds of suicidal plans in people with an early bedtime were 2.494-fold higher (95% CI 1.671 to 3.722) and the odds of suicide attempts in subjects with late bedtime were 1.313-fold higher (95% CI 1.005 to 1.716) than for subjects with a bedtime of 23:00. Conclusions The sleep-related time is associated with suicide-related behaviours in Korean adolescents. Multilateral approaches are needed to identify the greatest risk factors for suicidal behaviours. PMID:26341585

Associations between time in bed and suicidal thoughts, plans and attempts in Korean adolescents.

PubMed

Kim, Jae-Hyun; Park, Eun-Cheol; Lee, Sang Gyu; Yoo, Ki-Bong

2015-09-04

To examine the hypothesis that respondents with any of three specific sleep patterns would have a higher likelihood of suicidality than those without reports of these patterns in Korean adolescents. Data from the 2011-2013 Korea Youth Risk Behavior Web-based Survey were used. 191,642 subjects were included. The survey's target population was students in grades 7 through 12 in South Korea. Sleep time. Suicidal thoughts, plans and attempts. The odds of suicidal thoughts in subjects with very short or long time in bed were 1.487-fold higher (95% CI 1.219 to 1.815) or 0.611-fold lower (95% CI 0.460 to 0.811), respectively, than for subjects with 7 h/day in bed; the odds were similar for suicidal plans. The odds of suicidal thoughts in subjects with early or late awakening times were 1.231-fold higher (95% CI 1.050 to 1.442) or 1.528-fold lower (95% CI 1.000 to 2.334), respectively, than for subjects with 7 h/day in bed; these odds were lower for suicidal plans and attempts. The odds of suicidal thoughts in subjects with early bedtime were 1.748-fold higher (95% CI 1.302 to 2.346), the odds of suicidal plans in people with an early bedtime were 2.494-fold higher (95% CI 1.671 to 3.722) and the odds of suicide attempts in subjects with late bedtime were 1.313-fold higher (95% CI 1.005 to 1.716) than for subjects with a bedtime of 23:00. The sleep-related time is associated with suicide-related behaviours in Korean adolescents. Multilateral approaches are needed to identify the greatest risk factors for suicidal behaviours. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Effects of comorbidity and early age of onset in young people with Bipolar Disorder on self harming behaviour and suicide attempts.

PubMed

Moor, Stephanie; Crowe, Marie; Luty, Sue; Carter, Janet; Joyce, Peter R

2012-02-01

The age of the first episode of illness in Bipolar Disorder has been shown to be an important predictor of outcome with early onset, particularly onset before puberty, associated with greater comorbidity, a poorer quality of life and greatest impairment in functioning. Baseline data from a psychotherapy study was used to examine the prevalence of other comorbid psychiatric conditions and the impact of onset at an early age on both self harming behaviour and suicide attempts in young people with Bipolar Disorder. This study of 100 adolescents and young adults (aged 15-36 years) with Bipolar Disorder showed that comorbid conditions were very common, even at the start of their bipolar illness. Comorbidity increased as the age of onset decreased with very early onset (<13 years) patients bearing the greatest burden of disease. Greater comorbidity also significantly increased the risk of having self harmed and attempted suicide with high lethal intent. Self harming behaviour was predicted by having a lifetime diagnoses of Borderline Personality Disorder and Panic Disorder along with an early age of onset of Bipolar Disorder. In contrast, previous suicide attempts were predicted by greater comorbidity and not by very early (<13 years) age of onset. Copyright © 2011 Elsevier B.V. All rights reserved.

A systematic review of the relationship between internet use, self-harm and suicidal behaviour in young people: The good, the bad and the unknown.

PubMed

Marchant, Amanda; Hawton, Keith; Stewart, Ann; Montgomery, Paul; Singaravelu, Vinod; Lloyd, Keith; Purdy, Nicola; Daine, Kate; John, Ann

2017-01-01

Research exploring internet use and self-harm is rapidly expanding amidst concerns regarding influences of on-line activities on self-harm and suicide, especially in young people. We aimed to systematically review evidence regarding the potential influence of the internet on self-harm/suicidal behaviour in young people. We conducted a systematic review based on an electronic search for articles published between 01/01/2011 and 26/01/2015 across databases including Medline, Cochrane and PsychInfo. Articles were included if: the study examined internet use by individuals who engaged in self-harm/ suicidal behaviour, or internet use clearly related to self-harm content; reported primary empirical data; participants were aged under 25 years. New studies were combined with those identified in a previous review and subject to data extraction, quality rating and narrative synthesis. Forty-six independent studies (51 articles) of varying quality were included. Perceived influences were: positive for 11 studies (38191 participants); negative for 18 studies (119524 participants); and mixed for 17 studies (35235 participants). In contrast to previous reviews on this topic studies focused on a wide range of internet mediums: general internet use; internet addiction; online intervention/treatment; social media; dedicated self-harm websites; forums; video/image sharing and blogs. A relationship between internet use and self-harm/suicidal behaviour was particularly associated with internet addiction, high levels of internet use, and websites with self-harm or suicide content. While there are negative aspects of internet use the potential for isolation reduction, outreach and as a source of help and therapy were also identified. There is significant potential for harm from online behaviour (normalisation, triggering, competition, contagion) but also the potential to exploit its benefits (crisis support, reduction of social isolation, delivery of therapy, outreach). Young people appear to be increasingly using social media to communicate distress, particularly to peers. The focus should now be on how specific mediums' (social media, video/image sharing) might be used in therapy and recovery. Clinicians working with young people who self-harm or have mental health issues should engage in discussion about internet use. This should be a standard item during assessment. A protocol for this review was registered with the PROSPERO systematic review protocol registry: (http://www.crd.york.ac.uk/prospero/display_record.asp?ID=CRD42015019518).

Suicidal ideation in Chinese patients with chronic obstructive pulmonary disease: a controlled study.

PubMed

Wong, Tak-Shun; Xiang, Yu-Tao; Tsoh, Joshua; Ungvari, Gabor S; Ko, Fanny W S; Hui, David S C; Chiu, Helen F K

2016-05-01

No study has been published on the prevalence of suicidal behaviour in older Chinese patients with chronic obstructive pulmonary disease (COPD). This study examined the 1-year prevalence of suicidal ideation in older Chinese COPD patients and explored its demographic and clinical correlates. A consecutive sample of 143 COPD patients and 211 matched control subjects were recruited and interviewed using structured, standardized instruments. The 1-year prevalence of suicidal ideation in COPD patients and controls were 15.4% and 10.9%, respectively. In multivariate analyses, suicidal ideation was significantly associated with the severity of depressive symptoms in COPD patients. Suicidal ideation was not higher in COPD patients than in controls. © 2015 The Authors. Psychogeriatrics © 2015 Japanese Psychogeriatric Society.

Does low self-esteem predict health compromising behaviours among adolescents?

PubMed

Mcgee, R; Williams, S

2000-10-01

It is often believed that low self-esteem is associated with such health-compromising behaviours in adolescence as substance use, early sexual activity, eating problems and suicidal ideation. Surprisingly, there is little longitudinal research addressing this issue. This longitudinal study examines the predictive association between both global and academic self-esteem from ages 9 to 13 years, and a variety of health compromising behaviours at age 15, in a large sample of young New Zealanders. Levels of global self-esteem significantly predicted adolescent report of problem eating, suicidal ideation, and multiple health compromising behaviours. Earlier levels of self-esteem were unrelated to later substance use and early sexual activity. The findings are discussed in terms of their implications for efforts to raise self-esteem among young people. Copyright 2000 The Association for Professionals in Services for Adolescents.

Economic crisis and suicidal behaviour: the role of unemployment, sex and age in Andalusia, Southern Spain

PubMed Central

2014-01-01

Introduction Although suicide rates have increased in some European countries in relation to the current economic crisis and austerity policies, that trend has not been observed in Spain. This study examines the impact of the economic crisis on suicide attempts, the previously neglected endpoint of the suicidal process, and its relation to unemployment, age and sex. Methods The study was carried out in Andalusia, the most populated region of Spain, and which has a high level of unemployment. Information on suicide attempts attended by emergency services was extracted from the Health Emergencies Public Enterprise Information System (SIEPES). Suicide attempts occurring between 2003 and 2012 were included, in order to cover five years prior to the crisis (2003–2007) and five years after its onset (2008–2012). Information was retrieved from 24,380 cases (11,494 men and 12,886 women) on sex, age, address, and type of attention provided. Age-adjusted suicide attempt rates were calculated. Excess numbers of attempts from 2008 to 2012 were estimated for each sex using historical trends of the five previous years, through time regression models using negative binomial regression analysis. To assess the association between unemployment and suicide attempts rates, linear regression models with fixed effects were performed. Results A sharp increase in suicide attempt rates in Andalusia was detected after the onset of the crisis, both in men and in women. Adults aged 35 to 54 years were the most affected in both sexes. Suicide attempt rates were associated with unemployment rates in men, accounting for almost half of the cases during the five initial years of the crisis. Women were also affected during the recession period but this association could not be specifically attributed to unemployment. Conclusions This study enhances our understanding of the potential effects of the economic crisis on the rapidly increasing suicide attempt rates in women and men, and the association of unemployment with growing suicidal behaviour in men. Research on the suicide effects of the economic crisis may need to take into account earlier stages of the suicidal process, and that this effect may differ by age and sex. PMID:25062772

Resilience as positive coping appraisals: Testing the schematic appraisals model of suicide (SAMS).

PubMed

Johnson, J; Gooding, P A; Wood, A M; Tarrier, N

2010-03-01

The Schematic Appraisals Model of Suicide (SAMS) suggests that positive self-appraisals may be important for buffering suicidal thoughts and behaviours, potentially providing a key source of resilience. The current study aimed to explore whether positive self-appraisals buffered individuals from suicidality in the face of stressful life events. 78 participants who reported experiencing some degree of suicidality were recruited from a student population. They completed a battery of questionnaires including measures of suicidality, stressful life events and positive self-appraisals. Positive self-appraisals moderated the association between stressful life events and suicidality. For those reporting moderate or high levels of positive self-appraisals, raised incidence of stressful life events did not lead to increases in suicidality. These results support the SAMS framework, and suggest that positive self-appraisals may confer resilience to suicide. Positive self-appraisals may be a promising avenue for further resilience research, and an important area to target for suicide interventions. 2009 Elsevier Ltd. All rights reserved.

Impact of a mental health teaching programme on adolescents.

PubMed

Naylor, Paul B; Cowie, Helen A; Walters, Stephen J; Talamelli, Lorenzo; Dawkins, Judith

2009-04-01

Child and adolescent mental health disorders are present in around 10% of the population. Research indicates that many young people possess negative attitudes towards mental health difficulties among peers. To assess the impact of a mental health teaching programme on adolescent pupils' understanding. Two-group pre-test-post-test control group study in two English secondary schools. Experimental classes (School E) received a six-lesson teaching intervention on mental health; control classes (School C) did not. Participants were 14- and 15-year-old pupils. The intervention consisted of six lessons on mental health issues common to young people: stress; depression; suicide/self-harm; eating disorders; being bullied; and intellectual disability. School C was given access to these lesson plans and materials on completion of the study. Understanding was measured at two time points, Time 1 (T(1)) and Time 2 (T(2)), 8 months apart, by a Mental Health Questionnaire. Behavioural, emotional and relationship strengths and difficulties were measured by the self-rated Strengths and Difficulties Questionnaire (SDQ) with five subscales: hyperactivity, emotional symptoms, conduct problems, peer problems and prosocial behaviour. At T(2), pupils in School E compared with those in School C showed significantly more sensitivity and empathy towards people with mental health difficulties. They also used significantly fewer pejorative expressions to describe mental health difficulties. There was a significant reduction in SDQ scores on conduct problems and a significant increase on prosocial behaviour among School E pupils compared with controls. Pupils valued the intervention highly, in particular the lessons on suicide/self-harm. Teaching 14- and 15-year-olds about mental health difficulties helps to reduce stigma by increasing knowledge and promoting positive attitudes. The intervention also reduced self-reported conduct problems and increased prosocial behaviour. Generally, participating pupils were positive about the importance of lessons on mental health, and said that they had learnt much about the lesson topics.

Parental representation in eating disorder patients with suicide.

PubMed

Yamaguchi, N; Kobayashi, J; Tachikawa, H; Sato, S; Hori, M; Suzuki, T; Shiraishi, H

2000-08-01

We examined parental, personality, and symptomatological characteristics in relation to suicide attempts among eating disorder patients. Fifty-one eating disorder inpatients, divided into two groups according to lifetime suicide attempts, and 107 non-psychiatric subjects were compared on the following variables: Parental Bonding Instrument (PBI), Global Clinical Score (GCS), Eating Disorder Inventory-91 (EDI-91), Eating Attitudes Test-26 (EAT), clinical and personality characteristics, and family backgrounds. Suicidal patients reported significantly higher overprotection by both parents than non-suicidal patients and non-psychiatric subjects. Suicidal patients had a more prevalent history of child abuse, affective instability, unstable self-image, avoidance of abandonment, maladaptive perfectionism, personality disorder, and mood disorder. There were no differences in symptomatological factors or the severity of the eating disorders. The results suggest that high overprotection is associated with suicidal behaviour in eating disorder patients. The association between overprotective parenting and personality characteristics, and methods of suicide prevention are discussed briefly.

HIV-infection as a self-reported risk factor for attempted suicide in South Africa.

PubMed

Schlebusch, L; Vawda, N

2010-09-01

The aim of this study was to examine variables associated with recently diagnosed HIV-infection as a self-reported attempted suicide risk factor. The study cohort consisted of 112 general hospital in-patients who attempted suicide because of HIV-infection. All the patients were subject to a comprehensive mental state examination and administration of a semi-structured questionnaire to obtain biographical, sociodemographic and other relevant information. Pearson uncorrected Chi-square (X(2)) or Fisher's Exact Probability Test were used to analyze data utilising Epicalc 2000, version 1.02. Most patients expressed a heterosexual preference. The average age was 34.9 years. Females predominated and in both genders depression and substance abuse (mainly alcohol-related) accounted for the most common psychiatric diagnoses. Less than half of the patients were married. Partner relational problems was a statistically significant variable. The most prevalent co-morbid stressors were poor social support, fear of disclosure/stigmatization and socio-economic pressures. Cognitive deficits included problems with cognitive flexibility, concentration and memory. Based on estimated national suicidal behaviour prevalence rates, a descriptive HIV-related attempted suicide rate of 67.2 per 100 000 and an increased risk for attempted suicide of 13.33% to 18.87% were calculated. HIV-infection can be an underestimated suicide risk factor. Effective management and prevention programmes should include as imperatives early diagnosis of HIV-related suicidal behaviour, recognition of underlying psychopathology, neurocognitive deficits, associated stressors, the dynamics of partner relationship problems, as well as cultural awareness and sensitivity. Potential neurocognitive complications that can act as additional risk factors require further research.

[From the Competence Network on Depression and Suicidality to the German Depression Foundation. National and international prevention of suicidal behaviour and optimizing health care through using of E‑Mental-Health].

PubMed

Hegerl, Ulrich; Rummel-Kluge, Christine; Heinz, Ines

2016-04-01

Depression is a very common, severe, socio-economically highly relevant disorder and the main cause for approximately 10,000 suicides in Germany annually. There is capital room for improvement and optimization of the care for depressed patients, as effective and evidence-based treatment options are available. However, they are only used optimally by a minority of the people affected due to huge diagnostic and therapeutic deficits. The "Compentence Network on Depression and Suicidality" provided several evidence-based concepts to improve care for patients affected by depression and to prevent suicidal behaviour. Especially the four-level intervention approach of the Alliances Against Depression has been successfully adapted and implemented by more than 100 regions within Europe and globally as well. The infrastructure of the Competence Network could be efficiently sustained throughout the establishment of the German Depression Foundation and the European Alliance against Depression. Since 2014, all research activities have been extended nationally and internationally by the establishment of a Depression Research Centre with a special focus on various E‑Mental-Health-projects.

Child abuse and the prevalence of suicide attempts among those reporting suicide ideation.

PubMed

Martin, Michael S; Dykxhoorn, Jennifer; Afifi, Tracie O; Colman, Ian

2016-11-01

Victims of child abuse may be at increased risk of acting on suicide ideation, although this has not been empirically tested. We estimated the risk of suicide attempts associated with child abuse among individuals who reported suicide ideation. Secondary analysis of data from the population-based Canadian Community Health Survey Mental Health (n = 828). This population-based survey included various structured questionnaires, including the Composite International Diagnostic Interview to assess mental illness and suicidal thoughts and behaviours. Approximately 80 % of those who attempted suicide had a history of child abuse. Poor mental health, financial difficulties, poor coping skills, and reporting a suicide plan were also associated with an increased prevalence of attempting suicide; adjusted for these factors, child abuse was associated with a 1.77-fold increased prevalence (95 % CI 0.93, 3.36) of suicide attempts. Most individuals who attempt suicide experience child abuse, and worse health and social functioning. Adopting a life-course perspective to understand trajectories of suicide risk factors may inform prevention and treatment.

Does abortion reduce the mental health risks of unwanted or unintended pregnancy? A re-appraisal of the evidence.

PubMed

Fergusson, David M; Horwood, L John; Boden, Joseph M

2013-09-01

There have been debates about the linkages between abortion and mental health. Few reviews have considered the extent to which abortion has therapeutic benefits that mitigate the mental health risks of abortion. The aim of this review was to conduct a re-appraisal of the evidence to examine the research hypothesis that abortion reduces rates of mental health problems in women having unwanted or unintended pregnancy. Analysis of recent reviews (Coleman, 2011; National Collaborating Centre for Mental Health, 2011) identified eight publications reporting 14 adjusted odds ratios (AORs) spanning five outcome domains: anxiety; depression; alcohol misuse; illicit drug use/misuse; and suicidal behaviour. For each outcome, pooled AORs were estimated using a random-effects model. There was consistent evidence to show that abortion was not associated with a reduction in rates of mental health problems (p>0.75). Abortion was associated with small to moderate increases in risks of anxiety (AOR 1.28, 95% CI 0.97-1.70; p<0.08), alcohol misuse (AOR 2.34, 95% CI 1.05-5.21; p<0.05), illicit drug use/misuse (AOR 3.91, 95% CI 1.13-13.55; p<0.05), and suicidal behaviour (AOR 1.69, 95% CI 1.12-2.54; p<0.01). There is no available evidence to suggest that abortion has therapeutic effects in reducing the mental health risks of unwanted or unintended pregnancy. There is suggestive evidence that abortion may be associated with small to moderate increases in risks of some mental health problems.

Psychological and Social Predictors of Suicidal Ideation among Young Adolescents

ERIC Educational Resources Information Center

Kirkcaldy, Bruce D.; Eysenck, Michael W.; Siefen, Georg R.

2004-01-01

Although there is an enormous amount of literature demonstrating socio-psychological determinants of suicide and self-injurious behaviour among adults or clinical samples of children and adolescents, there is a scarcity of studies focussing on non-clinical adolescent samples. The current study examined associations between self-reported data on…

Suicidal Fantasies and Positive/Negative Effects.

ERIC Educational Resources Information Center

Fouts, Gregory; Norrie, Janice

This study attempted to provide some initial normative data to help professionals and researchers to distinguish between playful and stimulating suicidal fantasies as opposed to serious and compulsive thoughts and behaviours characterized by negative affects. It is argued that the former is a natural consequence of cognitive development, the entry…

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.

Managing Suicide Risk in Patients with Schizophrenia

PubMed Central

Kasckow, John; Felmet, Kandi; Zisook, Sidney

2011-01-01

The management of suicide risk in patients with schizophrenia poses many challenges for clinicians. Compared with the general population, these patients have an 8.5-fold greater risk of suicide. This article reviews the literature dealing with the treatment of at-risk patients with schizophrenia. An integrated psychosocial and pharmacological approach to managing this population of patients is recommended. Although there is at least modest evidence suggesting that antipsychotic medications protect against suicidal risk, the evidence appears to be most favourable for second-generation antipsychotics, particularly clozapine, which is the only medication approved by the US FDA for preventing suicide in patients with schizophrenia. In addition, treating depressive symptoms in patients with schizophrenia is an important component of suicide risk reduction. While selective serotonin receptor inhibitors (SSRIs) ameliorate depressive symptoms in patients with schizophrenia, they also appear to attenuate suicidal thoughts. Further research is needed to more effectively personalize the treatment of suicidal thoughts and behaviours and the prevention of suicide in patients with schizophrenia. PMID:21254789

[Stigma - risk factor and consequence of suicidal behavior : Implications for suicide prevention].

PubMed

Oexle, N; Rüsch, N

2017-11-16

Mental illness, previous suicidal behavior and loss of a relative by suicide are strong risk factors for suicidality. Both mental illness and suicide are stigmatized, which is a burden for those affected and potentially contributes to suicidality among stigmatized individuals. Many consequences of stigma, e. g. social isolation, low self-esteem and hopelessness, are well-known predictors of suicidality. Interventions to reduce stigmatization might therefore be an important component of successful suicide prevention. This paper discusses the currently available knowledge regarding this hypothesis. Many studies confirmed the association between the stigmatization of mental illness and suicidality and there is initial evidence for the influence of suicide stigma and suicidality. Nevertheless, the effectiveness of anti-stigma interventions to reduce suicidality and prevent suicide has not yet been tested. Reducing stigma among members of the general population and mental health care professionals as well as programs to support individuals in coping with stigmatization could be important components of successful suicide prevention.

Intimate partner sexual violence and risk for femicide, suicidality and substance use among women in antenatal care and general out-patients in Thailand.

PubMed

Pengpid, Supa; Peltzer, Karl; Laosee, Orapin; Suthisukon, Kawinarat

2018-02-06

Little is known about the occurrence and health consequences of intimate partner sexual assault. The aim of this study was to assess the prevalence and correlates of sexual assault in the context of intimate partner violence (IPV) in Thailand. In a cross-sectional survey adult female participants were systematically screened (self-administered or interview administered) for IPV in antenatal care and general outpatient clinics in nine randomly selected hospitals in two provinces in the central region. Measures included the Abuse Assessment Screen, Severity of Violence Against Women Scale, Danger assessment and suicidal behaviour. From 14,288 women screened, 1.5% were positive for IPV and 207 participated in the study. The mean age of the study participants was 26.8 years (SD = 9.3). Fifty-seven women, 27.5% of the sample, reported sexual assault, one or more times, during the relationship in the past 12 months. Most reported some form of psychological abuse (82.1%), physical violence (67.1%) and danger (72.0%). In all, 21.3% reported psychological, physical and sexual violence. Bivariate analyses found that older age, being recruited in the general out-patient department, greater number of children, high psychological abuse, high physical violence, danger and suicidal behaviour in the past 12 months were associated with sexual assault. In multivariable backward conditional logistic regression physical violence (OR = 5.32, CI = 2.52-11.24) and suicidal behaviour (OR = 3.28, CI = 1.37-7.83) were found to be associated with sexual assault. The study found a moderate rate of sexual assault in intimate violent partner relationships and those sexual assaults are more likely to co-occur with physical intimate partner violence and suicidal behaviour. This knowledge may be helpful in the detection and management of sexual assault in intimate violent partner relationships of women in health care settings in Thailand.

Dehydroepiandrosterone and dehydroepiandrosterone sulfate levels in combat veterans with or without a history of suicide attempt.

PubMed

Sher, L; Flory, J; Bierer, L; Makotkine, I; Yehuda, R

2018-05-22

The goal of this study was to determine whether combat veterans who have made a suicide attempt postdeployment can be distinguished from combat veterans who have never made a suicide attempt based on differences in psychological and biological variables. Demographic and clinical parameters of suicide attempters and non-attempters were assessed. Blood samples were assayed for dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEAS). Suicide attempters had higher Scale for Suicidal Ideation and Montgomery-Åsberg Depression Rating Scale (MADRS)-suicidal thoughts item scores in comparison with non-attempters. There was a trend toward higher MADRS scores in the suicide attempter group compared with non-attempters. Suicide attempters had significantly lower levels of DHEA and DHEAS compared with non-attempters. Scale for Suicidal Ideation scores in all study participants combined negatively correlate with DHEA and DHEAS levels. DHEAS levels negatively correlate with Scale for Suicidal Ideation scores in suicide non-attempters but not in suicide attempters. DHEA/DHEAS ratios positively correlate with total adolescence aggression scores, total adulthood aggression scores, and total aggression scale scores in suicide attempters but not in suicide non-attempters. There are psychobiological differences between combat veterans with or without a history of suicidal behaviour. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Clinical and epidemiological aspects of suicide in patients with schizophrenia.

PubMed

Gómez-Durán, Esperanza L; Martin-Fumadó, Carles; Hurtado-Ruíz, Gemma

2012-01-01

Suicide is a major cause of death among patients with schizophrenia. Suicide phenomenon's characterization is the best available approach for improved prediction and prevention of suicide. Patients at high risk for suicide need a more intensive monitoring and intervention. The aim of this review is to characterize, from a clinical-epidemiological point of view, the phenomenon of completed suicide in schizophrenia. We performed a systematic review to identify the most relevant studies published between 1994 and 2009, by searching on the international database Medline and among previous reviews references. Patients with schizophrenia experience higher mortality rates than the general population, especially due to the suicide. Most patients with schizophrenia who commit suicide are likely to be young and males, with a higher risk around illness onset and hospitalization periods. Previous suicide attempts are an important risk factor for completed suicide. Suicide risk is associated to psychotic positive symptoms, affective symptoms, depression and substance abuse. Treatment adherence is as protective factor. Patients with schizophrenia are likely to commit suicide by violent means. Suicide prevention should focus on treating affective symptoms and syndromes, improving treatment compliance and providing intensive monitoring to those patients at high risk of suicide, specially around hospitalization periods. Further studies are needed to clarify differential characteristics between suicide behaviour and completed suicide.

Characterization of suicidal behaviour with self-organizing maps.

PubMed

Leiva-Murillo, José M; López-Castromán, Jorge; Baca-García, Enrique

2013-01-01

The study of the variables involved in suicidal behavior is important from a social, medical, and economical point of view. Given the high number of potential variables of interest, a large population of subjects must be analysed in order to get conclusive results. In this paper, we describe a method based on self-organizing maps (SOMs) for finding the most relevant variables even when their relation to suicidal behavior is strongly nonlinear. We have applied the method to a cohort with more than 8,000 subjects and 600 variables and discovered four groups of variables involved in suicidal behavior. According to the results, there are four main groups of risk factors that characterize the population of suicide attempters: mental disorders, alcoholism, impulsivity, and childhood abuse. The identification of specific subpopulations of suicide attempters is consistent with current medical knowledge and may provide a new avenue of research to improve the management of suicidal cases.

The association of suicide and bullying in childhood to young adulthood: a review of cross-sectional and longitudinal research findings.

PubMed

Brunstein Klomek, Anat; Sourander, Andre; Gould, Madelyn

2010-05-01

To review the research addressing the association of suicide and bullying, from childhood to young adulthood, including cross-sectional and longitudinal research findings. Relevant publications were identified via electronic searches of PsycNet and MEDLINE without date specification, in addition to perusing the reference lists of relevant articles. Cross-sectional findings indicate that there is an increased risk of suicidal ideation and (or) suicide attempts associated with bullying behaviour and cyberbullying. The few longitudinal findings available indicate that bullying and peer victimization lead to suicidality but that this association varies by sex. Discrepancies between the studies available may be due to differences in the studies' participants and methods. Bullying and peer victimization constitute more than correlates of suicidality. Future research with long-term follow-up should continue to identify specific causal paths between bullying and suicide.

Suicidal behaviour on subway systems: a review of the epidemiology.

PubMed

Ratnayake, Ruwan; Links, Paul S; Eynan, Rahel

2007-11-01

Suicide on subway systems is a public health challenge that has been reported in urban centers worldwide. Our objective was to analyze studies of suicide on subway systems, develop a profile of characteristics that are suggestive of association with suicides or attempts, and show how this profile can inform prevention. A literature review involving epidemiology studies and studies relating to subway suicide was conducted. Twenty-eight studies were included in this review. Across studies, characteristics were not often assessed for risk factor status, although several characteristics were remarkably similar. Those attempting suicide on the subway appear to be affected by serious mental illness and have contact with mental health services before the suicidal behavior. Several characteristics may be shared among this population, emphasizing the potential for prevention in clinical and public health domains. Well-designed studies that utilize robust data collection and statistical methods are needed to establish the risk status associated with these characteristics.

The association between adolescent risk behaviours and feelings of sadness or hopelessness: a cross-sectional survey of South African secondary school learners.

PubMed

James, Shamagonam; Reddy, Sasiragha Priscilla; Ellahebokus, Afzal; Sewpaul, Ronel; Naidoo, Pamela

2017-08-01

Poor mental health in adolescents has shown associations with engagement in other risk behaviours. However, evidence of this association in Sub-Saharan Africa, particularly South Africa, is lacking. This study examines the associations between pertinent risk behaviours and feelings of sadness or hopelessness amongst a nationally representative sample of South African school going adolescents. Data was analysed from the South African Youth Risk Behaviour Survey 2011 (n=10,997), a cross-sectional national survey among grades 8-11 school learners. Logistic regression examined the association of demographic, substance use, violent behaviour, sexual activity and suicidal plans and attempts with the primary outcome, feelings of sadness or hopelessness. Having feelings of sadness or hopelessness was significantly associated with more senior grades, being bullied (AOR:1.67, 95% CI: 1.42-1.96), being assaulted by a partner (1.33 [1.05-1.68]), forced sex (1.78 [1.37-2.32]); gang membership (1.32 [1.06-1.65]), binge drinking (1.37 [1.14-1.65]), ever having sex (1.23 [1.02-1.47]), having ≥1 partner/s in preceding three months (1.25 [1.02-1.53]), having made a plan to attempt suicide (2.50 [1.95-3.21]) and suicide attempt (1.49 [1.21-1.85]). Adolescents in South Africa are experiencing a multiple burden of risk. Health promotion strategies targeting adolescent mental health and risk behaviours need to be developed and implemented in a timely and comprehensive manner.

Juvenile delinquency, social background and suicide--a Swedish national cohort study of 992,881 young adults.

PubMed

Björkenstam, Emma; Björkenstam, Charlotte; Vinnerljung, Bo; Hallqvist, Johan; Ljung, Rickard

2011-12-01

As the suicide rates in young adults do not show a clear decline, it is important to elucidate possible risk factors. Juvenile delinquency has been pointed out as a possible risk behaviour. This register-based cohort study comprises the birth cohorts between 1972 and 1981 in Sweden. We followed 992,881 individuals from the age of 20 years until 31 December 2006, generating 10 210 566 person-years and 1482 suicides. Juvenile delinquency was defined as being convicted of a crime between the ages of 15 and 19 years. Estimates of risk of suicide were calculated as incidence rate ratio (IRR) with 95% confidence intervals (CIs) using Poisson regression analysis with adjustment for potential confounding by their own and their parents' mental illness or substance abuse, parental education, single parenthood, social assistance, adoption and foster care. Among females, 5.9%, and among males, 17.9%, had at least one conviction between the ages 15 and 19 years. In the fully adjusted model, females with one conviction had a suicide risk of 1.7 times higher (95% CI 1.2-2.4), the corresponding IRR for men was 2.0 (95% CI 1.7-2.4) and 5.7 (95% CI 2.5-13.1) and 6.6 (95% CI 5.2-8.3), for women and men with five or more convictions. The effect of severe delinquency on suicide was independent of parental educational level. This study supports the hypothesis that individuals with delinquent behaviour in late adolescence have an increased risk of suicide as young adults. Regardless of causality issues, repeated juvenile offenders should be regarded by professionals in health, social and correctional services who come into contact with this group as a high-risk group for suicide.

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

Staying well after depression: trial design and protocol.

PubMed

Williams, J Mark G; Russell, Ian T; Crane, Catherine; Russell, Daphne; Whitaker, Chris J; Duggan, Danielle S; Barnhofer, Thorsten; Fennell, Melanie J V; Crane, Rebecca; Silverton, Sarah

2010-03-19

Depression is often a chronic relapsing condition, with relapse rates of 50-80% in those who have been depressed before. This is particularly problematic for those who become suicidal when depressed since habitual recurrence of suicidal thoughts increases likelihood of further acute suicidal episodes. Therefore the question how to prevent relapse is of particular urgency in this group. This trial compares Mindfulness-Based Cognitive Therapy (MBCT), a novel form of treatment combining mindfulness meditation and cognitive therapy for depression, with both Cognitive Psycho-Education (CPE), an equally plausible cognitive treatment but without meditation, and treatment as usual (TAU). It will test whether MBCT reduces the risk of relapse in recurrently depressed patients and the incidence of suicidal symptoms in those with a history of suicidality who do relapse. It recruits participants, screens them by telephone for main inclusion and exclusion criteria and, if they are eligible, invites them to a pre-treatment session to assess eligibility in more detail. This trial allocates eligible participants at random between MBCT and TAU, CPE and TAU, and TAU alone in a ratio of 2:2:1, stratified by presence of suicidal ideation or behaviour and current anti-depressant use. We aim to recruit sufficient participants to allow for retention of 300 following attrition. We deliver both active treatments in groups meeting for two hours every week for eight weeks. We shall estimate effects on rates of relapse and suicidal symptoms over 12 months following treatment and assess clinical status immediately after treatment, and three, six, nine and twelve months thereafter. This will be the first trial of MBCT to investigate whether MCBT is effective in preventing relapse to depression when compared with a control psychological treatment of equal plausibility; and to explore the use of MBCT for the most severe recurrent depression--that in people who become suicidal when depressed.

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

Pilot Trial of Inpatient Cognitive Therapy for the Prevention of Suicide in Military Personnel with Acute Stress Disorder or Post-Traumatic Stress Disorder

DTIC Science & Technology

2010-08-01

Therapy (PACT) as a targeted inpatient treatment for individuals admitted for a recent suicide attempt to a military hospital . (2) To assess the... therapy (PACT). Invited presentation at the Department of Defense Suicide Prevention Research Program Working Group, Frederick, MD. Martin, J. S ...depressed and anxious outpatients. Cognitive Behaviour Therapy , 36, 170-178. Bhar, S ., Ghahramanlou-Holloway, M., Brown, G., & Beck, A. T. (2008). Self

A systematic review of the relationship between internet use, self-harm and suicidal behaviour in young people: The good, the bad and the unknown

PubMed Central

Marchant, Amanda; Hawton, Keith; Stewart, Ann; Montgomery, Paul; Singaravelu, Vinod; Lloyd, Keith; Purdy, Nicola; Daine, Kate

2017-01-01

Background Research exploring internet use and self-harm is rapidly expanding amidst concerns regarding influences of on-line activities on self-harm and suicide, especially in young people. We aimed to systematically review evidence regarding the potential influence of the internet on self-harm/suicidal behaviour in young people. Methods We conducted a systematic review based on an electronic search for articles published between 01/01/2011 and 26/01/2015 across databases including Medline, Cochrane and PsychInfo. Articles were included if: the study examined internet use by individuals who engaged in self-harm/ suicidal behaviour, or internet use clearly related to self-harm content; reported primary empirical data; participants were aged under 25 years. New studies were combined with those identified in a previous review and subject to data extraction, quality rating and narrative synthesis. Results Forty-six independent studies (51 articles) of varying quality were included. Perceived influences were: positive for 11 studies (38191 participants); negative for 18 studies (119524 participants); and mixed for 17 studies (35235 participants). In contrast to previous reviews on this topic studies focused on a wide range of internet mediums: general internet use; internet addiction; online intervention/treatment; social media; dedicated self-harm websites; forums; video/image sharing and blogs. A relationship between internet use and self-harm/suicidal behaviour was particularly associated with internet addiction, high levels of internet use, and websites with self-harm or suicide content. While there are negative aspects of internet use the potential for isolation reduction, outreach and as a source of help and therapy were also identified. Conclusions There is significant potential for harm from online behaviour (normalisation, triggering, competition, contagion) but also the potential to exploit its benefits (crisis support, reduction of social isolation, delivery of therapy, outreach). Young people appear to be increasingly using social media to communicate distress, particularly to peers. The focus should now be on how specific mediums’ (social media, video/image sharing) might be used in therapy and recovery. Clinicians working with young people who self-harm or have mental health issues should engage in discussion about internet use. This should be a standard item during assessment. A protocol for this review was registered with the PROSPERO systematic review protocol registry: (http://www.crd.york.ac.uk/prospero/display_record.asp?ID=CRD42015019518). PMID:28813437

Measurement properties of tools used to assess suicidality in autistic and general population adults: A systematic review.

PubMed

Cassidy, S A; Bradley, L; Bowen, E; Wigham, S; Rodgers, J

2018-05-05

Adults diagnosed with autism are at significantly increased risk of suicidal thoughts, suicidal behaviours and dying by suicide. However, it is unclear whether any validated tools are currently available to effectively assess suicidality in autistic adults in research and clinical practice. This is crucial for understanding and preventing premature death by suicide in this vulnerable group. This two stage systematic review therefore aimed to identify tools used to assess suicidality in autistic and general population adults, evaluate these tools for their appropriateness and measurement properties, and make recommendations for appropriate selection of suicidality assessment tools in research and clinical practice. Three databases were searched (PsycInfo, Medline and Web of Knowledge). Four frequently used suicidality assessment tools were identified, and subsequently rated for quality of the evidence in support of their measurement properties using the COSMIN checklist. Despite studies having explored suicidality in autistic adults, none had utilised a validated tool. Overall, there was lack of evidence in support of suicidality risk assessments successfully predicting future suicide attempts. We recommend adaptations to current suicidality assessment tools and priorities for future research, in order to better conceptualise suicidality and its measurement in autism. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Validation of key behaviourally based mental health diagnoses in administrative data: suicide attempt, alcohol abuse, illicit drug abuse and tobacco use.

PubMed

Kim, Hyungjin Myra; Smith, Eric G; Stano, Claire M; Ganoczy, Dara; Zivin, Kara; Walters, Heather; Valenstein, Marcia

2012-01-23

Observational research frequently uses administrative codes for mental health or substance use diagnoses and for important behaviours such as suicide attempts. We sought to validate codes (International Classification of Diseases, 9th edition, clinical modification diagnostic and E-codes) entered in Veterans Health Administration administrative data for patients with depression versus a gold standard of electronic medical record text ("chart notation"). Three random samples of patients were selected, each stratified by geographic region, gender, and year of cohort entry, from a VHA depression treatment cohort from April 1, 1999 to September 30, 2004. The first sample was selected from patients who died by suicide, the second from patients who remained alive on the date of death of suicide cases, and the third from patients with a new start of a commonly used antidepressant medication. Four variables were assessed using administrative codes in the year prior to the index date: suicide attempt, alcohol abuse/dependence, drug abuse/dependence and tobacco use. Specificity was high (≥ 90%) for all four administrative codes, regardless of the sample. Sensitivity was ≤75% and was particularly low for suicide attempt (≤ 17%). Positive predictive values for alcohol dependence/abuse and tobacco use were high, but barely better than flipping a coin for illicit drug abuse/dependence. Sensitivity differed across the three samples, but was highest in the suicide death sample. Administrative data-based diagnoses among VHA records have high specificity, but low sensitivity. The accuracy level varies by different diagnosis and by different patient subgroup.

Exploring application of the Interpersonal-Psychological Theory of Suicidal Behaviour to self-injurious behaviour among women prisoners: Proposing a new model of understanding.

PubMed

Ireland, Jane L; York, Charlotte

2012-01-01

The current study examines the application of capacity, psychological distress, coping and personality to an understanding of self-injurious behaviour, with a specific focus on testing the Interpersonal-Psychological Theory of Suicidal Behaviour (IPTSB). One hundred and ninety women prisoners took part, completing a history questionnaire and measures of personality, coping styles and psychological distress. It was expected that self-injurious behaviour would be predicted by higher levels of emotional functioning difficulties, by an increased capacity to engage in such behaviours, by previous self-injurious behaviour, decreased levels of emotional stability and increased levels of emotional coping behaviour. Results supported the capacity component of the IPTSB, indicating that an increased history of self-injurious behaviour and of engagement in reckless behaviour were particular predictors. Increased psychological distress in some domains was also a predictor although the exact domain varied across the type of self-injurious engagement Increased levels of extraversion and decreased emotional coping predicted increased self-injurious engagement, although emotional coping only related to threats and cognition. The results point to the applicability of Interpersonal-Psychological Theory to understanding self-injurious behaviour and the importance of developing a revised model. The paper presents this in the form of the Integrated Model of Self-Injurious Activity. Copyright © 2011 Elsevier Ltd. All rights reserved.

Promoting Community Conversations About Research to End Suicide: learning and behavioural outcomes of a training-of-trainers model to facilitate grassroots community health education to address Indigenous youth suicide prevention.

PubMed

Wexler, Lisa; Trout, Lucas; Rataj, Suzanne; Kirk, Tanya; Moto, Roberta; McEachern, Diane

2017-01-01

Alaska Native (AN) youth suicide remains a substantial and recalcitrant health disparity, especially in rural/remote communities. Promoting Community Conversations About Research to End Suicide (PC CARES) is a community health intervention that responds to the need for culturally responsive and evidence-supported prevention practice, using a grassroots approach to spark multilevel and community-based efforts for suicide prevention. This paper describes theoretical and practical considerations of the approach, and assesses the feasibility and preliminary learning and behavioural outcomes of the training-of-trainers model. It details the training of a first cohort of intervention facilitators in Northwest Alaska (NWA). Thirty-two people from 11 NWA village communities completed the PC CARES facilitator training, preparing them to implement the intervention in their home communities. Facilitator pre-post surveys focused on readiness to facilitate, a group quiz assessed participants' understanding of relevant research evidence, and practice facilitation exercises demonstrated competency. Curriculum fidelity and accuracy scores were calculated using audio recordings from learning circles conducted by facilitators in their home communities. Facilitator reflections describe the successes of the model and identify several areas for improvement. As of March 2017, 20 of the 32 trained facilitators in 10 of the 11 participating villages have hosted 54 LCs, with a total of 309 unique community members. Coding of these LCs by 2 independent raters indicate acceptable levels of fidelity and accurate dissemination of research evidence by facilitators. Facilitator reflections were positive overall, suggesting PC CARES is feasible, acceptable and potentially impactful as a way to translate research to practice in under-resourced, rural AN communities. PC CARES represents a practical community education and mobilisation approach to Indigenous youth suicide prevention that displays preliminary success in learning and behavioural outcomes of local facilitators.

Suicide prevention strategies revisited: 10-year systematic review.

PubMed

Zalsman, Gil; Hawton, Keith; Wasserman, Danuta; van Heeringen, Kees; Arensman, Ella; Sarchiapone, Marco; Carli, Vladimir; Höschl, Cyril; Barzilay, Ran; Balazs, Judit; Purebl, György; Kahn, Jean Pierre; Sáiz, Pilar Alejandra; Lipsicas, Cendrine Bursztein; Bobes, Julio; Cozman, Doina; Hegerl, Ulrich; Zohar, Joseph

2016-07-01

Many countries are developing suicide prevention strategies for which up-to-date, high-quality evidence is required. We present updated evidence for the effectiveness of suicide prevention interventions since 2005. We searched PubMed and the Cochrane Library using multiple terms related to suicide prevention for studies published between Jan 1, 2005, and Dec 31, 2014. We assessed seven interventions: public and physician education, media strategies, screening, restricting access to suicide means, treatments, and internet or hotline support. Data were extracted on primary outcomes of interest, namely suicidal behaviour (suicide, attempt, or ideation), and intermediate or secondary outcomes (treatment-seeking, identification of at-risk individuals, antidepressant prescription or use rates, or referrals). 18 suicide prevention experts from 13 European countries reviewed all articles and rated the strength of evidence using the Oxford criteria. Because the heterogeneity of populations and methodology did not permit formal meta-analysis, we present a narrative analysis. We identified 1797 studies, including 23 systematic reviews, 12 meta-analyses, 40 randomised controlled trials (RCTs), 67 cohort trials, and 22 ecological or population-based investigations. Evidence for restricting access to lethal means in prevention of suicide has strengthened since 2005, especially with regard to control of analgesics (overall decrease of 43% since 2005) and hot-spots for suicide by jumping (reduction of 86% since 2005, 79% to 91%). School-based awareness programmes have been shown to reduce suicide attempts (odds ratio [OR] 0·45, 95% CI 0·24-0·85; p=0·014) and suicidal ideation (0·5, 0·27-0·92; p=0·025). The anti-suicidal effects of clozapine and lithium have been substantiated, but might be less specific than previously thought. Effective pharmacological and psychological treatments of depression are important in prevention. Insufficient evidence exists to assess the possible benefits for suicide prevention of screening in primary care, in general public education and media guidelines. Other approaches that need further investigation include gatekeeper training, education of physicians, and internet and helpline support. The paucity of RCTs is a major limitation in the evaluation of preventive interventions. In the quest for effective suicide prevention initiatives, no single strategy clearly stands above the others. Combinations of evidence-based strategies at the individual level and the population level should be assessed with robust research designs. The Expert Platform on Mental Health, Focus on Depression, and the European College of Neuropsychopharmacology. Copyright © 2016 Elsevier Ltd. All rights reserved.

Do First Generation Immigrant Adolescents Face Higher Rates of Bullying, Violence and Suicidal Behaviours Than Do Third Generation and Native Born?

PubMed

Pottie, Kevin; Dahal, Govinda; Georgiades, Katholiki; Premji, Kamila; Hassan, Ghayda

2015-10-01

We conducted a systematic review to examine first generation immigrant adolescents' likelihood of experiencing bullying, violence, and suicidal behaviours compared to their later-generation and native born counterparts, and to identify factors that may underlie these risks. Eighteen studies met full inclusion criteria. First generation immigrant adolescents experience higher rate of bullying and peer aggression compared to third generation and native counterparts. Refugee status and advanced parental age were associated with increased parent to child aggression among South East Asians. Family cohesion was associated with lower rates of violence. Suicidal ideation was lower across most immigrant adolescents' ethnicities, with the exception of Turkish and South Asian Surinamese female adolescents in the Netherlands. Bullying and peer aggression of immigrant children and adolescents and potential mitigating factors such as family cohesion warrant research and program attention by policymakers, teachers and parents.

A reversed gender pattern? A meta-analysis of gender differences in the prevalence of non-suicidal self-injurious behaviour among Chinese adolescents.

PubMed

Yang, Xueyan; Feldman, Marcus W

2017-07-28

A reversed gender pattern has been observed in the suicide rate in China compared to elsewhere. Like suicidal behaviour, non-suicidal self-injurious (NSSI) behaviour is a health-risk behaviour. We examined whether a reversed gender pattern existed in the prevalence of NSSI. Online literature databases were searched for English and Chinese articles on NSSI behaviours among the Chinese. A meta-analysis with a random-effects model and a subgroup analysis were used to estimate the odds ratios of gender differences in NSSI prevalence among Chinese adolescents including college students, middle school students, and clinical samples, as well as rural, urban, and Hong Kong middle school students. There was a male bias in NSSI prevalence among college students (OR = 1.56, 95% CI = [1.30, 1.87], p < 0.001), and a female bias among middle school students (OR = 0.83, 95% CI = [0.73, 0.94], p < 0.01), but there was no gender difference among clinical samples (OR = 0.88, 95% CI = [0.41, 1.89], p > 0.1). The NSSI prevalence among middle school students had a female bias in the rural (OR = 0.58, 95% CI = [0.47, 0.72], p < 0.001) and Hong Kong areas (OR = 0.91, 95% CI = [0.86, 0.96], p < 0.001), with the gender difference in NSSI prevalence in the Hong Kong areas being greater than in rural areas. No gender difference in NSSI prevalence was found in urban areas (OR = 1.01, 95% CI = [0.84, 1.22], p > 0.1) among middle school students. Our analysis indicated the existence of specific gender and age patterns in NSSI prevalence among Chinese adolescents. The sample type, age, and the areas that have different gender norms and culture could partly explain this pattern.

The role of schools in children and young people's self-harm and suicide: systematic review and meta-ethnography of qualitative research.

PubMed

Evans, Rhiannon; Hurrell, Chloe

2016-05-14

Evidence reports that schools influence children and young people's health behaviours across a range of outcomes. However there remains limited understanding of the mechanisms through which institutional features may structure self-harm and suicide. This paper reports on a systematic review and meta-ethnography of qualitative research exploring how schools influence self-harm and suicide in students. Systematic searches were conducted of nineteen databases from inception to June 2015. English language, primary research studies, utilising any qualitative research design to report on the influence of primary or secondary educational settings (or international equivalents) on children and young people's self-harm and suicide were included. Two reviewers independently appraised studies against the inclusion criteria, assessed quality, and abstracted data. Data synthesis was conducted in adherence with Noblit and Hare's meta-ethnographic approach. Of 6744 unique articles identified, six articles reporting on five studies were included in the meta-ethnography. Five meta-themes emerged from the studies. First, self-harm is often rendered invisible within educational settings, meaning it is not prioritised within the curriculum despite students' expressed need. Second, where self-harm transgresses institutional rules it may be treated as 'bad behaviour', meaning adequate support is denied. Third, schools' informal management strategy of escalating incidents of self-harm to external 'experts' serves to contribute to non-help seeking behaviour amongst students who desire confidential support from teachers. Fourth, anxiety and stress associated with school performance may escalate self-harm and suicide. Fifth, bullying within the school context can contribute to self-harm, whilst some young people may engage in these practices as initiation into a social group. Schools may influence children and young people's self-harm, although evidence of their impact on suicide remains limited. Prevention and intervention needs to acknowledge and accommodate these institutional-level factors. Studies included in this review are limited by their lack of conceptual richness, restricting the process of interpretative synthesis. Further qualitative research should focus on the continued development of theoretical and empirical insight into the relationship between institutional features and students' self-harm and suicide.

Suicide among forensic psychiatric patients.

PubMed

Johnson, C; Smith, J; Crowe, C; Donovan, M

1993-04-01

This paper examines the problem of suicide among patients discharged from a Regional Secure Unit. The stereotype that emerges is a young man with anti-social personality traits, suffering from an affective psychosis, with a history of substance abuse and impulsive violence directed both towards himself and others, who is alienated from care staff and social supports because of his provocative and uncooperative behaviour. In contrast with the general population, forensic patients are more likely to commit suicide using a violent method and are more likely to have a suicide verdict recorded by the coroner. The implications of these findings for treatment and preventive interventions are discussed.

Population attributable fractions of psychopathology and suicidal behaviour associated with childhood adversities in Northern Ireland.

PubMed

McLafferty, Margaret; O'Neill, Siobhan; Murphy, Sam; Armour, Cherie; Bunting, Brendan

2018-03-01

Childhood adversities are strong predictors of psychopathology and suicidality. However, specific adversities are associated with different outcomes, with cross-national variations reported. The current study examined rates of adversities reported in Northern Ireland (NI), and associations between adverse childhood experiences and psychopathology and suicidal behaviour were explored. Data was obtained from the Northern Ireland Study of Health and Stress (NISHS), conducted as part of the World Mental Health (WMH) survey initiative (2004-2008); response rate 68.4% (n = 1,986). The on-line survey used, the WHO Composite International Diagnostic Interview (CIDI) to examine psychopathology and associated risk factors in the NI population. Prevalence rates of retrospectively reported childhood adversities were calculated, with gender and age variations explored. Females were more likely to experience sexual abuse. Individuals who grew up during the worst years of the civil conflict in NI experienced elevated levels of childhood adversities. Participants who endured childhood adversities were more likely to have mental health problems but variations in risk factors were found for different disorders. Parental mental illness was associated with all disorders however, with ORs ranging from 2.20 for mood disorders to 4.07 for anxiety disorders. Population attributable fractions (PAF) estimated the reduction in psychopathology and suicidal behaviour in the population if exposure to adverse childhood events had not occurred. The highest PAF values were revealed for parental mental illness and sexual abuse. The findings indicate that a substantial proportion of psychopathology and suicide risk in NI are attributable to childhood adversities, providing support for early intervention and prevention initiatives. Copyright © 2017 Elsevier Ltd. All rights reserved.

Recollections of parental rejection, self-criticism and depression in suicidality.

PubMed

Campos, Rui C; Besser, Avi; Blatt, Sidney J

2013-01-01

The present study examines whether self-criticism and depressive symptoms mediate the relationship between recollections of parental rejection and suicidality. A community sample of 200 Portuguese adults completed, in counterbalanced order, a socio-demographic questionnaire, the short form of the Inventory for Assessing Memories of Parental Rearing Behaviour (EMBU), the Depressive Experiences Questionnaire (DEQ), the Center for Epidemiologic Studies Depression Scale (CES-D), and reports of any suicide intention and/or ideation and suicide attempts. Structural Equation Modeling (SEM) indicated that recollections of parental rejection are significantly associated with depressive symptoms and suicidality. Recollections of parental rejection are indirectly associated with depressive symptoms and suicidality through self-criticism. The association between self-criticism and suicidality is mediated by depressive symptoms. In addition to a significant direct association between recollections of parental rejection and suicidality, the final model indicated that recollections of parental rejection are significantly associated with self-criticism. That same self-criticism is significantly associated with depressive symptoms which, in turn, are significantly associated with suicidality. Individuals with recollections of parental rejection are at greater risk for suicide ideation and behavior, possibly because such experiences predispose them to intense self-criticism which is a risk factor for depression associated with suicidal ideation and behavior.

Nonsuicidal self-injury, suicidal thoughts and suicide attempts among sexual minority youth in Ireland during their emerging adult years.

PubMed

Power, Emmet; Coughlan, Helen; Clarke, Mary; Kelleher, Ian; Lynch, Fionnuala; Connor, Dearbhla; Fitzpatrick, Carol; Harley, Michelle; Cannon, Mary

2016-10-01

This study aimed to examine whether or not sexual minority youth constitute an at-risk group for nonsuicidal self-injury, suicidal ideation or suicide attempts during their emerging adult years. Using data from the Challenging Times Study, a population-based study of psychopathology and suicide in Ireland, analyses were conducted to test the associations between sexual minority status and the odds of any lifetime experience of nonsuicidal self-injury, suicidal thoughts or suicide attempts among Irish youth aged 19-24 years. Sexual minority youth had 6.6-fold (95% CI 1.7-24.7) increased risk of nonsuicidal self-injury, a 5.0-fold (95% CI 1.3-18.3) increased risk of suicidal ideation, a 7.7-fold (95% CI 1.8-32.0) increased risk of suicide intent and a 6.8-fold (95% CI 1.6-27.6) increased risk of a suicide attempt during their lifetime compared to their heterosexual peers. This study shows that emerging adulthood is a period of risk for suicide and nonsuicidal self-injurious behaviour among sexual minority youth. © 2015 Wiley Publishing Asia Pty Ltd.

Why alternative teenagers self-harm: exploring the link between non-suicidal self-injury, attempted suicide and adolescent identity

PubMed Central

2014-01-01

Background The term ‘self-harm’ encompasses both attempted suicide and non-suicidal self-injury (NSSI). Specific adolescent subpopulations such as ethnic or sexual minorities, and more controversially, those who identify as ‘Alternative’ (Goth, Emo) have been proposed as being more likely to self-harm, while other groups such as ‘Jocks’ are linked with protective coping behaviours (for example exercise). NSSI has autonomic (it reduces negative emotions) and social (it communicates distress or facilitates group ‘bonding’) functions. This study explores the links between such aspects of self-harm, primarily NSSI, and youth subculture. Methods An anonymous survey was carried out of 452 15 year old German school students. Measures included: identification with different youth cultures, i.e. Alternative (Goth, Emo, Punk), Nerd (academic) or Jock (athletic); social background, e.g. socioeconomic status; and experience of victimisation. Self-harm (suicide and NSSI) was assessed using Self-harm Behavior Questionnaire and the Functional Assessment of Self-Mutilation (FASM). Results An “Alternative” identity was directly (r ≈ 0.3) and a “Jock” identity inversely (r ≈ -0.1) correlated with self-harm. “Alternative” teenagers self-injured more frequently (NSSI 45.5% vs. 18.8%), repeatedly self-injured, and were 4–8 times more likely to attempt suicide (even after adjusting for social background) than their non-Alternative peers. They were also more likely to self-injure for autonomic, communicative and social reasons than other adolescents. Conclusions About half of ‘Alternative’ adolescents’ self-injure, primarily to regulate emotions and communicate distress. However, a minority self-injure to reinforce their group identity, i.e. ‘To feel more a part of a group’. PMID:24885081

Why alternative teenagers self-harm: exploring the link between non-suicidal self-injury, attempted suicide and adolescent identity.

PubMed

Young, Robert; Sproeber, Nina; Groschwitz, Rebecca C; Preiss, Marthe; Plener, Paul L

2014-05-22

The term 'self-harm' encompasses both attempted suicide and non-suicidal self-injury (NSSI). Specific adolescent subpopulations such as ethnic or sexual minorities, and more controversially, those who identify as 'Alternative' (Goth, Emo) have been proposed as being more likely to self-harm, while other groups such as 'Jocks' are linked with protective coping behaviours (for example exercise). NSSI has autonomic (it reduces negative emotions) and social (it communicates distress or facilitates group 'bonding') functions. This study explores the links between such aspects of self-harm, primarily NSSI, and youth subculture. An anonymous survey was carried out of 452 15 year old German school students. Measures included: identification with different youth cultures, i.e. Alternative (Goth, Emo, Punk), Nerd (academic) or Jock (athletic); social background, e.g. socioeconomic status; and experience of victimisation. Self-harm (suicide and NSSI) was assessed using Self-harm Behavior Questionnaire and the Functional Assessment of Self-Mutilation (FASM). An "Alternative" identity was directly (r ≈ 0.3) and a "Jock" identity inversely (r ≈ -0.1) correlated with self-harm. "Alternative" teenagers self-injured more frequently (NSSI 45.5% vs. 18.8%), repeatedly self-injured, and were 4-8 times more likely to attempt suicide (even after adjusting for social background) than their non-Alternative peers. They were also more likely to self-injure for autonomic, communicative and social reasons than other adolescents. About half of 'Alternative' adolescents' self-injure, primarily to regulate emotions and communicate distress. However, a minority self-injure to reinforce their group identity, i.e. 'To feel more a part of a group'.

Improving Universal Suicide Prevention Screening in Primary Care by Reducing False Negatives

DTIC Science & Technology

2016-09-01

AWARD NUMBER: W81XWH-14-1-0272 TITLE: Improving universal suicide prevention screening in primary care by reducing false negatives PRINCIPAL...COVERED 9/1/2015-8/31/2016 4. TITLE AND SUBTITLE Improving universal suicide prevention screening in primary care by 5a. CONTRACT NUMBER reducing...proposed project is to develop a shortened version of the Suicide Cognitions Scale (SCS) and to evaluate its efficacy as a universal suicide prevention

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

Bullying and mental health and suicidal behaviour among 14- to 15-year-olds in a representative sample of Australian children.

PubMed

Ford, Rebecca; King, Tania; Priest, Naomi; Kavanagh, Anne

2017-09-01

To provide the first Australian population-based estimates of the association between bullying and adverse mental health outcomes and suicidality among Australian adolescents. Analysis of data from 3537 adolescents, aged 14-15 years from Wave 6 of the K-cohort of Longitudinal Study of Australian Children was conducted. We used Poisson and linear regression to estimate associations between bullying type (none, relational-verbal, physical, both types) and role (no role, victim, bully, victim and bully), and mental health (measured by the Strengths and Difficulties Questionnaire, symptoms of anxiety and depression) and suicidality. Adolescents involved in bullying had significantly increased Strengths and Difficulties Questionnaire, depression and anxiety scores in all bullying roles and types. In terms of self-harm and suicidality, bully-victims had the highest risk of self-harm (prevalence rate ratio 4.7, 95% confidence interval [3.26, 6.83]), suicidal ideation (prevalence rate ratio 4.3, 95% confidence interval [2.83, 6.49]), suicidal plan (prevalence rate ratio 4.1, 95% confidence interval [2.54, 6.58]) and attempts (prevalence rate ratio 2.7, 95% confidence interval [1.39, 5.13]), followed by victims then bullies. The experience of both relational-verbal and physical bullying was associated with the highest risk of self-harm (prevalence rate ratio 4.6, 95% confidence interval [3.15, 6.60]), suicidal ideation or plans (prevalence rate ratio 4.6, 95% confidence interval [3.05, 6.95]; and 4.8, 95% confidence interval [3.01, 7.64], respectively) or suicide attempts (prevalence rate ratio 3.5, 95% confidence interval [1.90, 6.30]). This study presents the first national, population-based estimates of the associations between bullying by peers and mental health outcomes in Australian adolescents. The markedly increased risk of poor mental health outcomes, self-harm and suicidal ideation and behaviours among adolescents who experienced bullying highlights the importance of addressing bullying in school settings.

Ongoing university studies and the risk of suicide: a register-based nationwide cohort study of 5 million young and middle-aged individuals in Sweden, 1993–2011

PubMed Central

Lageborn, Christine Takami; Vaez, Marjan; Dahlin, Marie

2017-01-01

Objectives To investigate the risk of suicide, unnatural death and all-cause death in university students compared with non-students, taking previous educational attainment into account. Design Open cohort study of all residents aged 18–39 and living in Sweden at any time between 1 January 1993 and 31 December 2011. Setting We linked data from national registers and calculated person-years during university studies for three time periods (1993–1999, 2000–2005 and 2006–2011). Time as non-student was calculated and categorised according to attained educational level. Incidence rate ratios (IRR) with 95% CIs were calculated with Poisson regression models, controlling for age and period. Participants The cohort consisted of 5 039 419 individuals, 51% men and 49% women. Main outcome measures Incidence of suicide (International Classification of Diseases (ICD)-9: E950–E959, ICD-10: X60–X84) or death with undetermined intent (ICD-9: E980-E989, ICD-10: Y10-Y34), unnatural death (ICD-9: E800-E999 and ICD-10: V01-Y99) and all-cause death. Results A total of 7316 deaths due to suicide were identified, of which 541 were registered among university students. The risk of suicide was twofold during ongoing university studies compared with when having attained university education, IRR 2.37 (95% CI 2.07 to 2.72) in men and IRR 2.15 (95% CI 1.77 to 2.61) in women. Conclusions Having ongoing university studies was associated with a higher risk of suicide compared with having attained university-level education. This finding highlights the importance of achieving a deeper understanding of suicidal behaviour during years at university. Further studies should assess risk factors for suicide and suicidal behaviour in university students. PMID:28363927

Challenging Times: Prevalence of Psychiatric Disorders and Suicidal Behaviours in Irish Adolescents

ERIC Educational Resources Information Center

Lynch, Fionnuala; Mills, Carla; Daly, Irenee; Fitzpatrick, Carol

2006-01-01

Purpose: Against a background of a lack of systematic epidemiological research in Ireland in the area, this study set out to determine prevalence rates of psychiatric disorders, suicidal ideation and intent, and parasuicide in a population of Irish adolescents aged 12-15 years in a defined geographical area. Method: All 12-15-year olds attending…

Prioritizing Research to Reduce Youth Suicide and Suicidal Behavior

PubMed Central

Bridge, Jeffrey A.; Horowitz, Lisa M.; Fontanella, Cynthia A.; Grupp-Phelan, Jackie; Campo, John V.

2014-01-01

The goal of the National Action Alliance for Suicide Prevention (Action Alliance) is to reduce suicide and suicide attempts in the U.S. by 40% in the next decade. In this paper, a public health approach is applied to suicide prevention to illustrate how reductions in youth suicide and suicidal behavior might be achieved by prioritizing research in two areas: (1) increasing access to primary care–based behavioral health interventions for depressed youth; and (2) improving continuity of care for youth who present to emergency departments after a suicide attempt. Finally, some scientific, clinical, and methodologic breakthroughs needed to achieve rapid, substantial, and sustained reductions in youth suicide and suicidal behavior are discussed. PMID:25145744

Managing young people with self-harming or suicidal behaviour.

PubMed

Fisher, Gemma

2016-02-01

This literature review aimed to determine the risk factors being used to identify children and young people who are at increased risk of engaging in self-harm and suicidal behaviour, so that optimal care can be provided for this patient group in children's medical ward settings. The two main themes that emerged were mental and neurodevelopmental disorders, and external factors. Management strategies to aid healthcare professionals in caring for this patient group were also identified. The review concludes by highlighting the need to provide healthcare professionals with continuing education about the mental health problems of children and young people, including risk factors and management strategies.

Few Sex Differences in Hospitalized Suicide Attempters Aged 70 and Above.

PubMed

Wiktorsson, Stefan; Rydberg Sterner, Therese; Mellqvist Fässberg, Madeleine; Skoog, Ingmar; Ingeborg Berg, Anne; Duberstein, Paul; Van Orden, Kimberly; Waern, Margda

2018-01-16

Relatively little research attention has been paid to sex issues in late life suicidal behaviour. The aim was to compare clinical characteristics of women and men aged 70+ who were hospitalized after a suicide attempt. We hypothesized higher depression and anxiety scores in women, and we expected to find that men would more often attribute the attempt to health problems and compromised autonomy. Participants (56 women and 47 men, mean age 80) were interviewed by a psychologist. In addition to psychiatric and somatic health assessments, participants responded to an open-ended question concerning attributions of the attempt. There were no sex differences in depression and anxiety. Forty-five percent of the men and 14% of the women had a history of substance use disorder ( p = 0.02). At least one serious physical disability was noted in 60.7% of the women and 53.2% of the men ( p = 0.55). Proportions attributing their attempt to somatic illness did not differ (women, 14.5% vs. men 17.4%, p = 0.79), and similar proportions attributed the attempt to reduced autonomy (women, 21.8% vs. men, 26.1%, p = 0.64). We found strikingly similar figures for depression scores, functional disability and attributions for attempting suicide in older men and women. Larger studies are needed in diverse settings as sex differences might be influenced by cultural context.

[Atomoxetine for treatment of children and adolescents with ADHD].

PubMed

Resen, Katarina; Pagsberg, Anne Katrine; Jörgens, Gesche

2014-03-03

Atomoxetine reduces ADHD symptoms in children and adolescents significantly and is indicated for ADHD with co-morbid anxiety, depression and tics or with an increased risk of abuse. Number needed to treat is 3.4-5. Common adverse effects are stomach pain, decreased appetite and somnolence. Serious adverse effects include increased vascular tone, decreased growth rate and increased suicidal behaviour. In most cases adverse effects are mild to moderate and transient. Since atomoxetine was launched in 2006, 117 cases of toxic exposures have been reported in Denmark.

Predictive validity of neurotic disorders: a 50-year follow-up study.

PubMed

Jepsen, Peter Winning; Butler, Birgitte; Rasmussen, Stig; Juel, Knud; Bech, Per

2014-06-01

In 1965, Erling Jacobsen (1919-1988) defended his doctoral thesis on neurosis in which he tested the psychoanalytic theory of eridophobia as an internalising hostility factor with a specific causality for anxiety neurosis. He found no marked difference between anxiety neurosis and obsessive-compulsive neurosis, which, however, both differed from hysterical neurosis. The aim of this follow-up study was to evaluate to which extent anxiety neurosis and obsessive-compulsive neurosis when compared with hysterical neurosis co-existed with depression, both at the level of diagnostic behaviour, including committed suicide, and with regard to symptom profile. A total of 112 patients were followed on the Danish Central Psychiatric Research Register and the Danish Cause of Death Register with regard to their diagnostic behaviour. In a subset of the sample (n = 24), the patients were assessed using the Hopkins Symptom Checklist (SCL)-90. Both at the diagnostic level, including suicide rate, and at the level of symptom severity (SCL-90), anxiety neurosis and obsessive-compulsive neurosis were similar, in contrast to hysterical neurosis which had no more association with the other two categories of neurosis than would be expected by chance. Anxiety neurosis and obsessive-compulsive neurosis are more severe disorders than hysterical neurosis, both in terms of symptom profile and depression, including suicidal behaviour. The identified suicides were committed within the first two decades after discharge from the index hospitalisation. Poul M. Færgemann's Grant and the Neurosis Grant of 22 July 1959. not relevant.

HPA axis hyperactivity as suicide predictor in elderly mood disorder inpatients.

PubMed

Jokinen, Jussi; Nordström, Peter

2008-11-01

Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis function is associated with suicidal behaviour and age-associated alterations in HPA axis functioning may render elderly individuals more susceptible to HPA dysregulation related to mood disorders. Research on HPA axis function in suicide prediction in elderly mood disorder patients is sparse. The study sample consisted of 99 depressed elderly inpatients 65 years of age or older admitted to the department of Psychiatry at the Karolinska University Hospital between 1980 and 2000. The hypothesis was that elderly mood disorder inpatients who fail to suppress cortisol in the dexamethasone suppression test (DST) are at higher risk of suicide. The DST non-suppression distinguished between suicides and survivors in elderly depressed inpatients and the suicide attempt at the index episode was a strong predictor for suicide. Additionally, the DST non-suppression showed higher specificity and predictive value in the suicide attempter group. Due to age-associated alterations in HPA axis functioning, the optimal cut-off for DST non-suppression in suicide prediction may be higher in elderly mood disorder inpatients. These data demonstrate the importance of attempted suicide and DST non-suppression as predictors of suicide risk in late-life depression and suggest the use for neuroendocrine testing of HPA axis functioning as a complementary tool in suicide prevention.

Anxiety, depression, and the suicidal spectrum: a latent class analysis of overlapping and distinctive features.

PubMed

Podlogar, Matthew C; Rogers, Megan L; Stanley, Ian H; Hom, Melanie A; Chiurliza, Bruno; Joiner, Thomas E

2017-03-20

Anxiety and depression diagnoses are associated with suicidal thoughts and behaviours. However, a categorical understanding of these associations limits insight into identifying dimensional mechanisms of suicide risk. This study investigated anxious and depressive features through a lens of suicide risk, independent of diagnosis. Latent class analysis of 97 depression, anxiety, and suicidality-related items among 616 psychiatric outpatients indicated a 3-class solution, specifically: (1) a higher suicide-risk class uniquely differentiated from both other classes by high reported levels of depression and anxious arousal; (2) a lower suicide-risk class that reported levels of anxiety sensitivity and generalised worry comparable to Class 1, but lower levels of depression and anxious arousal; and (3) a low to non-suicidal class that reported relatively low levels across all depression and anxiety measures. Discriminants of the higher suicide-risk class included borderline personality disorder; report of worthlessness, crying, and sadness; higher levels of anxious arousal and negative affect; and lower levels of positive affect. Depression and anxiety diagnoses were not discriminant between higher and lower suicide risk classes. This transdiagnostic and dimensional approach to understanding the suicidal spectrum contrasts with treating it as a depressive symptom, and illustrates the advantages of a tripartite model for conceptualising suicide risk.

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

Is suicide mortality associated with meteorological and socio-economic factors? An ecological study in a city in Taiwan with a high suicide rate.

PubMed

Wu, Ya Wen; Chen, Chih Ken; Wang, Liang Jen

2014-06-01

Keelung City has the highest suicide rate in Taiwan. This study aimed to determine whether meteorological and socio-economic factors are associated with suicide mortality in Keelung City, by gender and by means of suicide. Data on suicides between January 2006 and December 2010 were provided by the Department of Health, Keelung City Government. The suicide victims were categorized into non-violent and violent groups, based on the International Classification of Disease, Ninth Revision. Meteorological data were obtained from the Central Weather Bureau of Taiwan. Socio-economic data were gathered from the Accounting and Statistics Office, Keelung City Government. Multiple linear regression analysis with backward elimination was performed to determine the model that was most effective in predicting dependent variables. During the 5-year study period, the overall suicide mortality rate was negatively associated with ambient temperature. Male suicide mortality was positively correlated with unemployment, and negatively correlated with ambient temperature, barometric pressure, rainy days, family income and number of holidays. Female suicide mortality and violent suicide mortality were not significantly correlated with any meteorological or socio-economic factors. Non-violent suicide mortality was positively correlated with unemployment, and negatively correlated with ambient temperature, barometric pressure and family income. Suicide is a complex psychopathological phenomenon. Further studies with individual data are warranted to confirm how meteorological and socio-economic conditions influence ones' suicidal behaviour.

Early Substance Use Initiation and Suicide Ideation and Attempts among School-Aged Adolescents in Four Pacific Island Countries in Oceania.

PubMed

Peltzer, Karl; Pengpid, Supa

2015-09-30

This study aimed to investigate the correlations between early initiation (<12 years) of smoking cigarettes, alcohol use, and drug use (cannabis) with suicidal ideation and suicide attempts in school-aged adolescents in four Pacific Island countries in Oceania. The sample included 6540 adolescents (≤13 to ≥16 years old) from Kiribati, Samoa, Solomon Islands, and Vanuatu. Bivariate and multivariable analyses were conducted to assess the association between pre-adolescent substance use initiation and suicidal ideation and suicide attempts. Results indicate a prevalence of 25.8% suicidal ideation in the past 12 months (ranging from 17.2% in Vanuatu to 34.7% in Kiribati) and 34.9% suicide attempts in the past 12 months (ranging from 23.5% in Vanuatu to 62.0% in Samoa). The prevalence of early cigarette smoking initiation was 15.7%, early alcohol initiation 13.8%, and early drug use initiation was 12.9%. Students who reported pre-adolescent substance use initiation, compared with non-substance users, were more likely reporting suicidal ideation and suicide attempts. The concurrent initiation of cigarette smoking, alcohol, and drug use should be targeted in early prevention programmes in order to prevent possible subsequent suicidal behaviours.

Psychosocial factors associated with suicidal ideation among young men exempted from compulsory military or civil service.

PubMed

Appelqvist-Schmidlechner, Kaija; Henriksson, Markus; Joukamaa, Matti; Parkkola, Kai; Upanne, Maila; Stengård, Eija

2011-12-01

The aim of this study was to identify factors associated with suicidal ideation among young men exempted from compulsory military or civil service in Finland. The study involved a total of 356 men exempted from military or civil service. The research data were collected using questionnaires and register data. One third of the young men exempted from compulsory military or civil service reported serious suicidal ideation. Of the men with serious suicidal ideation, one third had attempted suicide. Various childhood adversities and current stressful life events and problems were associated with suicidal ideation. Multivariate logistic regression analysis showed that the following factors were independently associated with suicidal ideation: maternal alcohol-related problems, changes in the family, discord with the boss over the past 12 months, and lack of social support. Accumulation of problems predicted suicidal ideation. Men exempted from compulsory military or civil service comprise an important target group in the prevention of suicide. In order to prevent suicidal behaviour among young men at risk, it is important to address the significance of social support and relationships, and likewise to be aware of early risk indicators such as maternal alcohol-related problems.

The impact of exercise on suicide risk: examining pathways through depression, PTSD, and sleep in an inpatient sample of veterans.

PubMed

Davidson, Collin L; Babson, Kimberly A; Bonn-Miller, Marcel O; Souter, Tasha; Vannoy, Steven

2013-06-01

Suicide has a large public health impact. Although effective interventions exist, the many people at risk for suicide cannot access these interventions. Exercise interventions hold promise in terms of reducing suicide because of their ease of implementation. While exercise reduces depression, and reductions in depressive symptoms are linked to reduced suicidal ideation, no studies have directly linked exercise and suicide risk. The current study examined this association, including potential mediators (i.e., sleep disturbance, posttraumatic stress symptoms, and depression), in a sample of Veterans. SEM analyses revealed that exercise was directly and indirectly associated with suicide risk. Additionally, exercise was associated with fewer depressive symptoms and better sleep patterns, each of which was, in turn, related to lower suicide risk.

Prioritizing research to reduce youth suicide and suicidal behavior.

PubMed

Bridge, Jeffrey A; Horowitz, Lisa M; Fontanella, Cynthia A; Grupp-Phelan, Jackie; Campo, John V

2014-09-01

The goal of the National Action Alliance for Suicide Prevention is to reduce suicide and suicide attempts in the U.S. by 40% in the next decade. In this paper, a public health approach is applied to suicide prevention to illustrate how reductions in youth suicide and suicidal behavior might be achieved by prioritizing research in two areas: (1) increasing access to primary care-based behavioral health interventions for depressed youth and (2) improving continuity of care for youth who present to emergency departments after a suicide attempt. Finally, some scientific, clinical, and methodologic breakthroughs needed to achieve rapid, substantial, and sustained reductions in youth suicide and suicidal behavior are discussed. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Self-harm intentions: can they be distinguished based upon a history of childhood physical and sexual abuse?

PubMed

Santa Mina, Elaine E

2010-12-01

A non-experimental, comparative design is used to measures self-harm intention in clients with and without a history of childhood physical and sexual abuse (CP/SA) presenting to an emergency department with an episode of self-harm behaviour. The traditional suicide literature identifies the key intention concepts of wish-to-die, lethality, hopelessness, and depression. However, the trauma literature understands self-harm behaviour to be an adaptive response to CP/SA and as such possibly helpful for managing intense affect and dissociation. The findings of this study demonstrate that a CP/SA history is not a distinguishing factor in self-harm intention. Almost all participants, regardless of abuse history, gave multiple reasons for their self-harm behaviour, in addition to or other than the wish-to-die. The striking similarity between the non-abused and abused groups with regard to self-harm intention challenges clinicians to assess for the full range of intentions of people who engage in self-harm and suicidal behaviour.

Functional Coping Dynamics and Experiential Avoidance in a Community Sample with No Self-Injury vs. Non-Suicidal Self-Injury Only vs. Those with Both Non-Suicidal Self-Injury and Suicidal Behaviour

PubMed Central

Nielsen, Emma; Sayal, Kapil; Townsend, Ellen

2017-01-01

Although emotional avoidance may be a critical factor in the pathway from psychological distress to self-injury and/or suicidality, little is known about the relative importance of differing functional coping dynamics and experiential avoidance between people with self-injury histories of differing intent (e.g., Non-Suicidal Self-Injury only vs. Non-Suicidal Self-Injury plus Suicidal Behaviour; NSSI vs. NSSI + SB). A community-based survey (N = 313; female, 81%; ages 16–49 years, M = 19.78, SD = 3.48) explored self-reported experiential avoidance and functional coping dynamics in individuals with (i) no self-injury history (controls); (ii) a history of NSSI only; and (iii) a history of NSSI + SB. Jonckheere-Terpstra trend tests indicated that avoidance coping was higher in the NSSI and NSSI + SB groups than in controls. Emotion regulation was higher in controls than those with a history of self-injury (NSSI and NSSI + SB). Approach and reappraisal coping demonstrated significant ordered effects such that control participants were higher in these coping dynamics than those with a history of NSSI only, who, in turn, were higher than those with a history of NSSI + SB (Control > NSSI > NSSI + SB). Endorsement of the reappraisal/denial facet of experiential avoidance was most pronounced in those with a history of NSSI + SB (Control < NSSI < NSSI + SB). No significant ordered effects were observed for other dimensions of experiential avoidance. Understanding how the endorsement of functional coping dynamics and which components of experiential avoidance vary between groups with differing self-injury intent histories has important implications for treatment planning. PMID:28555056

Functional Coping Dynamics and Experiential Avoidance in a Community Sample with No Self-Injury vs. Non-Suicidal Self-Injury Only vs. Those with Both Non-Suicidal Self-Injury and Suicidal Behaviour.

PubMed

Nielsen, Emma; Sayal, Kapil; Townsend, Ellen

2017-05-29

Although emotional avoidance may be a critical factor in the pathway from psychological distress to self-injury and/or suicidality, little is known about the relative importance of differing functional coping dynamics and experiential avoidance between people with self-injury histories of differing intent (e.g., Non-Suicidal Self-Injury only vs. Non-Suicidal Self-Injury plus Suicidal Behaviour; NSSI vs. NSSI + SB). A community-based survey (N = 313; female, 81%; ages 16-49 years, M = 19.78, SD = 3.48) explored self-reported experiential avoidance and functional coping dynamics in individuals with (i) no self-injury history (controls); (ii) a history of NSSI only; and (iii) a history of NSSI + SB. Jonckheere-Terpstra trend tests indicated that avoidance coping was higher in the NSSI and NSSI + SB groups than in controls. Emotion regulation was higher in controls than those with a history of self-injury (NSSI and NSSI + SB). Approach and reappraisal coping demonstrated significant ordered effects such that control participants were higher in these coping dynamics than those with a history of NSSI only, who, in turn, were higher than those with a history of NSSI + SB (Control > NSSI > NSSI + SB). Endorsement of the reappraisal/denial facet of experiential avoidance was most pronounced in those with a history of NSSI + SB (Control < NSSI < NSSI + SB). No significant ordered effects were observed for other dimensions of experiential avoidance. Understanding how the endorsement of functional coping dynamics and which components of experiential avoidance vary between groups with differing self-injury intent histories has important implications for treatment planning.

Suicide Deaths of Active-Duty U.S. Military and Omega-3 Fatty-Acid Status: A Case-Control Comparison

DTIC Science & Technology

2011-01-01

consumed at US military dining facilities, available restaurants , and choices made at home.35 Low DHA status can be readily reversed using low-cost...Finnish subjects, consuming fish less than twice per week was associated with a higher risk of depressive symptoms and suicidal thinking.8 Low DHA...Neurobiology of suicidal behaviour . Nat Rev Neurosci. 2003; 4(10):819–828. doi:10.1038/nrn1220 PubMed 24. McNamara RK, Able J, Jandacek R, et al

Health Professionals' Explanations of Suicidal Behaviour: Effects of Professional Group, Theoretical Intervention Model, and Patient Suicide Experience.

PubMed

Rothes, Inês Areal; Henriques, Margarida Rangel

2017-12-01

In a help relation with a suicidal person, the theoretical models of suicidality can be essential to guide the health professional's comprehension of the client/patient. The objectives of this study were to identify health professionals' explanations of suicidal behaviors and to study the effects of professional group, theoretical intervention models, and patient suicide experience in professionals' representations. Two hundred and forty-two health professionals filled out a self-report questionnaire. Exploratory principal components analysis was used. Five explanatory models were identified: psychological suffering, affective cognitive, sociocommunicational, adverse life events, and psychopathological. Results indicated that the psychological suffering and psychopathological models were the most valued by the professionals, while the sociocommunicational was seen as the least likely to explain suicidal behavior. Differences between professional groups were found. We concluded that training and reflection on theoretical models in general and in communicative issues in particular are needed in the education of health professionals.

Suicide intervention and non-ideal Kantian theory.

PubMed

Cholbi, Michael J

2002-01-01

Philosophical discussions of the morality of suicide have tended to focus on its justifiability from an agent's point of view rather than on the justifiability of attempts by others to intervene so as to preserve it. This paper addresses questions of suicide intervention within a broadly Kantian perspective. In such a perspective, a chief task is to determine the motives underlying most suicidal behaviour. Kant wrongly characterizes this motive as one of self-love or the pursuit of happiness. Psychiatric and scientifc evidence suggests that suicide is instead motivated by nihilistic disenchantment with the possibility of happiness which, at its apex, results in the loss of the individual's conception of her practical identity. Because of this, methods of intervention that appeal to agents' happiness, while morally benign, will prove ineffective in forestalling suicide. At the same time, more aggressive methods violate the Kantian concern for autonomy. This apparent dilemma can be resolved by seeing suicide intervention as an action undertaken in non-ideal circumstances, where otherwise unjustified manipulation, coercion, or paternalism are morally permitted.

The role of sleep disturbance in the relationship between post-traumatic stress disorder and suicidal ideation.

PubMed

Betts, Kim Steven; Williams, Gail M; Najman, Jacob M; Alati, Rosa

2013-10-01

We tested if the risk of suicidal ideation in individuals with PTSD symptoms was dependent on comorbid sleep disturbance. Our cross-sectional sample included 2465 participants with complete data from the 21 year follow-up of the Mater University Study of Pregnancy (MUSP), a birth cohort study of young Australians. Using structural equation modelling with indirect pathways we found that 12 month PTSD symptoms did not directly predict suicidal ideation at 21 when adjusting for major depression symptoms, polyvictimization and gender. However, PTSD symptoms had an indirect effect on suicidal ideation via past-month sleep disturbance. Our results suggest that increased suicidal ideation in those with PTSD may result from the fact that PTSD sufferers often exhibit other comorbid psychiatric conditions which are themselves known to predict suicidal behaviours. Sleep disturbance may be targeted in those who experience PTSD to help prevent suicidal ideation. Copyright © 2013 Elsevier Ltd. All rights reserved.

Investigation of Social, Emotional, and Cognitive Factors with Effect on Suicidal Behaviour in Adolescents with Depression.

PubMed

Soylu, Nusret; Taneli, Yeşim; Taneli, Suna

2013-12-01

Our study aimed at investigating social, emotional, and cognitive factors playing a role in the development of suicidal ideation in depressed adolescents and its turning into a suicide attempt. Sixty-three adolescents (48 female, 15 male) aged 12 to 18 years were included in the study. In face-to-face interviews, suicide ideation, suicide plans, and previous suicide attempts were evaluated, sociodemographic data were collected. Additionally, the Children's Depression Inventory, State-Trait Anxiety Inventory (STAI-I, II), Beck Hopelessness Scale, Coopersmith Self-Esteem Inventory, Multidimensional Scale of Perceived Social Support, Strengths and the Difficulties Questionnaire (SDQ) parent forms were applied. SPSS version 13.0 for Windows was used for statistical analysis. It has been established that in the last six months, 71.4% of cases (n=45) had suicidal ideation and 27% (n=17) attempted suicide. Factors associated with suicidal ideation in depressed adolescents were: high depression and anxiety levels, hopelessness and low self-esteem (p<0.05). Factors associated with suicide attempts were: separated family background, lower perceived family support and high rates of conduct difficulties (p<0.05). Patients with suicide attempt differed from patients with suicidal ideation but without suicide attempt in lower perceived family support only (p<0.05). It is thought that keeping in mind the factors associated with the development of suicidal ideation and its turning into a suicide attempt, will help clinicians in preventing suicide attempts in depressed adolescents.

Military Suicide Research Consortium

DTIC Science & Technology

2015-10-01

physical and sexual abuse and lifetime number of suicide attempts: A persistent and theoretically important relationship. Behaviour Research & Therapy ...meeting of the Association of Behavioral and Cognitive Therapies , Chicago, IL. Norr, A. M., Allan, N. P., Macatee, R. J., Capron, D. W., & Schmidt, N. B...presentation to the annual Association for Behavioral and Cognitive Therapies conference, Chicago, IL. >>Dr. Craig Bryan had the following: Bryan, C.J

Psychological and physical pain as predictors of suicide risk: evidence from clinical and neuroimaging findings.

PubMed

Rizvi, Sakina J; Iskric, Adam; Calati, Raffaella; Courtet, Philippe

2017-03-01

Suicide is a multidimensional clinical phenomenon with complex biological, social and psychological risk factors. Therefore, it is imperative for studies to focus on developing a unified understanding of suicide risk that integrates current clinical and neurobiological findings. A recent line of research has implicated different classifications of pain in understanding suicide risk, including the concepts of psychache and pain tolerance. Although psychache is defined as the experience of unbearable psychological pain, pain tolerance refers to the greatest duration or intensity of painful stimuli that one is able to bear. This review will focus on integrating current clinical and neurobiological findings by which psychache and pain tolerance confer suicide risk. Results indicate that psychache has been identified as a significant risk factor for suicide and that psychache may be associated with the neurocircuitry involved in the modulation of physical pain. Converging evidence has also been found linking pain tolerance to self-injurious behaviours and suicide risk. The experience of psychache and physical pain in relation to other predictors of suicide, including reward processing, hopelessness and depression, are further discussed. Future research examining the pain-suicide connection is required to understand the mechanism behind clinically relevant risk factors for suicide, which can ultimately inform the construction of empirically supported suicide risk assessment and intervention techniques.

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.

Perceived Stigma of Sudden Bereavement as a Risk Factor for Suicidal Thoughts and Suicide Attempt: Analysis of British Cross-Sectional Survey Data on 3387 Young Bereaved Adults.

PubMed

Pitman, Alexandra; Rantell, Khadija; Marston, Louise; King, Michael; Osborn, David

2017-03-09

The sudden death of a friend or relative, particularly by suicide, is a risk factor for suicide. People who experience sudden bereavement report feeling highly stigmatised by the loss, potentially influencing access to support. We assessed whether perceived stigma following sudden bereavement is associated with suicidal thoughts and suicide attempt. We analysed cross-sectional survey data on 3387 young adults bereaved by the sudden death of a close contact. We tested the association of high versus low perceived stigma (on the stigma sub-scale of the Grief Experience Questionnaire) with post-bereavement suicidal ideation and suicide attempt, using random effects logistic regression, adjusting for socio-demographic factors, pre-bereavement psychopathology, and mode of sudden bereavement (natural causes/unnatural causes/suicide). Subjects with high perceived stigma scores were significantly more likely to report post-bereavement suicidal thoughts (adjusted odds ratio (AOR) = 2.74; 95% confidence interval (CI) = 1.93-3.89) and suicide attempt (AOR = 2.73; 95% CI = 2.33-3.18) than those with low stigma scores. People who feel highly stigmatised by a sudden bereavement are at increased risk of suicidal thoughts and suicide attempt, even taking into account prior suicidal behaviour. General practitioners, bereavement counsellors, and others who support people bereaved suddenly, should consider inquiring about perceived stigma, mental wellbeing, and suicidal thoughts, and directing them to appropriate sources of support.

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.

Short Personality and Life Event scale for detection of suicide attempters.

PubMed

Artieda-Urrutia, Paula; Delgado-Gómez, David; Ruiz-Hernández, Diego; García-Vega, Juan Manuel; Berenguer, Nuria; Oquendo, Maria A; Blasco-Fontecilla, Hilario

2015-01-01

To develop a brief and reliable psychometric scale to identify individuals at risk for suicidal behaviour. Case-control study. 182 individuals (61 suicide attempters, 57 psychiatric controls, and 64 psychiatrically healthy controls) aged 18 or older, admitted to the Emergency Department at Puerta de Hierro University Hospital in Madrid, Spain. All participants completed a form including their socio-demographic and clinical characteristics, and the Personality and Life Events scale (27 items). To assess Axis I diagnoses, all psychiatric patients (including suicide attempters) were administered the Mini International Neuropsychiatric Interview. Descriptive statistics were computed for the socio-demographic factors. Additionally, χ(2) independence tests were applied to evaluate differences in socio-demographic and clinical variables, and the Personality and Life Events scale between groups. A stepwise linear regression with backward variable selection was conducted to build the Short Personality Life Event (S-PLE) scale. In order to evaluate the accuracy, a ROC analysis was conducted. The internal reliability was assessed using Cronbach's α, and the external reliability was evaluated using a test-retest procedure. The S-PLE scale, composed of just 6 items, showed good performance in discriminating between medical controls, psychiatric controls and suicide attempters in an independent sample. For instance, the S-PLE scale discriminated between past suicide and past non-suicide attempters with sensitivity of 80% and specificity of 75%. The area under the ROC curve was 88%. A factor analysis extracted only one factor, revealing a single dimension of the S-PLE scale. Furthermore, the S-PLE scale provides values of internal and external reliability between poor (test-retest: 0.55) and acceptable (Cronbach's α: 0.65) ranges. Administration time is about one minute. The S-PLE scale is a useful and accurate instrument for estimating the risk of suicidal behaviour in settings where the time is scarce. Copyright © 2015 SEP y SEPB. Published by Elsevier España. All rights reserved.

Associations between Cyberbullying and School Bullying Victimization and Suicidal Ideation, Plans and Attempts among Canadian Schoolchildren

PubMed Central

Sampasa-Kanyinga, Hugues; Roumeliotis, Paul; Xu, Hao

2014-01-01

Purpose The negative effects of peer aggression on mental health are key issues for public health. The purpose of this study was to examine the associations between cyberbullying and school bullying victimization with suicidal ideation, plans and attempts among middle and high school students, and to test whether these relationships were mediated by reports of depression. Methods Data for this study are from the 2011 Eastern Ontario Youth Risk Behaviour Survey, which is a cross-sectional regional school-based survey that was conducted among students in selected Grade 7 to 12 classes (1658 girls, 1341 boys; mean±SD age: 14.3±1.8 years). Results Victims of cyberbullying and school bullying incurred a significantly higher risk of suicidal ideation (cyberbullying: crude odds ratio, 95% confidence interval  = 3.31, 2.16–5.07; school bullying: 3.48, 2.48–4.89), plans (cyberbullying: 2.79, 1.63–4.77; school bullying: 2.76, 2.20–3.45) and attempts (cyberbullying: 1.73, 1.26–2.38; school bullying: 1.64, 1.18–2.27) compared to those who had not encountered such threats. Results were similar when adjusting for sociodemographic characteristics, substance use, and sedentary activities. Mediation analyses indicated that depression fully mediated the relationship between cyberbullying victimization and each of the outcomes of suicidal ideation, plans and attempts. Depression also fully mediated the relationship between school bullying victimization and suicide attempts, but partially mediated the relationship between school bullying victimization and both suicidal ideation and plans. Conclusion These findings support an association between both cyberbullying and school bullying victimization and risk of suicidal ideation, plans and attempts. The mediating role of depression on these links justifies the need for addressing depression among victims of both forms of bullying to prevent the risk of subsequent suicidal behaviours. PMID:25076490

Associations between cyberbullying and school bullying victimization and suicidal ideation, plans and attempts among Canadian schoolchildren.

PubMed

Sampasa-Kanyinga, Hugues; Roumeliotis, Paul; Xu, Hao

2014-01-01

The negative effects of peer aggression on mental health are key issues for public health. The purpose of this study was to examine the associations between cyberbullying and school bullying victimization with suicidal ideation, plans and attempts among middle and high school students, and to test whether these relationships were mediated by reports of depression. Data for this study are from the 2011 Eastern Ontario Youth Risk Behaviour Survey, which is a cross-sectional regional school-based survey that was conducted among students in selected Grade 7 to 12 classes (1658 girls, 1341 boys; mean ± SD age: 14.3 ± 1.8 years). Victims of cyberbullying and school bullying incurred a significantly higher risk of suicidal ideation (cyberbullying: crude odds ratio, 95% confidence interval  = 3.31, 2.16-5.07; school bullying: 3.48, 2.48-4.89), plans (cyberbullying: 2.79, 1.63-4.77; school bullying: 2.76, 2.20-3.45) and attempts (cyberbullying: 1.73, 1.26-2.38; school bullying: 1.64, 1.18-2.27) compared to those who had not encountered such threats. Results were similar when adjusting for sociodemographic characteristics, substance use, and sedentary activities. Mediation analyses indicated that depression fully mediated the relationship between cyberbullying victimization and each of the outcomes of suicidal ideation, plans and attempts. Depression also fully mediated the relationship between school bullying victimization and suicide attempts, but partially mediated the relationship between school bullying victimization and both suicidal ideation and plans. These findings support an association between both cyberbullying and school bullying victimization and risk of suicidal ideation, plans and attempts. The mediating role of depression on these links justifies the need for addressing depression among victims of both forms of bullying to prevent the risk of subsequent suicidal behaviours.

Biological indicators of suicide risk in youth with mood disorders: what do we know so far?

PubMed

Lewitzka, Ute; Doucette, Sarah; Seemüller, Florian; Grof, Paul; Duffy, Anne C

2012-12-01

Suicidal behaviour in youth is a major public health concern worldwide, and youth in the early stages of a primary mood disorder are an identifiable high-risk population. Neurobiological research in youth at risk for suicidality has sought to investigate the most promising parameters from research in adults. The present paper provides an overview of the current findings of neurobiological research in children and adolescents with mood disorders and suicidality including genetic/epigenetic findings, neuro-hormonal and immunological investigations. Longitudinal research in high-risk youth is a powerful way to investigate the influences and their pathways in determining suicidal risk in the context of a developing mood disorder. In the meantime, there are clear clinical indicators of risk to help identify youth who would benefit from close surveillance and early intervention.

Adolescent suicide in Ghana: A content analysis of media reports

PubMed Central

Quarshie, Emmanuel Nii-Boye; Osafo, Joseph; Akotia, Charity S.; Peprah, Jennifer

2015-01-01

Adolescent suicide is now a major health concern for many countries. However, there is paucity of systematic studies and lack of official statistics on adolescent suicide in Ghana. Mass media coverage of adolescent suicide (even though crude), at least, may reflect the reality of the phenomenon. With an ecological orientation, this study used qualitative content analysis to analyse the pattern of 44 media reports of adolescent suicide in Ghana from January 2001 through September 2014. Results showed that hanging was the dominant method used. The behaviour usually takes place within or near the adolescent's home environment. The act was often attributed to precursors within the microsystem (family and school) of the deceased. This study serves a seminal function for future empirical studies aimed at deeper examination of the phenomenon in order to inform prevention programmes. PMID:26015405

Treatment of Depression and Suicide in Older Adults

ERIC Educational Resources Information Center

Bhar, Sunil S.; Brown, Gregory K.

2012-01-01

This article describes a cognitive behavior therapy (CBT) intervention for suicide prevention in older adults. Although many studies have found that CBT interventions are efficacious for reducing depressive symptoms in the elderly, researchers have yet to evaluate the efficacy of such interventions for preventing suicide or reducing suicide risk…

Childhood-onset schizophrenia: what do we really know?

PubMed Central

Bartlett, Jennifer

2014-01-01

Childhood-onset schizophrenia (COS) is a rare, chronic mental illness that is diagnosed in children prior to the age of 13. COS is a controversial diagnosis among clinicians and can be very difficult to diagnose for a number of reasons. Schizophrenia is a psychotic disorder characterized by hallucinations, delusions, flat affect, limited motivation and anhedonia. The psychotic nature of this disorder is quite disruptive to the child's emotional regulation, behavioural control and can reduce the child's ability to perform daily tasks that are crucial to adaptive functioning. Prior to the onset of schizophrenia, children often develop premorbid abnormalities, which are disturbances to a child's functioning that may serve as warning signs. These disturbances can manifest in a variety of behavioural ways and may include introversion, depression, aggression, suicidal ideation and manic-like behaviours. This article will review the clinical presentation of schizophrenia in children and examine the existing knowledge around aetiology, treatment approaches, assessment techniques and differential diagnostic considerations. Gaps in the literature are identified and directions for future research are discussed. PMID:25750815

Factors Associated with Deliberate Self-Harm Behaviour among Depressed Adolescent Outpatients

ERIC Educational Resources Information Center

Tuisku, Virpi; Pelkonen, Mirjami; Kiviruusu, Olli; Karlsson, Linnea; Ruuttu, Titta; Marttunen, Mauri

2009-01-01

This study examined whether depressed adolescent outpatients with deliberate self-harm behaviour (DSH) differed from non-suicidal depressed adolescent outpatients in depressive and anxiety symptoms, alcohol use, perceived social support and number of negative life-events. Depressed adolescent outpatients (n = 155) aged 13-19 years were interviewed…

Associations among Adolescent Risk Behaviours and Self-Esteem in Six Domains

ERIC Educational Resources Information Center

Wild, Lauren G.; Flisher, Alan J.; Bhana, Arvin; Lombard, Carl

2004-01-01

Background: This study investigated associations among adolescents' self-esteem in 6 domains (peers, school, family, sports/athletics, body image and global self-worth) and risk behaviours related to substance use, bullying, suicidality and sexuality. Method: A multistage stratified sampling strategy was used to select a representative sample of…

CSF and plasma testosterone in attempted suicide.

PubMed

Stefansson, Jon; Chatzittofis, Andreas; Nordström, Peter; Arver, Stefan; Åsberg, Marie; Jokinen, Jussi

2016-12-01

Very few studies have assessed testosterone levels in the cerebrospinal fluid in suicide attempters. Aggressiveness and impulsivity are common behavioural traits in suicide attempters. Dual-hormone serotonergic theory on human impulsive aggression implies high testosterone/cortisol ratio acting on the amygdala and low serotonin in the prefrontal cortex. Our aim was to examine the CSF and plasma testosterone levels in suicide attempters and in healthy volunteers. We also assessed the relationship between the testosterone/cortisol ratio, aggressiveness and impulsivity in suicide attempters. 28 medication-free suicide attempters and 19 healthy volunteers participated in the study. CSF and plasma testosterone sulfate and cortisol levels were assessed with specific radio-immunoassays. The Karolinska Scales of Personality was used to assess impulsivity and aggressiveness. All patients were followed up for cause of death. The mean follow-up period was 21 years. Male suicide attempters had higher CSF and plasma testosterone levels than age- matched male healthy volunteers. There were no significant differences in CSF testosterone levels in female suicide attempters and healthy female volunteers. Testosterone levels did not differ significantly in suicide victims compared to survivors. In male suicide attempters, the CSF testosterone/cortisol ratio showed a significant positive correlation with both impulsivity and aggressiveness. Higher CSF testosterone levels may be associated with attempted suicide in young men through association with both aggressiveness and impulsivity, a key endophenotype in young male suicide attempters. Copyright © 2016 Elsevier Ltd. All rights reserved.

Cognitive vulnerability to depression in young people in secure accommodation: the influence of ethnicity and current suicidal ideation.

PubMed

Woolgar, Matthew; Tranah, Troy

2010-10-01

Young people in secure accommodation are at high risk of depression and self-harm. This study investigates the relationship between depressive symptoms, negative self-schemas and the cognitive vulnerability to depression in 38 young people in secure accommodation. The impact of a) current suicidal ideation and b) a previous history of self-harm behaviour on latent negative self-schemas was examined using a mood induction task. The low mood condition indicated these young people had a latent cognitive vulnerability to depression. However, this vulnerability was exacerbated in the context of current suicidal ideation but not by a history of self-harm behaviours. An unexpected finding was the negative self-schemas of young people from ethnic minority backgrounds were particularly susceptible to the mood induction. The findings are discussed both in terms of the cognitive vulnerabilities of adolescents detained in secure accommodation and the role of participant characteristics on the validity of mood induction studies in adolescence.

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.

Treating the Capability for Suicide: A Vital and Understudied Frontier in Suicide Prevention.

PubMed

Anestis, Michael D; Law, Keyne C; Jin, Hyejin; Houtsma, Claire; Khazem, Lauren R; Assavedo, Brittney L

2017-10-01

Current efforts at suicide prevention center largely on reducing suicidal desire among individuals hospitalized for suicidality or being treated for related psychopathology. Such efforts have yielded evidence-based treatments, and yet the national suicide rate has continued to climb. We propose that this disconnect is heavily influenced by an unmet need to consider population-level interventions aimed at reducing the capability for suicide. Drawing on lessons learned from other public health phenomena that have seen drastic declines in frequency in recent decades (HIV, lung cancer, motor vehicle accidents), we propose that current suicidality treatment efforts trail current suicidality theories in their lack of focus on the extent to which individuals thinking about suicide are capable of transitioning from ideation to attempt. We summarize extant evidence for specific capability-centered approaches (e.g., means safety) and propose other options for improving our ability to address this largely overlooked variable. We also note that population-level approaches in this regard would represent an important opportunity to decrease risk in individuals who either lack access to evidence-based care or underreport suicidal ideation, as a reduced capability for suicide would theoretically diminish the potency of suicidal desire and, in this sense, lower the odds of a transition from ideation to attempt. © 2016 The American Association of Suicidology.

Prevalence Comparison of Past-year Mental Disorders and Suicidal Behaviours in the Canadian Armed Forces and the Canadian General Population

PubMed Central

Zamorski, Mark A.; Boulos, David; Garber, Bryan G.

2016-01-01

Objective: Military personnel in Canada and elsewhere have been found to have higher rates of certain mental disorders relative to their corresponding general populations. However, published Canadian data have only adjusted for age and sex differences between the populations. Additional differences in the sociodemographic composition, labour force characteristics, and childhood trauma exposure in the populations could be driving these prevalence differences. Our objective is to compare the prevalence of past-year mental disorders and suicidal behaviours in the Canadian Armed Forces Regular Force with the rates in a representative, matched sample of Canadians in the general population (CGP). Methods: Data sources were the 2013 Canadian Forces Mental Health Survey and the 2012 Canadian Community Health Survey–Mental Health. CGP sample was restricted to match the age range, employment status, and history of chronic conditions of Regular Force personnel. An iterative proportional fitting method was used to approximate the marginal distribution of sociodemographic and childhood trauma variables in both samples. Results: Relative to the matched CGP, Regular Force personnel had significantly higher rates of past-year major depressive episode, generalized anxiety disorder, and suicide ideation. However, lower rates of alcohol use disorder were seen in Regular Force personnel relative to the matched CGP sample. Conclusions: Factors other than differences in sociodemographic composition and history of childhood trauma account for the excess burden of mental disorders and suicidal behaviours in the Canadian Armed Forces. Explanations to explore in future research include occupational trauma, selection effects, and differences in the context of administration of the 2 surveys. PMID:27270741

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.…

Firearms and suicide in US cities.

PubMed

Miller, Matthew; Warren, Molly; Hemenway, David; Azrael, Deborah

2015-04-01

On an average day in the USA more than 100 Americans die by suicide-half use firearms. Suicide rates overall and by firearms are higher, on average, in states where household firearm ownership is more common. In general this means in states where a greater proportion of the population lives in rural areas. The current ecological study focuses on the relation between measures of household firearm prevalence and suicide mortality in urban areas (metropolitan statistical areas and divisions) using survey-based measures of firearm ownership. Suicide rates (1999-2010) for metropolitan statistical areas that are comprised of large US cities come from death certificate records; rates of household firearm ownership come from the 2002 and 2004 Behavioural Risk Factor Surveillance System. Higher rates of firearm ownership are strongly associated with higher rates of overall suicide and firearm suicide, but not with non-firearm suicide. Stratification by gender, age and race did not materially affect the association between firearms and suicide. This study provides evidence consistent with previous case-control work and extends evidence from previous state- and region-level ecological studies that firearms in the home impose suicide risk above and beyond baseline. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Risk profiles of personality traits for suicidality among mood disorder patients and community controls.

PubMed

Su, M-H; Chen, H-C; Lu, M-L; Feng, J; Chen, I-M; Wu, C-S; Chang, S-W; Kuo, P-H

2018-01-01

To examine the associations between personality traits and suicidal ideation (SI) and attempt (SA) in mood disorder patients and community controls. We recruited 365 bipolar, 296 major depressive disorder patients, and 315 community controls to assess their lifetime suicidality. Participants filled out self-reported personality questionnaires to collect data of personality traits, including novelty seeking (NS), harm avoidance (HA), extraversion (E), and neuroticism (N). We used logistic regression models adjusted for diagnoses to analyze combinational effects of personality traits on the risk of suicide. Additionally, radar charts display personality profiles for suicidal behaviours by groups. All personality traits were associated with the risk of suicidality with various effect size, except for E that showed protective effect. High N or HA had prominent and independent risk effects on SI and SA. Combinations of high N and low E, or high HA and NS were the risk personality profiles for suicidality. Higher N scores further distinguished SA from SI in mood disorder patients. Introvert personality traits showed independent risk effects on suicidality regardless of diagnosis status. Among high-risk individuals with suicidal thoughts, higher neuroticism tendency is further associated with increased risk of suicide attempt. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Potential Mediating Pathways through Which Sports Participation Relates to Reduced Risk of Suicidal Ideation

ERIC Educational Resources Information Center

Taliaferro, Lindsay A.; Rienzo, Barbara A.; Miller, M. David; Pigg, R. Morgan; Dodd, Virginia J.

2010-01-01

Suicide ranks as the third leading cause of death for American youth. Researchers examining sport participation and suicidal behavior have regularly found inverse relationships. This study represents the first effort to test a model depicting potential mechanisms through which sport participation relates to reduced risk of suicidal ideation. The…

Association of suicide attempts with acne and treatment with isotretinoin: retrospective Swedish cohort study

PubMed Central

Alfredsson, Lars; Sjölin-Forsberg, Gunilla; Gerdén, Barbro; Bergman, Ulf; Jokinen, Jussi

2010-01-01

Objective To assess the risk of attempted suicide before, during, and after treatment with isotretinoin for severe acne. Design Retrospective cohort study linking a named patient register of isotretinoin users (1980-9) to hospital discharge and cause of death registers (1980-2001). Setting Sweden, 1980-2001. Population 5756 patients aged 15 to 49 years prescribed isotretinoin for severe acne observed for 17 197 person years before, 2905 person years during, and 87 120 person years after treatment. Main outcome measures Standardised incidence ratio (observed number divided by expected number of suicide attempts standardised by sex, age, and calendar year), calculated up to three years before, during, and up to 15 years after end of treatment. Results 128 patients were admitted to hospital for attempted suicide. During the year before treatment, the standardised incidence ratio for attempted suicide was raised: 1.57 (95% confidence interval 0.86 to 2.63) for all (including repeat) attempts and 1.36 (0.65 to 2.50) counting only first attempts. The standardised incidence ratio during and up to six months after treatment was 1.78 (1.04 to 2.85) for all attempts and 1.93 (1.08 to 3.18) for first attempts. Three years after treatment stopped, the observed number of attempts was close to the expected number and remained so during the 15 years of follow-up: standardised incidence ratio 1.04 (0.74 to 1.43) for all attempts and 0.97 (0.64 to 1.40) for first attempts. Twelve (38%) of 32 patients who made their first suicide attempt before treatment made a new attempt or committed suicide thereafter. In contrast, 10 (71%) of the 14 who made their first suicide attempt within six months after treatment stopped made a new attempt or committed suicide during follow-up (two sample test of proportions, P=0.034). The number needed to harm was 2300 new six month treatments per year for one additional first suicide attempt to occur and 5000 per year for one additional repeat attempt. Conclusions An increased risk of attempted suicide was apparent up to six months after the end of treatment with isotretinoin, which motivates a close monitoring of patients for suicidal behaviour for up to a year after treatment has ended. However, the risk of attempted suicide was already rising before treatment, so an additional risk due to the isotretinoin treatment cannot be established. As patients with a history of suicide attempts before treatment made new attempts to a lesser extent than did patients who started such behaviour in connection with treatment, patients with severe acne should not automatically have isotretinoin treatment withheld because of a history of attempted suicide. PMID:21071484

The moderating impact of childhood adversity profiles and conflict on psychological health and suicidal behaviour in the Northern Ireland population.

PubMed

McLafferty, Margaret; O'Neill, Siobhan; Murphy, Sam; Armour, Cherie; Ferry, Finola; Bunting, Brendan

2018-04-01

Childhood adversities are key etiological factors in the onset and persistence of psychopathology. In Northern Ireland the Troubles also impacted on the population's psychological health. This study used data from the Northern Ireland Study of Health and Stress a collaborative epidemiological study which used the WMH-CIDI to assess mental health disorders in a nationally representative sample (Part 2, n = 1986). The aims of the study were to assess co-occurrences of childhood adversities and investigate the impact of adversity profiles and conflict experience on psychopathology and suicidal behaviour. Latent Class Analysis uncovered 3 discrete childhood adversity profiles, a low, medium, and high risk class. Individuals from higher risk adversity profiles displayed significantly increased odds of having psychological problems, with conflict exposure also impacting on psychopathology. However, the study revealed that the impact of conflict exposure on suicidal behaviour was moderated by latent class membership and that some adversity may actually be protective. The findings highlight the need to consider that, while adversity can have a negative impact on psychopathology, a lack of adversity early in life may hinder some people from developing adequate coping strategies. Further research is required to identify adversity patterns and other interacting factors that are protective. Copyright © 2018 Elsevier B.V. All rights reserved.

Experiences of parents whose sons or daughters have (had) attempted suicide.

PubMed

Buus, Niels; Caspersen, Jimmy; Hansen, Rasmus; Stenager, Elsebeth; Fleischer, Elene

2014-04-01

The aim of this exploratory study was to gain further insights into the experiences of parents of sons or daughters who have attempted suicide and how these parents respond to the increased psychosocial burden following the suicide attempt(s). Suicide is a major public health problem and relatives are understood as playing an important role in suicide prevention; however, suicide and suicidal behaviour affect the relatives' lives profoundly, both emotionally and socially, and the psychosocial impact on families is underresearched. Focus groups with parents of sons or daughters who have attempted suicide. In January and February 2012, we interviewed two groups of parents recruited at a counselling programme for relatives of persons who have attempted suicide. The analysis combined a thematic analysis with a subsequent analysis of how the themes were negotiated in the conversational interactions. The findings were interpreted and discussed within an interactionist framework. The participants in the study described their experiences as a double trauma, which included the trauma of the suicide attempt(s) and the subsequent psychosocial impact on the family's well-being. The pressure on the parents was intense and the fundamentally unpredictable character of suicide attempts was frequently emphasized. Being the parent of a child who attempts suicide meant managing a life-threatening situation and the additional moral stigma. In part, the participants did this in the group by negotiating the character of the suicide attempt(s) and who was responsible. © 2013 John Wiley & Sons Ltd.

[Suicide risk factors in the professional military personnel in the Army of Serbia].

PubMed

Dedić, Gordana; Panić, Milivoje

2010-04-01

Recognition of suicide risk factors is important in taking adequate suicide preventive measures, Suicide Prevention Program for Professional Military Personnel (PMP) implemented in the Army of Serbia in 2003. The aim of our study was to establish suicide risk factors in PMP of the Army of Serbia. Analysis of suicide risk factors in PMP was carried out on the basis of data obtained by psychological suicide autopsy. The controls were demographically similar psychiatric outpatients with no history of suicidal behaviour. A descriptive statistics method was used for risk factors analysis. The t-test was used for testing statistical hypotheses. A total of 30 PMP, aged 22-49 years (30.53 +/- 6.24 on average) committed suicide within the period 1998-2007. Distal suicide risk factors in PMP were considered to be not being married, psychiatric heredity, having no outpatient psychiatric treatment, gambling, regular physical practice (bodybuilding), less transfer to a different post, low motivation for military service (p < 0.001), not having children, parental loss in early childhood, alcohol abuse (p < 0.005), low salary (p < 0.01) uncompleted military school, debts in the family (p < 0.05). The commonest proximal suicide risk factors were: actual family problems (36.6%), actual mental problems (13.3%), burnout (13.3%), negative balance of accounts (13.3%), professional problems (6.7%), behavioral model while for 10.0% PMP suicide risk factors could not be established. According to the presence of multiple suicide risk factors, Suicide Prevention Program for PMP in the Army of Serbia is directed to the prevention of both proximal and distal suicide risk factors.

A comparison of the manifest content in dreams of suicidal, depressed and violent patients.

PubMed

Firth, S T; Blouin, J; Natarajan, C; Blouin, A

1986-02-01

The manifest dream content of psychiatric in-patients who had been admitted because of suicidal attempts was compared with three in-patient control groups, patients who had been admitted for: a) depression and suicidal ideation without attempt; b) depression with no suicidal ideation and; c) commission of a violent act without suicidality. Standardized tests of dream content were used as well as the Beck scale for depression and certain subscales of the MMPI. The results confirmed that both suicidal and violent patients have more death content and destructive violence in their dreams, but that this was a function of the severity of depression and certain character traits such as impulsivity rather than being specific to the behaviour itself. The dream content is continuous with, and probably reflects, the waking state in the case of the depressives. On the other hand some of the findings require a more complex dynamic explanation lending some support to the idea that the dream may have an adaptive function.

Now or later? Understanding the etiologic period of suicide

PubMed Central

Vandoros, Sotiris; Kavetsos, Georgios

2015-01-01

Previous research shows that the announcement of austerity measures leads to an immediate and short-lived increase in behaviour that demonstrates anxiety, stress, frustration and other mental effects. This paper uses evidence from the same natural experiment to study whether, for a given decision to commit suicide (as documented by the overall increase over the study period), suicides follow immediately after the announcement of austerity measures in Greece; or whether this is an effect that matures in peoples' minds before being transformed into action. We use evidence from a natural experiment and follow an econometric approach. Our findings show that, despite an overall sharp increase in suicides over the study period, the increase does not follow immediately in the first few days after each such negative event. This suggests that suicides are not spontaneous. They are rather decisions that take time to mature. This time lag implies that suicides arguably attributed to recessions are, in principle, preventable and underlines the importance of mental health services. PMID:26844154

Can music preference indicate mental health status in young people?

PubMed

Baker, Felicity; Bor, William

2008-08-01

In the aftermath of the double suicide of two teenage girls in 2007, the media linked the themes of 'emo' music and the girls' mental state. But it is not just emo music that has been the subject of scrutiny by the media. Rap music, country, and heavy metal have also been blamed for antisocial behaviours including violence, theft, promiscuity and drug use. It remains an important research and clinical question as to whether music contributes to the acting out of behaviours described in the music lyrics or whether the preferred music represents the already existing behavioural tendencies in the subject. This paper surveys and discusses the relevant literature on music preference and adolescent music listening behaviours, and their links with adolescent mental health. Studies have found a relationship between various genres of music and antisocial behaviours, vulnerability to suicide, and drug use. However, studies reject that music is a causal factor and suggest that music preference is more indicative of emotional vulnerability. A limited number of studies have found correlations between music preference and mental health status. More research is needed to determine whether music preferences of those with diagnosed mental health issues differ substantially from the general adolescent population.

Suicide attempts and emergency room psychiatric consultation.

PubMed

Zeppegno, Patrizia; Gramaglia, Carla; Castello, Luigi Mario; Bert, Fabrizio; Gualano, Maria Rosaria; Ressico, Francesca; Coppola, Isabella; Avanzi, Gian Carlo; Siliquini, Roberta; Torre, Eugenio

2015-02-05

Suicidal behaviours are major public health concerns worldwide. They are associated with risk factors that vary with age and gender, occur in combination, and may change over time. The aim of our study was to investigate how frequently patients visiting a hospital emergency room (ER) require a psychiatric consultation for attempted suicide, and to outline the characteristics of this population. Determinants of emergency room visits for psychiatric reasons were studied prospectively from 2008 to 2011 at the "Maggiore" Hospital in Novara. 280 out of 1888 patients requiring psychiatric consultation were referred to the ER because of suicide attempt. Suicide attempters were more often female. The rate of suicide attempters among Italian people was 14.2%, compared to 19.5% in foreigners. Subjects living with parents or own family and those having a permanent job had a higher frequency of suicide attempt. Suicide attempts were more frequent among patients with a history of psychiatric disorders; nonetheless, suicide attempts were more common among those who had not previously been hospitalized in a psychiatric ward or were not under the care of a psychiatrist. The multivariate analysis found that female gender was a risk factor for suicide attempt, while being in the colder months of the year and, surprisingly, unemployment were protective factors. A better understanding of patients referring to the ER due to attempted suicide may allow the identification of at-risk subjects and the implementation of targeted treatment approaches.

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

Self-harm: Prevalence estimates from the second Australian Child and Adolescent Survey of Mental Health and Wellbeing.

PubMed

Zubrick, Stephen R; Hafekost, Jennifer; Johnson, Sarah E; Lawrence, David; Saw, Suzy; Sawyer, Michael; Ainley, John; Buckingham, William J

2016-09-01

To (1) estimate the lifetime and 12-month prevalence of self-harm without suicide intent in young people aged 12-17 years, (2) describe the co-morbidity of these behaviours with mental illness and (3) describe their co-variation with key social and demographic variables. A nationally representative random sample of households with children aged 4-17 years recruited in 2013-2014. The survey response rate was 55% with 6310 parents and carers of eligible households participating. In addition, 2967 (89%) of young people aged 11-17 completed a self-report questionnaire with 2653 of the 12- to 17-year-olds completing questions about self-harm behaviour. In any 12-month period, about 8% of all 12- to 17-year-olds (an estimated 137,000 12- to 17-year-olds) report engaging in self-harming behaviour without suicide intent. This prevalence increases with age to 11.6% in 16- to 17-year-olds. Eighteen percent (18.8%; 95% confidence interval [CI] = [14.5, 23.0]) of all 12- to 17-year-old young people with any mental health disorder measured by parent or carer report said that they had engaged in self-harm in the past 12 months. Among young people who were measured by self-report and met criteria for the Diagnostic and Statistical Manual of Mental Disorders' major depressive disorder almost half (46.6%; 95% CI = [40.0, 53.1]) also reported that they had engaged in self-harm in the past 12 months. Suicide risk among those who self-harm is significantly elevated relative to the general population. The demonstrated higher risks in these young people for continued harm or possible death support the need for ongoing initiatives to reduce self-harm through mental health promotion, improved mental health literacy and continuing mental health reform to ensure services are accessible to, and meet the needs of families and young persons. © The Royal Australian and New Zealand College of Psychiatrists 2015.

[Acting out and psychoactive substances: alcohol, drugs, illicit substances].

PubMed

Gillet, C; Polard, E; Mauduit, N; Allain, H

2001-01-01

In humans, some psychotropic agents (alcohol, drugs, illicit substances) have been suggested to play a role in the occurrence of major behavioural disorders, mainly due to the suppression of psychomotor inhibition. Behavioural disinhibition is a physiological mechanism which allows humans to behave appropriately according to a given environmental situation. The behavioural disinhibition induced by either therapeutic dosage or misuse involves the loss of restraint over certain types of social behaviour and may increase the risk of auto or hetero-aggression and acting out. The increased use of psychotropic agents in recent years and the occurrence of unwanted effects are worrying and must be detected and evaluated. The objective of the present study was to establish a causal relationship between psychoactive substance use and occurrence of major behavioural disorders, such as paradoxical rage reactions and suicidal behaviour, based on a literature analysis. It consisted of reviewing reports of drug-induced violent reactions in healthy volunteers and demonstrating, where possible, a cause-effect relationship. Patients with schizophrenia and psychopathic personalities were not included in our study since psychiatric comorbidity could influence behavioural responses. Psychotropic agents included drugs, licit and illicit substances already associated with violence in the past. Many reports used the "Go/No Go test" to evaluate the disinhibiting effect of psychotropic substances; this allows the "cognitive mapping" of drugs. The results suggest that only alcohol, antidepressants, benzodiazepines and cocaïne are related to aggressive behaviour. The best known precipitant of behavioural disinhibition is alcohol, which induces aggressive behaviour. However, there are large differences between individuals, and attentional mechanisms are now recognised as being important in mediating the effects of alcohol. Suicidal tendency as an adverse antidepressant reaction is rare, especially with atypical antidepressants. However, the risk of acting out exists and the responsibility of antidepressant agents in the genesis of suicidal tendencies is now established. The disinhibiting effects of benzodiazepines are well-known and proven by clinical trials. It's a "model" of acting out, and the causal relationship is undeniable. That cocaïne is related to violent behaviour is demonstrated by its pharmacological actions on CNS. The chronic use of cocaïne induces "a limbic dyscontrol syndrome" based on the altered activity of limbic structures. On the contrary, we could not demonstrate a causal relationship between aggression and either cannabis, ecstasy or phencyclidine. Cannabis abusers look particularly for euphoria and relaxing effects. Aggression as an adverse cannabis reaction is very rare and occurs in most cases in association with other drugs and in predisposed individuals. Ecstasy use may lead to long-term alterations of neuronal function in the human CNS and cause psychiatric disorders. However, there is insufficient information about long-term use of ecstasy to estimate its role in the occurrence of behavioural disorders. Clinical and forensic assumptions about phencyclidine and violence were not warranted. However, the substance-effect relationships can be criticized in the case of alcohol, antidepressants, benzodiazepines and cocaïne. In fact, individual, social and psychiatric factors exert an influence on behaviour that is superior to the pharmacological effect of psychotropic agents. The most important parameter in drug-induced behavioural disinhibition is dosage, but mode of administration is also important. In addition, polysubstance abuse is very common. Substances may be taken simultaneously and alcohol is frequently combined with drugs. The combinations of substances result in multiple interactions, and very little is known about the effects of these interactions on violence in humans. Co-occurrence of substance abuse and other mental disorders is also very frequent. Multiple substance abuse should be avoided, because potential interactions between two or more drugs are more likely to cause violent behaviour. In the future, a specific treatment of these deleterious phenomena will have to be considered in order to reduce drug-induced iatrogenic behavioural disorders.

Identifying Suicide Ideation and Suicidal Attempts in a Psychiatric Clinical Research Database using Natural Language Processing.

PubMed

Fernandes, Andrea C; Dutta, Rina; Velupillai, Sumithra; Sanyal, Jyoti; Stewart, Robert; Chandran, David

2018-05-09

Research into suicide prevention has been hampered by methodological limitations such as low sample size and recall bias. Recently, Natural Language Processing (NLP) strategies have been used with Electronic Health Records to increase information extraction from free text notes as well as structured fields concerning suicidality and this allows access to much larger cohorts than previously possible. This paper presents two novel NLP approaches - a rule-based approach to classify the presence of suicide ideation and a hybrid machine learning and rule-based approach to identify suicide attempts in a psychiatric clinical database. Good performance of the two classifiers in the evaluation study suggest they can be used to accurately detect mentions of suicide ideation and attempt within free-text documents in this psychiatric database. The novelty of the two approaches lies in the malleability of each classifier if a need to refine performance, or meet alternate classification requirements arises. The algorithms can also be adapted to fit infrastructures of other clinical datasets given sufficient clinical recording practice knowledge, without dependency on medical codes or additional data extraction of known risk factors to predict suicidal behaviour.

Relationship between Bullying and Suicidal Behaviour in Youth presenting to the Emergency Department

PubMed Central

Alavi, Nazanin; Reshetukha, Taras; Prost, Eric; Antoniak, Kristen; Patel, Charmy; Sajid, Saad; Groll, Dianne

2017-01-01

Objective Increasing numbers of adolescents are visiting emergency departments with suicidal ideation. This study examines the relationship between bullying and suicidal ideation in emergency department settings. Method A chart review was conducted for all patients under 18 years of age presenting with a mental health complaint to the emergency departments at Kingston General or Hotel Dieu Hospitals in Kingston, Canada, between January 2011 and January 2015. Factors such as age, gender, history of abuse, history of bullying, type and time of bullying, and diagnoses were documented. Results 77% of the adolescents had experienced bullying, while 68.9% had suicide ideation at presentation. While controlling for age, gender, grade, psychiatric diagnosis, and abuse, a history of bullying was the most significant predictor of suicidal ideation. Individuals in this study who reported cyber bullying were 11.5 times more likely to have suicidal ideation documented on presentation, while individuals reporting verbal bullying were 8.4 times more likely. Conclusions The prevalence of bullying in adolescent patients presenting to emergency departments is high. The relationship found between suicidal ideation and bullying demonstrates that clinicians should ask questions about bullying as a risk factor for suicide ideation during the assessment of children and adolescents. PMID:28747929

Suicidal behaviour of Indian patients with obsessive compulsive disorder.

PubMed

Dhyani, Mohan; Trivedi, Jitendra Kumar; Nischal, Anil; Sinha, Pramod Kumar; Verma, Subham

2013-04-01

The chronicity, distress, high rates of comorbidity and varying degree of non response to treatment in Obsessive Compulsive Disorder (OCD) may contribute to suicidal behavior. There is relatively little information on suicidal behavior in OCD subjects. Our study design is Single point non-invasive, cross sectional, clinical study of new and follow up cases. Assessment of Suicidal Behavior in patients of OCD attending the adult Psychiatry O.P.D. of Chatrapati Shahuji Maharaj Medical University (CSMMU) U.P. Lucknow using (DSM-IV) criteria for diagnosis of Obsessive Compulsive Disorder, Structured Clinical Interview for DSM-IV Axis-I disorders, Yale Brown Obsessive Compulsive Rating Scale, Scale for Suicidal Ideation (SSI), Beck's Hopelessness Scale (BHS). Mean standard deviation and t test for independent samples, Pearson's correlation coefficient. Statistically significant differences were seen in the SSI score between the "Clinical" and "Sub-Clinical" cases with Clinical group having higher scores. Value of correlation coefficient between YBOCS score and SSI and BHS score is positive and statistically significant (P<0.01). "Clinical" group of patients had significantly higher scores of suicidal ideation measured by Scale of Suicidal Ideation (SSI). There was a significantly positive correlation between disease severity (YBOCS Score) and degree of suicidal ideation (SIS Score).

The Role of Non-Suicidal Self-Injury and Binge-Eating/Purging Behaviours in Family Functioning in Eating Disorders.

PubMed

Depestele, Lies; Claes, Laurence; Dierckx, Eva; Baetens, Imke; Schoevaerts, Katrien; Lemmens, Gilbert M D

2015-09-01

This study aimed to investigate family functioning of restrictive and binge-eating/purging eating disordered adolescents with or without non-suicidal self-injury (NSSI), as perceived by the patients and their parents (mothers and fathers). In total, 123 patients (between 14 and 24 years), 98 mothers and 79 fathers completed the Family Assessment Device. Patients completed the Self-Injury Questionnaire-Treatment Related and the Symptom Checklist 90-Revised. No main effects were found of restrictive versus binge-eating/purging behaviour nor of presence/absence of NSSI. For the parents, a significant interaction between binge-eating/purging behaviour and NSSI emerged: Mothers and fathers reported worse family functioning in the binge-eating/purging group in presence of NSSI, whereas mothers reported worse family functioning in the restrictive group without NSSI. Parental perception of family functioning is affected by the combined presence of binge-eating/purging behaviour and NSSI. This finding should be taken into account when treating families living with eating disorders. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.

Do depression treatments reduce suicidal ideation? The effects of CBT, IPT, pharmacotherapy, and placebo on suicidality.

PubMed

Weitz, Erica; Hollon, Steven D; Kerkhof, Ad; Cuijpers, Pim

2014-01-01

Many well-researched treatments for depression exist. However, there is not yet enough evidence on whether these therapies, designed for the treatment of depression, are also effective for reducing suicidal ideation. This research provides valuable information for researchers, clinicians, and suicide prevention policy makers. Analysis was conducted on the Treatment for Depression Research Collaborative (TDCRP) sample, which included CBT, IPT, medication, and placebo treatment groups. Participants were included in the analysis if they reported suicidal ideation on the HRSD or BDI (score of ≥1). Multivariate linear regression indicated that both IPT (b=.41, p<.05) and medication (b =.47, p<.05) yielded a significant reduction in suicide symptoms compared to placebo on the HRSD. Multivariate linear regression indicated that after adjustment for change in depression these treatment effects were no longer significant. Moderate Cohen׳s d effect sizes from baseline to post-test differences in suicide score by treatment group are reported. These analyses were completed on a single suicide item from each of the measures. Moreover, the TDCRP excluded participants with moderate to severe suicidal ideation. This study demonstrates the specific effectiveness of IPT and medications in reducing suicidal ideation (relative to placebo), albeit largely as a consequence of their more general effects on depression. This adds to the growing body of evidence that depression treatments, specifically IPT and medication, can also reduce suicidal ideation and serves to further our understanding of the complex relationship between depression and suicide. Copyright © 2014 Elsevier B.V. All rights reserved.

Risk and Protective Factors for Suicidality at 6-Month Follow-up in Adolescent Inpatients Who Attempted Suicide: An Exploratory Model

PubMed Central

Consoli, Angèle; Cohen, David; Bodeau, Nicolas; Guilé, Jean-Marc; Mirkovic, Bojan; Knafo, Alexandra; Mahé, Vincent; Laurent, Claudine; Renaud, Johanne; Labelle, Réal; Breton, Jean-Jacques; Gérardin, Priscille

2015-01-01

Objective: To assess risk and protective factors for suicidality at 6-month follow-up in adolescent inpatients after a suicide attempt. Methods: One hundred seven adolescents from 5 inpatient units who had a suicide attempt were seen at 6-month follow-up. Baseline measures included sociodemographics, mood and suicidality, dependence, borderline symptomatology, temperament and character inventory (TCI), reasons for living, spirituality, and coping scores. Results: At 6-month follow-up, 41 (38%) subjects relapsed from suicidal behaviours. Among them, 15 (14%) had repeated a suicide attempt. Higher depression and hopelessness scores, the occurrence of a new suicide attempt, or a new hospitalization belonged to the same factorial dimension (suicidality). Derived from the best-fit structural equation modelling for suicidality as an outcome measure at 6-month follow-up, risk factors among the baseline variables included: major depressive disorder, high depression scores, and high scores for TCI self-transcendence. Only one protective factor emerged: coping–hard work and achievement. Conclusion: In this very high-risk population, some established risk factors (for example, a history of suicide attempts) may not predict suicidality. Our results suggest that adolescents who retain high scores for depression or hopelessness, who remain depressed, or who express a low value for life or an abnormally high connection with the universe are at higher risk for suicidality and should be targeted for more intense intervention. Improving adolescent motivation in school and in work may be protective. Given the sample size, the model should be regarded as exploratory. PMID:25886668

Potential mediating pathways through which sports participation relates to reduced risk of suicidal ideation.

PubMed

Taliaferro, Lindsay A; Rienzo, Barbara A; Miller, M David; Pigg, R Morgan; Dodd, Virginia J

2010-09-01

Suicide ranks as the third leading cause of death for American youth. Researchers examining sport participation and suicidal behavior have regularly found inverse relationships. This study represents the first effort to test a model depicting potential mechanisms through which sport participation relates to reduced risk of suicidal ideation. The participants were 450 undergraduate students. Measures assessed participants' involvement in university-run sports and other activities; frequency of physical activity; and perceived social support, self-esteem, depression, hopelessness, loneliness, and suicidal ideation. Regression analyses confirmed a path model and tested for mediation effects. Vigorous activity mediated relationships between sport participation and self-esteem and depression; and self-esteem and depression mediated the relationship between vigorous activity and suicidal ideation. Social support mediated relationships between sport participation and depression, hopelessness, and loneliness; and each of these risk factors partially mediated the relationship between social support and suicidal ideation. However no variable fully mediated the relationship between sport participation and suicidal ideation. This study provides a foundation for research designed to examine pathways through which sport participation relates to reduced risk of suicidal behavior.

A Markov chain model for studying suicide dynamics: an illustration of the Rose theorem

PubMed Central

2014-01-01

Background High-risk strategies would only have a modest effect on suicide prevention within a population. It is best to incorporate both high-risk and population-based strategies to prevent suicide. This study aims to compare the effectiveness of suicide prevention between high-risk and population-based strategies. Methods A Markov chain illness and death model is proposed to determine suicide dynamic in a population and examine its effectiveness for reducing the number of suicides by modifying certain parameters of the model. Assuming a population with replacement, the suicide risk of the population was estimated by determining the final state of the Markov model. Results The model shows that targeting the whole population for suicide prevention is more effective than reducing risk in the high-risk tail of the distribution of psychological distress (i.e. the mentally ill). Conclusions The results of this model reinforce the essence of the Rose theorem that lowering the suicidal risk in the population at large may be more effective than reducing the high risk in a small population. PMID:24948330

Criminal social identity and suicide ideation among Pakistani young prisoners.

PubMed

Shagufta, Sonia; Boduszek, Daniel; Dhingra, Katie; Kola-Palmer, Derrol

2015-01-01

Suicidal behaviour is a common in prisoners, yet little is known about the factors that may protect against thoughts of ending one's life. The purpose of this paper is to specify and test a structural model to examine the relationship between three criminal social identity (CSI) dimensions (in-group affect, in-group ties, and cognitive centrality) and suicide ideation while controlling for period of confinement, age, criminal friends, and offense type (violent vs non-violent). Participants were 415 male juvenile offenders incarcerated in prisons in Khyber Pakhtunkhwa Pakistan. A structural model was specified and tested using Mplus to examine the relationships between the three factors of CSI and suicidal thoughts, while controlling for age, offender type, period of confinement, and substance dependence. The model provided an adequate fit for the data, explaining 22 per cent of variance in suicidal thoughts. In-group affect (the level of personal bonding with other criminals) was found to exert a strong protective effect against suicide ideation. The research contributes important information on suicide ideation in Pakistan, an Islamic country in which suicide is considered a sin and subsequently a criminal offence. Results indicate that Juvenile offenders' sense of shared identity may help to prevent the development of thoughts of death by suicide. Consequently, separating and isolating young prisoners may be ill advised.

Is cannabis a risk factor for suicide attempts in men and women with psychotic illness?

PubMed

Waterreus, A; Di Prinzio, P; Badcock, J C; Martin-Iverson, M; Jablensky, A; Morgan, V A

2018-05-16

To investigate whether recent cannabis use by men and women with psychotic disorders was associated with increased risk of suicide attempt, and to determine associated factors, stratified by sex. Data from 1065 men and 725 women interviewed in the Australian national survey of psychosis were analysed to model separately, for each sex, the impact of daily, casual or no past-year cannabis use and other risk factors including age, on a past-year suicide attempt. In the past year, 168 (9.4%) participants attempted suicide. Unadjusted analyses showed daily cannabis users of both sexes had significantly increased odds of attempting suicide compared to non-users. After adjusting for confounding factors, this relationship was no longer significant. Depression had the strongest association with attempting suicide for both sexes. Sex differences in other risk factors were observed. In post hoc analysis, daily cannabis use was associated with higher odds of attempting suicide in older men compared to non-users; this was not found in younger men or women. Associations between past-year cannabis use and suicide attempts were confounded by other factors (depression, loneliness, homelessness and hallucinations). The possibility of greater risk of suicidal behaviour with regular cannabis use for older men should be considered.

Assessing the risk for suicide in schizophrenia according to migration, ethnicity and geographical ancestry.

PubMed

Hettige, Nuwan C; Bani-Fatemi, Ali; Kennedy, James L; De Luca, Vincenzo

2017-02-09

Suicide is a leading cause of mortality among those afflicted by schizophrenia. Previous studies demonstrated that the stressors associated with immigration may lead to an onset of schizophrenia and suicide separately in susceptible individuals. However, no studies have shown whether immigration may lead to suicidal behaviour for individuals with schizophrenia. Our study proposes that an individual's geographical ancestry, ethnicity or migration status may be predictive of suicide risk in schizophrenia. In a sample of 276 participants with schizophrenia spectrum disorders, we conducted cross-sectional assessments to collect clinical information. Self-identified ethnicity and suicide history were collected through self-report questionnaires and interview-based scales. Ancestry was identified using 292 genetic markers from HapMap. Migrants were classified as those who immigrated to Canada during their lifetime. Using a regression analysis, we tested whether a history of migration, ethnicity or geographical ancestry were predictive of a history of suicide attempts. Our analysis failed to demonstrate a significant relationship between suicide history and migration, ethnicity or ancestry. However, ethnicity appears to be significantly associated with the number of psychiatric hospitalizations in our sample. Ethnicity and migration history are not predictive of previous suicide attempts. Ethnicity may be an important demographic factor affecting access to mental health resources and frequency of hospitalizations.

Impulsivity and hopelessness as predictors of suicide-related ideation among older adults.

PubMed

Neufeld, Eva; O'Rourke, Norm

2009-10-01

Research has demonstrated that impulsivity is strongly associated with suicide-related ideation and behaviour among young adults. However, to date, the potential importance of impulsivity as a predictor of suicide-related ideation in later life has yet to be determined. Our study examined impulsivity, hopelessness, depressive symptomatology, and sociodemographic factors vis-à-vis suicide-related ideation among older adults at risk of self-harm. A sample (n = 117) of older adults was recruited from multiple sources for this study over a 1-year period. Suicide-related ideation was measured with the Geriatric Suicide Ideation Scale, a multidimensional measure of suicide-related ideation developed for use with older adults. Canonical correlation identified 2 pairings of linear composites in which impulsivity emerged along both as significantly associated with facets of suicide-related ideation. Of note, the greater proportion of variance in impulsivity was subsumed along the second set of vectors with somatic depressive symptoms. Our findings suggest that the impulse to self-harm may be even more pronounced among older adults less likely to present as typically depressed. It is further suggested that impulsivity is more broadly associated with suicide-related ideation than hopelessness, and that screening for impulsivity as well as hopelessness may increase clinicians' ability to identify older adults at greatest risk of self-harm.

Assessment of acquired capability for suicide in clinical practice.

PubMed

Rimkeviciene, Jurgita; Hawgood, Jacinta; O'Gorman, John; De Leo, Diego

2016-12-01

The Interpersonal Psychological Theory of suicide proposes that the interaction between Thwarted Belongingness, Perceived Burdensomeness, and Acquired Capability for Suicide (ACS) predicts proximal risk of death by suicide. Instruments to assess all three constructs are available. However, research on the validity of one of them, the acquired capability for suicide scale (ACSS), has been limited, especially in terms of its clinical relevance. This study aimed to explore the utility of the different versions of the ACSS in clinical assessment. Three versions of the scale were investigated, the full 20-item version, a 7-item version and a single item version representing self-perceived capability for suicide. In a sample of patients recruited from a clinic specialising in the treatment of suicidality and in a community sample, all versions of the ACSS were found to show reasonable levels of reliability and to correlate as expected with reports of suicidal ideation, self-harm, and attempted suicide. The item assessing self-perceived acquired capacity for suicide showed highest correlations with all levels of suicidal behaviour. However, no version of the ACSS on its own showed a capacity to indicate suicide attempts in the combined sample. It is concluded that the versions of the scale have construct validity, but their clinical utility is limited. An assessment using a single item on self-perceived ACS outperforms the full and shortened versions of ACSS in clinical settings and can be recommended with caution for clinicians interested in assessing this characteristic.

Overgeneral autobiographical memory and age of onset of childhood sexual abuse in patients with recurrent suicidal behaviour.

PubMed

Crane, Catherine; Duggan, Danielle S

2009-03-01

To explore the association between age of onset of childhood sexual abuse (CSA) and overgeneral memory (OGM) in a clinical sample. Presence and age of onset of CSA and levels of OGM were assessed in 49 patients attending hospital following a recurrence of suicidal behaviour. Twenty six participants reported CSA. Earlier age of onset of CSA was associated with greater OGM, indexed by fewer specific and more categoric memories. The association was not accounted for either by elevated levels of depression in those reporting earlier abuse, nor by levels of general verbal fluency. The findings are consistent with previous work and support the hypothesis that abuse occurring earlier in development results in more pronounced OGM.

"This is a question we have to ask everyone": asking young people about self-harm and suicide.

PubMed

O'Reilly, M; Kiyimba, N; Karim, K

2016-10-01

WHAT IS KNOWN ON THE SUBJECT?: An essential part of the mental health assessment is to evaluate the risk of harm to self. Fundamentally this involves asking directly about self-harming behaviour and suicidal thoughts or urges, but practitioners often find it difficult to open up these conversations. This evaluation of risk is particularly important as self-harm and suicidal thoughts are frequently found in young people who attend mental health services. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Young people are not always routinely asked directly about self-harm or suicidal thoughts when they are assessed. There are two ways that mental health practitioners introduce this topic: first, by building up to it by initially asking about general feelings, and second by stating that it is a requirement to ask everyone. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: These questions should not be avoided by mental health practitioners just because they are difficult. We offer suggestions as to how to ask questions about self-harm and suicide based on real-world practice. Introduction Questions about self-harm and suicide are essential in risk assessments with children and young people, yet little is known about how mental health practitioners do this. Aim The core aim was to examine how questions about self-harm and suicidal ideation are asked in real-world practice. Method A qualitative design was employed to analyse 28 video-recorded naturally occurring mental health assessments in a child and adolescent mental health service. Data were analysed using conversation analysis (CA). Results In 13 cases young people were asked about self-harm and suicide, but 15 were not. Analysis revealed how practitioners asked these questions. Two main styles were revealed. First was an incremental approach, beginning with inquiries about emotions and behaviours, building to asking about self-harm and suicidal intent. Second was to externalize the question as being required by outside agencies. Discussion The study concluded that the design of risk questions to young people had implications for how open they were to engaging with the practitioner. Implications for practice The study has implications for training and practice for psychiatric nurses and other mental health practitioners in feeling more confident in communicating with young people about self-harm and suicidal ideation. © 2016 John Wiley & Sons Ltd.

The Impact of Exercise on Suicide Risk: Examining Pathways through Depression, PTSD, and Sleep in an Inpatient Sample of Veterans

ERIC Educational Resources Information Center

Davidson, Collin L.; Babson, Kimberly A.; Bonn-Miller, Marcel O.; Souter, Tasha; Vannoy, Steven

2013-01-01

Suicide has a large public health impact. Although effective interventions exist, the many people at risk for suicide cannot access these interventions. Exercise interventions hold promise in terms of reducing suicide because of their ease of implementation. While exercise reduces depression, and reductions in depressive symptoms are linked to…

Pediatric Emergency Department Suicidal Patients: Two-Site Evaluation of Suicide Ideators, Single Attempters, and Repeat Attempters

ERIC Educational Resources Information Center

Asarnow, Joan Rosenbaum; Baraff, Larry J.; Berk, Michele; Grob, Charles; Devich-Navarro, Mona; Suddath, Robert; Piacentini, John; Tang, Lingqi

2008-01-01

The study examines ideators, single attempters, and repeats attempters of suicide to clarify optimal strategies for emergency department management and risk assessment to help them in reducing youth suicide and suicide attempts. Depression was found to be a strong predictor of suicide/suicide attempts along with substance use, externalizing…

Trends in suicidal behaviour and use of mental health services in Canadian military and civilian populations.

PubMed

Sareen, Jitender; Afifi, Tracie O; Taillieu, Tamara; Cheung, Kristene; Turner, Sarah; Bolton, Shay-Lee; Erickson, Julie; Stein, Murray B; Fikretoglu, Deniz; Zamorski, Mark A

2016-08-09

In the context of the Canadian mission in Afghanistan, substantial media attention has been placed on mental health and lack of access to treatment among Canadian Forces personnel. We compared trends in the prevalence of suicidal behaviour and the use of mental health services between Canadian military personnel and the general population from 2002 to 2012/13. We obtained data for respondents aged 18-60 years who participated in 4 nationally representative surveys by Statistics Canada designed to permit comparisons between populations and trends over time. Surveys of the general population were conducted in 2002 (n = 25 643) and 2012 (n = 15 981); those of military personnel were conducted in 2002 (n = 5153) and 2013 (n = 6700). We assessed the lifetime and past-year prevalence of suicidal ideation, plans and attempts, as well as use of mental health services. In 2012/13, but not in 2002, military personnel had significantly higher odds of both lifetime and past-year suicidal ideation than the civilian population (lifetime: adjusted odds ratio [OR] 1.32, 95% confidence interval [CI] 1.17-1.50; past year: adjusted OR 1.34, 95% CI 1.09-1.66). The same was true for suicidal plans (lifetime: adjusted OR 1.64, 95% CI 1.35-1.99; past year: adjusted OR 1.66, 95% CI 1.18-2.33). Among respondents who reported past-year suicidal ideation, those in the military had a significantly higher past-year utilization rate of mental health services than those in the civilian population in both 2002 (adjusted OR 2.02, 95% CI 1.31-3.13) and 2012/13 (adjusted OR 3.14, 95% CI 1.86-5.28). Canadian Forces personnel had a higher prevalence of suicidal ideation and plans in 2012/13 and a higher use of mental health services in 2002 and 2012/13 than the civilian population. © 2016 Canadian Medical Association or its licensors.

Trends in suicidal behaviour and use of mental health services in Canadian military and civilian populations

PubMed Central

Sareen, Jitender; Afifi, Tracie O.; Taillieu, Tamara; Cheung, Kristene; Turner, Sarah; Bolton, Shay-Lee; Erickson, Julie; Stein, Murray B.; Fikretoglu, Deniz; Zamorski, Mark A.

2016-01-01

Background: In the context of the Canadian mission in Afghanistan, substantial media attention has been placed on mental health and lack of access to treatment among Canadian Forces personnel. We compared trends in the prevalence of suicidal behaviour and the use of mental health services between Canadian military personnel and the general population from 2002 to 2012/13. Methods: We obtained data for respondents aged 18–60 years who participated in 4 nationally representative surveys by Statistics Canada designed to permit comparisons between populations and trends over time. Surveys of the general population were conducted in 2002 (n = 25 643) and 2012 (n = 15 981); those of military personnel were conducted in 2002 (n = 5153) and 2013 (n = 6700). We assessed the lifetime and past-year prevalence of suicidal ideation, plans and attempts, as well as use of mental health services. Results: In 2012/13, but not in 2002, military personnel had significantly higher odds of both lifetime and past-year suicidal ideation than the civilian population (lifetime: adjusted odds ratio [OR] 1.32, 95% confidence interval [CI] 1.17–1.50; past year: adjusted OR 1.34, 95% CI 1.09–1.66). The same was true for suicidal plans (lifetime: adjusted OR 1.64, 95% CI 1.35–1.99; past year: adjusted OR 1.66, 95% CI 1.18–2.33). Among respondents who reported past-year suicidal ideation, those in the military had a significantly higher past-year utilization rate of mental health services than those in the civilian population in both 2002 (adjusted OR 2.02, 95% CI 1.31–3.13) and 2012/13 (adjusted OR 3.14, 95% CI 1.86–5.28). Interpretation: Canadian Forces personnel had a higher prevalence of suicidal ideation and plans in 2012/13 and a higher use of mental health services in 2002 and 2012/13 than the civilian population. PMID:27221270

Preventing Suicides in the Military | NIH MedlinePlus the Magazine

MedlinePlus

... this page please turn Javascript on. Feature: Preventing Suicides Preventing Suicides in the Military Past Issues / Winter 2010 Table ... National Institute of Mental Health aims to reduce suicides among America's military and military veterans. "The suicide ...

Effect of 11 September 2001 on suicide and homicide in England and Wales.

PubMed

Salib, Emad

2003-09-01

The tragic events of 11 September 2001 and televised scenes of the terrorists' homicidal and suicidal acts could have had an impact on the behaviour of some people, who harbour suicidal ideation or homicidal tendencies. To assess the effect of 11 September 2001 on the rate of suicide and homicide in England and Wales. Analysis of the number of suicides (ICD-9 codes: E950-E959), undetermined injury deaths (E980-E989) and homicides (E960-E969) in England and Wales in the 12 weeks before and after 11 September 2001 and during a similar period in the previous two years. The number of suicides reported in the month of September 2001 was significantly lower than other months in the same year and any September of the previous 22 years in England and Wales. A suicide reduction in men, regardless of age, occurred in the week starting Tuesday 11 September 2001. A reduction in female suicide occurred during the four weeks following the attack. There was no evidence of a similar effect on homicide. The tragic events of 11 September 2001 appear to have had a brief but significant inverse effect on suicide.The finding of this study supports Durkheim's theory that periods of external threat create group integration within society and lower the suicide rate through the impact on social cohesion.

First-degree relatives of suicide completers may have impaired decision-making but functional cognitive control.

PubMed

Hoehne, A; Richard-Devantoy, S; Ding, Y; Turecki, G; Jollant, F

2015-09-01

The heritability of suicide is well established. Transmission of risk appears to follow traits more than disorders like depression. In the present project, we aimed at investigating the potential for transmission of cognitive deficits previously observed in suicide attempters, specifically impaired decision-making and cognitive control. Seventeen healthy first-degree relatives of suicide completers with no personal history of suicidal act were compared to 18 first-degree relatives of individuals with major depressive disorder but no family history of suicidal act, and 19 healthy controls. Decision-making was assessed with the Iowa Gambling Task, and cognitive control with the Stroop Task, the Hayling Sentence Completion Test, and the Trail-Making Test. Both suicide and depressed relatives showed lower gambling task net scores than healthy controls. However, there were trends toward lower learning abilities in suicide than depressed relatives (interaction: p = 0.07), with more risky choices at the end of the test. Suicide relatives also showed a higher number of self-corrected errors relative to the total number of errors in the Stroop colour test compared to both control groups, with no difference in interference scores. There was no group-difference for any other cognitive tests. Our findings suggest that decision-making impairment may be found in healthy relatives of suicides and represent a cognitive endophenotype of suicidal behaviour. Normal cognitive control (or self-corrected deficits) may protect relatives against suicidal acts. Impairments in value-based and control processes may, therefore, be part of the suicide vulnerability and represent potential targets of preventative interventions. Copyright © 2015 Elsevier Ltd. All rights reserved.

Suicidal ideation while incarcerated: Prevalence and correlates in a large sample of male prisoners in Flanders, Belgium.

PubMed

Favril, Louis; Vander Laenen, Freya; Vandeviver, Christophe; Audenaert, Kurt

Prisoners constitute a high-risk group for suicide. As an early stage in the pathway leading to suicide, suicidal ideation represents an important target for prevention, yet research on this topic is scarce in general prison populations. Using a cross-sectional survey design, correlates of suicidal ideation while incarcerated were examined in a sample of 1203 male prisoners, randomly selected from 15 Flemish prisons. Overall, a lifetime history of suicidal ideation and attempts was endorsed by 43.1% and 20.3% of respondents, respectively. Approximately a quarter of all prisoners (23.7%) reported past-year suicidal ideation during their current incarceration, which was significantly associated with both imported vulnerabilities (psychiatric diagnoses and a history of attempted suicide) and variables unique to the prison experience (lack of working activity, exposure to suicidal behaviour by peers, and low levels of perceived autonomy, safety and social support) in the multivariate regression analysis. A first-ever period of imprisonment and a shorter length of incarceration (≤12months) were also associated with increased odds of recent suicidal ideation. Collectively, the current findings underscore the importance of both vulnerability factors and prison-specific stressors for suicidal ideation in prisoners, and hence the need for a multi-faceted approach to suicide prevention in custodial settings. In addition to the provision of appropriate mental health care, environmental interventions that target modifiable aspects of the prison regime could provide a substantial buffer for the onset and persistence of suicidal ideation in this at-risk population. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Improving suicide mortality statistics in Tarragona (Catalonia, Spain) between 2004-2012.

PubMed

Barbería, Eneko; Gispert, Rosa; Gallo, Belén; Ribas, Gloria; Puigdefàbregas, Anna; Freitas, Adriana; Segú, Elena; Torralba, Pilar; García-Sayago, Francisco; Estarellas, Aina

2016-07-20

Monitoring and preventing suicidal behaviour requires, among other data, knowing suicide deaths precisely. They often appear under-reported or misclassified in the official mortality statistics. The aim of this study is to analyse the under-reporting found in the suicide mortality statistics of Tarragona (a province of Catalonia, Spain). The analysis takes into account all suicide deaths that occurred in the Tarragona Area of the Catalan Institute of Legal Medicine and Forensic Sciences (TA-CILMFS) between 2004 and 2012. The sources of information were the death data files of the Catalan Mortality Register, as well as the Autopsies Files of the TA-CILMFS. Suicide rates and socio-demographic profiles were statistically compared between the suicide initially reported and the final one. The mean percentage of non-reported cases in the period was 16.2%, with a minimum percentage of 2.2% in 2005 and a maximum of 26.8% in 2009. The crude mortality rate by suicide rose from 6.6 to 7.9 per 100,000 inhabitants once forensic data were incorporated. Small differences were detected between the socio-demographic profile of the suicide initially reported and the final one. Supplementary information was obtained on the suicide method, which revealed a significant increase in poisoning and suicides involving trains. An exhaustive review of suicide deaths data from forensic sources has led to an improvement in the under-reported statistical information. It also improves the knowledge of the method of suicide and personal characteristics. Copyright © 2016 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

Reasons for homicide and suicide in episodes by dyadic death in Yorkshire and Humberside.

PubMed

Milroy, C M

1995-07-01

Fifty-two episodes of homicide-suicide were examined to determine the reasons behind the episodes. Forty-nine of the assailants were male. The major reason for homicide-suicide was breakdown in a relationship (46%), the victim usually being the spouse. Mental illness was the second commonest reason (21%). Physical ill health (11%) and financial stress (10%) were important reasons in older couples. Criminal behaviour was the reason in 11% of cases. Alcohol was detected in 15 (29%) of assailants, with 10 (19%) having a blood-alcohol level over 100mg/100ml. The results are compared with other published studies.

Chain of Care for Patients with Intentional Self-Harm: An Effective Strategy to Reduce Suicide Rates?

ERIC Educational Resources Information Center

Rossow, Ingeborg; Mehlum, Lars; Gjertsen, Finn; Moller, Bjorn

2009-01-01

Chain of care for patients with intentional self-harm was important in the Norwegian national action plan to prevent suicide. In this study there were two aims: (1) to calculate the potential effects of chain of care on reducing suicide rates, and (2) to assess whether suicide rates decreased more in areas where chain of care had been implemented…

Reasons for living and hope as the protective factors against suicidality in Chinese patients with depression: a cross sectional study.

PubMed

Luo, Xingwei; Wang, Qin; Wang, Xiang; Cai, Taisheng

2016-07-20

The risk factors of suicidal ideation and attempts have been discussed in many researches. Few studies have examined reasons for living and hope as protective factors against suicide in a clinical population. It is unclear if these factors help to reduce suicide rates in patients with depression. The study aimed to assess the role of reasons for living and hope in the identification and reduction of suicidality and explore the influence of reasons for living or hope in the transition from suicidal ideation to suicide attempts. Patients with depression (N = 115) completed the Beck Depression Inventory, Reasons for Living Inventory, and Adult Suicidal Ideation Questionnaire. There were significant correlations among depression, hope, total reasons for living, and suicidal ideation and attempts. Further, after controlling for depression, reasons for living and hope had significant main effects on suicidal ideation. Hope also had a significant predictive effect in the transition of suicidal ideation to suicide attempt. We concluded that reasons for living and hope may protect against suicidal ideation and attempts in patients with depression. Especially hope could reduce the possibility of suicide attempt.

Youth suicide trends in Finland, 1969-2008.

PubMed

Lahti, Anniina; Räsänen, Pirkko; Riala, Kaisa; Keränen, Sirpa; Hakko, Helinä

2011-09-01

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. The data, obtained from Statistics Finland, consisted of all suicides (n = 901) committed by persons under 18 years of age over the period 1969-2008. Gender-specific trends were analysed separately for the years 1969-1989 and 1990-2008 using 3-year moving averages. Trends in methods of suicide were examined from 1975 to 2008 in five-year periods. The male-to-female ratio in youth suicides was 3.6:1. The male rates increased in 1969-1989, while the rates among females were inconsistent. After 1990, the rates decreased for males but turned to an increase among females. Shooting was the most common suicide method among males throughout the period, while hanging exceeded poisoning as the most common method among females after 1990. All violent suicides decreased for males and increased for females in 1990-2008. The increase in violent, i.e., more lethal, suicide methods among young females is alarming, as females are known to have higher rates of attempted suicide than males. Alcohol consumption, rates and treatment of depression and violent behaviour among adolescents are discussed as approaches towards explaining this phenomenon. © 2011 The Authors. Journal of Child Psychology and Psychiatry © 2011 Association for Child and Adolescent Mental Health.