Suicide risk in primary care: identification and management in older adults.

PubMed

Raue, Patrick J; Ghesquiere, Angela R; Bruce, Martha L

2014-09-01

The National Strategy for Suicide Prevention (2012) has set a goal to reduce suicides by 20% within 5 years. Suicide rates are higher in older adults compared to most other age groups, and the majority of suicide completers have visited their primary care physician in the year before suicide. Primary care is an ideal setting to identify suicide risk and initiate mental health care. We review risk factors for late-life suicide; methods to assess for different levels of suicidality; and recent research developments regarding both effective assessment and management of suicide risk among older primary care patients. We highlight that broader scale screening of suicide risk may be considered in light of findings that suicidality can occur even in the absence of major risk factors like depression. We also highlight collaborative care models targeting suicide risk, and recent innovative interventions that aim to prevent the development of suicidal ideation and suicidal behavior.

ATTITUDES TOWARD SUICIDE: THE EFFECT OF SUICIDE DEATH IN THE FAMILY*

PubMed Central

Zhang, Jie; Jia, Cun-Xian

2011-01-01

There have been few reports on the effect of suicide death on family members’ attitudes toward suicide. In order to estimate the extent to which suicide death affects attitudes toward suicide among family members of suicides, data of 264 informants from a case-control psychological autopsy study were analyzed. The results showed that there were no significant differences in attitudes toward suicide, measured by the General Social Survey’s (GSS) four questions, between informants of suicides and informants of living controls, between family members of suicides and family members of living controls, or between family members of suicides and non-family members of suicides. Our findings did not support the hypothesis that suicide death affects the attitudes toward suicide in suicides’ family members. However, some factors were found to be related to the pro-suicide attitudes measured by the four questions included in the GSS. PMID:20397616

Suicide Risk in Primary Care: Identification and Management in Older Adults

PubMed Central

Raue, Patrick J.; Ghesquiere, Angela R.; Bruce, Martha L.

2014-01-01

The National Strategy for Suicide Prevention (2012) has set a goal to reduce suicides by 20% within 5 years. Suicide rates are higher in older adults compared to most other age groups, and the majority of suicide completers have visited their primary care physician in the year before suicide. Primary care is an ideal setting to identify suicide risk and initiate mental health care. We review risk factors for late-life suicide; methods to assess for different levels of suicidality; and recent research developments regarding both effective assessment and management of suicide risk among older primary care patients. We highlight that broader scale screening of suicide risk may be considered in light of findings that suicidality can occur even in the absence of major risk factors like depression. We also highlight collaborative care models targeting suicide risk, and recent innovative interventions that aim to prevent the development of suicidal ideation and suicidal behavior. PMID:25030971

Suicide Terrorists: Are They Suicidal?

ERIC Educational Resources Information Center

Townsend, Ellen

2007-01-01

Are suicide terrorists suicidal? A review of the worldwide literature on suicide terrorism uncovered five published empirical studies describing data collected from potential suicide terrorists or the surviving friends and families of deceased terrorists. The many discrepancies uncovered between suicide terrorists and other suicides on key factors…

Personal suicidality in reception and identification with suicidal film characters.

PubMed

Till, Benedikt; Vitouch, Peter; Herberth, Arno; Sonneck, Gernot; Niederkrotenthaler, Thomas

2013-04-01

The authors investigated the impact of suicidality on identity work during film exposure. Adults with low suicidality (n = 150) watched either It's My Party or The Fire Within, censored versions of these films not depicting the suicide, or the control film that concluded with a non-suicidal death. Baseline suicidality was measured with questionnaires before the movie. Identity work and identification with the protagonist were measured after the movie. Suicidality was directly associated with identity work during film dramas depicting suicide methods. The reception of suicide-related media content seems to partially depend on personal suicidality. Potential implications for suicide prevention are discussed.

Permissive beliefs and attitudes about older adult suicide: a suicide enabling script?

PubMed

Winterrowd, Erin; Canetto, Silvia Sara; Benoit, Kathrin

2017-02-01

In the United States, suicide rates are highest among European American older adults. This phenomenon calls attention to cultural factors, specifically, the suicide beliefs and attitudes of European Americans. Beliefs and attitudes matter in the vulnerability to suicide. As predicted by cultural scripts of suicide theory, suicide is most likely among individuals and in communities where it is expected and is most acceptable. This study examined beliefs about the precipitants of, and protectors against older adult suicide, as well as suicide attitudes, in a predominantly European American community. Two hundred and fifty-five older adults (86% European American) and 281 younger adults (81% European American) indicated what they thought were the most likely older adult suicide precipitants and protectors, and their opinion about older adult suicide, depending on precipitant. Health problems were the most endorsed older adult suicide precipitants. Suicide precipitated by health problems was also rated most positively (e.g., rational, courageous). Older adults, persons with more education, and persons who did not identify with a religion expressed the most favorable attitudes about older adult suicide, across suicide precipitants. Men viewed older adult suicide as more admissible, and women, with more sympathy. Perceived suicide protectors included religiosity among older adults, and supportive relationships among younger adults. The belief, in this study's predominantly European American community, that older adult suicide is triggered by health problems, together with favorable attitudes about older adult suicide, suggest an enabling older adult suicide script, with implications for suicide risk and prevention.

The potential role of attitudes towards suicide between mental health status and suicidal ideation among Chinese children and adolescents.

PubMed

Tan, L; Yang, Q H; Chen, J L; Zou, H X; Xia, T S; Liu, Y

2017-09-01

The objective of this study was to investigate the contributions of mental health status and attitudes towards suicide on suicidal ideation in a sample of 6568 Chinese children and adolescents in China. Attitudes towards suicide were investigated as a possible moderator and mediator of the influence of mental health status on suicidal ideation. Descriptive statistical analyses, Pearson correlation analyses and hierarchical regression analyses were adopted as methods of data analyses. Approximately 35.38% of children and adolescents in our study reported having suicidal ideation. Mental health status and attitudes towards suicide both had an independent effect on the severity of suicidal ideation. Results indicated that mental health status was positively associated with suicidal ideation, while attitudes towards suicide were negatively associated with suicidal ideation. Moderation analysis showed that the impact of mental health status on suicidal ideation was significantly greater among children and adolescents who reported favourable attitudes towards suicide. Attitudes towards suicide partially mediated the link between mental health status and the severity of suicidal ideation. Specifically, students who experienced poorer mental health status might be more likely to report significantly more favourable attitudes towards suicide, which in turn promote greater suicidal ideation. These results have implications for the prevention of youth suicide, suggesting that mental health status and attitudes towards suicide could be important targets for prevention and intervention for children and adolescents at risk of suicidal ideation. © 2017 John Wiley & Sons Ltd.

Association of Internet search trends with suicide death in Taipei City, Taiwan, 2004-2009.

PubMed

Yang, Albert C; Tsai, Shi-Jen; Huang, Norden E; Peng, Chung-Kang

2011-07-01

Although Internet has become an important source for affected people seeking suicide information, the connection between Internet searches for suicide information and suicidal death remains largely unknown. This study aims to evaluate the association between suicide and Internet searches trends for 37 suicide-related terms representing major known risks of suicide. This study analyzes suicide death data in Taipei City, Taiwan and corresponding local Internet search trend data provided by Google Insights for Search during the period from January 2004 to December 2009. The investigation uses cross correlation analysis to estimate the temporal relationship between suicide and Internet search trends and multiple linear regression analysis to identify significant factors associated with suicide from a pool of search trend data that either coincides or precedes the suicide death. Results show that a set of suicide-related search terms, the trends of which either temporally coincided or preceded trends of suicide data, were associated with suicide death. These search factors varied among different suicide samples. Searches for "major depression" and "divorce" accounted for, at most, 30.2% of the variance in suicide data. When considering only leading suicide trends, searches for "divorce" and the pro-suicide term "complete guide of suicide," accounted for 22.7% of variance in suicide data. Appropriate filtering and detection of potentially harmful source in keyword-driven search results by search engine providers may be a reasonable strategy to reduce suicide deaths. Copyright © 2011 Elsevier B.V. All rights reserved.

Celebrity suicides and their differential influence on suicides in the general population: a national population-based study in Korea.

PubMed

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

2015-04-01

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

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

Exploring the association between exposure to suicide and suicide risk among military service members and veterans.

PubMed

Hom, Melanie A; Stanley, Ian H; Gutierrez, Peter M; Joiner, Thomas E

2017-01-01

Past research suggests that suicide has a profound impact on surviving family members and friends; yet, little is known about experiences with suicide bereavement among military populations. This study aimed to characterize experiences with suicide exposure and their associations with lifetime and current psychiatric symptoms among military service members and veterans. A sample of 1753 United States military service members and veterans completed self-report questionnaires assessing experiences with suicide exposure, lifetime history of suicidal thoughts and behaviors, current suicidal symptoms, and perceived likelihood of making a future suicide attempt. The majority of participants (57.3%) reported knowing someone who had died by suicide, and of these individuals, most (53.1%) reported having lost a friend to suicide. Chi-square tests, one-way ANOVAs, and logistic regression analyses revealed that those who reported knowing a suicide decedent were more likely to report more severe current suicidal symptoms and a history of suicidal thoughts and behaviors compared to those who did not know a suicide decedent. Hierarchical linear regression analyses indicated that greater self-reported interpersonal closeness to a suicide decedent predicted greater self-reported likelihood of a future suicide attempt, even after controlling for current suicidal symptoms and prior suicidal thoughts and behaviors. This study utilized cross-sectional data, and information regarding degree of exposure to suicide was not collected. Military personnel and veterans who have been bereaved by suicide may themselves be at elevated risk for suicidal thoughts and behaviors. Additional work is needed to delineate the relationship between these experiences. Copyright © 2016 Elsevier B.V. All rights reserved.

Non-Suicidal Self-Injury and Suicidal Ideation in Relation to Eating and General Psychopathology Among College-Age Women

PubMed Central

Eichen, Dawn M.; Kass, Andrea E.; Fitzsimmons-Craft, Ellen E.; Gibbs, Elise; Trockel, Mickey; Taylor, C. Barr; Wilfley, Denise E.

2015-01-01

Non-suicidal self-injury (NSSI) and suicidal ideation are potent risk factors for suicide and are associated with general and eating disorder-specific psychopathology. Limited research has examined the effects of combined NSSI+suicidal ideation thus concurrent examination is needed to understand potential differential effects on psychopathology. College-aged women (N=508) completed self-report measures of NSSI, suicidal ideation, general psychopathology, and eating disorder-specific psychopathology. MANOVAs determined whether the NSSI/Suicidal Ideation status groups differed on general and eating disorder pathology measures as a set. Significant MANOVAs were followed up with univariate ANOVAs and posthoc tests. Thirteen women endorsed NSSI+Suicidal Ideation, 70 endorsed NSSI-only, 25 endorsed Suicidal Ideation-only, and 400 endorsed no NSSI/Suicidal Ideation. Both general and eating disorder-specific psychopathology differed across groups. NSSI+Suicidal Ideation and Suicidal Ideation-only groups typically endorsed higher general psychopathology than the no NSSI/Suicidal Ideation and NSSI-only groups. Regarding eating disorder pathology, the NSSI+Suicidal Ideation group was more pathological than no NSSI/Suicidal Ideation and NSSI-only, except on the weight concerns scale, where NSSI+Suicidal Ideation only differed from no NSSI/Suicidal Ideation. The NSSI+Suicidal Ideation group was only greater than Suicidal Ideation-only on measures of depression and eating concern. Results highlight the importance of screening for both NSSI and suicidal ideation, especially for individuals with eating disorder symptoms. Likewise, screening for eating disorder pathology may be beneficial for individuals presenting with NSSI and suicidal ideation. PMID:26654754

The newsworthiness of suicide.

PubMed

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

2007-06-01

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

Emile Durkheim and altruistic suicide.

PubMed

Stack, Steven

2004-01-01

Altruistic suicides are marked by cultural approval and benefit the social order. They occur in social groups where there is a low value placed on the individual. The principle loci of altruistic suicide are primitive societies and the modern military. Subtypes of altruistic suicide (obligatory, optional, acute) are delineated and evaluated. Military suicide rates are seen as being inversely related to civilian suicide rates. Key limitations of Durkheim's model are discussed including his exaggerating the prevalence of obligatory suicide. Suggested points of departure for future research on altruistic suicide include comparative analyses of suicide in the modern military, and application of the concept of optional altruistic suicide to the impact of suicide acceptability on national suicide rates.

Predictors of Suicide Ideation in a Random Digit Dial Study: Exposure to Suicide Matters.

PubMed

van de Venne, Judy; Cerel, Julie; Moore, Melinda; Maple, Myfanwy

2017-07-03

Suicide is an important public health concern requiring ongoing research to understand risk factors for suicide ideation. A dual-frame, random digit dial survey was utilized to identify demographic and suicide-related factors associated with suicide ideation in a statewide sample of 1,736 adults. The PH-Q 9 Depression scale suicide ideation question was used to assess current suicide ideation in both the full sample and suicide exposed sub-sample. Being non-married and having previous suicide exposure were separately associated with higher risks of suicide ideation in the full sample. Being male, having increased suicide exposures, and having increased perceptions of closeness to the decedent increased risks, while older age decreased risks for the suicide exposed. Implications for future screening and research are discussed.

A Content Analysis of Online Suicide Notes: Attempted Suicide Versus Attempt Resulting in Suicide.

PubMed

Synnott, John; Ioannou, Maria; Coyne, Angela; Hemingway, Siobhan

2017-09-28

Fifty suicide notes of those who died by suicide and 50 suicide notes of those who survived their suicide attempt were analyzed using Smallest Space Analysis. The core of all suicide notes was discovered to be constructed with the use of four variables: saying goodbye to their audience, feelings of loneliness, method used to attempt suicide, and negative self-image. Furthermore, three different suicide note themes of those who died and three suicide note themes from those who survived were also identified. The analysis revealed that suicide note writers who died by their attempt were more likely to combine a dislike of themselves and a concern for loved ones. The implications of the work in terms of suicide prevention are discussed. © 2017 The American Association of Suicidology.

Medically Serious Suicide Attempters with or without Plan in Rural China1

PubMed Central

Sun, Long; Zhang, Jie

2015-01-01

Although previous studies have discussed the risk factors of unplanned suicide behavior in several countries, the unplanned suicide attempt in China was not explored in a large sample. We aim to look into the characteristics of unplanned suicide attempters in China, and compare them with those suicide attempters with plans. Subjects were 791 medically serious suicide attempters aged 15–54 years in rural China. The sixth item of Beck’s Suicide Intent Scale (SIS) was used to estimate the planned and unplanned suicide attempt. Logistic regression analysis was performed to examine the factors related to planned or unplanned suicide attempt. The results showed that the planned suicide attempt were associated with higher education, hopelessness and prior suicide act. The unplanned suicide attempt tend to suicide by pesticide and store pesticide at home. A ban of lethal pesticides may be a method for suicide prevention in rural China. PMID:26524517

[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.

Prevalence of suicidal ideation in Sri Lanka.

PubMed

Samaraweera, Sudath; Sumathipala, Athula; Siribaddana, Sisira; Sivayogan, S; Bhugra, Dinesh

2010-01-01

Suicidal ideation can often lead to suicide attempts and completed suicide. Studies have shown that Sri Lanka has one of the highest rates of suicide in the world but so far no studies have looked at prevalence of suicidal ideation in a general population in Sri Lanka. We wanted to determine the prevalence of suicidal ideation by randomly selecting six Divisional Secretariats (Dss) out of 17 in one district. This district is known to have higher than national average rates of suicide. 808 participants were interviewed using Sinhala versions of GHQ-30 and Beck's Scale for Suicidal Ideation. Of these, 387 (48%) were males, and 421 (52%) were female. On Beck's Scale for Suicidal Ideation, 29 individuals (4%) had active suicidal ideation and 23 (3%) had passive suicidal ideation. The active suicidal ideators were young, physically ill and had higher levels of helplessness and hopelessness. The prevalence of suicidal ideation in Sri Lanka is lower than reported from the West and yet suicide rates are higher. Further work must explore cultural and religious factors.

Suicidal behavior and assisted suicide in dementia.

PubMed

Draper, Brian M

2015-10-01

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

Comparison of Suicidal People Who Use the Internet for Suicide-Related Reasons and Those Who Do Not.

PubMed

Niederkrotenthaler, Thomas; Haider, Anna; Till, Benedikt; Mok, Katherine; Pirkis, Jane

2017-03-01

Studies have shown that suicidal individuals who use the Internet for suicide-related purposes are more suicidal than nonsuicide-related users, but evidence from European countries is lacking. We assessed differences between suicidal individuals who go online for suicide-related purposes and other suicidal individuals in Austria. Participants were 53 individuals aged between 18 and 24 years who felt suicidal in the past year and completed an anonymous online survey. Individuals who went online for suicide-related purposes were more suicidal, and more depressed, compared with individuals who did not use the Internet for suicide-related purposes. There were no large differences with regard to social anxiety and perceived barriers for help-seeking between the two groups. This study finds that suicidal online users are more depressed and suicidal than nonusers in a sample from Central Europe. Online interventions to combat depression and suicidality need to be strengthened to reach out to this important target population.

Suicide Neurosis--A Study of Sixty Young Suicide Attempters.

ERIC Educational Resources Information Center

Chinnian, R. Rawlin; Johnson, Shelonitda

Suicide and deviance are related because loss in social interaction is a consequence of deviance and an antecedent to suicide. This study examined the cognitive and affective experiences of suicidal individuals for evidence of neurosis. Sixty young attempted suicides with a history of a serious suicidal attempts attending the suicide prevention…

Current Suicide Proneness and Past Suicidal Behavior in Adjudicated Adolescents

ERIC Educational Resources Information Center

Langhinrichsen-Rohling, Jennifer; Lamis, Dorian A.

2008-01-01

Youth recently assigned to probation (n = 233) were assessed for current suicide proneness, depression, and hopelessness, as well as for recent suicide ideation, previous suicide ideation, or suicide attempt(s). The Life Attitudes Schedule-Short Form (LAS-SF) was used to assess suicide proneness. As per the LAS-SF, suicide proneness was defined…

The Interactive Effects of the Capability for Suicide and Major Depressive Episodes on Suicidal Behavior in a Military Sample

PubMed Central

Chu, Carol; Podlogar, Matthew; Hagan, Christopher R.; Buchman-Schmitt, Jennifer M.; Silva, Caroline; Chiurliza, Bruno; Hames, Jennifer L.; Stanley, Ian H.; Lim, LTC Ingrid C.; Joiner, Thomas E.

2015-01-01

Major depressive symptoms represent a significant risk for suicidal ideation and behavior. Given that suicide is fearsome, the interpersonal theory of suicide proposes that individuals who engage in suicidal behavior possess not only the desire to die, but also the acquired capability (AC) for suicide. This study examined whether major depressive episodes (MDEs) may be particularly relevant to suicidal behavior when considered in the context of AC. History of MDEs, AC, and suicide attempt history were examined in a large (n=3,377) sample of military members. Data were analyzed using hierarchical multiple regression. Results indicated that among individuals with high AC, the number of MDEs was significantly, positively associated with number of previous suicide attempts; MDEs were not significantly related to suicide attempt history among individuals with low AC. Findings held in the presence of robust covariates associated with suicidal behavior. Findings suggest that a history of MDEs alone may not indicate severe suicide risk – increased AC for suicide appears necessary for increased suicide risk. Implications for suicide treatment and prevention in military personnel are discussed. PMID:26834299

The Relationship between Attitudes toward Suicide and Family History of Suicide in Nagano Prefecture, Japan.

PubMed

Tsukahara, Teruomi; Arai, Hiroaki; Kamijo, Tomoko; Kobayashi, Yoshikiyo; Washizuka, Shinsuke; Arito, Heihachiro; Nomiyama, Tetsuo

2016-06-22

Certain attitudes toward suicide may be a risk factor for suicide among the bereaved. To explore this possibility, we examined the relationship between attitudes toward suicide and family history of suicide. We focused on two specific attitudes indicating resignation in a survey: #1 "When a person chooses to die by suicide, the suicide is inevitable" (i.e., inevitability belief); and #2 "A suicide cannot be stopped by any person, because suicide is unpreventable" (i.e., unpreventable belief). The data of 5117 fully completed questionnaires were analyzed. Logistic regression analysis revealed that the two attitudes of resignation were significantly associated with a family history of suicide. The adjusted odds ratio for #1 was 1.39 (95% CI, 1.07-1.79) for individuals having experienced suicide by a family member or relative, while that for #2 was 1.57 (95% CI, 1.27-1.95) for experiencing a suicide by a family member or relative and 1.25 (95% CI, 1.05-1.49) for experiencing a suicide by a friend, business associate, partner or other. These two attitudes of resignation toward suicide were significantly associated with a family history of suicide. These attitudes might increase suicide risk among the bereaved.

Suicide attempt history, self-esteem, and suicide risk in a sample of 116 depressed voluntary inpatients.

PubMed

Palmer, Charles James

2004-12-01

116 consecutively admitted depressed inpatients were divided into three groups based on self-reported history of suicidal ideation and history of suicide attempt. Participants in Group 1 (M age 34.0, SD= 14.0), 13 men and 24 women, reported no history of suicidal ideation or history of suicide attempt. Group 2 (M age 34.0, SD= 8.6), 14 men and 25 women, reported having a history of suicidal ideation but no history of suicide attempt. Group 3 (M age 34.0 yr., SD=6.3), 14 men and 26 women, reported a history of suicidal ideation and at least one suicide attempt. Each participant completed the Suicide Risk Scale and the Self-esteem Scale. Analysis of variance with Tukey post hoc comparisons yielded a significant difference between Groups 1 and 2, between Groups 1 and 3, and between Groups 2 and 3 on the Suicide Risk Scale. There was a significant difference between Group 1 and Group 2 and between Group 1 and Group 3 on the Self-esteem Scale. These data indicated that suicide ideation and suicide attempt history significantly elevated suicide risk. Self-esteem was significantly decreased by suicide ideation and suicide attempt history.

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

PubMed

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

2018-04-05

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

The impact of exposure to peer suicidal self-directed violence on youth suicidal behavior: a critical review of the literature.

PubMed

Crepeau-Hobson, M Franci; Leech, Nancy L

2014-02-01

There is considerable evidence that being exposed to the suicide or suicidal behavior of another can increase the risk for suicide. Significant relationships between media coverage and youth suicide have been documented in the professional literature. Exposure to familial suicidal behavior has also been established as a risk factor for youth suicidal behavior; However, peer suicide exposure is not as clear cut as research results in this area have been mixed. In the current paper the empirical literature focused on the associations between exposure to peer suicides and suicide attempts and youth suicidal behavior is critically reviewed. Effect sizes were computed for each of the 23 studies included in the review to allow for cross-study comparisons. The results demonstrate that having a friend or acquaintance attempt suicide is significantly related to risk for suicidal thoughts and behavior. However, the support for the relationship between the suicide of a peer and youth suicidal behavior was less consistent. Implications for clinical practice and suicide postvention as well as areas of future research are discussed. © 2013 The American Association of Suicidology.

A Google-based approach for monitoring suicide risk.

PubMed

Solano, Paola; Ustulin, Morena; Pizzorno, Enrico; Vichi, Monica; Pompili, Maurizio; Serafini, Gianluca; Amore, Mario

2016-12-30

People seeking information and news regarding suicide are likely to use the Internet. However, evidence of the relationship between suicide-related search volumes and national suicide-rates in different countries can be strikingly different. We aimed to investigate the relationship between suicide-rates and Google suicide-related search volumes in the Italian population (2008-2012) using the Italian mortality database that provided monthly national data concerning suicides (2008-2012). Moreover, this study aimed to identify future trends of national suicide rates on the basis of the results we obtained concerning the period 2013-14. Google Trends provided data of online monthly search-volumes of the term "suicide", "commit suicide" and "how to commit suicide" in Google Search and Google News (2008-2014). Google Search volumes for the term "suicide" lags suicide by three months (ρ=0.482, p-value<0.001), whereas no correlation was found between search volumes for "commit suicide" and "how to commit suicide" and national suicide rates. Google News search volumes for the three terms resulted in white noise. Apparently, online searches for suicide-related terms in Italy are more likely to be linked to factors other than suicidiality such as personal interest and suicide bereavement. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Psychological Processes and Repeat Suicidal Behavior: A Four-Year Prospective Study

PubMed Central

2013-01-01

Objective: Although suicidal behavior is a major public health concern, understanding of individually sensitive suicide risk mechanisms is limited. In this study, the authors investigated, for the first time, the utility of defeat and entrapment in predicting repeat suicidal behavior in a sample of suicide attempters. Method: Seventy patients hospitalized after a suicide attempt completed a range of clinical and psychological measures (depression, hopelessness, suicidal ideation, defeat, and entrapment) while in hospital. Four years later, a nationally linked database was used to determine who had been hospitalized again after a suicide attempt. Results: Over 4 years, 24.6% of linked participants were readmitted to hospital after a suicidal attempt. In univariate logistic regression analyses, defeat and entrapment as well as depression, hopelessness, past suicide attempts, and suicidal ideation all predicted suicidal behavior over this interval. However, in the multivariate analysis, entrapment and past frequency of suicide attempts were the only significant predictors of suicidal behavior. Conclusions: This longitudinal study supports the utility of a new theoretical model in the prediction of suicidal behavior. Individually sensitive suicide risk processes like entrapment could usefully be targeted in treatment interventions to reduce the risk of repeat suicidal behavior in those who have been previously hospitalized after a suicide attempt. PMID:23855989

Suicide Lethality: A Concept Analysis.

PubMed

DeBastiani, Summer; De Santis, Joseph P

2018-02-01

Suicide is a significant health problem internationally. Those who complete suicide may have different behaviors and risk factors than those who attempt a non-fatal suicide. The purpose of this article is to analyze the concept of suicide lethality and propose a clear definition of the concept through the identification of antecedents, attributes, and consequences. A literature search for articles published in the English language between 1970 and 2016 was conducted using MEDLINE, the Cochrane Library, Pubmed, Psychlit, Ovid, PsycINFO, and Proquest. The bibliographies of all included studies were also reviewed to identify additional relevant citations. A concept analysis was conducted on the literature findings using six stages of Walker and Avant's method. The concept analysis differentiated between suicide, lethality, suicidal behavior, and suicide lethality. Presence of a suicide plan or a written suicide note was not found to be associated with the majority of completed suicides included in the definition of suicide lethality. There are a few scales that measure the lethality of a suicide attempt, but none that attempt to measure the concept of suicide lethality as described in this analysis. Clarifying the concept of suicide lethality encourages awareness of the possibility of different suicidal behaviors associated with different suicide outcomes and will inform the development of future nursing interventions. A clearer definition of the concept of suicide lethality will guide clinical practice, research, and policy development aimed at suicide prevention.

Suicide Methods in Asia: Implications in Suicide Prevention

PubMed Central

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

2012-01-01

As the largest continent in the World, Asia accounts for about 60% of World suicides. Preventing suicide by restricting access to suicide methods is one of the few evidence-based suicide prevention strategies. However, there has been a lack of systematic exploration of suicide methods in Asian countries. To amend this shortage, the current review examines the leading suicide methods in different Asian countries, their trend, their age- and sex- specific characteristics, and their implications for suicide prevention. In total, 42 articles with leading suicide methods data in 17 Asian countries/regions were retrieved. The epidemiologic characteristics and recent trends of common suicide methods reflect specific socio-cultural, economic, and religious situations in the region. Common suicide methods shift with the introduction of technologies and constructions, and have specific age- or sex-characteristics that may render the restriction of suicide methods not equally effective for all sex and age sub-groups. Charcoal burning, pesticide poisoning, native plant poisoning, self-immolation, and jumping are all prominent examples. In the information society, suicide prevention that focuses on suicide methods must monitor and control the innovation and spread of knowledge and practices of suicide “technologies”. It may be more cost-effective to design safety into technologies as a way of suicide prevention while there is no rash of suicides yet by the new technologies. Further research on suicide methods is important for public health approaches to suicide prevention with sensitivity to socio-cultural, economic, and religious factors in different countries. PMID:22690187

The Impact of Celebrity Suicide on Subsequent Suicide Rates in the General Population of Korea from 1990 to 2010.

PubMed

Park, Juhyun; Choi, Nari; Kim, Seog Ju; Kim, Soohyun; An, Hyonggin; Lee, Heon-Jeong; Lee, Yu Jin

2016-04-01

The association between celebrity suicide and subsequent increase in suicide rates among the general population has been suggested. Previous studies primarily focused on celebrity suicides in the 2000s. To better understand the association, this study examined the impacts of celebrity suicides on subsequent suicide rates using the data of Korean celebrity suicides between 1990 and 2010. Nine celebrity suicides were selected by an investigation of media reports of suicide deaths published in three major newspapers in Korea between 1990 and 2010. Suicide mortality data were obtained from the National Statistical Office of Korea. Seasonal autoregressive integrated moving average models with intervention analysis were used to test the impacts of celebrity suicides, controlling for seasonality. Six of the 9 celebrity suicides had significant impacts on suicide rates both in the total population and in the same gender- or the same age-subgroups. The incident that occurred in the 1990s had no significant impact on the overall suicide rates, whereas the majority of the incidents in the 2000s had significant influences for 30 or 60 days following each incident. The influence of celebrity suicide was shown to reach its peak following the suicide death of a renowned actress in 2008. The findings may suggest a link between media coverage and the impact of celebrity suicide. Future studies should focus more on the underlying processes and confounding factors that may contribute to the impact of celebrity suicide on subsequent suicide rates.

The Impact of Celebrity Suicide on Subsequent Suicide Rates in the General Population of Korea from 1990 to 2010

PubMed Central

2016-01-01

The association between celebrity suicide and subsequent increase in suicide rates among the general population has been suggested. Previous studies primarily focused on celebrity suicides in the 2000s. To better understand the association, this study examined the impacts of celebrity suicides on subsequent suicide rates using the data of Korean celebrity suicides between 1990 and 2010. Nine celebrity suicides were selected by an investigation of media reports of suicide deaths published in three major newspapers in Korea between 1990 and 2010. Suicide mortality data were obtained from the National Statistical Office of Korea. Seasonal autoregressive integrated moving average models with intervention analysis were used to test the impacts of celebrity suicides, controlling for seasonality. Six of the 9 celebrity suicides had significant impacts on suicide rates both in the total population and in the same gender- or the same age-subgroups. The incident that occurred in the 1990s had no significant impact on the overall suicide rates, whereas the majority of the incidents in the 2000s had significant influences for 30 or 60 days following each incident. The influence of celebrity suicide was shown to reach its peak following the suicide death of a renowned actress in 2008. The findings may suggest a link between media coverage and the impact of celebrity suicide. Future studies should focus more on the underlying processes and confounding factors that may contribute to the impact of celebrity suicide on subsequent suicide rates. PMID:27051245

[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.

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

PubMed Central

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

2015-01-01

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

Non-suicidal self-injury and suicidal ideation in relation to eating and general psychopathology among college-age women.

PubMed

Eichen, Dawn M; Kass, Andrea E; Fitzsimmons-Craft, Ellen E; Gibbs, Elise; Trockel, Mickey; Barr Taylor, C; Wilfley, Denise E

2016-01-30

Non-suicidal self-injury (NSSI) and suicidal ideation are potent risk factors for suicide and are associated with general and eating disorder-specific psychopathology. Limited research has examined the effects of combined NSSI+suicidal ideation thus concurrent examination is needed to understand potential differential effects on psychopathology. College-aged women (N=508) completed self-report measures of NSSI, suicidal ideation, general psychopathology, and Eating Disorder-specific psychopathology. MANOVAs determined whether the NSSI/SI status groups differed on general and eating disorder pathology measures as a set. Significant MANOVAs were followed up with univariate ANOVAs and posthoc tests. Thirteen women endorsed NSSI+Suicidal Ideation, 70 endorsed NSSI-only, 25 endorsed Suicidal Ideation-only, and 400 endorsed no NSSI/Suicidal Ideation. Both general and eating disorder-specific psychopathology differed across groups. NSSI+Suicidal Ideation and Suicidal Ideation-only groups typically endorsed higher general psychopathology than the no NSSI/Suicidal Ideation and NSSI-only groups. Regarding eating disorder pathology, the NSSI+Suicidal Ideation group was more pathological than no NSSI/Suicidal Ideation and NSSI-only, except on the weight concerns scale, where NSSI+Suicidal Ideation only differed from no NSSI/Suicidal Ideation. The NSSI+Suicidal Ideation group was only greater than Suicidal Ideation-only on measures of depression and eating concern. Results highlight the importance of screening for both NSSI and suicidal ideation, especially for individuals with eating disorder symptoms. Likewise, screening for eating disorder pathology may be beneficial for individuals presenting with NSSI and suicidal ideation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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.

Attitudes towards suicide in urban and rural China: a population based, cross-sectional study.

PubMed

Zou, Yaming; Leung, Ricky; Lin, Shao; Yang, Mingan; Lu, Tao; Li, Xianyun; Gu, Jing; Hao, Chun; Dong, Guanghui; Hao, Yuantao

2016-05-26

Suicide intervention programs have been guided by findings that attitude towards suicide and suicidal behavior may be causally linked. These findings also make it imperative to identify the factors that influence attitudes towards suicide. However, there has been little research on attitudes towards suicide among the general population, especially in low-income and middle-income countries. This population-based, cross-sectional study investigated the associated factors of attitudes towards suicide among a representative sample of urban and rural adult residents in China. A multi-stage, stratified random sampling approach was implemented to select participants. Data were collected by a survey using the Scale of Public Attitudes about Suicide (SPAS). The survey also collected some socio-demographic factors and suicidal history of participants. Statistical tests were conducted to identify associated factors that account for variations in attitudes towards suicide. The residents in China generally hold a neutral attitude towards suicide. Attitudes towards suicide among Chinese residents were associated with age, duration of formal education, marital status, job and suicidal ideation. Different attitudinal subscales seemed not to share the same risk factors. However, gender, ethnicity, religious belief, housing style and economic status might not influence residents' attitudes towards suicide. Attitudes towards suicide among Chinese urban and rural residents generally had no statistical difference with one notable exception: opinions on whether or not suicides and suicide attempts are different phenomena. Age, duration of formal education, marital status, job and suicidal ideation seem to have an impact on attitudes towards suicide among residents. Urban and rural residents have similar attitudes towards suicide with the only statistically significance difference being their opinions on whether or not suicides and suicide attempts are different phenomena.

Some critical methodological issues in secondary analysis of world health organization data on elderly suicide rates.

PubMed

Shah, Ajit

2009-07-01

Suicides may be misclassified as accidental deaths in countries with strict legal definitions of suicide, with cultural and religious factors leading to poor registration of suicide and stigma attached to suicide. The concordance between four different definitions of suicides was evaluated by examining the relationship between pure suicide and accidental death rates, gender differences, age-associated trends and potential distil risk and protective factors by conducting secondary analysis of the latest World Health Organisation data on elderly death rates. The four definitions of suicide were: (i) one-year pure suicides rates; one-year combined suicide rates (pure suicide rates combined with accidental death rates); (iii) five-year average pure suicide rates; and (iv) five-year average combined suicides rates (pure suicides rates combined with accidental death rates). The predicted negative correlation between pure suicide and accidental death rates was not observed. Gender differences were similar for all four definitions of suicide. There was a highly significant concordance for the findings of age-associated trends between one-year pure and combined suicide rates, one-year and five-year average pure suicide rates, and five-year average pure and combined suicide rates. There was poor concordance between pure and combined suicide rates for both one-year and five-year average data for the 14 potential distil risk and protective factors, but this concordance between one-year and five-year average pure suicide rates was highly significant. The use of one-year pure suicide rates in cross-national ecological studies examining gender differences, age-associated trends and potential distil risk and protective factors is likely to be practical, pragmatic and resource-efficient.

The power of (Mis)perception: Rethinking suicide contagion in youth friendship networks.

PubMed

Zimmerman, Gregory M; Rees, Carter; Posick, Chad; Zimmerman, Lori A

2016-05-01

Suicide is a leading cause of death among youth. In the wake of peer suicide, youth are vulnerable to suicide contagion. But, questions remain about the mechanisms through which suicide spreads and the accuracy of youths' estimates of friends' suicidal behaviors. This study addresses these questions within school-aged youths' friendship networks. Social network data were drawn from two schools in the National Longitudinal Study of Adolescent to Adult Health, from which 2180 youth in grades 7-12 nominated up to ten friends. A measure of "perceived" friends' attempted suicide was constructed based on respondents' reports of their friends' attempted suicide. This measure was broader than a "true" measure of friends' attempted suicide, constructed from self-reports of nominated friends who attended respondents' schools. Sociograms graphically represented the accuracy with which suicide attempters estimated friends' suicide attempts. Results from cross-tabulation with Chi-square analysis indicated that approximately 4% of youth (88/2180) attempted suicide, and these youth disproportionately misperceived (predominantly overestimated) friends' suicidal behaviors, compared to non-suicide-attempters. Penalized logistic regression models indicated that friends' self-reported attempted suicide was unrelated to respondent attempted suicide. But, the odds of respondent attempted suicide were 2.54 times higher (95% CI, 1.06-6.10) among youth who accurately perceived friends' attempted suicide, and 5.40 times higher (95% CI, 3.34-8.77) among youth who overestimated friends' attempted suicide. The results suggest that at-risk youth overestimate their friends' suicidal behaviors, which exacerbates their own risk of suicidal behavior. Methodologically, this suggests that a continued collaboration among network scientists, suicide researchers, and medical providers is necessary to further examine the mechanisms surrounding this phenomenon. Practically, it is important to screen at-risk youth for exposure to peer suicide and to use the social environment created by adolescent friendship networks to empower and support youth who are susceptible to suicidal thoughts and behaviors. Copyright © 2016 Elsevier Ltd. All rights reserved.

To what extent does the reporting behavior of the media regarding a celebrity suicide influence subsequent suicides in South Korea?

PubMed

Lee, JeSuk; Lee, Weon-Young; Hwang, Jang-Sun; Stack, Steven John

2014-08-01

This study investigated the nature of media coverage of a national entertainer's suicide and its impact on subsequent suicides. After the celebrity suicide, the number of suicide-related articles reported surged around 80 times in the week after the suicide compared with the week prior. Many articles (37.1%) violated several critical items on the World Health Organization suicide reporting guidelines, like containing a detailed suicide method. Most gender and age subgroups were at significantly higher risk of suicide during the 4 weeks after the celebrity suicide. Results imply that massive and noncompliant media coverage of a celebrity suicide can cause a large-scale copycat effect. © 2014 The American Association of Suicidology.

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

PubMed

Bell, Carl C; McBride, Dominica F

2010-01-01

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

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

PubMed Central

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

2014-01-01

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

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.

Caring stress, suicidal attitude and suicide care ability among family caregivers of suicidal individuals: a path analysis.

PubMed

Chiang, C-Y; Lu, C-Y; Lin, Y-H; Lin, H-Y; Sun, F-K

2015-12-01

What is known on the subject? Suicide is a global mental health issue. Taking care of suicidal individuals is a substantial challenge. Most studies emphasize the suicidal individual. Few studies have emphasized the family caregivers of suicidal individuals. No study has explored the relationship between family caregivers' caring stress with suicidal attitudes and suicide care ability. What this paper adds to existing knowledge? The main results indicated that the older family caregivers tended to have a more negative attitude towards suicidal individuals. Female family caregivers' stress was higher than that of male family caregivers. A mild level of caring stress would help family caregivers have a more positive attitude towards suicidal individuals. Furthermore, a positive attitude would help family caregivers improve their caring ability. What are the implications for practice? Mental health nurses could help family caregivers, especially female family caregivers, reduce their holistic caring burden by looking for support resources and enhancing their coping strategies. Mental health nurses could help family caregivers promote positive attitudes towards suicidal relatives by understanding suicidal individuals' suffering. Suicide is a global mental health issue. Family caregivers play a key role in preventing suicide attempts. The aim of this study was to examine the relationship among stress due to the family caregiver's role, suicidal attitude of the family caregiver and suicide care ability among family caregivers. Additionally, instruments of caring stress, attitudes towards suicidal relatives and caring abilities used in the study were tested to measure construct validity. A cross-sectional correlational study was conducted with 164 family caregivers of people who are suicidal. The following three questionnaires were used: the Caring Stress Scale, the Suicidal Attitudes Scale and the Suicidal Caring Ability Scale. Structural equation modelling was performed using SPSS AMOS 19.0 to examine the path relationships among variables. Bivariate analyses showed that age was negatively correlated with suicidal attitude. In the final path model, caring stress had a positive effect on suicidal attitudes. Suicidal attitude and suicide care ability were highly positively correlated. Gender had a direct effect on caring stress, which indicated that female family caregivers experienced more stress from their role. Mental health nurses could help family caregivers become aware of the emotional pain that suicidal people experience and then promote their positive attitudes towards their suicidal relatives. Furthermore, family caregivers could increase their ability to care for their suicidal relatives, which could reduce the numbers of suicides. © 2015 John Wiley & Sons Ltd.

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

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

PubMed

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

2016-03-01

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

Prevalence and correlates of suicidal ideation and suicide attempts among veterans in primary care referred for a mental health evaluation.

PubMed

Ashrafioun, Lisham; Pigeon, Wilfred R; Conner, Kenneth R; Leong, Shirley H; Oslin, David W

2016-01-01

The Veterans Health Administration has made concerted efforts to increase mental health services offered in primary care. However, few studies have evaluated correlates of suicidal ideation and suicide attempt in veterans in primary care-mental health integration (PCMHI). The purpose of the present study is to examine associations between suicidal ideation and suicide attempts as dependent variables and demographic and clinical factors as the independent variables. Veterans (n=3004) referred from primary care to PCMHI were contacted for further assessment, which included past-year severity of suicidal thoughts (none, low, high) and attempts using the Paykel Suicide Scale, mental health disorders, and illicit drug use. Multinomial logistic regression models were used to identify correlates of suicidal ideation and suicide attempts. Thoughts of taking one's life was endorsed by 24% of participants and suicide attempts were reported in 2%. In adjusted models, depression, psychosis, mania, PTSD and generalized anxiety disorder were associated with high severity suicidal ideation, but not suicide attempt. Illicit drug use was not associated with suicidal ideation, but was the only variable associated with suicide attempt. The study was cross-sectional, focused on one clinical setting, and the suicide attempt analyses had limited power. PCMHI is a critical setting to assess suicidal ideation and suicide attempt and researchers and clinicians should be aware that the differential correlates of these suicide-related factors. Future research is needed to identify prospective risk factors and assess the utility of follow-up care in preventing suicide. Published by Elsevier B.V.

Are Suicide Terrorists Suicidal? A Critical Assessment of the Evidence

PubMed Central

2014-01-01

Objective: Most of the research on suicide terrorism is conducted in the political science and international relations fields. The prevailing wisdom within this literature is that suicide terrorists are not suicidal. But how good is the evidence for this assumption? Knowing whether suicide terrorists are suicidal has implications for prevention, rehabilitation, and the “softer” side of counterterrorism designed to win minds and hearts. In addition it may deepen our understanding of suicide itself. Design: This article uses a review of existing literature to examine the arguments and evidence for and against the possibility that suicide terrorists could be suicidal in the context of a broad range of explanations for suicide terrorism. Results: Much of the evidence against the possibility that suicide terrorists are suicidal is based on anecdote or faulty assumptions about suicide. Relatively few formal systematic studies of suicidality in suicide terrorists have been conducted. Nonetheless, there is emerging evidence that suicidality may play a role in a significant number of cases. Conclusion: The field needs a more multidimensional approach, more systematic data at the individual level, and greater international cross-disciplinary collaboration. Would-be suicide terrorists (intercepted and arrested on their way to an attack) should be routinely interviewed using standard internationally accepted psychiatric diagnostic interviews as well as suicidality and homicidality rating scales. Psychological autopsies should also be routinely conducted worldwide. Since no one research site can collect all of the information that is needed, the creation of an internationally shared database that focuses on suicide terrorists rather than simply incidents is encouraged. PMID:25520891

Media representation of gender patterns of suicide in Taiwan.

PubMed

Chen, Ying-Yeh; Yip, Paul S F; Tsai, Chi-Wei; Fan, Hsiang-Fang

2012-01-01

Extensive media reporting of suicide events has been indicated as a contributing factor to the upsurge in suicide rates in Taiwan in the past decade. The study compares gender differences in sociodemographic profiles and method of suicide selectively reported in the newspapers and all suicide cases registered in official death records. It also identifies gender differences in media reports of suicides. Articles reporting suicide news from four major newspapers in Taiwan (China Times, United Daily, Liberty Times, and Apple Daily) in 2009 were retrieved and analyzed. Gender differences in sociodemographic profiles of suicides reported in the newspapers and official records of all suicide deaths were compared. Any gender differences in newspaper depictions of contributing factors of suicide and situations surrounding the suicidal acts were compared. Newspapers in Taiwan tended to overreport unusual methods of suicide among men and extended suicide among women. The reasons for suicide in men were more frequently portrayed as work-related or after legal problems, whereas in women suicide was more frequently framed as due to mental illness or relationship problems. The news media tended to underreport mental illness as a reason for suicide in men. The analysis was based solely on news reporting in the four major newspapers during the year 2009. Media representation of suicide generally follow societal-gendered assumptions of acceptable/unacceptable behaviors. Media professionals should be more careful and responsible in reporting suicide news and avoid any gender bias in their framing of suicide stories. Sensitive rather than sensational reporting should be promoted in order not to reinforce the myths of suicides in the community.

Effects of media reports and the subsequent voluntary withdrawal from sale of suicide-related products on the suicide rate in Japan.

PubMed

Hagihara, Akihito; Abe, Takeru

2012-04-01

Media reports of suicides have an impact on suicide rates. However, countermeasures to this media effect have not been evaluated. We examined the association between media reports of suicides accomplished with the use of hydrogen sulfide, the voluntary stoppage of sales of suicide-related products, and suicide rates for people in their 20s, 30s, and 40s in Japan. The Box-Jenkins transfer function model was applied to monthly time series data from February 2003 to December 2009 (83 months). In the male suicide time series, media reports of suicide were not related to suicide counts (ω((R)) = 8.988, P = 0.694). Similarly, stopping the sale of bath salts was not related to the number of suicides (ω((S)) = -7.344, P = 0.694). However, in the female suicide time series, media reports of suicide were related to the number of suicides (ω((R)) = 17.225, P = 0.049). Similarly, stopping the sale of bath salts was related to the number of suicides (ω((S)) = -18.545, P = 0.040). The results suggest that stopping the sale of bath salts might be effective in reducing the number of copycat suicides among the women in their 20s, 30s, and 40s. In practice, stopping the sale of suicide-related products might be a potentially effective countermeasure to prevent copycat suicides triggered by media coverage of suicides.

Predictors of intimate partner problem-related suicides among suicide decedents in Kentucky

PubMed Central

Comiford, Ashley L.; Sanderson, Wayne T.; Chesnut, Lorie; Brown, Sabrina

2016-01-01

Abstract: Background: Suicide is the 10th leading cause of death in the United States. Furthermore, intimate partner problems are amid the top precipitating circumstances among suicide decedents. The aim of this study was to determine circumstantial associations of intimate partner problem-related suicides in suicide decedents in Kentucky. Methods: All suicides that were reported to the Kentucky Violent Death Reporting System between 2005 and 2012 were eligible for this study. Multiple logistic regression was used to explore predictors (precipitating health-related problems, life stressors, and criminal/legal issues) of intimate partner problem-related suicides. Results: Of the 4,754 suicides, included in this study, approximately 17% had intimate partner problems prior to suicide. In the adjusted analysis, mental health issues, alcohol problems, history of suicides attempts, suicides precipitated by another crime, and other legal problems increased the odds of having an intimate partner-related suicide. However, having physical health problems, prior to the suicide, decreased the odds of intimate partner-related suicide. Conclusions: These results provide insight for the development of suicide interventions for individuals with intimate partner problems by targeting risk factors that are prevalent among this population. Moreover, these results may help marriage/relationship and/or family/divorce court representatives identify individuals with intimate partner problems more at risk for suicide and alleviate the influence these suicide risk factors have on individuals experiencing Intimate partner problems. PMID:27092956

Predictors of intimate partner problem-related suicides among suicide decedents in Kentucky.

PubMed

Comiford, Ashley L; Sanderson, Wayne T; Chesnut, Lorie; Brown, Sabrina

2016-07-01

Suicide is the 10th leading cause of death in the United States. Furthermore, intimate partner problems are amid the top precipitating circumstances among suicide decedents. The aim of this study was to determine circumstantial associations of intimate partner problem-related suicides in suicide decedents in Kentucky. All suicides that were reported to the Kentucky Violent Death Reporting System between 2005 and 2012 were eligible for this study. Multiple logistic regression was used to explore predictors (precipitating health-related problems, life stressors, and criminal/legal issues) of intimate partner problem-related suicides. Of the 4,754 suicides, included in this study, approximately 17% had intimate partner problems prior to suicide. In the adjusted analysis, mental health issues, alcohol problems, history of suicides attempts, suicides precipitated by another crime, and other legal problems increased the odds of having an intimate partner-related suicide. However, having physical health problems, prior to the suicide, decreased the odds of intimate partner-related suicide. These results provide insight for the development of suicide interventions for individuals with intimate partner problems by targeting risk factors that are prevalent among this population. Moreover, these results may help marriage/relationship and/or family/divorce court representatives identify individuals with intimate partner problems more at risk for suicide and alleviate the influence these suicide risk factors have on individuals experiencing Intimate partner problems. © 2016 KUMS, All rights reserved.

Childhood bullying behaviors as a risk for suicide attempts and completed suicides: a population-based birth cohort study.

PubMed

Klomek, Anat Brunstein; Sourander, Andre; Niemelä, Solja; Kumpulainen, Kirsti; Piha, Jorma; Tamminen, Tuula; Almqvist, Fredrik; Gould, Madelyn S

2009-03-01

There are no previous studies about the association of childhood bullying behavior with later suicide attempts and completed suicides among both sexes. The aim was to study associations between childhood bullying behaviors at age 8 years and suicide attempts and completed suicides up to age 25 years in a large representative population-based birth cohort. The sample includes 5,302 Finnish children born in 1981. Information about bullying was gathered at age 8 years from self-report, as well as parent and teacher reports. Information about suicide attempts requiring hospital admission and completed suicides was gathered from three different Finnish registries until the study participants were 25 years old. Regression analyses were conducted to determine whether children who experience childhood bullying behaviors are at risk for later suicide attempts and completed suicides after controlling for baseline conduct and depression symptoms. The association between bullying behavior at age 8 years and later suicide attempts and completed suicides varies by sex. Among boys, frequent bullying and victimization are associated with later suicide attempts and completed suicides but not after controlling for conduct and depression symptoms; frequent victimization among girls is associated with later suicide attempts and completed suicides, even after controlling for conduct and depression symptoms. When examining childhood bullying behavior as a risk factor for later suicide attempts and completed suicides, each sex has a different risk profile.

Turkish Imams' Experience with and Their Attitudes Toward Suicide and Suicidal Persons.

PubMed

Eskin, Mehmet

2017-06-01

This study investigated the experience with and attitudes toward suicide and suicidality in 70 consenting imams serving in mosques in the province of Aydin which is located at the southwest part of Turkey. A self-report questionnaire was used to collect the data. Attitudes of imams to suicide and suicidality were compared with attitudes of male university students. Only 4 imams (5.7 %) reported having had suicidal thoughts in past, and none reported having attempted suicide. Almost 50 % said that someone in communities they serve has commited suicide and nearly 40 % reported leading funeral ceremony for someone who committed suicide. Majority of imams (64.3 %) were of the opinion that a funeral ceremony should be arranged for people who suicide and 87.1 % were of the opinion that people who suicide can be buried in a common cemetery, but only 21.4 % said that someone who attempted suicide can be appointed as imam. Compared to male medical students, imams saw suicide as an unacceptable option and those engaging in suicidal behavior to be punished after death. But they displayed socially accepting and helping reactions to an imagined close friend who attempted suicide. Therefore, it was concluded that imams might exhibit preventive reactions to suicide when they offer counseling for persons from their congregations during times of suicidal crises.

The rate of fatality and demographic characteristics associated with various suicide methods: a community-based study in Northern Taiwan.

PubMed

Lee, Chun-Yi; Wu, Ya-Wen; Chen, Chih-Ken; Wang, Liang-Jen

2014-01-01

Understanding lethality and risk factors of suicide methods is an initial step in suicide prevention. To investigate the fatality rate and demographic characteristics of various suicide methods. This study enrolled consecutive individuals with episodes of suicide attempts registered in a surveillance database in a city with a high rate of suicide mortality in Taiwan, from January 1, 2006, to December 31, 2010. In total, 3,089 suicide attempt events (including 2,583 nonfatal suicides and 506 completed suicides) occurred during the study period. Overall, the fatality rate of suicides was 16.4%. Charcoal burning accounted for the most suicide deaths (37.6%), with a fatality rate of 50.1%. Suicide by hanging carried the highest fatality rate (81.2%). Males tended to choose more lethal methods and had higher fatality rates compared with females. Elders and married persons were less likely to attempt suicide by charcoal burning. The case fatality ratio increased along with age among suicide attempts, but not in those using charcoal burning. The choice of suicide methods and lethality might be influenced by one's demographic characteristics. RESULTS from this study may provide clues for establishing suicide prevention strategies such as restricting access to common lethal suicide methods in the high-risk group.

Suicide rates in the national and expatriate population in Dubai, United Arab Emirates.

PubMed

Dervic, Kanita; Amiri, Leena; Niederkrotenthaler, Thomas; Yousef, Said; Salem, Mohamed O; Voracek, Martin; Sonneck, Gernot

2012-11-01

Reports on suicide from the Gulf region are scarce. Dubai is a city with a large expatriate population. However, total and gender-specific suicide rates for the national and expatriate populations are not known. To investigate total and gender-specific suicide rates in the national and expatriate population in Dubai and to elicit socio-demographic characteristics of suicide victims. Registered suicides in Dubai from 2003 to 2009, and aggregated socio-demographic data of suicide victims were analysed. Suicide rates per 100,000 population were calculated. Suicide rate among expatriates (6.3/100,000) was seven times higher than the rate among the nationals (0.9/100,000). In both groups, male suicide rate was more than three times higher than the female rate. Approximately three out of four expatriate suicides were committed by Indians. The majority of suicide victims were male, older than 30 years, expatriate, single and employed, with an education of secondary school level and below. Further research on risk factors for and protective factors against suicide, particularly among the expatriate population, is needed. Epidemiological monitoring of suicide trends at the national level and improvement of UAE suicide statistics would provide useful information for developing suicide prevention strategies.

Firearms and suicide in the United States: is risk independent of underlying suicidal behavior?

PubMed

Miller, Matthew; Barber, Catherine; White, Richard A; Azrael, Deborah

2013-09-15

On an average day in the United States, more than 100 Americans die by suicide; half of these suicides involve the use of firearms. In this ecological study, we used linear regression techniques and recently available state-level measures of suicide attempt rates to assess whether, and if so, to what extent, the well-established relationship between household firearm ownership rates and suicide mortality persists after accounting for rates of underlying suicidal behavior. After controlling for state-level suicide attempt rates (2008-2009), higher rates of firearm ownership (assessed in 2004) were strongly associated with higher rates of overall suicide and firearm suicide, but not with nonfirearm suicide (2008-2009). Furthermore, suicide attempt rates were not significantly related to gun ownership levels. These findings suggest that firearm ownership rates, independent of underlying rates of suicidal behavior, largely determine variations in suicide mortality across the 50 states. Our results support the hypothesis that firearms in the home impose suicide risk above and beyond the baseline risk and help explain why, year after year, several thousand more Americans die by suicide in states with higher than average household firearm ownership compared with states with lower than average firearm ownership.

Suicidal behavior in the Ukraine, 1988-1998.

PubMed

Kryzhanovskaya, L; Pilyagina, G

1999-01-01

This report studies the available data concerning suicide rates in the Ukraine and points to the importance of appropriate monitoring of suicides and attempted suicides. It illustrates the necessity of collecting this information and of developing "The Ukrainian National Program on Suicide Prevention." Unfortunately, suicide research and publications about suicide rates were prohibited in the former Soviet Union, so some of the data about suicidal behavior in the Ukraine is incomplete. We used the official suicide death statistics of the Ukraine from the Center of Statistics (Ukrainian Ministry of Health) for the period 1988-1998. The overall rate of suicide in the Ukraine is relatively high. Official statistics in the Ukraine show that there were 29.6 suicides per 100,000 population in 1998. The frequency of completed suicide differs in the various regions of the country, suicides being more frequent in the industrially developed regions and in the rural areas of the country than in the cities. In the western part of the Ukraine the frequency of suicide is relatively low (11.1 per 100,000). Between 1988 and 1997 the suicide rate increased by 57%. In 1998 the suicide rate for women was approximately five times lower than that for men.

The role of stressful life events preceding death by suicide: Evidence from two samples of suicide decedents.

PubMed

Buchman-Schmitt, Jennifer M; Chu, Carol; Michaels, Matthew S; Hames, Jennifer L; Silva, Caroline; Hagan, Christopher R; Ribeiro, Jessica D; Selby, Edward A; Joiner, Thomas E

2017-10-01

Stressful life events (SLEs) are associated with increased risk for suicidal behavior. Less is known regarding the intensity of SLEs and how this may vary as a function of suicide attempt history. As a large percentage of suicide decedents do not have a history of suicidal behavior, SLEs precipitating suicide may help characterize suicidality in this understudied population. This paper examines the intensity, number, and accumulation of SLEs preceding death by suicide among decedents with varying suicide attempt histories. Suicide attempts, SLEs, and suicide methods were examined in two samples: 62 prison-based and 117 community-based suicide decedents. Regression was used to compare the level of stressor precipitating death by suicide in decedents who died on a first attempt versus multiple previous attempts. A non-significant trend was observed in the prison population which was supported by significant findings in the community-based sample. Decedents who died on a first attempt experienced a stressor of a lower magnitude when compared to decedents with multiple previous suicide attempts. We discuss the implications of these findings in relation to the stress-diathesis model for suicide. Copyright © 2017 Elsevier B.V. All rights reserved.

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.

An Aspect of the Capability for Suicide-Fearlessness of the Pain Involved in Dying-Amplifies the Association Between Suicide Ideation and Attempts.

PubMed

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

2016-01-01

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

Teaching medical professionals and trainees about adolescent suicide prevention: five key problems.

PubMed

Sher, Leo

2012-01-01

Predicting and preventing suicide represent very difficult challenges for clinicians. The awareness of adolescent suicide as a major social and medical problem has increased over the past years. However, many health care professionals who have frequent contact with adolescents are not sufficiently trained in suicide evaluation techniques and approaches to adolescents with suicidal behavior. Suicide prevention efforts among adolescents are restricted by the fact that there are five key problems related to the evaluation and management of suicidality in adolescents: 1. Many clinicians underestimate the importance of the problem of adolescent suicidal behavior and underestimate its prevalence. 2. There is a misconception that direct questioning of adolescents about suicidality is sufficient to evaluate suicide risk. 3. Another misconception is that adolescents with non-psychiatric illnesses do not need to be evaluated for suicidality. 4. Many clinicians do not know about or underestimate the role of contagion in adolescent suicidal behavior. 5. There is a mistaken belief that adolescent males are at lower suicide risk than adolescent females. Educating medical professionals and trainees about the warning signs and symptoms of adolescent suicide and providing them with tools to recognize, evaluate, and manage suicidal patients represent a promising approach to adolescent suicide prevention.

Childhood gender nonconformity and harassment as predictors of suicidality among gay, lesbian, bisexual, and heterosexual Austrians.

PubMed

Plöderl, Martin; Fartacek, Reinhold

2009-06-01

The role of childhood gender role nonconformity (CGNC) and childhood harassment (CH) in explaining suicidality (suicide ideation, aborted suicide attempts, and suicide attempts) was examined in a sample of 142 lesbian, gay, and bisexual (LGB) adults and 148 heterosexual adults in Austria. Current and previous suicidality, CGNC, and CH were significantly greater in LGB participants compared to heterosexual participants. After controlling for CGNC, the effect of sexual orientation on CH diminished. CGNC correlated significantly with current suicidality in the LGB but not in the heterosexual group, and only non-significant correlations were found for CGNC with previous suicidality. Controlling for CH and CGNC diminished the effect of sexual orientation on current suicidality. Bayesian multivariate analysis indicated that current suicidality, but not previous suicidality, depended directly on CGNC. CH and CGNC are likely implicated in the elevated levels of current suicidality among adult LGB participants. As for previous suicidality, the negative impact of CGNC on suicidality might be overshadowed by stress issues affecting sexual minorities around coming out. The association of CGNC with current suicidality suggests an enduring effect of CGNC on the mental health and suicide risk of LGB individuals.

Searching for suicide-related information on Chinese websites.

PubMed

Chen, Ying-Yeh; Hung, Galen Chin-Lun; Cheng, Qijin; Tsai, Chi-Wei; Wu, Kevin Chien-Chang

2017-12-01

Growing concerns about cyber-suicide have prompted many studies on suicide information available on the web. However, very few studies have considered non-English websites. We aimed to analyze online suicide-related information accessed through Chinese-language websites. We used Taiwan's two most popular search engines (Google and Yahoo) to explore the results returned from six suicide-related search terms in March 2016. The first three pages listing the results from each search were analyzed and rated based on the attitude towards suicide (pro-suicide, anti-suicide, neutral/mixed, not a suicide site, or error). Comparisons across different search terms were also performed. In all, 375 linked webpages were included; 16.3% of the webpages were pro-suicide and 41.3% were anti-suicide. The majority of the pro-suicide sites were user-generated webpages (96.7%). Searches using the keywords 'ways to kill yourself' (31.7%) and 'painless suicide' (28.3%) generated much larger numbers of harmful webpages than the term 'suicide' (4.3%). We conclude that collaborative efforts with internet service providers and search engines to improve the ranking of anti-suicide webpages and websites and implement online suicide reporting guidelines are highly encouraged. Copyright © 2017 Elsevier B.V. All rights reserved.

Factors associated with attitudes toward suicide: among Japanese pharmacists participating in the Board Certified Psychiatric Pharmacy Specialist Seminar.

PubMed

Kodaka, Manami; Inagaki, Masatoshi; Yamada, Mitsuhiko

2013-01-01

Pharmacists could play a significant role in providing care for suicidal individuals. Previous studies reported that gatekeeper attitudes toward suicide could affect caregiving behaviors toward people at risk for suicide. Nevertheless, only few studies have examined the attitudes of pharmacists toward suicide. This study explores the factors associated with the attitudes of pharmacists toward suicide. A self-administered questionnaire and written explanation of the study were mailed to 541 pharmacists who had registered for the Board Certified Psychiatry Pharmacy Specialist Seminar in Tokyo, Japan. A Japanese version of the Attitudes Toward Suicide questionnaire was used to assess participant attitudes toward suicide. Multivariate analysis of covariance was used to assess relationships between participant attitudes toward suicide as well as demographics, occupational, and personal factors. Participants who had previously received suicide-related education were more likely to have positive attitudes toward suicide prevention. Conversely, those with a lifetime history of suicidal thoughts had more permissive attitudes toward one's right to commit suicide. Our findings suggest that pharmacist suicide prevention training programs should aim to alter permissiveness attitudes of trainees toward suicide.

The epidemiology of firearm suicide in the United States.

PubMed

Romero, Michael P; Wintemute, Garen J

2002-03-01

Little attention has been given to the role of firearms in suicide. In 1998, firearms were the leading method of committing suicide for both men and women, responsible for three times the number of suicides compared to the next leading method. Understanding the epidemiology of firearm suicide will increase awareness of firearm suicide as a major public health problem. Rates of firearm suicide have changed little over the past two decades and have consistently exceeded rates of firearm homicide. The firearm suicide rate among men is approximately six times that of women. While firearm suicide rates are highest among the elderly, the majority (66%) of firearm suicides are among persons under 55 years of age. Firearm suicide rates among women of all ages have dropped modestly, while rates among elderly men have risen considerably. Whites have roughly twice the rate of firearm suicide as do blacks and other race/ethnicity groups. Individual-level empirical studies have consistently indicated that keeping firearms in the home is associated with an increased risk of suicide. For suicide prevention to be effective, the availability and use of firearms in suicides must be addressed.

Moral objections to suicide and suicidal ideation among mood disordered Whites, Blacks, and Hispanics.

PubMed

Richardson-Vejlgaard, Randall; Sher, Leo; Oquendo, Maria A; Lizardi, Dana; Stanley, Barbara

2009-01-01

Understanding the beliefs that protect individuals against suicide can help to enhance suicide prevention strategies. One measure of suicide non-acceptability is the moral objections to suicide (MOS) sub-scale of the reasons for living inventory (RFLI). This study examined the MOS and suicidal ideation of White, Black, and Hispanic individuals with mood disorders. We expected minority individuals to have stronger objections to suicide. Eight hundred and four, White (588), Black (122) and Hispanic (94) participants with DSM-IV diagnoses of MDD or bipolar disorder were administered the scale for suicide ideation, the reasons for living inventory and several measures of clinical distress. Higher suicidal ideation was modestly correlated with lower MOS scores overall (r=0.15, p=0.001). Among Blacks however the relationship was inverted: despite having higher suicidal ideation than Whites or Hispanics, Blacks reported the least accepting attitudes toward suicide. These results suggest that attitudes regarding the acceptability of suicide may be independent of suicidal ideation.

A four-year longitudinal study examining psychache and suicide ideation in elevated-risk undergraduates: A test of Shneidman's model of suicidal behavior.

PubMed

Montemarano, Vanessa; Troister, Talia; Lambert, Christine E; Holden, Ronald R

2018-05-16

Using a 4-year follow-up design, this research investigated Shneidman's model of psychache (i.e., intense mental pain/anguish) as the cause of suicide. Operationalizing suicidal manifestations using suicide ideation, we evaluated Shneidman's assertion that psychache is the prominent predictor of suicide ideation and that other suicide-related psychological variables associate with suicide ideation only through psychache. Eighty-two undergraduates at elevated suicide risk were assessed at baseline and follow-up with measures of suicide ideation and three psychological predictors: depression, hopelessness, and psychache. At baseline, only psychache and neither depression nor hopelessness contributed significant, unique information to statistically predicting suicide ideation. For 4-year change in suicide ideation, only psychache and neither depression nor hopelessness provided significant, unique information. Results provided partial support for Shneidman's contention of the importance of psychache for suicidal behavior and that other psychological factors are only important to suicide insofar as they relate through psychache. © 2018 Wiley Periodicals, Inc.

Why not Commercial Assistance for Suicide? On the Question of Argumentative Coherence of Endorsing Assisted Suicide.

PubMed

Kipke, Roland

2015-09-01

Most people who endorse physician-assisted suicide are against commercially assisted suicide - a suicide assisted by professional non-medical providers against payment. The article questions if this position - endorsement of physician-assisted suicide on the one hand and rejection of commercially assisted suicide on the other hand - is a coherent ethical position. To this end the article first discusses some obvious advantages of commercially assisted suicide and then scrutinizes six types of argument about whether they can justify the rejection of commercially assisted suicide while simultaneously endorsing physician-assisted suicide. The conclusion is that they cannot provide this justification and that the mentioned position is not coherent. People who endorse physician-assisted suicide have to endorse commercially assisted suicide as well, or they have to revise their endorsement of physician-assisted suicide. © 2014 John Wiley & Sons Ltd.

Family history of suicide and high motor impulsivity distinguish suicide attempters from suicide ideators among college students.

PubMed

Wang, Yong-Guang; Chen, Shen; Xu, Zhi-Ming; Shen, Zhi-Hua; Wang, Yi-Quan; He, Xiao-Yan; Cao, Ri-Fang; Roberts, David L; Shi, Jian-Fei; Wang, Yi-Qiang

2017-07-01

Suicide in college students has become an important public health issue in China. The aim of this study was to identify the differences between suicide attempters and suicide ideators based on a cross-sectional survey. Our results indicate that although female gender, positive screening for psychiatric illness, positive family history of suicide, elevated overall impulsivity, and elevated motor impulsivity were correlated with suicidal ideation, only positive family history of suicide and high motor impulsivity could differentiate suicide attempters from suicidal ideators. Future research with a longitudinal and prospective study design should be conducted to confirm these findings. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

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

PubMed

Merinov, A V; Shustov, D I

2011-01-01

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

CSF 5-HIAA Predicts Suicide Risk after Attempted Suicide.

ERIC Educational Resources Information Center

Nordstrom, Peter; And Others

1994-01-01

Studied suicide risk after attempted suicide, as predicted by cerebrospinal fluid (CSF) monoamine metabolite concentrations, in 92 psychiatric mood disorder inpatients admitted shortly after attempting suicide. Results revealed that low CSF 5-hydroxyindoleacetic acid (5-HIAA) predicted short-range suicide risk after attempted suicide in mood…

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

Meta-analysis of the association between suicidal ideation and later suicide among patients with either a schizophrenia spectrum psychosis or a mood disorder.

PubMed

Chapman, C L; Mullin, K; Ryan, C J; Kuffel, A; Nielssen, O; Large, M M

2015-03-01

Recent studies of patients with a mix of psychiatric diagnoses have suggested a modest or weak association between suicidal ideation and later suicide. The aim of this study was to examine the extent to which the association between expressed suicidal ideation and later suicide varies according to psychiatric diagnosis. A systematic meta-analysis of studies that report the association between suicidal ideation and later suicide in patients with 'mood disorders', defined to include major depression, dysthymia and bipolar disorder, or 'schizophrenia spectrum psychosis', defined to include schizophrenia, schizophreniform disorder and delusional disorder. Suicidal ideation was strongly associated with suicide among patients with schizophrenia spectrum psychosis [14 studies reporting on 567 suicides, OR = 6.49, 95% confidence interval (CI) 3.82-11.02]. The association between suicidal ideation and suicide among patients with mood disorders (11 studies reporting on 860 suicides, OR = 1.49, 95% CI 0.92-2.42) was not significant. Diagnostic group made a significant contribution to between-study heterogeneity (Q-value = 16.2, df = 1, P < 0.001) indicating a significant difference in the strength of the associations between suicidal ideation and suicide between the two diagnostic groups. Meta-regression and multiple meta-regression suggested that methodological issues in the primary research did not explain the findings. Suicidal ideation was weakly but significantly associated with suicide among studies of patients with mood disorders over periods of follow-up of <10 years. Although our findings suggest that the association between suicidal ideation and later suicide is stronger in schizophrenia spectrum psychosis than in mood disorders this result should be interpreted cautiously due to the high degree of between-study heterogeneity and because studies that used stronger methods of reporting had a weaker association between suicidal ideation and suicide. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Practice Teachers' Responses to a Suicidal Student.

ERIC Educational Resources Information Center

Davidson, Michael; Range, Lillian M.

1997-01-01

Observes that because of the rate of suicides and attempted suicides among young people, teachers can expect to face suicidal students during their careers. Explores whether teachers can effectively employ no-suicide pacts with children. Finds that teachers took any suicide threat seriously but were uncomfortable using a no-suicide agreement. (DSK)

Suicide in the Middle Years

ERIC Educational Resources Information Center

Coombs, David W.; Hodges, Debra K.; Kohler, Connie

2012-01-01

This article presents an overview of adult suicide in the United States and Alabama. This includes the latest available information on the prevalence of suicide in the US and Alabama, demographic characteristics of suicide victims, trends in suicide, and known reasons behind adult suicide. With respect to adult suicide in Alabama, it focuses on…

Predictors of Suicidal Behavior in a Sample of Turkish Suicide Attempters

ERIC Educational Resources Information Center

Sayar, Kemal; Kose, Samet; Acar, Burcin; Ak, Ismail; Reeves, Robert A.

2004-01-01

In a Turkish sample, 100 suicide attempters, were compared with 60 healthy controls on measures of hopelessness, depression, and suicidal ideation. Suicide attempters were more depressive, more hopeless, and displayed greater suicidal ideation than healthy controls. Depression severity rather than hopelessness correlated with suicidal intent.…

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

PubMed Central

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

2016-01-01

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

Familial aggregation of suicide explained by cluster B traits: a three-group family study of suicide controlling for major depressive disorder.

PubMed

McGirr, Alexander; Alda, Martin; Séguin, Monique; Cabot, Sophie; Lesage, Alain; Turecki, Gustavo

2009-10-01

There is substantial evidence suggesting that suicide aggregates in families. However, the extent of overlap between the liability to suicide and psychiatric disorders, particularly major depressive disorder, remains an important issue. Similarly, factors that account for the familial transmission of suicidal behavior remain unclear. Thus, through direct and blind assessment of first-degree relatives, the authors conducted a family study of suicide by examining three proband groups: probands who committed suicide in the context of major depressive disorder, living depressed probands with no history of suicidal behavior, and psychiatrically normal community comparison probands. Participants were 718 first-degree relatives from 120 families: 296 relatives of 51 depressed probands who committed suicide, 185 relatives of 34 nonsuicidal depressed probands, and 237 relatives of 35 community comparison subjects. Psychopathology, suicidal behavior, and behavioral measures were assessed via interviews. The relatives of probands who committed suicide had higher levels of suicidal behavior (10.8%) than the relatives of nonsuicidal depressed probands (6.5%) and community comparison probands (3.4%). Testing cluster B traits as intermediate phenotypes of suicide showed that the relatives of depressed probands who committed suicide had elevated levels of cluster B traits; familial predisposition to suicide was associated with increased levels of cluster B traits; cluster B traits demonstrated familial aggregation and were associated with suicide attempts among relatives; and cluster B traits mediated, at least in part, the relationship between familial predisposition and suicide attempts among relatives. Analyses were repeated for severity of attempts, where cluster B traits also met criteria for endophenotypes of suicide. Familial transmission of suicide and major depression, while partially overlapping, are distinct. Cluster B traits and impulsive-aggressive behavior represent intermediate phenotypes of suicide.

Mysore study: A study of suicide notes.

PubMed

Namratha, P; Kishor, M; Sathyanarayana Rao, T S; Raman, Rajesh

2015-01-01

Suicide is one of the leading causes of preventable deaths. Recent data suggest South India as one of the regions with highest suicide rates in the world. In 2013, 134,799 people committed suicide in India according to the statistics released by the National Crime Records Bureau. Suicide note is one of the most important sources to understand suicide, which may be beneficial in suicide prevention. Studies on suicidal notes from this part of the world are sparse. The aim was to study the themes in suicide notes that might be useful in prevention strategies. A descriptive study of all suicide notes of those individuals who committed suicide between 2010 and 2013 available with Police Department, Mysore district was obtained and analyzed. A total of 22 suicide note were available. A majority of suicide note was in age group of 16-40 years (86%) and most were men (59%). All suicide notes were handwritten, the majority (70%) in regional language Kannada. Length of notes varied from just few words to few pages. Contents of suicide notes included apology/shame/guilt (80%), love for those left behind (55%) and instruction regarding practical affairs (23%). Most have blamed none for the act (50%). 23% mentioned that they are committing suicide to prove their innocence. 32% mentioned a last wish. The majority of suicidal note contained "guilt" which is a strong indicator of possible depression in deceased. Creating awareness about suicide among public and ensuring access to professionals trained in suicide prevention is need of the hour in this part of the world.

Mysore study: A study of suicide notes

PubMed Central

Namratha, P.; Kishor, M.; Sathyanarayana Rao, T. S.; Raman, Rajesh

2015-01-01

Background: Suicide is one of the leading causes of preventable deaths. Recent data suggest South India as one of the regions with highest suicide rates in the world. In 2013, 134,799 people committed suicide in India according to the statistics released by the National Crime Records Bureau. Suicide note is one of the most important sources to understand suicide, which may be beneficial in suicide prevention. Studies on suicidal notes from this part of the world are sparse. Objective: The aim was to study the themes in suicide notes that might be useful in prevention strategies. Materials and Methods: A descriptive study of all suicide notes of those individuals who committed suicide between 2010 and 2013 available with Police Department, Mysore district was obtained and analyzed. Results: A total of 22 suicide note were available. A majority of suicide note was in age group of 16–40 years (86%) and most were men (59%). All suicide notes were handwritten, the majority (70%) in regional language Kannada. Length of notes varied from just few words to few pages. Contents of suicide notes included apology/shame/guilt (80%), love for those left behind (55%) and instruction regarding practical affairs (23%). Most have blamed none for the act (50%). 23% mentioned that they are committing suicide to prove their innocence. 32% mentioned a last wish. Conclusion: The majority of suicidal note contained “guilt” which is a strong indicator of possible depression in deceased. Creating awareness about suicide among public and ensuring access to professionals trained in suicide prevention is need of the hour in this part of the world. PMID:26816426

Suicide and Murder-Suicide Involving Aircraft.

PubMed

Kenedi, Christopher; Friedman, Susan Hatters; Watson, Dougal; Preitner, Claude

2016-04-01

This is a systematic review of suicide and homicide-suicide events involving aircraft. In aeromedical literature and in the media, these very different events are both described as pilot suicide, but in psychiatry they are considered separate events with distinct risk factors. Medical databases, internet search engines, and aviation safety databases were searched in a systematic way to obtain relevant cases. Relevant articles were searched for additional references. There were 65 cases of pilot suicide and 6 cases of passengers who jumped from aircraft found. There were also 18 cases of homicide-suicide found involving 732 deaths. Pilots perpetrated 13 homicide-suicide events. Compared to non-aviation samples, a large percentage of pilot suicides in this study were homicide-suicides (17%). Homicide-suicide events occur extremely rarely. However, their impact in terms of the proportion of deaths is significant when compared to deaths from accidents. There is evidence of clustering where pilot suicides occur after by media reports of suicide or homicide-suicide. Five of six homicide-suicide events by pilots of commercial airliners occurred after they were left alone in the cockpit. This, along with a sixth incident in which active intervention by a Japan Air crew saved 147 lives, suggests that having two flight members in the cockpit is potentially protective. No single factor was associated with the risk for suicide or homicide-suicide. Factors associated with both events included legal and financial crises, occupational conflict, mental illness, and relationship stressors. Drugs and/or alcohol played a role in almost half of suicides, but not in homicide-suicides.

Psychological autopsy study comparing suicide decedents, suicide ideators, and propensity score matched controls: results from the study to assess risk and resilience in service members (Army STARRS).

PubMed

Nock, M K; Dempsey, C L; Aliaga, P A; Brent, D A; Heeringa, S G; Kessler, R C; Stein, M B; Ursano, R J; Benedek, D

2017-11-01

The suicide rate has increased significantly among US Army soldiers over the past decade. Here we report the first results from a large psychological autopsy study using two control groups designed to reveal risk factors for suicide death among soldiers beyond known sociodemographic factors and the presence of suicide ideation. Informants were next-of-kin and Army supervisors for: 135 suicide cases, 137 control soldiers propensity-score-matched on known sociodemographic risk factors for suicide and Army history variables, and 118 control soldiers who reported suicide ideation in the past year. Results revealed that most (79.3%) soldiers who died by suicide have a prior mental disorder; mental disorders in the prior 30-days were especially strong risk factors for suicide death. Approximately half of suicide decedents tell someone that they are considering suicide. Virtually all of the risk factors identified in this study differed between suicide cases and propensity-score-matched controls, but did not significantly differ between suicide cases and suicide ideators. The most striking difference between suicides and ideators was the presence in the former of an internalizing disorder (especially depression) and multi-morbidity (i.e. 3+ disorders) in the past 30 days. Most soldiers who die by suicide have identifiable mental disorders shortly before their death and tell others about their suicidal thinking, suggesting that there are opportunities for prevention and intervention. However, few risk factors distinguish between suicide ideators and decedents, pointing to an important direction for future research.

Suicidal ideation and suicidal behavior according to the C-SSRS in a European cohort of Huntington's disease gene expansion carriers.

PubMed

van Duijn, Erik; Vrijmoeth, Eslie M; Giltay, Erik J; Bernhard Landwehrmeyer, G

2018-03-01

Huntington's disease (HD) gene expansion carriers are at an increased risk of suicide, but so far, no studies have investigated the full spectrum of suicidality, including suicidal ideation, suicidal behavior and self-injurious behavior. We included 1451 HD gene expansion carriers (age 48.4 years (SD 14.0), 54.8% female) of the REGISTRY study of the European Huntington's Disease Network. Lifetime suicidal ideation and suicidal behavior were assessed with the Columbia-Suicidal Severity Rating Scale. Motor symptoms and disease stage were assessed using subscales of the Unified Huntington's Disease Rating Scale, and depressed mood and irritability were assessed by the Problem Behaviors Assessment. Lifetime passive suicidal ideation was reported by 21.2%. Participants in stage II showed the highest prevalence rate of suicidal ideation, while participants in stage IV/V showed the highest prevalence of suicidal behavior. A lifetime suicide attempt was reported by 6.5% of the HD gene expansion carriers. In multivariate regression analyses, both suicidal ideation and suicidal behavior were associated with a depressed mood, and to a lesser extend to irritability. Results may have been affected by denial or recall bias and no conclusions can be made about the temporal and causal relationships with depressed mood and irritability because of the cross-sectional analyses. Given the high prevalence of suicidal ideation and suicidal behavior in all stages of HD, it is important to screen HD gene expansion carriers for suicidal ideation and suicidal behavior on a regular basis in clinical practice. Copyright © 2017 Elsevier B.V. All rights reserved.

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

PubMed

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

2015-01-01

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

Suicidal ideation and suicide attempts in anxious or depressed family caregivers of patients with cancer: a nationwide survey in Korea.

PubMed

Park, Boyoung; Kim, So Young; Shin, Ji-Yeon; Sanson-Fisher, Robert W; Shin, Dong Wook; Cho, Juhee; Park, Jong Hyock

2013-01-01

To describe the prevalence of suicidal ideation and suicide attempts in family caregivers (FCs) of patients with cancer and to identify the factors associated with suicidal ideation and suicide attempts in FCs with anxiety or depression. A national, multicenter survey administered to 897 FCs asked questions concerning suicidal ideation and suicide attempts during the previous year and assessed anxiety, depression, socio-demographic factors, caregiving burden, patient factors, and quality of life (QOL). A total of 17.7% FCs reported suicidal ideation, and 2.8% had attempted suicide during the previous year. Among FCs with anxiety, 31.9% had suicidal ideation and 4.7% attempted suicide; the corresponding values for FCs with depression were 20.4% and 3.3%, respectively. Compared with FCs without anxiety and depression, FCs with anxiety or depression showed a higher adjusted odds ratios (aOR) for suicidal ideation (aOR= 4.07 and 1.93, respectively) and attempts (OR= 3.00 and 2.43, respectively). Among FCs with anxiety or depression, being female, unmarried, unemployed during caregiving, and having a low QOL were associated with increased odds of suicidal ideation. FCs with anxiety who became unemployed during caregiving constituted a high-risk group for suicide. Being unmarried and having a low QOL with respect to financial matters were associated with increased suicide attempts among FCs with depression. FCs with anxiety or depression were at high risk of suicide. Interventions to enhance social support and to improve perceived QOL may help prevent suicide and manage suicidal ideation in FCs with anxiety or depression.

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

PubMed

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

2012-01-01

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

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.

Suicidal ideation and suicide attempts among human immunodeficiency virus-infected adults: differences in risk factors and their implications.

PubMed

Kang, Cho Ryok; Bang, Ji Hwan; Cho, Sung-Il; Kim, Kui Nam; Lee, Hee-Jin; Ryu, Bo Yeong; Cho, Soo Kyung; Lee, Young Hwa; Oh, Myoung-Don; Lee, Jong-Koo

2016-01-01

Many studies have investigated risk factors for suicidal ideation and suicide attempt; however, most have failed to show differences in risk factors between suicidal ideation and suicide attempt among the human immunodeficiency virus (HIV)-infected population. This study was designed to identify differences in risk factors between suicidal ideation and suicide attempts among HIV-infected adults in Seoul. A face-to-face survey of 457 HIV-infected adults was conducted by the Seoul Metropolitan Government in 2013. Multivariate logistic regression analysis was used to identify factors associated with suicidal ideation and suicide attempt. Among 422 participants, 44% had suicidal ideation, and 11% had suicide attempts. The independent risk factors for suicidal ideation were young and middle age, living with someone, history of AIDS-defining opportunistic disease, history of treatment for depression, lower social support, and psychological status. Beneficiaries of National Medical Aid, economic barriers to treatment, history of treatment for depression, and lower psychological status were independently associated with suicide attempts. Patients with HIV in Korea were treated without cost in some centers. Thus, experiencing an economic barrier to treatment might be due in part to ignorance of HIV care policies. Our findings indicate that suicide attempts are associated with socioeconomic factors and information inequality regarding medical care. In conclusion, suicidal ideation closely associated with the psychosocial factors, whereas suicide attempt demonstrates a stronger association with socioeconomic factors. Suicide prevention measures should be implemented to provide information to help HIV-infected patients.

Prevalence of suicidal ideation and suicide attempts in the general population of China: A meta-Analysis

PubMed Central

CAO, XIAO-LAN; ZHONG, BAO-LIANG; XIANG, YU-TAO; UNGVARI, GABOR S.; LAI, KELLY Y. C.; CHIU, HELEN F. K.; CAINE, ERIC D.

2015-01-01

Objective The objective of this meta-analysis is to estimate the pooled prevalence of suicidal ideation and suicide attempts in the general population of Mainland China. Methods A systematic literature search was conducted via the following databases: PubMed, PsycINFO, MEDLINE, China Journals Full-Text Databases, Chongqing VIP database for Chinese Technical Periodicals and Wan Fang Data. Statistical analysis used the Comprehensive Meta-Analysis program. Results Eight studies met the inclusion criteria for the analysis; five reported on the prevalence of suicidal ideation and seven on that of suicide attempts. The estimated lifetime prevalence figures of suicidal ideation and suicide attempts were 3.9% (95% Confidence interval [CI]: 2.5%–6.0%) and 0.8% (95% CI: 0.7%–0.9%), respectively. The estimated female-male ratio for lifetime prevalence of suicidal ideation and suicide attempts was 1.7 and 2.2, respectively. Only the difference of suicide attempts between the two genders was statistically significant. Conclusion This was the first meta-analysis of the prevalence of suicidal ideation and suicide attempts in the general population of Mainland China. The pooled lifetime prevalence of both suicidal ideation and suicide attempts are relatively low; however, caution is required when assessing these self-report data. Women had a modestly higher prevalence for suicide attempts than men. The frequency for suicidal ideation and suicide attempts in urban regions was similar to those in rural areas. PMID:26060259

Policy and governance to address depression and suicide in Bhutan: The national suicide-prevention strategy.

PubMed

Dorji, Gampo; Choki, Sonam; Jamphel, Kinga; Wangdi, Yeshi; Chogyel, Tandin; Dorji, Chencho; Nirola, Damber Kumar

2017-04-01

Suicide and mental disorders are a growing public health issue in Bhutan, due in part to a rapidly transitioning society. The burden of suicide has been recognized by the Royal Government of Bhutan and, as a result, it introduced the country's first ever national suicide-prevention plan in 2015. The 3-year action plan takes a holistic approach to making suicide-prevention services a top social priority, through strengthening suicide-prevention policies, promoting socially protective measures, mitigating risk factors and reaching out to individuals who are at risk of suicide or affected by incidents of suicide. This article documents Bhutan's policy and governance for addressing depression and suicide within the context of its national suicide-prevention strategy, examines progress and highlights lessons for future directions in suicide prevention. Since the endorsement of the 3-year action plan by the prime minister's cabinet, the implementation of suicide-prevention measures has been accelerated through a high-level national steering committee. Activities include suicide-prevention actions by sectors such as health, education, monastic communities and police; building capacity of gatekeepers; and improving the suicide information system to inform policies and decision-making. Suicide-prevention activities have become the responsibility of local governments, paving the way for suicide prevention as an integral mandate across sectors and at grass-root levels in the Kingdom of Bhutan.

Correlations between interpersonal and cognitive difficulties: relationship to suicidal ideation in military suicide attempters.

PubMed

Shelef, L; Fruchter, E; Mann, J J; Yacobi, A

2014-10-01

Understanding suicidal ideation may help develop more effective suicide screening and intervention programs. The interpersonal and the cognitive-deficit theories seek to describe the factors leading to suicidal behavior. In the military setting it is common to find over- and under-reporting of suicidal ideation. This study sought to determine the relationship between these two models and determine to what degree their components can indirectly predict suicidal ideation. Suicide attempters (n=32) were compared with non-suicidal psychologically treated peers (n=38) and controls (n=33), matched for sex and age (mean 19.7years). Pearson's analysis was used to quantify the relationship between the variables from the two models and hierarchal regression analysis was used to determine the explanation of suicidal ideation variance by these variables. Suicide attempters have more difficulties in problem-solving, negative emotion regulation and burdensomeness compared with their peers (P<.001). These variables are all closely correlated with each other and to suicide ideation (r>±0.5; P<.001). Prior suicide attempt, loneliness and burdensomeness together explain 65% (P<.001) of the variance in suicidal ideation. Suicidal ideation is strongly correlated with components of interpersonal and cognitive difficulties. In addition to assessing current suicidal ideation, clinicians should assess past suicide attempt, loneliness and burdensomeness. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Rational suicide: an impoverished self-transformation.

PubMed

Maris, R

1982-01-01

The normal human condition is such that even with the best that life can offer suicide is understandable. Life is short, often painful, unpredictable, and lonely. In addition the lives of some individuals are in effect "suicidal careers" in that the harshness of normal life is combined for them with extra suicidal catalysts. Suicide makes sense. Minimally suicide resolves the life problem for the suicide. At the same time suicide is an impoverished self-transformation. Life, as trying and despairing as it can be, is still all we have, The suicide resolves the life problem by obliterating life itself, rather than by transforming self, history, and society. The suicide gives his or her life back inappropriately. In this sense no suicide is ever rational.

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.

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.

The impact of newspaper reporting of hydrogen sulfide suicide on imitative suicide attempts in Japan.

PubMed

Hagihara, Akihito; Abe, Takeru; Omagari, Megumi; Motoi, Midori; Nabeshima, Yoshihiro

2014-02-01

An analysis model based on monthly or fortnight data is inadequate to precisely evaluate the impact of media reporting of suicide on suicide rates as well as the time lag from exposure to the report of a suicide. Thus, we used daily time-series data and examined the association between newspaper articles on suicide and suicide attempts in Japan. The Box-Jenkins transfer function model was applied to daily time-series data for the period March 27-May 21, 2008. Newspaper articles on suicide using hydrogen sulfide at (t - 1) were related to suicide attempts at (t) (ps < 0.001 and 0.05). Newspaper articles on suicides using hydrogen sulfide on the front page at (t - 1) were related to suicide attempts at (t) (p < 0.00). The magnitude of the impact of newspaper articles about suicide at (t - 1) or (t - 3) on "copy-cat" suicide attempts became greater as the number of news articles violating the media suicide recommendations increased. The time lag between exposure to newspaper reports of suicide and attempts was 1 or 3 days, and the magnitude of the impact of front page articles was about four times as great as that of suicide articles in general.

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.

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.

Tolerance for psychological pain and capability for suicide: Contributions to suicidal ideation and behavior.

PubMed

Meerwijk, Esther L; Weiss, Sandra J

2018-04-01

Among people with suicide ideation most do not attempt suicide or die by suicide. In this online study of adult US Facebook users (n = 219), we examined capability for suicide, operationalized as fearlessness about death, and tolerance for psychological pain as potential variables that may explain why some people move from suicide ideation to suicidal behavior. Tolerance for psychological pain was significantly higher for participants who had never attempted suicide. Fearlessness about death was higher in participants who had attempted suicide, but not significantly. At high levels of psychological pain, one's belief in the ability to cope with psychological pain, a dimension of tolerance for psychological pain, was lower in participants with a history of suicide attempt than in participants who had never attempted suicide. The odds of suicidal desire were almost cut in half with each unit increase in participants' belief in their coping ability, whereas for each unit increase in fearlessness about death, the odds of suicidal desire increased by 65%. The Pearson correlation between tolerance for psychological pain and fearlessness about death was negligible. Our findings support a role for both tolerance for psychological pain and capability for suicide/fearlessness about death in the ideation-to-action framework of suicide. Copyright © 2018 Elsevier B.V. All rights reserved.

Detecting suicidality among adolescent outpatients: evaluation of trained clinicians' suicidality assessment against a structured diagnostic assessment made by trained raters.

PubMed

Holi, Matti Mikael; Pelkonen, Mirjami; Karlsson, Linnea; Tuisku, Virpi; Kiviruusu, Olli; Ruuttu, Titta; Marttunen, Mauri

2008-12-31

Accurate assessment of suicidality is of major importance. We aimed to evaluate trained clinicians' ability to assess suicidality against a structured assessment made by trained raters. Treating clinicians classified 218 adolescent psychiatric outpatients suffering from a depressive mood disorder into three classes: 1-no suicidal ideation, 2-suicidal ideation, no suicidal acts, 3-suicidal or self-harming acts. This classification was compared with a classification with identical content derived from the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS-PL) made by trained raters. The convergence was assessed by kappa- and weighted kappa tests. The clinicians' classification to class 1 (no suicidal ideation) was 85%, class 2 (suicidal ideation) 50%, and class 3 (suicidal acts) 10% concurrent with the K-SADS evaluation (gamma2 = 37.1, df 4, p = 0.000). Weighted kappa for the agreement of the measures was 0.335 (CI = 0.198-0.471, p < 0.0001). The clinicians under-detected suicidal and self-harm acts, but over-detected suicidal ideation. There was only a modest agreement between the trained clinicians' suicidality evaluation and the K-SADS evaluation, especially concerning suicidal or self-harming acts. We suggest a wider use of structured scales in clinical and research settings to improve reliable detection of adolescents with suicidality.

Suicide and deliberate self-harm in Afghanistan.

PubMed

Paiman, Mohammad Akbar; Khan, Murad Moosa

2017-04-01

Suicide and deliberate self-harm (DSH) are major public health problems globally. There is limited information on suicide and DSH from Afghanistan. To review available literature on suicide and DSH in Afghanistan. Using online resources and literature on suicidal behavior (suicide, DSH and suicidal ideation) was searched. There were only seven published studies identified on suicidal behavior in Afghanistan. Six of these have been published since 2003 and majority has focused on suicidal behavior in women. Both DSH and suicide are underreported and understudied subjects in Afghanistan. There is need for more research in this area. Copyright © 2017 Elsevier B.V. All rights reserved.

Care of the suicidal pediatric patient in the ED: a case study.

PubMed

Schmid, Alexis M; Truog, Amy W; Damian, Frances J

2011-09-01

The suicide rate among children and adolescents has increased worldwide over the past few decades, and many who attempt suicide are first seen at EDs. At Childrens Hospital Boston (CHB), an algorithm-the Risk of Suicidality Clinical Practice Algorithm-has been developed to ensure evidence-based care supported by best practice guidelines. The authors of this article provide an overview of pediatric suicide and suicide attempts; describe screening, assessment, and interventions used at CHB; and discuss the nursing implications. An illustrative case study is also provided. algorithm, Asperger's syndrome, attempted suicide, bullying, emergency, emergency department, patient safety, pediatrics, pediatric suicide, suicide, suicide screening, triage.

The suicide assessment scale: an instrument assessing suicide risk of suicide attempters.

PubMed

Niméus, A; Alsén, M; Träskman-Bendz, L

2000-11-01

The Suicide Assessment Scale (SUAS), a scale constructed to measure suicidality over time, was administered to 191 suicide attempters. Its predictive validity was tested. SUAS ratings were compared to ratings from other scales, and related to age and psychiatric diagnoses including co-morbidity. Eight patients committed suicide within 12 months after the SUAS assessment. Apart from advanced age, high scores in the SUAS were significant predictors of suicide. From a receiver operating characteristic (ROC) analysis, we identified cutoff SUAS scores which alone and in combination with certain diagnostic and demographic factors are of apparent value in the clinical evaluation of suicide risk after a suicide attempt.

Risk factors for self-directed violence in US Soldiers: A case-control study.

PubMed

Skopp, Nancy A; Zhang, Ying; Smolenski, Derek J; Reger, Mark A

2016-11-30

Military suicide has escalated in recent years, however almost no research has used military surveillance data to examine suicide risk factors. The aims of the current study were to compare suicide risk factors among US Soldiers who died by suicide, attempted suicide, and controls using a prospective case-control design. Controls were 247 Soldiers completing standard post-deployment assessment procedures. Cases were 276 suicide decedents (n=85) or suicide attempters (n=191), drawn from the Department of Defense Suicide Event Report. Compared to controls, suicide attempters and decedents had greater odds of failed intimate relationships, legal problems, and substance abuse problems in the past 90 days. Suicide attempters and decedents also had greater odds of a history of a mood disorder and prior suicide attempt compared to controls. Suicide decedents had greater odds of exposure to legal problems in the past 90 days and lower odds of ever having an anxiety disorder, compared to suicide attempters. Vigilance toward early detection of modifiable suicide risk factors such as relationship dissolution, mood disorders, substance abuse, and legal problems may help reduce suicide risk among US Soldiers. Published by Elsevier Ireland Ltd.

Which suicides are reported in the media - and what makes them "newsworthy"?

PubMed

Machlin, Anna; Pirkis, Jane; Spittal, Matthew J

2013-01-01

Media reporting of suicide has attracted public health attention because of its potential to trigger "copycat" acts. To determine the factors associated with an individual suicide featuring in the media. We identified from the National Coroners Information System (NCIS) all suicides that occurred in Australia over a 1-year period and established those that were reported in the Australian media using data from our earlier Media Monitoring Project. Available variables were used to examine factors associated with a suicide being reported in the media. Of the 2,161 suicides, 29 were reported in the media. Suicides by younger individuals were particularly likely to be reported, as were suicides by gunshot and other violent methods, suicides in commercial areas (e.g., office buildings and hotels) and medical/residential facilities and other institutions (e.g., detention centers), and suicides that occurred in the context of multiple fatality events (e.g., homicide-suicides and suicide pacts). Striking the right balance in terms of media reporting of suicide is crucial. The current study suggests that the reported suicides tend to be those that may either heighten the risk of lethal imitative behaviors or serve to distort public perceptions about suicide.

Nursing students’ attitude toward suicide prevention

PubMed Central

Nebhinani, Naresh; Mamta; Gaikwad, Achla D.; Tamphasana, L.

2013-01-01

Background: Preventing suicide depends upon different health professionals’ knowledge regarding suicide, attitude toward suicide attempters, skills to assess and manage suicidal risk. Objectives: This study was aimed to assess the attitude of nursing students toward suicide prevention. Materials and Methods: 308 nursing students were recruited from the two institutions through total enumeration method. Attitude toward suicide prevention scale was administered. Study design was cross-sectional. Results: Majority were single females, from urban locality, who were pursuing BSc Nursing with the mean age of 20 years. Only minority had previous exposure to suicide prevention programs or workshops. Nearly half of the subjects had positive attitude toward working with suicidal patients. Again half of the subjects considered unemployment and poverty as main causes of suicide and were quite hopeless about it and they also perceived that most of the suicidal people would not reveal their suicidal plans to others. Conclusions: Merely half of the students had positive attitude toward working with suicidal patients. Hence, there is strong need to organize more educational and training programs on suicide prevention so that these budding health professionals could be more equipped and trained to manage these suicidal patients. PMID:25013311

Factors influencing the suicide intervention skills of emergency medical services providers.

PubMed

Lygnugaryte-Griksiene, Aidana; Leskauskas, Darius; Jasinskas, Nedas; Masiukiene, Agne

2017-01-01

Lithuania currently has the highest suicide rate in Europe and the fifth highest worldwide. To identify the factors that influence the suicide intervention skills of emergency medical services (EMS) providers (doctors, nurses, paramedics). Two hundred and sixty-eight EMS providers participated in the research. The EMS providers were surveyed both prior to their training in suicide intervention and six months later. The questionnaire used for the survey assessed their socio-demographic characteristics, suicide intervention skills, attitudes towards suicide prevention, general mental health, strategies for coping with stress, and likelihood of burnout. Better suicide intervention skills were more prevalent among EMS providers with a higher level of education, heavier workload, more positive attitudes towards suicide prevention, better methods of coping with stress, and those of a younger age. Six months after the non-continuous training in suicide intervention, the providers' ability to assess suicide risk factors had improved, although there was no change in their suicide intervention skills. In order to improve the suicide intervention skills of EMS providers, particular attention should be paid to attitudes towards suicide prevention, skills for coping with stress, and continuous training in suicide intervention. EMS: Emergency medical services; SIRI: Suicide intervention response inventory.

Effect of media reporting of the suicide of a singer in Taiwan: the case of Ivy Li.

PubMed

Chen, Ying-Yeh; Tsai, Pei-Chen; Chen, Pao-Huan; Fan, Chun-Chieh; Hung, Galen Chin-Lun; Cheng, Andrew T A

2010-03-01

Suicide attempters are known to be vulnerable to the influence of media reporting of suicide events. This study investigates possible influences of media reporting of a celebrity suicide on subsequent suicide attempts and associated risk factors among suicide attempters. Sixty-three suicide attempters registered in a surveillance system of Taipei City Suicide Prevention Center were assessed using a structured interview soon after media reporting of the suicide of a young female singing star. Forty-three (68%) respondents had encountered with the suicide news. Among them, 37% reported being influenced by the media reporting on their subsequent suicide attempts. Men (adjusted OR 6.36, 95% CI 1.29-31.44) and younger age groups (adjusted OR 4.93, 95% CI 1.04-23.45) were more susceptible to the media reporting. There was a positive modeling effect in method of suicide (charcoal burning) (adjusted OR 7.27, 95% CI 6.31-168.66). This study has provided further evidence for suicide imitation among vulnerable people encountered with media reporting of celebrity suicide, and for the need to actively restrain reporting of suicides to decrease the imitation effect.

Is Suicide Ideation a Surrogate Endpoint for Geriatric Suicide?

ERIC Educational Resources Information Center

Links, Paul S.; Heisel, Marnin J.; Quastel, Adam

2005-01-01

The present study explored the validity of treating suicide ideation as a surrogate endpoint that can serve as a proxy for suicide in clinical intervention research with suicidal seniors. Two criteria; that suicide ideation is modulated by the proposed intervention and that modulation of suicide ideation leads to a quantitative reduction in…

Adolescent Suicide Attempters: What Predicts Future Suicidal Acts?

ERIC Educational Resources Information Center

Groholt, Berit; Ekeberg, Oivind; Haldorsen, Tor

2006-01-01

Predictors for repetition of suicide attempts were evaluated among 92 adolescent suicide attempters 9 years after an index suicide attempt (90% females). Five were dead, two by suicide. Thirty-one (42%) of 73 had repeated a suicide attempt. In multiple Cox regression analysis, four factors had an independent predictive effect: comorbid disorders,…

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

ERIC Educational Resources Information Center

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

2007-01-01

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

Suicide and Suicide Prevention: Greek versus Biblical Perspectives.

ERIC Educational Resources Information Center

Kaplan, Kalman J.

1992-01-01

Compares suicide in Greek tragedy and Hebrew Bible, concentrating on life situations portrayed in two sets of narratives promoting or preventing suicide. Notes frequency of suicides in Greek tragedy and infrequency of suicides in Bible. Compares stories of Narcissus and Jonah in attempt to pinpoint what is suicide-promoting in Greek narratives and…

Suicide Rates and State Laws Regulating Access and Exposure to Handguns

PubMed Central

Anestis, Joye C.

2015-01-01

Objectives. Using previous research, we examined the impact of 4 handgun laws (waiting periods, universal background checks, gun locks, and open carrying regulations) on suicide rates. Methods. We used publicly available databases to collect information on statewide laws, suicide rates, and demographic characteristics for 2013. Results. Each law was associated with significantly lower firearm suicide rates and the proportion of suicides resulting from firearms. In addition, each law, except for that which required a waiting period, was associated with a lower overall suicide rate. Follow-up analyses showed a significant indirect effect on overall suicide rates through the proportion of suicides by firearms, indicating that the reduced overall suicide rate was attributable to fewer suicide attempts, fewer handguns in the home, suicide attempts using less lethal means, or a combination of these factors. States that implemented any of these laws saw a decreased suicide rate in subsequent years, whereas the only state that repealed 1 of these laws saw an increased suicide rate. Conclusions. Our results were supportive of a potentially vital role in suicide prevention for state legislation that limits access and exposure to handguns. PMID:26270305

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

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

PubMed Central

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

2015-01-01

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

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

PubMed

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

2017-10-01

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

Suicide in women

PubMed Central

Vijayakumar, Lakshmi

2015-01-01

Suicide is a global public health problem. Asia accounts for 60% of the world's suicides, so at least 60 million people are affected by suicide or attempted suicide in Asia each year. The burden of female suicidal behavior, in terms of total burden of morbidity and mortality combined, is more in women than in men. Women's greater vulnerability to suicidal behavior is likely to be due to gender related vulnerability to psychopathology and to psychosocial stressors. Suicide prevention programmes should incorporate woman specific strategies. More research on suicidal behavior in women particularly in developing countries is needed. PMID:26330640

Health professionals' attitudes towards suicide prevention initiatives.

PubMed

Brunero, S; Smith, J; Bates, E; Fairbrother, G

2008-09-01

Preventing suicide can depend upon the ability of a range of different health professionals to make accurate suicide risk assessments and treatment plans. The attitudes that clinicians hold towards suicide prevention initiatives may influence their suicide risk assessment and management skills. This study measures a group of non-mental health professionals' attitude towards suicide prevention initiatives. Health professionals that had attended suicide prevention education showed significantly more positive attitudes towards suicide prevention initiatives. The findings in this study further support the effectiveness of educating non-mental health professionals in suicide risk awareness and management.

Differentiating Adolescent Suicide Attempters from Ideators: Examining the Interaction between Depression Severity and Alcohol Use

PubMed Central

McManama O’Brien, Kimberly H.; Becker, Sara J.; Spirito, Anthony; Simon, Valerie; Prinstein, Mitchell J.

2014-01-01

This study examined whether depressed mood, frequency of alcohol use, and their combination differentiated non-suicidal adolescents from those with suicidal ideation and adolescents with suicidal ideation from those who have made a suicide attempt. Hierarchical logistic regressions indicated that frequency of alcohol use did not differentiate non-suicidal adolescents from those with current suicidal ideation, but severity of depressed mood did so. In contrast, alcohol use was a significant differentiating factor between adolescents who had attempted suicide compared to those with suicidal ideation only, with severity of depressed mood not being significant. However, there was also a significant interaction effect such that for adolescents with suicidal ideation and low levels of depression, increased frequency of alcohol use was associated with increased odds of a suicide attempt. These findings suggest that alcohol use may hasten the transition from suicidal ideation to suicide attempt in adolescents with low levels of depressed mood. PMID:23889515

Active and passive problem solving: moderating role in the relation between depressive symptoms and future suicidal ideation varies by suicide attempt history.

PubMed

Quiñones, Victoria; Jurska, Justyna; Fener, Eileen; Miranda, Regina

2015-04-01

Research suggests that being unable to generate solutions to problems in times of distress may contribute to suicidal thoughts and behavior, and that depression is associated with problem-solving deficits. This study examined active and passive problem solving as moderators of the association between depressive symptoms and future suicidal ideation among suicide attempters and nonattempters. Young adults (n = 324, 73% female, mean age = 19, standard deviation = 2.22) with (n = 78) and without (n = 246) a suicide attempt history completed a problem-solving task, self-report measures of hopelessness, depression, and suicidal ideation at baseline, and a self-report measure of suicidal ideation at 6-month follow-up. Passive problem solving was higher among suicide attempters but did not moderate the association between depressive symptoms and future suicidal ideation. Among attempters, active problem solving buffered against depressive symptoms in predicting future suicidal ideation. Suicide prevention should foster active problem solving, especially among suicide attempters. © 2015 Wiley Periodicals, Inc.

Testing the warning signs of suicidal behavior among suicide ideators using the 2009 National survey on drug abuse and health.

PubMed

Gunn, John F; Lester, David; McSwain, Stephanie

2011-01-01

In order to help crisis counselors assess clients for their suicidal risk, in 2003 the American Association of Suicidology proposed ten warning signs, memorized through the acronym IS PATH WARM However, little research has been done investigating their effectiveness for predicting suicidal behavior The present study compared (1) suicide ideators with non-suicide ideator controls and (2) suicide ideators with suicide attempters on six of the IS PATH WARM warning signs, along with depression in the past year, marital status, and gender With regards to the comparison between suicide ideators and non-ideators, all variables but gender; abuse of alcohol in the past year, and anxiety in the past year were predictive of suicide ideation. However, when comparing suicide ideators who had not made a suicide attempt with those who had, only anger/aggression, depression in the past year, and marital status were predictive of a suicide attempt.

Body dysmorphic disorder symptoms and risk for suicide: The role of depression.

PubMed

Shaw, A M; Arditte Hall, K A; Rosenfield, E; Timpano, K R

2016-12-01

Body dysmorphic disorder (BDD) is associated with elevated suicidality. Little is known about why BDD patients are at increased risk. The interpersonal-psychological theory of suicide (IPTS) could clarify suicidality in BDD, and theorizes that perceived burdensomeness and thwarted belongingness lead to suicidal desire, while an acquired capability for suicide is necessary to attempt suicide. No study has investigated how BDD symptoms relate to IPTS constructs or mediators of the relationship between BDD and suicidality. Individuals (N=235) enrolled in Amazon.com's Mechanical Turk (MTurk), who had appearance concerns, completed questionnaires about BDD, depression, eating pathology, and suicide risk. MTurk is an online data collection platform in which participants complete surveys for payment. BDD symptoms predicted suicidal desire, but not acquired capability for suicide. Depression mediated the relationship between BDD and suicidal desire. Research should examine how fluctuations in BDD affect suicide risk. Replication in a clinical sample may inform treatments for BDD. Copyright © 2016 Elsevier Ltd. All rights reserved.

Suicide intervention training evaluation: a preliminary report.

PubMed

Tierney, R J

1994-01-01

To date, very little work has been done on evaluating training in suicide intervention. This study developed and piloted a comprehensive method for evaluating suicide intervention training by applying three studies of immediate training effects on (a) suicide intervention abilities, (b) attitudes to suicide and suicide intervention, and (c) knowledge about suicide. The focus of the evaluation was a broadly used 2-day suicide intervention training program. Changes in suicide intervention abilities were measured by the Suicide Intervention Response Inventory (SIRI) and by performance in simulated suicide intervention situations, scored with the Suicide Intervention Protocol (SIP). Subjects consisted of 19 workshop participants in a pre-post condition and 17 participants in a post-test only condition. Results indicated significant increases in skills in suicide intervention situations. No significant effects were noted on the SIRI. Results from the attitudes and knowledge studies were very preliminary. They are reported here so that others may become aware of the methodology being used and the status of evaluation of the target program. Implications for further research are discussed.

Suicide among military conscripts in Finland: a psychological autopsy study.

PubMed

Marttunen, M; Henriksson, M; Pelkonen, S; Schroderus, M; Lönnqvist, J

1997-01-01

This study describes suicides during compulsory military service and compares them with other young male suicides as part of a nationwide psychological autopsy study of all suicides in Finland during a single year. The victims' relatives and attending health care personnel were interviewed, and data from records were collected. Five of the seven conscript suicides had a depressive syndrome, often of short duration. Two victims previously had suicidal thoughts or attempted suicide. The most common suicide method was with firearms. Compared with other young male suicides, physical illness in conjunction with a psychiatric diagnosis was less common in the conscript victims. Civilian male suicides tended to have more substance abuse and more severe psychological impairment. They also committed suicide under the influence of alcohol more often than conscripts. Interpersonal separation was more often the precipitating event of the suicide among the conscripts than among the other suicides. Conscripts should be encouraged to utilize health and social services when they have psychosocial problems or even minor psychiatric symptoms.

Drugs Associated with More Suicidal Ideations Are also Associated with More Suicide Attempts

PubMed Central

Robertson, Henry T.; Allison, David B.

2009-01-01

Context In randomized controlled trials (RCTs), some drugs, including CB1 antagonists for obesity treatment, have been shown to cause increased suicidal ideation. A key question is whether drugs that increase or are associated with increased suicidal ideations are also associated with suicidal behavior, or whether drug–induced suicidal ideations are unlinked epiphenomena that do not presage the more troubling and potentially irrevocable outcome of suicidal behavior. This is difficult to determine in RCTs because of the rarity of suicidal attempts and completions. Objective To determine whether drugs associated with more suicidal ideations are also associated with more suicide attempts in large spontaneous adverse event (AE) report databases. Methodology Generalized linear models with negative binomial distribution were fitted to Food and Drug Administration (FDA) Adverse Event (AE) Reporting System (AERS) data from 2004 to 2008. A total of 1,404,470 AEs from 832 drugs were analyzed as a function of reports of suicidal ideations; other non-suicidal adverse reactions; drug class; proportion of reports from males; and average age of subject for which AE was filed. Drug was treated as the unit of analysis, thus the statistical models effectively had 832 observations. Main Outcome Measures Reported suicide attempts and completed suicides per drug. Results 832 drugs, ranging from abacavir to zopiclone, were evaluated. The 832 drugs, as primary suspect drugs in a given adverse event, accounted for over 99.9% of recorded AERS. Suicidal ideations had a significant positive association with suicide attempts (p<.0001) and had an approximately 131-fold stronger magnitude of association than non-suicidal AERs, after adjusting for drug class, gender, and age. Conclusions In AE reports, drugs that are associated with increased suicidal ideations are also associated with increased suicidal attempts or completions. This association suggests that drug-induced suicidal ideations observed in RCTs plausibly represent harbingers that presage the more serious suicide attempts and completions and should be a cause for concern. PMID:19798416

Suicides and Suicide Attempts during Long-Term Treatment with Antidepressants: A Meta-Analysis of 29 Placebo-Controlled Studies Including 6,934 Patients with Major Depressive Disorder.

PubMed

Braun, Cora; Bschor, Tom; Franklin, Jeremy; Baethge, Christopher

It is unclear whether antidepressants can prevent suicides or suicide attempts, particularly during long-term use. We carried out a comprehensive review of long-term studies of antidepressants (relapse prevention). Sources were obtained from 5 review articles and by searches of MEDLINE, PubMed Central and a hand search of bibliographies. We meta-analyzed placebo-controlled antidepressant RCTs of at least 3 months' duration and calculated suicide and suicide attempt incidence rates, incidence rate ratios and Peto odds ratios (ORs). Out of 807 studies screened 29 were included, covering 6,934 patients (5,529 patient-years). In total, 1.45 suicides and 2.76 suicide attempts per 1,000 patient-years were reported. Seven out of 8 suicides and 13 out of 14 suicide attempts occurred in antidepressant arms, resulting in incidence rate ratios of 5.03 (0.78-114.1; p = 0.102) for suicides and of 9.02 (1.58-193.6; p = 0.007) for suicide attempts. Peto ORs were 2.6 (0.6-11.2; nonsignificant) and 3.4 (1.1-11.0; p = 0.04), respectively. Dropouts due to unknown reasons were similar in the antidepressant and placebo arms (9.6 vs. 9.9%). The majority of suicides and suicide attempts originated from 1 study, accounting for a fifth of all patient-years in this meta-analysis. Leaving out this study resulted in a nonsignificant incidence rate ratio for suicide attempts of 3.83 (0.53-91.01). Therapists should be aware of the lack of proof from RCTs that antidepressants prevent suicides and suicide attempts. We cannot conclude with certainty whether antidepressants increase the risk for suicide or suicide attempts. Researchers must report all suicides and suicide attempts in RCTs. © 2016 S. Karger AG, Basel.

The impact of rock videos and music with suicidal content on thoughts and attitudes about suicide.

PubMed

Rustad, Robin A; Small, Jacob E; Jobes, David A; Safer, Martin A; Peterson, Rebecca J

2003-01-01

In Experiment 1, 133 college student volunteers watched a rock music video with or without suicidal content and then completed written measures assessing mood, priming of suicide-related thoughts, perceptions of personal risk, sensitivity to suicidality in others, and attitudes/beliefs about suicide. In Experiment 2, 104 college student volunteers listened to rock music with either suicidal or neutral content and then completed measures similar to Experiment 1, with the addition of a hopelessness measure. In both experiments, participants exposed to suicidal content wrote more scenarios with suicide-related themes in a projective storytelling task than those exposed to nonsuicidal content. However, there were virtually no group differences on explicit measures of affect, attitudes, and perceptions. Music and videos with suicide content appeared to prime implicit cognitions related to suicide but did not affect variables associated with increased suicide risk.

Suicidality in Body Dysmorphic Disorder

PubMed Central

Phillips, Katharine A.

2008-01-01

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

Predicting Risk for Suicide: A Preliminary Examination of Non-Suicidal Self-Injury and the Acquired Capability Construct in a College Sample.

PubMed

Brackman, Emily H; Morris, Blair W; Andover, Margaret S

2016-01-01

The interpersonal psychological theory of suicide provides a useful framework for considering the relationship between non-suicidal self-injury and suicide. Researchers propose that NSSI increases acquired capability for suicide. We predicted that both NSSI frequency and the IPTS acquired capability construct (decreased fear of death and increased pain tolerance) would separately interact with suicidal ideation to predict suicide attempts. Undergraduate students (N = 113) completed self-report questionnaires, and a subsample (n = 66) also completed a pain sensitivity task. NSSI frequency significantly moderated the association between suicidal ideation and suicide attempts. However, in a separate model, acquired capability did not moderate this relationship. Our understanding of the relationship between suicidal ideation and suicidal behavior can be enhanced by factors associated with NSSI that are distinct from the acquired capability construct.

Suicide to harass others: clues from mythology to understanding suicide bombing attacks.

PubMed

Preti, Antonio

2006-01-01

Suicide by revenge, the Samsonic suicide, and the suicide by devotio, all described in classical mythology and also reported in the ethnographic literature, belong to the same class of suicidal behaviors as kamikaze suicide and the suicide bombing attack: suicide to harass and burden others or suicide with a hostile intent. The lack of a social dimension to share in a positive manner may lead an individual to integrate him/herself in another social structure, e.g., a military organization, which allows the individual to express his/her desires and personal identity only by destroying others and themselves. The dynamics of these forms of suicide are also likely to work in other displays of life-threatening behavior, such as family annihilation, mass murder, and spree killing. A more thorough investigation of the dynamics operating in suicide bombing attacks could, therefore, contribute to preventative strategies against violence at large.

Epidemiology of Youth Suicide and Suicidal Behavior

PubMed Central

Cash, Scottye J.; Bridge, Jeffrey A.

2010-01-01

Purpose of Review Suicide is the third leading cause of death among young people in the U.S. and represents a significant public health problem worldwide. This review focuses on recent developments in our understanding of the epidemiology and risk factors for adolescent suicide and suicidal behavior. Recent Findings The suicide rate among children and adolescents in the U.S. has increased dramatically in recent years and has been accompanied by substantial changes in the leading methods of youth suicide, especially among young girls. Much work is currently underway to elucidate the relationships between psychopathology, substance use, child abuse, bullying, internet use, and youth suicidal behavior. Recent evidence also suggests sex-specific and moderating roles of gender in influencing risk for suicide and suicidal behavior. Summary Empirical research into the causal mechanisms underlying youth suicide and suicidal behavior is needed to inform early identification and prevention efforts. PMID:19644372

Putative effect of alcohol on suicide attempters: an evaluative study in a tertiary medical college.

PubMed

Bhattacharjee, Subir; Bhattacharya, Amit; Thakurta, Rajarshi Guha; Ray, Paramita; Singh, Om Prakash; Sen, Sreyashi

2012-10-01

Alcohol abuse is a known risk factor for suicide. Alcohol increases aggression and impulsivity, which are strongly related to suicidal behavior. Sociocultural factors influence both alcohol use and suicide rates. Studies, conducted in one population, are not applicable to other and the results cannot be generalized. The aim was to study the putative role of alcohol in suicide cases in the rural Indian population by analysis of various sociodemographic variables. This was a cross-sectional study in conducted in a tertiary medical college. Two hundred consecutive patients who survived a suicide attempt were evaluated by a psychiatrist. The data were recorded for sociodemographic variables, psychiatric disorders, suicide intent, lethality of the suicide attempt, and history of alcohol intake prior to the suicide attempt. Using alcohol intake prior to the suicide attempt as a determining dimension, various sociodemographic variables were analyzed for their statistical significance and the role of alcohol in suicide cases was assessed. Seventeen percent suicide attempt survivors had a history of alcohol intake prior to the suicide attempt. Fifteen percent had a history of alcohol use disorder. Alcohol use affected the suicide rate in the male population in the late twenties to mid-thirties age group, illiterate and people with high school education, semiskilled workers, shop owners, and student population. Alcohol dependence, bipolar II disorder, intermittent explosive disorder, and dysthymic disorder had higher rate of suicide attempt with the use of alcohol prior to the suicide attempt. Alcohol users attempted a more lethal suicide attempt and were found to have problems with primary support group and occupational problem as precipitating stressor for suicide attempt. Alcohol use increases the suicide rate, in the specific rural Indian population.

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.

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

PubMed Central

2012-01-01

Background Pesticide self-poisoning is the most commonly used suicide method worldwide, but few studies have investigated the national epidemiology of pesticide suicide in countries where it is a major public health problem. This study aims to investigate geographic variations in pesticide suicide and their impact on the spatial distribution of suicide in Taiwan. Methods Smoothed standardized mortality ratios for pesticide suicide (2002-2009) were mapped across Taiwan's 358 districts (median population aged 15 or above = 27 000), and their associations with the size of agricultural workforce were investigated using Bayesian hierarchical models. Results In 2002-2009 pesticide poisoning was the third most common suicide method in Taiwan, accounting for 13.6% (4913/36 110) of all suicides. Rates were higher in agricultural East and Central Taiwan and lower in major cities. Almost half (47%) of all pesticide suicides occurred in areas where only 13% of Taiwan's population lived. The geographic distribution of overall suicides was more similar to that of pesticide suicides than non-pesticide suicides. Rural-urban differences in suicide were mostly due to pesticide suicide. Areas where a higher proportion of people worked in agriculture showed higher pesticide suicide rates (adjusted rate ratio [ARR] per standard deviation increase in the proportion of agricultural workers = 1.58, 95% Credible Interval [CrI] 1.44-1.74) and overall suicide rates (ARR = 1.06, 95% CrI 1.03-1.10) but lower non-pesticide suicide rates (ARR = 0.91, 95% CrI 0.87-0.95). Conclusion Easy access to pesticides appears to influence the geographic distribution of suicide in Taiwan, highlighting the potential benefits of targeted prevention strategies such as restricting access to highly toxic pesticides. PMID:22471759

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.

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

PubMed

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

2012-04-02

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

Treatment of Suicide Attempters With Bipolar Disorder: A Randomized Clinical Trial Comparing Lithium and Valproate in the Prevention of Suicidal Behavior

PubMed Central

Oquendo, Maria A.; Galfalvy, Hanga C.; Currier, Dianne; Grunebaum, Michael F.; Sher, Leo; Sullivan, Gregory M.; Burke, Ainsley K.; Harkavy-Friedman, Jill; Sublette, M. Elizabeth; Parsey, Ramin V.; Mann, J. John

2013-01-01

Objective Bipolar disorder is associated with high risk for suicidal acts. Observational studies suggest a protective effect of lithium against suicidal behavior. However, testing this effect in randomized clinical trials is logistically and ethically challenging. The authors tested the hypothesis that lithium offers bipolar patients with a history of suicide attempt greater protection against suicidal behavior compared to valproate. Method Patients with bipolar disorder and past suicide attempts (N=98) were randomly assigned to treatment with lithium or valproate, plus adjunctive medications as indicated, in a double-blind 2.5-year trial. An intent-to-treat analysis was performed using the log-rank test for survival data. Two models were fitted: time to suicide attempt and time to suicide event (attempt or hospitalization or change in medication in response to suicide plans). Results There were 45 suicide events in 35 participants, including 18 suicide attempts made by 14 participants, six from the lithium group and eight from the valproate group. There were no suicides. Intent-to-treat analysis using the log-rank test showed no differences between treatment groups in time to suicide attempt or to suicide event. Post hoc power calculations revealed that the modest sample size, reflective of challenges in recruitment, only permits detection of a relative risk of 5 or greater. Conclusions Despite the high frequency of suicide events during the study, this randomized controlled trial detected no difference between lithium and valproate in time to suicide attempt or suicide event in a sample of suicide attempters with bipolar disorder. However, smaller clinically significant differences between the two drugs were not ruled out. PMID:21768611

Problem solving moderates the effects of life event stress and chronic stress on suicidal behaviors in adolescence.

PubMed

Grover, Kelly E; Green, Kelly L; Pettit, Jeremy W; Monteith, Lindsey L; Garza, Monica J; Venta, Amanda

2009-12-01

The present study examined the unique and interactive effects of stress and problem-solving skills on suicidal behaviors among 102 inpatient adolescents. As expected, life event stress and chronic stress each significantly predicted suicidal ideation and suicide attempt. Problem solving significantly predicted suicidal ideation, but not suicide attempt. Problem solving moderated the associations between life event stress and suicidal behaviors, as well as between chronic stress and suicidal ideation, but not chronic stress and suicide attempt. At high levels of stress, adolescents with poor problem-solving skills experienced elevated suicidal ideation and were at greater risk of making a nonfatal suicide attempt. The interactive effects decreased to non-significance after controlling for depressive symptoms and hopelessness. Clinical implications are discussed.

Bullying increased suicide risk: prospective study of Korean adolescents.

PubMed

Kim, Young Shin; Leventhal, Bennett L; Koh, Yun-Joo; Boyce, W Thomas

2009-01-01

This study examines the independent impact of bullying on suicide risk. Bullying was assessed by peer nomination in a prospective study of 1,655 7th and 8th grade Korean students, and suicide by youth self-report. Odds Ratios (ORs) of bullying for suicidal risks were computed, controlling for other suicide risk factors. Victim-Perpetrators and female Victims at baseline showed increased risk for persistent suicidality (OR: 2.4-9.8). Male Incident Victims exhibited increased risk for suicidal behaviors and ideations (OR = 4.4, 3.6). Female Persistent Perpetrators exhibited increased risks for suicidal behaviors; male Incident Perpetrators had increased risk for suicidal ideations (OR = 2.7, 2.3). Baseline-only male Victim-Perpetrators showed increased risk for suicidal ideations. (OR = 6.4). Bullying independently increased suicide risks.

Relationships between anhedonia, suicidal ideation and suicide attempts in a large sample of physicians.

PubMed

Loas, Gwenolé; Lefebvre, Guillaume; Rotsaert, Marianne; Englert, Yvon

2018-01-01

The relationships between anhedonia and suicidal ideation or suicide attempts were explored in a large sample of physicians using the interpersonal psychological theory of suicide. We tested two hypotheses: firstly, that there is a significant relationship between anhedonia and suicidality and, secondly, that anhedonia could mediate the relationships between suicidal ideation or suicide attempts and thwarted belongingness or perceived burdensomeness. In a cross-sectional study, 557 physicians filled out several questionnaires measuring suicide risk, depression, using the abridged version of the Beck Depression Inventory (BDI-13), and demographic and job-related information. Ratings of anhedonia, perceived burdensomeness and thwarted belongingness were then extracted from the BDI-13 and the other questionnaires. Significant relationships were found between anhedonia and suicidal ideation or suicide attempts, even when significant variables or covariates were taken into account and, in particular, depressive symptoms. Mediation analyses showed significant partial or complete mediations, where anhedonia mediated the relationships between suicidal ideation (lifetime or recent) and perceived burdensomeness or thwarted belongingness. For suicide attempts, complete mediation was found only between anhedonia and thwarted belongingness. When the different components of anhedonia were taken into account, dissatisfaction-not the loss of interest or work inhibition-had significant relationships with suicidal ideation, whereas work inhibition had significant relationships with suicide attempts. Anhedonia and its component of dissatisfaction could be a risk factor for suicidal ideation and could mediate the relationship between suicidal ideation and perceived burdensomeness or thwarted belongingness in physicians. Dissatisfaction, in particular in the workplace, may be explored as a strong predictor of suicidal ideation in physicians.

[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 between Impulsive and Non-Impulsive Suicide Attempts among Individuals Treated in Emergency Rooms of South Korea

PubMed Central

Lim, Meerae; Lee, Soojung

2016-01-01

Objective A considerable proportion of suicide attempts are the result of sudden desires. Understanding such impulsive suicide attempts is necessary for effective interventions. We evaluated the impulsivity of suicide attempters treated in emergency rooms. The aim of the study was to identify the characteristics of impulsive suicide attempts by comparing these individuals to those who attempted to commit suicide in a non-impulsive manner. Methods This study analyzed suicide attempters who visited the emergency departments of seven selected university hospitals. A total of 269 medical records in which impulsivity of suicide attempt were confirmed were subject to be analyzed. The impulsivity of the suicide attempt was examined using a summative score of items 6 and 15 on the Suicide Intent Scale. Results A total of 48.0% of the participants were impelled by sudden inclinations to attempt suicide. Impulsive attempters were younger, unmarried and less physical illness than non-impulsive attempters, whereas no significant differences were found on psychiatric history and previous suicide history. Impulsive suicide attempters had suicide ideations that were not as severe (χ2=55.33, p<0.001) or intense (t=-8.38, p<0.001) as their counterparts'. Furthermore, medical results of impulsive suicide attempts were better than non-impulsive suicide attempts (t=-3.77, p<0.001). Conclusion The results suggested that a considerable proportion of suicide attempts were the result of sudden inclinations. Impulsive attempts were made in relatively earlier stages of suicide ideation; consequently, they have less intent than non-impulsive attempts. PMID:27482239

Relationships between anhedonia, suicidal ideation and suicide attempts in a large sample of physicians

PubMed Central

Lefebvre, Guillaume; Rotsaert, Marianne; Englert, Yvon

2018-01-01

Background The relationships between anhedonia and suicidal ideation or suicide attempts were explored in a large sample of physicians using the interpersonal psychological theory of suicide. We tested two hypotheses: firstly, that there is a significant relationship between anhedonia and suicidality and, secondly, that anhedonia could mediate the relationships between suicidal ideation or suicide attempts and thwarted belongingness or perceived burdensomeness. Methods In a cross-sectional study, 557 physicians filled out several questionnaires measuring suicide risk, depression, using the abridged version of the Beck Depression Inventory (BDI-13), and demographic and job-related information. Ratings of anhedonia, perceived burdensomeness and thwarted belongingness were then extracted from the BDI-13 and the other questionnaires. Results Significant relationships were found between anhedonia and suicidal ideation or suicide attempts, even when significant variables or covariates were taken into account and, in particular, depressive symptoms. Mediation analyses showed significant partial or complete mediations, where anhedonia mediated the relationships between suicidal ideation (lifetime or recent) and perceived burdensomeness or thwarted belongingness. For suicide attempts, complete mediation was found only between anhedonia and thwarted belongingness. When the different components of anhedonia were taken into account, dissatisfaction—not the loss of interest or work inhibition—had significant relationships with suicidal ideation, whereas work inhibition had significant relationships with suicide attempts. Conclusions Anhedonia and its component of dissatisfaction could be a risk factor for suicidal ideation and could mediate the relationship between suicidal ideation and perceived burdensomeness or thwarted belongingness in physicians. Dissatisfaction, in particular in the workplace, may be explored as a strong predictor of suicidal ideation in physicians. PMID:29584785

Factors Associated with Recurrent Suicidal Ideation among Racially and Ethnically Diverse College Students with a History of Suicide Attempt: The Role of Mindfulness.

PubMed

Chesin, Megan S; Jeglic, Elizabeth L

2016-01-01

Although one-third of enrolled U.S. undergraduate college students are non-White, little is known about risk factors for suicidal behavior among racial and ethnic minority students. Thus, we set out to determine psychosocial factors associated with recurrent suicidal ideation among racially and ethnically diverse college students with a history of suicide attempt. From 2012-2013, 1,734 racially and ethnically diverse college students completed an on-line survey of suicidal behavior and associated factors. Depression, hopelessness, rejection sensitivity, and mindfulness, as well as past-year discrimination, ethnic identification, and acculturative stress were measured using well-validated self-report instruments. The Beck Scale for Suicide Ideation was used to assess current suicidal ideation. A subsample of 118 college students who self-reported a past suicide attempt were selected for the current analysis. Logistic regression analysis was used to test associations between risk factors and the presence of suicidal ideation, and linear regression analysis was used to test factors associated with suicidal ideation severity among those who reported current suicidal ideation. Depression was significantly related to both the presence and severity of current suicidal ideation. Mindfulness, and in particular awareness of present moment experience, was also inversely associated with ideation severity. We found depression and mindlessness were associated with suicidal ideation severity among a sample of diverse college students at high risk for suicidal behavior due to a past suicide attempt. Factors unique to the minority experience, such as acculturative stress, were not associated with current suicidal ideation. Implications for suicide prevention are discussed.

Suicide attempts before joining the military increase risk for suicide attempts and severity of suicidal ideation among military personnel and veterans.

PubMed

Bryan, Craig J; Bryan, AnnaBelle O; Ray-Sannerud, Bobbie N; Etienne, Neysa; Morrow, Chad E

2014-04-01

Past self-injurious thoughts and behaviors (SITB) are robust predictors of future suicide risk, but no studies have explored the prevalence of SITB occurring prior to military service among military personnel and veterans, or the association of premilitary SITB with suicidal ideation and suicide attempts during or after military service. The current study explores these issues in two separate samples. Self-report data were collected from 374 college student veterans via anonymous only survey (Study 1) and from 151 military personnel receiving outpatient mental health treatment (Study 2). Across both studies, premilitary suicide attempts were among the most prominent predictor of subsequent suicide attempts that occurred after joining the military, even when controlling for demographics and more recent emotional distress. Among military personnel who made a suicide attempt during or after military service, approximately 50% across both samples experienced suicidal ideation and up to 25% made a suicide attempt prior to joining the military. Military personnel and veterans who made suicide attempts prior to joining the military were over six times more likely to make a later suicide attempt after joining the military. In Study 2, significantly more severe current suicidal ideation was reported by participants with histories of premilitary suicide risk, even when controlling for SITB occurring while in the military. Military personnel and veterans who experienced SITB, especially suicide attempts, prior to joining the military are more likely to attempt suicide while in the military and/or as a veteran, and experience more severe suicidal crises. © 2014.

Predictors of suicide and suicide attempt in subway stations: a population-based ecological study.

PubMed

Niederkrotenthaler, Thomas; Sonneck, Gernot; Dervic, Kanita; Nader, Ingo W; Voracek, Martin; Kapusta, Nestor D; Etzersdorfer, Elmar; Mittendorfer-Rutz, Ellenor; Dorner, Thomas

2012-04-01

Suicidal behavior on the subway often involves young people and has a considerable impact on public life, but little is known about factors associated with suicides and suicide attempts in specific subway stations. Between 1979 and 2009, 185 suicides and 107 suicide attempts occurred on the subway in Vienna, Austria. Station-specific suicide and suicide attempt rates (defined as the frequency of suicidal incidents per time period) were modeled as the outcome variables in bivariate and multivariate Poisson regression models. Structural station characteristics (presence of a surveillance unit, train types used, and construction on street level versus other construction), contextual station characteristics (neighborhood to historical sites, size of the catchment area, and in operation during time period of extensive media reporting on subway suicides), and passenger-based characteristics (number of passengers getting on the trains per day, use as meeting point by drug users, and socioeconomic status of the population in the catchment area) were used as the explanatory variables. In the multivariate analyses, subway suicides increased when stations were served by the faster train type. Subway suicide attempts increased with the daily number of passengers getting on the trains and with the stations' use as meeting points by drug users. The findings indicate that there are some differences between subway suicides and suicide attempts. Completed suicides seem to vary most with train type used. Suicide attempts seem to depend mostly on passenger-based characteristics, specifically on the station's crowdedness and on its use as meeting point by drug users. Suicide-preventive interventions should concentrate on crowded stations and on stations frequented by risk groups.

Structural Parameters of Sex, Race, Age, and Education and Their Influence on Attitudes toward Suicide.

ERIC Educational Resources Information Center

Marks, Alan

1989-01-01

Surveyed 491 Arkansans concerning attitudes toward suicide. Over one-half of respondents knew someone who had committed or tried to commit suicide; 69 percent did not believe person has right to commit suicide; 71 percent believed normal persons would not commit suicide. Attitudes and experiences with suicide and suicidal people were…

Emotional Impact of a Video-Based Suicide Prevention Program on Suicidal Viewers and Suicide Survivors

ERIC Educational Resources Information Center

Bryan, Craig J.; Dhillon-Davis, Luther E.; Dhillon-Davis, Kieran K.

2009-01-01

In light of continuing concerns about iatrogenic effects associated with suicide prevention efforts utilizing video-based media, the impact of emotionally-charged videos on two vulnerable subgroups--suicidal viewers and suicide survivors--was explored. Following participation in routine suicide education as a part of the U.S. Air Force Suicide…

Adolescent Suicide. The Trauma of Adolescent Suicide. A Time for Special Leadership by Principals.

ERIC Educational Resources Information Center

Dempsey, Richard A.

This monograph was written to help principals and other school personnel explore the issues of adolescent suicide and its prevention. Chapter 1 presents statistics on the incidence of adolescent suicides and suicide attempts. Chapter 2, Causes of Suicide, reviews developmental tasks of adolescence, lists several contributors to adolescent suicide,…

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…

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.

Newspaper coverage of suicide and initiation of suicide clusters in teenagers in the USA, 1988-96: a retrospective, population-based, case-control study.

PubMed

Gould, Madelyn S; Kleinman, Marjorie H; Lake, Alison M; Forman, Judith; Midle, Jennifer Bassett

2014-06-01

Public health and clinical efforts to prevent suicide clusters are seriously hampered by the unanswered question of why such outbreaks occur. We aimed to establish whether an environmental factor-newspaper reports of suicide-has a role in the emergence of suicide clusters. In this retrospective, population-based, case-control study, we identified suicide clusters in young people aged 13-20 years in the USA from 1988 to 1996 (preceding the advent of social media) using the time-space Scan statistic. For each cluster community, we selected two matched non-cluster control communities in which suicides of similarly aged youth occurred, from non-contiguous counties within the same state as the cluster. We examined newspapers within each cluster community for stories about suicide published in the days between the first and second suicides in the cluster. In non-cluster communities, we examined a matched length of time after the matched control suicide. We used a content-analysis procedure to code the characteristics of each story and compared newspaper stories about suicide published in case and control communities with mixed-effect regression analyses. We identified 53 suicide clusters, of which 48 were included in the media review. For one cluster we could identify only one appropriate control; therefore, 95 matched control communities were included. The mean number of news stories about suicidal individuals published after an index cluster suicide (7·42 [SD 10·02]) was significantly greater than the mean number of suicide stories published after a non-cluster suicide (5·14 [6.00]; p<0·0001). Several story characteristics, including front-page placement, headlines containing the word suicide or a description of the method used, and detailed descriptions of the suicidal individual and act, appeared more often in stories published after the index cluster suicides than after non-cluster suicides. Our identification of an association between newspaper reports about suicide (including specific story characteristics) and the initiation of teenage suicide clusters should provide an empirical basis to support efforts by mental health professionals, community officials, and the media to work together to identify and prevent the onset of suicide clusters. US National Institute of Mental Health and American Foundation for Suicide Prevention. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Clinical Utility of the MMPI-2-RF Suicidal/Death Ideation Scale

PubMed Central

Gottfried, Emily; Bodell, Lindsay; Carbonell, Joyce; Joiner, Thomas

2014-01-01

Suicide is a major public health concern with over 100 individuals dying by suicide per day in the United States alone. Therefore, suicide risk assessment is an essential aspect of mental health care. The MMPI-2-RF has a Suicidal/Death Ideation (SUI) scale consisting of 5 items that describe recent suicidal ideation or behaviors. Although this scale has clear face validity, few studies have examined the clinical utility of this scale. The purpose of the current study was to examine associations between the SUI scale and other established measures of suicidal ideation and behavior, including the Depressive Symptom Inventory Suicidality Subscale (DSI-SS), Beck Scale for Suicide Ideation (BSS), self-report of lifetime suicide attempts, and clinician ratings of suicide risk. Participants were 998 therapy- and assessment-seeking outpatients. Analyses indicated that the SUI scale was positively associated with other self-reported measures of suicidal ideation and behavior. Significant differences in SUI scale scores also emerged among the clinician rating categories of suicide risk. The SUI scale was able to predict previous suicide attempts over and above age, gender, and other MMPI-2-RF scales related to depression. Finally, relative risk ratios for suicide attempts indicate increased risk of suicidality with higher T-scores on the SUI scale. Overall, findings suggest that the MMPI-2-RF SUI scale may be a useful tool for identifying individuals at risk for suicidal ideation and behavior in clinical settings. PMID:25068910

Predicting Future Suicide Attempts Among Adolescent and Emerging Adult Psychiatric Emergency Patients

PubMed Central

Horwitz, Adam G.; Czyz, Ewa K.; King, Cheryl A.

2014-01-01

Objective The purpose of this study was to longitudinally examine specific characteristics of suicidal ideation in combination with histories of suicide attempts and non-suicidal self-injury (NSSI) to best evaluate risk for a future attempt among high-risk adolescents and emerging adults. Method Participants in this retrospective medical record review study were 473 (53% female; 69% Caucasian) consecutive patients, ages 15–24 years (M = 19.4 years) who presented for psychiatric emergency (PE) services during a 9-month period. These patients’ medical records, including a clinician-administered Columbia-Suicide Severity Rating Scale, were coded at the index visit and at future visits occurring within the next 18 months. Logistic regression models were used to predict suicide attempts during this period. Results SES, suicidal ideation severity (i.e., intent, method), suicidal ideation intensity (i.e., frequency, controllability), a lifetime history of suicide attempt, and a lifetime history of NSSI were significant independent predictors of a future suicide attempt. Suicidal ideation added incremental validity to the prediction of future suicide attempts above and beyond the influence of a past suicide attempt, whereas a lifetime history of NSSI did not. Sex moderated the relationship between the duration of suicidal thoughts and future attempts (predictive for males, but not females). Conclusions Results suggest value in incorporating both past behaviors and current thoughts into suicide risk formulation. Furthermore, suicidal ideation duration warrants additional examination as a potential critical factor for screening assessments evaluating suicide risk among high-risk samples, particularly for males. PMID:24871489

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

PubMed

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

2017-02-01

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

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

PubMed Central

2014-01-01

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

Identifying Adolescents at Highly Elevated Risk for Suicidal Behavior in the Emergency Department

PubMed Central

Berona, Johnny; Czyz, Ewa; Horwitz, Adam G.; Gipson, Polly Y.

2015-01-01

Abstract Objective: The feasibility and concurrent validity of adolescent suicide risk screening in medical emergency departments (EDs) has been documented. The objectives of this short-term prospective study of adolescents who screened positive for suicide risk in the ED were: 1) to examine adolescents' rate of suicidal behavior during the 2 months following their ED visits and compare it with reported rates for psychiatric samples; and 2) to identify possible predictors of acute risk for suicidal behavior in this at-risk sample. Method: Participants were 81 adolescents, ages 14–19 years, seeking services for psychiatric and nonpsychiatric chief complaints, who screened positive for suicide risk because of recent suicidal ideation, a suicide attempt, and/or depression plus alcohol or substance misuse. A comprehensive assessment of suicidal behavior, using the Columbia-Suicide Severity Rating Scale, was conducted at baseline and 2 month follow-up. Results: Six adolescents (7.4%) reported a suicide attempt and 15 (18.5%) engaged in some type of suicidal behavior (actual, aborted, or interrupted suicide attempt; preparatory behavior) during the 2 months following their ED visit. These rates suggest that this screen identified a high-risk sample. Furthermore, adolescents who screened positive for suicidal ideation and/or attempt plus depression and alcohol/substance misuse were most likely to engage in future suicidal behavior (38.9%). Conclusions: In this study, use of a higher screen threshold (multiple suicide risk factors) showed promise for identifying highly elevated acute risk for suicidal behavior. PMID:25746114

Adolescent substance use behavior and suicidal behavior for boys and girls: a cross-sectional study by latent analysis approach.

PubMed

Wang, Peng-Wei; Yen, Cheng-Fang

2017-12-08

Adolescent suicidal behavior may consist of different symptoms, including suicidal ideation, suicidal planning and suicidal attempts. Adolescent substance use behavior may contribute to adolescent suicidal behavior. However, research on the relationships between specific substance use and individual suicidal behavior is insufficient, as adolescents may not use only one substance or develop only one facet of suicidal behavior. Latent variables permit us to describe the relationships between clusters of related behaviors more accurately than studying the relationships between specific behaviors. Thus, the aim of this study was to explore how adolescent substance use behavior contributes to suicidal behavior using latent variables representing adolescent suicidal and substance use behaviors. A total of 13,985 adolescents were recruited using a stratified random sampling strategy. The participants indicated whether they had experienced suicidal ideation, planning and attempts and reported their cigarette, alcohol, ketamine and MDMA use during the past year. Latent analysis was used to examine the relationship between substance use and suicidal behavior. Adolescents who used any one of the above substances exhibited more suicidal behavior. The results of latent variables analysis revealed that adolescent substance use contributed to suicidal behavior and that boys exhibited more severe substance use behavior than girls. However, there was no gender difference in the association between substance use and suicidal behavior. Substance use behavior in adolescents is related to more suicidal behavior. In addition, the contribution of substance use to suicidal behavior does not differ between genders.

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

PubMed

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

2017-01-01

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

Predicting Future Suicide Attempts among Depressed Suicide Ideators: A 10-year Longitudinal Study

PubMed Central

May, Alexis M.; Klonsky, E. David; Klein, Daniel N.

2012-01-01

Suicidal ideation and attempts are a major public health problem. Research has identified many risk factors for suicidality; however, most fail to identify which suicide ideators are at greatest risk of progressing to a suicide attempt. Thus, the present study identified predictors of future suicide attempts in a sample of psychiatric patients reporting suicidal ideation. The sample comprised 49 individuals who met full DSM-IV criteria for major depressive disorder and/or dysthymic disorder and reported suicidal ideation at baseline. Participants were followed for 10 years. Demographic, psychological, personality, and psychosocial risk factors were assessed using validated questionnaires and structured interviews. Phi coefficients and point-biserial correlations were used to identify prospective predictors of attempts, and logistic regressions were used to identify which variables predicted future attempts over and above past suicide attempts. Six significant predictors of future suicide attempts were identified – cluster A personality disorder, cluster B personality disorder, lifetime substance abuse, baseline anxiety disorder, poor maternal relationship, and poor social adjustment. Finally, exploratory logistic regressions were used to examine the unique contribution of each significant predictor controlling for the others. Co-morbid cluster B personality disorder emerged as the only robust, unique predictor of future suicide attempts among depressed suicide ideators. Future research should continue to identify variables that predict transition from suicidal thoughts to suicide attempts, as such work will enhance clinical assessment of suicide risk as well as theoretical models of suicide. PMID:22575331

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.

[Identification and assessment of suicidality].

PubMed

Prinz, Susanne; Egger, Stephan T

2014-10-29

Suicidality is a frequently observed but unfortunately frequently overlooked phenomenon. Every year over 1000 persons in Switzerland commit suicide; the number of attempted suicides is much higher. If suicidality is recognized promptly, appropriately assessed and adequate therapy initiated, suicides can be prevented. The assessment of suicidality can be facilitated by knowledge of the most important risk groups and factors, but also of protective factors. Various instruments are available which provide an overview of the influential factors, whereby some risk factors, e.g. access to suicidal methods or concrete suicide plans, involve a greater suicide risk than others. Such instruments, however, can never replace the overall assessment of a clinician which ought to arise from a dialogue characterized by empathy and transparency.

An application of Durkheim's theory of suicide to prison suicide rates in the United States.

PubMed

Tartaro, Christine; Lester, David

2005-06-01

E. Durkheim (1897) suggested that the societal rate of suicide might be explained by societal factors, such as marriage, divorce, and birth rates. The current study examined male prison suicide rates and suicide rates for men in the total population in the United States and found that variables based on Durkheim's theory of suicide explained prison suicide rates better than suicide rates for total population. Possible reasons for these findings are discussed.

Adolescent suicide in New York City: plenty of room for new research.

PubMed

Ganz, Debora; Sher, Leo

2012-01-01

The act of adolescent suicide continues to threaten adolescent populations in New York City (NYC). Consistent positive correlations have been found between a plethora of risk factors present in NYC adolescent populations and suicidal ideations and behaviors. Psychiatric conditions that may contribute to the rate of adolescent suicide in NYC include depression, bipolar disorder, substance abuse and schizophrenia. Unique factors that have been found to contribute to increased rates of completed suicides in NYC include the phenomena of railway suicides and suicide tourism. Homelessness and income inequality in NYC have also been consistently correlated with increased suicidality; with one study finding suicide attempts reported by a significant percentage of new admissions to homeless shelters. Adolescent populations in NYC that have been identified as particularly vulnerable to suicidality include runaway youth, homosexual youth, victimized adolescents and adolescents with a recent history of posttraumatic stress disorder (PTSD). Longitudinal studies in NYC have found that physical and sexual abuse is highly predictive of adolescent suicidality, with variations by ethnic group. Currently, there is a disturbing lack of sufficient research on adolescent suicide in NYC, specifically regarding causal factors, the effects of television on suicide, comorbid suicidality and drug abuse, and cultural factors contributing to suicide. This dearth of literature may be related to the ethical problems inherent in suicide research, self reports and/or post mortem analyses.

Clinical correlates of planned, more lethal suicide attempts in major depressive disorder.

PubMed

Nakagawa, Atsuo; Grunebaum, Michael F; Oquendo, Maria A; Burke, Ainsley K; Kashima, Haruo; Mann, J John

2009-01-01

Assessment of suicide plans is standard in acute psychiatric care, but there is a limited evidence base to guide this routine clinical practice. The purpose of this study was to investigate clinical correlates of suicide planning in depressed patients. 151 patients with major depressive disorder and a lifetime history of suicide attempt were studied. Subjects received a comprehensive evaluation including structured diagnostic interview for Axis I and II disorders, current symptoms, impulsivity, and systematic assessment of suicide planning prior to the most recent suicide attempt. Seriousness of suicide attempt planning correlated with lethality of suicidal acts. Comorbid anxiety disorder and anxiety correlated with less suicide planning. Specifically, this negative correlation was with comorbid panic disorder. Planning did not correlate with severity of depression or aggressive/impulsive traits. Cross-sectional design, retrospective recall of suicide planning data, limited applicability to completed suicide or other psychiatric disorders. In major depression, comorbid panic disorder appears protective against more carefully planned, higher lethality suicide attempts. Surprisingly, severity of depression and aggressive impulsive traits do not predict planning or lethality of suicide attempts. We have previously reported that anxiety severity protects against the probability of a suicide attempt and now extend that observation to show there is protection against lethality of a suicide attempt. Treatment of anxiety without directly treating major depression may place patients at greater risk of suicidal behavior.

Detecting suicidality among adolescent outpatients: evaluation of trained clinicians' suicidality assessment against a structured diagnostic assessment made by trained raters

PubMed Central

Holi, Matti Mikael; Pelkonen, Mirjami; Karlsson, Linnea; Tuisku, Virpi; Kiviruusu, Olli; Ruuttu, Titta; Marttunen, Mauri

2008-01-01

Background Accurate assessment of suicidality is of major importance. We aimed to evaluate trained clinicians' ability to assess suicidality against a structured assessment made by trained raters. Method Treating clinicians classified 218 adolescent psychiatric outpatients suffering from a depressive mood disorder into three classes: 1-no suicidal ideation, 2-suicidal ideation, no suicidal acts, 3-suicidal or self-harming acts. This classification was compared with a classification with identical content derived from the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS-PL) made by trained raters. The convergence was assessed by kappa- and weighted kappa tests. Results The clinicians' classification to class 1 (no suicidal ideation) was 85%, class 2 (suicidal ideation) 50%, and class 3 (suicidal acts) 10% concurrent with the K-SADS evaluation (γ2 = 37.1, df 4, p = 0.000). Weighted kappa for the agreement of the measures was 0.335 (CI = 0.198–0.471, p < 0.0001). The clinicians under-detected suicidal and self-harm acts, but over-detected suicidal ideation. Conclusion There was only a modest agreement between the trained clinicians' suicidality evaluation and the K-SADS evaluation, especially concerning suicidal or self-harming acts. We suggest a wider use of structured scales in clinical and research settings to improve reliable detection of adolescents with suicidality. PMID:19116040

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/

Suicide and suicidal behavior

MedlinePlus

Depression - suicide; Bipolar - suicide ... Borderline personality disorder Drug or alcohol dependence Major depression Schizophrenia Always take suicide attempts and threats seriously. If you or someone ...

Youths Treated for Non-Suicidal Self Harm at Increased Risk of Suicide Within a Year

MedlinePlus

... Non-Suicidal Self Harm at Increased Risk of Suicide Within a Year Page Content New research in ... likely than demographically matched peers to die from suicide within the following year. The study, " Suicide Following ...

Psychological and social factors affecting Internet searches on suicide in Korea: a big data analysis of Google search trends.

PubMed

Song, Tae Min; Song, Juyoung; An, Ji-Young; Hayman, Laura L; Woo, Jong-Min

2014-01-01

The average mortality rate for death by suicide among OECD countries is 12.8 per 100000, and 33.5 for Korea. The present study analyzed big data extracted from Google to identify factors related to searches on suicide in Korea. Google search trends for the search words of suicide, stress, exercise, and drinking were obtained for 2004-2010. Analyzing data by month, the relationship between the actual number of suicides and search words per year was examined using multi-level models. Both suicide rates and Google searches on suicide in Korea increased since 2007. An unconditional slope model indicated stress and suicide-related searches were positively related. A conditional model showed that factors associated with suicide by year directly affected suicide-related searches. The interaction between stress-related searches and the actual number of suicides was significant. A positive relationship between stress- and suicide-related searches further confirmed that stress affects suicide. Taken together and viewed in context of the big data analysis, our results point to the need for a tailored prevention program. Real-time big data can be of use in indicating increases in suicidality when search words such as stress and suicide generate greater numbers of hits on portals and social network sites.

"Suicide shall cease to be a crime": suicide and undetermined death trends 1970-2000 before and after the decriminalization of suicide in Ireland 1993.

PubMed

Osman, Mugtaba; Parnell, Andrew C; Haley, Clifford

2017-02-01

Suicide is criminalized in more than 100 countries around the world. A dearth of research exists into the effect of suicide legislation on suicide rates and available statistics are mixed. This study investigates 10,353 suicide deaths in Ireland that took place between 1970 and 2000. Irish 1970-2000 annual suicide data were obtained from the Central Statistics Office and modelled via a negative binomial regression approach. We examined the effect of suicide legislation on different age groups and on both sexes. We used Bonferroni correction for multiple modelling. Statistical analysis was performed using the R statistical package version 3.1.2. The coefficient for the effect of suicide act on overall suicide deaths was -9.094 (95 % confidence interval (CI) -34.086 to 15.899), statistically non-significant (p = 0.476). The coefficient for the effect suicide act on undetermined deaths was statistically significant (p < 0.001) and was estimated to be -644.4 (95 % CI -818.6 to -469.9). The results of our study indicate that legalization of suicide is not associated with a significant increase in subsequent suicide deaths. However, undetermined death verdict rates have significantly dropped following legalization of suicide.

Factors influencing the suicide intervention skills of emergency medical services providers

PubMed Central

Lygnugaryte-Griksiene, Aidana; Leskauskas, Darius; Jasinskas, Nedas; Masiukiene, Agne

2017-01-01

ABSTRACT Background: Lithuania currently has the highest suicide rate in Europe and the fifth highest worldwide. Aims: To identify the factors that influence the suicide intervention skills of emergency medical services (EMS) providers (doctors, nurses, paramedics). Method: Two hundred and sixty-eight EMS providers participated in the research. The EMS providers were surveyed both prior to their training in suicide intervention and six months later. The questionnaire used for the survey assessed their socio-demographic characteristics, suicide intervention skills, attitudes towards suicide prevention, general mental health, strategies for coping with stress, and likelihood of burnout. Results: Better suicide intervention skills were more prevalent among EMS providers with a higher level of education, heavier workload, more positive attitudes towards suicide prevention, better methods of coping with stress, and those of a younger age. Six months after the non-continuous training in suicide intervention, the providers’ ability to assess suicide risk factors had improved, although there was no change in their suicide intervention skills. Conclusions: In order to improve the suicide intervention skills of EMS providers, particular attention should be paid to attitudes towards suicide prevention, skills for coping with stress, and continuous training in suicide intervention. Abbreviations: EMS: Emergency medical services; SIRI: Suicide intervention response inventory PMID:28235388

Is It Rational to Pursue Zero Suicides Among Patients in Health Care?

PubMed

Mokkenstorm, Jan K; Kerkhof, Ad J F M; Smit, Johannes H; Beekman, Aartjan T F

2017-10-26

Suicide prevention is a major health care responsibility in need of new perspectives. This study reviews Zero Suicide, an emerging approach to suicide prevention that embraces the aspirational goal of zero suicides among patients treated in health care systems or organizations. Zero Suicide is gaining international momentum while at the same time evoking objections and concerns. Fundamental to Zero Suicide is a multilevel system view on suicide prevention, with three core elements: a direct approach to suicidal behaviors; continual improvement of the quality and safety of care processes; and an organizational commitment to the aspirational goal of zero suicides. The rationale and evidence for these components are clarified and discussed against the backdrop of concerns and objections that focus on possible undesired consequences of the pursuit of zero suicide, in particular for clinicians and for those who are bereaved by suicide. It is concluded that it is rational to pursue zero suicides as an aspirational goal, provided the journey toward zero suicides is undertaken in a systemic and sustained manner, in a way that professionals feel supported, empowered, and protected against blame and inappropriate guilt. © 2017 The Authors. Suicide and Life-Threatening Behavior published by Wiley Periodicals, Inc. on behalf of American Association of Suicidology.

The role of the kynurenine pathway in suicidality in adolescent major depressive disorder

PubMed Central

Bradley, Kailyn A. L.; Case, Julia A. C.; Khan, Omar; Ricart, Thomas; Hanna, Amira; Alonso, Carmen M.; Gabbay, Vilma

2015-01-01

The neuroimmunological kynurenine pathway (KP) has been implicated in major depressive disorder (MDD) in adults and adolescents, most recently in suicidality in adults. The KP is initiated by the enzyme indoleamine 2,3-dioxygenase (IDO), which degrades tryptophan (TRP) into kynurenine (KYN) en route to neurotoxins. Here, we examined the KP in 20 suicidal depressed adolescents—composed of past attempters and those who expressed active suicidal intent—30 non-suicidal depressed youth, and 22 healthy controls (HC). Plasma levels of TRP, KYN, 3-hydroxyanthranilic acid, and KYN/TRP (index of IDO) were assessed. Suicidal adolescents showed decreased TRP and elevated KYN/TRP compared to both non-suicidal depressed adolescents and HC. Findings became more significantly pronounced when excluding medicated participants, wherein there was also a significant positive correlation between KYN/TRP and suicidality. Finally, although depressed adolescents with a history of suicide attempt differed from acutely suicidal adolescents with respect to disease severity, anhedonia, and suicidality, the groups did not differ in KP measures. Our findings suggest a possible specific role of the KP in suicidality in depressed adolescents, while illustrating the clinical phenomenon that depressed adolescents with a history of suicide attempt are similar to acutely suicidal youth and are at increased risk for completion of suicide. PMID:25865484

The role of the kynurenine pathway in suicidality in adolescent major depressive disorder.

PubMed

Bradley, Kailyn A L; Case, Julia A C; Khan, Omar; Ricart, Thomas; Hanna, Amira; Alonso, Carmen M; Gabbay, Vilma

2015-06-30

The neuroimmunological kynurenine pathway (KP) has been implicated in major depressive disorder (MDD) in adults and adolescents, most recently in suicidality in adults. The KP is initiated by the enzyme indoleamine 2,3-dioxygenase (IDO), which degrades tryptophan (TRP) into kynurenine (KYN) en route to neurotoxins. Here, we examined the KP in 20 suicidal depressed adolescents-composed of past attempters and those who expressed active suicidal intent-30 non-suicidal depressed youth, and 22 healthy controls (HC). Plasma levels of TRP, KYN, 3-hydroxyanthranilic acid (3-HAA), and KYN/TRP (index of IDO) were assessed. Suicidal adolescents showed decreased TRP and elevated KYN/TRP compared to both non-suicidal depressed adolescents and HC. Findings became more significantly pronounced when excluding medicated participants, wherein there was also a significant positive correlation between KYN/TRP and suicidality. Finally, although depressed adolescents with a history of suicide attempt differed from acutely suicidal adolescents with respect to disease severity, anhedonia, and suicidality, the groups did not differ in KP measures. Our findings suggest a possible specific role of the KP in suicidality in depressed adolescents, while illustrating the clinical phenomenon that depressed adolescents with a history of suicide attempt are similar to acutely suicidal youth and are at increased risk for completion of suicide. Published by Elsevier Ireland Ltd.

Suicidality and its relationships with individual, family, peer, and psychopathology factors among adolescents with attention-deficit/hyperactivity disorder.

PubMed

Chou, Wen-Jiun; Liu, Tai-Ling; Hu, Huei-Fan; Yen, Cheng-Fang

2016-01-01

The aim of this study was to examine the prevalence rates of suicidal intent and its correlates among adolescents diagnosed with ADHD in Taiwan. A total of 287 adolescents aged 11-18 years and diagnosed with ADHD participated in this study. Their suicidal ideation and suicide attempts were assessed. Logistic regression analysis was used to examine the associations of suicide with individual, family, peer, ADHD, and psychopathology factors. A total of 12.2% of the participants reported suicidal ideation or a suicide attempt. A logistic regression analysis model showed that adolescents who were older, were bullying perpetrators, and reported high depression level were more likely to have suicidal intent. These three factors were also significantly correlated with suicidal ideation; however, only having high depression level was significantly correlated with suicidal attempts. The results of this study showed that a high proportion of adolescents with ADHD reported suicidal ideation or a suicide attempt. Multiple factors were significantly associated with suicidal intent among adolescents with ADHD. Clinicians, educational professionals, and parents of adolescents with ADHD should monitor the possibility of suicide in adolescents with ADHD who exhibit the correlates of suicidal intent identified in this study. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

PubMed

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

2010-01-01

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

Associations Between Peer Victimization and Suicidal Ideation and Suicide Attempt During Adolescence: Results From a Prospective Population-Based Birth Cohort.

PubMed

Geoffroy, Marie-Claude; Boivin, Michel; Arseneault, Louise; Turecki, Gustavo; Vitaro, Frank; Brendgen, Mara; Renaud, Johanne; Séguin, Jean R; Tremblay, Richard E; Côté, Sylvana M

2016-02-01

To test whether adolescents who are victimized by peers are at heightened risk for suicidal ideation and suicide attempt, using both cross-sectional and prospective investigations. Participants are from the Quebec Longitudinal Study of Child Development, a general population sample of children born in Quebec in 1997 through 1998 and followed up until 15 years of age. Information about victimization and serious suicidal ideation and suicide attempt in the past year was obtained at ages 13 and 15 years from self-reports (N = 1,168). Victims reported concurrently higher rates of suicidal ideation at age 13 years (11.6-14.7%) and suicide attempt at age 15 years (5.4-6.8%) compared to those who had not been victimized (2.7-4.1% for suicidal ideation and 1.6-1.9% for suicide attempt). Being victimized by peers at 13 years predicted suicidal ideation (odds ratio [OR] = 2.27; 95% CI = 1.25-4.12) and suicide attempt (OR = 3.05, 95% CI = 1.36-6.82) 2 years later, even after adjusting for baseline suicidality and mental health problems and a series of confounders (socioeconomic status, intelligence, family's functioning and structure, hostile-reactive parenting, maternal lifetime suicidal ideation/suicide attempt). Those who were victimized at both 13 and 15 years had the highest risk of suicidal ideation (OR = 5.41, 95% CI = 2.53-11.53) and suicide attempt (OR = 5.85, 95% CI = 2.12-16.18) at 15 years. Victimization is associated with an increased risk of suicidal ideation and suicide attempt over and above concurrent suicidality and prior mental health problems. The longer the history of victimization, the greater the risk. Copyright © 2016 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

[Suicidal behavior prevention for children under age 13: A systematic review].

PubMed

Baux-Cazal, L; Gokalsing, E; Amadeo, S; Messiah, A

2017-05-01

Our objective was to review international literature on suicidal behavior prevention for children under age 13. We gathered all relevant articles on suicide prevention for children under 13. We researched all publications in the French and English languages in PubMed (MEDLINE), PsychINFO and SUDOC databases published until February 2014, with the keywords "child", "child preschool", "prevention and control", "suicide", and "suicide attempted". Publications were included if they described suicidal behavior prevention programs (suicide prevention programs, attempted-suicide prevention programs, suicidal ideation screening programs), and if the studies concerned children under age 13. We also included references cited in the articles if they were not already present in our searches but met inclusion criteria. Studies were excluded if they analyzed populations of children and adolescents without sub-analysis for children under age 13. A total of 350 potentially relevant articles were identified, 33 of which met the inclusion criteria, including 4 retrieved from articles' bibliography. Preventive measures against suicidal behavior for children under 13 exist and include: social programs, maltreatment prevention, curriculum-based suicide prevention programs, suicide screening in schools, gatekeepers, reduction of access of lethal means of suicide, suicide screening by primary care, and post-suicide intervention programs. Overall, the evidence was limited by methodological concerns, particularly a lack of RCTs. However, positive effects were found: school-based suicide prevention programs and gatekeepers increased knowledge about suicide and how to seek help, post-suicide programs helped to reduce psychological distress in the short term. One study showed a decreased risk of attempted-suicide after entry into the child welfare system. There are promising interventions but there is not enough scientific evidence to support any efficient preventive measure against suicidal behavior for children under 13, whether primary, secondary, tertiary or post-intervention. More research is needed. Copyright © 2016 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Association between parental psychopathology and suicidal behavior among adult offspring: results from the cross-sectional South African Stress and Health survey

PubMed Central

2014-01-01

Background Prior studies have demonstrated a link between parental psychopathology and offspring suicidal behavior. However, it remains unclear what aspects of suicidal behavior among adult offspring are predicted by specific parental mental disorders, especially in Africa. This study set out to investigate the association between parental psychopathology and suicidal behavior among their adult offspring in a South African general population sample. Method Parental psychopathology and suicidal behavior in offspring were assessed using structured interviews among 4,315 respondents from across South Africa. The WHO CIDI was used to collect data on suicidal behavior, while the Family History Research Diagnostic Criteria Interview was used to assess prior parental psychopathology. Bivariate and multivariate survival models tested the associations between the type and number parental mental disorders (including suicide) and lifetime suicidal behavior in the offspring. Associations between a range of parental disorders and the onset of subsequent suicidal behavior (suicidal ideation, plans, and attempts) among adult offspring were tested. Results The presence of parental psychopathology significantly increased the odds of suicidal behavior among their adult offspring. More specifically, parental panic disorder was associated with offspring suicidal ideation, while parental panic disorder, generalized anxiety disorder and suicide were significantly associated with offspring suicide attempts. Among those with suicidal ideation, none of the tested forms of parental psychopathology was associated with having suicide plans or attempts. There was a dose–response relationship between the number of parental disorders and odds of suicidal ideation. Conclusions Parental psychopathology increases the odds of suicidal behavior among their adult offspring in the South African context, replicating results found in other regions. Specific parental disorders predicted the onset and persistence of suicidal ideation or attempts in their offspring. Further research into these associations is recommended in order to determine the mechanisms through which parent psychopathology increases the odds of suicidal behavior among offspring. PMID:24592882

Pathways for Preparation: Locating Suicide Education in Preparing Professionals for Encounters with Suicidal Adolescents

ERIC Educational Resources Information Center

Ranahan, Patti

2013-01-01

Current suicide prevention strategies often include suicide education based on the premise that education can lead to recognition of those at risk of suicide and others who are prepared can respond and potentially save lives. As suicide is a leading cause of death for young people, it is relevant to explore how suicide education is made available…

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

PubMed Central

2012-01-01

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

Mental Health Professionals' Suicide Risk Assessment and Management Practices.

PubMed

Roush, Jared F; Brown, Sarah L; Jahn, Danielle R; Mitchell, Sean M; Taylor, Nathanael J; Quinnett, Paul; Ries, Richard

2018-01-01

Approximately 20% of suicide decedents have had contact with a mental health professional within 1 month prior to their death, and the majority of mental health professionals have treated suicidal individuals. Despite limited evidence-based training, mental health professionals make important clinical decisions related to suicide risk assessment and management. The current study aimed to determine the frequency of suicide risk assessment and management practices and the association between fear of suicide-related outcomes or comfort working with suicidal individuals and adequacy of suicide risk management decisions among mental health professionals. Mental health professionals completed self-report assessments of fear, comfort, and suicide risk assessment and management practices. Approximately one third of mental health professionals did not ask every patient about current or previous suicidal thoughts or behaviors. Further, comfort, but not fear, was positively associated with greater odds of conducting evidence-based suicide risk assessments at first appointments and adequacy of suicide risk management practices with patients reporting suicide ideation and a recent suicide attempt. The study utilized a cross-sectional design and self-report questionnaires. Although the majority of mental health professionals report using evidenced-based practices, there appears to be variability in utilization of evidence-based practices.

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.

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.

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

PubMed

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

2015-01-01

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

[Religion and suicide - part 2: confessions, religiousness, secularisation and national suicide rates].

PubMed

Ritter, Kristina; Zitterl, Werner; Stompe, Thomas

2011-01-01

National suicide rates differ remarkably. The influence of religion on the frequency of suicides was already stressed by Durkheim, however, character and dimension of this influence are still unclear. Our study claims to assess the association between (a) the distribution of believers of different religions, (b) the secularization, (c) the religiousness and the national suicide rates by gender. Data of the distribution of religious confessions and of the religiousness of the inhabitants of the single countries were correlated with the national suicide rates and illustrated by means of Scatter/Dot-Plots. Independent of gender, low suicide rates were found in Islamic countries. Buddhist countries showed high suicide rates in women, and countries with a high percentage of inhabitants without confession high suicide rates in men. Only catholic countries showed an association between secularisation and suicide rates. In countries with a high proportion of religious inhabitants we found low suicide rates. Although none of the World religions support the human right of suicide, the mosaic religions of resurrection refuse suicide more strictly than the Eastern religions of reincarnation. All in all our study supports the hypothesis that religiousness can be seen as a protective factor against suicide.

Perceived School Climate and Chinese Adolescents' Suicidal Ideation and Suicide Attempts: The Mediating Role of Sleep Quality.

PubMed

Li, Dongping; Bao, Zhenzhou; Li, Xian; Wang, Yanhui

2016-02-01

School factors play important roles in adolescent suicide. However, little is known about how school climate is associated with adolescent suicide. This study examined the relationship between perceived school climate and adolescent suicidal ideation and suicide attempts, and whether these relations were explained by adolescent sleep quality. A total of 1529 Chinese adolescents (mean age = 14.74 years; 52% boys) participated in the study. They provided self-report data on control variables, perceived school climate, sleep quality, suicidal ideation, and suicide attempts. After controlling for sex, age, family structure, socioeconomic status, and parent-adolescent attachment, we found that perceived school climate negatively predicted adolescent suicidal ideation (odds ratio [OR] = 0.66, p < .001) and suicide attempts (OR = 0.72, p < .001). Moreover, perceived school climate positively predicated adolescent sleep quality (β = 0.13, p < .001), which in turn, negatively predicted adolescent suicidal ideation (OR = 0.75, p < .001) and suicide attempts (OR = 0.76, p < .001). These findings, although cross-sectional, indicate that perceived school climate plays an important role in adolescent suicidality. Moreover, the relation between perceived school climate and adolescent suicidality was largely mediated by adolescent sleep quality. © 2016, American School Health Association.

SUICIDE IN OLDER ADULTS: NURSING ASSESSMENT OF SUICIDE RISK

PubMed Central

Garand, Linda; Mitchell, Ann M.; Dietrick, Ann; Hijjawi, Sophia P.; Pan, Di

2010-01-01

A fundamental objective of the National Strategy for Suicide Prevention is the prevention of suicide in older adults, especially elderly males, because these individuals are at higher risk for suicide than any other age group. Furthermore, they are the fastest growing segment of the population. The suicide rates for older Caucasian men are particularly high. Because nurses play an important role in the identification of persons at risk for suicide, it is important that they be cognizant of the complex risk factors involved in late life suicide. Toward that end, we review the prevalence of suicidal behaviors in older adults and discuss risk factors that contribute to completed suicide in these individuals. Lastly, we discuss the role of nurses in the identification of older adults at risk for suicidal behavior so that life-saving treatment measures can be implemented. PMID:16546935

Religion and suicide: Buddhism, Native American and African religions, Atheism, and Agnosticism.

PubMed

Lizardi, D; Gearing, R E

2010-09-01

Research has repeatedly demonstrated that religiosity can potentially serve as a protective factor against suicidal behavior. A clear understanding of the influence of religion on suicidality is required to more fully assess for the risk of suicide. The databases PsycINFO and MEDLINE were used to search peer-reviewed journals prior to 2008 focusing on religion and suicide. Articles focusing on suicidality across Buddhism, Native American and African religions, as well as on the relationship among Atheism, Agnosticism, and suicide were utilized for this review. Practice recommendations are offered for conducting accurate assessment of religiosity as it relates to suicidality in these populations. Given the influence of religious beliefs on suicide, it is important to examine each major religious group for its unique conceptualization and position on suicide to accurately identify a client's suicide risk.

Suicide in Older Adults: The Role of Emotions and Cognition

PubMed Central

Szanto, Katalin; Alexopoulos, George S.

2014-01-01

Suicide in older adults is a significant clinical concern. In this review of recent findings, we concentrate on the role of emotions and cognition in suicide risk and behavior in older adults. We discuss the epidemiology of suicide in older adults, integrate recent findings on non-psychotic major depression, schizophrenia and suicidal ideation, explore the relationship of emotion regulation with suicide, present recent advances on suicide in demented patients, and describe the latest developments on cognition and decision processes in suicide. PMID:25226883

Current suicidal ideation in treatment-seeking individuals in the United Kingdom with gambling problems.

PubMed

Ronzitti, Silvia; Soldini, Emiliano; Smith, Neil; Potenza, Marc N; Clerici, Massimo; Bowden-Jones, Henrietta

2017-11-01

Studies show higher lifetime prevalence of suicidality in individuals with pathological gambling. However, less is known about the relationship between pathological gambling and current suicidal ideation. We investigated socio-demographic, clinical and gambling-related variables associated with suicidality in treatment-seeking individuals. Bivariate analyses and logistic regression models were generated on data from 903 individuals to identify measures associated with aspects of suicidality. Forty-six percent of patients reported current suicidal ideation. People with current suicidal thoughts were more likely to report greater problem-gambling severity (p<0.001), depression (p<0.001) and anxiety (p<0.001) compared to those without suicidality. Logistic regression models suggested that past suicidal ideation (p<0.001) and higher anxiety (p<0.05) may be predictive factors of current suicidality. Our findings suggest that the severity of anxiety disorder, along with a lifetime history of suicidal ideation, may help to identify treatment-seeking individuals with pathological gambling with a higher risk of suicidality, highlighting the importance of assessing suicidal ideation in clinical settings. Copyright © 2017 Elsevier Ltd. All rights reserved.

Analysis of Internet Suicide Pacts Reported by the Media in Mainland China.

PubMed

Jiang, Fang-Fan; Xu, Hui-Lan; Liao, Hui-Ying; Zhang, Ting

2017-01-01

In mainland China, frequent Internet suicide pacts in recent years have raised strong concerns from several social sectors and the influence of social networks on suicide is constantly growing. To identify the epidemiological characteristics of media-reported Internet suicide pacts in mainland China. Our study comprised 62 Internet suicide pacts involving 159 victims in mainland China before June 1, 2015. Kendall's randomness test, a trend test, and a circular distribution test were applied to identify the rising or concentrated trends in the time of occurrence of Internet suicide pacts. The overall male-to-female ratio was 2.3:1. Suicide victims were mainly people in their 20s to 30s (84.1%). In all, 87.1% suicide victims completed suicide in sealed hotels or rental housing, and charcoal-burning suicide accounted for 80.6% of cases. People who complete suicide as part of an Internet suicide pact are more likely to be males, aged 20-30 years. Charcoal-burning suicide in sealed hotels or rental housing was the commonest way of dying.

Psychological Strains and Youth Suicide in Rural China

PubMed Central

Zhang, Jie; Wieczorek, William F.; Conwell, Yeates; Tu, Xin Ming

2011-01-01

The strain theory of suicide postulates that suicide is usually preceded by psychological strains. A strain can be a consequence of any of four conflicts: differential values, aspiration and reality, relative deprivation, and lack of coping skills for a crisis. This study, with a blend of psychiatric and social predictors of suicide, identified correlates of suicide that are relevant to Chinese culture and tested the strain theory of suicide with Chinese data. We sampled 392 suicides and 416 living controls (both aged 15–34 years) from 16 rural counties in China in 2008 and interviewed two informants for each suicide and each control. We found that marriage and religion/religiosity did not distinguish the suicides from the living controls among Chinese rural young women. Religion/religiosity tended to be stronger for suicides than for controls. Psychological strains in the forms of relative deprivation, unrealized aspiration, and lack of coping skills were significantly associated with suicide, even after accounting for the role of mental illness. The strain theory of suicide forms a challenge to the psychiatric model popular in the West, at least in explaining the Chinese suicide. PMID:21640457

Bullying and Suicidality in Urban Chinese Youth: The Role of Teacher-Student Relationships.

PubMed

Han, Ziqiang; Fu, Mingqi; Liu, Chengcheng; Guo, Jing

2018-05-01

The aim of this study is to examine the link between bullying and the tendency toward suicide (suicidality). In particular, we tested the interaction effect of teacher-student relationships on the association between bullying and suicidality among urban youth in China. A total of 3,675 participants were recruited from 7 provinces in urban China. Three questions were used to capture suicidality-related measures: suicide ideation, suicide planning, and attempting suicide. Traditional bullying and cyberbullying were used to measure the effect of being bullied. The results show that being bullied, traditionally or online, is significantly associated with suicidality. The interaction effect between traditional bullying and the teacher-student relationship for suicidal ideation is significant (odds ratio 1.34, 95% confidence interval 1.03-1.74). However, no significant interaction effects in teacher-student relationships have been found in the association between cyberbullying and suicidality. The results indicate that teacher-student relationships have a significant protective, but limited, effect on the relationship between bullying and suicidality. Future development of suicidality intervention strategies adapted to the development of society will be beneficial.

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

PubMed

Price, James H; Khubchandani, Jagdish

2017-06-01

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

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

PubMed

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

2012-06-01

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

Effects of Statewide Job Losses on Adolescent Suicide-Related Behaviors

PubMed Central

Ananat, Elizabeth Oltmans; Gibson-Davis, Christina M.

2014-01-01

Objectives. We investigated the impact of statewide job loss on adolescent suicide-related behaviors. Methods. We used 1997 to 2009 data from the Youth Risk Behavior Survey and the Bureau of Labor Statistics to estimate the effects of statewide job loss on adolescents’ suicidal ideation, suicide attempts, and suicide plans. Probit regression models controlled for demographic characteristics, state of residence, and year; samples were divided according to gender and race/ethnicity. Results. Statewide job losses during the year preceding the survey increased girls’ probability of suicidal ideation and suicide plans and non-Hispanic Black adolescents’ probability of suicidal ideation, suicide plans, and suicide attempts. Job losses among 1% of a state’s working-age population increased the probability of girls and Blacks reporting suicide-related behaviors by 2 to 3 percentage points. Job losses did not affect the suicide-related behaviors of boys, non-Hispanic Whites, or Hispanics. The results were robust to the inclusion of other state economic characteristics. Conclusions. As are adults, adolescents are affected by economic downturns. Our findings show that statewide job loss increases adolescent girls’ and non-Hispanic Blacks’ suicide-related behaviors. PMID:25122027

Revisiting Impulsivity in Suicide

PubMed Central

Smith, April R.; Witte, Tracy K.; Teale, Nadia E.; King, Sarah L.; Bender, Ted W.; Joiner, Thomas E.

2008-01-01

Previous research and popular conceptualizations of suicide have posited that many suicides are the result of impulsive, “on a whim” decisions. However, recent research demonstrates that most suicides are not attempted impulsively, and in fact involve a plan. Legally, suicide has historically been considered to be a superseding intervening cause of death that exonerates other parties from liability, but currently there are two general exceptions to this view. Specifically, another party may be found responsible for a suicide if that party either caused the suicide or failed in its duty to prevent the suicide from occurring. Both of these exceptions assume that the resulting suicide was foreseeable. Given that recent research has indicated that most suicides are planned, and thereby foreseeable to a certain extent under many circumstances, this article discusses issues of foreseeability as they pertain to litigation involving third party liability for the suicide of university students, prison inmates, and mental health patients. The authors contend that the surest way for universities, prison staff, and mental health practitioners to avoid being held liable for a suicide is to appropriately assess for suicidal intent. PMID:19039790

A test of the interpersonal-psychological theory of suicide among arrested domestic violence offenders.

PubMed

Wolford-Clevenger, Caitlin; Brem, Meagan J; Elmquist, JoAnna; Florimbio, Autumn Rae; Smith, Phillip N; Stuart, Gregory L

2017-03-01

Little is known about risk factors for suicide ideation and attempts among domestic violence offenders. Guided by the interpersonal-psychological theory of suicide, this cross-sectional study examined risk factors for suicide ideation and attempts among 312 men and 84 women arrested for domestic violence and mandated to attend batterer intervention programs. Men reported greater capability for suicide, but no gender differences were found in perceived burdensomeness and thwarted belongingness. After controlling for correlates of suicide ideation, perceived burdensomeness-but not thwarted belongingness or its interaction with perceived burdensomeness-associated with suicide ideation. Suicide attempters exhibited greater perceived burdensomeness, drug use and problems, borderline personality disorder symptoms, depressive symptoms, and suicide ideation, but not capability for suicide, than nonattempters. Gender did not moderate the associations of the IPTS constructs with suicide ideation and attempts. These findings parallel tests of the interpersonal-psychological theory in other samples. Additional work is needed to identify factors that distinguish risk for suicide ideation from risk for suicide attempts among domestic violence offenders. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

A Test of the Interpersonal-Psychological Theory of Suicide among Arrested Domestic Violence Offenders

PubMed Central

Wolford-Clevenger, Caitlin; Brem, Meagan J.; Elmquist, JoAnna; Florimbio, Autumn Rae; Smith, Phillip N.; Stuart, Gregory L.

2017-01-01

Little is known about risk factors for suicide ideation and attempts among domestic violence offenders. Guided by the interpersonal-psychological theory of suicide, this cross-sectional study examined risk factors for suicide ideation and attempts among 312 men and 84 women arrested for domestic violence and mandated to attend batterer intervention programs. Men reported greater capability for suicide, but no gender differences were found in perceived burdensomeness and thwarted belongingness. After controlling for correlates of suicide ideation, perceived burdensomeness—but not thwarted belongingness or its interaction with perceived burdensomeness—associated with suicide ideation. Suicide attempters exhibited greater perceived burdensomeness, drug use and problems, borderline personality disorder symptoms, depressive symptoms, and suicide ideation, but not capability for suicide, than nonattempters. Gender did not moderate the associations of the IPTS constructs with suicide ideation and attempts. These findings parallel tests of the interpersonal-psychological theory in other samples. Additional work is needed to identify factors that distinguish risk for suicide ideation from risk for suicide attempts among domestic violence offenders. PMID:28119172

Googling suicide: surfing for suicide information on the Internet.

PubMed

Recupero, Patricia R; Harms, Samara E; Noble, Jeffrey M

2008-06-01

This study examined the types of resources a suicidal person might find through search engines on the Internet. We were especially interested in determining the accessibility of potentially harmful resources, such as prosuicide forums, as such resources have been implicated in completed suicides and are known to exist on the Web. Using 5 popular search engines (Google, Yahoo!, Ask.com, Lycos, and Dogpile) and 4 suicide-related search terms (suicide, how to commit suicide, suicide methods, and how to kill yourself), we collected quantitative and qualitative data about the search results. The searches were conducted in August and September 2006. Several coraters assigned codes and characterizations to the first 30 Web sites per search term combination (and "sponsored links" on those pages), which were then confirmed by consensus ratings. Search results were classified as being prosuicide, antisuicide, suicide-neutral, not a suicide site, or error (i.e., page would not load). Additional information was collected to further characterize the nature of the information on these Web sites. Suicide-neutral and anti-suicide pages occurred most frequently (of 373 unique Web pages, 115 were coded as suicide-neutral, and 109 were anti-suicide). While pro-suicide resources were less frequent (41 Web pages), they were nonetheless easily accessible. Detailed how-to instructions for unusual and lethal suicide methods were likewise easily located through the searches. Mental health professionals should ask patients about their Internet use. Depressed, suicidal, or potentially suicidal patients who use the Internet may be especially at risk. Clinicians may wish to assist patients in locating helpful, supportive resources online so that patients' Internet use may be more therapeutic than harmful.

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

PubMed

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

2017-01-15

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

Suicide in obsessive-compulsive disorder: a population-based study of 36 788 Swedish patients.

PubMed

Fernández de la Cruz, L; Rydell, M; Runeson, B; D'Onofrio, B M; Brander, G; Rück, C; Lichtenstein, P; Larsson, H; Mataix-Cols, D

2017-11-01

The risk of death by suicide in individuals with obsessive-compulsive disorder (OCD) is largely unknown. Previous studies have been small and methodologically flawed. We analyzed data from the Swedish national registers to estimate the risk of suicide in OCD and identify the risk and protective factors associated with suicidal behavior in this group. We used a matched case-cohort design to estimate the risk of deaths by suicide and attempted suicide in individuals diagnosed with OCD, compared with matched general population controls (1:10). Cox regression models were used to study predictors of suicidal behavior. We identified 36 788 OCD patients in the Swedish National Patient Register between 1969 and 2013. Of these, 545 had died by suicide and 4297 had attempted suicide. In unadjusted models, individuals with OCD had an increased risk of both dying by suicide (odds ratio (OR)=9.83 (95% confidence interval (CI), 8.72-11.08)) and attempting suicide (OR=5.45 (95% CI, 5.24-5.67)), compared with matched controls. After adjusting for psychiatric comorbidities, the risk was reduced but remained substantial for both death by suicide and attempted suicide. Within the OCD cohort, a previous suicide attempt was the strongest predictor of death by suicide. Having a comorbid personality or substance use disorder also increased the risk of suicide. Being a woman, higher parental education and having a comorbid anxiety disorder were protective factors. We conclude that patients with OCD are at a substantial risk of suicide. Importantly, this risk remains substantial after adjusting for psychiatric comorbidities. Suicide risk should be carefully monitored in patients with OCD.

Intrapersonal positive future thinking predicts repeat suicide attempts in hospital-treated suicide attempters.

PubMed

O'Connor, Rory C; Smyth, Roger; Williams, J Mark G

2015-02-01

Although there is clear evidence that low levels of positive future thinking (anticipation of positive experiences in the future) and hopelessness are associated with suicide risk, the relationship between the content of positive future thinking and suicidal behavior has yet to be investigated. This is the first study to determine whether the positive future thinking-suicide attempt relationship varies as a function of the content of the thoughts and whether positive future thinking predicts suicide attempts over time. A total of 388 patients hospitalized following a suicide attempt completed a range of clinical and psychological measures (depression, hopelessness, suicidal ideation, suicidal intent and positive future thinking). Fifteen months later, a nationally linked database was used to determine who had been hospitalized again after a suicide attempt. During follow-up, 25.6% of linked participants were readmitted to hospital following a suicide attempt. In univariate logistic regression analyses, previous suicide attempts, suicidal ideation, hopelessness, and depression-as well as low levels of achievement, low levels of financial positive future thoughts, and high levels of intrapersonal (thoughts about the individual and no one else) positive future thoughts predicted repeat suicide attempts. However, only previous suicide attempts, suicidal ideation, and high levels of intrapersonal positive future thinking were significant predictors in multivariate analyses. Positive future thinking has predictive utility over time; however, the content of the thinking affects the direction and strength of the positive future thinking-suicidal behavior relationship. Future research is required to understand the mechanisms that link high levels of intrapersonal positive future thinking to suicide risk and how intrapersonal thinking should be targeted in treatment interventions. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Suicide in obsessive–compulsive disorder: a population-based study of 36 788 Swedish patients

PubMed Central

Fernández de la Cruz, L; Rydell, M; Runeson, B; D'Onofrio, B M; Brander, G; Rück, C; Lichtenstein, P; Larsson, H; Mataix-Cols, D

2017-01-01

The risk of death by suicide in individuals with obsessive–compulsive disorder (OCD) is largely unknown. Previous studies have been small and methodologically flawed. We analyzed data from the Swedish national registers to estimate the risk of suicide in OCD and identify the risk and protective factors associated with suicidal behavior in this group. We used a matched case–cohort design to estimate the risk of deaths by suicide and attempted suicide in individuals diagnosed with OCD, compared with matched general population controls (1:10). Cox regression models were used to study predictors of suicidal behavior. We identified 36 788 OCD patients in the Swedish National Patient Register between 1969 and 2013. Of these, 545 had died by suicide and 4297 had attempted suicide. In unadjusted models, individuals with OCD had an increased risk of both dying by suicide (odds ratio (OR)=9.83 (95% confidence interval (CI), 8.72–11.08)) and attempting suicide (OR=5.45 (95% CI, 5.24–5.67)), compared with matched controls. After adjusting for psychiatric comorbidities, the risk was reduced but remained substantial for both death by suicide and attempted suicide. Within the OCD cohort, a previous suicide attempt was the strongest predictor of death by suicide. Having a comorbid personality or substance use disorder also increased the risk of suicide. Being a woman, higher parental education and having a comorbid anxiety disorder were protective factors. We conclude that patients with OCD are at a substantial risk of suicide. Importantly, this risk remains substantial after adjusting for psychiatric comorbidities. Suicide risk should be carefully monitored in patients with OCD. PMID:27431293

Perceived Discrimination Is an Independent Risk Factor for Suicidal Ideation among Sexual and Gender Minorities in Nepal

PubMed Central

Kohlbrenner, Verena; Deuba, Keshab; Karki, Deepak Kumar; Marrone, Gaetano

2016-01-01

Sexual and gender minorities experience an elevated burden of suicidality compared with the general population. Still, little is known about that burden and the factors generating it in the context of low- and middle-income countries. The present study assessed the prevalence of suicidal ideation, planned suicide, and attempted suicide among men who have sex with men (MSM) and transgender people (TG) in Nepal, and examined the association of perceived discrimination on the basis of sexual orientation with suicidal ideation and with attempted suicide. Data were obtained from a surveillance survey among MSM and TG in Nepal in 2012. A sample of 400 MSM and TG, recruited using respondent-driven sampling, completed a structured face-to-face interview. Throughout their lifetime, 26.8% of the participants had experienced suicidal ideation, 12.0% had made a suicide plan, and 9.0% had attempted suicide. In particular, more TG than MSM had experienced suicidal ideation (39.8% vs. 21.3%), had made a suicide plan (19.5% vs. 8.9%), and had attempted suicide (15.3% vs. 6.4%). Overall, the odds of having experienced suicidal ideation was significantly higher among the 38.3% of participants who had perceived discrimination based on their sexual orientation (AOR: 3.17; 95% CI: 1.83–5.48). Moreover, the odds of suicidal ideation was significantly higher as the extent of perceived discrimination increased (AOR: 1.35; 95% CI: 1.15–1.60). However, the odds of attempted suicide was not significantly associated with perceived discrimination (AOR: 1.40; 95% CI: 0.62–3.15). The findings highlight perceived discrimination as an independent risk factor for suicidal ideation. Future suicide prevention programs should target sexual and gender minorities and include elements focusing on discrimination. PMID:27437996

Perceived Discrimination Is an Independent Risk Factor for Suicidal Ideation among Sexual and Gender Minorities in Nepal.

PubMed

Kohlbrenner, Verena; Deuba, Keshab; Karki, Deepak Kumar; Marrone, Gaetano

2016-01-01

Sexual and gender minorities experience an elevated burden of suicidality compared with the general population. Still, little is known about that burden and the factors generating it in the context of low- and middle-income countries. The present study assessed the prevalence of suicidal ideation, planned suicide, and attempted suicide among men who have sex with men (MSM) and transgender people (TG) in Nepal, and examined the association of perceived discrimination on the basis of sexual orientation with suicidal ideation and with attempted suicide. Data were obtained from a surveillance survey among MSM and TG in Nepal in 2012. A sample of 400 MSM and TG, recruited using respondent-driven sampling, completed a structured face-to-face interview. Throughout their lifetime, 26.8% of the participants had experienced suicidal ideation, 12.0% had made a suicide plan, and 9.0% had attempted suicide. In particular, more TG than MSM had experienced suicidal ideation (39.8% vs. 21.3%), had made a suicide plan (19.5% vs. 8.9%), and had attempted suicide (15.3% vs. 6.4%). Overall, the odds of having experienced suicidal ideation was significantly higher among the 38.3% of participants who had perceived discrimination based on their sexual orientation (AOR: 3.17; 95% CI: 1.83-5.48). Moreover, the odds of suicidal ideation was significantly higher as the extent of perceived discrimination increased (AOR: 1.35; 95% CI: 1.15-1.60). However, the odds of attempted suicide was not significantly associated with perceived discrimination (AOR: 1.40; 95% CI: 0.62-3.15). The findings highlight perceived discrimination as an independent risk factor for suicidal ideation. Future suicide prevention programs should target sexual and gender minorities and include elements focusing on discrimination.

[Clinical psychiatry and suicide prevention].

PubMed

Cho, Yoshinori

2012-01-01

People do not commit suicide all of a sudden. There is a suicidal process where negative life events are there in the beginning, and social support and help-seeking behavior play an important role in impeding the progress of the process. Mental disturbance would be deeply associated with the suicidal process around the final stage, thinking of the fact that approximately 90% of the suicides suffered from mental disorders at the time of suicide. In considering the strategies for suicide prevention, there are two perspectives: a community model and a medical model. A community model is thought to be related mainly to the first half of the suicidal process and a medical model to the latter half. It is an ideal that both community and medical approaches are put into practice simultaneously. However, if resources available for suicide prevention are limited, a medical-model approach would be more efficient and should be given priority. Starting from a medical model and considering treatment and social resources necessary for suicidal people, the range of suicide prevention activities would be expand more efficiently than starting from a community-model approach. Clinical psychiatry plays a greatly important role in preventing suicide. It is found that approximately 20% of seriously injured suicide attempters were diagnosed as adjustment disorder in Japan, which means that even the mildly depressed can commit suicide. Therefore, no one can take a hands-off approach to suicidality as long as he/she works in the field of clinical psychiatry. It is earnestly desired to detect and treat properly the suicidal patients, but there is no perfect method. It would be helpful to pay attention to patients' personality development, stress-coping style and present suicidal ideation. Besides, as suicide prevention is not completed only in a consulting room, it is important for psychiatrists to look for teamwork.

The Role of Cytokines in the Pathophysiology of Suicidal Behavior

PubMed Central

Ganança, Licínia; Oquendo, Maria A.; Tyrka, Audrey R.; Cisneros-Trujillo, Sebastian; Mann, J. John; Sublette, M. Elizabeth

2016-01-01

Objective Immune dysregulation has been implicated in depression and other psychiatric disorders. What is less clear is how immune dysregulation can affect risk of suicidal behavior. We reviewed the scientific literature concerning cytokines related to suicidal ideation, suicidal behavior and suicide, and surveyed clinical and neurobiological factors associated with cytokine levels that may modulate effects of inflammation on suicide risk. Methods We searched PubMed, Embase, Scopus and PsycINFO for relevant studies published from 1980 through February, 2015. Papers were included if they were written in English and focused on cytokine measurements in patients with suicidal behaviors. Results The literature search yielded 22 studies concerning cytokines and suicidal ideation, suicide attempts or suicide completion. The most consistent finding was elevated interleukin (IL)-6, found in 8 out of 14 studies, in CSF, blood, and postmortem brain. In one study, IL-6 in CSF was also found to be higher in violent than nonviolent attempters and to correlate with future suicide completion. Low plasma IL-2 was observed in 2 studies of suicide attempters, while divergent results were seen for tumor necrosis factor (TNF)-α, interferon (IFN)-γ, transforming growth factor (TGF)-β, IL-4, and soluble Il-2 receptors. Conclusions Given the complexity suggested by the heterogenous cytokine findings, putative mediators and moderators of inflammation on suicidal behavior merit further study. Elevated IL-6 was the most robust cytokine finding, associated with suicidal ideation and both nonfatal suicide attempts and suicides. Future studies should evaluate the predictive value of high IL-6, consider how this may alter brain function to impact suicidal behavior, and explore the potential beneficial effects of reducing IL-6 on suicide risk. PMID:26546783

Intrapersonal Positive Future Thinking Predicts Repeat Suicide Attempts in Hospital-Treated Suicide Attempters

PubMed Central

2014-01-01

Objective: Although there is clear evidence that low levels of positive future thinking (anticipation of positive experiences in the future) and hopelessness are associated with suicide risk, the relationship between the content of positive future thinking and suicidal behavior has yet to be investigated. This is the first study to determine whether the positive future thinking–suicide attempt relationship varies as a function of the content of the thoughts and whether positive future thinking predicts suicide attempts over time. Method: A total of 388 patients hospitalized following a suicide attempt completed a range of clinical and psychological measures (depression, hopelessness, suicidal ideation, suicidal intent and positive future thinking). Fifteen months later, a nationally linked database was used to determine who had been hospitalized again after a suicide attempt. Results: During follow-up, 25.6% of linked participants were readmitted to hospital following a suicide attempt. In univariate logistic regression analyses, previous suicide attempts, suicidal ideation, hopelessness, and depression—as well as low levels of achievement, low levels of financial positive future thoughts, and high levels of intrapersonal (thoughts about the individual and no one else) positive future thoughts predicted repeat suicide attempts. However, only previous suicide attempts, suicidal ideation, and high levels of intrapersonal positive future thinking were significant predictors in multivariate analyses. Discussion: Positive future thinking has predictive utility over time; however, the content of the thinking affects the direction and strength of the positive future thinking–suicidal behavior relationship. Future research is required to understand the mechanisms that link high levels of intrapersonal positive future thinking to suicide risk and how intrapersonal thinking should be targeted in treatment interventions. PMID:25181026

Parental Self-Efficacy to Support Teens During a Suicidal Crisis and Future Adolescent Emergency Department Visits and Suicide Attempts.

PubMed

Czyz, Ewa K; Horwitz, Adam G; Yeguez, Carlos E; Ewell Foster, Cynthia J; King, Cheryl A

2017-07-17

This study of adolescents seeking emergency department (ED) services and their parents examined parents' self-efficacy beliefs to engage in suicide prevention activities, whether these beliefs varied based on teens' characteristics, and the extent to which they were associated with adolescents' suicide-related outcomes. Participants included 162 adolescents (57% female, 81.5% Caucasian), ages 13-17, and their parents. At index visit, parents rated their self-efficacy to engage in suicide prevention activities and their expectations regarding their teen's future suicide risk. Adolescents' ED visits for suicide-related concerns and suicide attempts were assessed 4 months later. Parents endorsed high self-efficacy to engage in most suicide prevention activities. At the same time, they endorsed considerable doubt in being able to keep their child safe if the teen has thoughts of suicide and in their child not attempting suicide in the future. Parents whose teens experienced follow-up suicide-related outcomes endorsed, at clinically meaningful effect sizes, lower self-efficacy for recognizing suicide warning signs, for obtaining the teen's commitment to refrain from suicide, and for encouraging their teen to cope, as well as lower confidence that their teen will not attempt suicide; self-efficacy to recognize warning signs was at trend level. Despite endorsing high self-efficacy for the majority of suicide prevention activities, parents of high-risk teens expressed less confidence in their capacity to influence their teen's suicidal behavior, which could undermine parents' effort to implement these strategies. The relationship between parental self-efficacy and youth suicide-related outcomes points to its potential value in guiding clinical decision making and interventions.

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

PubMed Central

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

2016-01-01

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

Transgender Youth and Suicidal Behaviors: Applying the Interpersonal Psychological Theory of Suicide

PubMed Central

Grossman, Arnold H.; Park, Jung Yeon; Russell, Stephen T.

2016-01-01

The interpersonal psychological theory of suicide (IPTS) was used to examine suicidal thoughts and behaviors among 129 transgender and gender nonconforming (TGNC) youth. Youth were categorized according to their gender identities: female-to-male (FTM), male-to-female (MTF), female-to-different-gender (FTDG), and male-to-different gender (MTDG). Higher percentages of suicidal ideation were reported by FTDG and FTM youth; and higher percentages of suicide attempts by FTDG and MTDG youth. Perceived burdensomeness and thwarted belongingness were significantly related to suicidal ideation and/or suicide attempts. Experiences of painful, provocative and harmful events and acquired capability significantly predicted suicide attempts. The findings support IPTS in explaining suicidal behaviors among TGNC youth. Implications for prevention and intervention efforts are discussed. PMID:28344728

Transgender Youth and Suicidal Behaviors: Applying the Interpersonal Psychological Theory of Suicide.

PubMed

Grossman, Arnold H; Park, Jung Yeon; Russell, Stephen T

2016-01-01

The interpersonal psychological theory of suicide (IPTS) was used to examine suicidal thoughts and behaviors among 129 transgender and gender nonconforming (TGNC) youth. Youth were categorized according to their gender identities: female-to-male (FTM), male-to-female (MTF), female-to-different-gender (FTDG), and male-to-different gender (MTDG). Higher percentages of suicidal ideation were reported by FTDG and FTM youth; and higher percentages of suicide attempts by FTDG and MTDG youth. Perceived burdensomeness and thwarted belongingness were significantly related to suicidal ideation and/or suicide attempts. Experiences of painful, provocative and harmful events and acquired capability significantly predicted suicide attempts. The findings support IPTS in explaining suicidal behaviors among TGNC youth. Implications for prevention and intervention efforts are discussed.

Social and Interpersonal Factors Relating to Adolescent Suicidality: A Review of the Literature

PubMed Central

King, Cheryl A.; Merchant, Christopher R.

2009-01-01

This article reviews the empirical literature concerning social and interpersonal variables as risk factors for adolescent suicidality (suicidal ideation, suicidal behavior, death by suicide. It also describes major social constructs in theories of suicide and the extent to which studies support their importance to adolescent suicidality. PsychINFO and PubMed searches were conducted for empirical studies focused on family and friend support, social isolation, peer victimization, physical/sexual abuse, or emotional neglect as these relate to adolescent suicidality. Empirical findings converge in documenting the importance of multiple social and interpersonal factors to adolescent suicidality. Research support for the social constructs in several major theories of suicide is summarized and research challenges are discussed. PMID:18576200

Suicidality in Body Dysmorphic Disorder: A Prospective Study

PubMed Central

Phillips, Katharine A.; Menard, William

2006-01-01

Objective Cross-sectional/retrospective data have indicated that individuals with body dysmorphic disorder (BDD) have high rates of suicidal ideation and attempts. However, no study, to the authors' knowledge, has prospectively examined suicidality in BDD. Method In the first prospective study of BDD's course, the authors examined suicidality in 185 subjects for up to 4 years. Results Suicidal ideation was reported by a mean of 57.8% of the subjects per year, and a mean of 2.6% attempted suicide per year. Two subjects (0.3% per year) completed suicide. Conclusions Individuals with BDD have high rates of suicidal ideation and attempts. The completed suicide rate is preliminary but suggests that the rate of completed suicide in BDD is markedly high. PMID:16816236

[Sleep disturbances and suicidality: relationships and clinical implications].

PubMed

Norra, C; Richter, N

2013-10-01

Besides several risk factors for suicide, there is a recent increase in clinical and epidemiological studies pointing to a potential relationship between sleep loss or sleep disturbances and suicidality. This work, based on a systematic literature research, gives an overview on the findings of relationships between suicidality (i. e., suicidal thoughts, suicide attempts, suicides) and sleep disturbances, especially insomnia, nightmares, but also hypersomnia and nocturnal panic attacks. There is evidence that sleep disturbances in suicidal insomniacs with comorbid psychiatric disorder are independently predictive for suicidality, too. Shared aspects of pathogenesis of the two entities and therapeutic options are also discussed. Recognition of sleep disturbances is essential for suicide prevention in clinical practice. © Georg Thieme Verlag KG Stuttgart · New York.

Perceived reasons for, opinions about, and suggestions for elders considering suicide: elderly outpatients' perspectives.

PubMed

Chen, Ying-Jen; Tsai, Yun-Fang; Ku, Yan-Chiou; Lee, Shwu-Hua; Lee, Hsiu-Lan

2014-07-01

The purposes of this study were to explore elderly outpatients' perceived reasons for, opinions of, and suggestions for elderly people considering suicide in Taiwan. Elderly outpatients (N = 83) were recruited in 2011-2012 by convenience sampling from three randomly selected medical centers in Taiwan. Data were collected in individual interviews using a semi-structured guide and analyzed by content analysis. Findings revealed that most participants had heard of elderly suicide, with television news as the main source for their information. Their opinions about elderly suicide reflected judgmental attitudes, negative emotional reactions, expectations of social welfare, and could happen after losing one's meaning in life. Their suggestions for elderly people considering suicide fell into four major themes: give up suicidal ideas, seek help, enhance social welfare, and attend religious activities. Since television news was the main source for participants' information about elderly suicide, this mass medium should be used in suicide prevention to disseminate suicide knowledge, increase access to help, and strengthen suicide-protective factors among the elderly. Furthermore, no participants mentioned depression as a reason for attempted or completed suicide among older people despite depression being a well-known suicide-risk factor. Future suicide-prevention programs should emphasize the role of depression in suicide among older people. Participants also did not suggest that older people considering suicide seek help from the health system. Thus, older people should be educated about the role of the health system in suicide prevention and trained as gatekeepers to recognize signs of suicide ideation and respond appropriately.

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

PubMed Central

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

2017-01-01

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

Psychopathology profiles of acutely suicidal adolescents: Associations with post-discharge suicide attempts and rehospitalization

PubMed Central

Berona, Johnny; Horwitz, Adam G.; Czyz, Ewa K.; King, Cheryl A.

2017-01-01

Background Suicidal adolescents are heterogeneous, which can pose difficulties in predicting suicidal behavior. The Youth Self-Report (YSR) psychopathology profiles predict the future onset of psychopathology and suicide-related outcomes. The present study examined the prevalence and correlates of YSR psychopathology profiles among suicidal adolescents and prospective associations with post-discharge rates of suicide attempts and psychiatric rehospitalization. Methods Participants were acutely suicidal, psychiatrically hospitalized adolescents (N=433 at baseline; n=355 at follow-up) who were enrolled in a psychosocial intervention trial during hospitalization. Psychopathology profiles were assessed at baseline. Suicide attempts and rehospitalization were assessed for up to 12 months following discharge. Results Latent profile analysis identified four psychopathology profiles: subclinical, primarily internalizing, and moderately and severely dysregulated. At baseline, profiles differed by history of non-suicidal self-injury (NSSI) and multiple suicide attempts (MA) as well as severity of suicide ideation, hopelessness, depressive symptoms, anxiety symptoms, substance abuse, and functional impairment. The dysregulation profiles predicted suicide attempts within 3 months post-discharge. The internalizing profile predicted suicide attempts and rehospitalization at 3 and 12 months. Limitations This study’s participants were enrolled in a randomized trial and were predominantly female, which limit generalizability. Additionally, only a history of NSSI was assessed. Conclusions The dysregulation profile was overrepresented among suicidal youth and associated with impairment in several domains as well as suicide attempts shortly after discharge. Adolescents with a severe internalizing profile also reported adverse outcomes throughout the study period. Psychopathology profiles warrant further examination in terms of their potential predictive validity in relation to suicide-related outcomes. PMID:27894037

How Does Legalization of Physician-Assisted Suicide Affect Rates of Suicide?

PubMed

Jones, David Albert; Paton, David

2015-10-01

Several US states have legalized or decriminalized physician-assisted suicide (PAS) while others are considering permitting PAS. Although it has been suggested that legalization could lead to a reduction in total suicides and to a delay in those suicides that do occur, to date no research has tested whether these effects can be identified in practice. The aim of this study was to fill this gap by examining the association between the legalization of PAS and state-level suicide rates in the United States between 1990 and 2013. We used regression analysis to test the change in rates of nonassisted suicides and total suicides (including assisted suicides) before and after the legalization of PAS. Controlling for various socioeconomic factors, unobservable state and year effects, and state-specific linear trends, we found that legalizing PAS was associated with a 6.3% (95% confidence interval 2.70%-9.9%) increase in total suicides (including assisted suicides). This effect was larger in the individuals older than 65 years (14.5%, CI 6.4%-22.7%). Introduction of PAS was neither associated with a reduction in nonassisted suicide rates nor with an increase in the mean age of nonassisted suicide. Legalizing PAS has been associated with an increased rate of total suicides relative to other states and no decrease in nonassisted suicides. This suggests either that PAS does not inhibit (nor acts as an alternative to) nonassisted suicide, or that it acts in this way in some individuals but is associated with an increased inclination to suicide in other individuals.

Occupation and suicide: Colorado, 2004-2006.

PubMed

Stallones, Lorann; Doenges, Timothy; Dik, Bryan J; Valley, Morgan A

2013-11-01

Occupation has been identified as a risk factor for suicide. Changes in work environments over time suggest occupations at high risk of suicide may also change. Therefore, periodic examination of suicide by occupation is warranted. The purpose of this article is to describe suicide rates by occupation, sex, and means used in Colorado for the period 2004-2006. To provide information useful in designing suicide prevention programs, the methods used in suicide across occupational groups also are examined. Data from the Colorado Violent Death Reporting System (COVDRS) were obtained for suicides that occurred between 2004 and 2006. Denominators to calculate rates by age, sex, and race used are from the 2000 US Census of the Population data. Men had higher suicide rates than women in all occupation categories except computers and mathematics. Among men, those in farming, fishing, and forestry (475.6 per 100,000) had the highest age-adjusted suicide rates. Among women, workers with the highest suicide rates were in construction and extraction (134.3 per 100,000). The examination of lethal means showed that workers in farming, fishing, and forestry had higher rates of suicide by firearms (50.18 per 100,000) compared with other workers. Healthcare practitioners and technicians had the highest rate of suicide by poisoning (14.25 per 100,000). Workers involved in construction and extraction (26.43 per 100,000) had higher rates of suicide by hanging, suffocation, or strangling. Significant differences in means of suicide were seen by occupation, which could guide future suicide prevention interventions that may decrease work-related suicide risks. Copyright © 2013 Wiley Periodicals, Inc.

Risk Factors and Social Background Associated with Suicide in Japan: A Review.

PubMed

Onishi, Kiichiro

2015-07-01

This study examines, from multiple perspectives, the risk factors associated with, and the social background of, individuals committing suicide in Japan. Effective suicide prevention measures are also proposed. An analysis of the risk factors for suicide, including the social background of suicide victims, suicide statistics, municipality surveys, interview surveys with bereaved families, mental health surveys, occupational injury inspections, and social resources available to victims, was conducted in the present study. Histories of both mental illnesses (especially depression) and previous suicide attempts are high-risk factors for suicide. Abuse and experience of violence were the remote causes of suicide. On average, more than three crisis factors were present prior to suicide. For example, overwork, problems with human relations, physical/mental disease, and poverty could form a chain that leads to suicide, regardless of gender. More than 40% of suicide attempts were the result of prescription medication overdose. Overall, 70-90% of suicide victims had medical treatment or an expert consultation before death. Staff and financial backing for voluntary telephone consultation were insufficient. Meanwhile, psychiatric social workers could not provide adequate services. Help seeking is the basis for suicide prevention. In addition to medication management and reducing work hours, communication with caregivers and healthcare providers as well as intervention for the prevention and treatment of mental illness are essential to suicide prevention. Psychotherapy by clinical psychologists is highly recommended. Active placement of psychiatric social workers for telephone consultations and for emergency hospitals' staff at the expense of the government will reduce suicides, suicide attempts, and the human and financial burden on hospitals.

The relationships of suicidal ideation with symptoms, neurocognitive function, and psychological factors in patients with first-episode psychosis.

PubMed

Chang, Wing Chung; Chen, Emily Sze Man; Hui, Christy Lai Ming; Chan, Sherry Kit Wa; Lee, Edwin Ho Ming; Chen, Eric Yu Hai

2014-08-01

Individuals with first-episode psychosis (FEP) have markedly elevated risk for suicide. Previous research on suicidality in early psychosis mainly focused on attempted and completed suicide. Data regarding risk factors for suicidal ideation, which is a common antecedent and predictor of suicide attempt, were limited. This study aimed to examine the prevalence of suicidal ideation and its relationships with clinical, neurocognitive and psychological factors in FEP patients. Eighty-nine Chinese patients aged 15 to 25years presenting with FEP to specialized early intervention service were recruited. A comprehensive set of assessments examining pre-treatment illness characteristics, symptom severity, neurocognitive function, and psychological factors were administered. Current suicidal ideation and history of suicide attempt were systematically evaluated. Approximately 42% of patients expressed suicidal ideation after service entry. Univariate regression analyses found that suicidal ideation was significantly associated with past suicide attempt, depressive symptoms, emotion expressivity, hopelessness, future expectation, attentional impulsiveness, internal and external locus of control, and the likelihood of endorsing fear of social approval and survival and coping beliefs as reasons for living. Final multivariate model showed that previous suicide attempt, depression, less severe diminished expression, greater degree of hopelessness and lower level of internal locus of control independently predicted suicidal ideation. Suicidal ideation was prevalent in FEP patients. Our findings implied that close monitoring and prompt intervention of those potentially modifiable risk factors for suicidal ideation including depression, hopelessness and perceived inadequate personal control may reduce suicide risk in the early course of psychotic illness. Copyright © 2014 Elsevier B.V. All rights reserved.

[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.

Explanatory risk factors in the relations between schizotypy and indicators of suicide risk.

PubMed

Jahn, Danielle R; DeVylder, Jordan E; Hilimire, Matthew R

2016-04-30

Schizotypy has been linked to suicide risk, but it is not known whether established suicide-related risk factors mediate this relation. The aim of this study was to assess the mediating effects of depressive symptoms, social anxiety, self-esteem, and intimate disclosure in peer relationships in the relation between interpersonal schizotypy and suicide ideation or lifetime suicide attempts. This aim was tested in 590 young adults using a nonparametric bootstrapping procedure. After inclusion of the mediators, interpersonal schizotypy was no longer directly associated with either suicide ideation or lifetime suicide attempts. Depression and self-esteem mediated the relation between interpersonal schizotypy and suicide ideation. No variables mediated the relation between interpersonal schizotypy and lifetime suicide attempts, and there were no significant direct relations when mediators were included. Schizotypy appears to be a distal risk factor for suicidal behavior; assessing depressive symptoms and self-esteem may provide more proximal information about suicide risk, and may be targets for mitigating suicide risk in individuals with schizotypy. Published by Elsevier Ireland Ltd.

Methods of suicide used by children and adolescents.

PubMed

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

2012-02-01

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

Suicidal Disclosures among Friends: Using Social Network Data to Understand Suicide Contagion*

PubMed Central

Mueller, Anna S.; Abrutyn, Seth

2015-01-01

A robust literature suggests that suicide is socially contagious; however, we know little about how and why suicide spreads. Using network data from the National Longitudinal Study of Adolescent to Adult Health, we examine the effects of alter’s (1) disclosed and (2) undisclosed suicide attempts, (3) suicide ideation and (4) emotional distress on ego’s mental health one year later to gain insights into the emotional and cultural mechanisms that underlie suicide contagion. We find that when egos know about alter’s suicide attempt, they report significantly higher levels of emotional distress and are more likely to report suicidality, net of extensive controls; however, alter’s undisclosed suicide attempts and ideation have no significant effect on ego’s mental health. Finally, we find evidence that emotional distress is contagious in adolescence, though it does not seem to promote suicidality. We discuss the implications of our findings for suicide contagion specifically and sociology more generally. PMID:25722129

Interpersonal suicide risk for American Indians: investigating thwarted belongingness and perceived burdensomeness.

PubMed

O'Keefe, Victoria M; Wingate, LaRicka R; Tucker, Raymond P; Rhoades-Kerswill, Sarah; Slish, Meredith L; Davidson, Collin L

2014-01-01

American Indians (AIs) experience increased suicide rates compared with other groups in the United States. However, no past studies have examined AI suicide by way of a recent empirically supported theoretical model of suicide. The current study investigated whether AI suicidal ideation can be predicted by two components: thwarted belongingness and perceived burdensomeness, from the Interpersonal-Psychological Theory of Suicide (T. E. Joiner, 2005, Why people die by suicide. Cambridge, MA: Harvard University Press). One hundred seventy-one AIs representing 27 different tribes participated in an online survey. Hierarchical regression analyses showed that perceived burdensomeness significantly predicted suicidal ideation above and beyond demographic variables and depressive symptoms; however, thwarted belongingness did not. Additionally, the two-way interaction between thwarted belongingness and perceived burdensomeness significantly predicted suicidal ideation. These results provide initial support for continued research on the components of the Interpersonal-Psychological Theory of Suicide, an empirically supported theoretical model of suicide, to predict suicidal ideation among AI populations.

Suicide in China: unique demographic patterns and relationship to depressive disorder.

PubMed

Law, Samuel; Liu, Pozi

2008-02-01

Recent research on suicide in China reveals several unique findings: 1) female suicides outnumber male suicides by a 3:1 ratio; 2) rural suicides outnumber urban suicides by a 3:1 ratio; 3) a large upsurge of young adult and older adult suicides has occurred; 4) a comparatively high national suicide rate two to three times the global average is evident; and, most startlingly, 5) a low rate of psychiatric illness, particularly depression, exists in suicide victims. The strongest empirical data suggest that these trends result from a high number of rural, young females who experience acute interpersonal or financial crises and then impulsively attempt suicide using lethal pesticides or poisons. Other suicide risk factors in China are similar to those that are well known internationally. Interactive sociological, cultural, and economic hypotheses unique to China provide further insight. Among those, the cultural-socioeconomic disadvantages of the Chinese rural female and cultural attitudes toward suicide are particularly noteworthy.

Detecting Changes in Suicide Content Manifested in Social Media Following Celebrity Suicides.

PubMed

Kumar, Mrinal; Dredze, Mark; Coppersmith, Glen; De Choudhury, Munmun

2015-09-01

The Werther effect describes the increased rate of completed or attempted suicides following the depiction of an individual's suicide in the media, typically a celebrity. We present findings on the prevalence of this effect in an online platform: r/SuicideWatch on Reddit. We examine both the posting activity and post content after the death of ten high-profile suicides. Posting activity increases following reports of celebrity suicides, and post content exhibits considerable changes that indicate increased suicidal ideation. Specifically, we observe that post-celebrity suicide content is more likely to be inward focused, manifest decreased social concerns, and laden with greater anxiety, anger, and negative emotion. Topic model analysis further reveals content in this period to switch to a more derogatory tone that bears evidence of self-harm and suicidal tendencies. We discuss the implications of our findings in enabling better community support to psychologically vulnerable populations, and the potential of building suicide prevention interventions following high-profile suicides.

Psychological Distress Increases Perceived Stigma Toward Attempted Suicide Among Those With a History of Past Attempted Suicide.

PubMed

Scocco, Paolo; Toffol, Elena; Preti, Antonio

2016-03-01

People who suffer from mental illness have high self-stigmatizing attitudes. This study aims to test the effect of psychopathological distress on stigma toward attempted suicide in a population of suicide attempters. Data were collected through an interview and 2 questionnaires (90-item Symptom Checklist; Stigma of Suicide Attempt scale) administered to 67 patients hospitalized after an attempted suicide. Participants with a history of past attempted suicide had higher scores on the Stigma of Suicide Attempt scale (t58.9 = -2.51, p = 0.014). Higher levels of psychological distress were related to greater perceived stigma only in individuals with a history of past attempted suicide (standardized coefficient = 0.37; t = 2.36; p = 0.024; R2 = 14%; adjusted R2 = 11.5%). A previous experience of attempted suicide is related to greater self-stigmatizing attitudes toward suicidal behavior. Among those who have previously attempted suicide in particular, psychopathological distress may significantly contribute to increase the perception of stigma.

Detecting Changes in Suicide Content Manifested in Social Media Following Celebrity Suicides

PubMed Central

Kumar, Mrinal; Dredze, Mark; Coppersmith, Glen; De Choudhury, Munmun

2015-01-01

The Werther effect describes the increased rate of completed or attempted suicides following the depiction of an individual’s suicide in the media, typically a celebrity. We present findings on the prevalence of this effect in an online platform: r/SuicideWatch on Reddit. We examine both the posting activity and post content after the death of ten high-profile suicides. Posting activity increases following reports of celebrity suicides, and post content exhibits considerable changes that indicate increased suicidal ideation. Specifically, we observe that post-celebrity suicide content is more likely to be inward focused, manifest decreased social concerns, and laden with greater anxiety, anger, and negative emotion. Topic model analysis further reveals content in this period to switch to a more derogatory tone that bears evidence of self-harm and suicidal tendencies. We discuss the implications of our findings in enabling better community support to psychologically vulnerable populations, and the potential of building suicide prevention interventions following high-profile suicides. PMID:28713876

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

ERIC Educational Resources Information Center

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

2011-01-01

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

[Are near-death experiences following attempted suicide important for suicide risk assessment? A case report].

PubMed

Kralovec, Karl; Plöderl, Martin; Aistleiner, Ursula; Fartacek, Clemens; Fartacek, Reinhold

2009-01-01

We describe a 59-year old patient who reported a near-death experience following attempted suicide. The near-death experience induced reduction of suicidality. Previous studies suggested a high prevalence of near-death experiences following attempted suicide and that near-death experiences may decrease rather than increase subsequent suicide risk. Implications for suicide risk assessment are discussed.

Suicide Mortality of Suicide Attempt Patients Discharged from Emergency Room, Nonsuicidal Psychiatric Patients Discharged from Emergency Room, Admitted Suicide Attempt Patients, and Admitted Nonsuicidal Psychiatric Patients

ERIC Educational Resources Information Center

Choi, Jae W.; Park, Subin; Yi, Ki K.; Hong, Jin P.

2012-01-01

The suicide mortality rate and risk factors for suicide completion of patients who presented to an emergency room (ER) for suicide attempt and were discharged without psychiatric admission, patients who presented to an ER for psychiatric problems other than suicide attempt and were discharged without psychiatric admission, psychiatric inpatients…

Aggression-impulsivity, mental pain, and communication difficulties in medically serious and medically non-serious suicide attempters.

PubMed

Gvion, Yari; Horresh, Netta; Levi-Belz, Yossi; Fischel, Tsvi; Treves, Ilan; Weiser, Mark; David, Haim Shem; Stein-Reizer, Orit; Apter, Alan

2014-01-01

Unbearable mental pain, depression, and hopelessness have been associated with suicidal behavior in general, while difficulties with social communication and loneliness have been associated with highly lethal suicide attempts in particular. The literature also links aggression and impulsivity with suicidal behavior but raises questions about their influence on the lethality and outcome of the suicide attempt. To evaluate the relative effects of aggression and impulsivity on the lethality of suicide attempts we hypothesized that impulsivity and aggression differentiate between suicide attempters and non-attempters and between medically serious and medically non-serious suicide attempters. The study group included 196 participants divided into four groups: 43 medically serious suicide attempters; 49 medically non-serious suicide attempters, 47 psychiatric patients who had never attempted suicide; and 57 healthy control subjects. Data on sociodemographic parameters, clinical history, and details of the suicide attempts were collected. Participants completed a battery of instruments for assessment of aggression-impulsivity, mental pain, and communication difficulties. The medically serious and medically non-serious suicide attempters scored significantly higher than both control groups on mental pain, depression, and hopelessness (p<.001 for all) and on anger-in, anger-out, violence, and impulsivity (p<.05 for all), with no significant difference between the two suicide attempter groups. Medically serious suicide attempters had significantly lower self-disclosure (p<.05) and more schizoid tendencies (p<.001) than the other three groups and significantly more feelings of loneliness than the medically non-serious suicide attempters and nonsuicidal psychiatric patients (p<.05). Analysis of aggression-impulsivity, mental pain, and communication variables with suicide lethality yielded significant correlations for self-disclosure, schizoid tendency, and loneliness. The interaction between mental pain and schizoid traits explained some of the variance in suicide lethality, over and above the contribution of each component alone. Aggression-impulsivity and mental pain are risk factors for suicide attempts. However, only difficulties in communication differentiate medically serious from medically non-serious suicide attempters. The combination of unbearable mental pain and difficulties in communication has a magnifying effect on the risk of lethal suicidal behavior. © 2014.

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

PubMed

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

2015-09-01

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

Suicidal behavior in obsessive-compulsive disorder.

PubMed

Kamath, Prakash; Reddy, Y C Janardhan; Kandavel, Thennarasu

2007-11-01

There are limited data on suicidal behavior in obsessive-compulsive disorder (OCD). This study examines suicidal behavior and its clinical correlates in OCD subjects. One hundred consecutive DSM-IV OCD subjects attending the specialty OCD clinic and the inpatient services of a major psychiatric hospital in India from November 1, 2003, to October 31, 2004, formed the sample of this study. Subjects were assessed systematically by using structured interviews and various rating scales. The Scale for Suicide Ideation-worst ever (lifetime) and -current measured suicidal ideation. The 24-item Hamilton Rating Scale for Depression (HAM-D) measured severity of depression, and the Beck Hopelessness Scale (BHS) measured hopelessness. We performed assessments at study entry. We employed binary logistic regression (Wald) forward stepwise analysis for prediction of suicidal ideation and suicide attempt, and we used structural equation modeling for identifying the potential factors contributing to suicidal ideation. The rates of suicidal ideation, worst ever and current, were 59% and 28%, respectively. History of suicide attempt was reported in 27% of the subjects. For past suicide attempt, worst ever suicidal ideation (p < .001) was the only significant predictor, with an overall prediction of 89%, and accounted for 60% of the variance. For worst ever suicidal ideation, major depression (p = .043), HAM-D score (p = .013), BHS score (p = .011), and history of attempt (p = .009) were significant predictors, with an overall prediction of 82% and variance of 56%. Somewhat similar predictors emerged as significant for current suicidal ideators, with an overall prediction of 85% and variance of 50%. In the structural equation model, too, presence of depression and high BHS score contributed to suicidal ideation. OCD is associated with a high risk for suicidal behavior. Depression and hopelessness are the major correlates of suicidal behavior. It is vital that patients with OCD undergo detailed assessment for suicide risk and associated depression. Aggressive treatment of depression may be warranted to modify the risk for suicide. Future studies should examine suicidal behavior in a prospective design in larger samples to examine if severity of OCD and treatment nonresponse contribute to suicide risk.

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

PubMed Central

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

2016-01-01

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

Sheehan Suicidality Tracking Scale (Sheehan-STS)

PubMed Central

2009-01-01

Objective: Accurate and prospective assessments of treatment-emergent suicidal thoughts and behaviors are essential to both clinical care and randomized clinical trials. The Sheehan Suicidality Tracking Scale is a prospective, patient self-report or clinician-administered rating scale that tracks both treatment-emergent suicidal ideation and behaviors. The Sheehan Suicidality Tracking Scale was incorporated into a multicenter, randomized, double-blind, placebo-controlled, and active comparator study examining the efficacy of an experimental corticotropin-releasing factor antagonist (BMS-562086) for the treatment of generalized anxiety disorder. Method: The Sheehan Suicidality Tracking Scale was administered to subjects at baseline, Week 2, Week 4, and Week 8 or early termination. Subjects completed theSheehan Suicidality Tracking Scale by self report. The Sheehan Suicidality Tracking Scale was designated as an exploratory outcome measure in the study protocol, and post-hoc analyses were performed to examine the performance of the Sheehan Suicidality Tracking Scale. Results: A total of 82 subjects completed the Sheehan Suicidality Tracking Scale during the course of the study. Altogether, these subjects provided 297 completed Sheehan Suicidality Tracking Scale ratings across the study time points. Sixty-one subjects (n=25 placebo, n=24 BMS-562086, and n=12 escitalopram) had a baseline and at least one post-baseline Sheehan Suicidality Tracking Scale measurement. The mean change from baseline at Week 8 in the Sheehan Suicidality Tracking Scale total score was -0.10, -0.02, and -0.06 for escitalopram, placebo, and BMS-562086 groups, respectively. The sensitivity of the Sheehan Suicidality Tracking Scale and HAM-D Item #3 (suicide) for identifying subjects with suicidal thoughts or behaviors was 100 percent and 63 percent, respectively. Conclusions: The Sheehan Suicidality Tracking Scale may be a sensitive psychometric tool to prospectively assess for treatment-emergent suicidal thoughts and behaviors. Despite the small sample size and low occurrence of suicidal ideation during the course of this clinical trial, the self-reported Sheehan Suicidality Tracking Scale demonstrated increased sensitivity over the rater administered HAM-D Item #3 in identifying suicide related ideations and behaviors. Further research in larger study samples as well as in other psychiatric disorders are needed. PMID:19724740

Creating a Chinese suicide dictionary for identifying suicide risk on social media.

PubMed

Lv, Meizhen; Li, Ang; Liu, Tianli; Zhu, Tingshao

2015-01-01

Introduction. Suicide has become a serious worldwide epidemic. Early detection of individual suicide risk in population is important for reducing suicide rates. Traditional methods are ineffective in identifying suicide risk in time, suggesting a need for novel techniques. This paper proposes to detect suicide risk on social media using a Chinese suicide dictionary. Methods. To build the Chinese suicide dictionary, eight researchers were recruited to select initial words from 4,653 posts published on Sina Weibo (the largest social media service provider in China) and two Chinese sentiment dictionaries (HowNet and NTUSD). Then, another three researchers were recruited to filter out irrelevant words. Finally, remaining words were further expanded using a corpus-based method. After building the Chinese suicide dictionary, we tested its performance in identifying suicide risk on Weibo. First, we made a comparison of the performance in both detecting suicidal expression in Weibo posts and evaluating individual levels of suicide risk between the dictionary-based identifications and the expert ratings. Second, to differentiate between individuals with high and non-high scores on self-rating measure of suicide risk (Suicidal Possibility Scale, SPS), we built Support Vector Machines (SVM) models on the Chinese suicide dictionary and the Simplified Chinese Linguistic Inquiry and Word Count (SCLIWC) program, respectively. After that, we made a comparison of the classification performance between two types of SVM models. Results and Discussion. Dictionary-based identifications were significantly correlated with expert ratings in terms of both detecting suicidal expression (r = 0.507) and evaluating individual suicide risk (r = 0.455). For the differentiation between individuals with high and non-high scores on SPS, the Chinese suicide dictionary (t1: F 1 = 0.48; t2: F 1 = 0.56) produced a more accurate identification than SCLIWC (t1: F 1 = 0.41; t2: F 1 = 0.48) on different observation windows. Conclusions. This paper confirms that, using social media, it is possible to implement real-time monitoring individual suicide risk in population. Results of this study may be useful to improve Chinese suicide prevention programs and may be insightful for other countries.

Creating a Chinese suicide dictionary for identifying suicide risk on social media

PubMed Central

Liu, Tianli

2015-01-01

Introduction. Suicide has become a serious worldwide epidemic. Early detection of individual suicide risk in population is important for reducing suicide rates. Traditional methods are ineffective in identifying suicide risk in time, suggesting a need for novel techniques. This paper proposes to detect suicide risk on social media using a Chinese suicide dictionary. Methods. To build the Chinese suicide dictionary, eight researchers were recruited to select initial words from 4,653 posts published on Sina Weibo (the largest social media service provider in China) and two Chinese sentiment dictionaries (HowNet and NTUSD). Then, another three researchers were recruited to filter out irrelevant words. Finally, remaining words were further expanded using a corpus-based method. After building the Chinese suicide dictionary, we tested its performance in identifying suicide risk on Weibo. First, we made a comparison of the performance in both detecting suicidal expression in Weibo posts and evaluating individual levels of suicide risk between the dictionary-based identifications and the expert ratings. Second, to differentiate between individuals with high and non-high scores on self-rating measure of suicide risk (Suicidal Possibility Scale, SPS), we built Support Vector Machines (SVM) models on the Chinese suicide dictionary and the Simplified Chinese Linguistic Inquiry and Word Count (SCLIWC) program, respectively. After that, we made a comparison of the classification performance between two types of SVM models. Results and Discussion. Dictionary-based identifications were significantly correlated with expert ratings in terms of both detecting suicidal expression (r = 0.507) and evaluating individual suicide risk (r = 0.455). For the differentiation between individuals with high and non-high scores on SPS, the Chinese suicide dictionary (t1: F1 = 0.48; t2: F1 = 0.56) produced a more accurate identification than SCLIWC (t1: F1 = 0.41; t2: F1 = 0.48) on different observation windows. Conclusions. This paper confirms that, using social media, it is possible to implement real-time monitoring individual suicide risk in population. Results of this study may be useful to improve Chinese suicide prevention programs and may be insightful for other countries. PMID:26713232

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.

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

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.

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.

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.

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

PubMed Central

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

2016-01-01

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

Long noncoding RNA expression in peripheral blood mononuclear cells and suicide risk in Chinese patients with major depressive disorder.

PubMed

Cui, Xuelian; Niu, Wei; Kong, Lingming; He, Mingjun; Jiang, Kunhong; Chen, Shengdong; Zhong, Aifang; Li, Wanshuai; Lu, Jim; Zhang, Liyi

2017-06-01

WHO stated that nearly one million people commit suicide every year worldly, and 40% of the suicide completer suffered from depression. The primary aim of this study was to explore the association between long noncoding RNAs (lncRNAs) expression in peripheral blood mononuclear cells (PBMCs) and suicide risk of patients with major depressive disorder (MDD). Using Human LncRNA 3.0 microarray profiling which includes 30,586 human lncRNAs and RT-PCR, six down-regulated lncRNAs were identified differentially expressed in MDD patients. According to suicidal ideation and suicidal attempt, the suicide risk of MDD patients was classified into suicidal ideation versus no suicidal ideation groups, and past attempt versus no past attempt groups, respectively. The expression of six lncRNAs in MDD patients and controls were examined by RT-PCR. The expression of six lncRNAs had significant differences between no suicidal ideation, suicidal ideation, and controls; corresponding lncRNAs associated with suicidal attempt had remarkable differences between no past attempt, past attempt, and controls. Additionally, only the expression of lncRNAs in suicidal ideation group and past attempt group markedly declined compared with controls. This study indicated that the expression of six down-regulated lncRNAs had a negative association with suicide risk in MDD patients, and the expression of lncRNAs in PBMCs could have the potential to help clinician judge the suicide risk of MDD patients to provide timely treatment and prevent suicide.

Major Depression and the Degree of Suicidality: Results of the European Group for the Study of Resistant Depression (GSRD).

PubMed

Dold, Markus; Bartova, Lucie; Fugger, Gernot; Kautzky, Alexander; Souery, Daniel; Mendlewicz, Julien; Papadimitriou, George N; Dikeos, Dimitris; Ferentinos, Panagiotis; Porcelli, Stefano; Serretti, Alessandro; Zohar, Joseph; Montgomery, Stuart; Kasper, Siegfried

2018-06-01

This European multicenter study aimed to elucidate suicidality in major depressive disorder. Previous surveys suggest a prevalence of suicidality in major depressive disorder of ≥50%, but little is known about the association of different degrees of suicidality with socio-demographic, psychosocial, and clinical characteristics. We stratified 1410 major depressive disorder patients into 3 categories of suicidality based on the Hamilton Rating Scale for Depression item 3 (suicidality) ratings (0=no suicidality; 1-2=mild/moderate suicidality; 3-4=severe suicidality). Chi-squared tests, analyses of covariance, and Spearman correlation analyses were applied for the data analyses. The prevalence rate of suicidality in major depressive disorder amounted to 46.67% (Hamilton Rating Scale for Depression item 3 score ≥1). 53.33% were allocated into the no, 38.44% into the mild/moderate, and 8.23% into the severe suicidality patient group. Due to the stratification of our major depressive disorder patient sample according to different levels of suicidality, we identified some socio-demographic, psychosocial, and clinical variables differentiating from the patient group without suicidality already in presence of mild/moderate suicidality (depressive symptom severity, treatment resistance, psychotic features, add-on medications in general), whereas others separated only when severe suicidality was manifest (inpatient treatment, augmentation with antipsychotics and benzodiazepines, melancholic features, somatic comorbidities). As even mild/moderate suicidality is associated with a failure of achieving treatment response, adequate recognition of this condition should be ensured in the clinical practice.

Internet suicide in Japan: a qualitative content analysis of a suicide bulletin board.

PubMed

Ikunaga, Ai; Nath, Sanjay R; Skinner, Kenneth A

2013-04-01

Netto shinju, or Internet group suicide, is a contemporary form of Japanese suicide where strangers connect on the Internet and make plans to commit suicide together. In the past decade, numerous incidents have occurred whereby young Japanese make contact on the Internet, exchange tips on suicide methods, and make plans to meet offline for group/individual suicide. A systematic qualitative content/thematic analysis of online communications posted on a popular Japanese suicide bulletin board yielded a textured, thematic understanding of this phenomenon. Themes identified reflected Shneidman's theory of suicide but with an emphasis on interpersonal concerns that are embedded in Japanese culture.

The Press Coverage of Celebrity Suicide and the Development of Suicide Frequencies in Germany.

PubMed

Schäfer, Markus; Quiring, Oliver

2015-01-01

The existence of the so-called "Werther effect" is well confirmed, and there are several recommendations on how the media should (not) report suicide to minimize the risk of copycat behavior. Unfortunately, very little is known about how suicide is actually reported. The article examines the German press coverage of six celebrity suicides with respect to compliance with guidelines on suicide reporting and analyzes changes in suicides in the wake of the reporting. It concludes that German media do not respect the recommendations in a substantial number of their articles. In addition, a significant increase in suicides and similar suicides is found.

What’s the Harm in Asking about Suicidal Ideation?

PubMed Central

Mathias, Charles W.; Furr, R. Michael; Sheftall, Arielle H.; Hill-Kapturczak, Nathalie; Crum, Paige; Dougherty, Donald M.

2013-01-01

Both researchers and oversight committees share concerns about patient safety in the study-related assessment of suicidality. However, concern about assessing suicidal thoughts can be a barrier to the development of empirical evidence that informs research on how to safely conduct these assessments. A question has been raised if asking about suicidal thoughts can result in iatrogenic increases of such thoughts, especially among at-risk samples. The current study repeatedly tested suicidal ideation at 6-month intervals for up to 2-years. Suicidal ideation was measured with the Suicidal Ideation Questionnaire Junior, and administered to adolescents who had previously received inpatient psychiatric care. Change in suicidal ideation was tested using several analytic techniques, each of which pointed to a significant decline in suicidal ideation in the context of repeated assessment. This and previous study outcomes suggest that asking an at-risk population about suicidal ideation is not associated with subsequent increases in suicidal ideation. PMID:22548324

Prevention of suicidal behavior

PubMed Central

Hegerl, Ulrich

2016-01-01

More than 800 000 people die every year from suicide, and about 20 times more attempt suicide. In most countries, suicide risk is highest in older males, and risk of attempted suicide is highest in younger females. The higher lethal level of suicidal acts in males is explained by the preference for more lethal methods, as well as other factors. In the vast majority of cases, suicidal behavior occurs in the context of psychiatric disorders, depression being the most important one. Improving the treatment of depression, restricting access to lethal means, and avoiding the Werther effect (imitation suicide) are central aspects of suicide prevention programs. In several European regions, the four-level intervention concept of the European Alliance Against Depression (www.EAAD.net), simultaneously targeting depression and suicidal behavior, has been found to have preventive effects on suicidal behavior. It has already been implemented in more than 100 regions in Europe. PMID:27489458

Case study of posts before and after a suicide on a Swedish internet forum

PubMed Central

Westerlund, Michael; Hadlaczky, Gergö; Wasserman, Danuta

2015-01-01

Websites and discussion forums have become an important and sometimes controversial source of information on suicide. Using a case report, our aim was to examine the responses, attitudes and beliefs that were communicated on a forum before, during and after a suicide act. We undertook two related analyses: a qualitative investigation of the messages that were posted before the suicide and a combined qualitative–quantitative analysis of the messages posted during and after the suicide. Nearly half the posted messages before the suicide encouraged the victim to complete the suicidal act, and a surprising number of posts after the suicide expressed excitement, although around half of the posts considered the suicide to be tragic. It is of great importance to increase awareness of suicide signals and understanding about how to respond to individuals who communicate suicide intentions on different forums on the internet. PMID:26628690

Religion and Suicide Risk: A Systematic Review.

PubMed

Lawrence, Ryan E; Oquendo, Maria A; Stanley, Barbara

2016-01-01

Although religion is reported to be protective against suicide, the empirical evidence is inconsistent. Research is complicated by the fact that there are many dimensions to religion (affiliation, participation, doctrine) and suicide (ideation, attempt, completion). We systematically reviewed the literature on religion and suicide over the last 10 years (89 articles) with a goal of identifying what specific dimensions of religion are associated with specific aspects of suicide. We found that religious affiliation does not necessarily protect against suicidal ideation, but does protect against suicide attempts. Whether religious affiliation protects against suicide attempts may depend on the culture-specific implications of affiliating with a particular religion, since minority religious groups can feel socially isolated. After adjusting for social support measures, religious service attendance is not especially protective against suicidal ideation, but does protect against suicide attempts, and possibly protects against suicide. Future qualitative studies might further clarify these associations.

Media suicide-reports, Internet use and the occurrence of suicides between 1987 and 2005 in Japan

PubMed Central

Hagihara, Akihito; Tarumi, Kimio; Abe, Takeru

2007-01-01

Background Previous investigations regarding the effects of suicide reports in the media on suicide incidence in Japan have been limited and inconclusive and, although Internet use has greatly increased, its influence on suicide is completely unknown. Thus, the relationship between newspaper articles about suicide, Internet use, and the incidence of suicide in Japan was examined. Methods A linear model was fitted to time series data from January 1987 to March 2005 (218 months). Results Consistent with previous findings, the number of newspaper articles about suicide was a predictor of suicide among both male and female subjects. Internet use was also a predictor of suicide among males, probably because males spent more time online than females. Conclusion Because this is the first, preliminary study examining the association between Internet use and suicide, further research is required to verify the present findings. PMID:17996117

Trends and Risk Factors of the Epidemic of Charcoal Burning Suicide in a Recent Decade among Korean People

PubMed Central

Stack, Steven John

2014-01-01

The aims of this study were to analyze annual trends of charcoal burning (CB) suicide, 2000 to 2011, and to examine the risk factors of CB suicide in Korea. Data on suicides (n=138,938) were obtained from the Statistics Korea. The proportion of CB suicides among all suicide deaths reported was 0.7% (84 cases) in 2007, and since 2008 it has rapidly increased to 7.9% (1,251 cases) in 2011. Of significant risk factors of CB suicide, the presence of the media report of Ahn's suicide was the greatest risk factor (adjusted odds ratio, 11.69; 95% CI, 10.30-13.23) of the initial phase of the continuing CB suicides since 2008. Korean Government should urgently consider effective measures against CB suicide, including enforced media regulations on reporting such suicides. Graphical Abstract PMID:25120332

Suicide, Satisfaction With Life, and Insight Capacity Among Adolescents With Mental Disorders.

PubMed

Schapir, Lior; Zalsman, Gil; Hasson-Ohayon, Ilanit; Gaziel, Meyrav; Morag-Yaffe, Mayad; Sever, Jonathan; Weizman, Abraham; Shoval, Gal

2016-09-01

Little is known about the role of insight and satisfaction with life in adolescent suicidal behavior. The objective of this study was to examine the relationship between suicide risk, insight, and satisfaction with life among adolescents with mental disorders. A total of 30 adolescents were evaluated using self-report measures of insight, satisfaction with life, and suicide risk. Regression analysis was used to assess the contribution of each factor to suicide risk. Positive correlations were found between suicide risk and insight dimensions. Satisfaction with life correlated negatively with suicide risk and insight dimensions. Insight explained 27.3% of suicide risk (p = .003). Both insight and satisfaction with life explained 39.0% of suicide risk (p = .031). Among adolescents with mental disorders, insight is a risk factor, whereas satisfaction with life is a protective factor for suicidality. Insight affects suicide risk of adolescents with mental disorders via reduction of satisfaction with life.

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

Characteristics of suicide hotspots on the Belgian railway network.

PubMed

Debbaut, Kevin; Krysinska, Karolina; Andriessen, Karl

2014-01-01

In 2004, railway suicide accounted for 5.3% of all suicides in Belgium. In 2008, Infrabel (Manager of the Belgian Railway Infrastructure) introduced a railway suicide prevention programme, including identification of suicide hotspots, i.e., areas of the railway network with an elevated incidence of suicide. The study presents an analysis of 43 suicide hotspots based on Infrabel data collected during field visits and semi-structured interviews conducted in mental health facilities in the vicinity of the hotspots. Three major characteristics of the hotspots were accessibility, anonymity, and vicinity of a mental health institution. The interviews identified several risk and protective factors for railway suicide, including the training of staff, introduction of a suicide prevention policy, and the role of the media. In conclusion, a comprehensive railway suicide prevention programme should continuously safeguard and monitor hotspots, and should be embedded in a comprehensive suicide prevention programme in the community.

Suicide notes.

PubMed

O'Donnell, I; Farmer, R; Catalan, J

1993-07-01

Detailed case reports of incidents of suicide and attempted suicide on the London Underground railway system between 1985 and 1989 were examined for the presence of suicide notes. The incidence of note-leaving was 15%. Notes provided little insight into the causes of suicide as subjectively perceived, or strategies for suicide prevention.

Selecting Suicide Ideation Assessment Instruments: A Meta-Analytic Review

ERIC Educational Resources Information Center

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

2018-01-01

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

Adolescent Suicide and Suicidal Behavior

ERIC Educational Resources Information Center

Bridge, Jeffrey A.; Goldstein, Tina R.; Brent, David A.

2006-01-01

This review examines the descriptive epidemiology, and risk and protective factors for youth suicide and suicidal behavior. A model of youth suicidal behavior is articulated, whereby suicidal behavior ensues as a result of an interaction of socio-cultural, developmental, psychiatric, psychological, and family-environmental factors. On the basis of…

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

PubMed

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

2014-01-01

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

Widening socioeconomic inequalities in Australian suicide, despite recent declines in suicide rates.

PubMed

Too, Lay San; Law, Phillip C F; Spittal, Matthew J; Page, Andrew; Milner, Allison

2018-04-30

This study aims to investigate trends in socioeconomic inequalities of suicide from 1979 to 2013 for Australian males and females aged 15-34 years and 35-64 years. Data on suicides and population were obtained from national registries. An area-based measure of socioeconomic status (SES) was used, and categorized into low, middle, and high SES areas. Suicide rates for each SES groups were estimated using a negative binomial regression model, adjusted for confounders. Socioeconomic inequalities in suicide were assessed using absolute and relative risk of low-to-high SES areas. Secular changes in socioeconomic inequalities were assessed using trend tests for relative risk. For young males, there was an increase in socioeconomic inequality driven by a significant decrease in suicide rates in high SES areas. For older males, inequality in suicide increased by 29%, which was related to a marked increase in suicide rates in low SES areas. Inequalities in both young and older female suicides also increased. These increases occurred when corresponding suicide rates in high SES areas decreased. Recent widening socioeconomic inequalities in Australian suicide have been primarily associated with declines in suicide rates in high SES areas. However, an increasing inequality in older male suicide is linked with low SES. Efforts targeting people from poor areas, especially older males, should be considered when developing suicide prevention strategy.

Psychological and Social Factors Affecting Internet Searches on Suicide in Korea: A Big Data Analysis of Google Search Trends

PubMed Central

Song, Tae Min; Song, Juyoung; Hayman, Laura L.; Woo, Jong-Min

2014-01-01

Purpose The average mortality rate for death by suicide among OECD countries is 12.8 per 100000, and 33.5 for Korea. The present study analyzed big data extracted from Google to identify factors related to searches on suicide in Korea. Materials and Methods Google search trends for the search words of suicide, stress, exercise, and drinking were obtained for 2004-2010. Analyzing data by month, the relationship between the actual number of suicides and search words per year was examined using multi-level models. Results Both suicide rates and Google searches on suicide in Korea increased since 2007. An unconditional slope model indicated stress and suicide-related searches were positively related. A conditional model showed that factors associated with suicide by year directly affected suicide-related searches. The interaction between stress-related searches and the actual number of suicides was significant. Conclusion A positive relationship between stress- and suicide-related searches further confirmed that stress affects suicide. Taken together and viewed in context of the big data analysis, our results point to the need for a tailored prevention program. Real-time big data can be of use in indicating increases in suicidality when search words such as stress and suicide generate greater numbers of hits on portals and social network sites. PMID:24339315

Suicidal behavior and insight into illness among patients with schizophrenia spectrum disorders.

PubMed

Kao, Yu-Chen; Liu, Yia-Ping

2011-09-01

The purpose of the present study was to explore the relationship between suicidal behavior and socio-demographic and clinical factors, including insight into illness, in patients with schizophrenia spectrum disorders. We evaluated 104 inpatients using the Self-Appraisal of Illness Questionnaire (SAIQ) for insight assessment, several Beck-related symptoms rating scales, and the Positive and Negative Syndrome Scale (PANSS) for psychopathology. These patients were also evaluated for suicidal behavior and risk using the critical items of the Scale for Suicide Ideation (SSI) and lifetime suicide attempts. Patients with suicidal behavior generally had greater insight into illness than those who were non-suicidal. After controlling for depressive symptoms, the association of insight into illness with current suicidal ideation remained significant, whereas the association between insight and lifetime suicide attempts was no longer significant. As predicted, the regression analyses revealed that those with greater suicide risk had significantly higher levels of depressive symptoms and hopelessness and more lifetime suicide attempts. Moreover, greater insight into illness appeared to have a close, independent connection to suicidal behavior. Our findings suggest that depression, hopelessness, and greater insight into illness are major risk factors for suicide in patients with schizophrenia. It is plausible that depression mediates the relationship between greater insight into illness and suicidal behavior. Aggressive improvement of insight without the risk of deteriorating depressive symptoms may be warranted to reduce the risk of suicide.

Perceived stops to suicidal thoughts, plans, and actions in persons experiencing psychosis.

PubMed

Gooding, P A; Sheehy, K; Tarrier, N

2013-01-01

Suicide has been conceived as involving a continuum, whereby suicidal plans and acts emerge from thoughts about suicide. Suicide prevention strategies need to determine whether different responses are needed at these points on the continuum. This study investigates factors that were perceived to counter suicidal ideation, plans, and acts. The 36 participants, all of whom had had experiences of psychosis and some level of suicidality, were presented with a vignette describing a protagonist with psychotic symptoms. They were asked to indicate what would counter the suicidal thoughts, plans, and acts of the protagonist described in the vignette. Qualitative techniques were first used to code these free responses into themes/categories. Correspondence analysis was then applied to the frequency of responses in each of these categories. Social support was identified as a strong counter to suicidal ideation but not as a counter to suicidal plans or acts. Help from health professionals was strongly related to the cessation of suicidal plans as were the opinions of the protagonist's children. Changing cognitions and strengthening psychological resources were more weakly associated with the cessation of suicidal ideation and plans. The protagonist's children were considered potentially helpful in addressing suicidal acts. These results suggest that both overlapping and nonoverlapping factors need to be considered in understanding suicide prevention, dependent on whether individuals are thinking about, planning, or attempting suicide.

The gap between suicide characteristics in the print media and in the population.

PubMed

Niederkrotenthaler, Thomas; Till, Benedikt; Herberth, Arno; Voracek, Martin; Kapusta, Nestor D; Etzersdorfer, Elmar; Strauss, Markus; Sonneck, Gernot

2009-08-01

Programmes to educate media professionals about suicide are increasingly established, but information about which suicide cases are most likely to be reported in the mass media is sparse. We applied binomial tests to compare frequencies of social characteristics of all domestic suicides in the 13 largest Austrian print media in 2005 with frequencies of suicide characteristics in the population. Additionally, each reported suicide case was linked to its respective entry in the suicide database. We performed a logistic regression analysis, with presence of an article as outcome, and sex of the suicide case, age, religious affiliation, family status, conduction of an autopsy and location of the suicide as explaining variables. Time of the year and federal state where the suicide happened was controlled for. Binomial tests showed that suicides involving murder or murder attempt were over-represented in the media. Reporting on mental disorders was under-represented. In the regression analysis, the likelihood of a report was negatively associated with the age of suicide cases. Foreign citizenship was a further predictor of a suicide report. The methods of drowning, jumping, shooting and rare methods were more likely to be reported than hanging, which is the most frequent suicide method in Austria. Suicide characteristics in the media are not representative of the population. The identified discrepancies provide a basis for tailor-made education of mass media professionals.

Suicidality in Huntington's Disease: A Qualitative Study on Coping Styles and Support Strategies.

PubMed

Hubers, Anna A M; Hamming, Annette; Giltay, Erik J; von Faber, Margaret; Roos, Raymund A C; van der Mast, Rose C; van Duijn, Erik

2016-05-31

Huntington's disease (HD) mutation carriers are at increased risk of suicidal ideation, suicide attempts, and completed suicide. However, research is lacking on coping strategies and treatment options that can be offered to suicidal HD mutation carriers. This study explores how individuals with pre-motor or motor symptomatic HD cope with suicidality, how their partners support them, and their ideas and wishes regarding how relatives and healthcare professionals can help them in coping with suicidality. This qualitative study included 11 HD mutation carriers who experienced suicidal ideation or attempted suicide and 3 of their partners. They participated in a focus group discussion or an individual in-depth interview. Two independent researchers fragmented the transcribed interviews, coded these fragments, grouped them under themes, and structured the data. HD study participants used four main strategies to cope with suicidality, including talking about suicidality, employing self-management activities, using medication, and discussing end-of-life wishes. Partners, relatives, and healthcare professionals can support suicidal HD mutation carriers in each of those four strategies. Despite the absence of a turnkey solution for suicidality in HD, healthcare professionals can play an important role in supporting suicidal HD mutation carriers by providing an opportunity to talk about suicidality, providing psychoeducation on self-management, prescribing medication, and discussing end-of-life wishes. Future HD-specific intervention studies could investigate the effect of combining these treatment strategies into one holistic approach.

Stigma and psychological distress in suicide survivors.

PubMed

Scocco, Paolo; Preti, Antonio; Totaro, Stefano; Ferrari, Alessandro; Toffol, Elena

2017-03-01

Suicide bereavement is frequently related to clinically significant psychological distress and affected by stigma. This study was designed to evaluate the relationship between psychological distress by psychopathological domains and stigma, in a sample of individuals bereaved by suicide (suicide survivors). The data were collected between January 2012 and December 2014 and included information on sociodemographic variables (gender, age, marital status and education level) and responses to the Stigma of Suicide Survivor scale (STOSSS) and the Brief Symptom Inventory (BSI). One hundred and fifty-five suicide survivors completed the evaluation and were included in the study. Levels of psychological distress in suicide survivors, as measured by BSI, were positively related to levels of perceived stigma toward suicide survivors, as measured by STOSSS. The association was not affected by age and gender, or by marital status, education level, days from suicide or a personal history of suicide attempt. Participants with higher scores on almost all subscales of the BSI, particularly the interpersonal sensitivity and paranoid ideation subscales, reported the highest levels of perceived stigma toward suicide survivors. Levels of distress in subjects bereaved by the suicide of a relative or friend were positively associated with levels of perceived stigma toward suicide survivors. Specific interventions dedicated to the bereavement of suicide survivors might help to alleviate not only psychological distress but also stigma towards loss by suicide. Copyright © 2017 Elsevier Inc. All rights reserved.

Emotional intelligence as a mediator between rumination and suicidal ideation among depressed inpatients: The moderating role of suicidal history.

PubMed

Abdollahi, Abbas; Talib, Mansor Abu

2015-08-30

Suicide is a substantial public health problem, and it remains a serious cause of death in the world. Therefore, this study was designed to examine the relationships between brooding, reflection, emotional intelligence (assessed by performance-based test), and suicidal ideation; the mediation role of emotional intelligence on the relationships between brooding and reflection with suicidal ideation; and the moderating role of suicidal history on the relationships between brooding, reflection, and emotional intelligence with suicidal ideation among Iranian depressed adolescents. The study consisted of a cross-sectional sample of 202 depressed adolescent inpatients from five public hospitals in Tehran, Iran completed measures of depression, rumination, emotional intelligence, and suicide attempt history as indices of suicidal ideation. Structural Equation Modelling estimated that depressed adolescent inpatients with high levels of brooding and reflective rumination, and low levels of emotional intelligence were more likely to report suicidal ideation. Moreover, emotional intelligence partially mediated the relationships between brooding and reflective rumination with suicidal ideation. Suicidal history moderated the relationships between brooding, reflection, and emotional intelligence with suicidal ideation. These findings reinforce the importance of emotional intelligence as an influencing factor against the deleterious effects of rumination styles and suicidal ideation. The results indicate that brooding and reflection have detrimental effects on suicidal ideation in depressed inpatients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Suicidal ideation, suicide attempt, and occupations among employed adults aged 18-64years in the United States.

PubMed

Han, Beth; Crosby, Alex E; Ortega, LaVonne A G; Parks, Sharyn E; Compton, Wilson M; Gfroerer, Joseph

2016-04-01

Approximately 70% of all US suicides are among working-age adults. This study was to determine whether and how 12-month suicidal ideation and suicide attempt were associated with specific occupations among currently employed adults aged 18-64 in the U.S. Data were from 184,300 currently employed adults who participated in the 2008-2013 National Surveys on Drug Use and Health (NSDUH). NSDUH provides nationally representative data on suicidal ideation and suicide attempt. Descriptive analyses and multivariable logistic regressions were conducted. Among currently employed adults aged 18-64 in the U.S., 3.5% had suicidal ideation in the past 12months (3.1% had suicidal ideation only, and 0.4% had suicidal ideation and attempted suicide). Compared with adults in farming, fishing, and forestry occupations (model adjusted prevalence (MAP)=1.6%), adults in the following occupations were 3.0-3.6 times more likely to have suicidal ideation in the past year (model adjusted relative risks (MARRs)=3.0-3.6): lawyers, judges, and legal support workers (MAP=4.8%), social scientists and related workers (MAP=5.4%), and media and communication workers (MAP=5.8%). Among employed adults aged 18-64 in the U.S., the 12-month prevalence of suicidal ideation varies by occupations. Adults in occupations that are at elevated risk for suicidal ideation may warrant focused suicide prevention. Published by Elsevier Inc.

The persistent shadow of suicide ideation and attempts in a high-risk group of psychiatric patients: A focus for intervention.

PubMed

Tillman, Jane G; Clemence, A Jill; Cree, Robyn; Lewis, Katie C; Stevens, Jennifer L; Reiss, David

2017-08-01

Patients with a history of suicidal ideation or attempts, especially if they have serious psychopathology with repeated hospitalizations, are burdened by ongoing risk for suicide. We studied this high-risk group to assess their psychological status following their most recent suicide attempt, in contrast to equally ill patients without a suicide history. Further, among suicidal patients, we compared those with only ideation, with a non-medically serious suicide attempt and with medically serious suicide attempts. We also report on the development of a new measure of psychic pain. Patients in residential treatment (n=131) completed self-report questionnaires about suicide history, impulsiveness, psychic pain, resilience, and reasons for living. A series of univariate ordinal logistic regressions identified variables to include in a multivariable logistic regression to examine the odds associated with increasing levels of suicidality. A history of suicidal ideation or suicide attempts is associated with proportionally more psychic pain and fewer current reasons for living. Prior history of abuse, impulsiveness, and general resilience were not significantly associated with suicidal severity. For patients who have suicidal ideation, or have attempted suicide, and also have additional risk factors including past hospitalization, treatments should include both understanding the sources of psychic pain and promoting individual discovery of reasons for living. Copyright © 2017 Elsevier Inc. All rights reserved.

Neutrophil-to-lymphocyte ratio predicting suicide risk in euthymic patients with bipolar disorder: Moderatory effect of family history.

PubMed

Ivković, Maja; Pantović-Stefanović, Maja; Dunjić-Kostić, Bojana; Jurišić, Vladimir; Lačković, Maja; Totić-Poznanović, Sanja; Jovanović, Aleksandar A; Damjanović, Aleksandar

2016-04-01

Neutrophil-to-lymphocyte ratio (NLR) has been independently related to bipolar disorder (BD) and factors associated with suicidal risk. The aim of our study was to explore the relationship between NLR and suicide risk in euthymic BD patients. We also sought to propose a model of interaction between NLR and stress-diathesis factors, leading to suicidal risk in BD. The study group consisted of 83 patients diagnosed with BD (36 suicide attempters; 47 suicide non-attempters), compared to the healthy control group (n=73) and matched according to age, gender, and body mass index (BMI). NLR was measured according to the complete blood count. Mood symptoms have been assessed by Young Mania Rating Scale and Montgomery-Asberg Depression Rating Scale. Early trauma and acute stress were evaluated by Early Trauma Inventory Self Report-Short Form and List of Threatening Experiences Questionnaire, respectively. Suicide risk has been assessed by Suicide Behaviors Questionnaire-Revised (SBQ-R). Significant correlation was found between NLR and SBQ-R score. The main effects of suicide attempts on NLR, after covarying for confounders, were observed, indicating increased NLR in BD suicide attempters compared to healthy controls. We found significant moderatory effects of family history on NLR relationship to suicidal risk, with NLR being significant positive predictor of suicidal risk only in the patients with positive family history of suicide attempts. The results suggest an enhancing effect of positive family history of suicide attempts on predictive effect of NLR on suicide risk. Our data support the idea that immune markers can predict suicide attempt risk in BD, but only in the subpopulation of BD patients with family history of suicide attempts. This could lead to prevention in suicide behavior in the patient population at particular risk of suicide. Copyright © 2016 Elsevier Inc. All rights reserved.

The investigation of factors related to suicide attempts in Southeastern Turkey

PubMed Central

Okan Ibiloglu, Aslihan; Atli, Abdullah; Demir, Suleyman; Gunes, Mehmet; Kaya, Mehmet Cemal; Bulut, Mahmut; Sir, Aytekin

2016-01-01

Background Suicide is an important health problem in Turkey as it is in all regions of the world. Suicidal behavior has multiple causes, which are broadly divided into those related to proximal stressors and those due to predisposition. Suicide statistics may be associated with mental health disorders, which are among the foremost predictors of suicide attempts. More than 90% of patients who commit suicide have a diagnosable psychiatric disorder, usually a major depressive disorder. Other major risk factors for suicide attempts are history of suicide attempts in the family, stressful life events, sleep disturbances, poor income, unemployment, severity of symptoms of depression, and anxiety. Sleep is a complex phenomenon. Sleep disturbances can therefore be contributed to the emergence of suicidal behavior allowing for the possibility of predicting future suicides. Methods We evaluated 106 patients who were admitted after suicide attempts to the Department of Psychiatry at Dicle University Faculty of Medicine. The recruited subjects were assessed by Structured Clinical Interview for DSM-IV Axis I disorders, and the intensity of symptoms was evaluated using the Beck Anxiety Inventory, Hamilton Depression Rating Scale, and Pittsburgh Sleep Quality Index. The mean values of the subjects attempting multiple and single suicides were compared using appropriate inferential statistical tests. Results Most suicide attempts are believed to be preventable. Our results revealed that a great variety of risk factors are associated with an increased risk for multiple suicide attempts. Most of these attempts appeared to be spontaneous and impulsive rather than planned. In particular, this study highlights the importance of previous suicide attempts, history of suicide in the family, history of stressful life events in the previous 6 months, poor income, unemployment, sleep disturbances, severe hopelessness with depression, and coexisting symptoms of anxiety as risk factors. Conclusion The first step in prevention of suicides is doubtlessly strong and reliable communication, due to the fact that the majority of subjects who commit suicide have had contact with a health professional during the month before the suicide. PMID:26966362

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

PubMed Central

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

2016-01-01

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

78 FR 78363 - Proposed Information Collection Activity; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-26

... reporting suicides and suicide attempts by refugees. Title: Refugee Suicide Report Form (RSR). OMB No.: 0970... allow ORR to systematically gather information on suicides and suicide attempts among refugee populations resettled in the U.S. Data will be collected on individuals who have made suicide attempts or...

The Heavy Metal Subculture and Suicide.

ERIC Educational Resources Information Center

Stack, Steven; And Others

1994-01-01

Assessed relationship between heavy metal music and suicide with data on heavy metal magazine subscriptions and youth suicide in 50 states. Found that, controlling for other predictors of suicide, greater strength of metal subculture, higher youth suicide rate, suggests that music perhaps nurtures suicidal tendencies already present in subculture.…

Revisiting the Association of Aggression and Suicidal Behavior in Schizophrenic Inpatients

ERIC Educational Resources Information Center

Neuner, Tanja; Hubner-Liebermann, Bettina; Hausner, Helmut; Hajak, Goran; Wolfersdorf, Manfred; Spiessl, Hermann

2011-01-01

Our study investigated the association of aggression and suicidal behavior in schizophrenic inpatients. Eight thousand nine hundred one admissions for schizophrenia (1998-2007) to a psychiatric university hospital were included. Schizophrenic suicides (n = 7)/suicide attempters (n = 40) were compared to suicides (n = 30)/suicide attempters (n =…

Suicide Ideation among College Students Evidencing Subclinical Depression

ERIC Educational Resources Information Center

Cukrowicz, Kelly C.; Schlegel, Erin F.; Smith, Phillip N.; Jacobs, Matthew P.; Van Orden, Kimberly A.; Paukert, Ambert L.; Pettit, Jeremy W.; Joiner, Thomas E.

2011-01-01

Identifying elevated suicide ideation in college students is a critical step in preventing suicide attempts and deaths by suicide on college campuses. Although suicide ideation may be most prominent in students with severe depression, this should not suggest that only students with severe depression experience significant risk factors for suicide.…

Can suicide be a good death?

PubMed

Lester, David

2006-01-01

The issue of whether suicide can be a good death was separated into two different questions: (1) can suicide be an appropriate death, and (2) can suicide be a rational death? Several definitions of an "appropriate" death were proposed, and suicide was seen as potentially appropriate. Similarly, several criteria for rationality were proposed and suicide was seen as sometimes meeting these criteria. Thus, suicide can be sometimes conceptualized as a "good" death.

Suicide Prevention: Suicide Prevention for Department of the Army Civilians

DTIC Science & Technology

2009-12-01

TG 325D December 2009 SUICIDE PREVENTION SUICIDE PREVENTION FOR DEPARTMENT OF THE ARMY CIVILIANS PREPARED BY THE U. S. ARMY... Suicide Prevention 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT... SUICIDE PREVENTION PROGRAM 2 INSTRUCTIONAL PROCEDURES 3 INSTRUCTOR NOTE 3 SUICIDE AWARENESS TRAINING FOR CIVILIAN EMPLOYEES

Suicidality and interrogative suggestibility.

PubMed

Pritchard-Boone, Lea; Range, Lillian M

2005-01-01

All people are subject to memory suggestibility, but suicidal individuals may be especially so. The link between suicidality and suggestibility is unclear given mixed findings and methodological weaknesses of past research. To test the link between suicidality and interrogative suggestibility, 149 undergraduates answered questions about suicidal thoughts and reasons for living, and participated in a direct suggestibility procedure. As expected, suggestibility correlated with suicidality but accounted for little overall variance (4%). Mental health professionals might be able to take advantage of client suggestibility by directly telling suicidal persons to refrain from suicidal thoughts or actions.

Weight status, psychological health, suicidal thoughts, and suicide attempts in Dutch adolescents: results from the 2003 E-MOVO project.

PubMed

van Wijnen, Lisa G C; Boluijt, Petra R; Hoeven-Mulder, Henriette B; Bemelmans, Wanda J E; Wendel-Vos, G C Wanda

2010-05-01

This study describes the association between weight status and psychological health, suicidal thoughts and suicide attempts in adolescents from a population-based study of 21,730 adolescents who responded to a classroom-based internet questionnaire. It demonstrated clear associations between weight status in adolescents and poor psychological health, suicidal thoughts and suicide attempts, especially in obese individuals. Obese boys and girls were more likely to be classified as "psychologically unhealthy" than were normal weight subjects. They also reported more suicidal thoughts and suicide attempts.

[Suicide attempts among Chilean adolescents].

PubMed

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

2015-03-01

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

Suicide, gender, and age variations in India. Are women in indian society protected from suicide?

PubMed

Mayer, Peter; Ziaian, Tahereh

2002-01-01

A new set of data concerning the pattern of suicide in India between 1991-1997 are presented. Suicide rates rose over this period despite a small decline in the Indian suicide rate in 1995 and 1996. It was found that between 1995 and 1997 there was a modest fall in the suicide rates among under 29-year-olds of both sexes, and an increase among those 30 years and older. The pattern of suicides in India is bimodal: the incidence of suicides is highest for those in the 30-44-year-old category of both sexes and tends to decline in higher age categories. Suicide rates were nearly equal for young women and men, a contrast with the pattern of suicide sex ratios in eight developed countries.

Practical Suicide-Risk Management for the Busy Primary Care Physician

PubMed Central

McDowell, Anna K.; Lineberry, Timothy W.; Bostwick, J. Michael

2011-01-01

Suicide is a public health problem and a leading cause of death. The number of people thinking seriously about suicide, making plans, and attempting suicide is surprisingly high. In total, primary care clinicians write more prescriptions for antidepressants than mental health clinicians and see patients more often in the month before their death by suicide. Treatment of depression by primary care physicians is improving, but opportunities remain in addressing suicide-related treatment variables. Collaborative care models for treating depression have the potential both to improve depression outcomes and decrease suicide risk. Alcohol use disorders and anxiety symptoms are important comorbid conditions to identify and treat. Management of suicide risk includes understanding the difference between risk factors and warning signs, developing a suicide risk assessment, and practically managing suicidal crises. PMID:21709131

Emotional impact of a video-based suicide prevention program on suicidal viewers and suicide survivors.

PubMed

Bryan, Craig J; Dhillon-Davis, Luther E; Dhillon-Davis, Kieran K

2009-12-01

In light of continuing concerns about iatrogenic effects associated with suicide prevention efforts utilizing video-based media, the impact of emotionally-charged videos on two vulnerable subgroups--suicidal viewers and suicide survivors--was explored. Following participation in routine suicide education as a part of the U.S. Air Force Suicide Prevention Program's video-based community briefing, a sample of young active duty airmen demonstrated small decreases in positive emotional states and larger decreases in negative emotional states, especially among suicidal females. No evidence of iatrogenic effects were observed among suicidal or survivor subgroups when compared to controls. Results support the use of video-based media as a safe educational strategy that might actually serve to decrease emotional distress among vulnerable subgroups.

The historical development of suicide mortality in Russia, 1870-2007.

PubMed

Jukkala, Tanya; Mäkinen, Ilkka Henrik; Stickley, Andrew

2015-01-01

Russia has one of the highest suicide mortality rates in the world. This study investigates the development of Russian suicide mortality over a longer time period in order to provide a context within which the contemporary high level might be better understood. Annual sex- and age-specific suicide-mortality data for Russia for the period 1870-2007 were studied, where available. Russian suicide mortality increased 11-fold over the period. Trends in male and female suicide developed similarly, although male suicide rates were consistently much higher. From the 1990s suicide has increased in a relative sense among the young (15-34), while the high suicide mortality among middle-aged males has reduced. Changes in Russian suicide mortality over the study period may be attributable to modernization processes.

Testing the Efficacy of Attention Bias Modification for Suicidal Thoughts: Findings From Two Experiments.

PubMed

Cha, Christine B; Najmi, Sadia; Amir, Nader; Matthews, John D; Deming, Charlene A; Glenn, Jeffrey J; Calixte, Rachelle M; Harris, Julia A; Nock, Matthew K

2017-01-02

This study explores whether four sessions of attention bias modification (ABM) decreases suicide-specific attentional bias. We conducted two experiments where suicide ideators completed either a Training or Control version of ABM, a computer-based intervention intended to target attentional bias. Suicide-specific attentional bias was measured using adapted Stroop and probe discrimination tasks. The first experiment with community-based suicide ideators did not show that ABM impacts attentional bias or suicidal ideation. The second experiment with clinically severe suicidal inpatients yielded similar results. Post-hoc findings suggest that the type of attentional bias targeted by the current intervention may differ from the type that marks suicide risk. There remains little to no evidence that the ABM intervention changes suicide-specific attentional bias or suicidal ideation.

Suicide in southwestern Greece 1979-1984.

PubMed

Beratis, S

1986-11-01

Study of suicide in a province of southwestern Greece (population 295,000) from 1979 through 1984 demonstrated: mean suicide rate 0.48/10,000 population/year; significant increase of the suicide rate in men after the age of 65, but not in women; significantly higher suicide rate in men from rural than from urban areas; significantly higher suicide rate in men than in women from rural areas, no difference in urban areas; differences in suicide frequency or age at suicide were observed between subjects of different marital status; violent methods of suicide were most frequently used; and psychological disorders were the most frequent causes of suicide. Many of these findings are observed for the first time. Some may be related to the characteristics of the population studied, whereas others may also be present in other populations.

Murder-suicide: A reaction to interpersonal crises.

PubMed

Haines, Janet; Williams, Christopher L; Lester, David

2010-10-10

The aim of this study was to examine the nature of homicide-suicides and determine the ways in which they differ from suicides without the perpetration of homicide in terms of their demographic characteristics, suicide, medical and psychiatric history, their psychological state leading up to the suicide, and their motives for their suicidal behavior. Cases of homicide-suicide from a 20-year period were extracted from the Coroner's inquest files and were matched to suicide-only cases on the basis of age and sex. The characteristics that predominantly distinguished the homicide-suicides were based on psychological state leading up to the act and motive for the act. It is proposed that homicide-suicides may be better understood within an expressive homicide framework. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Living arrangements and suicidal ideation among the Korean older adults.

PubMed

Kim, Jibum; Lee, Yun-Suk; Lee, Jinkook

2016-12-01

This study examines how living arrangements are associated with suicidal ideation for older adults in South Korea, which has the highest suicide rate among OECD countries, and a particularly high suicide rate for older persons. Analyzing a sample of 5795 women and 3758 men aged 65 and older from a nationwide representative cross-sectional data-set, we examined how many older adults think about suicide over a one-year period, why they think about suicide, and whether living arrangements are associated with suicidal ideation. About 1 out of 12 respondents in our sample reported suicidal ideation. While women and men did not differ in the prevalence of suicidal ideation, women attributed their suicidal feelings to health problems, while men attributed theirs to economic difficulties. Logistic regression results indicated that living arrangements are associated with suicidal ideation for men but not women. Older men living with a spouse were less likely to have suicidal ideation than older men with other living arrangements (i.e., living alone, living with children without spouse, living with spouse, and others). Our results highlight the importance of living arrangements to older men's suicidal ideation. We discuss gender differences in the implications of living arrangements to suicidal ideation within the context of Confucian culture.

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.

Risk of suicide ideation associated with problem-solving ability and attitudes toward suicidal behavior in university students.

PubMed

McAuliffe, Carmel; Corcoran, Paul; Keeley, Helen S; Perry, Ivan J

2003-01-01

The present paper investigates the risk of lifetime suicide ideation associated with problem-solving ability and attitudes toward suicidal behavior in a sample of 328 university students (41% male, 59% female). The response rate was 77% based on the total number of students registered for the relevant courses. A series of questions assessed lifetime suicide ideation, while problem solving and attitudes toward suicide were measured using the Self-Rating Problem Solving scale and four subscales of the Suicide Opinion Questionnaire, respectively (McLeavey, 1986; Domino et al., 1989). Almost one-third of the students surveyed had lifetime suicide ideation. Both genders were similar in terms of their suicide ideation history, problem solving, and attitudes toward suicidal behavior with the exception that male students were more in agreement with the attitude that suicidal behavior lacks real intent. Compared with 2% of nonideators and ideators, one in four planners reported that they would more than likely attempt suicide at some point in their life. Greater agreement with the attitude that suicidal behavior is normal was associated with significantly increased risk of being an ideator, as was poor problem solving and less agreement with the attitude that suicidal behavior is associated with mental illness.

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

PubMed

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

2017-06-01

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

Suicide and Suicidal Behavior

PubMed Central

Nock, Matthew K.; Borges, Guilherme; Bromet, Evelyn J.; Cha, Christine B.; Kessler, Ronald C.; Lee, Sing

2008-01-01

Suicidal behavior is a leading cause of injury and death worldwide. Information about the epidemiology of such behavior is important for policy-making and prevention. The authors reviewed government data on suicide and suicidal behavior and conducted a systematic review of studies on the epidemiology of suicide published from 1997 to 2007. The authors' aims were to examine the prevalence of, trends in, and risk and protective factors for suicidal behavior in the United States and cross-nationally. The data revealed significant cross-national variability in the prevalence of suicidal behavior but consistency in age of onset, transition probabilities, and key risk factors. Suicide is more prevalent among men, whereas nonfatal suicidal behaviors are more prevalent among women and persons who are young, are unmarried, or have a psychiatric disorder. Despite an increase in the treatment of suicidal persons over the past decade, incidence rates of suicidal behavior have remained largely unchanged. Most epidemiologic research on suicidal behavior has focused on patterns and correlates of prevalence. The next generation of studies must examine synergistic effects among modifiable risk and protective factors. New studies must incorporate recent advances in survey methods and clinical assessment. Results should be used in ongoing efforts to decrease the significant loss of life caused by suicidal behavior. PMID:18653727

Proximal risk factors and suicide methods among suicide completers from national suicide mortality data 2004-2006 in Korea.

PubMed

Im, Jeong-Soo; Choi, Soon Ho; Hong, Duho; Seo, Hwa Jeong; Park, Subin; Hong, Jin Pyo

2011-01-01

This study was conducted to examine differences in proximal risk factors and suicide methods by sex and age in the national suicide mortality data in Korea. Data were collected from the National Police Agency and the National Statistical Office of Korea on suicide completers from 2004 to 2006. The 31,711 suicide case records were used to analyze suicide rates, methods, and proximal risk factors by sex and age. Suicide rate increased with age, especially in men. The most common proximal risk factor for suicide was medical illness in both sexes. The most common proximal risk factor for subjects younger than 30 years was found to be a conflict in relationships with family members, partner, or friends. Medical illness was found to increase in prevalence as a risk factor with age. Hanging/Suffocation was the most common suicide method used by both sexes. The use of drug/pesticide poisoning to suicide increased with age. A fall from height or hanging/suffocation was more popular in the younger age groups. Because proximal risk factors and suicide methods varied with sex and age, different suicide prevention measures are required after consideration of both of these parameters. Copyright © 2011 Elsevier Inc. All rights reserved.

The specificity of public stigma: A comparison of suicide and depression-related stigma.

PubMed

Sheehan, Lindsay; Dubke, Rachel; Corrigan, Patrick W

2017-10-01

Each year, approximately 1.3 million Americans survive a suicide attempt. While stigma has been reported by suicide attempt survivors, limited research has examined how suicide stigma may differ from the stigma of mental illness. U.S. adults (n = 440) completed an online survey in which they were randomly assigned to one of four vignettes. Vignettes depicted a target individual with either past depression, past suicide attempt, death by suicide, or no information on suicide or mental illness (control). Participants completed a general measure of stigma, a suicide-specific stigma measure, and were surveyed on the recovery potential of individuals with mental illness and suicide attempt. While the general stigma measure failed to distinguish between groups, significant differences on the suicide stigma scale (SSAS-44) emerged between participants assigned in the depression and suicide conditions, especially for stereotype and prejudice subscales. Across conditions, participants believed that recovery was more realistic for someone described as having a mental illness than it was for someone described as having attempted suicide. These findings suggest that individuals who have attempted suicide are subject to differential stigma content from those with depression. Implications are discussed for combating stigma for suicide attempt survivors. Copyright © 2017 Elsevier B.V. All rights reserved.

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.

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

CONTEMPORARY PRINCIPLES OF SUICIDE PREVENTION.

PubMed

Ljusic, Dragana; Ravanic, Dragan; Filipovic Danic, Snezana; Soldatovic, Ivan; Cvetkovic, Jovana; Stojanovic Tasic, Mirjana

2016-11-01

Suicide remains a significant public health problem worldwide. This study is aimed at analyzing and presenting contemporary methods in suicide prevention in the world as well as at identifying specific risk groups and risk factors in order to explain their importance. in suicide prevention. The literature search covered electronic databases PubMed, Web of Science and Scopus. In order to select the relevant articles, the authors searched for the combination of key-words which included the following medical subject heading terms (suicide or suicide ideation or attempted) and (prevention or risk factors) and (man or elders or mental disorders). Data analysis covered meta-analyses, systematic reviews and original scientific papers with different characteristics of suicide preventions, risk factors and risk groups. Worldwide evidence-based interventions for suicide prevention are divided in universal, selective and indicated interventions. Restricted approach to various methods of committing suicide as well as pharmacotherapy contributes to a lower suicide rate. Suicide risk factors can be categorized as proximal and distal. The following groups are at highest risk of committing suicide: males. older persons and persons with registered psychiatric disorders. There is a lot of evidence that suicide is preventable. It is known that only 28 coun tries in the world have national suicide prevention strategies and Serbia is not one of them.

Temperament traits in suicidal and non-suicidal mood disorder patients in Taiwan.

PubMed

Liu, Shen-Ing; Huang, Yu-Hsin; Wu, Ying-Hui; Huang, Kuo-Yang; Huang, Hui-Chun; Sun, Fang-Ju; Huang, Chiu-Ron; Sung, Ming-Ru; Huang, Yo-Ping

2017-07-01

Suicide is a major social and clinical problem in Asia. Although studies have suggested that personality traits are possible risk factors for suicide, no study has been conducted among Chinese to compare the temperament traits of suicidal and non-suicidal mood disorder patients with those of healthy controls. This study compared temperament traits of two patient groups, those with a mood disorder who have attempted suicide (n=204), and those with a mood disorder who have not attempted suicide (n=160), and compared the traits of these patients to those of healthy controls (n=178), assessed by Cloninger's Tridimensional Personality Questionnaire and the Brown-Goodwin Aggression Inventory. Patients with suicidal attempts had significantly higher novelty seeking and aggression scores than healthy controls and patients without suicidal attempts. Two groups of patients with mood disorder had significantly higher harm avoidance scores than the healthy controls. However, patients with suicidal attempts did not have higher harm avoidance scores than patients without suicidal attempts. This study confirms findings that harm avoidance and mood disorder are related, and extends them by suggesting that those with a mood disorder and suicide attempts have higher novelty seeking and lifetime aggression scores than those without suicidal attempt, either patients or healthy controls. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Living Arrangements and Suicidal Ideation among the Korean Elderly

PubMed Central

Kim, Jibum; Lee, Yun-Suk; Lee, Jinkook

2016-01-01

Objectives This study examines how living arrangements are associated with suicidal ideation for older adults in South Korea, which has the highest suicide rate among OECD countries, and a particularly high suicide rate for older persons. Methods Analyzing a sample of 5,795 women and 3,758 men aged 65 and older from a nationwide representative cross-sectional data set, we examined how many older adults think about suicide over a one-year period, why they think about suicide, and whether living arrangements are associated with suicidal ideation. Results About one out of twelve respondents in our sample reported suicidal ideation. While women and men did not differ in the prevalence of suicidal ideation, women attributed their suicidal feelings to health problems, while men attributed theirs to economic difficulties. Logistic regression results indicated that living arrangements are associated with suicidal ideation for men but not women. Older men living with a spouse were less likely to have suicidal ideation than older men with other living arrangements (i.e., living alone, living with children without spouse, living with spouse and others). Conclusions Our results highlight the importance of living arrangements to older men’s suicidal ideation. We discuss gender differences in the implications of living arrangements to suicidal ideation within the context of Confucian culture. PMID:26317145

The Suicidal Narrative and Its Relationship to the Suicide Crisis Syndrome and Recent Suicidal Behavior.

PubMed

Cohen, Lisa Janet; Gorman, Bernard; Briggs, Jessica; Jeon, Min Eun; Ginsburg, Tal; Galynker, Igor

2018-02-04

In this study, we introduce the construct of the suicidal narrative, a hypothetical personal narrative linked to imminent suicide, and explore its relationship to near-term suicidal risk and the suicide crisis syndrome (SCS). Psychiatric outpatients (N = 289) were administered the Columbia Suicide-Severity Rating Scale (C-SSRS), Suicide Crisis Inventory (SCI), and Suicide Narrative Inventory (SNI), a novel instrument combining the documented risk factors of Thwarted Belongingness, Perceived Burdensomeness, Humiliation, Social Defeat, Goal Disengagement, and Goal Reengagement. Dimensional measures of past month, lifetime, and past suicidal phenomena, incorporating ideation and behavior, were calculated from the C-SSRS. Structural equation modeling was used to explore the interaction among variables. Factor analysis of the SNI yielded two orthogonal factors, termed Interpersonal and Goal Orientation. The former factor was comprised of Perceived Burdensomeness, Social Defeat, Humiliation, and Thwarted Belongingness, the latter of Goal Disengagement and Goal Reengagement. The Interpersonal factor correlated with both SCS severity and suicidal phenomena in each time frame and the Goal Orientation factor with no other variable. As hypothesized, the proposed model was significant for the past month only. Our findings support the construct of the suicidal narrative and its function as a near-term suicidal risk factor. © 2018 The American Association of Suicidology.

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

PubMed Central

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

2016-01-01

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

Reporting of suicide in the Australian media.

PubMed

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

2002-04-01

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

The clinical utility of the MMPI-2-RF Suicidal/Death Ideation Scale.

PubMed

Gottfried, Emily; Bodell, Lindsay; Carbonell, Joyce; Joiner, Thomas

2014-12-01

Suicide is a major public health concern, with over 100 individuals dying by suicide per day in the United States alone. Therefore, suicide risk assessment is an essential aspect of mental health care. The Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008-2011; Tellegen & Ben-Porath, 2008) has a Suicidal/Death Ideation (SUI) scale consisting of 5 items that describe recent suicidal ideation or behaviors. Although this scale has clear face validity, few studies have examined the clinical utility of this scale. The purpose of the current study was to examine associations between the SUI scale and other established measures of suicidal ideation and behavior, including the Depressive Symptom Inventory Suicidality Subscale (DSI-SS; Metalsky & Joiner, 1997), Beck Scale for Suicide Ideation (BSS; Beck & Steer, 1991; Beck, Steer, & Ranieri, 1988), self-report of lifetime suicide attempts, and clinician ratings of suicide risk. Participants were 998 therapy- and assessment-seeking outpatients. Analyses indicated that the SUI scale was positively associated with other self-reported measures of suicidal ideation and behavior. Significant differences in SUI scale scores also emerged among the clinician rating categories of suicide risk. The SUI scale was able to predict previous suicide attempts over and above age, gender, and other MMPI-2-RF scales related to depression. Finally, relative risk ratios for suicide attempts indicate increased risk of suicidality, with higher T scores on the SUI scale. Overall, findings suggest that the MMPI-2-RF SUI scale may be a useful tool for identifying individuals at risk for suicidal ideation and behavior in clinical settings. (c) 2014 APA, all rights reserved.

Relationship between peer victimization, cyberbullying, and suicide in children and adolescents: a meta-analysis.

PubMed

van Geel, Mitch; Vedder, Paul; Tanilon, Jenny

2014-05-01

Peer victimization is related to an increased chance of suicidal ideation and suicide attempts among children and adolescents. OBJECTIVE To examine the relationship between peer victimization and suicidal ideation or suicide attempts using meta-analysis. DATA SOURCES Ovid MEDLINE, PsycINFO, and Web of Science were searched for articles from 1910 to 2013. The search terms were bully*, teas*, victim*, mobbing, ragging, and harassment in combination with the term suic*. Of the 491 studies identified, 34 reported on the relationship between peer victimization and suicidal ideation, with a total of 284,375 participants. Nine studies reported on the relationship between peer victimization and suicide attempts, with a total of 70,102 participants. STUDY SELECTION Studies were eligible for inclusion if they reported an effect size on the relationship between peer victimization and suicidal ideation or suicide attempt in children or adolescents. Two observers independently coded the effect sizes from the articles. Data were pooled using a random effects model. MAIN OUTCOMES AND MEASURES This study focused on suicidal ideation and suicide attempts. Peer victimization was hypothesized to be related to suicidal ideation and suicide attempts. RESULTS Peer victimization was found to be related to both suicidal ideation (odds ratio, 2.23 [95% CI, 2.10-2.37]) and suicide attempts (2.55 [1.95 -3.34]) among children and adolescents. Analyses indicated that these results were not attributable to publication bias. Results were not moderated by sex, age, or study quality. Cyberbullying was more strongly related to suicidal ideation compared with traditional bullying. CONCLUSIONS AND RELEVANCE Peer victimization is a risk factor for child and adolescent suicidal ideation and attempts. Schools should use evidence-based practices to reduce bullying.

A literature review and meta-analyses of cannabis use and suicidality.

PubMed

Borges, Guilherme; Bagge, Courtney L; Orozco, Ricardo

2016-05-01

We lack a review of the epidemiological literature on cannabis use (acute use and chronic-usual quantity/frequency and heavy use) and suicidality (suicide death, suicide ideation, suicide attempt). The English language literature on Medline, PsychInfo, Google Scholar, and public-use databases was searched for original articles, critical review reports, and public use data on cannabis use and suicide for the period ranging from 1990-2015 (February). Odds ratios (OR) from random effects in meta-analyses for any cannabis use and heavy cannabis use were calculated. The acute cannabis-suicidality literature mostly includes descriptive toxicology reports. In terms of death by suicide, the average positive cannabis rate was 9.50% for studies sampling from all suicides, with higher cannabis detection rates amongst suicide decedents by non-overdose methods. We found only 4 studies providing estimates for any chronic cannabis use and death by suicide (OR=2.56 (1.25-5.27)). After deleting duplicates we found 6 studies on any cannabis use and suicide ideation (OR=1.43 (1.13-1.83)), 5 studies on heavy cannabis use and suicide ideation (OR=2.53 (1.00-6.39)), 6 studies on any cannabis use and suicide attempt (OR=2.23 (1.24-4.00)) and 6 studies on heavy cannabis use and suicide attempt (OR=3.20 (1.72-5.94)). We currently lack evidence that acute cannabis use increases imminent risk for suicidality. The evidence tends to support that chronic cannabis use can predict suicidality, but the lack of homogeneity in the measurement of cannabis exposure and, in some instances, the lack of systematic control for known risk factors tempered this finding. Copyright © 2016 Elsevier B.V. All rights reserved.

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

PubMed

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

2017-08-01

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

Predictors of psychological improvement on non-professional suicide message boards: content analysis.

PubMed

Niederkrotenthaler, T; Gould, M; Sonneck, G; Stack, S; Till, B

2016-12-01

Suicide message boards have been at the core of debates about negative influences of the Internet on suicidality. Nothing is currently known about communication styles that may help users to psychologically improve in these settings. In all, 1182 archival threads with 20 499 individual postings from seven non-professional suicide message boards supporting an 'against-suicide', 'neutral' or 'pro-suicide' attitude were randomly selected and subject to content analysis. Initial needs of primary posters (i.e. individual who open a thread), their psychological improvement by the end of the thread, their responses received and indicators of suicidality were coded. Differences between 'pro-suicide', 'neutral' and 'against suicide' boards, and correlations between primary posters and respondents in terms of suicidality were assessed. Logistic regression was used to test associations with psychological improvement. 'Pro-suicide' boards (n = 4) differed from 'neutral' (n = 1) and 'against-suicide' (n = 2) boards in terms of communicated contents. Indicators of suicidality correlated moderately to strongly between primary posters and respondents on 'pro-suicide' message boards, but less on other boards. Several communicative strategies were associated with psychological improvement in primary posters, including the provision of constructive advice [adjusted odds ratio (aOR) 4.10, 95% confidence interval (CI) 2.40-7.03], active listening (aOR 1.60, 95% CI 1.12-2.27), sympathy towards the poster (aOR 2.22, 95% CI 1.68-2.95) and provision of alternatives to suicide (aOR 2.30, 95% CI 1.67-3.18). Respondents resemble primary posters with regard to suicidality in 'pro-suicide' boards, which may hinder psychological improvement. Still, opportunities to intervene in these settings using simple communication techniques exist and need to be taken and evaluated.

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.

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.

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.

Estimating the rates of deaths by suicide among adults who attempt suicide in the United States.

PubMed

Han, Beth; Kott, Phillip S; Hughes, Art; McKeon, Richard; Blanco, Carlos; Compton, Wilson M

2016-06-01

In 2012, over 1.3 million U.S. adults reported that they attempted suicide in the past year, and 39,426 adults died by suicide. This study estimated national suicide case fatality rates among adult suicide attempters (fatal and nonfatal cases) and examined how they varied by sociodemographic characteristics. We pooled data on deaths by suicide (n = 147,427, fatal cases in the U.S.) from the 2008-2011 U S. mortality files and data on suicide attempters who survived (n = 2000 nonfatal cases) from the 2008-2012 National Surveys on Drug Use and Health. Descriptive analyses and multivariable logistic regression models were applied. Among adult suicide attempters in the U.S., the overall 12-month suicide case fatality rate was 3.2% (95% confidence interval (CI) = 2.9%-3.5%). It varied significantly by sociodemographic factors. For those aged 45 or older, the adjusted suicide case fatality rate was higher among men (7.6%) than among women (2.6%) (suicide case fatality rate ratio (SCFRR) = 3.0, 95% CI = 1.83-4.79), was higher among non-Hispanic whites (7.9%) than among non-white minorities (0.8-2.5%) (SCFRRs = 3.2-9.9), and was higher among those with less than high school education (16.0%) than among college graduates (1.8%) (SCFRR = 8.8, 95% CI = 3.83-20.16). Across male and female attempters, being aged 45 or older and non-Hispanic white and having less than secondary school were at a higher risk for death by suicide. Focusing on these demographic characteristics can help identify suicide attempters at higher risk for death by suicide, inform clinical assessments, and improve suicide prevention and intervention efforts by increasing high-risk suicide attempters' access to mental health treatment. Published by Elsevier Ltd.

The impact of indiscriminate media coverage of a celebrity suicide on a society with a high suicide rate: epidemiological findings on copycat suicides from South Korea.

PubMed

Ju Ji, Nam; Young Lee, Weon; Seok Noh, Maeng; Yip, Paul S F

2014-03-01

This study examines the extent to which the indiscriminate media coverage of the famous young actress Lee Eun-ju's suicide in 2005 affected suicides overall and in specific subgroups (by age, gender, and suicide method) in a suicide-prone society, South Korea. South Korea's 2003-2005 suicide data (n=34,237) were obtained from death certificate records of the National Statistical Office (NSO). Data was analyzed with Poisson time series auto-regression models. After adjusting for confounding factors (such as seasonal variation, calendar year, temperature, humidity, and unemployment rate), there was a significant increase in suicide (RR=1.40, 95%, CI=1.30-1.51, no. of excess mortalities=331; 95% CI=267-391) during the 4 weeks after Lee's suicide. This increase was more prominent in subgroups with similar characteristics to the celebrity. In particular, the relative risk of suicide during this period was the largest (5.24; 95% CI=3.31-8.29) in young women who used the same suicide method as the celebrity. Moreover, the incidence of these copycat suicides during the same time significantly increased in both genders and in all age subgroups among those who committed suicide using the same method as the celebrity (hanging). It is difficult to prove conclusively that the real motivation of the suicides was Lee's death. The findings from this study imply that, if the media indiscreetly reports the suicide of a celebrity in a suicide-prone society, the copycat effect can be far-reaching and very strong, particularly for vulnerable people. © 2013 Published by Elsevier B.V.

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

Methylomic profiling of cortex samples from completed suicide cases implicates a role for PSORS1C3 in major depression and suicide.

PubMed

Murphy, T M; Crawford, B; Dempster, E L; Hannon, E; Burrage, J; Turecki, G; Kaminsky, Z; Mill, J

2017-01-03

Major depressive disorder (MDD) represents a major social and economic health issue and constitutes a major risk factor for suicide. The molecular pathology of suicidal depression remains poorly understood, although it has been hypothesised that regulatory genomic processes are involved in the pathology of both MDD and suicidality. In this study, genome-wide patterns of DNA methylation were assessed in depressed suicide completers (n=20) and compared with non-psychiatric, sudden-death controls (n=20) using tissue from two cortical brain regions (Brodmann Area 11 (BA11) and Brodmann Area 25 (BA25)). Analyses focused on identifying differentially methylated regions (DMRs) associated with suicidal depression and epigenetic variation were explored in the context of polygenic risk scores for major depression and suicide. Weighted gene co-methylation network analysis was used to identify modules of co-methylated loci associated with depressed suicide completers and polygenic burden for MDD and suicide attempt. We identified a DMR upstream of the PSORS1C3 gene, subsequently validated using bisulfite pyrosequencing and replicated in a second set of suicide samples, which is characterised by significant hypomethylation in both cortical brain regions in MDD suicide cases. We also identified discrete modules of co-methylated loci associated with polygenic risk burden for suicide attempt, but not major depression. Suicide-associated co-methylation modules were enriched among gene networks implicating biological processes relevant to depression and suicidality, including nervous system development and mitochondria function. Our data suggest that there are coordinated changes in DNA methylation associated with suicide that may offer novel insights into the molecular pathology associated with depressed suicide completers.

Sexual Orientation Discordance and Nonfatal Suicidal Behaviors in U.S. High School Students.

PubMed

Annor, Francis B; Clayton, Heather B; Gilbert, Leah K; Ivey-Stephenson, Asha Z; Irving, Shalon M; David-Ferdon, Corinne; Kann, Laura K

2018-04-01

Studies among adults have documented association between sexual orientation discordance and some suicide risk factors. However, studies examining sexual orientation discordance and nonfatal suicidal behaviors in youth are rare. This study examines the association between sexual orientation discordance and suicidal ideation/suicide attempts among a nationally representative sample of U.S. high school students. Using sexual identity and sex of sexual contact measures from the 2015 national Youth Risk Behavior Survey (n=6,790), a sexual orientation discordance variable was constructed describing concordance and discordance (agreement and disagreement, respectively, between sexual identity and sex of sexual contacts). Three suicide-related questions (seriously considered attempting suicide, making a plan about how they would attempt suicide, and attempting suicide) were combined to create a two-level nonfatal suicide risk variable. Analyses were restricted to students who identified as heterosexual or gay/lesbian, who had sexual contact, and who had no missing data for sex or suicide variables. The association between sexual orientation discordance and nonfatal suicide risk was assessed using logistic regression. Analyses were performed in 2017. Approximately 4.0% of students experienced sexual orientation discordance. High suicide risk was significantly more common among discordant students compared with concordant students (46.3% vs 22.4%, p<0.0001). In adjusted models, discordant students were 70% more likely to have had suicidal ideation/suicide attempts compared with concordant students (adjusted prevalence ratio=1.7, 95% CI=1.4, 2.0). Sexual orientation discordance was associated with increased likelihood of nonfatal suicidal behaviors. Discordant adolescents may experience unique stressors that should be considered when developing and implementing suicide prevention programs. Published by Elsevier Inc.

Analysis of the phenomenon of attempted suicides in 1978-2010 in Poland, with particular emphasis on rural areas of Lublin Province.

PubMed

Makara-Studzińska, Marta; Sygit, Katarzyna; Sygit, Marian; Goździewska, Małgorzata; Zubilewicz, Jadwiga; Kryś-Noszczyk, Karolina

2012-01-01

The increasing quality of life of modern man should go hand-in-hand with reducing the scale of the problem of attempted suicides. During the last 55 years, the World Health Organization has recorded an increase in the number of suicides by about 60% in the developed and developing countries. In Poland, the highest rate of suicides have been committed by males, and the circumstances depended on gender, age and socio-economic factors. The aim of the presented study is to present the scale of the problem and present results of the analysis of the phenomenon of attempted suicides in 1978-2010, with particular emphasis on a Polish agricultural region - the Lublin Province in eastern Poland. 167,557 attempted suicides were analyzed across the country, included suicide attempts that resulted in death. Brief description of the state of knowledge and summary: Between 1978-2010 in Poland, the number of attempted suicides was higher in urban than in rural areas, especially among men aged between 31-50 years, while the tendency to commit suicide increased in rural areas in comparison to urban areas. Women usually represented a quarter of the people who attempted or committed suicide, with the majority cases reported in 2002. Most attempted suicides were carried out in the cities, but since 1990, the number of attempted suicides in the country is growing by an average of 8 per annum. In the Lublin Province, far more people are attempting to commit suicide in the rural areas. Despite the trend of increasing numbers of attempted suicides (about 4.36 suicides per year), the number of fatal suicides is decreasing, and the number of suicides committed by teenagers under 14 years of age is decreasing more dynamically.

Improving the detection and prediction of suicidal behavior among military personnel by measuring suicidal beliefs: an evaluation of the Suicide Cognitions Scale.

PubMed

Bryan, Craig J; David Rudd, M; Wertenberger, Evelyn; Etienne, Neysa; Ray-Sannerud, Bobbie N; Morrow, Chad E; Peterson, Alan L; Young-McCaughon, Stacey

2014-04-01

Newer approaches for understanding suicidal behavior suggest the assessment of suicide-specific beliefs and cognitions may improve the detection and prediction of suicidal thoughts and behaviors. The Suicide Cognitions Scale (SCS) was developed to measure suicide-specific beliefs, but it has not been tested in a military setting. Data were analyzed from two separate studies conducted at three military mental health clinics (one U.S. Army, two U.S. Air Force). Participants included 175 active duty Army personnel with acute suicidal ideation and/or a recent suicide attempt referred for a treatment study (Sample 1) and 151 active duty Air Force personnel receiving routine outpatient mental health care (Sample 2). In both samples, participants completed self-report measures and clinician-administered interviews. Follow-up suicide attempts were assessed via clinician-administered interview for Sample 1. Statistical analyses included confirmatory factor analysis, between-group comparisons by history of suicidality, and generalized regression modeling. Two latent factors were confirmed for the SCS: Unloveability and Unbearability. Each demonstrated good internal consistency, convergent validity, and divergent validity. Both scales significantly predicted current suicidal ideation (βs >0.316, ps <0.002) and significantly differentiated suicide attempts from nonsuicidal self-injury and control groups (F(6, 286)=9.801, p<0.001). Both scales significantly predicted future suicide attempts (AORs>1.07, ps <0.050) better than other risk factors. Self-report methodology, small sample sizes, predominantly male samples. The SCS is a reliable and valid measure that predicts suicidal ideation and suicide attempts among military personnel better than other well-established risk factors. Copyright © 2014 Elsevier B.V. All rights reserved.

Determining the effects of films with suicidal content: a laboratory experiment.

PubMed

Till, Benedikt; Strauss, Markus; Sonneck, Gernot; Niederkrotenthaler, Thomas

2015-07-01

Media stories on suicide can increase suicidal ideation, but little is known about variations in media effects with regard to audience vulnerability and story contents. We investigated the impact of three drama films with suicidal content that varied with regard to the final outcome (suicide completion, mastery of crisis and death by natural causes) and tested the moderating effect of baseline suicidality of the participants on the effects. Within a laboratory setting, we randomly assigned 95 adults to three film groups. We used questionnaires to analyse the effects of the films on mood, depression, life satisfaction, self-worth, assumed benevolence of the world and suicidality, as well as identification with the protagonist. We stratified the sample into participants with suicidal tendencies above and below the sample median. The film that ended with the protagonist's suicide led to a deterioration of mood particularly in individuals with baseline suicidality below the median, who also experienced an increase in self-worth. Participants with stronger suicidal tendencies experienced a rise in suicidality that depended on their level of identification with the protagonist. The film featuring the main character positively coping with his crisis increased life satisfaction particularly among participants with higher suicidal tendencies. The effects of suicide-related media material seem to vary with individual vulnerability and with type of media portrayal. Individuals with lower vulnerability experience more emotional reactions when exposed to a film culminating in suicide, but individuals with higher vulnerability experience a rise in suicidal tendencies particularly if they identify with the protagonist who died by suicide. In contrast, portrayals of individual mastery of crisis may have beneficial effects in more vulnerable individuals. © The Royal College of Psychiatrists 2015.

Methylomic profiling of cortex samples from completed suicide cases implicates a role for PSORS1C3 in major depression and suicide

PubMed Central

Murphy, T M; Crawford, B; Dempster, E L; Hannon, E; Burrage, J; Turecki, G; Kaminsky, Z; Mill, J

2017-01-01

Major depressive disorder (MDD) represents a major social and economic health issue and constitutes a major risk factor for suicide. The molecular pathology of suicidal depression remains poorly understood, although it has been hypothesised that regulatory genomic processes are involved in the pathology of both MDD and suicidality. In this study, genome-wide patterns of DNA methylation were assessed in depressed suicide completers (n=20) and compared with non-psychiatric, sudden-death controls (n=20) using tissue from two cortical brain regions (Brodmann Area 11 (BA11) and Brodmann Area 25 (BA25)). Analyses focused on identifying differentially methylated regions (DMRs) associated with suicidal depression and epigenetic variation were explored in the context of polygenic risk scores for major depression and suicide. Weighted gene co-methylation network analysis was used to identify modules of co-methylated loci associated with depressed suicide completers and polygenic burden for MDD and suicide attempt. We identified a DMR upstream of the PSORS1C3 gene, subsequently validated using bisulfite pyrosequencing and replicated in a second set of suicide samples, which is characterised by significant hypomethylation in both cortical brain regions in MDD suicide cases. We also identified discrete modules of co-methylated loci associated with polygenic risk burden for suicide attempt, but not major depression. Suicide-associated co-methylation modules were enriched among gene networks implicating biological processes relevant to depression and suicidality, including nervous system development and mitochondria function. Our data suggest that there are coordinated changes in DNA methylation associated with suicide that may offer novel insights into the molecular pathology associated with depressed suicide completers. PMID:28045465

The influence of media coverage of a celebrity suicide on subsequent suicide attempts.

PubMed

Cheng, Andrew T A; Hawton, Keith; Chen, Tony H H; Yen, Amy M F; Chen, Chung-Ying; Chen, Lin-Chen; Teng, Po-Ren

2007-06-01

To investigate the impact of media reporting of a celebrity suicide on subsequent suicide attempts. A Poisson time series autoregression analysis was conducted to examine whether there was a significant increase in suicide attempts during the 3-week period after the start of extensive media reporting of a celebrity suicide. The reporting began on May 2, 2005, and lasted about 17 days. To investigate the influence of media reporting on suicide attempts, a structured interview was conducted with 124 suicide attempters identified from 2 counties in Mid Taiwan who had exposure to the media reporting. After controlling for seasonal variation, calendar year, temperature, and humidity, there was a marked increase in the number of suicide attempts during the 3-week period after media reporting began (adjusted relative risk = 1.55, 95% CI = 1.26 to 1.91). Among 124 suicide attempters exposed to the media reports, 23.4% reported an influence from them. There was no relationship between the attempters' ages and the age of the celebrity or the method, but male attempters had a significantly higher risk for such influence. A considerably higher risk for such influence was found among subjects with a history of suicide attempt(s) in the previous year (odds ratio = 52.3, 95% CI = 5.96 to 459.1). The extensive media reporting of the suicide of a celebrity was followed by an increase in suicide attempts. The effect was particularly marked in individuals with a recent history of a suicide attempt. The results provide further support for the need for more restrained reporting of suicides as part of suicide prevention strategies and for special vigilance for contagious effects of such reporting on people who have carried out recent suicidal acts.

[Correlations between Beck's suicidal ideation scale, suicidal risk assessment scale RSD and Hamilton's depression rating scale].

PubMed

Ducher, J-L; Dalery, J

2008-04-01

Most of the people who will attempt suicide, talk about it beforehand. Therefore, recognition of suicidal risk is not absolutely impossible. Beck's suicidal ideation scale and Ducher's suicidal risk assessment scale (RSD) are common tools to help practicians in this way. These scales and the Hamilton's depression scale were included in an international multicentric, phase IV, double-blind study, according to two parallel groups who had been administered a fixed dose of fluvoxamin or fluoxetin for six weeks. This allowed examination of the correlations between these scales and the relations, which could possibly exist between suicidal risk, depression and anxiety. (a) Relationships between the Beck's suicidal ideation scale, the suicidal risk assessment scale RSD and Hamilton's depression before treatment. Before treatment, the analysis was conducted with 108 male and female depressive outpatients, aged 18 or over. Results revealed a significant positive correlation (with a Pearson's correlation coefficient r equal to 0.69 and risk p<0.0001) between Beck's suicidal ideation scale and the suicidal risk assessment scale RSD. These scales correlate less consistently with Hamilton's depression (Beck/Hamilton's depression: r=0.34; p=0.0004-RSD/Hamilton's depression: r=0.35; p=0.0002). We observed that the clinical anxiety scale by Snaith is also strongly correlated to these two suicidal risk assessment scales (Beck/CAS: r=0.48; p<0.0001-RSD/CAS: r=0.35; p=0.0005). Besides, the item "suicide" of Hamilton's depression scale accounts for more than a third of the variability of Beck's suicidal ideation scale and the suicidal risk assessment scale RSD. According to these results, the suicidal risk evaluated by these two scales seems to be significantly correlated with anxiety as much as with depression. On the other hand, the Clinical Global Impression is fairly significantly correlated with Beck's suicidal ideation scale (r=0.22; p=0.02), unlike the suicidal risk assessment scale RSD (r=0.42; p<0.0001) and Hamilton's depression scale (r=0.58; p<0.0001); (b) Relationships between Beck's suicidal ideation scale, the suicidal risk assessment scale RSD and Hamilton's depression under treatment. The follow-up under treatment (fluvoxamin or fluoxetin) during six weeks revealed the significantly better sensitivity of the RSD in comparison with Beck's suicidal ideation scale and Hamilton's depression scale, showing the significantly faster improvement in the RSD (p<0.0001). There was no significant difference between the evolution of Beck's suicidal ideation scale and Hamilton's depression scale. So, under treatment with fluvoxamin or fluoxetin, the improvement in suicidal risk appears to be as rapid as the improvement in depression. If we look at the treatment prescribed, only the suicidal risk assessment scale RSD revealed a significant difference between the two molecules, with more rapid improvement with fluvoxamin (p=0.015) from D14. In conclusion, the results of this study hypothesize that the suicidal risk, as assessed by Beck's suicidal ideation scale and the suicidal risk assessment scale RSD, appears to be consistently correlated with both the level of anxiety and depression. The study also suggests that all antidepressants may not be equally effective on suicidal risk.

Manifest Dream Content as a Predictor of Suicidality.

PubMed

Glucksman, Myron L; Kramer, Milton

2017-01-01

A number of behavioral, social, biological, and cultural factors are associated with suicide. However, the ability to predict an imminent suicide attempt remains problematic. Prior studies indicate that the manifest dream content of depressed, non-suicidal patients differs from that of depressed, suicidal patients. The dream imagery of depressed, suicidal patients contains themes of death, dying, violence, and departure. The dream imagery of depressed, non-suicidal patients contains themes of rejection, helplessness, hopelessness, humiliation, failure, and loss. In the present study, the dream reports of 52 depressed patients were collected and rated for various themes. Patients were divided into three groups: Depressed and non-suicidal; Depressed, with suicidal ideation; Depressed, with suicidal ideation and/or attempt(s). Themes of death and/or dying, and to a lesser extent, themes of violence, injury, and/or murder occurred with greater frequency in the dream reports of depressed patients with suicidal ideation and/or attempts, than in the dream reports of depressed patients without suicidal ideation or behavior. These observations correspond with the prevailing psychodynamic explanation of suicide; namely, that it is a murderous attack on the self that is identified with hated internalized objects.

Psychopathological characteristics and adverse childhood events are differentially associated with suicidal ideation and suicidal acts in mood disorders.

PubMed

Janiri, Delfina; Rossi, Pietro De; Kotzalidis, Georgios D; Girardi, Paolo; Koukopoulos, Alexia Emilia; Reginaldi, Daniela; Dotto, Francesco; Manfredi, Giovanni; Jollant, Fabrice; Gorwood, Philip; Pompili, Maurizio; Sani, Gabriele

2018-06-04

Depression is an important risk factor for suicide. However, other dimensions may contribute to the suicidal risk and to the transition from ideas to acts. We aimed to test the relative involvement of hopelessness, temperament, childhood trauma, and aggression in suicide risk in a large sample of patients with mood disorders. We assessed 306 patients with major depressive and bipolar disorders for clinical characteristics including hopelessness, temperament, childhood trauma, and aggression. We tested their associations with suicidal ideation and acts using standard univariate/bivariate methods, followed by multivariate logistic regression models. In multivariate analyses, the loss of expectations subscore of the hopelessness scale was associated with lifetime suicidal ideation but not suicide attempt. Childhood emotional abuse, severity of current depression, and female gender were associated with lifetime suicide attempts, whereas hyperthymic temperament was protective. Only hyperthymic temperament differentiated patients with a history of suicidal ideas vs. those with a history of suicide attempt. Findings support the association of hopelessness with suicidal ideation and point to considering in suicidal acts not only depression, but also childhood emotional abuse, hyperthymic temperament, and gender. Copyright © 2018. Published by Elsevier Masson SAS.

Correlation between Family Environment and Suicidal Ideation in University Students in China

PubMed Central

Zhai, Hui; Bai, Bing; Chen, Lu; Han, Dong; Wang, Lin; Qiao, Zhengxue; Qiu, Xiaohui; Yang, Xiuxian; Yang, Yanjie

2015-01-01

Background: This study investigated the association between suicidal ideation and family environment. The sample included 5183 Chinese university students. A number of studies on suicidal ideation have focused on individuals rather than families. This paper reviews the general principles of suicidal ideation and the consequences resulting from the family environment. Methods: This study used six different colleges as the dataset, which included 2645 males and 2538 females. Students were questioned with respect to social demographics and suicidal ideation factors. The data were analyzed with factor and logistic analyses to determine the association between suicidal ideation and poor family environment. Results: The prevalence of suicidal ideation was 9.2% (476/5183). Most participants with suicidal ideation had significant similarities: they had poor family structures and relationships, their parents had unstable work, and their parents used improper parenting styles. Female students were more likely to have suicidal thoughts than male students. Conclusions: This study shows that suicidal ideation is a public health issue among Chinese university students and demonstrates the importance of considering the family environment when examining university students’ suicidal ideation. Understanding family-related suicidal ideation risk factors can help to predict and prevent suicides among university students. PMID:25633031

Urban-Rural Differences in Suicide in the State of Maryland: The Role of Firearms.

PubMed

Nestadt, Paul S; Triplett, Patrick; Fowler, David R; Mojtabai, Ramin

2017-10-01

To assess whether the use of firearms explains rural-urban differences in suicide rates. We performed a retrospective analysis on all 6196 well-characterized adult suicides in Maryland from 2003 through 2015. We computed rate ratios by using census data and then stratified by sex, with adjustment for age and race. Suicide rates were higher in rural compared with urban counties. However, the higher rural suicide rates were limited to firearm suicides (incident rate ratio [IRR] = 1.66; 95% confidence interval [CI] = 1.20, 2.31). Nonfirearm suicide rates were not significantly higher in rural settings. Furthermore, 89% of firearm suicides occurred in men and the higher rural firearm suicide rate was limited to men (IRR = 1.36; 95% CI = 1.09, 1.69). Women were significantly less likely to complete suicide in rural areas (IRR = 0.63; 95% CI = 0.43, 0.94), regardless of method. Male firearm use drives the increased rate of suicide in rural areas. The opposite associations between urbanicity and suicide in men and women may be driven by the male preference for firearms as a method for committing suicide.

Is Case Management Effective for Long-Lasting Suicide Prevention?

PubMed

Wang, Liang-Jen; Wu, Ya-Wen; Chen, Chih-Ken

2015-01-01

Case management services have been implemented in suicide prevention programs. To investigate whether case management is an effective strategy for reducing the risks of repeated suicide attempts and completed suicides in a city with high suicide rates in northern Taiwan. The Suicide Prevention Center of Keelung City (KSPC) was established in April 2005. Subjects included a consecutive sample of individuals (N = 2,496) registered in KSPC databases between January 1, 2006, and December 31, 2011, with at least one episode of nonfatal self-harm. Subjects were tracked for the duration of the study. Of all the subjects, 1,013 (40.6%) received case management services; 416 (16.7%) had at least one other deliberate self-harm episode and 52 (2.1%) eventually died by suicide. No significant differences were found in the risks of repeated self-harm and completed suicides between suicide survivors who received case management and those who refused the services. However, a significant reduction in suicide rates was found after KSPC was established. Findings suggest that case management services might not reduce the risks of suicide repetition among suicide survivors during long-term follow-up. Future investigation is warranted to determine factors impacting the downward trend of suicide rates.

Completed Suicide with Violent and Non-Violent Methods in Rural Shandong, China: A Psychological Autopsy Study

PubMed Central

Sun, Shi-Hua; Jia, Cun-Xian

2014-01-01

Background This study aims to describe the specific characteristics of completed suicides by violent methods and non-violent methods in rural Chinese population, and to explore the related factors for corresponding methods. Methods Data of this study came from investigation of 199 completed suicide cases and their paired controls of rural areas in three different counties in Shandong, China, by interviewing one informant of each subject using the method of Psychological Autopsy (PA). Results There were 78 (39.2%) suicides with violent methods and 121 (60.8%) suicides with non-violent methods. Ingesting pesticides, as a non-violent method, appeared to be the most common suicide method (103, 51.8%). Hanging (73 cases, 36.7%) and drowning (5 cases, 2.5%) were the only violent methods observed. Storage of pesticides at home and higher suicide intent score were significantly associated with choice of violent methods while committing suicide. Risk factors related to suicide death included negative life events and hopelessness. Conclusions Suicide with violent methods has different factors from suicide with non-violent methods. Suicide methods should be considered in suicide prevention and intervention strategies. PMID:25111835

The social representations of suicide in France: An inter-regional study in Alsace and Brittany.

PubMed

Kopp-Bigault, Céline; Walter, Michel; Thevenot, Anne

2016-12-01

Suicide is a major worldwide public health issue. Various studies showed that individual attitudes toward suicide change in a region with high suicide rate. Attitudes are one of the components of a global and complex system: social representations (SRs). In France, the Brittany region has an abnormally high death rate due to suicides. Our research focuses on the SRs of suicide in this region. The hypothesis underlying this project is that suicide SRs are different between an area with a high suicide rate and a region less affected by suicide. A comparative study between the Brittany and Alsace regions, with the latter showing a statistically much lower suicide rate. The persons polled responded to a three-word free-association task around the question 'For you, suicide is …?' An analysis of word frequency and evocation rank was then carried out. In confirmation of our hypothesis, SRs were different between Brittany and the control region. The study's results open new avenues of research, specific to Brittany, in terms of the collective or individual effects of suicides, in terms of psycho-pathological conditions - essentially on depression, and in terms of training, on the stereotypes associated with suicide. © The Author(s) 2016.

Assessing the Use of Media Reporting Recommendations by the World Health Organization in Suicide News Published in the Most Influential Media Sources in China, 2003-2015.

PubMed

Chu, Xin; Zhang, Xingyi; Cheng, Peixia; Schwebel, David C; Hu, Guoqing

2018-03-05

Public media reports about suicide are likely to influence the population's suicidal attempts and completed suicides. Irresponsible reports might trigger copycat suicidal behaviors, while responsible reports may help reduce suicide rates. The World Health Organization (WHO) released recommendations to encourage responsible suicide reports in 2008. However, little is known about whether these recommendations are reflected in the suicide news for most countries, including China. In this study, we assessed the responsibility of suicide stories published in the most influential newspaper and Internet media sources in China from 2003 to 2015, using the media reporting recommendations by the World Health Organization (WHO). In total, 3965 and 1836 eligible stories from newspaper and Internet-based media, respectively, were included in the study. Newspapers and Internet-based media performed similarly in applying WHO recommendations to report suicide news. Three recommendations were applied in over 88% of suicide stories. However, four recommendations were seldom applied, including offering information about where to seek help and linking the suicide event to mental disorders. Government and the journalism industry should work together to improve media reporting of news about suicide in China.

Suicidal behavior and related traits among inpatient adolescents with first-episode schizophrenia.

PubMed

Shoval, Gal; Feld-Olspanger, Joy; Nahshoni, Eitan; Gothelf, Doron; Misgav, Sagit; Manor, Iris; Apter, Alan; Zalsman, Gil

2011-01-01

Suicide is a major cause of death in adolescents with first-episode schizophrenia (FES). The aim of this pilot study was to compare suicide-related traits between subjects with FES and those with other psychopathologies to evaluate risk factors for suicidal behavior. Twenty-five inpatient adolescents with FES and a control group of 28 psychiatric inpatients matched for sex and age were assessed for depression, anger, criminal behavior, aggression, and suicidal ideation, risk, and potential. The adolescents with FES had significantly lower depression (P = .003), anger (P = .025), and criminal behavior (P = .022) than did the controls. However, although suicide ideation was greater in the subjects with FES (P = .003), suicide risk was significantly lower than that in controls (P = .004). Decreased levels of both depression and anger as part of affective constriction in the group with schizophrenia could explain why the increased suicide ideation did not lead to a higher suicide risk in these inpatients. This study highlights the importance of distinguishing between suicidal ideation and actual suicide risk. We demonstrated that thoughts of suicide do not necessarily translate into an actual risk of suicidal behavior in adolescents with schizophrenia. Copyright © 2011 Elsevier Inc. All rights reserved.

Religion and spirituality along the suicidal path.

PubMed

Colucci, Erminia; Martin, Graham

2008-04-01

The inner experience of spiritual and religious feelings is an integral part of the everyday lives of many individuals. For over 100 years the role of religion as a deterrent to suicidal behavior has been studied in various disciplines. We attempt to systematize the existing literature investigating the relationship between religion/spirituality and suicide in this paper. After an overview of the attitudes of the dominant religions (e.g., Catholicism, Islam, and Buddhism) toward suicide, the three main theories that have speculated regarding the link between religion and suicide are presented: "integration theory" (Durkheim, 1897/1997), "religious commitment theory" (Stack, 1983a; Stark, 1983), and "network theory" (Pescosolido & Georgianna, 1989). Subsequent to this theoretical introduction, we report on studies on religion/spirituality keeping the suicidal path as a reference: from suicidal ideation to nonlethal suicidal behavior to lethal suicidal behavior. Studies presenting indications of religious beliefs as a possible risk factor for suicidal behavior are also presented. The last section reviews possible intervention strategies for suicidal patients and suicide survivors. Indications for future research, such as more studies on nonreligious forms of spirituality and the use of qualitative methodology to achieve a better and deeper understanding of the spiritual dimension of suicidal behavior and treatment, are offered.

Suicide Rates by Occupational Group - 17 States, 2012.

PubMed

McIntosh, Wendy LiKamWa; Spies, Erica; Stone, Deborah M; Lokey, Colby N; Trudeau, Aimée-Rika T; Bartholow, Brad

2016-07-01

In 2012, approximately 40,000 suicides were reported in the United States, making suicide the 10th leading reported cause of death for persons aged ≥16 years (1). From 2000 to 2012, rates of suicide among persons in this age group increased 21.1%, from 13.3 per 100,000 to 16.1 (1). To inform suicide prevention efforts, CDC analyzed suicide by occupational group, by ascribing occupational codes to 12,312 suicides in 17 states in 2012 from the National Violent Death Reporting System (NVDRS) (2). The frequency of suicide in different occupational groups was examined, and rates of suicide were calculated by sex and age group for these categories. Persons working in the farming, fishing, and forestry group had the highest rate of suicide overall (84.5 per 100,000 population) and among males (90.5); the highest rates of suicide among females occurred among those working in protective service occupations (14.1). Overall, the lowest rate of suicide (7.5) was found in the education, training, and library occupational group. Suicide prevention approaches directed toward persons aged ≥16 years that enhance social support, community connectedness, access to preventive services, and the reduction of stigma and barriers to help-seeking are needed.

Sociodemographic, lifestyle and health determinants of suicidal behaviour in Malaysia.

PubMed

Cheah, Yong Kang; Azahadi, Mohd; Phang, Siew Nooi; Abd Manaf, Noor Hazilah

2018-03-01

Suicide has become a serious matter in both developed and developing countries. The objective of the present study is to examine the factors affecting suicidal behaviour among adults in Malaysia. A nationally representative data which consists of 10,141 respondents is used for analysis. A trivariate probit model is utilised to identify the probability of having suicide ideation, suicide plan and suicide attempt. Results of the regression analysis show that to ensure unbiased estimates, a trivariate probit model should be used instead of three separate probit models. The determining factors of suicidal behaviour are income, age, gender, ethnicity, education, marital status, self-rated health and being diagnosed with diabetes and hypercholesterolemia. The likelihood of adopting suicidal behaviour is lower among higher income earners and older individuals. Being male and married significantly reduce the propensity to engage in suicidal behaviour. Of all the ethnic groups, Indian/others displays the highest likelihood of adopting suicidal behaviour. There is a positive relationship between poor health condition and suicide. Policies targeted at individuals who are likely to adopt suicidal behaviour may be effective in lowering the prevalence of suicide. Copyright © 2018 Elsevier B.V. All rights reserved.

TPH2 polymorphisms and alcohol-related suicide.

PubMed

Zupanc, Tomaž; Pregelj, Peter; Tomori, Martina; Komel, Radovan; Paska, Alja Videtič

2011-02-18

Substantial evidence from family, twin, and adoption studies corroborates implication of genetic and environmental factors, as well as their interactions, on suicidal behavior and alcoholism risk. Serotonergic disfunction seems to be involved in the pathophysiology of substance abuse, and has also an important role in suicidal behavior. Recent studies of the tryptophan hydroxylase 2 showed mild or no association with suicide and alcohol-related suicide. We performed SNP and alcohol analysis on 388 suicide victims and 227 controls. The results showed association between suicide (Pχ²=0.043) and alcohol-related suicide (Pχ²=0.021) for SNP Rs1843809. A tendency for association was determined also for polymorphism Rs1386493 (Pχ²=0.055) and alcohol-related suicide. Data acquired from psychological autopsies in a subsample of suicide victims (n=79) determined more impulsive behavior (Pχ²=0.016) and verbal aggressive behavior (Pχ²=0.025) in the subgroup with alcohol misuse or dependency. In conclusion, our results suggest implication of polymorphisms in suicide and alcohol-related suicide, but further studies are needed to clarify the interplay among serotonergic system disfunction, suicide, alcohol dependence, impulsivity and the role of TPH2 enzyme. © 2010 Elsevier Ireland Ltd. All rights reserved.

Psychological strains and youth suicide in rural China.

PubMed

Zhang, Jie; Wieczorek, William F; Conwell, Yeates; Tu, Xin Ming

2011-06-01

The strain theory of suicide postulates that suicide is usually preceded by psychological strains. A strain can be a consequence of any of four conflicts: differential values, aspiration and reality, relative deprivation, and lack of coping skills for a crisis. This study, with a blend of psychiatric and social predictors of suicide, identified correlates of suicide that are relevant to Chinese culture and tested the strain theory of suicide with Chinese data. We sampled 392 suicides and 416 living controls (both aged 15-34 years) from 16 rural counties in China in 2008 and interviewed two informants for each suicide and each control. We found that marriage and religion/religiosity did not distinguish the suicides from the living controls among Chinese rural young women. Religion/religiosity tended to be stronger for suicides than for controls. Psychological strains in the forms of relative deprivation, unrealized aspiration, and lack of coping skills were significantly associated with suicide, even after accounting for the role of mental illness. The strain theory of suicide forms a challenge to the psychiatric model popular in the West, at least in explaining the Chinese suicide. Copyright © 2011 Elsevier Ltd. All rights reserved.

Correlation between family environment and suicidal ideation in university students in China.

PubMed

Zhai, Hui; Bai, Bing; Chen, Lu; Han, Dong; Wang, Lin; Qiao, Zhengxue; Qiu, Xiaohui; Yang, Xiuxian; Yang, Yanjie

2015-01-27

This study investigated the association between suicidal ideation and family environment. The sample included 5183 Chinese university students. A number of studies on suicidal ideation have focused on individuals rather than families. This paper reviews the general principles of suicidal ideation and the consequences resulting from the family environment. This study used six different colleges as the dataset, which included 2645 males and 2538 females. Students were questioned with respect to social demographics and suicidal ideation factors. The data were analyzed with factor and logistic analyses to determine the association between suicidal ideation and poor family environment. The prevalence of suicidal ideation was 9.2% (476/5183). Most participants with suicidal ideation had significant similarities: they had poor family structures and relationships, their parents had unstable work, and their parents used improper parenting styles. Female students were more likely to have suicidal thoughts than male students. This study shows that suicidal ideation is a public health issue among Chinese university students and demonstrates the importance of considering the family environment when examining university students' suicidal ideation. Understanding family-related suicidal ideation risk factors can help to predict and prevent suicides among university students.

Early maladaptive schemas and suicidal risk in an Iranian sample of patients with obsessive-compulsive disorder.

PubMed

Khosravani, Vahid; Sharifi Bastan, Farangis; Samimi Ardestani, Mehdi; Jamaati Ardakani, Razieh

2017-09-01

There are few studies on suicidal risk and its related factors in patients diagnosed with obsessive-compulsive disorder (OCD). This study investigated the associations of early maladaptive schemas, OC symptom dimensions, OCD severity, depression and anxiety with suicidality (i.e., suicidal ideation and suicide attempts) in OCD patients. Sixty OCD outpatients completed the Scale for Suicide Ideation (SSI), the Young Schema Questionnaire-Short Form (YSQ-SF), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Dimensional Obsessive-Compulsive Scale (DOCS) and the Depression Anxiety Stress Scales (DASS-21). 51.7% of patients had lifetime suicide attempts and 75% had suicidal ideation. OCD patients with lifetime suicide attempts exhibited significantly higher scores on early maladaptive schemas than those without such attempts. Logistic regression analysis revealed that the mistrust/abuse schema and the OC symptom dimension of unacceptable thoughts explained lifetime suicide attempts. The mistrust/abuse schema, unacceptable thoughts and depression significantly predicted suicidal ideation. These findings indicated that the mistrust/abuse schema may contribute to high suicidality in OCD patients. Also, patients suffering from unacceptable thoughts need to be assessed more carefully for warning signs of suicide. Copyright © 2017 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

Outcome of patients with major depressive disorder after serious suicide attempt.

PubMed

Suominen, Kirsi; Haukka, Jari; Valtonen, Hanna M; Lönnqvist, Jouko

2009-10-01

To investigate the outcome of subjects with major depressive disorder after serious suicide attempt and to examine the effect of psychotic symptoms on their outcome. The study population included all individuals aged 16 years or older in Finland who were hospitalized with ICD-10 diagnoses of major depressive disorder and attempted suicide from 1996 to 2003 (N = 1,820). The main outcome measures were completed suicides, overall mortality, and repeated suicide attempts during drug treatment versus no treatment. During the 4-year follow-up period, 13% of patients died, 6% completed suicide, and 31% made a repeat suicide attempt. Subjects with major depression with psychotic features completed suicide more often than subjects without psychotic features during the follow-up (hazard ratio [HR] 3.32; 95% CI, 1.95 - 5.67). Antidepressant treatment reduced all-cause mortality by 24% (HR 0.74; 95% CI, 0.56 - 0.97) but did not reduce suicide mortality (HR 1.06; 95% CI, 0.71 - 1.58). Psychotic symptoms during major depressive episode increase the risk of completed suicide after serious suicide attempt. The quality of treatment for major depression with psychotic features after attempted suicide should be improved to prevent suicide. Copyright 2009 Physicians Postgraduate Press, Inc.

Gaps in Crisis Mental Health: Suicide and Homicide-Suicide.

PubMed

Carretta, Carrie M; Burgess, Ann W; Welner, Michael

2015-10-01

Gaps in crises of mental health emerge from poor distinction between the qualities of people who suicide and those who murder and then kill themselves. The role, if any, that substance use has in such lethal violence is an example of such a lack of distinction. In this study, a sample of medical examiner investigative and toxicology reports from Los Angeles and Orange counties in California were available for analysis for 432 suicide cases and 193 homicide-suicide cases. This informed clearer toxicological and pharmacological distinction of suicide from homicide-suicide. Blood alcohol levels were higher in persons committing suicide than in homicide-suicide perpetrators (p=.004). Homicide-suicide perpetrators had almost twice the level of stimulants in their system than people who suicide (p=.022) but did not have comparatively elevated levels of drugs or alcohol. Predictors of suicide included the following: substance abuse history, high number of drugs in system, death inside a house, and legal impairment by alcohol. Predictors of homicide-suicide included gunshot as the cause of death, female gender, domestic conflict, children living in the home, and prior arrest for substance abuse. Copyright © 2015 Elsevier Inc. All rights reserved.

Suicide and Suicidal Thoughts

MedlinePlus

... the best way to identify risk. Murder and suicide In rare cases, people who are suicidal are ... access to a firearm Starting antidepressants and increased suicide risk Most antidepressants are generally safe, but the ...

A structural equation model of perceived and internalized stigma, depression, and suicidal status among people living with HIV/AIDS.

PubMed

Zeng, Chengbo; Li, Linghua; Hong, Yan Alicia; Zhang, Hanxi; Babbitt, Andrew Walker; Liu, Cong; Li, Lixia; Qiao, Jiaying; Guo, Yan; Cai, Weiping

2018-01-15

Previous studies have shown positive association between HIV-related stigma and depression, suicidal ideation, and suicidal attempt among people living with HIV/AIDS (PLWH). But few studies have examined the mechanisms among HIV-related stigma, depression, and suicidal status (suicidal ideation and/or suicidal attempt) in PLWH. The current study examined the relationships among perceived and internalized stigma (PIS), depression, and suicidal status among PLWH in Guangzhou, China using structural equation modeling. Cross-sectional study by convenience sampling was conducted and 411 PLWH were recruited from the Number Eight People's Hospital from March to June, 2013 in Guangzhou, China. Participants were interviewed on their PIS, depressive symptoms, suicidal status, and socio-demographic characteristics. PLWH who had had suicidal ideation and suicidal attempts since HIV diagnosis were considered to be suicidal. Structural equation model was performed to examine the direct and indirect associations of PIS and suicidal status. Indicators to evaluate goodness of fit of the structural equation model included Chi-square Statistic, Comparative Fit Index (CFI), Root Mean Square Error of Approximation (RMSEA), Standardized Root Mean Square Residual (SRMR), and Weighted Root Mean Square Residual (WRMR). More than one-third (38.4%) of the PLWH had depressive symptoms and 32.4% reported suicidal ideation and/or attempt since HIV diagnosis. The global model showed good model fit (Chi-square value = 34.42, CFI = 0.98, RMSEA = 0.03, WRMR = 0.73). Structural equation model revealed that direct pathway of PIS on suicidal status was significant (standardized pathway coefficient = 0.21), and indirect pathway of PIS on suicidal status via depression was also significant (standardized pathway coefficient = 0.24). There was a partial mediating effect of depression in the association between PIS and suicidal status. Our findings suggest that PIS is associated with increased depression and the likelihood of suicidal status. Depression is in turn positively associated with suicidal status and plays a mediating role between PIS and suicidal status. Therefore, to reduce suicidal ideation and attempt in PLWH, targeted interventions to reduce PIS and improve mental health status of PLWH are warranted.

The Reciprocal Relationship between Suicidality and Stigma.

PubMed

Carpiniello, Bernardo; Pinna, Federica

2017-01-01

Although suicidality is frequently the cause of stigma, it is conversely true that stigma may be the cause of suicidality. The present paper focuses on the complex relationships that exist between suicidal behavior and stigmatizing attitudes. A narrative review of the topic will be presented on the basis of the relevant literature collected from an electronic search of PubMed, ISI Web of Knowledge, and Scopus databases, using stigma, public stigma, structural stigma, perceived stigma, self-stigma, suicide, attempted suicide, and suicidality as key words. A negative perception is frequently held of suicidal people, labeling them as weak and unable to cope with their problems, or selfish. Individuals who have attempted suicide are subject to similar processes of stigmatization and "social distancing"; insurance policies include an exclusion clause against death by suicide. Subjects with a direct personal experience of depression or suicide strongly endorse a feeling of self-stigma; those who have attempted suicide are often ashamed and embarrassed by their behavior and tend to hide the occurrence as much as possible. Similar processes are observed among family members of subjects who have committed suicide or made a suicide attempt, with a higher perceived stigma present in those bereaved by suicide. Perceived or internalized stigma produced by mental or physical disorders, or through belonging to a minority group, may represent a significant risk factor for suicide, being severely distressing, reducing self-esteem and acting as a barrier in help-seeking behaviors. With the aim of preventing suicide, greater efforts should be made to combat the persisting stigmatizing attitudes displayed toward mental disorders and suicide itself. Indeed, the role of stigma as a risk factor for suicide should further motivate and spur more concerted efforts to combat public stigma and support those suffering from perceived or internalized stigma. Experts and scientific societies should form an alliance with the media in an effort to promote a marked change in the societal perception of mental health issues and suicide. As stigma may result in severe consequences, specialist care and psychological interventions should be provided to populations submitted to stigma.

Suicide among people with epilepsy: A population-based analysis of data from the U.S. National Violent Death Reporting System, 17 states, 2003-2011.

PubMed

Tian, Niu; Cui, Wanjun; Zack, Matthew; Kobau, Rosemarie; Fowler, Katherine A; Hesdorffer, Dale C

2016-08-01

This study analyzed suicide data in the general population from the U.S. National Violent Death Reporting System (NVDRS) to investigate suicide burden among those with epilepsy and risk factors associated with suicide and to suggest measures to prevent suicide among people with epilepsy. The NVDRS is a multiple-state, population-based, active surveillance system that collects information on violent deaths including suicide. Among people 10years old and older, we identified 972 suicide cases with epilepsy and 81,529 suicide cases without epilepsy in 17 states from 2003 through 2011. We estimated their suicide rates, evaluated suicide risk among people with epilepsy, and investigated suicide risk factors specific to epilepsy by comparing those with and without epilepsy. In 16 of the 17 states providing continual data from 2005 through 2011, we also compared suicide trends in people with epilepsy (n=833) and without epilepsy (n=68,662). From 2003 through 2011, the estimated annual suicide mortality rate among people with epilepsy was 16.89/100,000 per persons, 22% higher than that in the general population. Compared with those without epilepsy, those with epilepsy were more likely to have died from suicide in houses, apartments, or residential institutions (81% vs. 76%, respectively) and were twice as likely to poison themselves (38% vs. 17%) (P<0.01). More of those with epilepsy aged 40-49 died from suicide than comparably aged persons without epilepsy (29% vs. 22%) (P<0.01). The proportion of suicides among those with epilepsy increased steadily from 2005 through 2010, peaking significantly in 2010 before falling. For the first time, the suicide rate among people with epilepsy in a large U.S. general population was estimated, and the suicide risk exceeded that in the general population. Suicide prevention efforts should target people with epilepsy 40-49years old. Additional preventive efforts include reducing the availability or exposure to poisons, especially at home, and supporting other evidence-based programs to reduce mental illness comorbidity associated with suicide. Published by Elsevier Inc.

Contributors to suicidality in rural communities: beyond the effects of depression

PubMed Central

2012-01-01

Background Rural populations experience a higher suicide rate than urban areas despite their comparable prevalence of depression. This suggests the identification of additional contributors is necessary to improve our understanding of suicide risk in rural regions. Investigating the independent contribution of depression, and the impact of co-existing psychiatric disorders, to suicidal ideation and suicide attempts in a rural community sample may provide clarification of the role of depression in rural suicidality. Methods 618 participants in the Australian Rural Mental Health Study completed the Composite International Diagnostic Interview, providing assessment of lifetime suicidal ideation and attempts, affective disorders, anxiety disorders and substance-use disorders. Logistic regression analyses explored the independent contribution of depression and additional diagnoses to suicidality. A receiver operating characteristic (ROC) analysis was performed to illustrate the benefit of assessing secondary psychiatric diagnoses when determining suicide risk. Results Diagnostic criteria for lifetime depressive disorder were met by 28% (174) of the sample; 25% (154) had a history of suicidal ideation. Overall, 41% (63) of participants with lifetime suicidal ideation and 34% (16) of participants with a lifetime suicide attempt had no history of depression. When lifetime depression was controlled for, suicidal ideation was predicted by younger age, being currently unmarried, and lifetime anxiety or post-traumatic stress disorder. In addition to depression, suicide attempts were predicted by lifetime anxiety and drug use disorders, as well as younger age; being currently married and employed were significant protective factors. The presence of comorbid depression and PTSD significantly increased the odds of reporting a suicide attempt above either of these conditions independently. Conclusions While depression contributes significantly to suicidal ideation, and is a key risk factor for suicide attempts, other clinical and demographic factors played an important role in this rural sample. Consideration of the contribution of factors such as substance use and anxiety disorders to suicidal ideation and behaviours may improve our ability to identify individuals at risk of suicide. Acknowledging the contribution of these factors to rural suicide may also result in more effective approaches for the identification and treatment of at-risk individuals. PMID:22873772

Addressing the surveillance goal in the National Strategy for Suicide Prevention: the Department of Defense Suicide Event Report.

PubMed

Gahm, Gregory A; Reger, Mark A; Kinn, Julie T; Luxton, David D; Skopp, Nancy A; Bush, Nigel E

2012-03-01

The US National Strategy for Suicide Prevention (National Strategy) described 11 goals across multiple areas, including suicide surveillance. Consistent with these goals, the Department of Defense (DoD) has engaged aggressively in the area of suicide surveillance. The DoD's population-based surveillance system, the DoD Suicide Event Report (DoDSER) collects information on suicides and suicide attempts for all branches of the military. Data collected includes suicide event details, treatment history, military and psychosocial history, and psychosocial stressors at the time of the event. Lessons learned from the DoDSER program are shared to assist other public health professionals working to address the National Strategy objectives.

Suicide clusters among young Kenyan men.

PubMed

Goodman, Michael L; Puffer, Eve S; Keiser, Philip H; Gitari, Stanley

2017-11-01

Suicide is a leading cause of global mortality. Suicide clusters have recently been identified among peer networks in high-income countries. This study investigates dynamics of suicide clustering within social networks of young Kenya men ( n = 532; 18-34 years). We found a strong, statistically significant association between reported number of friends who previously attempted suicide and present suicide ideation (odds ratio = 1.9; 95% confidence interval (1.42, 2.54); p < 0.001). This association was mediated by lower collective self-esteem (23% of total effect). Meaning in life further mediated the association between collective self-esteem and suicide ideation. Survivors of peer suicide should be evaluated for suicide risk.

Risk factors of suicide attempt among people with suicidal ideation in South Korea: a cross-sectional study.

PubMed

Choi, Soo Beom; Lee, Wanhyung; Yoon, Jin-Ha; Won, Jong-Uk; Kim, Deok Won

2017-06-15

Suicide is a serious public health concern worldwide, and the fourth leading cause of death in Korea. Few studies have focused on risk factors for suicide attempt among people with suicidal ideation. The aim of the present study was to investigate the risk factors and develop prediction models for suicide attempt among people with suicidal ideation in the Korean population. This study included 1567 men and 3726 women aged 20 years and older who had suicidal ideation from the Korea National Health and Nutrition Examination Survey from 2007 to 2012. Among them, 106 men and 188 women attempted suicide. Multivariate logistic regression analysis with backward stepwise elimination was performed to find risk factors for suicide attempt. Sub-group analysis, dividing participants into under 50 and at least 50 years old was also performed. Among people with suicidal ideation, age, education, cancer, and depressive disorder were selected as risk factors for suicide attempt in men. Age, education, national basic livelihood security, daily activity limitation, depressive disorder, stress, smoking, and regular exercise were selected in women. Area under curves of our prediction models in men and women were 0.728 and 0.716, respectively. It is important to pay attention to populations with suicidal ideation and the risk factors mentioned above. Prediction models using the determined risk factors could be useful to detect high-risk groups early for suicide attempt among people with suicidal ideation. It is necessary to develop specific action plans for these high-risk groups to prevent suicide.

Hypnotic Medications and Suicide: Risk, Mechanisms, Mitigation, and the FDA.

PubMed

McCall, W Vaughn; Benca, Ruth M; Rosenquist, Peter B; Riley, Mary Anne; McCloud, Laryssa; Newman, Jill C; Case, Doug; Rumble, Meredith; Krystal, Andrew D

2017-01-01

Insomnia is associated with increased risk for suicide. The Food and Drug Administration (FDA) has mandated that warnings regarding suicide be included in the prescribing information for hypnotic medications. The authors conducted a review of the evidence for and against the claim that hypnotics increase the risk of suicide. This review focused on modern, FDA-approved hypnotics, beginning with the introduction of benzodiazepines, limiting its findings to adults. PubMed and Web of Science were searched, crossing the terms "suicide" and "suicidal" with each of the modern FDA-approved hypnotics. The FDA web site was searched for postmarketing safety reviews, and the FDA was contacted with requests to provide detailed case reports for hypnotic-related suicide deaths reported through its Adverse Event Reporting System. Epidemiological studies show that hypnotics are associated with an increased risk for suicide. However, none of these studies adequately controlled for depression or other psychiatric disorders that may be linked with insomnia. Suicide deaths have been reported from single-agent hypnotic overdoses. A separate concern is that benzodiazepine receptor agonist hypnotics can cause parasomnias, which in rare cases may lead to suicidal ideation or suicidal behavior in persons who were not known to be suicidal. On the other hand, ongoing research is testing whether treatment of insomnia may reduce suicidality in adults with depression. The review findings indicate that hypnotic medications are associated with suicidal ideation. Future studies should be designed to assess whether increases in suicidality result from CNS impairments from a given hypnotic medication or whether such medication decreases suicidality because of improvements in insomnia.

The application of the interpersonal-psychological theory of suicide to a sample of Swiss patients attending a psychiatric emergency department for a non-lethal suicidal event.

PubMed

Baertschi, Marc; Costanza, Alessandra; Richard-Lepouriel, Hélène; Pompili, Maurizio; Sarasin, François; Weber, Kerstin; Canuto, Alessandra

2017-03-01

Visits to emergency departments (EDs) for suicidal ideation or a suicide attempt have increased in the past decades. Yet comprehensive models of suicide are scarce, potentially enhancing misunderstandings from health professionals. This study aimed to investigate the applicability of the interpersonal-psychological theory of suicide (IPTS) in a population visiting EDs for suicide-related issues. Three major hypotheses formulated by the IPTS were tested in a sample of 167 individuals visiting EDs for suicidal ideation or a suicide attempt. As predicted by the IPTS, greater levels of perceived burdensomeness (PB) were associated with presence of current suicidal ideation. However, contrary to the theory assumptions, thwarted belongingness (TB) was not predictive of current suicidal ideation (Hypothesis 1). Similarly, the interaction between PB, TB and hopelessness did not account for the transition from passive to active suicidal ideation (Hypothesis 2). The interaction between active suicidal ideation and fearlessness of death did not either predict the transition from active suicidal ideation to suicidal intent (Hypothesis 3). The cross-sectional design limited the interpretation of causal hypotheses. Patients visiting EDs during nights and weekends were underrepresented. A general measure of hopelessness was considered, not a measure of hopelessness specifically related to PB and TB. Although the three hypotheses were only partially verified, health professionals might consider the IPTS as useful for the management of patient with suicide-related issues. Clinical intervention based on perceived burdensomeness could notably be proposed shortly after ED admission. Copyright © 2017 Elsevier B.V. All rights reserved.

Maternal or paternal suicide and offspring's psychiatric and suicide-attempt hospitalization risk.

PubMed

Kuramoto, S Janet; Stuart, Elizabeth A; Runeson, Bo; Lichtenstein, Paul; Långström, Niklas; Wilcox, Holly C

2010-11-01

We examined whether the risk for psychiatric morbidity requiring inpatient care was higher for offspring who experienced parental suicide, compared with offspring of fatal accident decedents, and whether the association varied according to the deceased parent's gender. Children and adolescents (0-17 years of age) who experienced maternal (N = 5600) or paternal (N = 17,847) suicide in 1973-2003 in Sweden were identified by using national, longitudinal, population-based registries. Cox regression modeling was used to compare psychiatric hospitalization risks among offspring of suicide decedents and propensity score-matched offspring of accident decedents. Offspring of maternal suicide decedents had increased risk of suicide-attempt hospitalization, after controlling for psychiatric hospitalization for decedents and surviving parents, compared with offspring of maternal accidental decedents. Offspring of paternal suicide decedents had similar risk of suicide-attempt hospitalization, compared with offspring of accident decedents, but had increased risk of hospitalization attributable to depressive and anxiety disorders. The magnitude of risks for offspring suicide-attempt hospitalization was greater for those who experienced maternal versus paternal suicide, compared with their respective control offspring (interaction P = .05; offspring of maternal decedents, adjusted hazard ratio: 1.80 [95% confidence interval: 1.19-2.74]; offspring of paternal decedents, adjusted hazard ratio: 1.14 [95% confidence interval: 0.96-1.35]). Maternal suicide is associated with increased risk of suicide-attempt hospitalization for offspring, beyond the risk associated with maternal accidental death. However, paternal suicide is not associated with suicide-attempt hospitalization. Future studies should examine factors that might differ between offspring who experience maternal versus paternal suicide, including genetic or early environmental determinants.

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

Suicidal behavior-related hospitalizations among pregnant women in the USA, 2006-2012.

PubMed

Zhong, Qiu-Yue; Gelaye, Bizu; Miller, Matthew; Fricchione, Gregory L; Cai, Tianxi; Johnson, Paula A; Henderson, David C; Williams, Michelle A

2016-06-01

Suicide is one of the leading causes of maternal mortality in many countries, but little is known about the epidemiology of suicide and suicidal behavior among pregnant women in the USA. We sought to examine trends and provide nationally representative estimates for suicidal behavior (including suicidal ideation and suicide and self-inflicted injury) among pregnant women from 2006 to 2012 in the USA. Pregnant women aged 12-55 years were identified through pregnancy- and delivery-related hospitalization records from the National (Nationwide) Inpatient Sample. Suicidal behavior was identified by the International Classification of Diseases, Ninth Revision, Clinical Modification codes. Annual, nationwide estimates and trends were determined using discharge and hospital weights. The prevalence of suicidal ideation more than doubled from 2006 to 2012 (47.5 to 115.0 per 100,000 pregnancy- and delivery-related hospitalizations), whereas the prevalence of suicide and self-inflicted injury remained stable. Nearly 10 % of suicidal behavior occurred in the 12-18-year group, showing the highest prevalence per 100,000 pregnancy- and delivery-related hospitalizations (158.8 in 2006 and 308.7 in 2012) over the study period. For suicidal ideation, blacks had higher prevalence than whites; women in the lowest income quartile had the highest prevalence. Although the prevalence of suicidal behavior was higher among hospitalizations with depression diagnoses, more than 30 % of hospitalizations were for suicidal behavior without depression diagnoses. Our findings highlight the increasing burden and racial differences in suicidal ideation among US pregnant women. Targeted suicide prevention efforts are needed for high-risk pregnant women including teens, blacks, and low-income women.

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.

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

PubMed Central

Mergl, Roland; Hegerl, Ulrich

2017-01-01

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

Suicides and Medically Serious Attempters Are of the Same Population in Chinese Rural Young Adults1

PubMed Central

Zhang, Jie; Sun, Long; Conwell, Yeates; Qin, Ping; Jia, Cun-Xian; Xiao, Shuiyuan; Tu, Xin-Ming

2015-01-01

Background Suicide rates in China are among the highest in the world, although there has been a decreasing trend in the past few years. One practical approach to study the characteristics and risk factors of suicide is to interview the suicide attempters. Aims It was to compare completed suicides with serious attempters that may shed lights on suicide prevention strategies. Method This is a combination of two case control studies for suicide completers and suicide attempters respectively. After a sample of suicides (n=392) and community living controls (n=416) were obtained and studied in rural China, we collected in the same rural areas data of suicide attempt and studied 507 medically serious attempters and 503 community counterparts. Results Characteristics and previously observed risk factors were compared between the suicides and the attempters, and we found that the demographic characteristics and risk factors for the suicides were also for the medically serious attempters but at some lesser degrees for the attempters than for the suicides. It was especially true of suicide intent, deficient coping, negative life events, and impulsivity. While most of the demographic characteristics were not significantly different between the suicides and the attempters, most of the clinical variables could distinguish the two groups. Conclusions The suicide victims and the serious attempters could be of the same group of people who were at the edge of fatal self-injury, and the same clinical risk factors but of different degrees have divided them into the life and death groups. PMID:25723561

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

PubMed

Paul, Elise; Mergl, Roland; Hegerl, Ulrich

2017-01-01

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

Suicide-Related Knowledge and Confidence Among Behavioral Health Care Staff in Seven States.

PubMed

Silva, Caroline; Smith, April R; Dodd, Dorian R; Covington, David W; Joiner, Thomas E

2016-11-01

Death by suicide is a serious and growing public health concern in the United States. This noncontrolled, naturalistic study examined professionals' knowledge about suicide and confidence in working with suicidal individuals, comparing those who had received either of two gatekeeper trainings-Question, Persuade, and Refer (QPR) or Applied Suicide Intervention Skills Training (ASIST)-or other suicide-relevant training or no training. Participants (N=16,693) were individuals in various professional roles in the field of behavioral health care in Indiana, Kentucky, New York, Pennsylvania, Tennessee, Texas, and Utah. Participants completed a survey assessing suicide knowledge and skills confidence. Most participants (52.9%) reported no previous suicide prevention or assessment training. Individuals with suicide-relevant training demonstrated greater suicide knowledge and confidence than those with no such training. Among those who had received any training, no differences were found in suicide knowledge; however, individuals who had received ASIST reported greater confidence in working with suicidal individuals, compared with those who had received other training. Professional role and prior experience with a client who had died by suicide had significant positive relationships with suicide knowledge and confidence. Regional differences emerged between states and are examined within the context of statewide suicide prevention initiatives. Increasing access to and incentives for participating in suicide-relevant training among behavioral health care staff may foster a more knowledgeable and confident group of gatekeepers. Future research should examine whether increases in knowledge and confidence among staff translate into actual changes in practice that help protect and serve at-risk individuals.

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.

ERP investigation of attentional disengagement from suicide-relevant information in patients with major depressive disorder.

PubMed

Baik, Seung Yeon; Jeong, Minkyung; Kim, Hyang Sook; Lee, Seung-Hwan

2018-01-01

Previous studies suggest the presence of attentional bias towards suicide-relevant information in suicidal individuals. However, the findings are limited by their reliance on behavioral measures. This study investigates the role of difficulty in disengaging attention from suicide-relevant stimuli using the P300 component of event-related potentials (ERPs). Forty-four adults with Major Depressive Disorder (MDD) were administered the spatial cueing task using suicide-relevant and negatively-valenced words as cue stimuli. Disengagement difficulty was measured using reaction time and P300 during invalid trials. P300 amplitudes at Pz were higher in suicide-relevant compared to negatively-valenced word condition on invalid trials for participants with low rates of suicidal behavior. However, no such difference was found among participants with high rates of suicidal behavior. P300 amplitudes for suicide-relevant word condition were negatively correlated with "lifetime suicide ideation and attempt" at Pz. No significant results were found for the reaction time data, indicating that the ERP may be more sensitive in capturing the attentional disengagement effect. The groups were divided according to Suicidal Behaviors Questionnaire-Revised (SBQ-R) total score. Neutral stimulus was not included as cue stimuli. Most participants were under medication during the experiment. Our results indicate that patients with MDD and low rates of suicidal behavior show difficulty in disengaging attention from suicide-relevant stimuli. We suggest that suicide-specific disengagement difficulties may be related to recentness of suicide attempt and that acquired capability for suicide may contribute to reduced disengagement difficulties. Copyright © 2017 Elsevier B.V. All rights reserved.

Completed suicides and self-harm in Malaysia: a systematic review.

PubMed

Armitage, Christopher J; Panagioti, Maria; Abdul Rahim, Wirda; Rowe, Richard; O'Connor, Rory C

2015-01-01

Most of the research into suicide and self-harm has been conducted in the United States and Europe, yet the volume of research does not reflect the distribution of suicide globally, with Asia accounting for up to 60% of all suicides. The present study systematically reviews the literature to assess the prevalence and correlates of suicidal acts in Malaysia in Southeast Asia. Five relevant databases were searched from inception up to February 2014, and a narrative synthesis of the results from the included studies was performed. Studies were eligible for inclusion if they were correlational survey research and archival/observational research describing self-harm and suicide. Outcomes included completed suicides and self-harm including suicide attempts and self-poisoning, suicide plans and suicidal ideation. In total, 39 studies met the inclusion criteria. The principal findings were that the prevalence of suicide in Malaysia is approximately 6-8 per 100,000 population per year and that there is an excess of suicide among men, people younger than 40 years and the Indian minority group. The past-month prevalence rates of suicidal ideation, plans and attempts are 1.7, 0.9% and 0.5%, respectively, whereas the past-year prevalence rates of suicidal ideation range between 6% and 8%. The present research marks a first step towards understanding the prevalence and correlates of suicide and self-harm in Malaysia. However, the heterogeneity of the included studies was high. Further research into the antecedents, consequences and interventions for suicide and self-harm in the Malaysian context is required. Copyright © 2015 Elsevier Inc. All rights reserved.

Sleep disorders and the interpersonal-psychological theory of suicide: independent pathways to suicidality?

PubMed

Nadorff, Michael R; Anestis, Michael D; Nazem, Sarra; Claire Harris, H; Samuel Winer, E

2014-01-01

Although sleep disorders are a risk factor for suicidal behavior little research has examined why sleep disorders confer suicide risk. The present study examined the relation between two sleep disorders, insomnia symptoms and nightmares, and suicide risk in the context of Joiner's interpersonal-psychological theory of suicide (IPTS). The present study utilized two large samples (N=747 and 604) recruited from two large public universities in the Southeast. Both studies included measures of insomnia symptoms, nightmares, depressive symptoms, and prior suicide attempts. In addition, study one contained a measure of suicide risk. In study 1, the relations between insomnia symptoms and both suicide risk and prior attempts were not significant after controlling for the IPTS. However, nightmares were related to both suicide risk and suicide attempts independent of the IPTS. Furthermore, nightmares nearly missed significance in the prediction of suicide risk (p=0.054) and significantly predicted suicide attempts even after controlling for depressive symptoms. In study 2, both insomnia and nightmares were found to be significantly associated with prior suicide attempts after controlling for the IPTS and depressive symptoms. The study is limited by its use of a college sample and cross-sectional design. These studies suggest that the IPTS may not explain the relation between sleep problems and suicidality. More research is needed to understand the mechanism by which sleep disorders confer suicide risk, which is clinically relevant as it may inform specific interventions to reduce the adverse effects of sleep disorders. © 2013 Published by Elsevier B.V.

Lithium and suicide prevention in bipolar disorder.

PubMed

Benard, V; Vaiva, G; Masson, M; Geoffroy, P A

2016-06-01

Bipolar disorder (BD) is a severe and recurrent psychiatric disorder. The severity of prognosis in BD is mainly linked to the high rate of suicide in this population. Indeed, patients with BD commit suicide 20 to 30 times more frequently than the general population, and half of the BD population with an early age of onset have a history of suicide attempt. International therapeutic guidelines recommend lithium (Li) as the first-line treatment in BD for its prophylactic action on depressive or manic episodes. In addition, Li is the only mood stabilizer that has demonstrated efficacy in suicide prevention. This effect of Li is unfortunately often unknown to psychiatrists. Thus, this review aims to highlight evidence about the preventive action of Li on suicide in BD populations. We conducted a literature search between April 1968 and August 2014 in PubMed database using the following terms: "lithium" AND "suicide" OR "suicidality" OR "suicide attempt". As confirmed by a recent meta-analysis, many studies show that Li has a significant effect on the reduction of suicide attempts and deaths by suicide in comparison to antidepressants or other mood-stabilisers in BD populations. Studies have demonstrated that long-term treatment with Li reduces suicide attempts by about 10% and deaths by suicide by about 20%. The combination of Li and an antidepressant could reduce suicidal behaviours by reducing suicidal ideation prior to depressive symptoms. It appears crucial for Li efficacy in suicide prevention to maintain the Li blood concentrations in the efficient therapeutic zone and to instate long-term Li treatment. The "impulsive-aggressive" endophenotype is associated with suicide in BD. The specific action of Li on the 5-HT serotoninergic system could explain the specific anti-suicidal effects of Li via the modulation of impulsiveness and aggressiveness. Furthermore, genetic variants of the glycogen synthase kinase 3α/β (GSK3α and β; proteins inhibited by Li) seem to be associated with more impulsiveness in BD populations. The anti-suicidal effect of Li has been very well demonstrated. By its specific action on the serotoninergic system, treatment with Li significantly reduces "impulsive-aggressive" behaviour which is a vulnerability factor common to suicide and BD. Long-term appropriately modulated treatment with Li seems to have considerable impact on the reduction of suicidal behaviours, suicidal ideation and death by suicide in the BD population. Copyright © 2016 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Preventing Suicide through Improved Training in Suicide Risk Assessment and Care: An American Association of Suicidology Task Force Report Addressing Serious Gaps in U.S. Mental Health Training

ERIC Educational Resources Information Center

Schmitz, William M., Jr.; Allen, Michael H.; Feldman, Barry N.; Gutin, Nina J.; Jahn, Danielle R.; Kleespies, Phillip M.; Quinnett, Paul; Simpson, Skip

2012-01-01

There are twice as many suicides as homicides in the United States, and the suicide rate is rising. Suicides increased 12% between 1999 and 2009. Mental health professionals often treat suicidal patients, and suicide occurs even among patients who are seeking treatment or are currently in treatment. Despite these facts, training of most mental…

The Impact of Rock Videos and Music with Suicidal Content on Thoughts and Attitudes about Suicide.

ERIC Educational Resources Information Center

Rustad, Robin A.; Small, Jacob E.; Jobes, David A.; Safer, Martin A.; Peterson, Rebecca J.

2003-01-01

Two experiments exposed college student volunteers to rock music with or without suicidal content. Music and videos with suicide content appeared to prime implicit cognitions related to suicide but did not affect variables associated with increased suicide risk. (Contains 60 references and 3 tables.) (Author/JBJ)

Assessment of Psychiatrically Hospitalized Suicidal Adolescents: Self-Report Instruments as Predictors of Suicidal Thoughts and Behavior

ERIC Educational Resources Information Center

Huth-Bocks, Alissa C.; Kerr, David C. R.; Ivey, Asha Z.; Kramer, Anne C.; King, Cheryl A.

2007-01-01

Objective: The validity and clinical utility of the Reynolds Adolescent Depression Scale, Beck Hopelessness Scale, Suicidal Ideation Questionnaire-Junior, and Suicide Probability Scale (SPS) were examined longitudinally among suicidal adolescents. Method: Between 1998 and 2000, 289 psychiatrically hospitalized, suicidal youth, ages 12 to 17 years,…

You Can't Recover from Suicide: Perspectives on Suicide Education in MSW Programs

ERIC Educational Resources Information Center

Ruth, Betty J.; Gianino, Mark; Muroff, Jordana; McLaughlin, Donna; Feldman, Barry N.

2012-01-01

Suicide is a profound worldwide public health problem that has received increased attention in recent years. The major federal response, the National Strategy for Suicide Prevention, calls for more suicide education for mental health professionals, including social workers. Little is known about the amount of suicide education in MSW curricula…

Suicides in the Developing World: Case Study from Pakistan

ERIC Educational Resources Information Center

Khan, Murad Moosa; Hyder, Adnan Ali

2006-01-01

There are no official data on suicide from Pakistan, a conservative South Asian Islamic country with traditionally low suicide rates. Both suicide and attempted suicide are illegal acts, as well as socially and religiously condemned, making research in this area difficult. Recent reports suggest an increase in suicide rates. In this study, police…

Personal Suicidality in Reception and Identification with Suicidal Film Characters

ERIC Educational Resources Information Center

Till, Benedikt; Vitouch, Peter; Herberth, Arno; Sonneck, Gernot; Niederkrotenthaler, Thomas

2013-01-01

The authors investigated the impact of suicidality on identity work during film exposure. Adults with low suicidality ("n" = 150) watched either "It's My Party" or "The Fire Within," censored versions of these films not depicting the suicide, or the control film that concluded with a non-suicidal death. Baseline…

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

ERIC Educational Resources Information Center

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

2012-01-01

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

Domains of Chronic Stress and Suicidal Behaviors among Inpatient Adolescents

ERIC Educational Resources Information Center

Pettit, Jeremy W.; Green, Kelly L.; Grover, Kelly E.; Schatte, Dawnelle J.; Morgan, Sharon T.

2011-01-01

Little is known about the role of chronic stress in youth suicidal behaviors. This study examined the relations between specific domains of chronic stress and suicidal behaviors among 131 inpatient youth (M age = 15.02 years) who completed measures of stress, suicidal ideation, suicide attempt, and suicide intent. After controlling for…

Suicides and Suicide Attempts in the U.S. Military, 2008-2010

ERIC Educational Resources Information Center

Bush, Nigel E.; Reger, Mark A.; Luxton, David D.; Skopp, Nancy A.; Kinn, Julie; Smolenski, Derek; Gahm, Gregory A.

2013-01-01

The Department of Defense Suicide Event Report Program collects extensive information on suicides and suicide attempts from the U.S. Air Force, Army, Marine Corps, and Navy. Data are compiled on demographics, suicide event details, behavioral health treatment history, military history, and information about other potential risk factors such as…

Assessing the Effects of Peer Suicide on Youth Suicide

ERIC Educational Resources Information Center

Feigelman, William; Gorman, Bernard S.

2008-01-01

Using data from all waves of the National Longitudinal Survey of Adolescent Health, we investigated the short-term and long-term impact of an adolescent friend's suicide on an adolescent's depression and suicidality. Results suggest that a friend's suicide is associated with heightened suicide thoughts and attempts and greater depression during…

Predicting Suicidal Ideation with the Depression Hopelessness and Suicide Screening Form (DHS)

ERIC Educational Resources Information Center

Mills, Jeremy F.; Kroner, Daryl G.

2008-01-01

The current study examines a series of interactions between a prior history of suicidal behavior and cognitions permissive of suicide, and the variables of depression and hopelessness in the relationship with suicidal ideation in two samples of incarcerated offenders. Results indicate that both a prior history of suicidal behavior and cognitions…

Comprehensive College Student Suicide Assessment: Application of the BASIC ID

ERIC Educational Resources Information Center

Paladino, Derrick; Minton, Casey A. Barrio

2008-01-01

Whether one knows someone who is thinking of suicide, has attempted suicide, or has completed suicide, nearly all individuals who encounter suicide are affected. The influence and residual affects of suicide are further amplified as the issue reaches across communities such as college or university campuses. College and university staff must…

Religiousness and Non-Hopeless Suicide Ideation

ERIC Educational Resources Information Center

Simonson, Randy H.

2008-01-01

Individuals who think about suicide but do not feel suicidally hopeless tend to be less religious and can therefore entertain thoughts of suicide unabated by religiousness. Religiousness, suicide ideation, and hopelessness were surveyed among 279 Idaho college students, 37 (13%) of whom were non-hopeless suicide ideators. A total of only 21 (7%)…

The Newsworthiness of Suicide

ERIC Educational Resources Information Center

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

2007-01-01

There is a paucity of studies examining which suicides are considered newsworthy. By combining data on media reports of individuals' suicides with routinely collected suicide data, it was found that 1% of Australian suicides were reported over a 1-year period. There was evidence of over-reporting of suicides by older people and females, and those…

Trajectories of Suicidal Ideation from Sixth through Tenth Grades in Predicting Suicide Attempts in Young Adulthood in an Urban African American Cohort.

PubMed

Musci, Rashelle J; Hart, Shelley R; Ballard, Elizabeth D; Newcomer, Alison; Van Eck, Kathryn; Ialongo, Nicholas; Wilcox, Holly

2016-06-01

The trajectory of suicidal ideation across early adolescence may inform the timing of suicide prevention program implementation. This study aimed to identify developmental trajectories of suicidal ideation among an urban cohort of community-residing African Americans (AA) longitudinally followed from middle school through early adulthood (ages 11-19 years). Subtypes based on the developmental course of suicidal ideation from late childhood through mid-adolescence were identified using longitudinal latent class analysis (LLCA) with 581 AA adolescents (52.7% male; 71.1% free or reduced school meals). The developmental trajectories of suicidal ideation were then used to predict suicide attempts in young adulthood. Our LLCA indicated two subtypes (i.e., ideators and nonideators), with 8% of the sample in the ideator class. This trajectory class shows a peak of suicidal ideation in seventh grade and a steady decline in ideation in subsequent grades. Additionally, suicidal ideation trajectories significantly predicted suicide attempt. Results of these analyses suggest the need for suicide prevention approaches prior to high school for AA youth. © 2015 The American Association of Suicidology.

Gratitude and suicidal ideation and suicide attempts among Chinese adolescents: direct, mediated, and moderated effects.

PubMed

Li, Dongping; Zhang, Wei; Li, Xian; Li, Nini; Ye, Baojuan

2012-02-01

In a sample of 1252 Chinese adolescents (mean age = 15.00 years), this study examined the direct relations between gratitude and adolescents' suicidal ideation and suicide attempts. This study also examined indirect relations between gratitude and suicidal ideation and suicide attempts via two self-system beliefs--coping efficacy and self-esteem. Finally, this study examined the extent to which stressful life events moderated the direct and indirect relations between gratitude and suicidal ideation and suicide attempts. The odds of suicidal ideation and suicide attempts were lower among adolescents who scored higher on gratitude, after controlling for demographic variables. Self-esteem mediated the relations between gratitude and suicidal ideation and suicide attempts, while the mediating role of coping efficacy was not significant. Moreover, stressful life events moderated the mediated path through self-esteem. This indirect effect was stronger for adolescents low on stressful life events than that for those high on stressful life events. This study discusses the theoretical and practical implications of these findings. Copyright © 2011 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

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.

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.

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

The use of technology in Suicide Prevention.

PubMed

Larsen, Mark E; Cummins, Nicholas; Boonstra, Tjeerd W; O'Dea, Bridianne; Tighe, Joe; Nicholas, Jennifer; Shand, Fiona; Epps, Julien; Christensen, Helen

2015-01-01

Suicide is one of the leading causes of death globally, and is notably a significant cause of death amongst young people. A suicide outcome is a complex combination of personal, social, and health factors, and therefore suicide prevention is a challenge, requiring a systems approach incorporating public health strategies, screening at-risk individuals, targeted interventions, and follow-up for suicide survivors and those bereaved by suicide. Engineering practice has been implicated in the hindrance of the adoption of suicide prevention strategies, such as installing safety barriers at the Golden Gate Bridge, however technological developments offer new opportunities in suicide prevention, and the potential to reduce the number of deaths by suicide. We present an overview of current technological developments which are facilitating research in the field of suicide prevention, including multiple modes of screening such as network analysis of mobile-phone collected connectivity data, automatic detection of suicidality from social media content, and crisis detection from acoustic variability in speech patterns. The current field of mhealth apps for suicide prevention is assessed, and an innovative app for an Indigenous population is presented. From this overview, future challenges - technical and ethical - are discussed.

Suicide and attempted suicide: epidemiological surveillance as a crucial means of a local suicide prevention project in Trento's Province.

PubMed

Di Napoli, Wilma Angela; Della Rosa, Alberto

2015-09-01

The World Health Organization identifies suicide among the top 10 causes of death in many countries with an overall mortality rate of 16 per 100,000 inhabitants. Furthermore suicide attempts present a frequency 4-10 times greater than the suicidal events, representing also one of the main risk factors to lead to recurrent attempts of suicide. In 2008 the Autonomous Province of Trento launched a suicide prevention pogram called "Invitation to Life" which includes various interventions intended to counter the phenomenon of suicide in the region. Actually the epidemiological research upon the phenomenon of suicide in Trentino region is one of the main pillars of the project: it represents a fundamental requirement to identify risk and protective factors in the population in order to adopt more specific and effective preventive strategies. This article aims to present methods and instruments for epidemiological monitoring of suicide and attempted suicide which are applied in Trentino and to describe results after seven years from the beginning of the local prevention program "Invitation to life".

Suicide in Iran: The Facts and the Figures from Nationwide Reports

PubMed Central

Hassanian-Moghaddam, Hossein; Zamani, Nasim

2017-01-01

Objective: Data on national rates of suicide is limited in Iran, preventing an action plan for health scope of suicide prevention. The current brief study was conducted to review available national published data on suicide and to interpret the probable discrepancies. Method: We evaluated all 20-year recent published original articles on committed suicides searching Iranian scientific databases, PubMed, and Google Scholar with the keywords of suicide, mortality, and Iran. Results: Articles showed an overall increased trend of suicidal deaths in Iran. Discrepancies existed regarding suicide rate and demographic characteristics among 9 English and Persian published articles. Although a suicide rate of 6.2 per 100 000 was reported in 2003, almost 31 times greater than 1991, an average suicide rate of 9.9 per 100 000 was calculated based on data interpretations. Conclusion: Apparently, Iran has had the highest increase in suicide-related deaths among Eastern Mediterranean Region (EMR) and Islamic countries during the recent decades. National policies to prevent suicide have not been efficient enough, and urgent intervention is needed.‏ PMID:28496505

Patterns and predictors of help-seeking contacts with health services and general practitioner detection of suicidality prior to suicide: a cohort analysis of suicides occurring over a two-year period.

PubMed

Leavey, Gerard; Rosato, Michael; Galway, Karen; Hughes, Lynette; Mallon, Sharon; Rondon, Janeet

2016-04-30

Contact with primary care and psychiatric services prior to suicide may be considerable, presenting opportunities for intervention. However, there is scant knowledge on the frequency, nature and determinants of contact. Retrospective cohort study-an analysis of deaths recorded as suicide by the Northern Ireland Coroner's Office linked with data from General Practice patient records over a 2 year period Eighty-seven per cent of suicides were in contact with General Practice services in the 12 months before suicide. The frequency of contact with services was considerable, particularly among patients with a common mental disorder or substance misuse problems. A diagnosis of psychiatric problems was absent in 40% of suicides. Excluding suicide attempts, the main predictors of a noted general practitioner concern for patient suicidality are male gender, frequency of consultations, diagnosis of mental illness and substance misuse. Despite widespread and frequent contact, a substantial proportion of suicidal people were undiagnosed and untreated for mental health problems. General Practitioner alertness to suicidality may be too narrowly focused.

Suicide in America: Frequently Asked Questions

MedlinePlus

... a will Do People Threaten Suicide to Get Attention? Suicidal thoughts or actions are a sign of ... of suicide should be taken seriously and requires attention. Threatening to die by suicide is not a ...

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

[Association of loneliness, impulsivity and alcohol use with suicidal behavior in adolescents].

PubMed

Salvo G, Lilian; Castro S, Andrea

2013-04-01

Suicide and suicide attempts are public health problems. Their prevention requives the detection of predictor factors. To determine the predictive valué of loneliness, impulsivity and alcohol use on suicidal behavior in adolescents. Suicidal behavior, Loneliness (UCLA), Impulsivity (Barratt) scales and the Alcohol Use Disorders Identification Test (AUDIT), were applied to 763 high school students aged 14 to 19 years (49% males), living in Chillan, Chile. Nineteen percent of participants had attempted suicide and 34.3% had suicidal ideation. Loneliness, impulsivity and alcohol use were directly related to suicidal behavior. These predictors explained 31 % of the suicidal behavior. The most important risk factor was loneliness, followed by femóle gender, impulsivity and alcohol use. Loneliness, impulsivity and alcohol use are risk factors for suicide among adolescents. Women are at higher risk than men.

Child and Adolescent Clinical Features Preceding Adult Suicide Attempts.

PubMed

Serra, Giulia; Koukopoulos, Athanasios; De Chiara, Lavinia; Napoletano, Flavia; Koukopoulos, Alexia; Sani, Gabriele; Faedda, Gianni L; Girardi, Paolo; Reginaldi, Daniela; Baldessarini, Ross J

2017-07-03

The objective of this study was to identify the predictive value of juvenile factors for adult suicidal behavior. We reviewed clinical records to compare factors identified in childhood and adolescence between adult suicidal versus nonsuicidal major affective disorder subjects. Suicide attempts occurred in 23.1% of subjects. Age-at-first-symptom was 14.2 vs. 20.2 years among suicidal versus nonsuicidal subjects (p < 0.0001). More prevalent in suicidal versus non-suicidal subjects by multivariate analysis were: depressive symptoms, hyper-emotionality, younger-at-first-affective-episode, family suicide history, childhood mood-swings, and adolescence low self-esteem. Presence of one factor yielded a Bayesian sensitivity of 64%, specificity of 50%, and negative predictive power of 86%. Several juvenile factors were associated with adult suicidal behavior; their absence was strongly associated with a lack of adult suicidal behavior.

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.

Biological basis of suicide and suicidal behavior

PubMed Central

Pandey, Ghanshyam N

2013-01-01

Objective Suicide is a major public health concern as each year 30,000 people die by suicide in the US alone. In the teenage population, it is the second leading cause of death. There have been extensive studies of psychosocial factors associated with suicide and suicidal behavior. However, very little is known about the neurobiology of suicide. Recent research has provided some understanding of the neurobiology of suicide, which is the topic of this review. Methods Neurobiology of suicide has been studied using peripheral tissues, such as platelets, lymphocytes, and cerebral spinal fluid obtained from suicidal patients or from the postmortem brains of suicide victims. Results These studies have provided encouraging information with regard to the neurobiology of suicide. They show an abnormality of serotonergic mechanism, such as increased serotonin receptor subtypes and decreased serotonin metabolites, such as 5-hydroxyindoleacetic acid. These studies also suggest abnormalities of receptor-linked signaling mechanisms, such as phosphoinositide and adenylyl cyclase signaling mechanisms. Other biological systems that appear to be dysregulated in suicide are the hypothalamic-pituitary-adrenal (HPA) axis, and abnormalities of neurotrophins and neurotrophin receptors. More recently, several studies also indicate abnormalities of neuroimmune functions in suicide. Conclusions These studies have been discussed in detail in the following review. Some encouraging information has emerged, primarily related to some of these neurobiological mechanisms. It is hoped that neurobiological studies may eventually result in identifying appropriate biomarkers for suicidal behavior as well as appropriate therapeutic targets for its treatment. PMID:23773657

Rising longitudinal trajectories in suicide rates: The role of firearm suicide rates and firearm legislation.

PubMed

Anestis, Michael D; Selby, Edward A; Butterworth, Sarah E

2017-07-01

Firearms account for approximately half of all US suicide deaths each year despite being utilized in only a small minority of suicide attempts. We examined the extent to which overall suicide rates fluctuated relative to firearm and non-firearm suicide rates across a period of 16years (1999-2015). We further tested the notion of means substitution by examining the association between firearm suicide rates and non-firearm suicide rates. Lastly, we examined the extent to which the presence of specific laws related to handgun ownership previously shown cross-sectionally to be associated with lower suicide rates (universal background checks, mandatory waiting periods) were associated with an attenuated trajectory in suicide rates across the study period. As anticipated, whereas decreases in firearm suicide rates were associated with decreases in overall suicide rates (b=0.46, SE=0.07, p<0.001), decreases in firearm suicides were not associated with off-setting increases in suicides by other methods (b=-0.04, SE=0.05, p=0.36). Furthermore, the absence of universal background check (b=0.12, SE=0.05, p=0.028) and mandatory waiting period (b=0.16, SE=0.06, p=0.008) laws was associated with a more steeply rising trajectory of statewide suicide rates. These results mitigate concerns regarding means substitution and speak to the potential high yield impact of systematically implemented means safety prevention efforts focused on firearms. Copyright © 2017 Elsevier Inc. All rights reserved.

Suicidal ideation and suicide attempts in a nationwide sample of operational Norwegian ambulance personnel.

PubMed

Sterud, Tom; Hem, Erlend; Lau, Bjørn; Ekeberg, Oivind

2008-01-01

This is the first paper on suicidal ideation and attempts among ambulance personnel. This study aimed to investigate levels of suicidal ideation and suicide attempts among ambulance personnel, and to identify important correlates and the factors to which ambulance personnel attribute their serious suicidal ideation. A comprehensive nationwide questionnaire survey of 1,180 operational ambulance personnel was conducted. Measurements included: Paykel's Suicidal Feelings in the General Population questionnaire, the Hospital Anxiety and Depression scale, the Subjective Health Complaints Questionnaire, the Maslach Burnout Inventory, the Job Satisfaction Scale, the Basic Character Inventory, and the Rosenberg Self-Esteem Scale. Lifetime prevalence ranged from 28% for feelings that life was not worth living to 10.4% for seriously considered suicide and 3.1% for a suicide attempt. Serious suicidal ideation was independently associated with job-related emotional exhaustion (feelings of being overextended and depleted of resources) (OR 1.5, 95% CI 1.1-2.0) and bullying at work (OR 1.7, 95% CI 1.02-2.7), younger age, not married/cohabitant, depression symptoms, low self-esteem and the personality trait reality weakness. In general, suicidal thoughts were hardly attributable to working conditions, since only 1.8% of ambulance personnel attributed suicidal ideation to work problems alone. In conclusion, ambulance personnel reported a moderate level of suicidal ideation and suicide attempts. Although serious suicidal ideation was rarely attributed to working conditions in general, this study suggests that job-related factors like emotional exhaustion and bullying may be of importance.

[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.

Predictors of suicide in the patient population admitted to a locked-door psychiatric acute ward

PubMed Central

Fosse, Roar; Ryberg, Wenche; Carlsson, Merete Kvalsvik; Hammer, Jan

2017-01-01

Objective No prior study appears to have focused on predictors of suicide in the general patient population admitted to psychiatric acute wards. We used a case-control design to investigate the association between suicide risk factors assessed systematically at admission to a locked-door psychiatric acute ward in Norway and subsequent death by suicide. Method From 2008 to 2013, patients were routinely assessed for suicide risk upon admission to the acute ward with a 17-item check list based on recommendations from the Norwegian Directorate of Health and Social Affairs. Among 1976 patients admitted to the ward, 40 patients, 22 men and 18 women, completed suicide within December 2014. Results Compared to a matched control group (n = 120), after correction for multiple tests, suicide completers scored significantly higher on two items on the check list: presence of suicidal thoughts and wishing to be dead. An additional four items were significant in non-corrected tests: previous suicide attempts, continuity of suicidal thoughts, having a suicide plan, and feelings of hopelessness, indifference, and/or aggression. A brief scale based on these six items was the only variable associated with suicide in multivariate regression analysis, but its predictive value was poor. Conclusion Suicide specific ideations may be the most central risk markers for suicide in the general patient population admitted to psychiatric acute wards. However, a low predictive value may question the utility of assessing suicide risk. PMID:28301590

Suicidal ideation, suicide attempt, and occupations among employed adults aged 18–64 years in the United States

PubMed Central

Han, Beth; Crosby, Alex E.; Ortega, LaVonne A.G.; Parks, Sharyn E.; Compton, Wilson M.; Gfroerer, Joseph

2016-01-01

Objective Approximately 70% of all US suicides are among working-age adults. This study was to determine whether and how 12-month suicidal ideation and suicide attempt were associated with specific occupations among currently employed adults aged 18–64 in the U.S. Methods Data were from 184,300 currently employed adults who participated in the 2008–2013 National Surveys on Drug Use and Health (NSDUH). NSDUH provides nationally representative data on suicidal ideation and suicide attempt. Descriptive analyses and multivariable logistic regressions were conducted. Results Among currently employed adults aged 18–64 in the U.S., 3.5% had suicidal ideation in the past 12 months (3.1% had suicidal ideation only, and 0.4% had suicidal ideation and attempted suicide). Compared with adults in farming, fishing, and forestry occupations (model adjusted prevalence (MAP) = 1.6%), adults in the following occupations were 3.0–3.6 times more likely to have suicidal ideation in the past year (model adjusted relative risks (MARRs) = 3.0–3.6): lawyers, judges, and legal support workers (MAP = 4.8%), social scientists and related workers (MAP = 5.4%), and media and communication workers (MAP = 5.8%). Conclusions Among employed adults aged 18–64 in the U.S., the 12-month prevalence of suicidal ideation varies by occupations. Adults in occupations that are at elevated risk for suicidal ideation may warrant focused suicide prevention. PMID:26995251

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.

Suicidal behavior and attitudes in Slovak and Turkish high school students: a cross-cultural investigation.

PubMed

Eskin, Mehmet; Palova, Eva; Krokavcova, Martina

2014-01-01

Suicidal behavior and its variation across social contexts are of importance for the science of suicidology. Due to its special character controlled experimental studies on suicide are ruled out for ethical reasons. Cross-cultural studies may throw light on the etiology of both suicidal behavior and its cross-cultural variation. The present study compared suicidal behavior and attitudes in 423 Slovak and 541 Turkish high school students by means of a self-report questionnaire. The two groups reported similar percentages (Slovak = 36.4%; Turkish = 33.8%) of lifetime, past 12-months or current suicidal ideation but significantly more Turkish (12.2%) than Slovak (4.8%) students reported lifetime or past 12-months suicide attempts. Slovak adolescents displayed more liberal and permissive attitudes toward suicide, while those of Turkish adolescents were more rejecting. Turkish students rated themselves to be more religious and hence they believed to a greater extent that suicidal persons would be punished in a life after death than their Slovak peers. However, attitudes of Turkish students toward an imagined suicidal close friend were more accepting than the attitudes of Slovak students. Comparison of suicidal and nonsuicidal students revealed that those reporting suicidal ideation or attempts were more accepting of suicide and viewed suicide as a solution to a greater extent than the nonsuicidal ones. The results from this study suggest that cultural factors play a role in suicidal behavior, attitudes and reactions in a predicted direction.

Anxious temperament as a risk factor of suicide attempt.

PubMed

Tanabe, Sanshi; Terao, Takeshi; Shiotsuki, Ippei; Kanehisa, Masayuki; Ishii, Keisuke; Shigemitsu, Osamu; Fujiki, Minoru; Hoaki, Nobuhiko

2016-07-01

Suicide has been reported to be associated with cyclothymic, irritable, depressive and anxious temperaments. In contrast, hyperthymic temperament has been reported to be protective against suicide. In the present study, we hypothesized that Japanese patients with suicide attempt may have higher scores of cyclothymic, irritable, depressive, and anxious temperaments but lower scores of hyperthymic temperament than non-suicidal patients. In order to examine this hypothesis, we investigated Japanese patients of a university emergency center. The association of temperament and suicide attempt was investigated in 116 patients referred to a university emergency center for intoxication or injury. Of them, 35 patients of suspected suicide attempt were categorized as 18 patients who intended to die with attempted suicide and suffered from self-inflicted but not fatal injury (Suicide Attempt II), 4 patients whose intention to die were undetermined although they suffered from self-inflicted injury (Undetermined Suicide-Related Behavior II), and 13 patients who had no intention to die although they suffered from self-inflicted injury (Self-Harm II). Logistic regression analyses and multiple regression analyses were used to identify factors associated with the present suicide attempt and the number of suicide attempts, respectively. Anxious temperament scores were significantly and directly associated with Suicide Attempt II group whereas irritable temperament scores were associated with Self-Harm II group. The present findings suggest that those with anxious temperament may have more suicide attempts than those with other temperaments, indicating anxious temperament as a risk factor of suicide attempt. Copyright © 2016 Elsevier Inc. All rights reserved.

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

Suicide voices: testimonies of trauma in the French workplace

PubMed Central

Waters, Sarah

2016-01-01

Workplace suicide has become an urgent social concern internationally with rising numbers of employees choosing to kill themselves in the face of extreme pressures at work. Yet, research on this phenomenon is hampered by fragmentary statistical data and the sheer contentiousness of this issue. This paper presents the preliminary findings of a research project on workplace suicides in France, where there has been a ‘suicide epidemic’ across a wide range of companies. I draw on an analysis of suicide letters linked to 23 suicide cases across three French companies during the period 2005–2015. My methodological approach is informed by the work of suicide sociologist, Jack D Douglas, who emphasised the importance of narrative, testimony and voice to our understanding of the causes of suicide. Douglas argued that an analysis of the ‘social meanings’ of suicide should start with a consideration of the motivations attributed to self-killing by suicidal individuals themselves and those close to them. Why does work or conditions of work push some individuals to take their own lives? What can the ‘suicide voices’ articulated in recent testimonies tell us about the causes of workplace suicide? In this paper, I treat suicide letters as a unique mode of testimony that can reveal some of the profound effects of workplace transformations on subjective, intimate and lived experiences of work. By examining French suicide testimonies, my aim is to deepen our understanding of the nature and causes of suicide in today’s globalised workplaces. PMID:27613808

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.

Suicidality in adolescents and adults with binge-eating disorder: Results from the national comorbidity survey replication and adolescent supplement.

PubMed

Forrest, Lauren N; Zuromski, Kelly L; Dodd, Dorian R; Smith, April R

2017-01-01

The relation between binge-eating disorder (BED) and suicidality (i.e., suicide ideation, plan, and/or attempt) has not been studied extensively, and it is unknown whether BED is uniquely associated with suicidality when adjusting for comorbid psychopathology. Moreover, the course of suicidality in BED has not been determined and it is unknown whether BED precedes suicidality or vice versa. A total of 10,123 adolescents and 2,980 adults from two nationally representative surveys were administered diagnostic interviews assessing psychopathology and suicidality, as well the retrospectively reported ages of onset. Among adults and adolescents, BED was associated with elevated odds of suicide ideation, plan, and attempt at a univariate level, but BED was not associated with elevated odds of suicidality when adjusting for comorbid psychopathology. Kaplan-Meier estimates of temporal patterns displayed that most adolescents experienced suicidality onset following BED onset, whereas most adults experienced suicidality onset prior to BED onset. BED, comorbid disorders, and suicidality share common factors and interrelations, and individuals with BED and comorbid disorders may be at particularly high risk for suicidal outcomes. The presence of BED in adolescence may serve as a marker for more severe symptomatology that precedes the occurrence of suicidality. Research is needed to understand how eating disorder symptoms, comorbid symptoms, and suicidality affect one another over time. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2017; 50:40-49). © 2016 Wiley Periodicals, Inc.

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

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

PubMed

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

2017-06-01

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

Modeling suicide in bipolar disorders.

PubMed

Malhi, Gin S; Outhred, Tim; Das, Pritha; Morris, Grace; Hamilton, Amber; Mannie, Zola

2018-02-19

Suicide is a multicausal human behavior, with devastating and immensely distressing consequences. Its prevalence is estimated to be 20-30 times greater in patients with bipolar disorders than in the general population. The burden of suicide and its high prevalence in bipolar disorders make it imperative that our current understanding be improved to facilitate prediction of suicide and its prevention. In this review, we provide a new perspective on the process of suicide in bipolar disorder, in the form of a novel integrated model that is derived from extant knowledge and recent evidence. A literature search of articles on suicide in bipolar disorder was conducted in recognized databases such as Scopus, PubMed, and PsycINFO using the keywords "suicide", "suicide in bipolar disorders", "suicide process", "suicide risk", "neurobiology of suicide" and "suicide models". Bibliographies of identified articles were further scrutinized for papers and book chapters of relevance. Risk factors for suicide in bipolar disorders are well described, and provide a basis for a framework of epigenetic mechanisms, moderated by neurobiological substrates, neurocognitive functioning, and social inferences within the environment. Relevant models and theories include the diathesis-stress model, the bipolar model of suicide and the ideation-to-action models, the interpersonal theory of suicide, the integrated motivational-volitional model, and the three-step theory. Together, these models provide a basis for the generation of an integrated model that illuminates the suicidal process, from ideation to action. Suicide is complex, and it is evident that a multidimensional and integrated approach is required to reduce its prevalence. The proposed model exposes and provides access to components of the suicide process that are potentially measurable and may serve as novel and specific therapeutic targets for interventions in the context of bipolar disorder. Thus, this model is useful not only for research purposes, but also for future real-world clinical practice. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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

PubMed

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

2015-09-23

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

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.

Racial Differences in Adolescents' Answering Questions About Suicide.

PubMed

Anderson, Laura M; Lowry, Lynda S; Wuensch, Karl L

2015-01-01

The present purpose was to examine racial differences in response rate and serious behavioral suicide risk based on the national Youth Risk Behavior Surveillance Survey (YRBS). Data from 15,245 adolescents (YRBS, 2011) were included. Survey items pertaining to making suicidal plans and attempting suicide were included. Significant differences in responding and content emerged, especially with regard to suicide attempts. Racial minority adolescents are at elevated risk for serious suicidal behaviors and are more likely to omit items pertaining to suicide attempts. African American adolescents rarely reported having attempted suicide, but they also frequently failed to respond to that question.

[Suicide and suicide prevention in Vienna from 1938 to 1945].

PubMed

Sonneck, Gernot; Hirnsperger, Hans; Mundschütz, Reinhard

2012-01-01

Beginning with the inception of suicide prevention in interwar Vienna, the paper illustrates how the high number of counselling centres contrasted with a discourse of selection. Despite the fact that suicide rates proved extremely high, suicide prevention declined in importance between 1934 and 1945. Suicide was increasingly attributed to the weak and the inferior. The massive threat to Vienna's Jewish population and the high suicide rates among Viennese Jews are also outlined. The paper concludes with a synopsis of V. E. Frankl's activities in the field of suicide prevention at the Rothschild Hospital as well as the concentration camp in Theresienstadt.

The Willingness to Intervene Against Suicide Questionnaire.

PubMed

Aldrich, Rosalie S; Harrington, Nancy G; Cerel, Julie

2014-01-01

Three studies resulted in the Willingness to Intervene Against Suicide Questionnaire. College students (ns = 172, 253, and 367) completed an online questionnaire based on theory of planned behavior constructs regarding suicide intervention. Exploratory factor analysis produced 10 factors: intervening will affect the suicidal person and the participant; important others recommend seeking help, suggesting the suicidal person see a counselor, and talking to the suicidal person; interpersonal and intervention self-efficacy; and intention to seek outside help, encourage to seek outside help, and recognize a need for action. The Willingness to Intervene Against Suicide Questionnaire assesses college students' willingness to intervene when someone is suicidal.

The Relationship of Self-reported Executive Functioning to Suicide Ideation and Attempts: Findings from a Large U.S.-based Online Sample.

PubMed

Saffer, Boaz Y; Klonsky, E David

2017-01-01

An increasing number of studies demonstrate that individuals with a history of suicidality exhibit impaired executive functioning abilities. The current study examines whether these differences are linked to suicidal thoughts or suicidal acts-a crucial distinction given that most people who think about suicide will not act on their thoughts. A large online sample of U.S. participants with a history of suicide ideation (n = 197), suicide attempts (n = 166), and no suicidality (n = 180) completed self-report measures assessing executive functioning, suicide ideation and attempts; in addition, depression, self-efficacy, and history of drug abuse and brain injury were assessed as potential covariates. Individuals with recent suicide attempts reported significantly worse executive functioning than ideators. This difference was not accounted for by depression, self-efficacy, history of drug abuse or brain injury. Self-reported executive functioning may represent an important short-term risk factor for suicide attempts.

University students' perceived self-efficacy in identifying suicidal warning signs and helping suicidal friends find campus intervention resources.

PubMed

King, Keith A; Vidourek, Rebecca A; Strader, Jennifer L

2008-10-01

Currently, suicide is the third leading cause of death among youth 18 to 24 years of age and the second leading cause of death on college campuses. A sample of students (N = 1,019) from three midwestern universities were surveyed regarding their perceived self-efficacy in identifying suicide warning signs and campus suicide intervention resources. The results indicated that 11% strongly believed they could recognize a friend at suicidal risk, while 17% strongly believed they could ask a friend if he or she was suicidal. Students who had received high school suicide prevention education and who had ever had a family member or friend express suicidal thoughts to them were those most confident in recognizing a friend at risk, asking a friend if he/she is suicidal, and helping a friend to see a counselor. Most (71%) were not aware of on-campus help resources. These findings underscore the importance of suicide prevention education throughout the high school and college years.

Insomnia Symptoms, Nightmares, and Suicidal Ideation in Older Adults

PubMed Central

2013-01-01

Objectives. Prior research has found that insomnia symptoms and nightmares are associated with suicidal ideation, suicide attempts, and death by suicide. However, to the best of our knowledge, no research has examined the relation between insomnia symptoms, nightmares, and suicidal ideation in older adults. The current project aimed to fill this void by investigating the relation between insomnia symptoms, nightmares, and suicidal ideation in an older adult sample. Method. The study utilized a cross-sectional design. The sample consisted of 81 older adult patients (age ≥ 65 years) recruited from a family medicine clinic. The participants were asked to complete surveys about their sleep, symptoms of depression, and suicidal ideation. Results. Insomnia symptoms, but not nightmares, were significantly related to suicidal ideation. In addition, insomnia symptoms were related to suicidal ideation independent of nightmares. Furthermore, the relation between insomnia symptoms and suicidal ideation was mediated by depressive symptoms. Discussion. These findings have implications for the identification and treatment of suicidal ideation in older adults. PMID:22929392

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.

[Risk factors for suicide attempt among college students at Central South University].

PubMed

Xu, Hui-lan; Xiao, Shui-yuan; Feng, Shan-shan; Chen, Xi-xi

2004-04-01

To understand the prevalence and risk factors for suicidal ideation among college students and to provide a scientific basis for promoting psychological health and suicide prevention. 623 college students at Central South University were selected using stratified cluster sampling and administered a suicide ideation questionnaire, a Symptom Check List (SCL-90), an Adolescent Self-Rating Life Events Check List (ASLEC), a Social Support Rating Scale (SSRS) and a questionnaire about background information. Multivariate logistic regression analysis was employed to identify risk factors for suicide ideation. One year prior to our investigation, 14.6% of respondents had suicide ideation, 2.5% had made a specific suicide plan, and 1.8% had made a suicide attempt. The main risk factors for suicide ideation were dissatisfaction with the selected major of study, limited social support, recent negative life events and depressive tendency. The prevalence of suicide ideation among these college students was high. Appropriate measures focusing on the risk factors identified in this study should be urgently developed to prevent suicides in college students.

The effects of misclassification biases on veteran suicide rate estimates.

PubMed

Huguet, Nathalie; Kaplan, Mark S; McFarland, Bentson H

2014-01-01

We assessed the impact that possible veteran suicide misclassification biases (i.e., inaccuracy in ascertainment of veteran status on the death certificate and misclassification of suicide as other manner of death) have on veteran suicide rate estimates. We obtained suicide mortality data from the 2003-2010 National Violent Death Reporting System and the 2003-2010 Department of Defense Casualty Analysis System. We derived population estimates from the 2003-2010 American Community Survey and 2003-2010 Department of Veterans Affairs data. We computed veteran and nonveteran suicide rates. The results showed that suicide rates were minimally affected by the adjustment for the misclassification of current military personnel suicides as veterans. Moreover, combining suicides and deaths by injury of undetermined intent did not alter the conclusions. The National Violent Death Reporting System is a valid surveillance system for veteran suicide. However, more than half of younger (< 25 years) male and female suicides, labeled as veterans, were likely to have been current military personnel at the time of their death and misclassified on the death certificate.

Gender Differences among Medically Serious Suicide Attempters aged 15–54 Years in Rural China

PubMed Central

Sun, Long; Zhang, Jie

2017-01-01

China is one of few countries which reported higher female suicide rates in the worldwide. However, little is known about the gender differences among Chinese rural suicide attempters. This study aims to analyze the gender differences among medically serious suicide attempters aged 15–54 years in rural China. Subjects were 791 medically serious suicide attempters and 791 controls aged 15–54 years in rural China. Socio-demographic, psychological and some critical variables were assessed in the interview. The results showed that all of the factors (education years, family suicide history, negative life events, social support, impulsivity and mental disorder) associated with male suicide attempters also could be found for females. Physical disease, mental disorder and pesticide ingestion played more roles on male suicide attempters. Ever married, peasant, religious belief, and less social support played more roles on female suicide attempters. Compared with male suicide attempters, female ones are mainly influenced by social factors. A gender-specific approach should be emphasized in suicide prevention. PMID:28249203

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

Criminal prosecution of suicide attempt survivors in Ghana.

PubMed

Adinkrah, Mensah

2013-12-01

Recently, there have been calls for the decriminalization (or depenalization) of nonfatal suicidal behavior (attempted suicide) in Ghana, India, Uganda, and other societies that currently criminalize nonfatal suicidal behavior. Despite this, there is a dearth of systematic studies that examine the extent, nature, and characteristics of attempted suicide prosecutions in countries that currently criminalize nonfatal suicidal behavior. The current study, therefore, explores the phenomenon of criminal prosecution and punishment for suicide attempters in Ghana, one among several countries where nonfatal suicidal behavior is a crime. Drawing from data extracted from local Ghanaian print and electronic news media articles, the study examines the sociodemographic characteristics of suicide attempt survivors, the patterns of nonfatal suicidal behavior, as well as the criminal justice outcomes of the criminal prosecutions. The findings indicate that the majority of defendants pled guilty to or were found guilty of the charge and sentenced to penalties ranging from monetary fines to incarceration. The results are discussed with regard to their implications for reducing nonfatal suicidal behavior in Ghana.

Project SOAR: a training program to increase school counselors' knowledge and confidence regarding suicide prevention and intervention.

PubMed

King, K A; Smith, J

2000-12-01

School counselors are often the lead individuals in school suicide prevention programs. All school counselors in Dallas, Texas, receive training through Project SOAR (Suicide, Options, Awareness, and Relief), a suicide prevention program. This study assessed Dallas school counselors' knowledge of suicidal risk factors and perceived ability to initiate appropriate steps when confronted with a suicidal student. A two-page, 44-item survey was distributed to all Dallas school counselors attending a mandatory meeting in spring 1999. A total of 186 school counselors (75%) responded. Most had been a school counselor for less than 10 years and one-half received initial SOAR training less than four years ago. The majority strongly agreed that they could recognize suicidal warning signs, assess a student's risk for suicide, and offer support to a suicidal student. In addition, most knew the intervention steps to take when a student assessed at high suicidal risk. When compared to school counselors nationwide, these counselors reported increased confidence in identifying students at suicidal risk.

Psychogenic nonepileptic seizures and suicidal behavior on a video/EEG telemetry unit: the need for psychiatric assessment and screening for suicide risk.

PubMed

Kaufman, Kenneth R; Struck, Peter J

2010-12-01

Patients with epilepsy and psychogenic nonepileptic seizures (PNES) have an increased prevalence of psychiatric illness and risk for suicidal ideation/suicidal behavior/suicide compared with the general population. Recent literature suggests that antiepileptic drugs (AEDs) used to treat epilepsy, pain, and psychiatric disorders increase the risk of suicide and that this increased risk may be AED selective. This case analyzes a suicide attempt on a video/EEG telemetry unit. Specific risk factors associated with increased risk of suicidal behaviors pertinent to this case are reviewed: epilepsy, multiple psychiatric diagnoses including affective disorder, AEDs, PNES, prior medically serious suicide attempt, and suicide attempt within the past month. Specific psychometric rating scales to screen for both psychiatric illness and suicide risk and psychiatric assessment should be integral components of the evaluation and treatment of patients on video/EEG telemetry units. Copyright © 2010 Elsevier Inc. All rights reserved.

Suicide risk in patients with anxiety disorders: a meta-analysis of the FDA database.

PubMed

Khan, Arif; Leventhal, Robyn M; Khan, Shirin; Brown, Walter A

2002-04-01

Previous reports of suicide risk in patients with anxiety disorders have been inconsistent. Using the FDA database, we assessed suicide and suicide attempt risk among patients, participating in recent clinical trials evaluating new anti-anxiety medications, with diagnosis of panic disorder (PD), social anxiety disorder or social phobia (SP), generalized anxiety disorder (GAD), post traumatic stress disorder (PTSD), and obsessive compulsive disorder (OCD). Overall, among 20076 participating anxious patients, 12 committed suicide and 28 attempted suicide. The annual suicide risk rate was 193/100000 patients and annual suicide attempt risk was 1350/100000 patients. Clinical trial data have limited applicability to clinical practice. Participants in clinical trials are a highly selected, nonrepresentative sample of the clinical population. A number of patients never complete clinical trials and thus data are based on a limited sub-sample. These trials were not primarily designed to assess suicide risk. Suicide risk in patients with anxiety disorders is higher than previously thought. Patients with anxiety disorders warrant explicit evaluation for suicide risk.

Between moral infraction and existential crisis: Exploring physicians and nurses' attitudes to suicide and the suicidal patient in Ghana.

PubMed

Osafo, Joseph; Akotia, Charity S; Boakye, Kofi E; Dickson, Erica

2018-05-26

Negative attitudes of health professionals towards suicide may hamper their willingness and skills to work with attempt survivors. The purpose of this study was to explore the attitudes of physicians and nurses towards suicide and the suicidal patient. A semi-structured qualitative interview was conducted on Twenty five (25) health professionals: (15 physicians and 10 casualty nurses) from five hospitals in Accra, the capital of Ghana. Findings showed that while majority of physicians viewed suicide as an existential crisis, most of the nurses viewed it as a moral infraction. Three key attitudes towards suicide and the suicidal patient were observed: stable, dissonant and transitioned. The findings are discussed under three main themes: Contexts, Theorizing suicide, and Shades of attitudes. Nurses and Physicians are key gatekeepers in suicide prevention in Ghana. Training is however, needed to improve both attitudes (especially for nurses) and competence towards suicide prevention in the country. Copyright © 2018 Elsevier Ltd. All rights reserved.

Gender differences and psychological factors associated with suicidal ideation among youth in Malaysia.

PubMed

Ibrahim, Norhayati; Amit, Noh; Che Din, Normah; Ong, Hui Chien

2017-01-01

Suicide is a global phenomenon that has been showing an upward trend in recent years. It is the second leading cause of death among youth. Studies on suicidal ideation warrant greater attention, as it leads to suicide attempts and other health risk behaviors. Thus, the objective of this study was to compare gender differences in suicidal ideation and determine the predictors of suicidal ideation among youth. This cross-sectional study was carried out among 232 youths aged between 15 and 25 years from selected urban areas in Malaysia. The results showed that suicidal ideation was higher among male participants compared with female participants. Age was the predictor of suicidal ideation for males, while depression and loss of motivation, as components of hopelessness, were the predictors of suicidal ideation among females. Hence, it is important that professionals conduct early identification tests for suicidality among young people. This will facilitate the early detection of depression and hopelessness, which is important, in order to prevent suicidal behaviors or other problems before these occur.

The relation of childhood trauma to suicide ideation in patients suffering from obsessive-compulsive disorder with lifetime suicide attempts.

PubMed

Khosravani, Vahid; Kamali, Zoleikha; Jamaati Ardakani, Razieh; Samimi Ardestani, Mehdi

2017-09-01

The aim of this study was to evaluate the relations of childhood trauma (CT) and obsessive-compulsive (OC) symptom dimensions to suicide ideation in patients with obsessive-compulsive disorder (OCD). Seventy OCD outpatients with lifetime suicide attempts and 60 controls were included. Participants completed the Scale for Suicide Ideation (SSI), the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Dimensional Obsessive-Compulsive Scale (DOCS) and the Depression Anxiety Stress Scales (DASS-21). Among OCD patients, 97.1% had current suicide ideation. OCD patients revealed higher scores on CT, suicide ideation, depression and anxiety than controls. The CT history of sexual abuse (SA) and OC symptom dimension of unacceptable thoughts explained suicide ideation. It was concluded that SA and unacceptable thoughts may contribute to high suicidality and have important implications for the assessment and treatment of suicide risk in OCD patients with lifetime suicide attempts. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Insomnia symptoms, nightmares, and suicidal ideation in older adults.

PubMed

Nadorff, Michael R; Fiske, Amy; Sperry, Jeannie A; Petts, Rachel; Gregg, Jeffrey J

2013-03-01

Prior research has found that insomnia symptoms and nightmares are associated with suicidal ideation, suicide attempts, and death by suicide. However, to the best of our knowledge, no research has examined the relation between insomnia symptoms, nightmares, and suicidal ideation in older adults. The current project aimed to fill this void by investigating the relation between insomnia symptoms, nightmares, and suicidal ideation in an older adult sample. The study utilized a cross-sectional design. The sample consisted of 81 older adult patients (age ≥ 65 years) recruited from a family medicine clinic. The participants were asked to complete surveys about their sleep, symptoms of depression, and suicidal ideation. Insomnia symptoms, but not nightmares, were significantly related to suicidal ideation. In addition, insomnia symptoms were related to suicidal ideation independent of nightmares. Furthermore, the relation between insomnia symptoms and suicidal ideation was mediated by depressive symptoms. These findings have implications for the identification and treatment of suicidal ideation in older adults.

Suicide in Latin America: a growing public health issue.

PubMed

Mascayano, Franco; Irrazabal, Matias; D Emilia, Wyatt; Vaner, Sidney Jane; Sapag, Jaime C; Alvarado, Ruben; Yang, Lawrence Hsin; Sinah, Binoy

2015-01-01

Suicide has become an international public mental health challenge, resulting in a need for interventions to address it as an individual, family, and community levels. The current scope review assesses trends regarding suicide within Latin America and the Caribbean: risk factors, protective factors, and mediators of suicidal ideation and behavior. Body: Our review is split into three sections, as a way of addressing the complex topic of suicide in an organized, comprehensive manner: (i) epidemiology of suicide in Latin America and Caribbean; (ii) factors associated to suicide ideation and attempts; and (iii) cultural factors as a predictors and mediators of suicide. Further, proper evidence about the association between suicide and cultural dimensions such as Familismo, Machismo/Marianismo, Religion and Acculturation is provided. Upon analyzing trends of and factors associated with suicide, we offer recommendations regarding future studies and intervention programs. We conclude that interventions and research should be based on and in response to cultural values and norms related to suicide within each community, in order to make more culturally-specific programs.

Prevalence and Associated Factors of Suicidal Ideation and Attempt among People Living with HIV/AIDS at Zewditu Memorial Hospital, Addis Ababa, Ethiopia: A Cross-Sectional Study

PubMed Central

Gebremariam, Etsay Hailu; Nasir, Zebiba

2017-01-01

Background. Human Immune Deficiency Virus (HIV/AIDS) continues to be an underrecognized risk for suicidal ideation, suicidal attempt, and completion of suicide. Suicidal ideation and attempt in HIV/AIDS is not only a predictor of future attempted suicide and completed suicide. Methods. An institution based cross-sectional study was conducted among HIV-positive patients attending HIV care at Zewditu Memorial Hospital. Systematic random sampling technique was used to recruit 423 participants from April to May 2014. Composite International Diagnostic Interview was used to collect data. Multivariable logistic regression was computed to assess factors associated with suicidal ideation and attempt. Result. Suicidal ideation and suicidal attempt were found to be 22.5% and 13.9%, respectively. WHO clinical stage of HIV, not being on HAART, depression, family history of suicidal attempt, and perceived stigma were associated with suicidal ideation. WHO clinical stage, being female, not being on HAART, use of substance, and depression were associated with suicidal attempt. Conclusion. Early diagnosis and treatment of opportunistic infections, depression, and early initiation of ART need to be encouraged in HIV-positive adults. Furthermore, counseling on substance use and its consequences and early identification of HIV-positive people with family history of suicidal ideation have to be considered. PMID:28491869

Culturally sanctioned suicide: Euthanasia, seppuku, and terrorist martyrdom

PubMed Central

Pierre, Joseph M

2015-01-01

Suicide is one of the greatest concerns in psychiatric practice, with considerable efforts devoted to prevention. The psychiatric view of suicide tends to equate it with depression or other forms of mental illness. However, some forms of suicide occur independently of mental illness and within a framework of cultural sanctioning such that they aren’t regarded as suicide at all. Despite persistent taboos against suicide, euthanasia and physician-assisted suicide in the context of terminal illness is increasingly accepted as a way to preserve autonomy and dignity in the West. Seppuku, the ancient samurai ritual of suicide by self-stabbing, was long considered an honorable act of self-resolve such that despite the removal of cultural sanctioning, the rate of suicide in Japan remains high with suicide masquerading as seppuku still carried out both there and abroad. Suicide as an act of murder and terrorism is a practice currently popular with Islamic militants who regard it as martyrdom in the context of war. The absence of mental illness and the presence of cultural sanctioning do not mean that suicide should not be prevented. Culturally sanctioned suicide must be understood in terms of the specific motivations that underlie the choice of death over life. Efforts to prevent culturally sanctioned suicide must focus on alternatives to achieve similar ends and must ultimately be implemented within cultures to remove the sanctioning of self-destructive acts. PMID:25815251

Recent trends in elderly suicide rates in England and Wales.

PubMed

Hoxey, K; Shah, A

2000-03-01

The proportion of elderly in the population is increasing due to increased life expectancy and falling birth rate, and suicide rates increase with age. This study examined the following in England and Wales: (i) recent trends in the elderly suicide rate; (ii) recent trends in method-specific elderly suicide rate; (iii) the relationship between elderly population size and elderly suicide rate in recent years; and (iv) the sex difference in overall and method-specific elderly suicide rate. Data on the various suicide variables were ascertained from the annually published mortality data for years 1985 to 1996. The main findings of this study were: (i) there is a trend towards decline in the overall pure and combined suicide rates for elderly men and women over the 12 year study period; (ii) the main contributors to this decline are suicides due to poisoning by solid and liquid substances (E950), hanging, strangulation and suffocation (E953), drowning (E954), firearms and explosives (E955), and jumping from high places (E957); (iii) the overall pure and combined suicide rates and that for most categories of suicide was higher in men compared to women; and (iv) suicide rates decreased with an increase in the elderly population size. Suicide rates can decline due to a number of reasons. The challenge now is to ensure further decline in suicide rates to meet the Our Healthier Nations target.

An Empirical Model and Ethnic Differences in Cultural Meanings Via Motives for Suicide.

PubMed

Chu, Joyce; Khoury, Oula; Ma, Johnson; Bahn, Francesca; Bongar, Bruce; Goldblum, Peter

2017-10-01

The importance of cultural meanings via motives for suicide - what is considered acceptable to motivate suicide - has been advocated as a key step in understanding and preventing development of suicidal behaviors. There have been limited systematic empirical attempts to establish different cultural motives ascribed to suicide across ethnic groups. We used a mixed methods approach and grounded theory methodology to guide the analysis of qualitative data querying for meanings via motives for suicide among 232 Caucasians, Asian Americans, and Latino/a Americans with a history of suicide attempts, ideation, intent, or plan. We used subsequent logistic regression analyses to examine ethnic differences in suicide motive themes. This inductive approach of generating theory from data yielded an empirical model of 6 cultural meanings via motives for suicide themes: intrapersonal perceptions, intrapersonal emotions, intrapersonal behavior, interpersonal, mental health/medical, and external environment. Logistic regressions showed ethnic differences in intrapersonal perceptions (low endorsement by Latino/a Americans) and external environment (high endorsement by Latino/a Americans) categories. Results advance suicide research and practice by establishing 6 empirically based cultural motives for suicide themes that may represent a key intermediary step in the pathway toward suicidal behaviors. Clinicians can use these suicide meanings via motives to guide their assessment and determination of suicide risk. Emphasis on environmental stressors rather than negative perceptions like hopelessness should be considered with Latino/a clients. © 2017 Wiley Periodicals, Inc.

An Observational Study of Suicide Death in Homeless and Precariously Housed People in Toronto.

PubMed

Sinyor, Mark; Kozloff, Nicole; Reis, Catherine; Schaffer, Ayal

2017-07-01

Homelessness has been identified as an important risk factor for suicide death, but there is limited research characterising homeless people who die by suicide. The goal of this study is to identify personal, clinical, and suicide method-related factors that distinguish homeless and precariously housed people who die from suicide from those who are not homeless at the time of suicide. Coroner records were reviewed for all suicide deaths in Toronto from 1998 to 2012. Data abstracted included housing status as well as other demographics, clinical variables such as the presence of mental illness, and suicide method. Of 3319 suicide deaths, 60 (1.8%) were homeless and 230 (6.9%) were precariously housed. Homeless and precariously housed people were each younger than nonhomeless people ( P < 0.0001). Compared with nonhomeless, homeless people were more likely to be male and less likely to be married, to have interpersonal conflict, or to leave a suicide note. Homeless people and precariously housed were more likely to have died by fall/jump than nonhomeless people (62%, 57%, and 29%, respectively). Homeless and precariously housed people are overrepresented among suicide deaths in a large urban center and differ demographically, clinically, and in their suicide method from nonhomeless people who die by suicide. Targeted suicide prevention strategies should aim to address factors specific to homeless people.

Using the Patient Health Questionnaire (PHQ-9) and the Edinburgh Postnatal Depression Scale (EPDS) to assess suicidal ideation among pregnant women in Lima, Peru.

PubMed

Zhong, Qiu-Yue; Gelaye, Bizu; Rondon, Marta B; Sánchez, Sixto E; Simon, Gregory E; Henderson, David C; Barrios, Yasmin V; Sánchez, Pedro Mascaro; Williams, Michelle A

2015-12-01

We sought to examine the concordance of two suicidal ideation items from the Patient Health Questionnaire-9 (PHQ-9) and the Edinburgh Postnatal Depression Scale (EPDS), to evaluate the prevalence of suicidal ideation among pregnant women, and to assess the co-occurrence of suicidal ideation with antepartum depressive symptoms. A cross-sectional study was conducted among 1,517 pregnant women attending prenatal care clinics in Lima, Peru. Item 9 of the PHQ-9 assesses suicidal ideation over the last 14 days while item 10 of the EPDS assesses suicidal ideation in the past 7 days. The two suicidal ideation items have a high concordance rate (84.2 %) but a moderate agreement (the Cohen's kappa = 0.42). Based on the PHQ-9 and the EPDS, 15.8 and 8.8 % of participants screened positive for suicidal ideation, respectively. Assessed by the PHQ-9, 51 % of participants with suicidal ideation had probable depression. In prenatal care clinics, screening for suicidal ideation is needed for women with and without depressive symptoms. Future studies are needed to identify additional predictors of antepartum suicidality, determine the appropriate duration of reporting period for suicidal ideation screening, and assess the percentage of individuals with positive responses to the two suicidal ideation items at high risk of planning and attempting suicide.

Sex and age trends in Australia's suicide rate over the last decade: Something is still seriously wrong with men in middle and late life.

PubMed

Burns, Richard A

2016-11-30

Despite significant investment in mental health and suicide intervention strategies in Australia, the extent of change in suicide rates over the last decade is unclear. This paper analyses sex and age trajectories in suicide rates over the last decade in Australia. Age Standardized Suicide Rates from 2004 to 2013 were obtained from the Australian Bureau of Statistics and reflect rates of suicide per 100,000 within age and sex cohorts. Age-related suicide rates were consistent over the last decade. For both males and females, there were increases in mid-life suicide rates before declining around 55-65 years of age. However, rates of suicide in men increased in late-life with rates for those aged 70-79 comparable with those in mid-life. Rates amongst men aged 85+ were consistently the highest rates over the decade. Positively, there was decline in suicide rates among younger men aged 20-34 years. However, more consistently, for both sexes across most age cohorts, there were either increases or no change in suicide rate. Apart from declines in younger-adult males, analysis of age-standardized suicide rates indicate no improvement in suicide rates. High suicide rates amongst middle-aged and older males remain a significant public health issue that needs to be addressed. Crown Copyright © 2016. Published by Elsevier Ireland Ltd. All rights reserved.

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.

Are predictors of future suicide attempts and the transition from suicidal ideation to suicide attempts shared or distinct: a 12-month prospective study among patients with depressive disorders.

PubMed

Chan, Lai Fong; Shamsul, Azhar Shah; Maniam, Thambu

2014-12-30

Our study aimed to examine the interplay between clinical and social predictors of future suicide attempt and the transition from suicidal ideation to suicide attempt in depressive disorders. Sixty-six Malaysian inpatients with a depressive disorder were assessed at index admission and within 1 year for suicide attempt, suicidal ideation, depression severity, life event changes, treatment history and relevant clinical and socio-demographic factors. One-fifth of suicidal ideators transitioned to a future suicide attempt. All future attempters (12/66) had prior ideation and 83% of attempters had a prior attempt. The highest risk for transitioning from ideation to attempt was 5 months post-discharge. Single predictor models showed that previous psychiatric hospitalization and ideation severity were shared predictors of future attempt and ideation to attempt transition. Substance use disorders (especially alcohol) predicted future attempt and approached significance for the transition process. Low socio-economic status predicted the transition process while major personal injury/illness predicted future suicide attempt. Past suicide attempt, subjective depression severity and medication compliance predicted only future suicide attempt. The absence of prior suicide attempt did not eliminate the risk of future attempt. Given the limited sample, future larger studies on mechanisms underlying the interactions of such predictors are needed. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Genetic and familial environmental effects on suicide attempts: a study of Danish adoptees and their biological and adoptive siblings.

PubMed

Petersen, Liselotte; Sørensen, Thorkild I A; Kragh Andersen, Per; Mortensen, Preben Bo; Hawton, Keith

2014-02-01

Genetic factors have been found to influence the risk of suicide. It is less clear if this also applies to attempted suicide. We have investigated genetic and familial environmental factors by studying the occurrence of suicide attempts in biological and adoptive siblings of adoptees who attempted suicide compared to siblings of adoptees with no suicide attempts. We used a random sample of 1933 adoptees from the Danish Adoption Register, a register of non-familial adoptions of Danish children, i.e. the adoptive parents are biologically unrelated to the adoptee. Analyses were conducted on incidence rates of attempted suicide in biological and adoptive siblings given occurrence of attempted suicide in the adoptees while also taking into account psychiatric disorders. Information about suicidal attempt and history of psychiatric disorder was based on hospital admissions. The rate of attempted suicide in full siblings of adoptees who attempted suicide before age 60 years was higher than in full siblings of adoptees who had not attempted suicide (incidence rate ratios (IRR)=3.45; 95% confidence interval [CI]=0.94-12.7). After adjustment for history of psychiatric admission of siblings the increased rate was statistically significant (IRR=3.88; 95% CI-1.42-10.6). Information on attempted suicide and psychiatric history was limited to that which involved hospitalisation. Genetic factors influence risk of suicide attempts. © 2013 Published by Elsevier B.V.

Suicide among the elderly and associated factors in South Korea.

PubMed

Shin, Kyoung Min; Cho, Sun-Mi; Hong, Chang Hyung; Park, Kyung Soon; Shin, Yun Mi; Lim, Ki Young; Koh, Sang Hyun

2013-01-01

With the population of the elderly increasing, suicides among elderly people present a serious problem for global societies. However, there are few studies on suicide among elderly subjects, especially in Asia. The study aimed to determine the relationship between physical health, mental health, social environmental condition, and the suicide behavior among elderly subjects in the city of Suwon, located southeast of Seoul. We analyzed 1548 Korean aged over 60 years from baseline data of a larger prospective study called the Suwon Project. The study protocol included sociodemographic variables, mental health factors, and physical health factors. In the interview, the subjects were asked about suicide ideation and history of suicide attempt. Of the total subjects, 7.42% reported suicide ideation and 1.42% reported a history of suicide attempt. A logistic regression analysis showed that physical illness, five stroke warning signs, anxiety and depression associated with suicide ideation, and depression strongly corresponded to the suicide ideation. Anxiety, depression, and stroke warning signs were associated with history of suicide attempt among the elderly. Additionally, stroke warning signs and depression are independently associated with history of suicide attempt. This study revealed that stroke warning signs have a high correlation with history of suicide attempt in the elderly, independent from the depression factors. This study suggests that there is an independent relationship between physical health status and suicide behavior in the case of elders.

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

PubMed Central

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

2016-01-01

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

Suicide Rates and Methods in Active Duty Military Personnel, 2005 to 2011: A Cohort Study.

PubMed

Anglemyer, Andrew; Miller, Matthew L; Buttrey, Samuel; Whitaker, Lyn

2016-08-02

Suicide prevention programs have become ubiquitous among military units; identifying temporal trends and nonclinical factors associated with the chosen suicide methods may help improve suicide prevention strategies. To calculate suicide rates of active duty military personnel and identify those who are at risk for firearm-specific suicide. Retrospective cohort study. Military units in the United States. All active duty enlisted U.S. military personnel from 2005 to 2011. Suicide rates per 100 000 were calculated for each branch. Adjusted odds ratios for firearm-specific suicide were calculated with 95% CIs. 1455 military personnel committed suicide from 2005 to 2011. From 2006 to 2011, the rates were highest among army personnel (19.13 to 29.44 cases per 100 000). Among suicides with a known cause of death, 62% were attributed to firearms. The results of this study also suggest that among army personnel or marines who committed suicide, those with infantry or special operations job classifications were more likely than those in noninfantry positions to use a firearm. Results are generalizable only to enlisted personnel and reflect only stateside suicides. Data regarding previous psychiatric illness, deployment history, and firearms ownership were lacking. These results may help inform policymakers and advisors about differences in risks of suicide and violent suicide among the armed services and may help guide efforts to prevent self-harm within the military. None.

The influence of media reporting of the suicide of a celebrity on suicide rates: a population-based study.

PubMed

Cheng, Andrew T A; Hawton, Keith; Lee, Charles T C; Chen, Tony H H

2007-12-01

The impact of media reporting of suicides of entertainment celebrities may affect suicide rates due to an imitation effect. We investigated the impact on suicides of the media reporting of the suicide of a male television celebrity. All suicides during 2003-2005 in Taiwan (n = 10,945) were included in this study. A Poisson time series autoregression analysis was conducted to examine whether there was an increase in suicides during the 4-week period after extensive media reporting of the celebrity suicide. After controlling for seasonal variation, calendar year, temperature, humidity and unemployment rate, there was a marked increase in the number of suicides during the 4-week period after media reporting (relative risk = 1.17, 95% CI 1.04-1.31). The increase was in men (relative risk = 1.30, 95% CI 1.14-1.50) and for the individuals using the same highly lethal method (hanging) as the TV actor did (relative risk = 1.51, 95% CI 1.25-1.83). However, the age groups in which the increase occurred were younger than the age of the celebrity. The extensive media reporting of the celebrity suicide was followed by an increase in suicides with a strong implication of a modelling effect. The results provide further support for the need for more restrained reporting of suicides as part of suicide prevention strategies to decrease the imitation effect.

Associations between film preferences and risk factors for suicide: an online survey.

PubMed

Till, Benedikt; Tran, Ulrich S; Voracek, Martin; Sonneck, Gernot; Niederkrotenthaler, Thomas

2014-01-01

Several studies indicate that exposure to suicide in movies is linked to subsequent imitative suicidal behavior, so-called copycat suicides, but little is currently known about whether the link between exposure to suicidal movies and suicidality is reflected in individual film preferences. 943 individuals participated in an online survey. We assessed associations between preferred film genres as well as individual exposure to and rating of 50 pre-selected films (including 25 featuring a suicide) with suicidal ideation, hopelessness, depression, life satisfaction, and psychoticism. Multiple regression analyses showed that preferences for film noir movies and milieu dramas were associated with higher scores on suicidal ideation, depression and psychoticism, and low scores on life satisfaction. Furthermore, preferences for thrillers and horror movies as well as preferences for tragicomedies, tragedies and melodramas were associated with higher scores of some of the suicide risk factors. There was also a dose-response relationship between positive rating of suicide films and higher life satisfaction. Due to the cross-sectional design of the study causality cannot be assessed. Individual film genre preferences seem to reflect risk factors of suicide, with film genres focusing on sad contents being preferred by individuals with higher scores on suicide risk factors. However, suicide movies are more enjoyed by viewers with higher life satisfaction, which may reflect a better ability to cope with such content.

Associations between Film Preferences and Risk Factors for Suicide: An Online Survey

PubMed Central

Till, Benedikt; Tran, Ulrich S.; Voracek, Martin; Sonneck, Gernot; Niederkrotenthaler, Thomas

2014-01-01

Several studies indicate that exposure to suicide in movies is linked to subsequent imitative suicidal behavior, so-called copycat suicides, but little is currently known about whether the link between exposure to suicidal movies and suicidality is reflected in individual film preferences. 943 individuals participated in an online survey. We assessed associations between preferred film genres as well as individual exposure to and rating of 50 pre-selected films (including 25 featuring a suicide) with suicidal ideation, hopelessness, depression, life satisfaction, and psychoticism. Multiple regression analyses showed that preferences for film noir movies and milieu dramas were associated with higher scores on suicidal ideation, depression and psychoticism, and low scores on life satisfaction. Furthermore, preferences for thrillers and horror movies as well as preferences for tragicomedies, tragedies and melodramas were associated with higher scores of some of the suicide risk factors. There was also a dose-response relationship between positive rating of suicide films and higher life satisfaction. Due to the cross-sectional design of the study causality cannot be assessed. Individual film genre preferences seem to reflect risk factors of suicide, with film genres focusing on sad contents being preferred by individuals with higher scores on suicide risk factors. However, suicide movies are more enjoyed by viewers with higher life satisfaction, which may reflect a better ability to cope with such content. PMID:25028966

Association of suicide rates, gun ownership, conservatism and individual suicide risk.

PubMed

Kposowa, Augustine J

2013-09-01

The purpose of the study was to examine the association of suicide rates, firearm ownership, political conservatism, religious integration at the state level, and individual suicide risk. Social structural and social learning and social integration theories were theoretical frameworks employed. It was hypothesized that higher suicide rates, higher state firearm availability, and state conservatism elevate individual suicide risk. Data were pooled from the Multiple Cause of Death Files. Multilevel logistic regression models were fitted to all deaths occurring in 2000 through 2004 by suicide. The state suicide rate significantly elevated individual suicide risk (AOR = 1.042, CI = 1.037, 1.046). Firearm availability at the state level was associated with significantly higher odds of individual suicide (AOR = 1.004, CI = 1.003, 1.006). State political conservatism elevated the odds of individual suicides (AOR = 1.005, CI = 1.003, 1.007), while church membership at the state level reduced individual odds of suicide (AOR = 0.995, CI = 0.993, 0.996). The results held even after controlling for socioeconomic and demographic variables at the individual level. It was concluded that the observed association between individual suicide odds and national suicide rates, and firearm ownership cannot be discounted. Future research ought to focus on integrating individual level data and contextual variables when testing for the impact of firearm ownership. Support was found for social learning and social integration theories.

Longitudinal Trajectories and Predictors of Adolescent Suicidal Ideation and Attempts Following Inpatient Hospitalization

ERIC Educational Resources Information Center

Prinstein, Mitchell J.; Nock, Matthew K.; Simon, Valerie; Aikins, Julie Wargo; Cheah, Charissa S. L.; Spirito, Anthony

2008-01-01

Remarkably little is known regarding the temporal course of adolescent suicidal ideation and behavior, the prediction of suicidal attempts from changes in suicidal ideation, or the prediction of suicidal attempts after accounting for suicidal ideation as a predictor. A sample of 143 adolescents 12-15 years old was assessed during psychiatric…

Gratitude and Suicidal Ideation and Suicide Attempts among Chinese Adolescents: Direct, Mediated, and Moderated Effects

ERIC Educational Resources Information Center

Li, Dongping; Zhang, Wei; Li, Xian; Li, Nini; Ye, Baojuan

2012-01-01

In a sample of 1252 Chinese adolescents (mean age = 15.00 years), this study examined the direct relations between gratitude and adolescents' suicidal ideation and suicide attempts. This study also examined indirect relations between gratitude and suicidal ideation and suicide attempts via two self-system beliefs--coping efficacy and self-esteem.…

Perceived School Climate and Chinese Adolescents' Suicidal Ideation and Suicide Attempts: The Mediating Role of Sleep Quality

ERIC Educational Resources Information Center

Li, Dongping; Bao, Zhenzhou; Li, Xian; Wang, Yanhui

2016-01-01

Background: School factors play important roles in adolescent suicide. However, little is known about how school climate is associated with adolescent suicide. This study examined the relationship between perceived school climate and adolescent suicidal ideation and suicide attempts, and whether these relations were explained by adolescent sleep…

A Comparison of Suicide Note Writers with Suicides Who Did Not Leave Notes

ERIC Educational Resources Information Center

Callanan, Valerie J.; Davis, Mark S.

2009-01-01

There is disagreement in the suicide literature on the value of suicide notes as a data source, particularly regarding the extent to which suicide decedents who write notes differ from those who do not. Using 10 years of suicide cases from Summit County, Ohio, these two groups were compared on 40 variables including sociodemographic…

Suicide and Suicidal-Related Behaviors among Indigenous Pacific Islanders in the United States

ERIC Educational Resources Information Center

Else, Iwalani; Andrade, Naleen; Nahulu, Linda

2007-01-01

The authors present a comprehensive review on U.S. Pacific Islander suicide and suicide-related behaviors to extend the knowledge and understanding of suicide and suicide-related behaviors among the indigenous peoples of the state of Hawai'i, the territories of American Samoa, Guam, Commonwealth of the Northern Mariana Islands, and the Pacific…

Some Syndromes Among Suicidal People: The Problem of Suicide Potentiality.

ERIC Educational Resources Information Center

Wold, Carl I.

An on-going research project at the Los Angeles Suicide Prevention Center is attempting to describe the potential suicide. Comparisons on a rating scale were made among patients who commit suicide and a random sample of case histories from the coroner's office. Approximately 10 syndromes or subgroupings of people who commit suicide have been…

Lay Theories of Suicide: An Examination of Culturally Relevant Suicide Beliefs and Attributions among African Americans and European Americans

ERIC Educational Resources Information Center

Walker, Rheeda L.; Lester, David; Joe, Sean

2006-01-01

The purpose of this study was to examine African Americans' lay beliefs and attributions toward suicide. The Attitudes Toward Suicide Scale, Life Ownership Orientation Questionnaire, Stigma Questionnaire, and Suicide Ideation Questionnaire were administered to 251 undergraduate college students. Beliefs about stigma associated with suicide were…

Factors in Suicide Completions and Suicide Attempts among Schizophrenic, Other Psychotic and Nonpsychotic Patients.

ERIC Educational Resources Information Center

Kaplan, Kalman J.; And Others

Some researchers have attempted to connect suicide to a general history of mental illness; others have searched for diagnosis-free suicide risk factors; and still others have argued that different risk profiles may emerge for different diagnoses. In addition to these issues, it appears that suicide completers and suicide attempters show somewhat…

Comparative Study of Suicide Potential among Pakistani and American Psychiatric Patients

ERIC Educational Resources Information Center

Farooqi, Yasmin Nilofer

2004-01-01

This study compared suicide potential and suicide attempts in 50 Pakistani and 50 American psychiatric patients all of whom reported a positive history of suicide attempts during the past 1-5 years. It further explored the role of nationality, gender, diagnosis, and marital status in respondents' potential for suicide and suicide attempts. The…

The internal suicide debate hypothesis: exploring the life versus death struggle.

PubMed

Harris, Keith M; McLean, John P; Sheffield, Jeanie; Jobes, David

2010-04-01

Researchers and theorists (e.g., Shneidman, Stengel, Kovacs, and Beck) hyothesized that suicidal people engage in an internal debate, or struggle, over whether to live or die, but few studies have tested its tenability. This study introduces direct assessment of a suicidal debate, revealing new aspects of suicidal ideation. Results, from an online survey (N = 1,016), showed nearly all suicide-risk respondents engaged in the debate. In addition, debate frequency accounted for 54% of the variance in suicidality scores, and showed significant associations with other indicators of suicide risk. Likely factors of the debate, reasons for living and dying, showed significant differences by suicidality, and most suicide-risk participants reported going online for such purposes, demonstrating a behavioral component of the debate.

Borderline Personality Disorder Diagnostic Criteria as Risk Factors for Suicidal Behavior Through the Lens of the Interpersonal Theory of Suicide.

PubMed

Rogers, Megan L; Joiner, Thomas E

2016-01-01

Borderline personality disorder diagnostic criteria, particularly affective dysregulation and behavioral dysregulation, are avenues through which suicide risk is conferred, though pathways are not well understood. The interpersonal theory of suicide may help elucidate these associations. The current study examined indirect relationships between affective and behavioral dysregulation and suicidal ideation through perceived burdensomeness, thwarted belongingness, and the acquired capability for suicide. 169 outpatients completed measures prior to their intake assessment. Perceived burdensomeness accounted for the relationship between affective dysregulation and suicidal ideation. The acquired capability did not explain the association between behavioral dysregulation and suicide attempt history. Affective and behavioral dysregulation may be key targets in treatment for reducing suicide risk.

The Crisis Treatment of Suicide

PubMed Central

Tabachnick, Norman

1970-01-01

Almost all suicidal persons who consult physicians wish to live. Generally they fall into one of two groups. Interpersonal suiciders manifest frequent threats and attempts, are emotionally labile, have ill-defined suicide plans, and clear ideas as to how their crises might be resolved. Intrapersonal suiciders are less open in manifestations of suicidal drive, withdrawn rather than emotional, often have clearly-formulated suicide plans and do not have ideas (other than suicide) as to how their crises might end. The suicidal situation results from two factors: (1) the loss of some valuable person or commodity, and (2) the loss of self-esteem. What ensues is temporary character disorganization—crisis. Treatment is based on restoration or replacement of lost objects and building up of self-esteem. PMID:5429131

Suicides in Hong Kong and Australia.

PubMed

Yip, P S

1998-01-01

Although the suicide rate for both Hong Kong and Australia was about 12 per 100,000 in 1994, the age- and gender-specific rates, methods of suicide, and time trends vary greatly for these two places. This paper explores the possible social, economic, and cultural background to explain this discrepancy. We used the official suicide death statistics of Hong Kong and Australia for the period 1984-1994. We calculated age-standardized suicide rates in order to take into account the differences in the age composition between the two countries and years. We employed a log-linear (Poisson) model to detect the age- and gender-specific trends, and to determine whether there were specific age or gender groups whose suicide behavior had changed significantly between 1984 and 1994. Hong Kong experienced a slight increase in suicide rate for both genders in the years 1984-1994, whereas Australia experienced a cubic trend for both genders during the same period and a rise in suicide rate in recent years. The suicide rate in Hong Kong increased with age, with a sharp increase (nearly four times the average) among the group aged 75 or over. A relatively low gender ratio (male:female) was also observed in Hong Kong, whereas in Australia there was not much difference in suicide rates among all age groups, though the suicide rate of the group aged 75 or over was 1.2 times the average. The gender ratio in Australia was higher, and the male suicide rate was four times higher than that of females. The Hong Kong suicide rate in females was twice that of Australia, whereas the Hong Kong male suicide rate was about half that of Australia. Jumping and hanging were the most common methods of suicide in Hong Kong, accounting for more than 80% of all suicide deaths. Poisoning (including gas poisoning) was the most common method used in Australia, with firearms being more common among young males. Australia had a higher years of potential life lost (YPLL) than Hong Kong because of the higher suicide rate among young males (aged 15-24). The high suicide rate among the elderly in Hong Kong raises the possibility that medical and social support to the elderly could be enhanced. The high female suicide rate in Hong Kong could be related to workload, responsibility, and expectations. The high suicide rate in Australia among males aged 15-24 was disturbing. Availability of the suicide methods is certainly one explanation for the difference in suicide methods used in Hong Kong and Australia.

[Relationships between various forms of childhood abuse and suicidal behaviors among middle school students].

PubMed

Wan, Yuhui; Liu, Wan; Sun, Ying; Hao, Jiahu; Tao, Fangbiao

2016-04-01

To study the relationship between various forms of childhood abuse and suicidal behaviors among middle school students. A total of 14 221 cases were retained from an epidemiological study, involving students from junior and senior middle schools in Guangzhou, Xinxiang, Shenyang and Chongqing. Information related to the demographic characteristics, types, number, timing and perpetrators of exposure to childhood abuse and suicidal behaviors was obtained. Logistic regression was used to analyze the relationships of each form of childhood abuse and suicidal behaviors. Number of cases (rates) of childhood abuse, physical abuse, emotional abuse, sexual abuse, suicidal ideation, suicidal planning and suicidal attempts among middle school students appeared as 7 246 (51.0%), 5 824 (41.0%), 5 409 (38.0%), 1 039 (7.3%), 2 042 (14.4%), 1 174 (8.3%) and 548 (3.9%), respectively. Boys reported more physical abuse than girls, while girls reported more emotional abuse and suicide ideation than boys (P<0.01). However, no gender differences were found in cases as sexual abuse, suicide planning or attempted suicide (P>0.01). After controlling for confounding variables, experiences on childhood abuse were significantly associated with suicidal ideation (OR=2.03, 95% CI: 1.72-2.40) and suicidal planning (OR=1.93, 95%CI: 1.57-2.37) among boys but significantly associated with suicidal ideation (OR= 2.45, 95% CI: 2.12-2.82), suicidal planning (OR=2.46, 95% CI: 2.02-3.00) and attempted suicide (OR=2.12, 95% CI: 1.61-2.78) among girls. RESULTS from multivariable logistic regression analysis showed that each type of childhood abuse, occurring at any time within the first 16 years of life, especially with continuous exposure, was significantly associated with suicidal behaviors. A significant graded-relationship was found between number of abusive childhood experiences and suicidal behaviors. Students that had been maltreated by parents or others were at high risk of engaging in suicidal behaviors. The findings suggest that the experience of any form of childhood abuse should be considered a risk factor for suicidal behaviors among the middle school students.

Discerning suicide in drug intoxication deaths: Paucity and primacy of suicide notes and psychiatric history.

PubMed

Rockett, Ian R H; Caine, Eric D; Connery, Hilary S; D'Onofrio, Gail; Gunnell, David J; Miller, Ted R; Nolte, Kurt B; Kaplan, Mark S; Kapusta, Nestor D; Lilly, Christa L; Nelson, Lewis S; Putnam, Sandra L; Stack, Steven; Värnik, Peeter; Webster, Lynn R; Jia, Haomiao

2018-01-01

A paucity of corroborative psychological and psychiatric evidence may be inhibiting detection of drug intoxication suicides in the United States. We evaluated the relative importance of suicide notes and psychiatric history in the classification of suicide by drug intoxication versus firearm (gunshot wound) plus hanging/suffocation-the other two major, but overtly violent methods. This observational multilevel (individual/county), multivariable study employed a generalized linear mixed model (GLMM) to analyze pooled suicides and undetermined intent deaths, as possible suicides, among the population aged 15 years and older in the 17 states participating in the National Violent Death Reporting System throughout 2011-2013. The outcome measure was relative odds of suicide versus undetermined classification, adjusted for demographics, precipitating circumstances, and investigation characteristics. A suicide note, prior suicide attempt, or affective disorder was documented in less than one-third of suicides and one-quarter of undetermined deaths. The prevalence gaps were larger among drug intoxication cases than gunshot/hanging cases. The latter were more likely than intoxication cases to be classified as suicide versus undetermined manner of death (adjusted odds ratio [OR], 41.14; 95% CI, 34.43-49.15), as were cases documenting a suicide note (OR, 33.90; 95% CI, 26.11-44.05), prior suicide attempt (OR, 2.42; 95% CI, 2.11-2.77), or depression (OR, 1.61; 95% CI, 1.38 to 1.88), or bipolar disorder (OR, 1.41; 95% CI, 1.10-1.81). Stratification by mechanism/cause intensified the association between a note and suicide classification for intoxication cases (OR, 45.43; 95% CI, 31.06-66.58). Prior suicide attempt (OR, 2.64; 95% CI, 2.19-3.18) and depression (OR, 1.48; 95% CI, 1.17-1.87) were associated with suicide classification in intoxication but not gunshot/hanging cases. Without psychological/psychiatric evidence contributing to manner of death classification, suicide by drug intoxication in the US is likely profoundly under-reported. Findings harbor adverse implications for surveillance, etiologic understanding, and prevention of suicides and drug deaths.

Discerning suicide in drug intoxication deaths: Paucity and primacy of suicide notes and psychiatric history

PubMed Central

Caine, Eric D.; Connery, Hilary S.; D’Onofrio, Gail; Gunnell, David J.; Miller, Ted R.; Nolte, Kurt B.; Kaplan, Mark S.; Kapusta, Nestor D.; Lilly, Christa L.; Nelson, Lewis S.; Putnam, Sandra L.; Stack, Steven; Värnik, Peeter; Webster, Lynn R.; Jia, Haomiao

2018-01-01

Objective A paucity of corroborative psychological and psychiatric evidence may be inhibiting detection of drug intoxication suicides in the United States. We evaluated the relative importance of suicide notes and psychiatric history in the classification of suicide by drug intoxication versus firearm (gunshot wound) plus hanging/suffocation—the other two major, but overtly violent methods. Methods This observational multilevel (individual/county), multivariable study employed a generalized linear mixed model (GLMM) to analyze pooled suicides and undetermined intent deaths, as possible suicides, among the population aged 15 years and older in the 17 states participating in the National Violent Death Reporting System throughout 2011–2013. The outcome measure was relative odds of suicide versus undetermined classification, adjusted for demographics, precipitating circumstances, and investigation characteristics. Results A suicide note, prior suicide attempt, or affective disorder was documented in less than one-third of suicides and one-quarter of undetermined deaths. The prevalence gaps were larger among drug intoxication cases than gunshot/hanging cases. The latter were more likely than intoxication cases to be classified as suicide versus undetermined manner of death (adjusted odds ratio [OR], 41.14; 95% CI, 34.43–49.15), as were cases documenting a suicide note (OR, 33.90; 95% CI, 26.11–44.05), prior suicide attempt (OR, 2.42; 95% CI, 2.11–2.77), or depression (OR, 1.61; 95% CI, 1.38 to 1.88), or bipolar disorder (OR, 1.41; 95% CI, 1.10–1.81). Stratification by mechanism/cause intensified the association between a note and suicide classification for intoxication cases (OR, 45.43; 95% CI, 31.06–66.58). Prior suicide attempt (OR, 2.64; 95% CI, 2.19–3.18) and depression (OR, 1.48; 95% CI, 1.17–1.87) were associated with suicide classification in intoxication but not gunshot/hanging cases. Conclusions Without psychological/psychiatric evidence contributing to manner of death classification, suicide by drug intoxication in the US is likely profoundly under-reported. Findings harbor adverse implications for surveillance, etiologic understanding, and prevention of suicides and drug deaths. PMID:29320540

Spatial suicide clusters in Australia between 2010 and 2012: a comparison of cluster and non-cluster among young people and adults.

PubMed

Robinson, Jo; Too, Lay San; Pirkis, Jane; Spittal, Matthew J

2016-11-22

A suicide cluster has been defined as a group of suicides that occur closer together in time and space than would normally be expected. We aimed to examine the extent to which suicide clusters exist among young people and adults in Australia and to determine whether differences exist between cluster and non-cluster suicides. Suicide data were obtained from the National Coronial Information System for the period 2010 and 2012. Data on date of death, postcode, age at the time of death, sex, suicide method, ICD-10 code for cause of death, marital status, employment status, and aboriginality were retrieved. We examined the presence of spatial clusters separately for youth suicides and adult suicides using the Scan statistic. Pearson's chi-square was used to compare the characteristics of cluster suicides with non-cluster suicides. We identified 12 spatial clusters between 2010 and 2012. Five occurred among young people (n = 53, representing 5.6% [53/940] of youth suicides) and seven occurred among adults (n = 137, representing 2.3% [137/5939] of adult suicides). Clusters ranged in size from three to 21 for youth and from three to 31 for adults. When compared to adults, suicides by young people were significantly more likely to occur as part of a cluster (difference = 3.3%, 95% confidence interval [CI] = 1.8 to 4.8, p < 0.0001). Suicides by people with an Indigenous background were also significantly more likely to occur in a cluster than suicide by non-Indigenous people and this was the case among both young people and adults. Suicide clusters have a significant negative impact on the communities in which they occur. As a result it is important to find effective ways of managing and containing suicide clusters. To date there is limited evidence for the effectiveness of those strategies typically employed, in particular in Indigenous settings, and developing this evidence base needs to be a future priority. Future research that examines in more depth the socio-demographic and clinical factors associated with suicide clusters is also warranted in order that appropriate interventions can be developed.

Suicide Trends Among Elementary School-Aged Children in the United States From 1993 to 2012.

PubMed

Bridge, Jeffrey A; Asti, Lindsey; Horowitz, Lisa M; Greenhouse, Joel B; Fontanella, Cynthia A; Sheftall, Arielle H; Kelleher, Kelly J; Campo, John V

2015-07-01

Suicide is a leading cause of death among school-aged children younger than 12 years but little is known about the epidemiology of suicide in this age group. To describe trends in suicide among US children younger than 12 years by sociodemographic group and method of death. Period trend analysis of national mortality data on suicide in children aged 5 to 11 years in the United States from January 1, 1993, to December 31, 2012. Data were analyzed per 5-year periods, between 1993 to 1997 and 2008 to 2012. Number of suicide deaths and crude suicide rates. Period trends in rates of suicide were estimated using negative binomial regression incidence rate ratios (IRRs). The overall suicide rate among children aged 5 to 11 years remained stable between 1993 to 1997 and 2008 to 2012 (from 1.18 to 1.09 per 1 million; IRR = 0.96; 95% CI, 0.90-1.03). However, the suicide rate increased significantly in black children (from 1.36 to 2.54 per 1 million; IRR = 1.27; 95% CI, 1.11-1.45) and decreased in white children (from 1.14 to 0.77 per 1 million; IRR = 0.86; 95% CI, 0.79-0.94). The overall firearm suicide rate (IRR = 0.69; 95% CI, 0.57-0.85) and firearm suicide rate among white boys (IRR = 0.72; 95% CI, 0.59-0.88) decreased significantly during the study. The rate of suicide by hanging/suffocation increased significantly in black boys (IRR = 1.35; 95% CI, 1.14-1.61), although the overall change in suicide rates by hanging/suffocation or other suicide methods did not change during the study. The stable overall suicide rate in school-aged children in the United States during 20 years of study obscured a significant increase in suicide incidence in black children and a significant decrease in suicide incidence among white children. Findings highlight a potential racial disparity that warrants attention. Further studies are needed to monitor these emerging trends and identify risk, protective, and precipitating factors relevant to suicide prevention efforts in children younger than 12 years.

Prevalence of Suicidal Ideation and Its Association with Positive Affect in Working Women: A Day Reconstruction Study

PubMed Central

Tian, Lili; Yang, Ying; Yang, Huijing; Huebner, E. Scott

2017-01-01

The suicide rate for females in China is the second highest worldwide, and China is the only country in the world in which the rate of suicides is higher for women than men. Affective instability has been shown to be a strong predictor of suicidal ideation, particularly among women. However, prior research has mainly focused on the impact of women's negative affect on suicidal ideation, ignoring the influence of positive affect on suicidal ideation. Studies have revealed that hopelessness, which is 1.3 times more important than depression for explaining suicidal ideation, is driven more by low levels of positive affect than by high levels of negative affect. Although positive affect has also been found to be related to suicidal ideation, and it demonstrates independent, beneficial effects on mental health, much remains to be learned about the association between positive affective instability and suicidal ideation. Therefore, we investigated the prevalence of suicidal ideation among Chinese working women and explored the differences between working women with and without suicidal ideation in the intensity and daily variability of positive affect. A total of 222 young working women of ages 22–36 years (M = 27.64, SD = 3.73) were recruited from a free weekend psychology lecture. The women subsequently completed a daily diary Day Reconstruction Method (DRM) as well as a suicidal ideation questionnaire. We used hierarchical linear modeling (HLM) to analyze the data, and the results showed that: (1) 10.81% of participates reported suicidal ideation, the intensity of positive affect (happiness, warmth/friendliness, interest and relaxation/calmness) was significantly lower for women with suicidal ideation compared to women without suicidal ideation; (2) differing diurnal patterns of positive emotions were observed between women with and without suicidal ideation; women with suicidal ideation demonstrated a significantly lower trend of growth and a higher volatility in happiness, warmth/friendliness, relaxation/calmness. Given that lower intensity of positive affect and greater affective instability significantly predicted suicidal ideation in Chinese women, researchers should pay more attention to the role of positive affect in female suicide prevention research and intervention efforts in the future. PMID:28377731