Substance use disorder and risk of suicidal ideation, suicide attempt and suicide death: a meta-analysis.

PubMed

Poorolajal, Jalal; Haghtalab, Tahereh; Farhadi, Mehran; Darvishi, Nahid

2016-09-01

This meta-analysis addressed the association between substance use disorder (SUD) and suicide outcomes based on current evidence. We searched PubMed, Web of Science and Scopus until May 2015. We also searched the reference lists of included studies and Psycinfo website. We included observational (cohort, case-control, cross-sectional) studies addressing the association between SUD and suicide. Our outcomes of interest were suicide ideation, suicide attempt and suicide death. For each outcome, we calculated the odds ratio (OR) or risk ratio (RR) with 95% confidence intervals (CI) based on the random-effects model. We identified a total of 12 413 references and included 43 studies with 870 967 participants. There was a significant association between SUD and suicidal ideation: OR 2.04 (95% CI: 1.59, 2.50; I 2 = 88.8%, 16 studies); suicide attempt OR 2.49 (95% CI: 2.00, 2.98; I 2 = 94.3%, 24 studies) and suicide death OR 1.49 (95% CI: 0.97, 2.00; I 2 = 82.7%, 7 studies). Based on current evidence, there is a strong association between SUD and suicide outcomes. However, evidence based on long-term prospective cohort studies is limited and needs further investigation. Moreover, further evidence is required to assess and compare the association between suicide outcomes and different types of illicit drugs, dose-response relationship and the way they are used. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Is Cumulative Exposure to Suicide Attempts and Deaths A Risk Factor for Suicidal Behavior among Firefighters? A Preliminary Study

PubMed Central

Kimbrel, Nathan A.; Pennington, Michelle L.; Cammarata, Claire M.; Leto, Frank; Ostiguy, William J.; Gulliver, Suzy B.

2016-01-01

The present study examined the association between cumulative exposure to suicide attempts and deaths and suicidal behavior in a sample of 61 professional firefighters. On average, firefighters reported 13.1 (SD=16.6) exposures over the course of their lifetime. Cumulative exposure to suicide attempts and deaths was positively correlated with suicidal behavior (r = 0.38, p = 0.004). Moreover, firefighters with 12+ exposures were more likely to screen positive for risk of suicidal behavior (OR = 7.885, p = 0.02). Additional research on the potential impact of cumulative exposure to suicide attempts and deaths on firefighters’ health and safety is needed. PMID:27371810

The Costs of Suicide and Sudden Death within an Organization

ERIC Educational Resources Information Center

Kinder, Andrew; Cooper, Cary L.

2009-01-01

The effect of any death spreads out to many people. Deaths that occur in the workplace need to be handled with particular care given that the bereaved family as well as work colleagues will have been affected. Death by suicide or situations when an employee becomes suicidal can challenge even the most experienced manager. This article aims to…

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.

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

PubMed

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

2015-02-01

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

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.

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.

Hemin-induced suicidal erythrocyte death.

PubMed

Gatidis, Sergios; Föller, Michael; Lang, Florian

2009-08-01

Several diseases, such as malaria, sickle cell disease, and ischemia/reperfusion may cause excessive formation of hemin, which may in turn trigger hemolysis. A variety of drugs and diseases leading to hemolysis triggers suicidal erythrocyte death or eryptosis, i.e., cell membrane scrambling and cell shrinkage. Eryptosis is elicited by increased cytosolic Ca(2+) activity and by ceramide. The present study explored whether hemin stimulates eryptosis. Cell membrane scrambling was estimated from annexin V-binding to phosphatidylserine exposed at the cell surface, cell shrinkage from forward scatter in fluorescence-activated cell sorter analysis, cytosolic Ca(2+) activity from Fluo3 fluorescence and ceramide formation from fluorescence-labeled antibody binding. Exposure to hemin (1-10 microM) within 48 h significantly increased annexin V-binding, decreased forward scatter, increased cytosolic Ca(2+) activity, and stimulated ceramide formation. In conclusion, hemin stimulates suicidal cell death, which may in turn contribute to the clearance of circulating erythrocytes and thus to anemia.

Teen Suicide and Changing Cause-of-Death Certification, 1953-1987.

ERIC Educational Resources Information Center

Males, Mike

1991-01-01

Examined whether tripling in teenage suicides since 1950s represents increase in suicides or in skill of medical examiners. Examined firearms and poisoning death from 1953-87. Concludes that increase in youth suicide is less dramatic than reported, and suicide increase indicated among youths and adults occurred from 1964-71 and has since…

Incidence of Near-Death Experiences Following Attempted Suicide.

ERIC Educational Resources Information Center

Greyson, Bruce

1986-01-01

Near-death experiences, profound subjective experiences occurring during a close brush with death and containing transcendental or mystical elements, have been reported to reduce suicidal ideation, despite their "romanticization" of death. Further studies are indicated in regard to the effect of those experiences on subsequent suicidal…

Capability for suicide interacts with states of heightened arousal to predict death by suicide beyond the effects of depression and hopelessness

PubMed Central

Ribeiro, Jessica D.; Yen, Shirley; Joiner, Thomas; Siegler, Ilene C.

2016-01-01

Background States of heightened arousal (e.g., agitation, sleep disturbance) have been repeatedly linked to suicidal thoughts and behaviors, including attempts and death. Studies have further indicated that these states may be particularly pernicious among individuals who evidence high suicidal capability. The objective of this study was to examine the interactive effects of heightened arousal and the capability for suicide in the prospective prediction of death by suicide. We examine this relation beyond the effects of robust predictors of suicide, namely depression and hopelessness. Methods Participants were drawn from a larger study of undergraduates who completed baseline assessments during their freshman year and were then followed to time of death. The sample in this study only included individuals who had died by suicide (n=96) or other causes (n=542). Proxy measures to assess predictor variables were constructed using items from the MMPI, which was administered at baseline. An independent sample of clinical outpatients (n=was used to evaluate the construct validity of the proxy measures). Results Results were in line with expectation: heightened arousal interacted with capability for suicide to prospectively predict death by suicide, such that, as severity of heightened arousal symptoms increased, the likelihood of death by suicide increased among individuals high but not low on capability for suicide. Limitations Limitations include the use of proxy measures, the extended length of follow-up, and the homogeneity of the sample (i.e., primarily White males). Conclusion These findings add to an emerging literature that supports the moderating influence of capability for suicide on the relationship between states of heightened arousal on the likelihood of death by suicide. PMID:26342889

Regional Variations in Suicide and Undetermined Death Rates among Adolescents across Canada.

PubMed

Renaud, Johanne; Lesage, Alain; Gagné, Mathieu; MacNeil, Sasha; Légaré, Gilles; Geoffroy, Marie-Claude; Skinner, Robin; McFaull, Steven

2018-04-01

Trends in rates of adolescent suicide and undetermined deaths in Canada from 1981 to 2012 were examined, focusing specifically on variations between Canadian regions. Exploratory hypotheses were formulated for regional variability in adolescent suicide rates over time in Canada. A descriptive time trend analysis using public domain vital statistics data was performed. All deaths from 1981 to 2012 among 15 to 19 year olds coded as suicides or undetermined intent according to the International Classification of Diseases, 9 th and 10 th Revisions were included. While there was an overall stability in adolescent suicide and undetermined death rates across Canada, regional analyses showed that Quebec experienced a 7.6% annual reduction between 2001 and 2012 while the Prairies and Atlantic provinces experienced significant annual increases since 2001. Ontario and British Columbia have had non-significant fluctuations since 2001. The trends remained similar overall when excluding undetermined deaths from the analyses. Variations in adolescent suicide trends across provinces were found. Factors such as provincial suicide action and prevention legislation contributing to these variations remain to be studied, but these regional differences point towards the need for better consistency of suicide prevention strategies across the country.

Increase in suicides the months after the death of Robin Williams in the US

PubMed Central

Santaella-Tenorio, Julian; Keyes, Katherine M.

2018-01-01

Investigating suicides following the death of Robin Williams, a beloved actor and comedian, on August 11th, 2014, we used time-series analysis to estimate the expected number of suicides during the months following Williams’ death. Monthly suicide count data in the US (1999–2015) were from the Centers for Disease Control and Prevention Wide-ranging ONline Data for Epidemiologic Research (CDC WONDER). Expected suicides were calculated using a seasonal autoregressive integrated moving averages model to account for both the seasonal patterns and autoregression. Time-series models indicated that we would expect 16,849 suicides from August to December 2014; however, we observed 18,690 suicides in that period, suggesting an excess of 1,841 cases (9.85% increase). Although excess suicides were observed across gender and age groups, males and persons aged 30–44 had the greatest increase in excess suicide events. This study documents associations between Robin Williams’ death and suicide deaths in the population thereafter. PMID:29415016

Suicidal Death of a Spouse: The Social Perception of the Survivor.

ERIC Educational Resources Information Center

Calhoun, Lawrence G.; And Others

1986-01-01

Investigated reactions of others to the surviving spouse of an individual who commits suicide. Results indicated (compared to those spouses of accident and leukemia victims) that the spouse of a suicide was viewed as being more to blame for the death, as having had a greater chance of preventing the death, and as being more ashamed of the death.…

Suicides, homicides, accidents, and other external causes of death among blacks and whites in the Southern Community Cohort Study.

PubMed

Sonderman, Jennifer S; Munro, Heather M; Blot, William J; Tarone, Robert E; McLaughlin, Joseph K

2014-01-01

Prior studies of risk factors associated with external causes of death have been limited in the number of covariates investigated and external causes examined. Herein, associations between numerous demographic, lifestyle, and health-related factors and the major causes of external mortality, such as suicide, homicide, and accident, were assessed prospectively among 73,422 black and white participants in the Southern Community Cohort Study (SCCS). Hazard ratios (HR) and 95% confidence intervals (CI) were calculated in multivariate regression analyses using the Cox proportional hazards model. Men compared with women (HR = 2.32; 95% CI: 1.87-2.89), current smokers (HR = 1.74; 95% CI: 1.40-2.17), and unemployed/never employed participants at the time of enrollment (HR = 1.67; 95% CI 1.38-2.02) had increased risk of dying from all external causes, with similarly elevated HRs for suicide, homicide, and accidental death among both blacks and whites. Blacks compared with whites had lower risk of accidental death (HR = 0.46; 95% CI: 0.38-0.57) and suicide (HR = 0.55; 95% CI: 0.31-0.99). Blacks and whites in the SCCS had comparable risks of homicide death (HR = 1.05; 95% CI: 0.63-1.76); however, whites in the SCCS had unusually high homicide rates compared with all whites who were resident in the 12 SCCS states, while black SCCS participants had homicide rates similar to those of all blacks residing in the SCCS states. Depression was the strongest risk factor for suicide, while being married was protective against death from homicide in both races. Being overweight/obese at enrollment was associated with reduced risks in all external causes of death, and the number of comorbid conditions was a risk factor for iatrogenic deaths. Most risk factors identified in earlier studies of external causes of death were confirmed in the SCCS cohort, in spite of the low SES of SCCS participants. Results from other epidemiologic cohorts are needed to confirm the novel findings identified

Psychiatric morbidity, violent crime, and suicide among children and adolescents exposed to parental death.

PubMed

Wilcox, Holly C; Kuramoto, Satoko J; Lichtenstein, Paul; Långström, Niklas; Brent, David A; Runeson, Bo

2010-05-01

This retrospective cohort study examined the risk for suicide, psychiatric hospitalization, and violent criminal convictions among offspring of parents who died from suicide, accidents, and other causes. Population-based data from multiple Swedish national registers were linked from 1969 to 2004. Participants were 44,397 offspring of suicide decedents, 41,467 offspring of accident decedents, 417,365 offspring of parents who died by other causes, and 3,807,867 offspring of alive parents. We estimated risk by mode of parental death (suicide, accident, other) and offspring age at parental death (childhood, adolescence, young adulthood). Offspring of suicide decedents were at greater risk for suicide than offspring of alive parents (incidence rate ratio [IRR] = 1.9; 95% confidence interval [CI] = 1.4 to 2.5), whereas offspring of accident decedents and other parental death were not at increased risk (p < .001). The risk for offspring suicide differed by the developmental period during which parental suicide occurred. Child and adolescent offspring of suicide decedents were at threefold greater risk for suicide (IRR = 3.0; 95% CI = 1.7 to 5.3; IRR = 3.1, 95% CI = 2.1 to 4.6, respectively). Young adults were not at increased risk for suicide (IRR = 1.3; 95% CI = 0.9 to 1.9). Offspring of suicide decedents had an especially high risk of hospitalization for suicide attempt, depressive, psychotic, and personality disorders. Child survivors of parental suicide were at particularly high risk for hospitalization for drug disorders and psychosis. All offspring who experienced parental death, regardless of mode or age, were at increased risk for violent criminal convictions. Mode of parental death and offspring age at parental death are associated with offspring long-term risk for suicide and hospitalization for specific psychiatric disorders.

Misclassification of suicide deaths: examining the psychiatric history of overdose decedents.

PubMed

Bohnert, Amy S B; McCarthy, John F; Ignacio, Rosalinda V; Ilgen, Mark A; Eisenberg, Anna; Blow, Frederic C

2013-10-01

The intent of a death from overdose can be difficult to determine. The goal of this study was to examine the association of psychiatric diagnoses among overdose deaths ruled by a medical examiner as intentional, unintentional and indeterminate intent. All Veterans Health Administration patients in Fiscal Year 1999 (n=3 291 891) were followed through Fiscal Year 2006. We tested the relative strength of association between psychiatric disorders among types of overdoses (categorised by intent) using multinomial models, adjusted for age, sex, Veterans Affairs priority status and Charlson comorbidity scores. Data were from National Death Index records and patient medical records. Substance use disorders (SUD) had a stronger association with indeterminate intent overdoses than intentional overdoses (adjusted OR (AOR)=1.80, 95% CI 1.47 to 2.22). SUDs also had a stronger association with unintentional overdoses than intentional (AOR=1.48, 95% CI 1.27 to 1.72), but the reverse was true for all other psychiatric disorders (except post-traumatic stress disorder). Overdoses ruled indeterminate may be misclassified suicide deaths and are important to suicide surveillance and prevention efforts. Additionally, overdose deaths not classified as suicides may include some cases due to suicidal-like thinking without overt suicidal intent.

Regional Variations in Suicide and Undetermined Death Rates among Adolescents across Canada

PubMed Central

Lesage, Alain; Gagné, Mathieu; MacNeil, Sasha; Légaré, Gilles; Geoffroy, Marie-Claude; Skinner, Robin; McFaull, Steven

2018-01-01

Objective Trends in rates of adolescent suicide and undetermined deaths in Canada from 1981 to 2012 were examined, focusing specifically on variations between Canadian regions. Exploratory hypotheses were formulated for regional variability in adolescent suicide rates over time in Canada. Methods A descriptive time trend analysis using public domain vital statistics data was performed. All deaths from 1981 to 2012 among 15 to 19 year olds coded as suicides or undetermined intent according to the International Classification of Diseases, 9th and 10th Revisions were included. Results While there was an overall stability in adolescent suicide and undetermined death rates across Canada, regional analyses showed that Quebec experienced a 7.6% annual reduction between 2001 and 2012 while the Prairies and Atlantic provinces experienced significant annual increases since 2001. Ontario and British Columbia have had non-significant fluctuations since 2001. The trends remained similar overall when excluding undetermined deaths from the analyses. Conclusions Variations in adolescent suicide trends across provinces were found. Factors such as provincial suicide action and prevention legislation contributing to these variations remain to be studied, but these regional differences point towards the need for better consistency of suicide prevention strategies across the country. PMID:29662522

Differences in suicide and death ideation among veterans and nonveterans with serious mental illness.

PubMed

Jahn, Danielle R; Muralidharan, Anjana; Drapalski, Amy L; Brown, Clayton H; Fang, Li Juan; Lucksted, Alicia

2018-02-01

Individuals with serious mental illness and veterans are two populations at elevated risk for suicide; however, research has not examined whether veterans with serious mental illness may be at higher suicide risk than nonveterans with serious mental illness. Additionally, overlapping risk factors for suicide in these populations may account for differences in suicide-related outcomes between these groups. Therefore, the aim of this study was to identify differences in death ideation and suicide ideation among veterans and nonveterans with serious mental illness. We also aimed to explore these effects after adjusting for potentially shared risk factors. We found that veterans with serious mental illness reported death ideation and suicide ideation more than twice as often as nonveterans with serious mental illness. After adjusting for demographic, psychiatric, and theory-driven risk factors, the effect of veteran status on death ideation remained significant, though the effect on suicide ideation was no longer significant. Depressive and psychotic symptoms were significant predictors of death ideation; depressive symptoms and hostility were significant predictors of suicide ideation. Clinicians should particularly monitor death ideation and suicide ideation in veterans with serious mental illness, as well as associated clinical risk factors such as depression, psychotic symptoms, and hostility. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Thoughts of Death and Suicidal Ideation in Nonpsychiatric Human Immunodeficiency Virus Seropositive Individuals

ERIC Educational Resources Information Center

Robertson, Kevin; Parsons, Thomas D.; van der Horst, Charles; Hall, Colin

2006-01-01

The present study examines the prevalence of death thoughts and suicidality in HIV infection. Subjects (n=246) were examined for psychiatric morbidity and suicidality. Compared to high risk HIV seronegatives, HIV seropositives (HIV+) had significantly increased frequency and severity of both suicidal ideation and death thoughts. Two-thirds of…

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.

Mining for Murder-Suicide: An Approach to Identifying Cases of Murder-Suicide in the National Violent Death Reporting System Restricted Access Database.

PubMed

McNally, Matthew R; Patton, Christina L; Fremouw, William J

2016-01-01

The National Violent Death Reporting System (NVDRS) is a United States Centers for Disease Control and Prevention (CDC) database of violent deaths from 2003 to the present. The NVDRS collects information from 32 states on several types of violent deaths, including suicides, homicides, homicides followed by suicides, and deaths resulting from child maltreatment or intimate partner violence, as well as legal intervention and accidental firearm deaths. Despite the availability of data from police narratives, medical examiner reports, and other sources, reliably finding the cases of murder-suicide in the NVDRS has proven problematic due to the lack of a unique code for murder-suicide incidents and outdated descriptions of case-finding procedures from previous researchers. By providing a description of the methods used to access to the NVDRS and coding procedures used to decipher these data, the authors seek to assist future researchers in correctly identifying cases of murder-suicide deaths while avoiding false positives. © 2015 American Academy of Forensic Sciences.

Stimulation of suicidal erythrocyte death by sulforaphane.

PubMed

Alzoubi, Kousi; Calabrò, Salvatrice; Faggio, Caterina; Lang, Florian

2015-03-01

Sulforaphane, an isothiocyanate from cruciferous vegetable, counteracts malignancy. The effect is at least in part due to the stimulation of suicidal death or apoptosis of tumour cells. Mechanisms invoked in sulforaphane-induced apoptosis include mitochondrial depolarization and altered gene expression. Despite the lack of mitochondria and nuclei, erythrocytes may, similar to apoptosis of nucleated cells, enter eryptosis, a suicidal cell death characterized by cell shrinkage and phosphatidylserine translocation to the erythrocyte surface. Stimulators of eryptosis include increase of cytosolic Ca(2+)-activity ([Ca(2+)]i). This study explored whether sulforaphane stimulates eryptosis. Cell volume was estimated from forward scatter, phosphatidylserine exposure at the cell surface from annexin V binding and [Ca(2+)]i from Fluo-3 fluorescence. A 48-hr treatment of human erythrocytes with sulforaphane (50-100 μM) significantly decreased forward scatter, significantly increased the percentage of annexin V binding cells and significantly increased [Ca(2+)]i. The effect of sulforaphane (100 μM) on annexin V binding was significantly blunted but not abrogated by the removal of extracellular Ca(2+). Sulforaphane (100 μM) significantly increased ceramide formation. In conclusion, sulforaphane stimulates suicidal erythrocyte death or eryptosis, an effect at least partially, but not exclusively, due to the stimulation of Ca(2+) entry and ceramide formation. © 2014 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

Does art imitate death? Depictions of suicide in fiction.

PubMed

Pridmore, Saxby; Walter, Garry

2013-02-01

To determine whether fiction (narrative products) deals with the issue of suicide and, if so, what it tells us about suicide "drivers". Accounts of suicide in narrative products were sought through web-based lists, book club members, other active readers and a prize-winning film writer and producer. Seventy-one depictions of fictional suicidal events were identified. In 12 suicides, the author appeared to indicate that the death was directly or indirectly due to mental disorder. In 15 suicides, the motivation could not be determined by the reader, and in 44 cases the motivation was social/situational factors. Suicidal events are depicted in fiction, and the features are broadly similar to the features of suicide in the real world. Should it be determined that cultural influences, including fiction, are important in suicide, any preventive activities aimed at modifying cultural influences will need to consider all forms of narrative product.

The Correlations of Attitudes toward Suicide with Death Anxiety, Religiosity, and Personal Closeness to Suicide.

ERIC Educational Resources Information Center

Minear, Julianne D.; Brush, Lorelei R.

1980-01-01

A study of college students showed the more supportive students were about the right of people to commit suicide, the more anxious they felt about death, the less strongly they were committed to a religion, and the more seriously they had thought about committing suicide. (Author)

Death and suicide among former child and adolescent psychiatric patients

PubMed Central

Engqvist, Ulf; Rydelius, Per-Anders

2006-01-01

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

Death and suicide among former child and adolescent psychiatric patients.

PubMed

Engqvist, Ulf; Rydelius, Per-Anders

2006-11-02

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

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

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

The Impact of Improving Suicide Death Classification in South Korea: A Comparison with Japan and Hong Kong

PubMed Central

Chan, Chee Hon; Caine, Eric D.; Chang, Shu Sen; Lee, Won Jin; Cha, Eun Shil; Yip, Paul Siu Fai

2015-01-01

Introduction The suicide rate of South Korea has increased dramatically during the past decades, as opposed to steadily decreasing trends in Japan and Hong Kong. Although the recent increase of suicide in South Korea may be related to changing socioeconomic conditions and other contextual factors, it may also reflect, in part, a reduction of misidentified suicide cases due to improving classification of manner of death. Method We compared the annual proportional change of suicide, undetermined death, and accidental death from South Korea with those of Japan and Hong Kong from 1992 to 2011; a greater proportional change of the manner-of-death categories during the period is indicative of a relatively less stable registration and hence a greater potential for misclassification bias on reported suicide trends. Subgroup analyses stratifying the deaths by methods were also conducted. To estimate the impact, the age-standardized rates of these three death categories in each site were calculated. Results We found that, during the 20-year observation period, the proportional change of suicide, undetermined death, and accidental death in South Korea was significantly greater than Japan and Hong Kong. Similar observations were made in subgroup analyses. While death rates of the three manners in Japan and Hong Kong generally moved in a parallel fashion, the increase of suicide in South Korea occurred concomitantly with a significant reduction of its accidental death rate. 43% of the increase in suicides could be attributed to the decrease in accidental deaths, while 57% of the increase could be due to fundamental causes. Conclusion Our data suggest that, during the mid-1990s and after, the increasing burden of suicide in South Korea initially was masked, in part, by misclassification. Thus, the later apparently rapid increase of suicides reflected steadily improving classification of manner of death, as well as a more fundamental increase in the suicide rate. PMID:25992879

The impact of improving suicide death classification in South Korea: a comparison with Japan and Hong Kong.

PubMed

Chan, Chee Hon; Caine, Eric D; Chang, Shu Sen; Lee, Won Jin; Cha, Eun Shil; Yip, Paul Siu Fai

2015-01-01

The suicide rate of South Korea has increased dramatically during the past decades, as opposed to steadily decreasing trends in Japan and Hong Kong. Although the recent increase of suicide in South Korea may be related to changing socioeconomic conditions and other contextual factors, it may also reflect, in part, a reduction of misidentified suicide cases due to improving classification of manner of death. We compared the annual proportional change of suicide, undetermined death, and accidental death from South Korea with those of Japan and Hong Kong from 1992 to 2011; a greater proportional change of the manner-of-death categories during the period is indicative of a relatively less stable registration and hence a greater potential for misclassification bias on reported suicide trends. Subgroup analyses stratifying the deaths by methods were also conducted. To estimate the impact, the age-standardized rates of these three death categories in each site were calculated. We found that, during the 20-year observation period, the proportional change of suicide, undetermined death, and accidental death in South Korea was significantly greater than Japan and Hong Kong. Similar observations were made in subgroup analyses. While death rates of the three manners in Japan and Hong Kong generally moved in a parallel fashion, the increase of suicide in South Korea occurred concomitantly with a significant reduction of its accidental death rate. 43% of the increase in suicides could be attributed to the decrease in accidental deaths, while 57% of the increase could be due to fundamental causes. Our data suggest that, during the mid-1990s and after, the increasing burden of suicide in South Korea initially was masked, in part, by misclassification. Thus, the later apparently rapid increase of suicides reflected steadily improving classification of manner of death, as well as a more fundamental increase in the suicide rate.

Socioeconomic factors outweigh climate in the regional difference of suicide death rate in Taiwan.

PubMed

Tsai, Jui-Feng

2010-09-30

The present study explored both socioeconomic and climatic factors to obtain a more comprehensive view of the asymmetric regional suicide death rate during 1998-2006 in Taiwan. The annual suicide death rate, population and meteorological data from 19 cities/counties in Taiwan were analysed by multiple regression. Five socioeconomic (sex ratio, no spouse, aged, unemployment and low income) and three climatic (temperature, rainfall and sunshine) factors were identified as significant, explaining 59.0% of the variance in the total suicide death rate. 'Without spouse' and 'aged' were associated with the highest risk, while 'low income with financial aids' was strongly protective. The most influential climatic factor was 'temperature,' which was negatively correlated with suicide. 'Sunshine' was positively associated with suicide. The socioeconomic and climatic factors contributed 52.7% and 6.8%, respectively, to the variance of the total suicide death rate. Limitations of the study included the fact that no individual events were considered, the study was of relatively short duration and it was confined to the territory of Taiwan. Socioeconomic factors outweighed climatic factors in explaining regional differences in the suicide death rate in Taiwan. Temperature weighed more than sunshine. 'Thermotherapy' seems more clinically relevant than the popular light therapy, at least in Taiwan. Copyright © 2008 Elsevier Ltd. All rights reserved.

A Retrospective Study of Blade Wound Characteristics in Suicide and Homicide.

PubMed

Krywanczyk, Alison; Shapiro, Steven

2015-12-01

The distinction between self-inflicted blade wounds and blade wounds inflicted by another can be difficult in situations where there is little available history or context. We reviewed homicides and suicides in the past 10 years at the Vermont Office of the Chief Medical Examiner to define the characteristics of homicidal and suicidal blade wounds. All homicides and suicides involving blade wounds, not just those in which blade wounds were the cause of death, were included. Information regarding victim demographics, location and type of injuries, toxicology, and evidence of suicidality was gathered. Blade wounds were the cause of death in 85.7% of homicides but only in 36% of suicides. Hanging and gunshot wounds were the cause of death in 28% and 24% of suicides, respectively. Multiple stab wounds were found in 10% of homicides and in 0% of suicides, whereas multiple incised wounds were found in 60% of suicides and only 10% of homicides. However, several unusual instances of suicide were found, including suicides with clothing damage or bone or cartilage injury from blade wounds. No characteristics of blade wounds were definitive for homicide or suicide. History and circumstances of the scene are thus crucial in determining the manner of death.

Suicide verdicts as opposed to accidental deaths in substance-related fatalities (UK, 2001-2007).

PubMed

Vento, Alessandro E; Schifano, Fabrizio; Corkery, John M; Pompili, Maurizio; Innamorati, Marco; Girardi, Paolo; Ghodse, Hamid

2011-07-01

Substance-related deaths account for a great number of suicides. To investigate levels and characteristics of suicide verdicts, as opposed to accidental deaths, in substance misusers. Psychological autopsy study of cases from the UK National Programme on Substance Abuse Deaths (np-SAD) during the period 2001-2007. Between January 2001 and December 2007, 2108 suicides were reported to the np-SAD. Typical suicide victims were White and older than 50 (respectively 95% and 41% of cases). Medications, especially antidepressants (44%), were prescribed to 87% of victims. Significantly fewer suicide victims than controls presented positive blood toxicological results for illicit drugs (namely: cocaine, heroin, amphetamines, ecstasy-type drugs, cannabis, and GHB/GBL) and alcohol. Suicide prevention programmes should devote specific attention to deaths among substance misusers who are at high risk of fatal intentional self-harm. Specific characteristics distinguish those at risk; caregivers should be better educated as to what these factors are. Limitations of the current study included lack of provision of comprehensive information relating to the victims' psychosocial variables. Furthermore, no differentiation between different classes of antidepressants in terms of involvement in suicide was here provided. Copyright © 2011 Elsevier Inc. All rights reserved.

Decreases in Suicide Deaths and Attempts Linked to the White Mountain Apache Suicide Surveillance and Prevention System, 2001-2012.

PubMed

Cwik, Mary F; Tingey, Lauren; Maschino, Alexandra; Goklish, Novalene; Larzelere-Hinton, Francene; Walkup, John; Barlow, Allison

2016-12-01

We evaluated the impact of a comprehensive, multitiered youth suicide prevention program among the White Mountain Apache of Arizona since its implementation in 2006. Using data from the tribally mandated Celebrating Life surveillance system, we compared the rates, numbers, and characteristics of suicide deaths and attempts from 2007 to 2012 with those from 2001 to 2006. The overall Apache suicide death rates dropped from 40.0 to 24.7 per 100 000 (38.3% decrease), and the rate among those aged 15 to 24 years dropped from 128.5 to 99.0 per 100 000 (23.0% decrease). The annual number of attempts also dropped from 75 (in 2007) to 35 individuals (in 2012). National rates remained relatively stable during this time, at 10 to 13 per 100 000. Although national rates remained stable or increased slightly, the overall Apache suicide death rates dropped following the suicide prevention program. The community surveillance system served a critical role in providing a foundation for prevention programming and evaluation.

Unusual self-electrocution simulating judicial electrocution by an adolescent.

PubMed

Murty, O P

2008-06-01

Electrocution is one of the rarest modes of suicide. In this case, one school going adolescent committed suicide by electrocution using bare electric wire. This is a rare case of suicidal death by applying live wires around the wrists, simulating the act of judicial electrocution. He positioned himself on armed chair and placed the nude wire loops from a cable around both wrists and switched on the current by plugging in to nearest socket by foot. There were linear electric contact wounds completely encircling around the both wrists. In addition to these linear electric burns all around wrists, there were electrical burns over both hands. This death highlights the need of supervision and close watch on children for self-destructing activities and behavior. This case also highlights unusual method adopted by adolescent to end his life.

Homicide and Suicide During the Perinatal Period: Findings from the National Violent Death Reporting System

PubMed Central

Palladino, Christie Lancaster; Singh, Vijay; Campbell, Jacquelyn; Flynn, Heather; Gold, Katherine

2012-01-01

Objective Homicide and suicide are two important and potentially preventable causes of maternal injury. We analyzed data from the National Violent Death Reporting System to estimate the rates of pregnancy-associated homicide and suicide in a multi-state sample, to compare these rates with other causes of maternal mortality, and to describe victims’ demographic characteristics. Methods We analyzed data from female victims of reproductive age from 2003–2007. We identified pregnancy-associated violent deaths as deaths due to homicide or suicide during pregnancy or within the first year postpartum. We calculated the rates of pregnancy-associated homicide and suicide as the number of deaths per 100,000 live births in the sample population. We used descriptive statistics to report victims’ demographic characteristics and prevalence of intimate partner violence (IPV). Results There were 94 counts of pregnancy-associated suicide and 139 counts of pregnancy-associated homicide, yielding pregnancy-associated suicide and homicide rates of 2.0 and 2.9 deaths/100,000 live births, respectively. Victims of pregnancy-associated suicide were significantly more likely to be older and of Caucasian or American Indian descent as compared to all live births in NVDRS states. Pregnancy-associated homicide victims were significantly more likely to be at the extremes of the age range and African American. 54.3% of pregnancy-associated suicides involved intimate partner conflict that appeared to contribute to the suicide. 45.3% of pregnancy-associated homicides were IPV-associated. Conclusions Our results indicate that pregnancy-associated homicide and suicide are important contributors to maternal mortality and confirm the need to evaluate the relationships between socio demographic disparities and IPV with pregnancy-associated violent death. PMID:22015873

'Hidden' suicides amongst deaths certified as undetermined intent, accident by pesticide poisoning and accident by suffocation in Taiwan.

PubMed

Chang, Shu-Sen; Sterne, Jonathan A C; Lu, Tsung-Hsueh; Gunnell, David

2010-02-01

To identify cause-of-death categories in which suicides might be misclassified in Taiwan. We plotted secular trends (1971-2007) in sex- and method-specific rates of deaths classified as suicide, undetermined intent and accident for the Taiwanese population aged 15+ and compared the sex, age and marital status profiles of deaths in these three categories by method of death. The demographic profiles of registered suicides generally resembled those for deaths of undetermined intent and accidents by pesticide poisoning/suffocation but differed from those for accidents from non-pesticide poisoning/drowning/falling/poisoning by non-domestic gas. For the period 1990-2007, suicide rates based on suicides alone (14.8 per 100,000) would increase by 23, 7 and 1%, respectively, when including deaths of undetermined intent, accidental pesticide poisonings and accidental suffocations. Suicide rates may be underestimated by more than 30% in Taiwan because some suicides are 'hidden' amongst deaths certified as due to other causes.

Ethnic/racial misidentification in death: a problem which may distort suicide statistics.

PubMed

Andres, V R

1977-01-01

Since the majority of suicide studies are ex post facto studies of demographic data collected by pathologists anc coroner's investigators, the role of the forensic scientist in determining the accuracy of statistical analyses of death is extremely important. This paper discusses how two salient features of a decedent, surname and residence location, can be misleading in determining the ethnic/racial classification of the decreased. Because many Southern California Indians have Spanish Surnames and most do not reside on an Indian reservation it is shown that the suicide statistics may represent an over-estimation of actual Mexican-American suicidal deaths while simultaneously representing an under-estimation of the suicides among American Indians of the region.

Study of deaths by suicide of homosexual prisoners in Nazi Sachsenhausen concentration camp.

PubMed

Cuerda-Galindo, Esther; López-Muñoz, Francisco; Krischel, Matthis; Ley, Astrid

2017-01-01

Living conditions in Nazi concentration camps were harsh and inhumane, leading many prisoners to commit suicide. Sachsenhausen (Oranienburg, Germany) was a concentration camp that operated from 1936 to 1945. More than 200,000 people were detained there under Nazi rule. This study analyzes deaths classified as suicides by inmates in this camp, classified as homosexuals, both according to the surviving Nazi files. This collective was especially repressed by the Nazi authorities. Data was collected from the archives of Sachsenhausen Memorial and the International Tracing Service in Bad Arolsen. Original death certificates and autopsy reports were reviewed. Until the end of World War II, there are 14 death certificates which state "suicide" as cause of death of prisoners classified as homosexuals, all of them men aged between 23 and 59 years and of various religions and social strata. Based on a population of 1,200 prisoners classified as homosexuals, this allows us to calculate a suicide rate of 1,167/100,000 (over the period of eight years) for this population, a rate 10 times higher than for global inmates (111/100,000). However, our study has several limitations: not all suicides are registered; some murders were covered-up as suicides; most documents were lost during the war or destroyed by the Nazis when leaving the camps and not much data is available from other camps to compare. We conclude that committing suicides in Sachsenhausen was a common practice, although accurate data may be impossible to obtain.

Forensic toxicology analysis of self-poisoning suicidal deaths in Tehran, Iran; trends between 2011-2015.

PubMed

Kordrostami, Roya; Akhgari, Maryam; Ameri, Maryam; Ghadipasha, Masoud; Aghakhani, Kamran

2017-06-13

Suicide ranks among the top ten causes of death in all age groups all over the world. There are many methods for committing suicide including self-poisoning, firearm and hanging. The aim of the present study was to provide an overview of self-poisoning related suicidal deaths with special focus on forensic toxicology analysis results in Tehran, Iran from 2011 to 2015. All suspicious cases with the the history of self-poisoning were investigated to define the cause and manner of death under the supervision of forensic medicine practitioners. Postmortem samples were analysed in forensic toxicology laboratory to confirm the presence of drugs in cadaver of suicidal cases. Drugs and poisons were analysed using thin layer chromatography, high performance liquid chromatography, gas chromatography/mass spectrometry, headspace gas chromatography and gas chromatography equipped with nitrogen phosphorus detector. Demographic data were collected from autopsy reports of all cases with confirmed self-poisoning suicidal cause of death. Results showed that 674 cases of self-poisoning deaths were investigated during a five-year study period, of which 68.55% were male. The most often used suicide method was self-poisoning in young population. Phosphine gas liberated from aluminum phosphide tablets was the most toxic substance detected in postmortem samples (619 cases) followed by opioids, methamphetamine, organophosphates, cyanide and strychnine. In conclusion self-poisoning suicidal death was predominant in young male population in Tehran, Iran. It seems that free access to suicide means such as drugs and poisons should be restricted by national and health authorities. Not applicable.

Daydreaming about Death: Violent Daydreaming as a Form of Emotion Dysregulation in Suicidality

ERIC Educational Resources Information Center

Selby, Edward A.; Anestis, Michael D.; Joiner, Thomas E., Jr.

2007-01-01

Anecdotal and empirical evidence suggests that suicidal individuals may daydream about suicide as a method of mood regulation (including increasing positive affect). These daydreams may center on future suicidal plans, previous suicide attempts, or on the ways that others will react to their death. Yet, even though violent daydreams may increase…

Maternal Deaths From Suicide and Overdose in Colorado, 2004-2012.

PubMed

Metz, Torri D; Rovner, Polina; Hoffman, M Camille; Allshouse, Amanda A; Beckwith, Krista M; Binswanger, Ingrid A

2016-12-01

To ascertain demographic and clinical characteristics of maternal deaths from self-harm (accidental overdose or suicide) to identify opportunities for prevention. We report a case series of pregnancy-associated deaths resulting from self-harm in the state of Colorado between 2004 and 2012. Self-harm deaths were identified from several sources, including death certificates. Birth and death certificates along with coroner, prenatal care, and delivery hospitalization records were abstracted. Descriptive analyses were performed. For context, we describe demographic characteristics of women with a maternal death from self-harm and all women with live births in Colorado. Among the 211 total maternal deaths in Colorado over the study interval, 30% (n=63) resulted from self-harm. The pregnancy-associated death ratio from overdose was 5.0 (95% confidence interval [CI] 3.4-7.2) per 100,000 live births and from suicide 4.6 (95% CI 3.0-6.6) per 100,000 live births. Detailed records were obtained for 94% (n=59) of women with deaths from self-harm. Deaths were equally distributed throughout the first postpartum year (mean 6.21±3.3 months postpartum) with only six maternal deaths during pregnancy. Seventeen percent (n=10) had a known substance use disorder. Prior psychiatric diagnoses were documented in 54% (n=32) and prior suicide attempts in 10% (n=6). Although half (n=27) of the women with deaths from self-harm were noted to be taking psychopharmacotherapy at conception, 48% of them discontinued the medications during pregnancy. Fifty women had toxicology testing available; pharmaceutical opioids were the most common drug identified (n=21). Self-harm was the most common cause of pregnancy-associated mortality, with most deaths occurring in the postpartum period. A four-pronged educational and program building effort to include women, health care providers, health care systems, and both governments and organizations at the community and national levels may allow for a

Violent Deaths Among Georgia Workers: An Examination of Suicides and Homicides by Occupation, 2006-2009.

PubMed

Lavender, Antionette; Ramirez-Irizarry, Viani; Bayakly, A Rana; Koplan, Carol; Bryan, J Michael

2016-11-01

Workers in certain occupations may be at an increased risk of a violent-related death such as homicide or suicide. The purpose of this study is to describe rates of violent deaths among Georgia workers by occupation, including cases occurring at work and outside of the workplace, and identify leading circumstances surrounding suicides and homicides for the occupations most at risk. Data from the 2006-2009 Georgia Violent Death Reporting System were used. Occupational text fields were recoded into 23 major occupation categories based on the 2010 Standard Occupational Classification system. Crude rates and standardized mortality ratios for violent deaths (suicides and homicides) were calculated by occupation among Georgia workers aged ≥16 years. The leading circumstances precipitating violent deaths among the high-risk occupations were described. Analyses were conducted during 2012-2013 and 2015. A total of 4,616 Georgia resident workers were victims of a violent death during 2006-2009. Of these deaths, 2,888 (62.6%) were suicides and 1,728 (37.4%) were homicides. Farming, fishing, and forestry occupations had the highest rate of violent deaths at 80.5 per 100,000 workers followed by construction and extraction occupations at 65.5 per 100,000. The most common suicide circumstances among workers were having a current depressed mood, a current mental health problem, and an intimate partner problem. Use of the Violent Death Reporting System provides a unique opportunity to explore violent deaths among workers. This analysis shows the need to ensure that workers have access to workplace and community-based suicide and violence prevention services. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Paediatric suicide in the USA: analysis of the National Child Death Case Reporting System.

PubMed

Trigylidas, Theodore E; Reynolds, Eliza M; Teshome, Getachew; Dykstra, Heather K; Lichenstein, Richard

2016-08-01

Suicide is a leading cause of death among youths. The relationship between mental health, psychosocial factors and youth suicidality needs further analysis. To describe paediatric suicide in the USA and the impact of mental health and substance abuse using the National Child Death Review Case Reporting System (CDR-CRS). To identify psychosocial correlates contributing to suicide and whether these factors are more common among individuals with history of mental illness or substance abuse. Deidentified data (CDR-CRS) from 2004 to 2012 was obtained from 29 participating states. Demographic data and psychosocial correlates, including age, gender, cause of death, history of mental illness and/or substance abuse, school concerns, previous suicide attempts and family history of suicide, were collected. A total of 2850 suicides were identified. Mean age was 15.6±1.9 years; (range 7-21 years) 73.6% male and 65.1% Caucasian. The leading causes of death were asphyxia (50.2%) and weapon/firearm (36.5%). Among all subjects, 25.5% had history of mental illness and 19.0% had history of substance abuse. 60.0% had no report of mental illness or substance abuse. Subjects with both mental illness and substance abuse were more likely to have school concerns (OR=4.1 (p<0.001)), previous suicide attempts (OR=4.2 (p<0.001)) and a family history of suicide (OR=3.2 (p<0.001)) compared with subjects without those characteristics. Most suicide records in the CDR-CRS had no indication of mental illness or substance abuse. The youth with mental-illness/substance-abuse issues were more likely to have other compounding psychosocial correlates that may be warning signs of suicide. 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 due to mental diseases based on the Vital Statistics Survey Death Form].

PubMed

Takizawa, Tohru

2012-06-01

Mental diseases such as schizophrenia and depression put patients at risk for suicide. It is extremely important to understand that one way of preventing suicide is to determine the actual mental state of the individual. The purpose of this study was to analyze the true mental state of suicide victims reported in the vital statistics. This study investigated the vital statistics of 30,299 suicide victims in Japan in 2008. The use of these basic statistics for non-statistical purposes was approved by the Japanese Ministry of Health, Labour and Welfare. The method involved reviewing the Vital Statistics Survey Death Form at the Ministry of Health, Labour and Welfare as well as analyzing their Online Reporting of Vital Statistics. Furthermore, this study was able to validate 29,799 of the 30,299 suicides (98.3%) that occurred in 2008. Mental diseases were validated not only from the "Cause of death" section as marked on the death certificate, but also by information found in sections for "Additional items for death by external cause" and "Other special remarks." RESULTS; From the Vital Statistics Survey Death Form and Online Reporting of Vital Statistics, 2964 individuals with either a mental disease or mental disorder were identified. Of the 2964 identified individuals, 55 had dementia (of which 13 were dementia in Alzheimer's disease), 116 had alcohol dependence/psychotic disorder, 550 had schizophrenia, 101 had bipolar affective disorder, 1,913 has had a depressive episode, 13 had obsessive-compulsive disorder, 22 had adjustment disorders, 14 had eating disorders, 49 had nonorganic sleep disorders, 24 had personality disorder, and 6 had pervasive developmental disorders. In addition, 125 individuals had more than one mental disease. The national police statistics from 2008 show that 1,368 suicide victims had schizophrenia and 6,490 had depression. These figures show quite a difference between the results of this study and the police statistics. Further, there have

Does Marital Status Predict the Odds of Suicidal Death in Taiwan? A Seven-Year Population-Based Study

ERIC Educational Resources Information Center

Yeh, Jui-Yuan; Xirasagar, Sudha; Liu, Tsai-Ching; Li, Chong-Yi; Lin, Herng-Ching

2008-01-01

Using nationwide, 7-year population-based data for 1997-2003, we examined marital status to see if it predicted suicide among the ethnic Chinese population of Taiwan. Using cause of death data, with a case-control design, two groups--total adult suicide deaths, n = 17,850, the study group, and adult deaths other than suicide, n = 71,400 (randomly…

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

Does marital status predict the odds of suicidal death in taiwan? A seven-year population-based study.

PubMed

Yeh, Jui-Yuan; Xirasagar, Sudha; Liu, Tsai-Ching; Li, Chong-Yi; Lin, Herng-Ching

2008-06-01

Using nationwide, 7-year population-based data for 1997-2003, we examined marital status to see if it predicted suicide among the ethnic Chinese population of Taiwan. Using cause of death data, with a case-control design, two groups-total adult suicide deaths, n = 17,850, the study group, and adult deaths other than suicide, n = 71,400 (randomly selected from age, sex, and geographic region matched controls, four per suicide)-were studied. Using multiple logistic regression analysis including age-marital status interaction, adjusted estimates show divorced status to be the most detrimental for suicide propensity, with males showing stronger effect size. Females never married, aged below 35 and 65-plus, and widowed 65-plus had lower suicide odds.

Suicide and accidental deaths in children and adolescents in England and Wales, 2001-2010.

PubMed

Windfuhr, Kirsten; While, David; Hunt, Isabelle M; Shaw, Jenny; Appleby, Louis; Kapur, Nav

2013-12-01

To investigate the impact of narrative verdicts on suicide statistics among 10-19-year-olds; to identify the number and rate of suicide and accidental deaths, particularly in 10-14-year-olds. National cohort study. England and Wales. Mid-year population estimates from the Office for National Statistics (ONS) were used to calculate rates per 100,000 population for suicide (undetermined and suicide verdicts) and accidental deaths (poisoning, hanging) for those aged 10-14 and 15-19. Trends in rates over time (2001-2010) were investigated using Poisson regression. Interaction tests were carried out to determine differences in trends between the two time periods (2001-2005 and 2006-2010). There were 1523 suicides (2.25/100,000). Suicide rates were highest in those aged 15-19 years (4.04/100,000) and in males (3.14/100,000). Between 2001 and 2010, rates significantly decreased among those aged 15-19 years (incidence rate-ratio (IRR): 0.95; 95% CI 0.93 to 0.97), with no change in rates of accidental deaths (IRR: 1.01, 95% CI 0.95 to 1.07). However, there was a significant interaction between the two time periods for accidental poisonings (2001-2005: IRR: 0.79 (95% CI 0.69 to 0.91); 2006-2010: IRR: 1.01 (95% CI 0.89 to 1.15), interaction p=0.012) and accidental hangings (2001-2005: IRR: 0.93 (95% CI 0.76 to 1.14); 2006-2010: IRR: 1.25 (95% CI 1.04 to 1.49), interaction=0.01) Undetermined deaths significantly decreased among females aged 15-19 yeras (IRR: 0.93; 95% CI 0.88 to 0.98). There were no significant trends among 10-14-year-olds. Rates of suicide are higher among older adolescents and males. There was a significant fall in suicide rates in males aged 15-19 years that was not accounted for by changes in rates of accidental death. The absence of a significant trend in suicide or accidental deaths in those aged 10-14 years may have been the result of small numbers. However, monitoring should continue to identify longitudinal trends in all young people.

Suicide and accidental death in Australia's rural farming communities: a review of the literature.

PubMed

Kennedy, Alison J; Maple, Myfanwy J; McKay, Kathy; Brumby, Susan A

2014-01-01

Australia's farmers constitute a heterogeneous group within the rural population. This literature review incorporates four broad areas: an understanding of farming communities, families and individuals and the contexts in which they live and work; an exploration of the challenges to morbidity and mortality that these communities face; a description of the patterns of suicide and accidental death in farming communities; and an outline of what is missing from the current body of research. Recommendations will be made on how these gaps may be addressed. In developing this comprehensive literature review, a snowballing and saturation approach was adopted. Initial search terms included suicid*, farm*, accident*, fatal*, death, sudden death, rural OR remote, Australia and NOT Australia. Databases searched included SCOPUS, PubMed, Proquest and SafetyLit; research from 1995 onwards was examined for relevance. Earlier seminal texts were also included. Reference lists of retrieved articles were searched and citations explored for further relevant research material. The primary focus was on Australian peer-reviewed research with supplementary grey literature. International material was used as examples. The literature variously describes farmers as members of both rural farming communities and farming families, and as individuals within an occupational classification. Within each of these classifications, there is evidence of the cumulative impact of a multiplicity of social, geographical and psychological factors relating to work, living and social arrangements that impact the health and wellbeing of Australia's farmers and their families, particularly accidental death and suicide. Research consistently demonstrates traumatic death to be at a greater rate than in the general Australian population, with reductions found more recently in some modes of farming-related accidental death. Patterns of accidental death and suicide are commonly linked to the changing shape of

Unusual fentanyl patch administration.

PubMed

Thomas, Sandra; Winecker, Ruth; Pestaner, Joseph P

2008-06-01

Fentanyl is an extremely potent narcotic analgesic that is becoming more popular as a drug of abuse. Because of the unique way in which the drug is packaged and delivered, the potential for unusual methods of abuse exists. We report the first case of true fentanyl patch ingestion in the medical literature. Initially, though unusual, cases of fentanyl ingestion were thought to have been reported, but further investigation of the literature revealed that in other case reports the patches had been held in the mouth and chewed. Because no reports of swallowing the patch had been published, suicide was initially a strong consideration in this case; however, further investigation showed that the decedent and his brother enjoyed swallowing the patches for quick "highs." Cases such as these serve to remind medical examiners and law enforcement officials of the value of performing thorough death investigations by performing complete autopsies with toxicological testing and correlating with investigation information to form an opinion with regard to the cause and manner of death.

Forecasting state-level premature deaths from alcohol, drugs, and suicides using Google Trends data.

PubMed

Parker, Jason; Cuthbertson, Courtney; Loveridge, Scott; Skidmore, Mark; Dyar, Will

2017-04-15

Vital statistics on the number of, alcohol-induced death (AICD) drug-induced death (DICD), and suicides at the local-level are only available after a substantial lag of up to two years after the events occur. We (1) investigate how well Google Trends search data explain variation in state-level rates in the US, and (2) use this method to forecast these rates of death for 2015 as official data are not yet available. We tested the degree to which Google Trends data on 27 terms can be fit to CDC data using L 1 -regularization on AICD, DICD, and suicide. Using Google Trends data, we forecast 2015 AICD, DICD, and suicide rates. L 1 -regularization fit the pre-2015 data much better than the alternative model using state-level unemployment and income variables. Google Trends data account for substantial variation in growth of state-level rates of death: 30.9% for AICD, 23.9% for DICD, and 21.8% for suicide rates. Every state except Hawaii is forecasted to increase in all three of these rates in 2015. The model predicts state, not local or individual behavior, and is dependent on continued availability of Google Trends data. The method predicts state-level AICD, DICD, and suicide rates better than the alternative model. The study findings suggest that this methodology can be developed into a public health surveillance system for behavioral health-related causes of death. State-level predictions could be used to inform state interventions aimed at reducing AICD, DICD, and suicide. Copyright © 2017. Published by Elsevier B.V.

Study of deaths by suicide of homosexual prisoners in Nazi Sachsenhausen concentration camp

PubMed Central

Cuerda-Galindo, Esther; Krischel, Matthis; Ley, Astrid

2017-01-01

Living conditions in Nazi concentration camps were harsh and inhumane, leading many prisoners to commit suicide. Sachsenhausen (Oranienburg, Germany) was a concentration camp that operated from 1936 to 1945. More than 200,000 people were detained there under Nazi rule. This study analyzes deaths classified as suicides by inmates in this camp, classified as homosexuals, both according to the surviving Nazi files. This collective was especially repressed by the Nazi authorities. Data was collected from the archives of Sachsenhausen Memorial and the International Tracing Service in Bad Arolsen. Original death certificates and autopsy reports were reviewed. Until the end of World War II, there are 14 death certificates which state “suicide” as cause of death of prisoners classified as homosexuals, all of them men aged between 23 and 59 years and of various religions and social strata. Based on a population of 1,200 prisoners classified as homosexuals, this allows us to calculate a suicide rate of 1,167/100,000 (over the period of eight years) for this population, a rate 10 times higher than for global inmates (111/100,000). However, our study has several limitations: not all suicides are registered; some murders were covered-up as suicides; most documents were lost during the war or destroyed by the Nazis when leaving the camps and not much data is available from other camps to compare. We conclude that committing suicides in Sachsenhausen was a common practice, although accurate data may be impossible to obtain. PMID:28426734

Death by Suicide in Graves' Disease and Graves' Orbitopathy: A Nationwide Danish Register Study.

PubMed

Ferløv-Schwensen, Charlotte; Brix, Thomas Heiberg; Hegedüs, Laszlo

2017-12-01

Graves' disease (GD) is associated with excess morbidity and mortality, but little is known about unnatural manners of death and the potential relation with Graves' orbitopathy (GO). This study investigated the risk of unnatural death in Graves' patients with and without orbitopathy compared to matched control populations. This was a cohort study covering all adult Danes (≥18 years) diagnosed with GD or GO during 1995-2012. Median follow-up time was 7.9 years (range 0-17.5 years). Utilizing the Danish Register of Causes of Death and the Danish National Patient Registry, 28,461 subjects with GD and 3965 with GO were identified and matched for age and sex with four subjects from the background population. The manner of death was identified, and hazard ratios (HR) for mortality due to unnatural deaths (accident, suicide, violence/homicide, and unknown) were calculated using Cox regression analyses, adjusted for pre-existing somatic and psychiatric morbidity. In Graves' disease overall (GD + GO), there was an increased risk of death from unknown unnatural manners (HR = 2.01 [confidence interval (CI) 1.17-3.45], p = 0.012) and of suicide, although the latter difference was not with certainty statistically significant (HR = 1.43 [CI 1.00-2.04], p = 0.053). There was no significant difference in risk of death from suicide in GD subjects compared to their controls (HR = 1.27 [CI 0.85-1.89], p = 0.253). However, GO patients had a significantly higher risk of death from suicide (HR = 2.71 [CI 1.16-6.32], p = 0.022). Mortality by suicide was increased in Graves' disease overall, most significantly in patients with GO, also after adjustment for pre-existing somatic and psychiatric disease. These findings indicate that GD and GO may have a significant role in the pathophysiological mechanisms of suicidal behavior. Beyond independent confirmation, reasons for this need to be explored in order to introduce preventive measures.

Shared death: self, sociality and internet group suicide in Japan.

PubMed

Ozawa-De Silva, Chikako

2010-07-01

Existing models for understanding suicide fail to account for the distinctiveness of Internet group suicide, a recent phenomenon in Japan. Drawing from an ethnography of Internet suicide websites, two social commentaries in Japanese popular culture, and the work of developmental psychologist Philippe Rochat, I argue that participation in Internet suicide forums and even the act of Internet group suicide result from both a need for social connectedness and the fear of social rejection and isolation that this need engenders. These needs and fears are especially strong in the case of Japan, where the dominant cultural rhetoric ties selfhood closely to the social self that is the object of perception and experience by others. I show how such an understanding of Internet group suicide helps us to understand some of its basic characteristics, which are otherwise difficult to explain and which have puzzled the Japanese media and popular accounts: the "ordinariness" or casual nature of Internet group suicide, the wish for an easy or comfortable death, the wish to die with others, and the wish to "vanish." Internet group suicide sheds light on questions of Japanese selfhood in modernity and expands our understanding of suicide in Japan in general.

Details on suicide among US physicians: data from the National Violent Death Reporting System.

PubMed

Gold, Katherine J; Sen, Ananda; Schwenk, Thomas L

2013-01-01

Physician suicide is an important public health problem as the rate of suicide is higher among physicians than the general population. Unfortunately, few studies have evaluated information about mental health comorbidities and psychosocial stressors which may contribute to physician suicide. We sought to evaluate these factors among physicians versus non-physician suicide victims. We used data from the United States National Violent Death Reporting System to evaluate demographics, mental health variables, recent stressors and suicide methods among physician versus non-physician suicide victims in 17 states. The data set included 31,636 suicide victims of whom 203 were identified as physicians. Multivariable logistic regression found that having a known mental health disorder or a job problem which contributed to the suicide significantly predicted being a physician. Physicians were significantly more likely than non-physicians to have antipsychotics, benzodiazepines and barbiturates present on toxicology testing but not antidepressants. Mental illness is an important comorbidity for physicians who complete a suicide but postmortem toxicology data shows low rates of medication treatment. Inadequate treatment and increased problems related to job stress may be potentially modifiable risk factors to reduce suicidal death among physicians. Copyright © 2013 Elsevier Inc. All rights reserved.

Australia's 1996 gun law reforms: faster falls in firearm deaths, firearm suicides, and a decade without mass shootings.

PubMed

Chapman, S; Alpers, P; Agho, K; Jones, M

2006-12-01

After a 1996 firearm massacre in Tasmania in which 35 people died, Australian governments united to remove semi-automatic and pump-action shotguns and rifles from civilian possession, as a key component of gun law reforms. To determine whether Australia's 1996 major gun law reforms were associated with changes in rates of mass firearm homicides, total firearm deaths, firearm homicides and firearm suicides, and whether there were any apparent method substitution effects for total homicides and suicides. Observational study using official statistics. Negative binomial regression analysis of changes in firearm death rates and comparison of trends in pre-post gun law reform firearm-related mass killings. Australia, 1979-2003. Changes in trends of total firearm death rates, mass fatal shooting incidents, rates of firearm homicide, suicide and unintentional firearm deaths, and of total homicides and suicides per 100,000 population. In the 18 years before the gun law reforms, there were 13 mass shootings in Australia, and none in the 10.5 years afterwards. Declines in firearm-related deaths before the law reforms accelerated after the reforms for total firearm deaths (p = 0.04), firearm suicides (p = 0.007) and firearm homicides (p = 0.15), but not for the smallest category of unintentional firearm deaths, which increased. No evidence of substitution effect for suicides or homicides was observed. The rates per 100,000 of total firearm deaths, firearm homicides and firearm suicides all at least doubled their existing rates of decline after the revised gun laws. Australia's 1996 gun law reforms were followed by more than a decade free of fatal mass shootings, and accelerated declines in firearm deaths, particularly suicides. Total homicide rates followed the same pattern. Removing large numbers of rapid-firing firearms from civilians may be an effective way of reducing mass shootings, firearm homicides and firearm suicides.

Maternal Deaths From Suicide and Overdose in Colorado, 2004–2012

PubMed Central

Metz, Torri D.; Rovner, Polina; Hoffman, M. Camille; Allshouse, Amanda A.; Beckwith, Krista M.; Binswanger, Ingrid A.

2016-01-01

Objective To ascertain demographic and clinical characteristics of maternal deaths from self-harm (accidental overdose or suicide) in order to identify opportunities for prevention. Methods We report a case series of pregnancy-associated deaths due to self-harm in the state of Colorado between 2004 and 2012. Self-harm deaths were identified from several sources, including death certificates. Birth and death certificates along with coroner, prenatal care and delivery hospitalization records were abstracted. Descriptive analyses were performed. For context, we describe demographic characteristics of women with a maternal death from self-harm and all women with live births in Colorado. Results Among the 211 total maternal deaths in Colorado over the study interval, 30% (n=63) resulted from self-harm. The pregnancy-associated death ratio from overdose was 5.0 (95% CI 3.4, 7.2) per 100,000 live births and from suicide 4.6 (95% CI 3.0, 6.6) per 100,000 live births. Detailed records were obtained for 94% (n=59) of women with deaths from self-harm. Deaths were equally distributed throughout the first postpartum year (mean 6.21 ± 3.3 months postpartum) with only 6 maternal deaths during pregnancy. Seventeen percent (n=10) had a known substance use disorder. Prior psychiatric diagnoses were documented in 54% (n=32) and prior suicide attempts in 10% (n=6). While half (n=27) of the women with deaths from self-harm were noted to be taking psycho-pharmacotherapy at conception, 48% of them discontinued the medications during pregnancy. Fifty women had toxicology testing available; pharmaceutical opioids were the most common drug identified (n=21). Conclusion Self-harm was the most common cause of pregnancy-associated mortality with most deaths occurring in the postpartum period. A four-pronged educational and program building effort to include women, providers, health care systems, and both governments and organizations at the community and national level may allow for a

Determinants of suicide and accidental or violent death in the Australian HIV Observational Database.

PubMed

McManus, Hamish; Petoumenos, Kathy; Franic, Teo; Kelly, Mark D; Watson, Jo; O'Connor, Catherine C; Jeanes, Mark; Hoy, Jennifer; Cooper, David A; Law, Matthew G

2014-01-01

Rates of suicide and accidental or violent death remain high in HIV-positive populations despite significantly improved prognosis since the introduction of cART. We conducted a nested case-control study of suicide and accidental or violent death in the Australian HIV Observational Database (AHOD) between January 1999 and March 2012. For each case, 2 controls were matched by clinic, age, sex, mode of exposure and HIV-positive date to adjust for potential confounding by these covariates. Risk of suicide and accidental or violent death was estimated using conditional logistic regression. We included 27 cases (17 suicide and 10 violent/accidental death) and 54 controls. All cases were men who have sex with men (MSM) or MSM/ injecting drug use (IDU) mode of exposure. Increased risk was associated with unemployment (Odds Ratio (OR) 5.86, 95% CI: 1.69-20.37), living alone (OR 3.26, 95% CI: 1.06-10.07), suicidal ideation (OR 6.55, 95% CI: 1.70-25.21), and >2 psychiatric/cognitive risk factors (OR 4.99, 95% CI: 1.17-30.65). CD4 cell count of >500 cells/µL (OR 0.25, 95% CI: 0.07-0.87) and HIV-positive date ≥1990 (1990-1999 (OR 0.31, 95% CI: 0.11-0.89), post-2000 (OR 0.08, 95% CI: 0.01-0.84)) were associated with decreased risk. CD4 cell count ≥500 cells/µL remained a significant predictor of reduced risk (OR 0.15, 95% CI: 0.03-0.70) in a multivariate model adjusted for employment status, accommodation status and HIV-positive date. After adjustment for psychosocial factors, the immunological status of HIV-positive patients contributed to the risk of suicide and accidental or violent death. The number of psychiatric/cognitive diagnoses contributed to the level of risk but many psychosocial factors were not individually significant. These findings indicate a complex interplay of factors associated with risk of suicide and accidental or violent death.

Suicide deaths of active-duty US military and omega-3 fatty-acid status: a case-control comparison.

PubMed

Lewis, Michael D; Hibbeln, Joseph R; Johnson, Jeremiah E; Lin, Yu Hong; Hyun, Duk Y; Loewke, James D

2011-12-01

The recent escalation of US military suicide deaths to record numbers has been a sentinel for impaired force efficacy and has accelerated the search for reversible risk factors. To determine whether deficiencies of neuroactive, highly unsaturated omega-3 essential fatty acids (n-3 HUFAs), in particular docosahexaenoic acid (DHA), are associated with increased risk of suicide death among a large random sample of active-duty US military. In this retrospective case-control study, serum fatty acids were quantified as a percentage of total fatty acids among US military suicide deaths (n = 800) and controls (n = 800) matched for age, date of collection of sera, sex, rank, and year of incident. Participants were active-duty US military personnel (2002-2008). For cases, age at death ranged from 17-59 years (mean = 27.3 years, SD = 7.3 years). Outcome measures included death by suicide, postdeployment health assessment questionnaire (Department of Defense Form 2796), and ICD-9 mental health diagnosis data. Risk of suicide death was 14% higher per SD of lower DHA percentage (OR = 1.14; 95% CI, 1.02-1.27; P < .03) in adjusted logistic regressions. Among men, risk of suicide death was 62% greater with low serum DHA status (adjusted OR = 1.62; 95% CI, 1.12-2.34; P < .01, comparing DHA below 1.75% [n = 1,389] to DHA of 1.75% and above [n = 141]). Risk of suicide death was 52% greater in those who reported having seen wounded, dead, or killed coalition personnel (OR = 1.52; 95% CI, 1.11-2.09; P < .01). This US military population had a very low and narrow range of n-3 HUFA status. Although these data suggest that low serum DHA may be a risk factor for suicide, well-designed intervention trials are needed to evaluate causality. © Copyright 2011 Physicians Postgraduate Press, Inc.

Mortality, or Probability of Death, from a Suicidal Act in the United States

ERIC Educational Resources Information Center

Friedmann, Harry; Kohn, Robert

2008-01-01

The probability of death resulting from a suicidal act as a function of age is explored. Until recently, data on suicide attempts in the United States were not available, and therefore the relationship between attempts and completed suicide could not be systematically investigated. Now, with new surveillance of self-harm data from the Centers for…

NOAA declares string of seal deaths in New England an unusual mortality

Science.gov Websites

Alerts NOAA Organizations Working With NOAA Media & Constituents NOAA In Your State Emergency string of seal deaths in New England an unusual mortality event Public reminded to maintain safe distance the Working Group on Marine Mammal Unusual Mortality Events, a panel of international experts

Age Differences in Death and Suicidal Ideation in Anxious Primary Care Patients.

PubMed

Petkus, Andrew J; Wetherell, Julie Loebach; Stein, Murray B; Chavira, Denise A; Craske, Michelle G; Sherbourne, Cathy; Sullivan, Greer; Bystritsky, Alexander; Roy-Byrne, Peter

2018-01-01

The objective of this study was to examine age differences in the likelihood of endorsing of death and suicidal ideation in primary care patients with anxiety disorders. Participants were drawn from the Coordinated Anxiety Learning and Management (CALM) Study, an effectiveness trial for primary care patients with panic disorder (PD), generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD), and/or social anxiety disorder (SAD). Approximately one third of older adults with anxiety disorders reported feeling like they were better off dead. Older adults with PD and SAD were more likely to endorse suicidal ideation lasting at least more than half the prior week compared with younger adults with these disorders. Older adults with SAD endorsed higher rates of suicidal ideation compared with older adults with other anxiety disorders. Multivariate analyses revealed the importance of physical health, social support, and comorbid MDD in this association. Suicidal ideation is common in anxious, older, primary care patients and is particularly prevalent in socially anxious older adults. Findings speak to the importance of physical health, social functioning, and MDD in this association. When working with anxious older adults it is important to conduct a thorough suicide risk assessment and teach skills to cope with death and suicidal ideation-related thoughts.

Australia's 1996 gun law reforms: faster falls in firearm deaths, firearm suicides, and a decade without mass shootings

PubMed Central

Chapman, S; Alpers, P; Agho, K; Jones, M

2006-01-01

Background After a 1996 firearm massacre in Tasmania in which 35 people died, Australian governments united to remove semi‐automatic and pump‐action shotguns and rifles from civilian possession, as a key component of gun law reforms. Objective To determine whether Australia's 1996 major gun law reforms were associated with changes in rates of mass firearm homicides, total firearm deaths, firearm homicides and firearm suicides, and whether there were any apparent method substitution effects for total homicides and suicides. Design Observational study using official statistics. Negative binomial regression analysis of changes in firearm death rates and comparison of trends in pre–post gun law reform firearm‐related mass killings. Setting Australia, 1979–2003. Main outcome measures Changes in trends of total firearm death rates, mass fatal shooting incidents, rates of firearm homicide, suicide and unintentional firearm deaths, and of total homicides and suicides per 100 000 population. Results In the 18 years before the gun law reforms, there were 13 mass shootings in Australia, and none in the 10.5 years afterwards. Declines in firearm‐related deaths before the law reforms accelerated after the reforms for total firearm deaths (p = 0.04), firearm suicides (p = 0.007) and firearm homicides (p = 0.15), but not for the smallest category of unintentional firearm deaths, which increased. No evidence of substitution effect for suicides or homicides was observed. The rates per 100 000 of total firearm deaths, firearm homicides and firearm suicides all at least doubled their existing rates of decline after the revised gun laws. Conclusions Australia's 1996 gun law reforms were followed by more than a decade free of fatal mass shootings, and accelerated declines in firearm deaths, particularly suicides. Total homicide rates followed the same pattern. Removing large numbers of rapid‐firing firearms from civilians may be an effective way of

Australia's 1996 gun law reforms: faster falls in firearm deaths, firearm suicides, and a decade without mass shootings.

PubMed

Chapman, S; Alpers, P; Agho, K; Jones, M

2015-10-01

After a 1996 firearm massacre in Tasmania in which 35 people died, Australian governments united to remove semi-automatic and pump-action shotguns and rifles from civilian possession, as a key component of gun law reforms. To determine whether Australia's 1996 major gun law reforms were associated with changes in rates of mass firearm homicides, total firearm deaths, firearm homicides and firearm suicides, and whether there were any apparent method substitution effects for total homicides and suicides. Observational study using official statistics. Negative binomial regression analysis of changes in firearm death rates and comparison of trends in pre-post gun law reform firearm-related mass killings. Australia, 1979-2003. Changes in trends of total firearm death rates, mass fatal shooting incidents, rates of firearm homicide, suicide and unintentional firearm deaths, and of total homicides and suicides per 100 000 population. In the 18 years before the gun law reforms, there were 13 mass shootings in Australia, and none in the 10.5 years afterwards. Declines in firearm-related deaths before the law reforms accelerated after the reforms for total firearm deaths (p=0.04), firearm suicides (p=0.007) and firearm homicides (p=0.15), but not for the smallest category of unintentional firearm deaths, which increased. No evidence of substitution effect for suicides or homicides was observed. The rates per 100 000 of total firearm deaths, firearm homicides and firearm suicides all at least doubled their existing rates of decline after the revised gun laws. Australia's 1996 gun law reforms were followed by more than a decade free of fatal mass shootings, and accelerated declines in firearm deaths, particularly suicides. Total homicide rates followed the same pattern. Removing large numbers of rapid-firing firearms from civilians may be an effective way of reducing mass shootings, firearm homicides and firearm suicides. Published by the BMJ Publishing Group Limited. For

The interaction effect between low income and severe illness on the risk of death by suicide after self-harm.

PubMed

Chung, Chi-Hsiang; Pai, Lu; Kao, Senyeong; Lee, Meei-Shyuan; Yang, Tsung-Tsair; Chien, Wu-Chien

2013-01-01

Previous Western studies have reported that the prevalence of death by suicide within 1 year after self-harm was 0.5-2%; however, no studies have focused on the Far East. To calculate the prevalence of death by suicide after self-harm over different lengths of follow-up time and to determine the predictors of death by suicide after self-harm. Our study was based on 3,388 inpatients hospitalized between 2000 and 2007 in any of the 1,230 hospitals in Taiwan. Death by suicide after self-harm among the members of this cohort was tracked after 3 months, 6 months, and 1-8 years. The tracking continued until December 31, 2008. We analyzed the prevalence and risk factors of death by suicide after self-harm using Cox's regression model. Of the 3,388 individuals with a history of self-harm included in the study, 48 (1.4%) died by suicide after self-harm within 3 months and 97 (2.9%) within 1 year. In all, 144 (4.3%) died by suicide after self-harm within 8 years. The predictors of death by suicide were violent methods (such as hanging, drowning, firearms, and jumping), low income, and severe illness. Moreover, an interaction effect was noted between low income and severe illness on the outcome (death by suicide). It seems that effective healthcare for individuals who engage in self-harming behavior would benefit from supplementing medical care with social assistance, such as the support of a social worker.

Autopsy findings of suicidal deaths committed by firearms in Ankara, Turkey.

PubMed

Canturk, Gurol; Canturk, Nergis; Odabasi, Aysun Balseven; Erkol, Zerrin; Bosgelmez, Memnune

2009-07-01

The purpose of this study was to examine autopsy findings from suicidal deaths using firearms in Ankara, Turkey, and to compare the results with those reported from other studies. We retrospectively evaluated suicidal deaths by firearms referred for autopsy to the Morgue Department, Institute of Forensic Medicine, between 2002 and 2004. Results were subjected to discriminant analyses using SPSS 11.5 package program. One hundred and fifteen cases (83.3%) were male, the ratio of male to female was 5 to 1 and the mean age was 31.96 years (range:12-85 years). Forty cases were aged between 12 years and 20 years, 28 were aged between 0 and 18 (20.29%). One hundred and thirty-three cases (96.4%) had one bullet entry and five cases (3.6%) had two bullet entries. Out of 143 bullet entries, 116 (81.12%) were caused by gunshots fired from contact or near contact range. Regarding bullet entry sites, 103 (72.03%) were on the head with 56 (54.37%) located on the right temporal region. Gunshot related crimes are an increasing cause for concern in Turkey. However, a simple preventive measure may prevent the suicidal deaths of many young people.

Determinants of Suicide and Accidental or Violent Death in the Australian HIV Observational Database

PubMed Central

McManus, Hamish; Petoumenos, Kathy; Franic, Teo; Kelly, Mark D.; Watson, Jo; O’Connor, Catherine C.; Jeanes, Mark; Hoy, Jennifer; Cooper, David A.; Law, Matthew G.

2014-01-01

Background Rates of suicide and accidental or violent death remain high in HIV-positive populations despite significantly improved prognosis since the introduction of cART. Methods We conducted a nested case-control study of suicide and accidental or violent death in the Australian HIV Observational Database (AHOD) between January 1999 and March 2012. For each case, 2 controls were matched by clinic, age, sex, mode of exposure and HIV-positive date to adjust for potential confounding by these covariates. Risk of suicide and accidental or violent death was estimated using conditional logistic regression. Results We included 27 cases (17 suicide and 10 violent/accidental death) and 54 controls. All cases were men who have sex with men (MSM) or MSM/ injecting drug use (IDU) mode of exposure. Increased risk was associated with unemployment (Odds Ratio (OR) 5.86, 95% CI: 1.69–20.37), living alone (OR 3.26, 95% CI: 1.06–10.07), suicidal ideation (OR 6.55, 95% CI: 1.70–25.21), and >2 psychiatric/cognitive risk factors (OR 4.99, 95% CI: 1.17–30.65). CD4 cell count of >500 cells/µL (OR 0.25, 95% CI: 0.07–0.87) and HIV-positive date ≥1990 (1990–1999 (OR 0.31, 95% CI: 0.11–0.89), post-2000 (OR 0.08, 95% CI: 0.01–0.84)) were associated with decreased risk. CD4 cell count ≥500 cells/µL remained a significant predictor of reduced risk (OR 0.15, 95% CI: 0.03–0.70) in a multivariate model adjusted for employment status, accommodation status and HIV-positive date. Conclusions After adjustment for psychosocial factors, the immunological status of HIV-positive patients contributed to the risk of suicide and accidental or violent death. The number of psychiatric/cognitive diagnoses contributed to the level of risk but many psychosocial factors were not individually significant. These findings indicate a complex interplay of factors associated with risk of suicide and accidental or violent death. PMID:24586519

Thoughts of Death and Suicide in Early Adolescence

ERIC Educational Resources Information Center

Vander Stoep, Ann; McCauley, Elizabeth; Flynn, Cynthia; Stone, Andrea

2009-01-01

The prevalence and persistence of thoughts of death and suicide during early adolescence were estimated in a community-based cohort. A latent class approach was used to identify distinct subgroups based on endorsements to depression items administered repeatedly over 24 months. Two classes emerged, with 75% in a low ideation class across four…

Gender and age differences in suicide mortality in the context of violent death: findings from a multi-state population-based surveillance system.

PubMed

Bozzay, Melanie L; Liu, Richard T; Kleiman, Evan M

2014-07-01

Males are more likely than females to die by all forms of violent death, including suicide. The primary purpose of the present study was to explore whether the gender difference in suicide rates is largely accounted for by males' general greater tendency to experience violent deaths. The current study examined gender and age differences in suicides and other violent deaths, using data from a population-based surveillance system. Pearson's chi-square tests and logistic regression analyses were conducted with data for 32,107 decedents in the 2003-2005 National Violent Death Reporting System (NVDRS). Decedents were categorized by gender, age, and death by suicide versus other violent means. When suicides were examined in the greater context of violent death, the total proportion of violent deaths due to suicide did not differ across gender. When deaths were examined by age group, after controlling for ethnicity, marital status, and U.S. location in which the death occurred, males in early to mid childhood were significantly more likely than same-aged females to die by suicide relative to all other violent deaths. The portion of deaths due to suicide was for the most part equal across both genders in late childhood, young adulthood, and mid-adulthood. Older males were more likely than older females to die by suicide relative to other violent deaths. Our findings suggest that that the risk of dying by suicide relative to other violent deaths may be more pronounced at certain developmental stages for each gender. This knowledge may be valuable in tailoring prevention strategies. Copyright © 2014 Elsevier Inc. All rights reserved.

Death by hanging while watching violent pornographic videos on the Internet - suicide or accidental autoerotic death?

PubMed

Vennemann, B; Pollak, S

2006-03-01

In deaths by hanging, it may sometimes be difficult to differentiate between autoerotic accident and suicide. Our report deals with a 30-year-old man who was found hanged in the living room of his flat. The deceased was wearing headphones connected to a PC. Within the deceased's view was a computer screen showing the last picture of a video file downloaded from the Internet with the head of an unclothed, allegedly hanged female. The deceased's left hand was inside his trousers in the genital region. The autopsy did not only show findings typical for hanging, but also advanced sarcoidosis, which was known to the victim. Although this basic illness could have been a possible motive for suicide, the circumstances in the presented case pointed more in the direction of an accidental autoerotic death. As far as we know, this is the first description of a death during autoerotic activity in which sexual stimulation was achieved by watching a video file downloaded from the Internet.

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.

The number and characteristics of newspaper and Twitter reports on suicides and road traffic deaths in young people.

PubMed

Scourfield, Jonathan; Colombo, Gualtiero; Burnap, Pete; Evans, Rhiannon; Jacob, Nina; Williams, Matthew; Caul, Sarah

2018-06-01

In the light of concern about the harmful effects of media reporting of suicides and a lack of comparative research, this study compares the number and characteristics of reports on young people's suicides and road traffic accidents (RTAs) in newspapers and Twitter. Comparison of newspaper and Twitter reporting of deaths by suicide and RTA in young people (11-18) during a six-month period. Tweets about young people's suicides were more numerous than newspaper reports. Twitter and newspaper reports were more strongly correlated for suicides than for RTAs. Recent suicides were less likely to be reported in newspapers than recent deaths by RTA. Bullying-related suicides were especially newsworthy. Suicide prevention organisations should consider routinely monitoring social media reporting.

Death Ideation and Suicidal Ideation in a Community Sample Who Do Not Meet Criteria for Major Depression.

PubMed

Joo, Jinhui; Hwang, Seungyoung; Gallo, Joseph J

2016-03-01

Suicide is strongly associated with depression, but many without depression have thoughts of death. To characterize persons who did not meet criteria for depressive illness but endorsed death ideation or suicidal ideation over the course of a 10-year follow-up. Subjects included 753 participants of the Baltimore sample of the Epidemiologic Catchment Area Program, a population-based 10-year follow-up survey, who neither met criteria for major depressive disorder nor reported death or suicidal ideation in 1994. Persons with death ideation or suicidal ideation in 2004 were generally distressed as measured by the General Health Questionnaire. At baseline, both groups endorsed difficulty with concentration, feeling unhappy, and taking things hard. Functional problems such as social withdrawal were endorsed by both groups. Those with suicidal ideation had a longer lifetime history of social phobia. Persons with death ideation did not use more health services but sought help from persons in their social network. Thoughts of death are associated with distress even in persons who do not have depressive illness. This group of persons may have subclinical depressive symptoms that will not be detected by depression screening. Detection of these persons will require broadening our concept of persons at risk.

Suicide death rates in patients with cardiovascular diseases - A 15-year nationwide cohort study in Taiwan.

PubMed

Wu, Victor Chien-Chia; Chang, Shang-Hung; Kuo, Chang-Fu; Liu, Jia-Rou; Chen, Shao-Wei; Yeh, Yung-Hsin; Luo, Shue-Fen; See, Lai-Chu

2018-06-01

The literature on suicide mortality rates in patients with cardiovascular diseases (CVDs) is limited. Taiwan National Health Insurance Research Database and Taiwan Death Registry were retrieved for patients with the 5 CVDs: congestive heart failure (CHF), acute myocardial infarction (AMI), ischemic stroke (IS), hemorrhagic stroke (HS), and pacemaker implantation (PMI) between January 1, 2001, and December 31, 2015. We excluded patients younger than 15 years old. The primary outcome was suicidal death. The standardized mortality ratio (SMR) was used to compare the risk of suicidal death in the 5 CVDs to the general population. From 2001 to 2015, there were 212,206 patients with CHF, 178,894 patients with AMI, 475,359 patients with IS, 189,555 patients with HS, and 64,173 patients with PMI. The suicide death rate per 100,000 person-year, 95% CI was 59.6 (54.5-64.8) for those with CHF, 44.6 (40.1-49.1) for AMI, 57.6 (54.7-60.5) for IS, 44.6 (40.2-49.0) for HS, 54.0 (45.9-62.0) for PMI, and 20.3 (20.1-20.4) for the general population. Patients with CHF patients had the highest SMR (2.10), followed by IS (1.96), PMI (1.86), HS (1.65), and AMI (1.46). The SMRs for patients with CVDs peaked at year 2 after the diagnosis, declined for patients with AMI, IS, and HS, increased and decreased for PMI alternately, and reached very similar values all five CVDs after 10th year after the diagnosis. Patients with acute CVD with AMI, IS, and HS had suicide death rates peaked early after diagnosis, but patients with chronic CVD with CHF and PMI had suicide death rates that increased progressively. In addition, patients with PMI, CHF, IS had highest association with psychiatric illness and patients with PMI who were of young to middle age had highest suicide death rate. Copyright © 2018 Elsevier B.V. All rights reserved.

Suicidal and death ideation among adults with obsessive-compulsive disorder presenting for intensive intervention.

PubMed

Storch, Eric A; Kay, Brian; Wu, Monica S; Nadeau, Joshua M; Riemann, Bradley

2017-02-01

This study examined the frequency and relation of death and/or suicidal ideation to treatment response in 101 adults with obsessive-compulsive disorder (OCD) presenting for intensive intervention. Within 2 days of admission to an intensive treatment program, 101 adults with OCD completed the Yale-Brown Obsessive Compulsive Scale-Self Report, Quick Inventory of Depressive Symptomatology-Self Report, Intolerance of Uncertainty Scale, Obsessive-Compulsive Inventory-Revised, Penn State Worry Questionnaire, and Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form, and were administered the Columbia Suicide Scale by a trained clinician. A majority of patients reported death ideation within their lifetime (62.4%) and within the past month (67%). Approximately 12% of patients reported recent suicidal ideation. Patients with recent suicidal ideation reported significantly more depressive symptoms, more OCD symptoms, and less life satisfaction compared with patients not reporting suicidal ideation. Although prevalent, the presence of suicidal ideation was not associated with treatment response in the current sample. Suicidal ideation and history are prevalent among patients being treated intensively and are associated with OCD severity and depression, but they do not predict intensive multimodal treatment response.

Suicide and violent deaths in survivors of cancer in childhood, adolescence and young adulthood-A national cohort study.

PubMed

Gunnes, Maria W; Lie, Rolv T; Bjørge, Tone; Ghaderi, Sara; Syse, Astri; Ruud, Ellen; Wesenberg, Finn; Moster, Dag

2017-02-01

Suicide risk in adult cancer patients is found to be elevated, but limited information exists regarding risks of suicide and non-suicidal violent deaths when diagnosed with cancer in young age. We investigate suicide and violent deaths in a national cohort including individuals diagnosed with cancer before age 25. Through the linkage of different national registries (Cancer Registry of Norway, Norwegian Causes of Death Registry and the National Registry) a cohort of all live births in Norway during 1965-1985 was defined and followed up through 2008. Individuals diagnosed with cancer before age 25 and the cancer-free references were compared using an extended Cox proportional hazard regression model. The cohort comprised 1,218,013 individuals, including 5,440 diagnosed with cancer before age 25. We identified 24 suicides and 14 non-suicidal violent deaths in the cancer group. The hazard ratio (HR) of suicide in the cancer group was 2.5 (95% confidence interval (CI) 1.7-3.8), and was increased both when diagnosed with cancer in childhood (0-14 years of age); HR = 2.3 (95% CI: 1.2-4.6), and during adolescence/young adulthood (15-24 years); HR = 2.6 (95% CI: 1.5-4.2). Survivors of bone/soft tissue sarcomas, CNS tumors and testicular cancer were at particular risk. The risk of non-suicidal violent death was not increased in the cancer survivors (HR = 1.0; 95% CI: 0.6-1.7). Although based on small numbers and the absolute risk of suicide being low, these are novel findings with important implications for establishing adequate follow-up including suicide prevention strategies for young cancer survivors. © 2016 UICC.

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

PubMed

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

2010-01-01

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

The influence of thoughts of death and suicidal ideation on the course of depression in older depressed patients.

PubMed

Bogers, Ista C H M; Zuidersma, Marij; Boshuisen, Marjolein L; Comijs, Hannie C; Oude Voshaar, Richard C

2017-08-01

Thoughts of death are not regularly included in diagnostic instruments and rarely examined separately from thoughts of suicide. This exploratory study examined whether thoughts of death and thoughts of suicide affect the course of late-life depressive disorders. In 378 depressed older persons, thoughts of death and thoughts of suicide were assessed using questions from the Composite International Diagnostic Interview. After 2 years, the presence of a DSM-IV-TR diagnosis of minor or major depression or dysthymia was assessed with the Composite International Diagnostic Interview. The Inventory of Depressive Symptomatology was administered every 6 months up till 3-year follow-up. Multinomial logistic regression showed that thoughts of death as well as thoughts of suicide predicted double depression at follow-up (OR = 2.14 [95% CI: 1.04-4.40] and OR = 6.47 [95% CI: 2.22-3.02], respectively), compared with patients without these thoughts. Results became non-significant when adjusted for baseline depression severity (OR = 1.17 [95% CI: 0.52-2.63] and OR = 2.57 [95% CI: 0.79-8.84], respectively). Mixed linear models showed that severity of depression was lowest in the reference group, while symptoms decreased more over time in those with either thoughts of death or suicide. Patients with thoughts of death or with thoughts of suicide were more severely depressed at baseline and follow-up, with the highest risk of being depressed at follow-up for patients with thoughts of suicide. These associations could be explained by baseline depression severity. The results suggest that thoughts of death and thoughts of suicide are important risk markers in predicting the course of depression. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

[Demands for death (suicide assistance and euthanasia) in palliative medicine].

PubMed

Moynier-Vantieghem, Karine; Weber, Catherine; Espolio, Desbaillet Yolanda; Pautex, Sophie; Zulian, Gilbert

2010-02-03

During a prospective open survey over 12 months of hospitalized patients, 44 death demands were registered for 39 patients (25 cancer, 6 cardiovascular disorder, 2 Parkinson's disease, 3 arthritis, 1 COPD, 1 dementia and 1 severe depression). 14 patients were also depressed. 28 requested euthanasia, 16 suicide assistance. At 1 month, 3 persisted, 16 had abandoned, 16 had died and 4 were not questioned. At 6 months, 7 were alive but had abandoned and 2 had committed suicide at their home. The majority of death demands correspond to euthanasia which is a murder according to the penal code. In front of such demand, realistic short-term objectives must be established. Many patients give up their project. This indicates great uncertainty in front of care and greatest ambivalence in front of life.

A longitudinal epidemiological comparison of suicide and other causes of death in Italian children and adolescents.

PubMed

Pompili, Maurizio; Vichi, Monica; De Leo, Diego; Pfeffer, Cynthia; Girardi, Paolo

2012-02-01

The objective of the study is to evaluate temporal trends, gender effects and methods of completed suicide amongst children and adolescent (aged 10-17) when compared with temporal trends of deaths from other causes. Data were extracted from the Italian Mortality Database, which is collected by the Italian National Census Bureau (ISTAT) and processed by the Statistics Unit of National Centre for Epidemiology, Surveillance and Health Promotion (CNESPS) at the National Institute of Health (Istituto Superiore di Sanità). A total of 1,871 children and adolescents, age 10-17 years, committed suicide in Italy from 1971 to 2003 and 109 died by suicide during the last 3-year period of observation (2006-2008). The average suicide rate over the entire period of observation was 0.91 per 100,000; the rate was 1.21 for males and 0.59 for females. During the study period, the general mortality of children and adolescents, age 10-17 years, decreased dramatically, the average annual percentage change decrease was of -3.3% (95% CI -4.4 to -1.9) for males and -2.9% (95% IC -4.4 to -2.5) for females. The decrease was observed, for both genders, for all causes of deaths except suicide. For males, the most frequent method was hanging (54.5%), followed by shooting/fire arms (19.6%), falls/jumping from high places (12.7%); for females, the most frequent method, jumping from high places/falls, accounted for 35.7% of suicides during the whole study period. In conclusion, this study highlights that over the course of several decades suicide is a far less preventable cause of death as compared to other causes of death amongst children and adolescents. Our study demonstrated that suicide rates in adolescents are not a stable phenomenon over the 40 years period of study. It suggested that rates for males and females differed and varied in different ways during specific time periods of this study. National suicide prevention actions should parallel prevention measures implemented to reduce

Perceived Burdensomeness, Thwarted Belongingness, and Fearlessness about Death: Associations With Suicidal Ideation among Female Veterans Exposed to Military Sexual Trauma.

PubMed

Monteith, Lindsey L; Bahraini, Nazanin H; Menefee, Deleene S

2017-12-01

Military sexual trauma (MST) is prevalent among female Veterans and is associated with increased risk for suicidal self-directed violence. Yet research examining processes which contribute to suicidal ideation and attempts among MST survivors has been sparse, focusing primarily on psychiatric symptoms or diagnoses, rather than employing a theory-driven approach. The interpersonal-psychological theory (Joiner, 2005) is a leading theory of suicide that may be particularly relevant for understanding suicidal ideation among female Veterans who have experienced MST. We examined whether constructs derived from the interpersonal-psychological theory of suicide (perceived burdensomeness, thwarted belongingness, and fearlessness about death; Joiner, 2005) were associated with suicidal ideation among female Veterans who had experienced MST, when adjusting for known risk factors for suicide. Ninety-two female Veterans with a history of MST completed the Interpersonal Needs Questionnaire, Acquired Capability for Suicide Scale - Fearlessness about Death Scale, and Beck Scale for Suicide Ideation. Perceived burdensomeness, thwarted belongingness, and fearlessness about death were each associated with suicidal ideation in the past week, adjusting for prior suicide attempts, current depressive symptoms, and current symptoms of posttraumatic stress disorder. When including all three interpersonal-psychological constructs in the model, only perceived burdensomeness and fearlessness about death were significantly associated with suicidal ideation. These findings provide knowledge regarding interpersonal processes that may contribute to suicidal ideation among this high-risk, yet understudied, population. These results also underscore the importance of assessing for interpersonal-psychological constructs-particularly perceived burdensomeness and fearlessness about death-when working with female Veterans who have experienced MST. © 2017 Wiley Periodicals, Inc.

Hands Tied with Bag Full of Books in Suicidal Hanging.

PubMed

Sikary, Asit Kumar; Behera, Chittaranjan; Murty, Om Prakash; Rautji, Ravi

2016-01-01

Hanging deaths associated with binding of limbs, masking of a face, and gagging are always suspicious. In suicidal hanging, the victim uses these added techniques to prevent him from backing out of his decision and to ensure death. However, binding of limbs and adding extra weight to the suspension in hanging are not reported. Herein, we report a case where the victim tied a bag containing books weighing 7 kg (15.4 lbs) to both his hands during hanging. The forensic specialist must be aware of the unusual presentation of suicidal hanging which may suggest foul play. The manner of death must be established after detailed analysis of circumstantial evidence, information obtained from the witnesses, complete autopsy, and toxicological examination. © 2015 American Academy of Forensic Sciences.

Predictors of Suicide and Accident Death in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS)

PubMed Central

Schoenbaum, Michael; Kessler, Ronald C.; Gilman, Stephen E.; Colpe, Lisa J.; Heeringa, Steven G.; Stein, Murray B.; Ursano, Robert J.; Cox, Kenneth L.

2014-01-01

IMPORTANCE The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) is a multicomponent study designed to generate actionable recommendations to reduce Army suicides and increase knowledge of risk and resilience factors for suicidality. OBJECTIVES To present data on prevalence, trends, and basic sociodemographic and Army experience correlates of suicides and accident deaths among active duty Regular Army soldiers between January 1, 2004, and December 31, 2009, and thereby establish a foundation for future Army STARRS investigations. DESIGN, SETTING, AND PARTICIPANTS Analysis of trends and predictors of suicide and accident deaths using Army and Department of Defense administrative data systems. Participants were all members of the US Regular Army serving at any time between 2004 and 2009. MAIN OUTCOMES AND MEASURES Death by suicide or accident during active Army service. RESULTS The suicide rate rose between 2004 and 2009 among never deployed and currently and previously deployed Regular Army soldiers. The accident death rate fell sharply among currently deployed soldiers, remained constant among the previously deployed, and trended upward among the never deployed. Increased suicide risk was associated with being a man (or a woman during deployment), white race/ethnicity, junior enlisted rank, recent demotion, and current or previous deployment. Sociodemographic and Army experience predictors were generally similar for suicides and accident deaths. Time trends in these predictors and in the Army’s increased use of accession waivers (which relaxed some qualifications for new soldiers) do not explain the rise in Army suicides. CONCLUSIONS AND RELEVANCE Predictors of Army suicides were largely similar to those reported elsewhere for civilians, although some predictors distinct to Army service emerged that deserve more in-depth analysis. The existence of a time trend in suicide risk among never-deployed soldiers argues indirectly against the view

Firearm suicide committed using an unusual combination of tandem missiles: a bullet, a nail, and a screw.

PubMed

Mihailovic, Zoran; Savic, Slobodan; Atanasijevic, Tatjana

2007-09-01

An interesting case of firearm suicide carried out using an unusual type of handmade weapon and a peculiar combination of tandem missiles is presented. A nail and a screw were placed in the rifle barrel ahead of a bullet, and all 3 were simultaneously discharged. The inflicted injury began with 1 common channel, which later split in 2 separate channels, both directed backwards and upwards; one was caused by the screw, ending in the epistropheal body, and the other, caused by the bullet and the nail, penetrated into the cranial cavity, where it bifurcated in 2 branches, one from the bullet, ending in the cerebellar tissue, and the other from the nail, penetrated through the brain stem. The established site of the entrance suicidal wound, the appearance of the weapon, and the unusual missiles are discussed with regard to the available references dealing with different types of nail injuries to the head.

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

Comparative analysis of death by suicide in Brazil and in the United States: descriptive, cross-sectional time series study.

PubMed

Abuabara, Alexander; Abuabara, Allan; Tonchuk, Carin Albino Luçolli

2017-01-01

The World Health Organization recognizes suicide as a public health priority. Increased knowledge of suicide risk factors is needed in order to be able to adopt effective prevention strategies. The aim of this study was to analyze and compare the association between the Gini coefficient (which is used to measure inequality) and suicide death rates over a 14-year period (2000-2013) in Brazil and in the United States (US). The hypothesis put forward was that reduction of income inequality is accompanied by reduction of suicide rates. Descriptive cross-sectional time-series study in Brazil and in the US. Population, death and suicide death data were extracted from the DATASUS database in Brazil and from the National Center for Health Statistics in the US. Gini coefficient data were obtained from the World Development Indicators. Time series analysis was performed on Brazilian and American official data regarding the number of deaths caused by suicide between 2000 and 2013 and the Gini coefficients of the two countries. The suicide trends were examined and compared. Brazil and the US present converging Gini coefficients, mainly due to reduction of inequality in Brazil over the last decade. However, suicide rates are not converging as hypothesized, but are in fact rising in both countries. The hypothesis that reduction of income inequality is accompanied by reduction of suicide rates was not verified.

Suicide Trends Among and Within Urbanization Levels by Sex, Race/Ethnicity, Age Group, and Mechanism of Death - United States, 2001-2015.

PubMed

Ivey-Stephenson, Asha Z; Crosby, Alex E; Jack, Shane P D; Haileyesus, Tadesse; Kresnow-Sedacca, Marcie-Jo

2017-10-06

Suicide is a public health problem and one of the top 10 leading causes of death in the United States. Substantial geographic variations in suicide rates exist, with suicides in rural areas occurring at much higher rates than those occurring in more urban areas. Understanding demographic trends and mechanisms of death among and within urbanization levels is important to developing and targeting future prevention efforts. 2001-2015. Mortality data from the National Vital Statistics System (NVSS) include demographic, geographic, and cause of death information derived from death certificates filed in the 50 states and the District of Columbia. NVSS was used to identify suicide deaths, defined by International Classification of Diseases, 10th Revision (ICD-10) underlying cause of death codes X60-X84, Y87.0, and U03. This report examines annual county level trends in suicide rates during 2001-2015 among and within urbanization levels by select demographics and mechanisms of death. Counties were collapsed into three urbanization levels using the 2006 National Center for Health Statistics classification scheme. Suicide rates increased across the three urbanization levels, with higher rates in nonmetropolitan/rural counties than in medium/small or large metropolitan counties. Each urbanization level experienced substantial annual rate changes at different times during the study period. Across urbanization levels, suicide rates were consistently highest for men and non-Hispanic American Indian/Alaska Natives compared with rates for women and other racial/ethnic groups; however, rates were highest for non-Hispanic whites in more metropolitan counties. Trends indicate that suicide rates for non-Hispanic blacks were lowest in nonmetropolitan/rural counties and highest in more urban counties. Increases in suicide rates occurred for all age groups across urbanization levels, with the highest rates for persons aged 35-64 years. For mechanism of death, greater increases in rates

Suicide among nursing home residents in Australia: A national population-based retrospective analysis of medico-legal death investigation information.

PubMed

Murphy, Briony J; Bugeja, Lyndal C; Pilgrim, Jennifer L; Ibrahim, Joseph E

2018-05-01

Suicide among nursing home residents is a growing public health concern, currently lacking in empirical research. This study aims to describe the frequency and nature of suicide among nursing home residents in Australia. This research comprised a national population-based retrospective analysis of suicide deaths among nursing home residents in Australia reported to the Coroner between July 2000 and December 2013. Cases were identified using the National Coronial Information System, and data collected from paper-based coroners' records on individual, incident, and organizational factors, as well as details of the medico-legal death investigation. Data analysis comprised univariate and bivariate descriptive statistical techniques; ecological analysis of incidence rates using population denominators; and comparison of age and sex of suicide cases to deaths from other causes using logistic regression. The study identified 141 suicides among nursing home residents, occurring at a rate of 0.02 deaths per 100 000 resident bed days. The ratio of deaths from suicide to deaths from any other cause was higher in males than females (OR = 3.56, 95%CI = 2.48-5.12, P = <0.001). Over half of the residents who died from suicide had a diagnosis of depression (n = 93, 66.0%) and had resided in the nursing home for less than 12 months (n = 71, 50.3%). Common major life stressors identified in suicide cases included the following: health deterioration (n = 112, 79.4%); isolation and loneliness (n = 60, 42.6%); and maladjustment to nursing home life (n = 42, 29.8%). This research provides a foundational understanding of suicide among nursing home residents in Australia and contributes important new information to the international knowledge base. Copyright © 2018 John Wiley & Sons, Ltd.

Depressive Symptoms on the Geriatric Depression Scale and Suicide Deaths in Older Middle-aged Men: A Prospective Cohort Study

PubMed Central

2016-01-01

Objectives: Prospective evaluations of the associations between depressive symptoms and suicide deaths have been mainly performed in high-risk populations, such as individuals with psychiatric disorders or histories of self-harm. The purpose of this study was to prospectively examine whether more severe depressive symptoms assessed using the Geriatric Depression Scale (GDS) were associated with a greater risk of death from suicide in a general-risk population. Methods: A total of 113 478 men from the Korean Veterans Health Study (mean age, 58.9 years) who participated in a postal survey in 2004 were followed up for suicide mortality until 2010. Results: Over 6.4 years of follow-up, 400 men died by suicide (56.7 deaths per 100 000 person-years). More severe depressive symptoms were associated with greater risk of suicide death (p for trend <0.001). The unadjusted hazard ratios (HRs) in comparison to the absence of depression were 2.18 for mild depression, 2.13 for moderate depression, 3.33 for severe depression, and 3.67 for extreme depression. After adjusting for potential confounders, men with a potential depressive disorder had an approximate 90% higher mortality from suicide (adjusted HR, 1.92; 95% confidence interval [CI], 1.38 to 2.68; p<0.001) than men without depression. Each five-point increase in the GDS score was associated with a higher risk of death by suicide (adjusted HR, 1.22; p<0.001). The value of the area under the receiver operating characteristics curve of GDS scores for suicide deaths was 0.61 (95% CI, 0.58 to 0.64). Conclusions: Depressive symptoms assessed using the GDS were found to be a strong independent predictor of future suicide. However, the estimate of relative risk was weaker than would be expected based on retrospective psychological autopsy studies. PMID:27255076

Depressive Symptoms on the Geriatric Depression Scale and Suicide Deaths in Older Middle-aged Men: A Prospective Cohort Study.

PubMed

Yi, Sang-Wook

2016-05-01

Prospective evaluations of the associations between depressive symptoms and suicide deaths have been mainly performed in high-risk populations, such as individuals with psychiatric disorders or histories of self-harm. The purpose of this study was to prospectively examine whether more severe depressive symptoms assessed using the Geriatric Depression Scale (GDS) were associated with a greater risk of death from suicide in a general-risk population. A total of 113 478 men from the Korean Veterans Health Study (mean age, 58.9 years) who participated in a postal survey in 2004 were followed up for suicide mortality until 2010. Over 6.4 years of follow-up, 400 men died by suicide (56.7 deaths per 100 000 person-years). More severe depressive symptoms were associated with greater risk of suicide death (p for trend <0.001). The unadjusted hazard ratios (HRs) in comparison to the absence of depression were 2.18 for mild depression, 2.13 for moderate depression, 3.33 for severe depression, and 3.67 for extreme depression. After adjusting for potential confounders, men with a potential depressive disorder had an approximate 90% higher mortality from suicide (adjusted HR, 1.92; 95% confidence interval [CI], 1.38 to 2.68; p<0.001) than men without depression. Each five-point increase in the GDS score was associated with a higher risk of death by suicide (adjusted HR, 1.22; p<0.001). The value of the area under the receiver operating characteristics curve of GDS scores for suicide deaths was 0.61 (95% CI, 0.58 to 0.64). Depressive symptoms assessed using the GDS were found to be a strong independent predictor of future suicide. However, the estimate of relative risk was weaker than would be expected based on retrospective psychological autopsy studies.

Suicides by persons reported as missing prior to death: a retrospective cohort study.

PubMed

Sveticic, Jerneja; Too, Lay San; De Leo, Diego

2012-01-01

A first study to compare suicides by missing persons with other suicide cases. Retrospective cohort study for the period 1994-2007. GEOGRAPHICAL LOCATION: Queensland, Australia. 194 suicides by missing persons and 7545 other suicides were identified through the Queensland Suicide Register and the National Coroners Information System. χ(2) statistics and binary logistic regression were used to identify distinct characteristics of suicides by missing persons. Compared with other suicide cases, missing persons significantly more often died by motor vehicle exhaust gas toxicity (23.7% vs 16.4%; χ(2)=7.32, p<0.01), jumping from height (6.7% vs 3.2%; χ(2)=7.08, p<0.01) or drowning (8.2% vs 1.8%; χ(2)=39.53, p<0.01), but less frequently by hanging (29.4% vs 39.9%; χ(2)=8.82, p<0.01). They were most frequently located in natural outdoors locations (58.2% vs 11.1%; χ(2)=388.25, p<0.01). Persons gone missing were less likely to have lived alone at time of death (OR 0.45, 95% CI 0.26 to 0.76), yet more likely to be institutionalised (OR 3.12, 95% CI 1.28 to 7.64). They were less likely to have been physically ill (OR 0.64, 95% CI 0.43 to 0.95) or have a history of problematic consumptions of alcohol (OR 0.52, 95% CI 0.31 to 0.87). In comparison to other suicide cases, missing persons more often communicated their suicidal intent prior to death (OR 1.58, 95% CI 1.13 to 2.22). Suicides by missing persons show several distinct characteristics in comparisons to other suicides. The findings have implications for development of suicide prevention strategies focusing on early identification and interventions targeting this group. In particular, it may offer assistance to police in designing risk assessment procedures and subsequent investigations of missing persons.

Suicides by persons reported as missing prior to death: a retrospective cohort study

PubMed Central

Sveticic, Jerneja; Too, Lay San

2012-01-01

Objective A first study to compare suicides by missing persons with other suicide cases. Design Retrospective cohort study for the period 1994–2007. Geographical location Queensland, Australia. Population 194 suicides by missing persons and 7545 other suicides were identified through the Queensland Suicide Register and the National Coroners Information System. Main outcome measure χ2 statistics and binary logistic regression were used to identify distinct characteristics of suicides by missing persons. Results Compared with other suicide cases, missing persons significantly more often died by motor vehicle exhaust gas toxicity (23.7% vs 16.4%; χ2=7.32, p<0.01), jumping from height (6.7% vs 3.2%; χ2=7.08, p<0.01) or drowning (8.2% vs 1.8%; χ2=39.53, p<0.01), but less frequently by hanging (29.4% vs 39.9%; χ2=8.82, p<0.01). They were most frequently located in natural outdoors locations (58.2% vs 11.1%; χ2=388.25, p<0.01). Persons gone missing were less likely to have lived alone at time of death (OR 0.45, 95% CI 0.26 to 0.76), yet more likely to be institutionalised (OR 3.12, 95% CI 1.28 to 7.64). They were less likely to have been physically ill (OR 0.64, 95% CI 0.43 to 0.95) or have a history of problematic consumptions of alcohol (OR 0.52, 95% CI 0.31 to 0.87). In comparison to other suicide cases, missing persons more often communicated their suicidal intent prior to death (OR 1.58, 95% CI 1.13 to 2.22). Conclusions Suicides by missing persons show several distinct characteristics in comparisons to other suicides. The findings have implications for development of suicide prevention strategies focusing on early identification and interventions targeting this group. In particular, it may offer assistance to police in designing risk assessment procedures and subsequent investigations of missing persons. PMID:22454187

A review of factors associated with greater likelihood of suicide attempts and suicide deaths in bipolar disorder: Part II of a report of the International Society for Bipolar Disorders Task Force on Suicide in Bipolar Disorder.

PubMed

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

2015-11-01

Many factors influence the likelihood of suicide attempts or deaths in persons with bipolar disorder. One key aim of the International Society for Bipolar Disorders Task Force on Suicide was to summarize the available literature on the presence and magnitude of effect of these factors. A systematic review of studies published from 1 January 1980 to 30 May 2014 identified using keywords 'bipolar disorder' and 'suicide attempts or suicide'. This specific paper examined all reports on factors putatively associated with suicide attempts or suicide deaths in bipolar disorder samples. Factors were subcategorized into: (1) sociodemographics, (2) clinical characteristics of bipolar disorder, (3) comorbidities, and (4) other clinical variables. We identified 141 studies that examined how 20 specific factors influenced the likelihood of suicide attempts or deaths. While the level of evidence and degree of confluence varied across factors, there was at least one study that found an effect for each of the following factors: sex, age, race, marital status, religious affiliation, age of illness onset, duration of illness, bipolar disorder subtype, polarity of first episode, polarity of current/recent episode, predominant polarity, mood episode characteristics, psychosis, psychiatric comorbidity, personality characteristics, sexual dysfunction, first-degree family history of suicide or mood disorders, past suicide attempts, early life trauma, and psychosocial precipitants. There is a wealth of data on factors that influence the likelihood of suicide attempts and suicide deaths in people with bipolar disorder. Given the heterogeneity of study samples and designs, further research is needed to replicate and determine the magnitude of effect of most of these factors. This approach can ultimately lead to enhanced risk stratification for patients with bipolar disorder. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Unusual Case of Suicide With a Modified Trap Gun.

PubMed

Vadysinghe, Amal; Dassanayake, Prasanna; Wickramasinghe, Medhani

2017-06-01

Trap gun is an illegal, locally manufactured gun with a basic trip system used to hunt wild animals. The body of a 28-year-old man was found in the jungle in supine position with both legs apart. A trap gun was between the legs pointing toward the cranial side of the body. It had 2 free wires that were not connected together. There was no evidence of foul play.The body had a single-entry wound (2.5-cm diameter) in the anterior chest, with blackening, burning, and tattooing. Six metal particles and nylon clothing material were embedded into soft tissue. No exit wound was found. Toxicology analysis reported an alcohol level of 72 mg/dL. The cause of death was multiple shrapnel injury to the chest at close to intermediate range by a single discharge from a trap gun. Circumstance was concluded as suicide.Ballistic and firearm experts opined that an illegal, manually operated, battery-powered ignition device was used to ignite the gun powder. We report the first case of suicide by a modified trap gun in literature.

A review of factors associated with greater likelihood of suicide attempts and suicide deaths in bipolar disorder: Part II of a report of the International Society for Bipolar Disorders Task Force on Suicide in Bipolar Disorder

PubMed Central

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

2018-01-01

Objectives Many factors influence the likelihood of suicide attempts or deaths in persons with bipolar disorder. One key aim of the International Society for Bipolar Disorders Task Force on Suicide was to summarize the available literature on the presence and magnitude of effect of these factors. Methods A systematic review of studies published from 1 January 1980 to 30 May 2014 identified using keywords ‘bipolar disorder’ and ‘suicide attempts or suicide’. This specific paper examined all reports on factors putatively associated with suicide attempts or suicide deaths in bipolar disorder samples. Factors were subcategorized into: (1) sociodemographics, (2) clinical characteristics of bipolar disorder, (3) comorbidities, and (4) other clinical variables. Results We identified 141 studies that examined how 20 specific factors influenced the likelihood of suicide attempts or deaths. While the level of evidence and degree of confluence varied across factors, there was at least one study that found an effect for each of the following factors: sex, age, race, marital status, religious affiliation, age of illness onset, duration of illness, bipolar disorder subtype, polarity of first episode, polarity of current/recent episode, predominant polarity, mood episode characteristics, psychosis, psychiatric comorbidity, personality characteristics, sexual dysfunction, first-degree family history of suicide or mood disorders, past suicide attempts, early life trauma, and psychosocial precipitants. Conclusion There is a wealth of data on factors that influence the likelihood of suicide attempts and suicide deaths in people with bipolar disorder. Given the heterogeneity of study samples and designs, further research is needed to replicate and determine the magnitude of effect of most of these factors. This approach can ultimately lead to enhanced risk stratification for patients with bipolar disorder. PMID:26175498

Factors associated with suicide among adolescents and young adults not in mental health treatment at time of death.

PubMed

McLone, Suzanne G; Kouvelis, Antigone; Mason, Maryann; Sheehan, Karen

2016-10-01

Suicide is the third-leading cause of death among Illinois residents aged 15 to 24 years. The Illinois Violent Death Reporting System (IVDRS) was developed to help prevent these deaths by providing timely, complete data. Understanding the circumstances surrounding suicide for those aged 15 to 24 years who are not receiving mental health treatment can help others: (1) recognize signs of potential crisis and (2) connect them to mental health treatment. The IVDRS data were collected from five Illinois counties-Cook, DuPage, Kane, McHenry, and Peoria-from 2005 to 2010. All cases with the manner suicide, aged 15 to 24 years, were extracted for analysis. Data were described using frequencies and percentages, and statistical differences between groups were determined using χ analysis. There were a total of 386 suicides in those aged 15 to 24 years in IVDRS from 2005 to 2010. Most 15- to 19-year-olds (67%) and 20- to 24-year-olds (78%) were not receiving mental health treatment at the time of death. Among those not receiving mental health treatment, 22% and 13% of those aged 15 to 19 and 20 to 24 years, respectively, had disclosed their intent to commit suicide to another. One third were identified as being depressed or in a depressed mood (not necessarily a clinical diagnosis) in both age groups. One quarter in both age groups experienced a crisis (current, acute precipitating, or forthcoming event) within 2 weeks of their suicides. The majority of adolescents and young adults were not in mental health treatment at the time death. Among those not in mental health treatment at the time of death, the 15- to 19-year-olds were more likely to share their suicidal intentions than the 20- to 24-year-olds. Epidemiological study, level IV.

Asphyxial suicide by inhalation of chloroform inside a plastic bag.

PubMed

Zorro, Andres Rodriguez

2014-01-01

Asphyxia suicide by placing a plastic bag over the head in addition with inhalation of gases or use of sedative substances is an unusual method of committing suicide, but frequently referenced by right to die groups in the Internet. This article reports 2 suicides in which chloroform was used to induce unconsciousness and subsequent asphyxia by placing the head in a plastic bag. Case histories of 2 males, ages 23 and 28, are described with special emphasis on characteristics death related to suffocation using plastic bags and chloroform. The final remarkable point in both cases is that the victims previously searched the WEB for instructions of suicide methods. The importance of the phenomenon of misuse of Internet by young people who commit suicide is stressed. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

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.

Collecting Sexual Orientation and Gender Identity Data in Suicide and Other Violent Deaths: A Step Towards Identifying and Addressing LGBT Mortality Disparities

PubMed Central

Lane, Andrew

2015-01-01

Abstract Sexual orientation and gender identity (SO/GI) are not systematically recorded at time of death, limiting identification of mortality disparities in lesbian, gay, bisexual, and transgender (LGBT) people. LGBT populations are thought to have elevated risk of suicide based on high rates of reported lifetime suicide attempts. Lack of data on suicide deaths, however, hinders understanding of the prevalence and patterns of suicide among LGBT populations and development of targeted interventions and prevention programs. This report describes recent efforts to address this knowledge gap by systematically collecting SO/GI information in the investigation of suicide and other violent deaths. PMID:26790023

Collecting Sexual Orientation and Gender Identity Data in Suicide and Other Violent Deaths: A Step Towards Identifying and Addressing LGBT Mortality Disparities.

PubMed

Haas, Ann P; Lane, Andrew

2015-03-01

Sexual orientation and gender identity (SO/GI) are not systematically recorded at time of death, limiting identification of mortality disparities in lesbian, gay, bisexual, and transgender (LGBT) people. LGBT populations are thought to have elevated risk of suicide based on high rates of reported lifetime suicide attempts. Lack of data on suicide deaths, however, hinders understanding of the prevalence and patterns of suicide among LGBT populations and development of targeted interventions and prevention programs. This report describes recent efforts to address this knowledge gap by systematically collecting SO/GI information in the investigation of suicide and other violent deaths.

Economic Contraction, Alcohol Intoxication and Suicide: Analysis of the National Violent Death Reporting System

PubMed Central

Kaplan, M.S.; Huguet, N.; Caetano, R.; Giesbrecht, N.; Kerr, W.C.; McFarland, B.H.

2014-01-01

Objectives Although there is a large and growing body of evidence concerning the impact of contracting economies on suicide mortality risk, far less is known about the role alcohol consumption plays in the complex relationship between economic conditions and suicide. The aims were to compare the postmortem alcohol intoxication rates among male and female suicide decedents before (2005–07), during (2008–09), and after (2010–11) the economic contraction in the United States. Methods Data from the restricted National Violent Death Reporting System 2005–11 for male and female suicide decedents aged 20 years and older were analyzed by Poisson regression analysis to test whether there was significant change in the fractions of suicide decedents who were acutely intoxicated at the time of death (defined as blood alcohol concentration ≥ 0.08 g/dl) prior, during, and after the downturn. Results The fraction of all suicide decedents with alcohol intoxication increased by 7% after the onset of the recession from 22.2% in 2005–07 to 23.9% in 2008–11. Compared to the years prior to the recession, male suicide decedents showed a 1.09-fold increased risk of alcohol intoxication within the first two years of the recession. Surprisingly, there was evidence of a lag effect among female suicide decedents, who had a 1.14-fold (95% CI, 1.02 to 1.27) increased risk of intoxication in 2010–11 compared to 2005–07. Conclusions These findings suggest that acute alcohol intoxication in suicide interacts with economic conditions, becoming more prevalent during contractions. PMID:25024394

An empirical analysis of suicidal death trends in India: a 5 year retrospective study.

PubMed

Badiye, Ashish; Kapoor, Neeti; Ahmed, Shagufa

2014-10-01

Suicide, a major problem worldwide, continues to be a criminal offence in most of the developing countries of the world, including India. This paper retrospectively examines the latest trends and the relevant determinants of the suicidal deaths in one of the most important city of central India- Nagpur of Maharashtra state, carried out for a period of 5 years i.e. 2009-2013. Total 2036 cases were analyzed. An alarmingly increasing trend in the rate of suicides has been observed in the region, which increased from 16% to 22.68% during the study period. The male to female suicide ratio was found to be 2.50:1. The rate of suicidal deaths ranged from 15.34 to 21.74 per 100,000 populations. Hanging was found to be the most preferred mean adopted for suicide by males (54.77%) and females (47.65%), while, Family problems was the most common cause of suicide among both male (38.25%) and female (52.65%). The Suicides were concentrated in the age group of 30-44 years for males (35.76%), while in the age group of 15-29 years for females (51.75%). The prevalence was higher among the people who were married, being as high as 1099 (66.73%) males and 372 (56.45%) females. Highest trend has been found among the people with matriculate/secondary education level. The males with job in private sector accounted for 1007 suicides (61.14%) and 434 (65.86%) females in the category of housewives (non-working, homemakers) committed the same. Copyright © 2014 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Probing the implicit suicidal mind: does the Death/Suicide Implicit Association Test reveal a desire to die, or a diminished desire to live?

PubMed

Harrison, Dominique P; Stritzke, Werner G K; Fay, Nicolas; Ellison, T Mark; Hudaib, Abdul-Rahman

2014-09-01

Assessment of implicit self-associations with death relative to life, measured by a death/suicide implicit association test (d/s-IAT), has shown promise in the prediction of suicide risk. The current study examined whether the d/s-IAT reflects an individual's desire to die or a diminished desire to live and whether the predictive utility of implicit cognition is mediated by life-oriented beliefs. Four hundred eight undergraduate students (285 female; Mage = 20.36 years, SD = 4.72) participated. Participants completed the d/s-IAT and self-report measures assessing 6 indicators of suicide risk (suicide ideation frequency and intensity, depression, nonsuicidal self-harm thoughts frequency and intensity, and nonsuicidal self-harm attempts), as well as survival and coping beliefs and history of prior suicide attempts. The d/s-IAT significantly predicted 5 out of the 6 indicators of suicide risk above and beyond the strongest traditional indicator of risk, history of prior suicide attempts. However, the effect of the d/s-IAT on each of the risk indicators was mediated by individuals' survival and coping beliefs. Moreover, the distribution of d/s-IAT scores primarily reflected variability in self-associations with life. Implicit suicide-related cognition appears to reflect a gradual diminishing of the desire to live, rather than a desire to die. Contemporary theories of suicide and risk assessment protocols need to account for the dynamic relationship between both risk and life-oriented resilience factors, and intervention strategies aimed at enhancing engagement with life should be a routine part of suicide risk management. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Long-term exposure to air pollution and the risk of suicide death: A population-based cohort study.

PubMed

Min, Jin-Young; Kim, Hye-Jin; Min, Kyoung-Bok

2018-07-01

Suicide is a major public health problem. Previous studies have reported a significant association between acute exposure to air pollution and suicide; little attention has been paid to the long-term effects of air pollution on risk of suicide. We investigated whether long-term exposure to particulate matter of ≤10μm in diameter (PM 10 ), nitrogen dioxide (NO 2 ), and sulfur dioxide (SO 2 ) would be associated with a greater risk of death by suicide. The study sample comprised 265,749 adults enrolled in the National Health Insurance Service-National Sample Cohort (2002-2013) in South Korea. Suicide death was defined as per ICD-10 code. Data on air pollution exposure used nationwide monitoring data, and individual exposure levels were assigned using geographic information systems. Air pollution exposure was categorized as the interquartile range (IQR) and quartiles. Hazards ratios (HRs) were calculated for the occurrence of suicide death after adjusting for potential covariates. During the study period, 564 (0.2%) subjects died from suicide. Increases in IQR pollutants (7.5μg/m 3 for PM 10 , 11.8ppb for NO 2 , and 0.8ppb for SO 2 ) significantly increased HR for suicide death [PM 10 : HR=3.09 (95% CI: 2.63-3.63); NO 2 : HR=1.33 (95% CI: 1.09-1.64); and SO 2 : HR=1.15 (95% CI: 1.07-1.24)]. Compared with the lowest level of air pollutants (Quartile 1), the risk of suicide significantly increased in the highest quartile level (Quartile 4) for PM 10 (HR=4.03; 95% CI: 2.97-5.47) and SO 2 (HR=1.65; 95% CI: 1.29-2.11) and in the third quartile for NO 2 (HR=1.52; 95% CI: 1.17-1.96). HRs for subjects with a physical or mental disorder were higher than that those for subjects without the disorder. Subjects living in metropolitan areas were more vulnerable to long-term PM 10 exposure than those living in non-metropolitan areas. Long-term exposure to air pollution was associated with a significantly increased risk of suicide death. People having underlying diseases or

Suicidal Behaviors in Surviving Monozygotic and Dizygotic Co-Twins: Is the Nature of the Co-Twin's Cause of Death a Factor?

ERIC Educational Resources Information Center

Segal, Nancy L.

2009-01-01

Genetically informative samples can address hereditary and experiential influences on suicide-related behaviors. The frequency of suicide-related behaviors was compared in twins from two survivor groups: (1) those whose co-twins' deaths were suicides (monozygotic [MZ]: n = 47; dizygotic [DZ]: n = 31), and (2) those whose co-twins' deaths were…

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.

Fearlessness about Death: The psychometric properties and construct validity of the revision to the Acquired Capability for Suicide Scale

PubMed Central

Ribeiro, Jessica D.; Witte, Tracy K.; Van Orden, Kimberly A.; Selby, Edward A.; Gordon, Kathryn H.; Bender, Theodore W.; Joiner, Thomas E.

2014-01-01

The Interpersonal Theory of Suicide proposes that suicidal behavior is so frightening that in order for an individual to engage in suicidal behavior, desire for suicide must be accompanied by the capability to do so. The capability for suicide is characterized by both a sense of fearlessness about death and elevated physiological pain tolerance. The primary aim of the current project was to reevaluate and revise the Acquired Capability for Suicide Scale (ACSS) and offer a revision to the scale. Expert review of the scale items resulted in retaining seven items assessing fearlessness about death. The recommendation is made to refer to the revised scale as the ACSS-Fearlessness about Death (ACSS-FAD) to reflect its content more specifically. A model with the 7 retained items provided good fit to the data across three independent samples of young adults. Multiple group analyses examining measurement invariance across men and women found that the latent structure of the scale is comparable across gender. Data are also presented demonstrating convergent and discriminant validity for the scale in young adults and an inpatient psychiatric sample. Findings support the viability of the ACSS-FAD, indicating the scale has a replicable factor structure that generalizes across males and females and is substantively related to the construct of fearlessness about death. Taken together, the present work extends our knowledge of the psychometrics of the ACSS-FAD in particular and the nature of fearlessness about death in general. PMID:24274043

Economic contraction, alcohol intoxication and suicide: analysis of the National Violent Death Reporting System.

PubMed

Kaplan, M S; Huguet, N; Caetano, R; Giesbrecht, N; Kerr, W C; McFarland, B H

2015-02-01

Although there is a large and growing body of evidence concerning the impact of contracting economies on suicide mortality risk, far less is known about the role alcohol consumption plays in the complex relationship between economic conditions and suicide. The aims were to compare the postmortem alcohol intoxication rates among male and female suicide decedents before (2005-2007), during (2008-2009) and after (2010-2011) the economic contraction in the USA. Data from the restricted National Violent Death Reporting System (2005-2011) for male and female suicide decedents aged 20 years and older were analysed by Poisson regression analysis to test whether there was significant change in the fractions of suicide decedents who were acutely intoxicated at the time of death (defined as blood alcohol content ≥0.08 g/dL) prior, during and after the downturn. The fraction of all suicide decedents with alcohol intoxication increased by 7% after the onset of the recession from 22.2% in 2005-2007 to 23.9% in 2008-2011. Compared with the years prior to the recession, male suicide decedents showed a 1.09-fold increased risk of alcohol intoxication within the first 2 years of the recession. Surprisingly, there was evidence of a lag effect among female suicide decedents, who had a 1.14-fold (95% CI 1.02 to 1.27) increased risk of intoxication in 2010-2011 compared with 2005-2007. These findings suggest that acute alcohol intoxication in suicide interacts with economic conditions, becoming more prevalent during contractions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Association of Poor Subjective Sleep Quality With Risk for Death by Suicide During a 10-Year Period

PubMed Central

Bernert, Rebecca A.; Turvey, Carolyn L.; Conwell, Yeates; Joiner, Thomas E.

2014-01-01

IMPORTANCE Older adults have high rates of sleep disturbance, die by suicide at disproportionately higher rates compared with other age groups, and tend to visit their physician in the weeks preceding suicide death. To our knowledge, to date, no study has examined disturbed sleep as an independent risk factor for late-life suicide. OBJECTIVE To examine the relative independent risk for suicide associated with poor subjective sleep quality in a population-based study of older adults during a 10-year observation period. DESIGN, SETTING, AND PARTICIPANTS A longitudinal case-control cohort study of late-life suicide among a multisite, population-based community sample of older adults participating in the Established Populations for Epidemiologic Studies of the Elderly. Of 14 456 community older adults sampled, 400 control subjects were matched (on age, sex, and study site) to 20 suicide decedents. MAIN OUTCOMES AND MEASURES Primary measures included the Sleep Quality Index, the Center for Epidemiologic Studies–Depression Scale, and vital statistics. RESULTS Hierarchical logistic regressions revealed that poor sleep quality at baseline was significantly associated with increased risk for suicide (odds ratio [OR], 1.39; 95% CI, 1.14-1.69; P < .001) by 10 follow-up years. In addition, 2 sleep items were individually associated with elevated risk for suicide at 10-year follow-up: difficulty falling asleep (OR, 2.24; 95% CI, 1.27-3.93; P < .01) and nonrestorative sleep (OR, 2.17; 95% CI, 1.28-3.67; P < .01). Controlling for depressive symptoms, baseline self-reported sleep quality was associated with increased risk for death by suicide (OR, 1.30; 95% CI, 1.04-1.63; P < .05). CONCLUSIONS AND RELEVANCE Our results indicate that poor subjective sleep quality is associated with increased risk for death by suicide 10 years later, even after adjustment for depressive symptoms. Disturbed sleep appears to confer considerable risk, independent of depressed mood, for the most

Substance misuse in life and death in a 2-year cohort of suicides.

PubMed

Galway, Karen; Gossrau-Breen, Diana; Mallon, Sharon; Hughes, Lynette; Rosato, Michael; Rondon-Sulbaran, Janeet; Leavey, Gerard

2016-03-01

Although substance misuse is a key risk factor in suicide, relatively little is known about the relationship between lifetime misuse and misuse at the time of suicide. To examine the relationship between substance misuse and subsequent suicide. Linkage of coroners' reports to primary care records for 403 suicides occurring over 2 years. With alcohol misuse, 67% of the cohort had previously sought help for alcohol problems and 39% were intoxicated at the time of suicide. Regarding misuse of other substances, 54% of the cohort was tested. Almost one in four (38%) tested positive, defined as an excess of drugs over the prescribed therapeutic dosage and/or detection of illicit substances. Those tested were more likely to be young and have a history of drug misuse. A deeper understanding of the relationship between substance misuse and suicide could contribute to prevention initiatives. Furthermore, standardised toxicology screening processes would avoid diminishing the importance of psychosocial factors involved in suicide as a 'cause of death'. © The Royal College of Psychiatrists 2016.

Massive increase in injury deaths of undetermined intent in ex-USSR Baltic and Slavic countries: hidden suicides?

PubMed

Värnik, Peeter; Sisask, Merike; Värnik, Airi; Yur'yev, Andriy; Kõlves, Kairi; Leppik, Lauri; Nemtsov, Aleksander; Wasserman, Danuta

2010-06-01

Observed changes in subcategories of injury death were used to test the hypothesis that a sizeable proportion of ''injury deaths of undetermined intent'' (Y10-Y34 in ICD 10) in the Baltic and Slavic countries after the USSR dissolved in 1991 were hidden suicides. Using male age-adjusted suicide rates for two distinctly different periods, 1981-90 and 1992-2005, changes, ratios and correlations were calculated. The data were compared with the EU average. After the USSR broke up, the obligation to make a definitive diagnosis became less strict. A massive increase in ''injury deaths of undetermined intent'' resulted. The mean rate for the second period reached 52.8 per 100,000 males in Russia (the highest rate) and 12.9 in Lithuania (the lowest), against 3.2 in EU-15. The rise from the first to the second period was highest in Belarus (56%) and Russia (44%). The number of injury deaths of undetermined intent was almost equal to that of suicides in Russia in 2005 (ratio 1.0) and Ukraine in 2002 (1.1). In all the countries, especially the Slavic ones, prevalence trends of injury-death subcategories were uniform, i.e. strongly correlated over time. No direct substitution of one diagnosis for another was evident. There is no evidence that the category of ''injury deaths of undetermined intent'' in the Baltic and Slavic countries hides suicides alone. Aggregate level analysis indicates that accidents and homicides could sometimes be diagnosed as undetermined.

Implications of Parental Suicide and Violent Death for Promotion of Resilience of Parentally-Bereaved Children

ERIC Educational Resources Information Center

Brown, Ana C.; Sandler, Irwin N.; Tein, Jenn-Yun; Liu, Xianchen; Haine, Rachel A.

2007-01-01

This article considers the implications of suicide and violent deaths (including suicide, homicide, and accidents) for the development of interventions for parentally bereaved children. Analyses of data from the Family Bereavement Program find minimal differences in children's mental health problems, grief or risk and protective factors based on…

Dyadic Death: Murder-Suicide.

ERIC Educational Resources Information Center

Berman, Alan L.

1979-01-01

Results indicated a lower incidence for homocide-suicides than reported previously and several distinguishing characteristics of murderers who subsequently commit suicide. Presented at the 10th Annual Meeting of the American Association of Suicidology, May 1977, Boston. (Author)

Suicide Trends Among and Within Urbanization Levels by Sex, Race/Ethnicity, Age Group, and Mechanism of Death — United States, 2001–2015

PubMed Central

Crosby, Alex E.; Jack, Shane P. D.; Haileyesus, Tadesse; Kresnow-Sedacca, Marcie-jo

2017-01-01

Problem/Condition Suicide is a public health problem and one of the top 10 leading causes of death in the United States. Substantial geographic variations in suicide rates exist, with suicides in rural areas occurring at much higher rates than those occurring in more urban areas. Understanding demographic trends and mechanisms of death among and within urbanization levels is important to developing and targeting future prevention efforts. Reporting Period 2001–2015. Description of System Mortality data from the National Vital Statistics System (NVSS) include demographic, geographic, and cause of death information derived from death certificates filed in the 50 states and the District of Columbia. NVSS was used to identify suicide deaths, defined by International Classification of Diseases, 10th Revision (ICD-10) underlying cause of death codes X60–X84, Y87.0, and U03. This report examines annual county level trends in suicide rates during 2001–2015 among and within urbanization levels by select demographics and mechanisms of death. Counties were collapsed into three urbanization levels using the 2006 National Center for Health Statistics classification scheme. Results Suicide rates increased across the three urbanization levels, with higher rates in nonmetropolitan/rural counties than in medium/small or large metropolitan counties. Each urbanization level experienced substantial annual rate changes at different times during the study period. Across urbanization levels, suicide rates were consistently highest for men and non-Hispanic American Indian/Alaska Natives compared with rates for women and other racial/ethnic groups; however, rates were highest for non-Hispanic whites in more metropolitan counties. Trends indicate that suicide rates for non-Hispanic blacks were lowest in nonmetropolitan/rural counties and highest in more urban counties. Increases in suicide rates occurred for all age groups across urbanization levels, with the highest rates for persons

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

PubMed

Molina, D Kimberley; Hargrove, Veronica M

2017-03-01

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

An Integrative Suicide Prevention Program for Visitor Charcoal Burning Suicide and Suicide Pact

ERIC Educational Resources Information Center

Wong, Paul W. C.; Liu, Patricia M. Y.; Chan, Wincy S. C.; Law, Y. W.; Law, Steven C. K.; Fu, King-Wa; Li, Hana S. H.; Tso, M. K.; Beautrais, Annette L.; Yip, Paul S. F.

2009-01-01

An integrative suicide prevention program was implemented to tackle an outbreak of visitor charcoal burning suicides in Cheung Chau, an island in Hong Kong, in 2002. This study evaluated the effectiveness of the program. The numbers of visitor suicides reduced from 37 deaths in the 51 months prior to program implementation to 6 deaths in the 42…

An unusual case of murder-suicide: The importance of studying knots.

PubMed

D'Ovidio, Cristian; Rosato, Enrica; Carnevale, Aldo

2017-01-01

An atypical murder-suicide that involved a married couple over 80 years of age was investigated at the Institute of Legal Medicine of the University of Chieti-Pescara and is presented and discussed here. The whole story allows us to confront the difficulties involved in the discovery of a dead body in water when the circumstantial evidence does not allow any unique interpretation of the facts. The atypical and misleading element appeared to be how the body of the man was tied, with the interpretation inclined towards a homicidal manner of death. It was only by combining the contributions of each of the findings that emerged during the course of the autopsy with the circumstantial evidence from the site inspection that it was possible to reach resolution of this case, which was then identified as a murder-suicide. Copyright © 2016 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

An analysis of suicide and undetermined deaths in 17 predominantly Islamic countries contrasted with the UK.

PubMed

Pritchard, Colin; Amanullah, S

2007-03-01

Suicide is expressly condemned in the Qu'ran, and traditionally few Islamic countries have reported suicide. Undetermined deaths are classified by the World Health Organization (WHO) as Other Violent Deaths (OVD) in ICD-9, or Other External Causes (OEC) in ICD-10. It has been suggested that to avoid under-reporting of suicides, both formal suicide verdicts and OVD should be considered together because OVD may contain 'hidden' suicides. The latest WHO mortality data, by age and gender, were analysed and tested by chi2 tests. Levels of suicide and OVD in 17 Islamic countries were examined and contextually compared with UK rates. The regional Islamic cultural differences in Middle Eastern, South Asian, European Islam countries and those of the former Union of Socialist Soviet Republics (FUSSR) were analysed separately to test the hypotheses that there would be no difference between regional suicide and OVD rates per million (pm) and 17 Islamic countries and UK rates. Suicide rates were higher for males than females, and 'older' (65+) higher than 'younger' (15-34) rates in every country reviewed. The rate for Middle Eastern males was 0-36 pm, South Asian 0-12 pm, European 53-177 pm and FUSSR 30-506 pm, with three countries exceeding the UK rate of 116 pm. The Western male average OVD rate was 22 pm; the UK 55 pm rate was highest. Middle Eastern OVD was 1-420 pm, South Asian 0-166 pm, European 1-66 pm and FUSSR 11-361 pm. OVD rates in 10 Islamic countries were considerably higher than the Western average and eight had OVD rates considerably higher than their suicide rates. Islamic suicide rates varied widely and the high OVD rates, especially the Middle Eastern, may be a repository for hiding culturally unacceptable suicides.

Male suicide among construction workers in Australia: a qualitative analysis of the major stressors precipitating death.

PubMed

Milner, Allison; Maheen, Humaira; Currier, Dianne; LaMontagne, Anthony D

2017-06-19

Suicide rates among those employed in male-dominated professions such as construction are elevated compared to other occupational groups. Thus far, past research has been mainly quantitative and has been unable to identify the complex range of risk and protective factors that surround these suicides. We used a national coronial database to qualitatively study work and non-work related influences on male suicide occurring in construction workers in Australia. We randomly selected 34 cases according to specific sampling framework. Thematic analysis was used to develop a coding structure on the basis of pre-existing theories in job stress research. The following themes were established on the basis of mutual consensus: mental health issues prior to death, transient working experiences (i.e., the inability to obtain steady employment), workplace injury and chronic illness, work colleagues as a source of social support, financial and legal problems, relationship breakdown and child custody issues, and substance abuse. Work and non-work factors were often interrelated pressures prior to death. Suicide prevention for construction workers needs to take a systematic approach, addressing work-level factors as well as helping those at-risk of suicide.

The incidence and course of depression in bereaved youth 21 months after the loss of a parent to suicide, accident, or sudden natural death.

PubMed

Brent, David; Melhem, Nadine; Donohoe, M Bertille; Walker, Monica

2009-07-01

This study examined effects of bereavement 21 months after a parent's death, particularly death by suicide. The participants were 176 offspring, ages 7-25, of parents who died by suicide, accident, or sudden natural death. They were assessed 9 and 21 months after the death, along with 168 nonbereaved subjects. Major depression and alcohol or substance abuse 21 months after the parent's death were more common among bereaved youth than among comparison subjects. Offspring with parental suicide or accidental death had higher rates of depression than comparison subjects; those with parental suicide had higher rates of alcohol or substance abuse. Youth with parental suicide had a higher incidence of depression than those bereaved by sudden natural death. Bereavement and a past history of depression increased depression risk in the 9 months following the death, which increased depression risk between 9 and 21 months. Losing a mother, blaming others, low self-esteem, negative coping, and complicated grief were associated with depression in the second year. Youth who lose a parent, especially through suicide, are vulnerable to depression and alcohol or substance abuse during the second year after the loss. Depression risk in the second year is mediated by the increased incidence of depression within the first 9 months. The most propitious time to prevent or attenuate depressive episodes in bereaved youth may be shortly after the parent's death. Interventions that target complicated grief and blaming of others may also improve outcomes in symptomatic youth with parental bereavement.

Suicide, guns, and buyback programs: An epidemiologic analysis of firearm-related deaths in Connecticut.

PubMed

Baumann, Laura; Clinton, Heather; Berntsson, Rob; Williams, Susan S; Rovella, James C; Shapiro, David; Thaker, Shefali; Borrup, Kevin; Lapidus, Garry; Campbell, Brendan T

2017-12-01

Gun buyback programs aim to remove unwanted firearms from the community with the goal of preventing firearm injury and death. Buyback programs are held in many communities, but evidence demonstrating their effectiveness is lacking. The purpose of this study is to compare firearms collected at buyback events to crime guns and firearms used in homicides and suicides. Detailed firearm and case data were obtained from the Hartford Police Department and the Office of the Chief Medical Examiner from January through December of 2015. Information was reviewed for guns collected at buyback events, crime guns confiscated by police, and for weapons associated with firearm fatalities. Detailed firearm data included type, manufacturer, model, and caliber (small, ≤ 0.32 caliber; medium, 0.357 caliber to 9 mm; large, ≥ 0.40 caliber). χ analyses were used for comparisons between groups. In 2015, 224 crime guns were seized by the Hartford Police, 169 guns were collected at four community buyback events, and there were 187 firearm-related deaths statewide (105 suicides, 81 homicides, 1 legal intervention). Comparisons between buyback, crime, and fatality-related firearms are shown in the table below. Medium caliber handguns account for the majority of crime guns and fatalities, and buyback programs collected smaller caliber handguns. The demographics of individuals who turn in guns at buyback events and commit suicide are similar: age (buyback, 63 ± 11; suicide, 52 ± 18; homicide, 34 ± 12 years), sex (buyback, 81%; suicide, 91%; homicide, 84% men), and race (buyback, 80%; suicide, 97%; homicide, 47% white). Handguns account for the majority of crime guns and firearm-related fatalities in Connecticut. Buyback programs are both an opportunity to remove unwanted handguns from the community and to remove firearms from the homes of individuals at increased risk of suicide. Epidemiologic/therapeutic study, level IV.

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.

Method overtness, forensic autopsy, and the evidentiary suicide note: A multilevel National Violent Death Reporting System analysis.

PubMed

Rockett, Ian R H; Caine, Eric D; Stack, Steven; Connery, Hilary S; Nolte, Kurt B; Lilly, Christa L; Miller, Ted R; Nelson, Lewis S; Putnam, Sandra L; Nestadt, Paul S; Jia, Haomiao

2018-01-01

Higher prevalence of suicide notes could signify more conservatism in accounting and greater proneness to undercounting of suicide by method. We tested two hypotheses: (1) an evidentiary suicide note is more likely to accompany suicides by drug-intoxication and by other poisoning, as less violent and less forensically overt methods, than suicides by firearm and hanging/suffocation; and (2) performance of a forensic autopsy attenuates any observed association between overtness of method and the reported presence of a note. This multilevel (individual/county), multivariable analysis employed a generalized linear mixed model (GLMM). Representing the 17 states participating in the United States National Violent Death Reporting System throughout 2011-2013, the study population comprised registered suicides, aged 15 years and older. Decedents totaled 32,151. The outcome measure was relative odds of an authenticated suicide note. An authenticated suicide note was documented in 31% of the suicide cases. Inspection of the full multivariable model showed a suicide note was more likely to manifest among drug intoxication (adjusted odds ratio [OR], 1.70; 95% CI, 1.56, 1.85) and other poisoning suicides (OR, 2.12; 1.85, 2.42) than firearm suicides, the referent. Respective excesses were larger when there was no autopsy or autopsy status was unknown (OR, 1.86; 95% CI, 1.61, 2.14) and (OR, 2.25; 95% CI, 1.86, 2.72) relative to the comparisons with a forensic autopsy (OR, 1.62, 95% CI, 1.45, 1.82 and OR, 2.01; 95% CI, 1.66, 2.43). Hanging/suffocation suicides did not differ from the firearm referent given an autopsy. Suicide requires substantial affirmative evidence to establish manner of death, and affirmation of drug intoxication suicides appears to demand an especially high burden of proof. Findings and their implications argue for more stringent investigative standards, better training, and more resources to support comprehensive and accurate case ascertainment, as the

What people close to death say about euthanasia and assisted suicide: a qualitative study

PubMed Central

Chapple, A; Ziebland, S; McPherson, A; Herxheimer, A

2006-01-01

Objective To explore the experiences of people with a “terminal illness”, focusing on the patients' perspective of euthanasia and assisted suicide. Method A qualitative study using narrative interviews was conducted throughout the UK. The views of the 18 people who discussed euthanasia and assisted suicide were explored. These were drawn from a maximum variation sample, who said that they had a “terminal” illness, malignant or non‐malignant. Results That UK law should be changed to allow assisted suicide or voluntary euthanasia was felt strongly by most people. Those who had seen others die were particularly convinced that this should be a right. Some had multiple reasons, including pain and anticipated pain, fear of indignity, loss of control and cognitive impairment. Those who did not want to be a burden also had other reasons for wanting euthanasia. Suicide was contemplated by a few, who would have preferred a change in the law to allow them to end their lives with medical help and in the company of family or friends. The few who opposed a change in UK law, or who felt ambivalent, focused on involuntary euthanasia, cited religious reasons or worried that new legislation might be open to abuse. Conclusion Qualitative research conducted on people who know they are nearing death is an important addition to the international debate on euthanasia and assisted suicide. Those who had seen others die were particularly convinced that the law should be changed to allow assisted death. PMID:17145910

What people close to death say about euthanasia and assisted suicide: a qualitative study.

PubMed

Chapple, A; Ziebland, S; McPherson, A; Herxheimer, A

2006-12-01

To explore the experiences of people with a "terminal illness", focusing on the patients' perspective of euthanasia and assisted suicide. A qualitative study using narrative interviews was conducted throughout the UK. The views of the 18 people who discussed euthanasia and assisted suicide were explored. These were drawn from a maximum variation sample, who said that they had a "terminal" illness, malignant or non-malignant. That UK law should be changed to allow assisted suicide or voluntary euthanasia was felt strongly by most people. Those who had seen others die were particularly convinced that this should be a right. Some had multiple reasons, including pain and anticipated pain, fear of indignity, loss of control and cognitive impairment. Those who did not want to be a burden also had other reasons for wanting euthanasia. Suicide was contemplated by a few, who would have preferred a change in the law to allow them to end their lives with medical help and in the company of family or friends. The few who opposed a change in UK law, or who felt ambivalent, focused on involuntary euthanasia, cited religious reasons or worried that new legislation might be open to abuse. Qualitative research conducted on people who know they are nearing death is an important addition to the international debate on euthanasia and assisted suicide. Those who had seen others die were particularly convinced that the law should be changed to allow assisted death.

The Incidence and Course of Depression in Bereaved Youth 21 Months After the Loss of a Parent to Suicide, Accident, or Sudden Natural Death

PubMed Central

Brent, David; Melhem, Nadine; Donohoe, M. Bertille; Walker, Monica

2009-01-01

Objective This study examined effects of bereavement 21 months after a parent’s death, particularly death by suicide. Method The participants were 176 offspring, ages 7–25, of parents who died by suicide, accident, or sudden natural death. They were assessed 9 and 21 months after the death, along with 168 nonbereaved subjects. Results Major depression and alcohol or substance abuse 21 months after the parent’s death were more common among bereaved youth than among comparison subjects. Offspring with parental suicide or accidental death had higher rates of depression than comparison subjects; those with parental suicide had higher rates of alcohol or substance abuse. Youth with parental suicide had a higher incidence of depression than those bereaved by sudden natural death. Bereavement and a past history of depression increased depression risk in the 9 months following the death, which increased depression risk between 9 and 21 months. Losing a mother, blaming others, low self-esteem, negative coping, and complicated grief were associated with depression in the second year. Conclusions Youth who lose a parent, especially through suicide, are vulnerable to depression and alcohol or substance abuse during the second year after the loss. Depression risk in the second year is mediated by the increased incidence of depression within the first 9 months. The most propitious time to prevent or attenuate depressive episodes in bereaved youth may be shortly after the parent’s death. Interventions that target complicated grief and blaming of others may also improve outcomes in symptomatic youth with parental bereavement. PMID:19411367

Contesting the Equivalency of Continuous Sedation until Death and Physician-assisted Suicide/Euthanasia: A Commentary on LiPuma.

PubMed

Raho, Joseph A; Miccinesi, Guido

2015-10-01

Patients who are imminently dying sometimes experience symptoms refractory to traditional palliative interventions, and in rare cases, continuous sedation is offered. Samuel H. LiPuma, in a recent article in this Journal, argues that continuous sedation until death is equivalent to physician-assisted suicide/euthanasia based on a higher brain neocortical definition of death. We contest his position that continuous sedation involves killing and offer four objections to the equivalency thesis. First, sedation practices are proportional in a way that physician-assisted suicide/euthanasia is not. Second, continuous sedation may not entirely abolish consciousness. Third, LiPuma's particular version of higher brain neocortical death relies on an implausibly weak construal of irreversibility--a position that is especially problematic in the case of continuous sedation. Finally, we explain why continuous sedation until death is not functionally equivalent to neocortical death and, hence, physician-assisted suicide/euthanasia. Concluding remarks review the differences between these two end-of-life practices. © The Author 2015. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Suicide and murder-suicide involving automobiles.

PubMed

Pridmore, Saxby; Varbanov, Svetlin; Sale, Ian

2017-02-01

We aim to explore the phenomenon of suicide by driving one vehicle into another, and draw attention to the cost to occupants of targeted vehicles. We examined academic literature, court and newspaper reports, and online sources. Driver suicide may be achieved by colliding with a fixed object or another vehicle. When a second vehicle is targeted, the occupants of that vehicle experience property loss, and potentially physical and psychiatric injury, or death. Driver suicides are associated with death of another person, in 11.3% of cases. Some suicidal individuals are able to act with great consideration for the consequences of their actions. Every effort must be made to help suicidal people with mental disorders or other predicaments. There is a need for public discussion of suicide by targeting an oncoming vehicle. It is less likely that suicide drivers who target other vehicles are unable to choose and more likely they have not considered the consequences of their actions.

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.

The Experiences of Parents Readjusting to the Workplace Following the Death of a Child by Suicide

ERIC Educational Resources Information Center

Gibson, Joan; Gallagher, Mary; Jenkins, Mary

2010-01-01

Suicide among young people has become a growing concern in life in the 21st century and is a tragedy faced by an increasing number of families and in particular parents. This study set out to focus on the experiences of parents reentering the workplace following the death of a child by suicide. Although the immediate aftermath of experiencing…

Retrospective Analysis of Hanging Deaths in Ontario.

PubMed

Tugaleva, Elena; Gorassini, Donald R; Shkrum, Michael J

2016-11-01

Hanging deaths from investigation standpoint are rarely problematic. Unusual circumstances can on occasion raise suspicion of foul play. Associated neck injuries are reported in the literature with variable frequency (from 0% to 76.8%). This study retrospectively analyzed 755 hanging deaths in Ontario (Canada) to evaluate the demographic features and circumstances of hanging fatalities, and the frequency of hanging-related neck injuries. A number of cases showed unusual/special circumstances (e.g., complex, double suicides, restraints). Among 632 cases with complete autopsies, hyoid and larynx fractures were present in 46 cases (7.3%) with the most common being isolated hyoid fractures. The incidence of cricoid fractures was 0.5% and cervical spine injuries, 1.1%. A higher incidence of neck injuries occurred among males, long drop hangings, and in cases with complete suspension. There was a tendency for the number of fractures to increase with increasing age and weight of the deceased. © 2016 American Academy of Forensic Sciences.

Suicide in Peacekeepers: Risk Factors for Suicide versus Accidental Death

ERIC Educational Resources Information Center

Thoresen, Siri; Mehlum, Lars

2006-01-01

To investigate risk factors for suicide in veterans of peacekeeping, 43 suicides and 41 fatal accidents in Norwegian peacekeepers (1978 to 1995) were compared in a psychological autopsy study. Mental health problems were the most important risk factor for suicide. Both living alone and the break-up of a love relationship contributed uniquely to…

QuickStats: Death Rates for Motor Vehicle Traffic Injury,* Suicide,† and Homicide§ Among Children and Adolescents aged 10-14 Years - United States, 1999-2014.

PubMed

2016-11-04

In 1999, the mortality rate for children and adolescents aged 10-14 years for deaths from motor vehicle traffic injury (4.5 per 100,000) was about four times higher than the rate for deaths for suicide and homicide (both at 1.2). From 1999 to 2014, the death rate for motor vehicle traffic injury declined 58%, to 1.9 in 2014 (384 deaths). From 1999 to 2007, the death rate for suicide fluctuated and then doubled from 2007 (0.9) to 2014 (2.1, 425 deaths). The death rate for homicide gradually declined to 0.8 in 2014. In 2013 and 2014, the differences between death rates for motor vehicle traffic injury and suicide were not statistically significant.

[The death of Kaspar Hauser (17 Dec 1833)--assassination, suicide or self-inflicted injury?].

PubMed

Risse, Manfred; Bartsch, Christine; Dreyer, Thomas; Weiler, Günter

2005-01-01

The death of Kaspar Hauser is described taking present medicolegal and criminological knowledge into account, the main question being whether the injury was self-inflicted, homicidal or suicidal. In spite of a critical retrospective analysis this question cannot be answered with sufficient certainty even from our modern perspective. It seems unlikely that the stab to the chest was inflicted exclusively for the purpose of self-damage, but both a suicidal stab and a homicidal act (assassination) cannot be definitely ruled out.

Deaths at the workplace. Accidents or homicides?

PubMed

Boglioli, L R; Taff, M L

1990-03-01

The medical examiner is responsible for certifying and determining the cause of death of any person dying from criminal violence, accident, suicide, when unattended by a physician, in police custody, or in any suspicious or unusual manner. A less well-recognized, but no less important, responsibility of the medical examiner is the investigation of deaths of individuals who die at the workplace. The manner of death of most job-related fatalities has been traditionally classified as accidental. In recent times, prosecutors have scrutinized these cases more carefully. The results of some investigations have prompted them to bring criminal charges against employers for blatant negligence that contributed directly to injuries and deaths of employees. This paper is devoted to a review of the controversy surrounding the issue of industrial homicide, illustrative cases, and the role of the medical examiner in the investigation of deaths at the workplace.

Suicide in Canada

PubMed Central

McFaull, Steven; Rhodes, Anne E.; Bowes, Matthew; Rockett, Ian R. H.

2016-01-01

Objective: The aim of this study is to compare Canadian suicide rates with other external causes of death to examine potential poisoning misclassifications as a contributor to suicide underreporting. Method: The study used Statistics Canada mortality data from 2000 to 2011 to calculate sex-and age-specific ratios by external cause of injury codes. Results: The overall Canadian suicide rate, as well as the poisoning suicide rate, declined over the study timeframe by an average annual percentage change (AAPC) of 1.0% each year. However, unintentional and undetermined poisonings increased significantly during the timeframe. Unintentional poisoning mortality (primarily narcotics and hallucinogens, including opioids) increased in proportion to suicides for both sexes, although females were consistently higher. The undetermined death to suicide ratio was higher and increasing for females. Poisonings of undetermined intent increased over time to comprise 47% to 80% of the undetermined death category for males and females combined. Conclusions: Canadian poisoning suicide rates declined, in contrast to rising unintentional and undetermined poisoning mortality rates. This trend is similar to that of the United States, supporting the hypothesis that misclassification of poisoning deaths may also be an issue in Canada.

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

PubMed

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

2012-08-01

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

Suicide and media reporting: a longitudinal and spatial analysis.

PubMed

Yang, Albert C; Tsai, Shih-Jen; Yang, Cheng-Hung; Shia, Ben-Chang; Fuh, Jong-Ling; Wang, Shuu-Jiun; Peng, Chung-Kang; Huang, Norden E

2013-03-01

The impact of media reporting on copycat suicides has been well established in various cases of celebrity suicide. However, knowledge is limited about the spatial and temporal relationship between suicide death and media reporting over a long period of time. This study investigated the association of suicide deaths with suicide news in longitudinal and spatial dimensions. All suicides during 2003-2010 (n = 31,364) were included. Suicide news in the study period was retrieved from Google News, and included all available news media in Taiwan. Empirical mode decomposition was used to identify the main intrinsic oscillation, reflecting both major and minor suicide events, and time-dependent intrinsic correlation was used to quantify the temporal correlation between suicide deaths and suicide news. The media reporting of suicide was synchronized with increased suicide deaths during major suicide events such as celebrity death, and slightly lagged behind the suicide deaths for 1 month in other periods without notable celebrity deaths. The means of suicide reported in the media diversely affected the suicide models. Reports of charcoal burning suicide exhibited an exclusive copycat effect on actual charcoal burning deaths, whereas media reports of jumping had a wide association with various suicide models. Media reports of suicide had a higher association with suicide deaths in urban than in rural areas. This report suggested that a delayed effect of copycat suicide may exist in media reports of minor suicide events. The competitive reporting of minor suicide events must be avoided and addressed by media professionals.

Does air pollution trigger suicide? A case-crossover analysis of suicide deaths over the life span.

PubMed

Casas, Lidia; Cox, Bianca; Bauwelinck, Mariska; Nemery, Benoit; Deboosere, Patrick; Nawrot, Tim Steve

2017-11-01

In addition to underlying health disorders and socio-economic or community factors, air pollution may trigger suicide mortality. This study evaluates the association between short-term variation in air pollution and 10 years of suicide mortality in Belgium. In a bidirectional time-stratified case-crossover design, 20,533 suicide deaths registered between January 1st 2002 and December 31st 2011 were matched by temperature with control days from the same month and year. We used municipality-level air pollution [particulate matter (PM 10 ) and O 3 concentrations] data and meteorology data. We applied conditional logistic regression models adjusted for duration of sunshine and day of the week to obtain odds ratios (OR) and their 95% CI for an increase of 10 µg/m 3 in pollutant concentrations over different lag periods (lag 0, 0-1, 0-2, 0-3, 0-4, 0-5, and 0-6 days). Effect modification by season and age was investigated by including interaction terms. We observed significant associations of PM 10 and O 3 with suicide during summer (OR ranging from 1.02 to 1.07, p-values <0.05). For O 3 , significant associations were also observed during spring and autumn. Age significantly modified the associations with PM 10 , with statistically significant associations observed only among 5-14 year old children (lag 0-6: OR = 1.45; 95% CI: 1.03-2.04) and ≥85 years old (e.g. lag 0-4: OR = 1.17; 95% CI: 1.06-1.29). Recent increases in outdoor air pollutants such as PM 10 or O 3 can trigger suicide, particularly during warm periods, even at concentrations below the European thresholds. Furthermore, PM 10 may have strong trigger effects among children and elderly population.

A Unusual Lightning Death in an Indoor Setting: A Case Report.

PubMed

Ventura, Francesco; Barranco, Rosario; Bonsignore, Alessandro; De Stefano, Francesco

2017-03-01

Death due to lightning strikes is infrequent, above all indoors. Some cases may take on a medical legal interest due to the unusual and uncommon circumstances in which they occur. The authors report an extremely rare case of electrocution occurred inside a house in a rural area. A 53-year-old man was reached by an electrical discharge originating from lightning while he was doing renovation work on a cottage. In this case, the correct interpretation of the autopsy and histological aspects and the attentive analysis of the circumstantial and environmental data led to the correct diagnosis of death and to the reconstruction of the dynamics with which it occurred. It was in fact possible to reconstruct that during a violent thunderstorm, lightning, discharging from the bottom upward formed an electric arc. The victim, who was close to metal objects (sawhorses), was struck on the left foot and the current exited from the right hand passing through the heart causing immediate death.

Implicit Measure of Life/Death Orientation Predicts Response of Suicidal Ideation to Treatment in Psychiatric Inpatients.

PubMed

Ellis, Thomas E; Rufino, Katrina A; Green, Kelly L

2016-01-01

In this study, we set out to extend empirical research on the Life-Death Implicit Association Test (IAT) by administering the measure to an adult psychiatric inpatient population with suicidal ideation. We sought to examine its association with other suicide-relevant measures and to determine whether it adds predictive utility beyond that offered by other measures of suicide risk. The IAT was administered (N = 124) at biweekly intervals as part of an assessment battery at an inpatient facility for complex, treatment resistant psychiatric disorders (average length of stay: approximately 6 weeks). Multiple regression procedures were utilized to examine relationships among the measures and their predictive utility with respect to suicidal ideation at discharge. Consistent with prior research with other populations, significant associations were found between IAT performance and explicit (self-report and interview) measures of suicide risk. Moreover, the IAT was found to predict suicidal ideation at discharge above and beyond number of prior suicide attempts and admission scores on measures of depression, suicidal ideation, and hopelessness. Change in IAT performance over the course of treatment was observed. The IAT shows promise as an addition to explicit measures conventionally used to estimate suicide risk in psychiatric patients. These findings are consistent with a cognitive vulnerability model of suicide risk.

Drug suicide: a sex-equal cause of death in 16 European countries.

PubMed

Värnik, Airi; Sisask, Merike; Värnik, Peeter; Wu, Jing; Kõlves, Kairi; Arensman, Ella; Maxwell, Margareth; Reisch, Thomas; Gusmão, Ricardo; van Audenhove, Chantal; Scheerder, Gert; van der Feltz-Cornelis, Christina M; Coffey, Claire; Kopp, Maria; Szekely, Andras; Roskar, Saska; Hegerl, Ulrich

2011-01-29

There is a lack of international research on suicide by drug overdose as a preventable suicide method. Sex- and age-specific rates of suicide by drug self-poisoning (ICD-10, X60-64) and the distribution of drug types used in 16 European countries were studied, and compared with other self-poisoning methods (X65-69) and intentional self-injury (X70-84). Data for 2000-04/05 were collected from national statistical offices. Age-adjusted suicide rates, and age and sex distributions, were calculated. No pronounced sex differences in drug self-poisoning rates were found, either in the aggregate data (males 1.6 and females 1.5 per 100,000) or within individual countries. Among the 16 countries, the range (from some 0.3 in Portugal to 5.0 in Finland) was wide. 'Other and unspecified drugs' (X64) were recorded most frequently, with a range of 0.2-1.9, and accounted for more than 70% of deaths by drug overdose in France, Luxembourg, Portugal and Spain. Psychotropic drugs (X61) ranked second. The X63 category ('other drugs acting on the autonomic nervous system') was least frequently used. Finland showed low X64 and high X61 figures, Scotland had high levels of X62 ('narcotics and hallucinogens, not elsewhere classified') for both sexes, while England exceeded other countries in category X60. Risk was highest among the middle-aged everywhere except in Switzerland, where the elderly were most at risk. Suicide by drug overdose is preventable. Intentional self-poisoning with drugs kills as many males as females. The considerable differences in patterns of self-poisoning found in the various European countries are relevant to national efforts to improve diagnostics of suicide and appropriate specific prevention. The fact that vast majority of drug-overdose suicides came under the category X64 refers to the need of more detailed ICD coding system for overdose suicides is needed to permit better design of suicide-prevention strategies at national level.

Drug suicide: a sex-equal cause of death in 16 European countries

PubMed Central

2011-01-01

Background There is a lack of international research on suicide by drug overdose as a preventable suicide method. Sex- and age-specific rates of suicide by drug self-poisoning (ICD-10, X60-64) and the distribution of drug types used in 16 European countries were studied, and compared with other self-poisoning methods (X65-69) and intentional self-injury (X70-84). Methods Data for 2000-04/05 were collected from national statistical offices. Age-adjusted suicide rates, and age and sex distributions, were calculated. Results No pronounced sex differences in drug self-poisoning rates were found, either in the aggregate data (males 1.6 and females 1.5 per 100,000) or within individual countries. Among the 16 countries, the range (from some 0.3 in Portugal to 5.0 in Finland) was wide. 'Other and unspecified drugs' (X64) were recorded most frequently, with a range of 0.2-1.9, and accounted for more than 70% of deaths by drug overdose in France, Luxembourg, Portugal and Spain. Psychotropic drugs (X61) ranked second. The X63 category ('other drugs acting on the autonomic nervous system') was least frequently used. Finland showed low X64 and high X61 figures, Scotland had high levels of X62 ('narcotics and hallucinogens, not elsewhere classified') for both sexes, while England exceeded other countries in category X60. Risk was highest among the middle-aged everywhere except in Switzerland, where the elderly were most at risk. Conclusions Suicide by drug overdose is preventable. Intentional self-poisoning with drugs kills as many males as females. The considerable differences in patterns of self-poisoning found in the various European countries are relevant to national efforts to improve diagnostics of suicide and appropriate specific prevention. The fact that vast majority of drug-overdose suicides came under the category X64 refers to the need of more detailed ICD coding system for overdose suicides is needed to permit better design of suicide-prevention strategies at

Characteristics and Risk Factors for Suicide and Deaths Among College Students: A 23-Year Serial Prevalence Study of Data From 8.2 Million Japanese College Students.

PubMed

Uchida, Chiyoko; Uchida, Mai

2017-04-01

Suicide is a leading cause of death for college students. The aim of this study was to identify risk factors of suicide among college students that could improve university services to help prevent college suicide. We conducted a 23-year serial prevalence study of the prevalence and characteristics of death and suicide among 8,262,314 Japanese college students. We analyzed rates of suicide from the 1989 to 1990 academic year through the 2011-2012 academic year and characterized suicide among this population, focusing on students' sex and psychiatric and academic backgrounds to identify risk factors for suicide. Suicide rates increased throughout the 23 years, and suicide was the leading cause of death every year from 1996 onward. Suicide accounted for 42.4% of all deaths that happened in the 23 years. Male students, medicine majors, students in the final year of their program, and students who completed extra years of schooling or took academic leaves of absence were at higher risk for suicide. Only 16.4% had received an official psychiatric diagnosis and 16.0% had received services through the university health center prior to the suicides. Results suggest the need for a stronger support system for college students. Areas for improvement could include better advertising of mental health services, student and staff education about suicide risk factors, and mentorship and outreach programs for students in their final year of classes, those majoring in medicine, and those who have taken leaves of absence or failed classes. Accommodations at the administrative level would also be helpful for students who need to retake classes or transfer credit. © Copyright 2017 Physicians Postgraduate Press, Inc.

Suicidal ideation versus suicidal obsession: a case report.

PubMed

Wetzler, Alzbeta Juven; Elias, Rachela; Fostick, Leah; Zohar, Joseph

2007-07-01

This case report illustrates the relationship between stress and obsessive-compulsive disorder (OCD) by describing an unusual case of OCD sequelae following a suicide attempt. The patient is a 29-year-old married woman who suffered a major depressive episode without OCD and tried to commit suicide by drinking household cleaner. Following the attempt, violent obsessive thoughts of harming herself and others emerged along with avoidance behavior. After exposure therapy, there was a decrease in her obsessive thoughts, less anxiety, and no avoidance behavior. This report highlights not only the existence of "posttraumatic obsession" but also the importance of accurate interpretation of suicidal preoccupation, leading to the diagnosis of OCD rather then suicidal ideation secondary to depression.

Adolescent suicide prevention.

PubMed

Novick, Lloyd F; Cibula, Donald A; Sutphen, Sally M

2003-05-01

This case-prevention of adolescent suicide-is one of a series of teaching cases in the Case-Based Series in Population-Oriented Prevention (C-POP). It has been developed for use in medical school and residency prevention curricula. The complete set of cases is presented in this supplement to the American Journal of Preventive Medicine. This teaching case examines the issue of prevention of adolescent and young adult suicide both at an individual and at a population or community level, using data from the Onondaga County Health Department. In the first section of the case, students are asked to determine whether five deaths related to falling or jumping at a local shopping mall should be considered to be suicidal deaths. Students then develop skills in the reporting as well as in the epidemiology of adolescent suicidal deaths in Onondaga County. As the case progresses, students analyze the results of a local surveillance study of suicidal attempts and ideation. The case concludes with students evaluating a hypothetical screening study intended to reduce the risk of suicidal death and discussing a research design to examine the effectiveness of this prevention strategy.

Service contacts prior to death in people dying by suicide in the Scottish Highlands.

PubMed

Stark, Cameron R; Vaughan, Susan; Huc, Sara; O'Neill, Noelle

2012-01-01

Many people who die by suicide have been in contact with health services prior to their death. This study examined service contacts in people in urban and rural areas of the Scottish Highlands. Highland residents dying by suicide or undetermined intent in 2001-2004 were identified using routine death records. Health service databases were searched to identify general hospital, mental health and general practice notes. 177 residents died in the time period (136 males). At least one type of record was identified on 175 people, including general practice records (167 people, 94.4%), psychiatric hospital records (n=87, 49.2%) and general hospital records (n=142, 80.2%). Of these, 52.5% had been in contact with at least one health service in the month before their death, including 18.6% with mental health services, and 46.4% with general practice. In total, 68.9% had a previous diagnosis of mental illness, 52.5% of substance misuse problems, and 40.1% of self-harm. The commonest mental illness diagnosis was depression (n=97, 54.8%). There was no difference in rates of GP contact in rural and urban areas. Of those dying in urban areas, 32% had been in contact with mental health services in the previous month, compared with 21% in Accessible Rural/Accessible Small Towns, and 11% in Remote Rural/Remote Small Towns (p<0.01). People in rural areas were less likely to have had contact with mental health services in the year before their death (p<0.01), and to have had lower recorded lifetime rates of mental health service contact (p<0.001), deliberate self-harm (p<0.005) and mental illness (p<0.001). Overall service contact rates prior to death by suicide were very similar to the results of a previous meta-analysis. Rates of contact with specialist mental health services were significantly lower in rural than urban areas, and this finding increased with greater rurality.

Are pregnant and postpartum women: at increased risk for violent death? Suicide and homicide findings from North Carolina.

PubMed

Samandari, Ghazaleh; Martin, Sandra L; Kupper, Lawrence L; Schiro, Sharon; Norwood, Tammy; Avery, Matt

2011-07-01

The purpose of this study is to estimate rates of suicide and homicide death among pregnant, postpartum and non-pregnant/non-postpartum women ages 14-44, and to determine comparative rates of violent death for pregnant and/or postpartum women compared to non-pregnant/non-postpartum women. North Carolina surveillance and vital statistics data from 2004 to 2006 were used to examine whether pregnant or postpartum women have higher (or lower) rates of suicide and homicide compared to other reproductive-aged women. The suicide rate for pregnant women was 27% of the rate for non-pregnant/non-postpartum women (rate ratio= 0.27, 95% CI = 0.11-0.66), and the suicide rate for postpartum women was 54% of the rate for non-pregnant/non-postpartum women (rate ratio = 0.54, 95% CI = 0.31-0.95). Homicide rates also were lower for pregnant and postpartum women, with the homicide rate for pregnant women being 73% of the rate for non-pregnant/non-postpartum women (rate ratio = 0.73, 95% CI = 0.39-1.37), and the homicide rate for postpartum women being half the rate for non-pregnant/non-postpartum women (rate ratio = 0.50, 95% CI = 0.26-0.98). Although pregnant and postpartum women are at risk for homicide and suicide death, the highest risk group is non-pregnant/non-postpartum women. Violence prevention efforts should target all women of reproductive age, and pay particular attention to non-pregnant/non-postpartum women, who may have less access to health care services than pregnant and postpartum women.

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.

Physical and psychosomatic health outcomes in people bereaved by suicide compared to people bereaved by other modes of death: a systematic review.

PubMed

Spillane, Ailbhe; Larkin, Celine; Corcoran, Paul; Matvienko-Sikar, Karen; Riordan, Fiona; Arensman, Ella

2017-12-12

Little research has been conducted into the physical health implications of suicide bereavement compared to other causes of death. There is some evidence that suicide bereaved parents have higher morbidity, particularly in terms of chronic illness. This systematic review aims to examine the physical and psychosomatic morbidities of people bereaved by a family member's suicide and compare them with family members bereaved by other modes of death. MEDLINE, EMBASE, CINAHL, and PsycINFO were searched from 1985 to February 2016. The search was re-run in March 2017. Peer-reviewed English language articles comparing suicide-bereaved family members to non-suicide bereaved family members on measures of physical or psychosomatic health were eligible for inclusion. Cohort, cross-sectional, case-control and cohort-based register studies were eligible for inclusion. A modified version of the Newcastle Ottawa Scale was used for quality assessment. Results were synthesised using narrative synthesis. The literature search located 24 studies which met the inclusion criteria. Seven studies found statistically significant associations between physical health and suicide bereavement. Five of the studies found that suicide-bereaved family members were more likely to experience pain, more physical illnesses and poorer general health. They were also at increased risk of cardiovascular disease, hypertension, diabetes and chronic obstructive pulmonary disease. In contrast, another study in Denmark found that those bereaved by suicide had a lower risk of a number of physical health disorders, including cancers, diabetes, cardiovascular and chronic lower respiratory tract disorders compared to those bereaved by other causes of death. Additionally, a further study conducted in the United States found that suicide-bereaved children visited a GP less frequently than non-suicide bereaved children. Review findings are relevant for clinicians working with people bereaved by suicide as they

Study of Deaths by Suicide in the Soviet Special Camp Number 7 (Sachsenhausen), 1945-1950.

PubMed

López-Muñoz, Francisco; Cuerda-Galindo, Esther; Krischel, Matthis

2017-03-01

After World War II, Sachsenhausen Nazi concentration camp (Oranienburg) was administered until the spring of 1950 by Soviet occupation forces (Special Camp Number 7) and used mainly for political prisoners. Our study analyzes suicides in this camp during the Soviet period. Data was collected from the archives of Sachsenhausen Memorial, Special Camp Collection. Original documents containing certificates or autopsy reports of prisoners who committing suicide were reviewed. In this period, authorities registered 17 suicides. The age of suicides was between 19 and 64 years. The most frequent cause of imprisonment was Blockleiter (Kapo in Nazi period, n = 4), Mitarbeiter Gestapo (member of the Gestapo, n = 3) and Wehrmacht (military, n = 3). Hanging was the most frequent method of suicide. The average time spent in the camp until suicide was 715 days. The number of recorded suicides under Soviet control is considerably lower (calculated rate 2.8/10,000 per year) than under Nazi control (calculated rate 11/10,000 per year). This could be due to comparably more favorable conditions for prisoners and the abolishment of the death penalty during this period. Possible motives for suicides include feelings of guilt for crimes committed, fear of punishment and a misguided understanding of honor on the eve of criminal trials.

Suicide Attempt as a Risk Factor for Completed Suicide: Even More Lethal Than We Knew.

PubMed

Bostwick, J Michael; Pabbati, Chaitanya; Geske, Jennifer R; McKean, Alastair J

2016-11-01

While suicide attempt history is considered to robustly predict completed suicide, previous studies have limited generalizability because of using convenience samples of specific methods/treatment settings, disregarding previous attempts, or overlooking first-attempt deaths. Eliminating these biases should more accurately estimate suicide prevalence in attempters. This observational retrospective-prospective cohort study using the Rochester Epidemiology Project identified 1,490 (males, N=555; females, N=935) Olmsted County residents making index suicide attempts (first lifetime attempts reaching medical attention) between January 1, 1986, and December 31, 2007. The National Death Index identified suicides between enrollment and December 31, 2010 (follow-up 3-25 years). Medical records were queried for sex, age, method, and follow-up care for index attempt survivors. Coroner records yielded data on index attempt deaths. During the study period, 81/1,490 enrollees (5.4%) died by suicide. Of the 81, 48 (59.3%) perished on index attempt; 27 of the surviving 33 index attempt survivors (81.8%) killed themselves within a year. Males were disproportionately represented: 62/81 (11.2% of men, 76.5% of suicides) compared with 19/81 (2.0% of women, 23.5% of suicides). Of dead index attempters, 72.9% used guns, yielding an odds ratio for gunshot death, compared with all other methods, of 140 (95% CI=60-325). When adjusted for covariates, survivors given follow-up psychiatric appointments had significantly lower likelihood of subsequent suicide (odds ratio=0.212, 95% CI=0.089-0.507). At 5.4%, completed suicide prevalence in this community cohort of suicide attempters was almost 59% higher than previously reported. An innovative aspect of this study explains the discrepancy: by including index attempt deaths-approximately 60% of total suicides-suicide prevalence more than doubled. We contend that counting both index and subsequent attempt deaths more accurately reflects

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

PubMed

Karbeyaz, Kenan; Akkaya, Harun; Balci, Yasemin

2013-01-01

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

Suicide: current trends.

PubMed

Bailey, Rahn K; Patel, Tejas C; Avenido, Jaymie; Patel, Milapkumar; Jaleel, Mohammad; Barker, Narviar C; Khan, Jahanzeb Ali; Ali, Shahid; Jabeen, Shagufta

2011-07-01

Suicide is the act of a human being intentionally causing his or her own death. More than 1 million people commit suicide every year. It is the 13th leading cause of death worldwide, with China, India, and Japan accounting for almost half of all suicides. In less than 50 years, the rate of suicide among Sri Lankans has risen from a modest level to one of the highest in the world (118 per 100,000). Suicide is a major preventable cause of premature death. It is influenced by psychosocial, cultural, and environmental risk factors. The impact of suicide can be devastating for all concerned. It is common in people who are living with chronic mental illness. Individuals with severe clinical depression and alcohol use disorders are at highest risk if untreated. On an interpersonal level, friends and families of suicide victims require social support. On a national level, governments need to recognize the causes of suicide and protect those most vulnerable. If governments commit to defining national responses to prevent suicide, significant progress can be made. On a global scale, research and health organizations can identify global trends and encourage the sharing of information in effective prevention activities. In September 2010, World Suicide Prevention Day, with a theme of "Many faces, many places: suicide prevention across the world," encouraged public awareness worldwide to unite in commitment and action to promote understanding about suicide and removal of stigmatization'. There is compelling evidence that adequate prevention and awareness can reduce suicide rates.

Impact of the 1998 Football World Cup on Suicide Rates in France: Results from the National Death Registry

ERIC Educational Resources Information Center

Encrenaz, Gaelle; Contrand, Benjamin; Leffondre, Karen; Queinec, Raphaelle; Aouba, Albertine; Jougla, Eric; Miras, Alain; Lagarde, Emmanuel

2012-01-01

Our objective was to determine whether the Federation Internationale de Football Association (FIFA) World Cup in 1998 had a short-term impact on the number of suicides in France. Exhaustive individual daily data on suicides from 1979 to 2006 were obtained from the French epidemiological center on the medical causes of death (CepiDC-INSERM;…

A peculiar case of suicide enacted through the ancient Japanese ritual of Jigai.

PubMed

Maiese, Aniello; Gitto, Lorenzo; dell'Aquila, Massimiliano; Bolino, Giorgio

2014-03-01

In the past, self-infliction of sharp force was a classic form of suicide, while in modern times it is quite rare, constituting only 2% to 3% of all self-inflicted deaths. In Japan, the jigai (Japanese characters: see text) ritual is a traditional method of female suicide, carried out by cutting the jugular vein using a knife called a tantō. The jigai ritual is the feminine counterpart of seppuku (well-known as harakiri), the ritual suicide of samurai warriors, which was carried out by a deep slash into the abdomen. In contrast to seppuku, jigai can be performed without assistance, which was fundamental for seppuku.The case we describe here involves an unusual case of suicide in which the victim was a male devotee of Japanese culture and weapons. He was found dead in his bathtub with a deep slash in the right lateral-cervical area, having cut only the internal jugular vein with a tantō knife, exactly as specified by the jigai ritual.

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

Subintentional Suicide among Youth.

ERIC Educational Resources Information Center

Smith, D. F.

1980-01-01

Subintentional suicide is a classification that refers to ill-defined deaths and practices that lead toward death. Types of subintentional suicide among adolescents include drug abuse and risk taking when driving automobiles. (JN)

Mental health, substance use and intimate partner problems among pregnant and postpartum suicide victims in the National Violent Death Reporting System.

PubMed

Gold, Katherine J; Singh, Vijay; Marcus, Sheila M; Palladino, Christie Lancaster

2012-01-01

Suicide during pregnancy and postpartum is a tragic event for the victim and profoundly impacts the baby, the family and the community. Prior efforts to study risks for pregnancy-associated suicide have been hampered by the lack of data sources which capture pregnancy and delivery status of victims. Introduction of the United States National Violent Death Reporting System (NVDRS) offers new insights into violent deaths by linking multiple data sources and allowing better examination of psychosocial risk factors. The analysis used data from 17 states reporting to the NVDRS from 2003 to 2007 to evaluate suicide patterns among pregnant, postpartum, and nonpregnant or postpartum women. Demographic factors, mental health status, substance use, precipitating circumstances, intimate partner problems and suicide methods were compared among groups. The 2083 female suicide victims of reproductive age demonstrated high prevalence of existing mental health diagnosis and current depressed mood, with depressed mood significantly higher among postpartum women. Substance use and presence of other precipitating factors were high and similar among groups. Intimate partner problems were higher among pregnant and postpartum victims. Postpartum women were more likely to die via asphyxia as cause of death compared to poisoning or firearms. These findings describe important mental health, substance use and intimate partner problems seen with pregnancy-associated suicide. The study highlights mental health risk factors which could potentially be targeted for intervention in this vulnerable population. Copyright © 2012 Elsevier Inc. All rights reserved.

[Family, Suicide and Mourning].

PubMed

Garciandía Imaz, José Antonio

2013-01-01

Death is an event that always breaks into family life in a surprising way. Of all the deaths, suicide is the one which more strongly questions the functionality of a family and increases the risk of difficulties in the mourning process. Families in which a suicide has occurred are exposed to a greater possibility of disintegration, disorganization and pathological expressions in their members. To present a reduced and circumscribed narrative revision, restricted to examine the relationship between suicide and the mourning process in the family. The suicide of a loved one is an event that may contribute to pathological grief and mental dysfunctions in surviving relatives. Death in the family is a natural phenomenon. However, death by suicide is one of the phenomena that can generate more alterations in the structure and organization of the family, due to the difficulty related to the mourning process. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Self-injurious thoughts and behaviors as risk factors for future suicide ideation, attempts, and death: a meta-analysis of longitudinal studies

PubMed Central

Ribeiro, J. D.; Franklin, J. C.; Fox, K. R.; Bentley, K. H.; Kleiman, E. M.; Chang, B. P.; Nock, M. K.

2016-01-01

Background A history of self-injurious thoughts and behaviors (SITBs) is consistently cited as one of the strongest predictors of future suicidal behavior. However, stark discrepancies in the literature raise questions about the true magnitude of these associations. The objective of this study is to examine the magnitude and clinical utility of the associations between SITBs and subsequent suicide ideation, attempts, and death. Method We searched PubMed, PsycInfo, and Google Scholar for papers published through December 2014. Inclusion required that studies include at least one longitudinal analysis predicting suicide ideation, attempts, or death using any SITB variable. We identified 2179 longitudinal studies; 172 met inclusion criteria. Results The most common outcome was suicide attempt (47.80%), followed by death (40.50%) and ideation (11.60%). Median follow-up was 52 months (mean = 82.52, s.d. = 102.29). Overall prediction was weak, with weighted mean odds ratios (ORs) of 2.07 [95% confidence interval (CI) 1.76–2.43] for ideation, 2.14 (95% CI 2.00–2.30) for attempts, and 1.54 (95% CI 1.39–1.71) for death. Adjusting for publication bias further reduced estimates. Diagnostic accuracy analyses indicated acceptable specificity (86–87%) and poor sensitivity (10–26%), with areas under the curve marginally above chance (0.60–0.62). Most risk factors generated OR estimates of <2.0 and no risk factor exceeded 4.5. Effects were consistent regardless of sample severity, sample age groups, or follow-up length. Conclusions Prior SITBs confer risk for later suicidal thoughts and behaviors. However, they only provide a marginal improvement in diagnostic accuracy above chance. Addressing gaps in study design, assessment, and underlying mechanisms may prove useful in improving prediction and prevention of suicidal thoughts and behaviors. PMID:26370729

The media and suicide.

PubMed

Sudak, Howard S; Sudak, Donna M

2005-01-01

The authors aim to inform readers of the theory that when newspapers, film, and television describe suicidal deaths, additional suicides may result by virtue of contagion or copy-cat effects; to review data that support and refute this theory; to present some promising and recommended ways to prevent copy-cat suicide; and to cite news-media examples of both particularly bad and good reporting. A review of the literature on media-related suicide was conducted, which included reviewing materials published in scientific journals and data published by the U.S. Public Health Service, Centers for Disease Control, and materials from private, not-for-profit agencies. Data support an increased number of suicides resulting from media accounts of suicide that romanticize or dramatize the description of suicidal deaths. Specific guidelines for the media that may be able to decrease these additional deaths have been devised. Psychiatrists should be familiar with the harm that may result from improper reporting of suicide in the media since they may be called upon by reporters or family members following the suicide of one of their patients or following the suicide of a newsworthy person. Following the media guidelines available may prevent such contagion effects from occurring.

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…

Suicide in the Highlands of Scotland.

PubMed

Stark, C; Matthewson, F; O'Neill, N; Oates, K; Hay, A

2002-01-01

The Highlands have one of the highest suicide rates in Scotland. This paper describes suicide and deliberate self-harm in the Highlands in the last 20 years and explores possible reasons for the differences from the Scottish average. Retrospective analysis of routine data from the SMRI/SMR01 scheme and information on deaths from the Registrar General. Suicide and undetermined deaths were combined in the analysis. Highland and Scotland 1978-98. The high rates in Highland are caused by an excess of male deaths. Highland has had consistently high male suicide rates over the 20 year period compared to Scotland. These differences do not disappear when deaths of non-Highland residents are excluded. By comparison, deliberate self-harm admissions follow a similar pattern to Scotland as a whole. Causes of death differed from Scotland as a whole, with an over-representation of drowning, gases and firearm deaths. Highland suicide rates are elevated compared to Scotland. This is mainly due to an excess of deaths in men up to the age of 74 years, and is not accounted for by deaths of non-residents. Female deaths are not elevated in comparison to the rest of Scotland. Male attempted suicide rates do not differ from Scotland. Lethality of method--drowning, car exhausts and firearms--may contribute to the elevated male death rates.

Suicide in ancient Greece.

PubMed

Laios, K; Tsoukalas, G; Kontaxaki, M-I; Karamanou, M; Androutsos, G

2014-01-01

that there were many reasons to suicide someone in antiquity. Very important factor was to avoid captivity and the consequent overcrowding of indignity, especially for politicians and military leaders. Also intention in these circumstances was to avoid torture and the disgrace of rape. Strong grief is another reason, as in case of death of family members. The erotic disappointment had place in ancient suicides, which concerned both men and women, while there were also suicide for financial reasons. Especially for the elderly, the despair of the anility in conjunction with physical illness and cachexia, were important factors for these people to decide thee suicidal. Finally, the methods of suicide fitted their epoch, but bear resemblance to those of the modern time. Poisoning was very common to both men and women but equally popular in both sexes was also the hanging. It was not unusual to fall from a high in order to reach the death, while stabbing a sword in the body for self killing was widespread in men and soldiers.

Time Varying Prediction of Thoughts of Death and Suicidal Ideation in Adolescents: Weekly Ratings over Six Month Follow-Up

PubMed Central

Selby, Edward A.; Yen, Shirley; Spirito, Anthony

2012-01-01

Objective Suicidal ideation (SI) and thoughts of death are often experienced as fluctuating; therefore a dynamic representation of this highly important indicator of suicide risk is warranted. Theoretical accounts have suggested that affective, behavioral, and interpersonal factors may influence the experience of thoughts of death/suicidal ideation. This study aimed to examine the prospective and dynamic impact of these constructs in relation to thoughts of death and SI. Method We assessed adolescents with a recent hospitalization for elevated suicide risk over six months. Using the methodology of the Longitudinal Interval Follow-Up Evaluation (LIFE), weekly ratings for SI, course of depressive illness, affect sensitivity, negative affect intensity, behavioral dysregulation, peer invalidation, and family invalidation were obtained. Results Using multilevel modeling, results indicated that: 1) same-week ratings between these constructs and SI were highly correlated at baseline and throughout follow-up; 2) baseline ratings of affect sensitivity, behavioral dysregulation, and peer invalidation were positive prospective predictors of SI at any week of follow-up; 3) weekly ratings of each of these constructs had significant associations with next-week ratings of SI; and 4) ratings of SI had positive significant associations with next-week ratings on each of the constructs. Conclusions These results suggest that affective sensitivity, behavioral dysregulation, peer invalidation, and suicidal ideation are highly associated with SI levels both chronically (over months) and acutely (one week to the next), while depression, negative affect intensity, and family invalidation were more acutely predictive of SI. Elevated SI may then aggravate all these factors in a reciprocal manner. PMID:23148530

Risk factors for unnatural death: Fatal accidental intoxication, undetermined intent and suicide: Register follow-up in a criminal justice population with substance use problems.

PubMed

Olsson, Martin O; Bradvik, Louise; Öjehagen, Agneta; Hakansson, Anders

2016-05-01

Risk factors for suicide and fatal accidental intoxication are extensively studied, while risk factors for intoxications/injuries of undetermined intent are less well known. The latter have shown an overlap with suicides, but also with fatal accidental intoxications. The objective was to analyze potential differences and similarities in the patterns of risk factors for accidental intoxications, injuries/intoxications with undetermined intent, and suicides, respectively. A follow-up register study was conducted, using data from ASI interviews with clients in the criminal justice system in Sweden (n=6744), followed in the National Causes of Death Register. A set of risk factors from the ASI interview were tested in bivariate analysis with the respective cause of death, yielding significant risk factors further analyzed in three Cox regression models. In Cox regression analyses, death from fatal accidental intoxication was associated with male gender (HR 4.09), use of heroin (HR 2.86), and use of cannabis (HR 1.94), and death from intoxication/injury of undetermined intent was associated with use of heroin (HR 3.48), binge drinking of alcohol (HR 2.46) and previous psychiatric hospitalization (HR 2.41), while negatively associated with depression (HR 0.33). Death from suicide was associated with previous suicide attempts (HR 2.78) and use of sedatives (HR 2.17). In this population of criminal justice clients with reported substance use problems, fatal injuries/intoxications with undetermined intent - like fatal accidental intoxications - appear to be associated with substance use variables, and cannot readily be assumed to represent the same background factors as suicide. Copyright © 2016. Published by Elsevier Ireland Ltd.

Deciphering Suicide and Other Manners of Death Associated with Drug Intoxication: A Centers for Disease Control and Prevention Consultation Meeting Summary.

PubMed

Stone, Deborah M; Holland, Kristin M; Bartholow, Brad; E Logan, Joseph; LiKamWa McIntosh, Wendy; Trudeau, Aimee; Rockett, Ian R H

2017-08-01

Manner of death (MOD) classification (i.e., natural, accident, suicide, homicide, or undetermined cause) affects mortality surveillance and public health research, policy, and practice. Determination of MOD in deaths caused by drug intoxication is challenging, with marked variability across states. The Centers for Disease Control and Prevention hosted a multidisciplinary meeting to discuss drug intoxication deaths as they relate to suicide and other MOD. The meeting objectives were to identify individual-level, system-level, and place-based factors affecting MOD classification and identify potential solutions to classification barriers. Suggested strategies included improved standardization in death scene investigation, toxicology, and autopsy practice; greater accountability; and creation of job aids for investigators. Continued collaboration and coordination of activities are needed among stakeholders to affect prevention efforts.

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.

Youth Suicide and Guns. Firearm Facts.

ERIC Educational Resources Information Center

Duker, Laurie, Ed.

Whether or not a suicide attempt results in death depends in large part on the method chosen. If a teenager attempts suicide with a gun, his or her death is nearly guaranteed. This brief fact sheet presents data on firearms and suicide, the third leading cause of death for adolescents and young adults in the United States. Any number of societal…

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

Machine learning of neural representations of suicide and emotion concepts identifies suicidal youth

PubMed Central

Just, Marcel Adam; Pan, Lisa; Cherkassky, Vladimir L.; McMakin, Dana; Cha, Christine; Nock, Matthew K.; Brent, David

2017-01-01

The clinical assessment of suicidal risk would be significantly complemented by a biologically-based measure that assesses alterations in the neural representations of concepts related to death and life in people who engage in suicidal ideation. This study used machine-learning algorithms (Gaussian Naïve Bayes) to identify such individuals (17 suicidal ideators vs 17 controls) with high (91%) accuracy, based on their altered fMRI neural signatures of death and life-related concepts. The most discriminating concepts were death, cruelty, trouble, carefree, good, and praise. A similar classification accurately (94%) discriminated 9 suicidal ideators who had made a suicide attempt from 8 who had not. Moreover, a major facet of the concept alterations was the evoked emotion, whose neural signature served as an alternative basis for accurate (85%) group classification. The study establishes a biological, neurocognitive basis for altered concept representations in participants with suicidal ideation, which enables highly accurate group membership classification. PMID:29367952

Suicide Attempt as a Risk Factor for Completed Suicide: Even More Lethal Than We Knew

PubMed Central

Bostwick, J. Michael; Pabbati, Chaitanya; Geske, Jennifer R.; McKean, Alastair J.

2017-01-01

Objective While suicide attempt history is considered to robustly predict completed suicide, previous studies have limited generalizability from using convenience samples of specific methods/treatment settings, disregarding previous attempts, or overlooking first-attempt deaths. Eliminating these biases should more accurately estimate suicide prevalence in attempters. Method This observational retrospective-prospective cohort study using the Rochester Epidemiology Project identified 1,490 (555 males/935 females) Olmsted County residents making index suicide attempts (first lifetime attempts reaching medical attention) between 01-01-1986 and 12-31-2007. The National Death Index identified suicides between enrollment and 12-31-2010 (follow-up 3-25 years). Medical records were queried for sex, age, method, and follow-up care for index attempt survivors. Coroner records yielded data on index attempt deaths. Results During the study period, 81/1490 enrollees (5.4%) died by suicide. Of the 81, 48 (59.3%) perished on index attempt; 27 of the surviving 33 index attempt survivors (81.8%) killed themselves within a year. Males were disproportionately represented: 62/81 (11.2% of men; 76.5% of suicides) vs 19/81 (2.0% of women, 23.5% of suicides). Of dead index attempters, 72.9% used guns, yielding an odds ratio for gunshot death vs all other methods of 140 [95%CI:60,325]. When adjusted for covariates, survivors given follow-up psychiatric appointments had significantly lower likelihood of subsequent suicide (OR=0.212[95%CI:0.089, 0.507]). Conclusions At 5.4%, completed suicide prevalence in this community cohort of suicide attempters was almost 59% higher than previously reported. An innovative aspect of this study explains the discrepancy: by including index attempt deaths—approximately 60% of total suicides—suicide prevalence more than doubled. We contend that counting both index and subsequent attempts deaths more accurately reflects prevalence. Our findings support

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.

Presence of minor and major mental health impairment in adolescence and death from suicide and unintentional injuries/accidents in men: a national longitudinal cohort study.

PubMed

Fadum, Elin Anita; Fønnebø, Vinjar; Borud, Einar Kristian

2017-01-01

To examine the association between minor and major mental health impairment in late adolescence and death from suicide and unintentional injuries/accidents in men. In Norway, all men attend a compulsory military medical and psychological examination. We included 558 949 men aged 17-19 years at the time of military examination in 1980-1999 and followed them up for death from suicide and unintentional injuries/accidents until the end of 2013. We used Cox proportional hazard models to examine the association between the presence of minor and major mental health impairments at examination and death from suicide and unintentional injuries/accidents. Compared to men with no mental health impairment, those with minor mental health impairment was associated with an increased risk of death from suicide (adjusted HR (HR adj )=1.63, 95% CI 1.39 to 1.92), transport accidents (HR adj =1.33, 95% CI 1.09 to 1.63), accidental poisoning (HR adj =2.27, 95% CI 1.79 to 2.88) and other unintentional injuries/accidents (HR adj =1.54, 95% CI 1.17 to 2.02). In men with major mental health impairment, the risk of death from suicide and accidental poisoning was elevated two times (HR adj =2.29, 95% CI 1.85 to 2.85) and three times (HR adj =3.53, 95% CI 2.61 to 4.79), respectively. We found an increased risk of death from suicide and unintentional injuries/accidents in men who had minor and major mental health impairment at age 17-19 years. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The Effect of Cause of Death on Responses to the Bereaved: Suicide Compared to Accident and Natural Causes.

ERIC Educational Resources Information Center

Allen, Breon G.; And Others

1994-01-01

Examined impact of cause of death on responses to bereaved individual. Sixty adults listened to audiotape of recently bereaved widow. There were three versions of tape, each identical except for stated cause of death: suicide, accident, or heart attack. Found that respondents were more anxious after interaction than before. Perceptions of person…

Suicide amongst Cambridge University students 1970-1996.

PubMed

Collins, I P; Paykel, E S

2000-03-01

Anecdote, media coverage and earlier research suggest that the rate of suicide amongst students at Cambridge and Oxford Universities is unduly high. There is also a popular belief that student suicide is common at examination times. Student deaths at the University of Cambridge were identified using the University database. The cause of death was determined by reference to death certificates and coroners' inquest records. We identified 157 student deaths during academic years 1970-1996, of which 36 appeared to be suicides. The overall suicide rate was 11.3/100,000 person years at risk. Suicide rates were similar to those seen amongst 15- to 24-year-olds in the general population. There were non-significant trends for male postgraduates to be over-represented and first-year undergraduates under-represented. Examination times were not associated with excess suicide. Suicide rates in University of Cambridge students do not appear to be unduly high.

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

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.

Risk factors for suicide in offspring bereaved by sudden parental death from external causes.

PubMed

Burrell, Lisa Victoria; Mehlum, Lars; Qin, Ping

2017-11-01

Parentally bereaved offspring have an increased suicide risk as a group, but the ability to identify specific individuals at risk on the basis of risk and protective factors is limited. The present study aimed to investigate to what degree different risk factors influence suicide risk in offspring bereaved by parental death from external causes. Based on Norwegian registers, individual-level data were retrieved for 375 parentally bereaved suicide cases and 7500 parentally bereaved gender- and age-matched living controls. Data were analysed with conditional logistic regression. Bereaved offspring with low social support, indicated by offspring's single status and repeated changes in marital status and residence, had a significantly increased suicide risk compared to bereaved offspring with high social support. Moreover, low socioeconomic status, having an immigration background, having lost both parents and loss due to suicide significantly increased suicide risk. Several variables relevant to bereavement outcome, such as coping mechanisms and the quality of the parent-offspring relationship are impossible to examine by utilizing population registers. Moreover, the availability of data did not enable the measurement of marital stability and residence stability across the entire lifespan for older individuals. Healthcare professionals should be aware of the additional risk posed by the identified risk factors and incorporate this knowledge into existing practice and risk assessment in order to identify individuals at risk and effectively target bereaved family and friends for prevention and intervention programs. Ideal follow-up for bereaved families should include a specific focus on mobilizing social support. Copyright © 2017 Elsevier B.V. All rights reserved.

Suicide, guns, and public policy.

PubMed

Lewiecki, E Michael; Miller, Sara A

2013-01-01

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

Suicide, Guns, and Public Policy

PubMed Central

Miller, Sara A.

2013-01-01

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

[Suicide in adolescence].

PubMed

Bouvard, M P; Doyen, C

1996-12-01

With 1500 death each year, suicide does represent the second cause of death in young people (between 15 and 25 years). There is a clear increase of suicide rate during adolescence, with an higher rate of suicide attempts in females, but an higher mortality in boys. Suicidal behaviors in adolescents are clinically characterized by impulsivity, rhythmicity (during schooling) and seasonality. Risks factors are numerous. However, psychiatric disorders represent the main one, especially depressive states, conduct disorders and their association. In adolescents familial and environment events may have an important role in suicidal behaviors, especially the role of imitation behavior. These different factors interact and constitute dynamic models. The role of each factor can be involved differently considering the sex. Dangerosity of suicide in adolescents should not be under-estimated, as it has been the case in the past. It is particularly true if we consider the high rate of recidive (approximatively 50%) in this population. These data emphasized the importance of a careful evaluation of all suicidal adolescents more precisely of depressive symptoms and aggressive and/or delinquent behavior and of prevention.

Caffeine and suicide: a systematic review.

PubMed

Silva, Adriana Cardoso; de Oliveira Ribeiro, Natalia Pinho; de Mello Schier, Alexandre Rafael; Pereira, Valeska Martinho; Vilarim, Marina Machado; Pessoa, Tamires Marinho; Arias-Carrión, Oscar; Machado, Sergio; Nardi, Antonio Egidio

2014-01-01

Suicide is considered a deliberate act initiated and concluded by a person with full knowledge or expectation of a fatal result, and one of the main symptoms of depression. An individual's conscious and excessive ingestion of a damaging substance is also considered to be an attempted suicide. Despite limited knowledge of caffeine abuse, deaths from overdose of caffeine have been reported in the literature. Thus, this study aims to review the existing literature on caffeine consumption and suicide attempts and deaths, investigating the relation between caffeine consumption and suicide attempts and deaths. We found 24 studies that discuss the relationship between caffeine and suicide. The findings revealed that, despite being an addictive substance and potentially fatal in higher doses, caffeine was still a rare factor in a number of studies concerning its relation with suicide attempts and death. The majority of the research found in this study was of the case study type. Furthermore, the majority of studies focus on the assistance offered to the victim and the procedures undertaken to control the bodily damage created. The existing studies indicate the substance may act as either a direct or an indirect agent in suicide. Therefore, a better understanding of how caffeine may be linked to suicide is crucial for its prevention.

Reducing Suicide among Youth.

ERIC Educational Resources Information Center

NEA Today, 2000

2000-01-01

The suicide rate for children aged 10 to 14 has doubled over the last 10 years, making suicide the fourth leading cause of death for that age group. Offers important information on suicide prevention for educators. (ASK)

Stimulation of ceramide formation and suicidal erythrocyte death by vitamin K(3) (menadione).

PubMed

Qadri, Syed M; Eberhard, Matthias; Mahmud, Hasan; Föller, Michael; Lang, Florian

2009-11-25

Vitamin K(3) is an essential micronutrient required for the activation of coagulation factors and thus hemostasis. Administration of vitamin K(3) analogues may cause anemia, which at least in theory could be due to stimulation of suicidal erythrocyte death or eryptosis characterized by cell shrinkage and phospholipid scrambling of the erythrocyte cell membrane leading to exposure of phosphatidylserine at the erythrocyte surface. Eryptosis is triggered by an increase in the cytosolic Ca(2+) activity, by ceramide and by energy depletion (decrease of cytosolic ATP). The present experiments explored, whether vitamin K(3) may influence eryptosis. Hemolysis was estimated from the supernatant hemoglobin concentration, phosphatidylserine-exposing erythrocytes from annexin V-binding in fluorescence-activated cell sorter (FACS) analysis, erythrocyte volume from forward scatter in FACS analysis, ceramide formation from binding of fluorescent antibodies, and erythrocyte ATP content from a luciferin-luciferase assay. As a result, vitamin K(3) (> or =1microM) caused lysis of an only small fraction of erythrocytes, but significantly increased ceramide formation, significantly increased the percentage of annexin V-binding erythrocytes, significantly decreased forward scatter and, at higher concentrations, significantly decreased the cellular ATP content. In conclusion, vitamin K(3) stimulates suicidal erythrocyte death, an effect at least partially due to ceramide formation and ATP depletion.

Suicide and Suicide Attempts in Adolescents.

PubMed

Shain, Benjamin

2016-07-01

Suicide is the second leading cause of death for adolescents 15 to 19 years old. This report updates the previous statement of the American Academy of Pediatrics and is intended to assist pediatricians, in collaboration with other child and adolescent health care professionals, in the identification and management of the adolescent at risk for suicide. Suicide risk can only be reduced, not eliminated, and risk factors provide no more than guidance. Nonetheless, care for suicidal adolescents may be improved with the pediatrician's knowledge, skill, and comfort with the topic, as well as ready access to appropriate community resources and mental health professionals. Copyright © 2016 by the American Academy of Pediatrics.

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

Contribution of Imitative Suicide to the Suicide Rate in Prisons

ERIC Educational Resources Information Center

McKenzie, Nigel; Keane, Michael

2007-01-01

Suicide rates in prisons are high. Our aim was to investigate the contribution of imitative suicide to the prison suicide rate. We used Knox tests for space-time clustering in a case register of natural and self-inflicted deaths in prisons in England and Wales and model simulations to estimate the effect size. We found significant space-time…

Suicide Risk Monitoring: The Missing Piece in Suicide Risk Assessment

ERIC Educational Resources Information Center

Erbacher, Terri A.; Singer, Jonathan B.

2018-01-01

Suicide is the second leading cause of death among youth aged 10-25 years and approximately 1-in-6 adolescents reported serious suicidal ideation in the past year. Schools are a unique environment in which to identify and respond to youth suicide risk. Although there are screening tools for identifying which youth are at risk and assessment…

Suicide among Arab-Americans

PubMed Central

El-Sayed, Abdulrahman M.; Tracy, Melissa; Scarborough, Peter; Galea, Sandro

2011-01-01

Background Arab-American (AA) populations in the US are exposed to discrimination and acculturative stress—two factors that have been associated with higher suicide risk. However, prior work suggests that socially oriented norms and behaviors, which characterize recent immigrant ethnic groups, may be protective against suicide risk. Here we explored suicide rates and their determinants among AAs in Michigan, the state with the largest proportion of AAs in the US. Methodology/Principal Findings ICD-9/10 underlying cause of death codes were used to identify suicide deaths from among all deaths in Michigan between 1990 and 2007. Data from the 2000 U.S. Census were collected for population denominators. Age-adjusted suicide rates among AAs and non-ethnic whites were calculated by gender using the direct method of standardization. We also stratified by residence inside or outside of Wayne County (WC), the county with the largest AA population in the state. Suicide rates were 25.10 per 100,000 per year among men and 6.40 per 100,000 per year among women in Michigan from 1990 to 2007. AA men had a 51% lower suicide rate and AA women had a 33% lower rate than non-ethnic white men and women, respectively. The suicide rate among AA men in WC was 29% lower than in all other counties, while the rate among AA women in WC was 20% lower than in all other counties. Among non-ethnic whites, the suicide rate in WC was higher compared to all other counties among both men (12%) and women (16%). Conclusions/Significance Suicide rates were higher among non-ethnic white men and women compared to AA men and women in both contexts. Arab ethnicity may protect against suicide in both sexes, but more so among men. Additionally, ethnic density may protect against suicide among Arab-Americans. PMID:21379577

Suicide among Arab-Americans.

PubMed

El-Sayed, Abdulrahman M; Tracy, Melissa; Scarborough, Peter; Galea, Sandro

2011-02-17

Arab-American (AA) populations in the US are exposed to discrimination and acculturative stress-two factors that have been associated with higher suicide risk. However, prior work suggests that socially oriented norms and behaviors, which characterize recent immigrant ethnic groups, may be protective against suicide risk. Here we explored suicide rates and their determinants among AAs in Michigan, the state with the largest proportion of AAs in the US. ICD-9/10 underlying cause of death codes were used to identify suicide deaths from among all deaths in Michigan between 1990 and 2007. Data from the 2000 U.S. Census were collected for population denominators. Age-adjusted suicide rates among AAs and non-ethnic whites were calculated by gender using the direct method of standardization. We also stratified by residence inside or outside of Wayne County (WC), the county with the largest AA population in the state. Suicide rates were 25.10 per 100,000 per year among men and 6.40 per 100,000 per year among women in Michigan from 1990 to 2007. AA men had a 51% lower suicide rate and AA women had a 33% lower rate than non-ethnic white men and women, respectively. The suicide rate among AA men in WC was 29% lower than in all other counties, while the rate among AA women in WC was 20% lower than in all other counties. Among non-ethnic whites, the suicide rate in WC was higher compared to all other counties among both men (12%) and women (16%). Suicide rates were higher among non-ethnic white men and women compared to AA men and women in both contexts. Arab ethnicity may protect against suicide in both sexes, but more so among men. Additionally, ethnic density may protect against suicide among Arab-Americans.

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.

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.

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…

An Unusual Stellar Death on Christmas Day

NASA Technical Reports Server (NTRS)

Thone, C. C.; de Ugarte Postigo, A.; Fryer, C. L.; Page, K. L.; Gorosabel, J.; Aloy, M. A.; Perley, D. A.; Kouveliotou, C.; Janka, H. T.; Mimica, P.;

Effects of Race and Precipitating Event on Suicide versus Nonsuicide Death Classification in a College Sample

ERIC Educational Resources Information Center

Walker, Rheeda L.; Flowers, Kelci C.

2011-01-01

Race group differences in suicide death classification in a sample of 109 Black and White university students were examined. Participants were randomly assigned to read three vignettes for which the vignette subjects' race (only) varied. The vignettes each described a circumstance (terminal illness, academic failure, or relationship difficulties)…

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.

Suicidal hanging within an automobile.

PubMed

Blanco Pampin, J M; López-Abajo Rodriguez, B A

2001-12-01

Accidental asphyxia related to cars has been described in different reports, but suicidal hanging in an automobile is very unusual. Two cases of suicidal hanging inside an automobile are described, illustrating an unusual form of hanging. In one case, the deceased used his belt as a ligature, and the point of attachment was the window of the car. The second victim used the safety belt of the passenger seat. In both cases, the automobile engine was turned off, all the windows were closed, and the door locks were blocked. The medicolegal cause of hanging was based on the scene of the investigation, police and witness reports, social history, autopsy findings, and toxicologic examinations.

FastStats: Self-Inflicted Injury/Suicide

MedlinePlus

... this? Submit What's this? Submit Button NCHS Home Suicide and Self-Inflicted Injury Recommend on Facebook Tweet ... Tables, table 17 [PDF – 676 KB] Mortality All suicides Number of deaths: 44,193 Deaths per 100, ...

Suicide Prevention among High School Students: Evaluation of a Nonrandomized Trial of a Multi-Stage Suicide Screening Program

ERIC Educational Resources Information Center

Torcasso, Gina; Hilt, Lori M.

2017-01-01

Background: Suicide is a leading cause of death among youth. Suicide screening programs aim to identify mental health issues and prevent death by suicide. Objective: The present study evaluated outcomes of a multi-stage screening program implemented over 3 school years in a moderately-sized Midwestern high school. Methods: One hundred ninety-three…

Arsenic: Association of regional concentrations in drinking water with suicide and natural causes of death in Italy.

PubMed

Pompili, Maurizio; Vichi, Monica; Dinelli, Enrico; Erbuto, Denise; Pycha, Roger; Serafini, Gianluca; Giordano, Gloria; Valera, Paolo; Albanese, Stefano; Lima, Annamaria; De Vivo, Benedetto; Cicchella, Domenico; Rihmer, Zoltan; Fiorillo, Andrea; Amore, Mario; Girardi, Paolo; Baldessarini, Ross J

2017-03-01

Arsenic, as a toxin, may be associated with higher mortality rates, although its relationship to suicide is not clear. Given this uncertainty, we evaluated associations between local arsenic concentrations in tapwater and mortality in regions of Italy, to test the hypothesis that both natural-cause and suicide death rates would be higher with greater trace concentrations of arsenic. Arsenic concentrations in drinking-water samples from 145 sites were assayed by mass spectrometry, and correlated with local rates of mortality due to suicide and natural causes between 1980 and 2011, using weighted, least-squares univariate and multivariate regression modeling. Arsenic concentrations averaged 0.969 (CI: 0.543-1.396) µg/L, well below an accepted safe maximum of 10µg/L. Arsenic levels were negatively associated with corresponding suicide rates, consistently among both men and women in all three study-decades, whereas mortality from natural causes increased with arsenic levels. Contrary to an hypothesized greater risk of suicide with higher concentrations of arsenic, we found a negative association, suggesting a possible protective effect, whereas mortality from natural causes was increased, in accord with known toxic effects of arsenic. The unexpected inverse association between arsenic and suicide requires further study. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Suicide Attempts and Suicide among Marines: A Decade of Follow-Up

ERIC Educational Resources Information Center

Gradus, Jaimie L.; Shipherd, Jillian C.; Suvak, Michael K.; Giasson, Hannah L.; Miller, Matthew

2013-01-01

Suicidal behavior among military personnel is of paramount public health importance because of the increased risk of death from suicide in this population. Pre- and post-Marine recruit training risk factors for suicide attempts among current and former Marines were examined in 10 years following recruit training. The characteristics of the…

College Student Suicide

ERIC Educational Resources Information Center

Taub, Deborah J.; Thompson, Jalonda

2013-01-01

Suicide is the second-leading cause of death among college students, and it is estimated that 1,088 college students die by suicide each year (National Mental Health Association and the Jed Foundation, 2002). This chapter presents the context of college student mental health within which the problem of college student suicide is situated. Because…

National Initiative to Prevent Suicide (NIPS): A New Proposal to Improve the Understanding and Prevention of Suicide.

PubMed

Preskorn, Sheldon H

2016-09-01

Suicide is a staggering, tragic, and growing cause of death in the United States. Despite a government-led 20-year effort, the suicide rate increased by 25% between 1999 and 2014. To prevent suicide, it is essential to understand the biological factors-genetic and epigenetic-and environmental factors that underlie it. To gain this increased understanding, the equivalent of the "War on Cancer" initiative is needed. The War on Cancer initiative, which began in the 1970s, has transformed the treatments and outcomes of cancer, and the same could occur with a similar initiative on suicide. This article proposes a National Initiative to Prevent Suicide (NIPS), with the first step being the establishment of a National Suicide Database (NSD). The NSD would be established by a government-private partnership much as was done by the National Cancer Institute in the War on Cancer. The NSD would be established under the auspices of the National Institute of Mental Health and the Centers for Disease Control and Prevention. Approximately $600 million are currently spent annually by taxpayers in the United States to support the medicolegal death investigation system, composed of 3137 county coroner or medical examiner offices across the country. In their investigation of deaths due to suicide, these offices collect extensive information, including biological samples, from the >40,000 deaths due to suicide that occur each year. The proposal presented in this column calls for this material to be stored in the NSD so that vetted government and public/private researchers can investigate the causes of suicide. This information will make possible the development of new methods, including laboratory evaluations, for assessing suicide risk as well as new treatments to prevent suicide. In support of this proposed new initiative, this article/proposal reviews the current medicolegal death investigation system and recent advances in our understanding of the biological basis of suicide. The

The railway suicide death of a famous German football player: impact on the subsequent frequency of railway suicide acts in Germany.

PubMed

Ladwig, Karl-Heinz; Kunrath, Sabine; Lukaschek, Karoline; Baumert, Jens

2012-01-01

The railway suicide of Robert Enke, an internationally respected German football goal keeper, sent shockwaves throughout the world of football. We analyzed its impact on the frequency of subsequent railway suicide acts (RS). Two analytic approaches were performed applying German Railway Event database Safety (EDS) data: first, an inter-year approach comparing the incidence of RS during a predefined "index period" with identical time windows in 2006 to 2008; second, an intra-year approach comparing the number of RS 28 days before and after the incidence. To analyze a possible "compensatory deficit", the number of RS in the subsequent first quarter of 2010 was compared with the identical time windows in the preceding three years. Incidence ratios with 95% confidence intervals were estimated by Poisson regression. Findings were controlled for temperature. Compared to the preceding three years, the incidence ratio (IR) of the number of RS in the index period increased by 1.81 (1.48-2.21; p<0.001), leading to an overall percentage change of 81% (48-121%; p<0.001). Comparing the number of suicides 28 days before and after the incidence revealed an even more pronounced increase of IR (2.2; 1.6-3.0). No modifications of these associations were observed by daytime, by location of the suicide and fatality. No compensatory deficit occurred in the post-acute period. The substantial increase of RS in the aftermath of the footballer's suicide death brought about copycat behavior in an unforeseen amount, even though the media reporting was largely sensitive and preventive measures were taken. Copyright © 2011 Elsevier B.V. All rights reserved.

Time to hospitalization for suicide attempt by the timing of parental suicide during offspring early development

PubMed Central

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

2013-01-01

Context Previous studies have suggested that children who experience parental suicide at earlier ages are at higher risk of future hospitalization for suicide attempt. However, how the trajectories of risk differ by offspring age at the time of parental suicide is currently unknown. Objective To study time at risk to hospitalization for suicide attempt among offspring after experiencing parental suicide or accidental death by offspring developmental period at the time of parental death. Design Population-based retrospective cohort study Setting Sweden Participants 26,096 offspring who experienced parental suicide and 32,395 offspring of accident decedents prior to age 25 from 1973-2003. Main Outcome Measures Hospitalization for suicide attempt. Parametric survival analysis was used to model the time to hospitalization for suicide attempt across offspring who lost a parent during early childhood (0-5 years old), later childhood (6-12), adolescence (13-17) and young adulthood (18-24). Results The risk in offspring who lost a parent during early or late childhood surpassed the other two age groups’ hazards approximately 5 years after the origin and, for the youngest group, continued to rise over the course of decades. Offspring who lost a parent during adolescence or young adulthood were at greatest risk within 1 to 2 years after parental suicide, and risk declined over time. The shape of hospitalization risk was similar among those who experienced parental fatal accident. When the shape of hospitalization for suicide attempt at each developmental period was fixed to be the same between the two groups, offspring who lost a parent to suicide had earlier risk to hospitalization for suicide attempt hospitalization than offspring who lost a parent to an accident. Conclusion The hospitalization risk for suicide attempt in offspring who lost a parent during their childhood is different from those who lost a parent during adolescence or young adulthood. The results suggest

Adolescent Suicide Postvention in Schools: Managing Grief of Peer Survivors.

ERIC Educational Resources Information Center

Mauk, Gary W.

During 1988 there were 4,929 deaths by suicide among persons 15 to 24 years of age in the United States, making suicide the third leading cause of death in this age group, following accidents and homicide. Adolescent suicide is a particularly toxic form of death for the peers who are left behind. A "survivor of suicide" is defined as…

PREVENTION OF SUICIDE

PubMed Central

Bennett, A. E.

1954-01-01

Suicide is the ninth major cause of death in the nation. California, according to the latest comprehensive figures (1949), ranks about 50 per cent above the national average. Yet the importance of suicide as a cause of death is gravely underestimated. At hospitals and other agencies only emergency treatment is given before discharge of persons who attempt suicide, although it is known that many will repeat the attempt. Rarely is psychiatric evaluation carried out or definitive treatment prescribed. Suicidal symptoms are often ignored in other cases. Physicians have a responsibility, as in any disorder, to recognize signs and symptoms of impending suicide and to use all means of prevention. Prevention could be forwarded by the education of physicians and laymen in detecting early signs of depression, in recognizing accident proneness, and in insisting upon legal control of use of barbiturates, a common means of suicide. Lay associations should encourage individuals with suicidal impulses to go to psychiatric clinics for help. Police should learn how to deal with suicidal attempts, and hospitals should include psychiatric examination and advice as to treatment of all such persons. Suicidal attempts should be registered and reported to public health officers in the same way as are other dangerous diseases. More research should be done on case records of these patients, in order to better understand motivations and means of prevention. PMID:13209373

A follow-up study of attempted railway suicides.

PubMed

O'Donnell, I; Arthur, A J; Farmer, R D

1994-02-01

This paper reports the subsequent mortality of 94 persons who attempted suicide by jumping in front of London Underground trains between 1977 and 1979. The follow-up period was 10 yr. Despite the apparent seriousness of the method, completion of suicide was not found to be higher than in previous studies of attempted suicide by other methods. By the end of the follow-up period 18 persons had died, nine of natural causes. Coroners' inquests were held for the unnatural deaths. Seven verdicts of suicide and two of accidental death were recorded. Of the nine unnatural deaths four were from multiple injuries, three from drowning, one from asphyxia and one from acute narcotic poisoning. All four multiple injury deaths were women, three of these were from repeated incidents involving London Underground trains. The time interval between the index attempt and eventual death for the suicide/accident group ranged from 1 day to 43 months. For ethical reasons it was not possible to follow-up attempted suicides who were presumed to have remained alive.

Suicide note and the psychological autopsy: Associated behavioral aspects.

PubMed

Acinas, Maria Patricia; Robles, José I; Peláez-Fernández, M Ángeles

2015-01-01

When a death occurs under traumatic, ambiguous, unknown, or uncertain circumstances, a death of suicidal origin can be considered. On many occasions, a suicide note is found next to body that helps to clarify certain aspects needed for the investigation to elucidate whether the death is really due to suicide or other causes. There are several types of suicide note (farewell, instructions, accusation of others, request for forgiveness, justification of one’s own suicide) that can contribute to the study of the victim’s psychological state and the circumstances that led to death. There is no unanimously approved way to conduct the psychological autopsy, but there are protocols for obtaining relevant information and preparing the report.

Suicide preceded by murder: the epidemiology of homicide-suicide in England and Wales 1988-92.

PubMed

Barraclough, Brian; Harris, E Clare

2002-05-01

We describe for the first time the epidemiology of homicide-suicide incidents for England and Wales. Previous descriptions have been of incidents in London (1946-62) and Yorkshire and Humberside (1975-1992). Death certificates were obtained for all who died in homicide-suicide incidents in England and Wales (1988-1992) that were reported by the police to the Home Office. Incidents were included in the analysis if the interval between death or fatal injury of victim and suspect was 3 or fewer days. Three hundred and twenty-seven people died in 144 incidents (180 victims and 147 suspects). Eighty per cent of incidents had one victim and one suspect. Three incidents were also suicide pacts between two suspects killing their children. Eighty-eight per cent of incidents exclusively involved members of the same family, 9 % acquaintances or strangers, and 3 % both family and acquaintances or strangers. Seventy-five per cent of victims were female, 85% of suspects male. The victims of male suspects were predominantly their womenfolk, past and present, and their children, and of female suspects their young children. Car exhaust and firearms accounted for 40% of victim and 50% of suspect deaths. Of all homicides during 1988-1992, 3 % of male, 11% of female and 19% of child deaths occurred in homicide-suicide incidents. Similarly, of all suicides, 0.8% of male and 0.4% of female deaths occurred in homicide-suicide incidents. Homicide-suicide in England and Wales is mostly 'a family matter', men of predominantly lower social class killing their kin, and pre-menopausal mothers their young children, before they kill themselves. A few men kill strangers during a crime and then themselves.

Suicide Prevention: An Emerging Priority For Health Care.

PubMed

Hogan, Michael F; Grumet, Julie Goldstein

2016-06-01

Suicide is a significant public health problem. It is the tenth leading cause of death in the United States, and the rate has risen in recent years. Many suicide deaths are among people recently seen or currently under care in clinical settings, but suicide prevention has not been a core priority in health care. In recent years, new treatment and management strategies have been developed, tested, and implemented in some organizations, but they are not yet widely used. This article examines the feasibility of improving suicide prevention in health care settings. In particular, we consider Zero Suicide, a model for better identification and treatment of patients at risk for suicide. The approach incorporates new tools for screening, treatment, and support; it has been deployed with promising results in behavioral health programs and primary care settings. Broader adoption of improved suicide prevention care may be an effective strategy for reducing deaths by suicide. Project HOPE—The People-to-People Health Foundation, Inc.

Young People's Risk of Suicide Attempts in Relation to Parental Death: A Population-Based Register Study

ERIC Educational Resources Information Center

Jakobsen, Ida Skytte; Christiansen, Erik

2011-01-01

Background: The objective of this study was to examine the association between the death of a biological parent and subsequent suicide attempts by young people (aged 10-22 years), and to explore sociodemographic factors as modifying factors in the process. Methods: The study used a nested case-control design. The full study population was obtained…

Suicide: The Psychosocial Dimension

ERIC Educational Resources Information Center

Hendin, Herbert

1978-01-01

Explores relationships among culture, character, and suicide, drawing on author's research in Scandinavia and his studies of suicide among United States urban blacks and college students. Varying psychodynamic ways suicidal individuals in differing cultures and subcultures conceive of, use, and absorb death tell us much about how we live. (Author)

Children of suicide: the telling and the knowing.

PubMed

Cain, Albert C

2002-01-01

Amidst the still limited literature on survivors of suicide, and the particularly scanty literature on children of parental suicide, little focal attention has been given to the special issues surrounding surviving parents telling the children that their deceased parent's death was a suicide. Those few papers that deal with this topic have primarily emphasized the destructive consequences of not telling of the suicidal nature of the death, with imperatives to tell the children the whole truth and do so promptly post-death. Based primarily on clinical and preventive work with children of suicide, this absolutism and one-size-fits-all approach is questioned, the difference between being told and knowing accented and illustrated, and the nature and effects of surviving parent explanatory frameworks for the suicide--the 'why' of it--explored.

Investigating Correlates of Suicide Among Male Youth: Questioning the Close Affinity Between Suicide Attempts and Deaths.

PubMed

Feigelman, William; Joiner, Thomas; Rosen, Zohn; Silva, Caroline

2016-04-01

This study was based on a sample of male high school students who completed National Longitudinal Adolescent Health Surveys in 1994, 1995, and 2001. We studied these students prospectively, comparing those who later died by suicide (n = 21) with those who were still living (n = 10,101). We employed chi-square and analysis of variance tests for statistical significance between suicide decedents and living respondents. Results showed suicide decedents were more likely to have experienced the suicide loss of another family member, to have been expelled from school, to have engaged in more delinquent actions including fighting, and to have greater involvement with the criminal justice system. Although one might have expected suicide casualties to have exhibited a greater amount of suicidal thoughts, attempts, and higher incidences of suicidality among their friends, our analyses did not find that these factors were associated with actual suicides. Should these findings be replicated, this would point to a need to refine youth suicide risk assessments. Collecting life histories, as well as identifying patterns of delinquency and fighting, may serve as more potentially fruitful means for assessing genuine suicide risk than some traditional risk assessment methods.z. © 2015 The American Association of Suicidology.

Suicide in Serbia.

PubMed

Ilic, M; Ilic, I

2016-03-15

Suicide remains a significant public health problem worldwide. The aim of this study was to assess the mortality trend of suicide in Serbia for the years 1991-2014. Data on persons who died of suicide and self-inflicted injury (site codes E950-E959 revision 9 and X60-X84 revision 10 of the International Classification of Diseases to classify death, injury and cause of death) were obtained from the Statistical Office of the Republic of Serbia. The age standardized rate was calculated by direct method (per 100,000 persons, using Segi's World population as standard population). Average annual percentage change (AAPC) with the corresponding 95% confidence interval (CI) was computed for trend using the joinpoint regression analysis. Total 33,930 (24,016 men and 9914 women) suicide deaths occurred in Serbia during the observed period, with the average annual age-standardized mortality rate being 12.7 per 100,000 inhabitants (19.5 per 100,000 in men and 6.7 per 100,000 in women). Suicide mortality in all age groups was higher among men than women. In both genders, suicide rates were highest in the oldest age group. Significantly decreased trend in suicide mortality was recorded continuously from 1991 to 2014 (AAPC=-1.9%, 95%CI -2.2 to -1.6). The most frequently used suicide method in both genders was hanging, strangulation or suffocation with 61.2% off all suicides. Changes in mortality rates were significant both for suicide by firearms, air guns and explosives (AAPC=-1.5% (AAPC=-1.5% in men and -3.1%-3.1% in women) and for suicide by hanging, strangulation, and suffocation (AAPC=-1.2% (AAPC=-1.2% in men and -3.0%-3.0% in women). In men, nonsignificant increase in suicide by firearms, air guns and explosives observed during the period 1991-1997 (by +6.1% per year) was followed by a significant decrease until 2014 (by -3.1% per year). The significantly increased mortality in suicide by firearms, air guns, and explosives was observed in older men (aged 40-69 years and 80

The Development of the Concept of Suicide in Children.

ERIC Educational Resources Information Center

Normand, Claude L.; Mishara, Brian L.

1992-01-01

Examined development of concept of suicide in 60 children. Found that 10 percent of first, 50 percent of third, and 95 percent of fifth graders had basic understanding of suicide. Attitudes toward suicide were neutral or negative. Concept of suicide was significantly related to concept of death and experiences with death and was also related to…

Population health outcome models in suicide prevention policy.

PubMed

Lynch, Frances L

2014-09-01

Suicide is a leading cause of death in the U.S. and results in immense suffering and significant cost. Effective suicide prevention interventions could reduce this burden, but policy makers need estimates of health outcomes achieved by alternative interventions to focus implementation efforts. To illustrate the utility of health outcome models to help in achieving goals defined by the National Action Alliance for Suicide Prevention's Research Prioritization Task Force. The approach is illustrated specifically with psychotherapeutic interventions to prevent suicide reattempt in emergency department settings. A health outcome model using decision analysis with secondary data was applied to estimate suicide attempts and deaths averted from evidence-based interventions. Under optimal conditions, the model estimated that over 1 year, implementing evidence-based psychotherapeutic interventions in emergency departments could decrease the number of suicide attempts by 18,737, and if offered over 5 years, it could avert 109,306 attempts. Over 1 year, the model estimated 2,498 fewer deaths from suicide, and over 5 years, about 13,928 fewer suicide deaths. Health outcome models could aid in suicide prevention policy by helping focus implementation efforts. Further research developing more sophisticated models of the impact of suicide prevention interventions that include a more complex understanding of suicidal behavior, longer time frames, and inclusion of additional outcomes that capture the full benefits and costs of interventions would be helpful next steps. Copyright © 2014 American Journal of Preventive Medicine. All rights reserved.

Robin Williams' suicide: a case study.

PubMed

Tohid, Hassaan

2016-01-01

The world renowned comedian and four-time Oscar nominated actor Robin Williams died on August 11, 2014. From the outset, the news indicated that his death was believed to be a suicide and this was later confirmed to be true by the autopsy reports. Williams had been suffering from severe depression, which is believed to be the leading contributor to his suicide. In this case study, I will highlight the event of the actor's suicide and the main risk factors along with depression leading to his tragic death. As of the end of 2015, no other case study seemed to have addressed or explored the links between the cause (or causes) and events leading to Robin Williams' suicide. Robin Williams was suffering from relationship problems, financial problems, drug addiction, and major depression. All of these factors led to his suicide. The chances of committing suicide drastically increase in the presence of any of the key risk factors. Unfortunately, the actor Robin Williams was dealing with four of the major risk factors all together, which put him at a high risk of committing suicide and eventually led to his tragic death.

Suicide on Instagram - Content Analysis of a German Suicide-Related Hashtag.

PubMed

Arendt, Florian

2018-06-21

Suicide is the second leading cause of death among 15-29-year-olds globally. Unfortunately, the suicide-related content on Instagram, a popular social media platform for youth, has not received the scholarly attention it deserves. The present study provides a content analysis of posts tagged as #selbstmord, a German suicide-related hashtag. These posts were created between July 5 and July 11, 2017. Approximately half of all posts included words or visuals related to suicide. Cutting was by far the most prominent method. Although sadness was the dominant emotion, self-hate and loneliness also appeared regularly. Importantly, inconsistency - a gap between one's inner mental state (e.g., sadness) and one's overtly expressed behavior (e.g., smiling) - was also a recurring theme. Conversely, help-seeking, death wishes, and professional awareness-intervention material were very rare. An explorative analysis revealed that some videos relied on very fast cutting techniques. We provide tentative evidence that users may be exposed to purposefully inserted suicide-related subliminal messages (i.e., exposure to content without the user's conscious awareness). We only investigated the content of posts on one German hashtag, and the sample size was rather small. Suicide prevention organizations may consider posting more awareness-intervention materials. Future research should investigate suicide-related subliminal messages in social media video posts. Although tentative, this finding should raise a warning flag for suicide prevention scholars.

The Media and Suicide

ERIC Educational Resources Information Center

Sudak, Howard S.; Sudak, Donna M.

2005-01-01

Objective: The authors aim to inform readers of the theory that when newspapers, film, and television describe suicidal deaths, additional suicides may result by virtue of contagion or copy-cat effects; to review data that support and refute this theory; to present some promising and recommended ways to prevent copy-cat suicide; and to cite…

Simultaneous homicide-suicide: a case report of double drowning.

PubMed

Melez, İpek Esen; Avşar, Abdullah; Başpınar, Bünyamin; Melez, Deniz Oğuzhan; Şahin, Fatih; Özdeş, Taşkın

2014-09-01

Homicide-suicide is a tragic phenomenon which typically does not result in a criminal charge or trial. However, correct diagnosis and classification of homicide-suicide cases are important to determine the perpetrators and dynamics of each category properly. The deaths in the homicide-suicide acts can be divided into two categories with respect to the number of involved individuals: dyadic deaths and triple or multiple deaths. These two categories can also be divided into two subgroups according to the chronology of the incidents: simultaneous deaths and consecutive deaths. Herein, a simultaneous homicide-suicide case of a father and daughter where both deaths occurred through drowning which was not found in the selected literature review and where the victim was a child is presented. The article aims to clarify the term discrepancies about multiple death cases in the literature and to discuss the pathological and psychosocial characteristics of the simultaneous dyadic death cases. © 2014 American Academy of Forensic Sciences.

The health status of elderly persons in the last year of life: a comparison of deaths by suicide, injury, and natural causes.

PubMed Central

Grabbe, L; Demi, A; Camann, M A; Potter, L

1997-01-01

OBJECTIVES: This study identified health status variables related to suicide by elderly persons and compared the health status of suicide decedents with natural death and injury decedents. METHODS: Data were obtained from the 1986 National Mortality Followback Survey. RESULTS: When other variables were controlled for, suicide decedents were significantly more likely than injury decedents to have a history of cancer (odds ratio [OR] = 51.94), moderate (OR = 29.37) or heavy (OR = 22.87) alcohol use, and mental or emotional disorder (OR = 10.91) and to be White (OR = 18.54) and male (OR = 9.12). CONCLUSIONS: The findings indicate that a history of cancer should be considered as a risk for suicide in the elderly. PMID:9096548

Completed suicide in adults of rural Kerala: rates and determinants.

PubMed

Sauvaget, C; Ramadas, K; Fayette, J M; Thomas, G; Thara, S; Sankaranarayanan, R

2009-01-01

India has witnessed a dramatic increase in suicide rates during the past few decades. The southern state of Kerala has been reporting the highest rates of suicide. Since suicide rates are estimated from death registries, they are likely to be under-reported because the civil registration system is incomplete and suicide deaths are poorly reported. A cohort of 132 000 participants (age 35 years and above) in Thiruvananthapuram (erstwhile Trivandrum) district, Kerala was followed up for mortality from 1996 to 2005, after having filled-in a lifestyle questionnaire at baseline. The cause of death was based on verbal autopsy. Suicide methods were recorded and rates were estimated, and suicide risks were calculated according to several socioeconomic factors. During the follow up period, a total of 11 608 deaths, of which 385 were suicides (3.3% of total deaths), were registered. The overall suicide rate was 39.3/100 000 person-years among adults 35-90 years of age (men: 78/ 100000; women: 16.5/100000). The predominant methods of suicide were hanging, followed by poisoning and drowning. The suicide determinants were male gender, middle-age (40-60 years), Hindu, alcohol drinkers and secondary education level (< or = 7 years). Neither low socioeconomic level, living alone, nor being a married woman was associated with suicide risk. Suicide rates were consistent with the official rates of Thiruvananthapuram district (37/100 000). However, our study population did not include the 14-34-year-old age-group which represents more than 37% of all suicides and hence it is more likely that the official rates are under-reported. Determinants of suicide were in line with previous studies.

DILEMMAS IN THE ATTITUDE TOWARDS SUICIDE.

PubMed

Carasevici, B

2016-01-01

Although apparently easy to define, the suicidal act or attempt raises complex and difficult problems due to the multitude of conditions and situations that can lead to it. In all cases the suicide's definition has always centred on the intention of one person to deliberately cause his or her death in an active manner. Defining suicide has been consecutively the temptation of philosophers, sociologists, theologians, psychologists and psychiatrists. From an epistemological point of view the suicide is an open concept without precise borders, yet not incoherent. Scientists have constantly tried to establish evaluation criteria of suicidal acts but these are variable. One can even assume that there is an infinity of combinations of characteristics that would legit- imize the label of suicide, although none of them can be particularized in any way. Not even death itself represents a necessary condition for the evaluation of an act as suicide.

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.

School Suicide Risk Assessment

ERIC Educational Resources Information Center

Brock, Stephen E.; Louvar Reeves, Melissa A.

2018-01-01

Suicide is a leading cause of death among youth ages 10 years and older. Further, recent federal surveillance data suggest the rates of suicidal ideation and behaviors to be increasing. With these facts in mind, in this paper, we examine the school psychologist's role in suicide risk assessment; which assesses the degree to which students, who…

Suicide Clusters and Contagion

ERIC Educational Resources Information Center

Zenere, Frank J.

2009-01-01

Youth suicide is one of the most serious preventable health problems in the United States. It is the third leading cause of death among adolescents. According to a recent national survey of students in grades 9-12, nearly 15% of respondents had seriously considered suicide and 7% actually had attempted suicide in the previous 12 months. Moreover,…

Editorial: Reducing adolescent suicide.

PubMed

Bloch, Michael H

2016-07-01

Suicide is currently the second leading cause of death in young people ages 10-19 (CDC, 2015). Current statistics suggest that in the US one in every seven youths has seriously considered or made a plan to commit suicide and one in every 13 youths has attempted suicide in the previous year (CDC, 2015). Suicide represents a - if not the - major public health problem in adolescents. © 2016 Association for Child and Adolescent Mental Health.

Examining suicide: imaging's contributions.

PubMed

Church, Elizabeth J

2015-01-01

For many people, the death of hope leads inexorably to the conclusion that the only viable solution, the only way to put an end to unendurable pain, is suicide. What leads a person to commit this final, desperate act, and how might we predict, intervene, and prevent suicide? Health care workers, including radiologic technologists, can play an important role in detecting warning signs in patients and in better understanding what factors may lead to suicide. Although certain forms of suicide such as suicide bombings and assisted suicide are beyond its scope, this article explores medical imaging's contributions to the study of this phenomenon.

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

Farming suicides during the Victorian drought: 2001-2007.

PubMed

Guiney, Robyn

2012-02-01

The objective of this study was to determine whether farming suicides increased in Victoria during the prolonged drought in south eastern Australia and gain an understanding of Victorian farming suicides during the period. Intentional self-harm deaths of farmers and primary producers notified to the Victorian State Coroner from 2001 to 2007 were examined to identify characteristics and determine whether the annual number of farming suicides increased. Farming suicides accounted for just over 3% of Victorian suicides. The total number of farming suicides was 110 for the period and ranged between 11 and 19 deaths per year, rising and falling inconsistently from year to year. Males accounted for nearly 95% of farming suicides, with firearms and hanging the most frequently used methods, and most deaths occurring between 30 and 59 years of age. The small number of relevant cases and fluctuations in the annual number of deaths provides no evidence of a pattern of increasing farming suicides during the drought years, when there was approximately one suicide every 3 weeks. Given the elevated suicide risk in male farmers and association with multiple psychosocial and environmental factors, it cannot be concluded, however, that suicide risk itself did not increase during this period of heightened uncertainty and stress. Drought should not be dismissed among the many risk factors, and it is possible that increased mental health awareness and community support programs targeting drought-affected areas contributed to improved management of stress and suicide risk in regional and rural Victoria over the past decade. © 2012 The Author. Australian Journal of Rural Health © National Rural Health Alliance Inc.

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

PubMed Central

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

2006-01-01

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

Grief Experiences and Expectance of Suicide

ERIC Educational Resources Information Center

Wojtkowiak, Joanna; Wild, Verena; Egger, Jos

2012-01-01

Suicide is generally viewed as an unexpected cause of death. However, some suicides might be expected to a certain extent, which needs to be further studied. The relationships between expecting suicide, feeling understanding for the suicide, and later grief experiences were explored. In total, 142 bereaved participants completed the Grief…

Suicide Among Veterans in 16 States, 2005 to 2008: Comparisons Between Utilizers and Nonutilizers of Veterans Health Administration (VHA) Services Based on Data From the National Death Index, the National Violent Death Reporting System, and VHA Administrative Records

PubMed Central

Katz, Ira R.; Ignacio, Rosalinda V.; Kemp, Janet

2012-01-01

Objectives. We sought to compare suicide rates among veterans utilizing Veterans Health Administration (VHA) services versus those who did not. Methods. Suicide rates from 2005 to 2008 were estimated for veterans in the 16 states that fully participated in the National Violent Death Reporting System (NVDRS), using data from the National Death Index, NVDRS, and VHA records. Results. Between 2005 and 2008, veteran suicide rates differed by age and VHA utilization status. Among men aged 30 years and older, suicide rates were consistently higher among VHA utilizers. However, among men younger than 30 years, rates declined significantly among VHA utilizers while increasing among nonutilizers. Over these years, an increasing proportion of male veterans younger than 30 years received VHA services, and these individuals had a rising prevalence of diagnosed mental health conditions. Conclusions.The higher rates of suicide for utilizers of VHA among veteran men aged 30 and older were consistent with previous reports about which veterans utilize VHA services. The increasing rates of mental health conditions in utilizers younger than 30 years suggested that the decreasing relative rates in this group were related to the care provided, rather than to selective enrollment of those at lower risk for suicide. PMID:22390582

Suicide and Its Impact on Campus

ERIC Educational Resources Information Center

Levine, Heidi

2008-01-01

Although any death on campus can have profound effects on the community, leaving survivors to grope for meaning and cope with feelings of grief and loss, deaths by suicide entail several additional challenges. Shneidman (2001) estimated that an individual's suicide touches the lives of at least six others, creating wide-ranging psychological…

Evaluation of Postmortem Cerebrospinal Fluid S100B Protein and Serotonin Levels: Comparison of Suicidal Versus Nonsuicidal Deaths in Konya, Turkey.

PubMed

Dogan, Kamil Hakan; Unaldi, Mustafa; Demirci, Serafettin

2016-09-01

Although suicide is a preventable public health problem, objective assays for suicide risk are limited. In this study, it was aimed to determine levels of S100B protein and serotonin as a marker for risk of suicide. S100B protein and serotonin levels were investigated with ELISA method in the cerebrospinal fluid (CSF) in medicolegal autopsy cases, including those of suicide cases (n = 32) and nonsuicide cases (n = 56). The CSF S100B levels were higher (9.3 ± 2.9 ng/mL vs. 5.4 ± 2.0 ng/mL), and serotonin levels were lower (10.4 ± 4.9 ng/mL vs. 19.0 ± 5.7 ng/mL) in suicide group than nonsuicide group (p < 0.05). There was no correlation between S100B protein and serotonin levels with gender, age groups, postmortem interval, and cause of death. It is concluded that both S100B protein and serotonin in CSF may be useful for determination of suicide risk. © 2016 American Academy of Forensic Sciences.

The legacy of minimum legal drinking age law changes: Long-term effects on suicide and homicide deaths among women

PubMed Central

Grucza, Richard A; Hipp, Pamela R.; Norberg, Karen E.; Rundell, Laura; Evanoff, Anastasia; Cavazos-Rehg, Patricia; Bierut, Laura J.

2013-01-01

Background Prior to the establishment of the uniform drinking age of 21 in the United States, many states permitted legal purchase of alcohol at younger ages. Lower drinking ages were associated with several adverse outcomes, including elevated rates of suicide and homicide among youth. The objective of this study is to examine whether individuals who were legally permitted to drink prior to age 21 remained at elevated risk in adulthood. Methods Analysis of data from the U.S. Multiple Cause of Death files, 1990–2004, combined with data on the living population from the U.S. Census and American Community Survey. The assembled data contained records on over 200,000 suicides and 130,000 homicides for individuals born between 1949 and 1972, the years during which the drinking age was in flux. Logistic regression models were used to evaluate whether adults who were legally permitted to drink prior to age 21 were at elevated risk for death by these causes. A quasi-experimental analytical approach was employed which incorporated state and birth year fixed effects to account for unobserved covariates associated with policy exposure. Results In the population as a whole, we found no association between minimum drinking age and homicide or suicide. However, significant policy-by-sex interactions were observed for both outcomes, such that women exposed to permissive drinking age laws were at higher risk for both suicide (OR=1.12; 95% CI 1.05, 1.18, p=0.0003) and homicide (OR=1.15; 95% CI 1.04, 1.25; p=0.0028). Effect sizes were stronger for the portion of the cohort born after 1960, whereas no significant effects were observed for women born prior to 1960. Conclusions Lower drinking ages may result in persistent elevated risk for suicide and homicide among women born after 1960. The national drinking age of 21 may be preventing about 600 suicides and 600 homicides annually. PMID:22085045

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.

The Effect of Marital Integration on African American Suicide.

ERIC Educational Resources Information Center

Stack, Steven

1996-01-01

Analysis of nationwide data on 2,099 African American suicides and 1,729 African American natural deaths indicates that being divorced or widowed significantly raises the odds of death by suicide, but being single does not. A parallel analysis for whites finds greater support for a link between marital status and suicide. (RJM)

Societal Reaction to a Child's Death by Suicide.

ERIC Educational Resources Information Center

Rudestam, Kjell E.; Imbroll, Doreen

1983-01-01

Explored the impact of a child's suicide on the community. Adults (N=80) responded to newspaper accounts of a girl who died either from disease, an accident, a drug overdose, or hanging. The child and her family were perceived as most disturbed and her parents most blameworthy in the suicide. (JAC)

Time varying prediction of thoughts of death and suicidal ideation in adolescents: weekly ratings over 6-month follow-up.

PubMed

Selby, Edward A; Yen, Shirley; Spirito, Anthony

2013-01-01

Suicidal ideation (SI) and thoughts of death are often experienced as fluctuating; therefore a dynamic representation of this highly important indicator of suicide risk is warranted. Theoretical accounts have suggested that affective, behavioral, and interpersonal factors may influence the experience of thoughts of death/SI. This study aimed to examine the prospective and dynamic impact of these constructs in relation to thoughts of death and SI. We assessed adolescents with a recent hospitalization for elevated suicide risk over 6 months. Using the methodology of the Longitudinal Interval Follow-Up Evaluation, weekly ratings for SI, course of depressive illness, affect sensitivity, negative affect intensity, behavioral dysregulation, peer invalidation, and family invalidation were obtained. Using multilevel modeling, results indicated that (a) same-week ratings between these constructs and SI were highly correlated at baseline and throughout follow-up; (b) baseline ratings of affect sensitivity, behavioral dysregulation, and peer invalidation were positive prospective predictors of SI at any week of follow-up; (c) weekly ratings of each of these constructs had significant associations with next-week ratings of SI; and (d) ratings of SI had positive significant associations with next-week ratings on each of the constructs. These results suggest that affective sensitivity, behavioral dysregulation, peer invalidation, and SI are highly associated with SI levels both chronically (over months) and acutely (one week to the next), whereas depression, negative affect intensity, and family invalidation were more acutely predictive of SI. Elevated SI may then aggravate all these factors in a reciprocal manner.

Suicidal inhalation of motorbike exhaust: adding new data to the literature about the contribution of gasoline in the cause of death.

PubMed

Martínez, María A; Ballesteros, Salomé

2006-01-01

We would like to alert toxicologists to the importance of testing for gasoline, and for volatile hydrocarbons in general, in deaths involving inhalation of exhaust fumes occurring in closed spaces with running motors or machinery. We present here a case of suicidal inhalation of motorbike exhaust, a mixture of carbon monoxide (CO) and gasoline vapor, by a 38-year-old female. She was found in her closed home garage with a hose extending from the exhaust pipe of a motorbike through a cellophane plastic device into a closed tent in which the victim lay. She left two suicide notes nearby. The carboxyhemoglobin (COHb) was measured using visible spectrophotometry. The toxicological screening and quantitation of gasoline was performed by means of gas chromatography with flame-ionization detector and confirmation was performed using gas chromatography-mass spectrometry. The %COHb determined in blood was 73%. Gasoline concentrations in heart blood and vitreous humor were 22.3 and 1.0 mg/L, respectively. Although fatalities with CO at this rate are common, we would like to highlight the role of gasoline and add new quantitative data of this toxic substance to the scarce literature. Based upon the toxicological data, along with the information provided by the medical examiner, the cause of death was determined to be CO and gasoline poisoning and the manner of death suicide.

Suicide Prevention for LGBT Students

ERIC Educational Resources Information Center

Johnson, R. Bradley; Oxendine, Symphony; Taub, Deborah J.; Robertson, Jason

2013-01-01

Extensive media coverage of the suicide deaths of several gay and lesbian youth has highlighted lesbian, gay, bisexual, and transgender (LGBT) youth as a population at-risk for suicide. In addition, it has caused colleges and universities to address mental health and suicide behavior among this very diverse college population. One issue that…

Teenage Suicide in Oregon 1983-1985.

ERIC Educational Resources Information Center

Oregon State Dept. of Human Resources, Portland.

During the 3-year period from 1983 through 1985, 80 Oregon teenagers intentionally took their own lives, making suicide second only to accidents as the leading cause of death among Oregon teenagers. Data on suicides committed by individuals between the ages of 10 and 19 were retrieved from death certificates on file with the Oregon Health Division…

Did the suicide barrier work after all? Revisiting the Bloor Viaduct natural experiment and its impact on suicide rates in Toronto.

PubMed

Sinyor, Mark; Schaffer, Ayal; Redelmeier, Donald A; Kiss, Alex; Nishikawa, Yasunori; Cheung, Amy H; Levitt, Anthony J; Pirkis, Jane

2017-06-19

This research aims to determine the long-term impact of the Bloor Street Viaduct suicide barrier on rates of suicide in Toronto and whether media reporting had any impact on suicide rates. Natural experiment. City of Toronto, Canada; records at the chief coroner's office of Ontario 1993-2003 (11 years before the barrier) and 2004-2014 (11 years after the barrier). 5403 people who died by suicide in the city of Toronto. Changes in yearly rates of suicide by jumping at Bloor Street Viaduct, other bridges including nearest comparison bridge and walking distance bridges, and buildings, and by other means. Suicide rates at the Bloor Street Viaduct declined from 9.0 deaths/year before the barrier to 0.1 deaths/year after the barrier (incidence rate ratio (IRR) 0.005, 95% CI 0.0005 to 0.19, p=0.002). Suicide deaths from bridges in Toronto also declined significantly (IRR 0.53, 95% CI 0.40 to 0.71, p<0.0001). Media reports about suicide at the Bloor Street Viaduct were associated with an increase in suicide-by-jumping from bridges the following year. The current study demonstrates that, over the long term, suicide-by-jumping declined in Toronto after the barrier with no associated increase in suicide by other means. That is, the barrier appears to have had its intended impact at preventing suicide despite a short-term rise in deaths at other bridges that was at least partially influenced by a media effect. Research examining barriers at other locations should interpret short-term results with caution. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Surveillance for Violent Deaths - National Violent Death Reporting System, 17 States, 2013.

PubMed

Lyons, Bridget H; Fowler, Katherine A; Jack, Shane P D; Betz, Carter J; Blair, Janet M

2016-08-19

In 2013, more than 57,000 persons died in the United States as a result of violence-related injuries. This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) regarding violent deaths from 17 U.S. states for 2013. Results are reported by sex, age group, race/ethnicity, marital status, location of injury, method of injury, circumstances of injury, and other selected characteristics. 2013. NVDRS collects data from participating states regarding violent deaths obtained from death certificates, coroner/medical examiner reports, law enforcement reports, and secondary sources (e.g., child fatality review team data, supplemental homicide reports, hospital data, and crime laboratory data). This report includes data from 17 states that collected statewide data for 2013 (Alaska, Colorado, Georgia, Kentucky, Maryland, Massachusetts, North Carolina, New Jersey, New Mexico, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, Utah, Virginia, and Wisconsin). NVDRS collates documents for each death and links deaths that are related (e.g., multiple homicides, a homicide followed by a suicide, or multiple suicides) from a single incident. For 2013, a total of 18,765 fatal incidents involving 19,251 deaths were captured by NVDRS in the 17 states included in this report. The majority (66.2%) of deaths were suicides, followed by homicides (23.2%), deaths of undetermined intent (8.8%), deaths involving legal intervention (1.2%) (i.e., deaths caused by law enforcement and other persons with legal authority to use deadly force, excluding legal executions), and unintentional firearm deaths (<1%). (The term legal intervention is a classification incorporated into the International Classification of Diseases, Tenth Revision [ICD-10] and does not denote the lawfulness or legality of the circumstances surrounding a death caused by law enforcement.) Suicides occurred at higher rates among males, non-Hispanic whites, American Indian/Alaska Natives, persons aged 45

A pilot integrative genomics study of GABA and glutamate neurotransmitter systems in suicide, suicidal behavior, and major depressive disorder.

PubMed

Yin, Honglei; Pantazatos, Spiro P; Galfalvy, Hanga; Huang, Yung-Yu; Rosoklija, Gorazd B; Dwork, Andrew J; Burke, Ainsley; Arango, Victoria; Oquendo, Maria A; Mann, John J

2016-04-01

Gamma-amino butyric acid (GABA) and glutamate are the major inhibitory and excitatory neurotransmitters in the mammalian central nervous system, respectively, and have been associated with suicidal behavior and major depressive disorder (MDD). We examined the relationship between genotype, brain transcriptome, and MDD/suicide for 24 genes involved in GABAergic and glutamatergic signaling. In part 1 of the study, 119 candidate SNPs in 24 genes (4 transporters, 4 enzymes, and 16 receptors) were tested for associations with MDD and suicidal behavior in 276 live participants (86 nonfatal suicide attempters with MDD and 190 non-attempters of whom 70% had MDD) and 209 postmortem cases (121 suicide deaths of whom 62% had MDD and 88 sudden death from other causes of whom 11% had MDD) using logistic regression adjusting for sex and age. In part 2, RNA-seq was used to assay isoform-level expression in dorsolateral prefrontal cortex of 59 postmortem samples (21 with MDD and suicide, 9 MDD without suicide, and 29 sudden death non-suicides and no psychiatric illness) using robust regression adjusting for sex, age, and RIN score. In part 3, SNPs with subthreshold (uncorrected) significance levels below 0.05 for an association with suicidal behavior and/or MDD in part 1 were tested for eQTL effects in prefrontal cortex using the Brain eQTL Almanac (www.braineac.org). No SNPs or transcripts were significant after adjustment for multiple comparisons. However, a protein coding transcript (ENST00000414552) of the GABA A receptor, gamma 2 (GABRG2) had lower brain expression postmortem in suicide (P = 0.01) and evidence for association with suicide death (P = 0.03) in a SNP that may be an eQTL in prefrontal cortex (rs424740, P = 0.02). These preliminary results implicate GABRG2 in suicide and warrant further investigation and replication in larger samples. © 2016 Wiley Periodicals, Inc.

Epidemiology of Suicide in Cuba, 1987-2014.

PubMed

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

2016-07-01

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

Autopsy rate in suicide is low among elderly in Denmark compared with Finland.

PubMed

Ylijoki-Sørensen, Seija; Boldsen, Jesper Lier; Boel, Lene Warner Thorup; Bøggild, Henrik; Lalu, Kaisa; Sajantila, Antti

2014-11-01

National differences in the legislation on cause and manner of death investigation are reflected in a high autopsy rate in suicides in Finland and a low corresponding rate in Denmark. The consequences for mortality statistics of these different investigation practices on deaths classified as suicides in Denmark and Finland, respectively, are not known in detail. The aim of this article was to analyse autopsy rates in deaths classified as suicides, and to identify any differences in investigation practices in deaths with a comparable cause of death, but classified as unnatural deaths other than suicide. Data from the mortality registries were summarised for the years 2000, 2005 and 2010. Autopsy rates (total, forensic and medical) were analysed with regard to deaths classified as suicide, and they were compared for three age groups (1-50 years, 51-70 years and ≥71 years) and for causes of death. Deaths classified as suicide were compared with other unnatural classifications, and comparable causes of death were coded into six subgroups: poisonings, suffocations/strangulations, firearm discharges, drowning/submersions, explosions/flames and other/unspecified causes. The total autopsy rate for suicides was 99.8% in Finland and 13.2% in Denmark. Almost all of these autopsies were conducted as forensic autopsies. In the age group ≥71 years, Danish suicides outnumbered Finnish suicides (410 versus 283). The total autopsy rate was lower in the more senior age group in Denmark (19.5%, 9.9%, 5.6%), whereas it was consistently high in Finland (99.8%, 99.9%, 99.6%). Among Danish deaths due to poisonings, the autopsy rate was 89.5% when these were classified as accidents, but only 20.7% for cases classified as suicides. The number of deaths in the two Danish subgroups was comparable (550 versus 553). In Denmark, the decision regarding the need, if any, for a forensic autopsy is made during the external forensic examination of the body. Our study showed that the limited use

Suicide Prevention in Juvenile Facilities.

ERIC Educational Resources Information Center

Hayes, Lindsay M.

2000-01-01

Youth suicide is recognized as a serious public health problem, but suicide within juvenile facilities has not received comparable attention, and the extent and nature of these deaths remain unknown. This article utilizes an example of a young man in a juvenile justice facility who succeeded in committing suicide to illustrate these points.…

Do Undiagnosed Suicide Decedents Have Symptoms of a Mental Disorder?

PubMed

Joiner, Thomas E; Buchman-Schmitt, Jennifer M; Chu, Carol

2017-12-01

Psychological autopsy studies consistently report that the rate of detected mental disorders among suicide decedents is below 100%. This implies three possibilities: (a) a subset of suicide decedents did not have a mental disorder at the time of death; (b) all suicide decedents suffered from a mental disorder, but some were undetected due to methodological limitations; and/or (c) suicide decedents with an undetected mental disorder displayed significant and perhaps subclinical features of a mental disorder. In this article, we examined these possibilities by evaluating the differences in symptoms and stressors between suicide decedents who were undiagnosed and those diagnosed with a mental disorder at the time of death. We reviewed 130 case studies of community-based suicide decedents originally described in Robins' (1981) psychological autopsy study. Without exception, suicide decedents in Robins' sample suffered either from a clearly diagnosable mental disorder or displayed features indicative of a significant, even if subclinical, presentation of a mental disorder. Undiagnosed and diagnosed suicide decedents did not significantly differ with regards to demographics, violence of suicide method, suicide attempt history, the number and intensity of stressful life events preceding death, and whether their death was a murder-suicide. Although clearly not all who suffer from mental disorders will die by suicide, these findings imply that all who die by suicide appear to exhibit, at minimum, subclinical psychiatric symptoms with the great majority showing prominent clinical symptoms. We conclude with clinical implications and recommendations for future study. © 2017 Wiley Periodicals, Inc.

Withaferin A-stimulated Ca2+ entry, ceramide formation and suicidal death of erythrocytes.

PubMed

Jilani, Kashif; Lupescu, Adrian; Zbidah, Mohanad; Shaik, Nazneen; Lang, Florian

2013-02-01

Withaferin A, a triterpenoid component from Withania somnifera, counteracts malignancy, an effect attributed to stimulation of apoptosis. Withaferin A is partially effective through induction of oxidative stress, altered gene expression and mitochondrial depolarization. Erythrocytes lack mitochondria and nuclei but may enter apoptosis-like eryptosis, a suicidal cell death characterized by cell shrinkage and cell membrane scrambling with phosphatidylserine exposure at the cell surface. Triggers of eryptosis include increase of cytosolic Ca(2+)-activity [Ca(2+)](i) following activation of oxidant-sensitive Ca(2+)-permeable cation channels, ceramide formation and/or ATP-depletion. The present study explored, whether withaferin A triggers eryptosis. To this end, [Ca(2+)](i) was estimated from Fluo3-fluorescence, cell volume from forward scatter, phosphatidylserine exposure from annexin-V-binding, hemolysis from hemoglobin release, oxidative stress from DCFDA-fluorescence and ceramide abundance utilizing antibodies. A 48 h exposure to withaferin A significantly decreased forward scatter (at ≥ 10 μM withaferin concentration) and increased [Ca(2+)](i) (≥ 5 μM), ROS-formation (≥ 10 μM) ceramide-formation ( ≥ 10 μM) as well as annexin-V-binding ( ≥ 5 μM). Withaferin A treatment was followed by slight but significant increase of hemolysis. Extracellular Ca(2+) removal, amiloride, and the antioxidant N-acetyl-l-cysteine significantly blunted withaferin A-triggered annexin-V-binding. The present observations reveal that withaferin A triggers suicidal erythrocyte death despite the absence of gene expression and key elements of apoptosis such as mitochondria. Copyright © 2012 Elsevier Ltd. All rights reserved.

Suicide in later life: failed treatment or rational choice?

PubMed

Carlson, Whitney L; Ong, Thuan D

2014-08-01

Suicide is the deliberate act of causing death by self-directed injurious behavior with intent to die. Assisted dying, also known as assisted suicide, involves others to help hasten death. Physician-assisted dying specifically refers to the participation of a physician in facilitating one's death by providing a lethal means. Any decision to actively end a life has profound emotional and psychological effects on survivors. The article discusses the effects that older adults' deaths through suicide, assisted dying, and physician-assisted dying have on survivors and the implications for clinical practice. Copyright © 2014 Elsevier Inc. All rights reserved.

Rethinking suicide bombing.

PubMed

Aggarwal, Neil

2009-01-01

Current issues in the emerging psychiatric literature on suicide bombing tend to center around the pathologies of suicide bombers and the role of psychiatry as an adequate tool for analysis. Attention to broader social science research may allow mental health professionals to develop more accurate models of behavior to explain and possibly prevent future attacks. The psychiatric literature on suicide bombing was reviewed and compared to similar anthropological literature. A probe into the methodologies of researching suicide bombing, definitions of "war" and "terrorism", and beliefs on life, death, homicide, and suicide demonstrate that most of the psychiatric literature reflects a particular perspective which aspires towards a certain universalism. Anthropological approaches can disclose standpoints taken for granted since any interventions with respect to suicide bombing must eventually account for values which are ultimately culturally determined.

Socioeconomic inequalities in suicidal ideation, parasuicides, and completed suicides in South Korea.

PubMed

Kim, Myoung-Hee; Jung-Choi, Kyunghee; Jun, Hee-Jin; Kawachi, Ichiro

2010-04-01

As a result of unprecedented increase in suicides over the last decade, Korea now ranks at the top of OECD countries in suicide statistics (26.1 deaths per 100,000 population in 2005). Our study sought to document socioeconomic inequalities in self-destructive behaviors including suicidal ideation, parasuicide, and completed suicide. For prevalence of suicidal ideation and parasuicide, we used four waves of data from the Korea National Health and Nutrition Examination Survey (1995, 1998, 2001, and 2005). For suicide mortality, we abstracted suicide cases from the National Death Registration records, and linked them with population denominators from the national census in 1995, 2000, and 2005. We examined variation in self-destructive behaviors according to level of educational attainment (at the individual level), as well as area-level characteristics including level of deprivation and degree of urbanicity. Age-standardized rates were calculated through direct standardization using the 2005 census population as the standard. Inequalities were measured by the relative index of inequality and the slope index of inequality. The age-standardized prevalence of suicidal ideation decreased across consecutive surveys in both genders (18.0-13.5% for men, 27.5-22.9% for women). Parasuicides similarly decreased over time. By contrast, completed suicides increased over time (20.9-42.8 per 100,000 for men and 8.9-20.9 for women). The most prominent increases in completed suicides were observed among the elderly in both genders. Lower education, rural residence, and area deprivation was each associated with higher suicide rates. Both absolute as well as relative inequalities in suicide by socioeconomic position widened over time. Our findings suggest that the current suicide epidemic in Korea has social origins. In addition to clinical approaches targeted to the prevention of suicides in high risk individuals, social policies are needed to protect disadvantaged populations at

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.

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

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.

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

PubMed

Anestis, Michael D

2016-01-01

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

[The number of deaths by suicide after the Great East Japan Earthquake based on demographic statistics in the coastal and non-coastal areas of Iwate, Miyagi, and Fukushima prefectures].

PubMed

Masaki, Naoko; Hashimoto, Shuji; Kawado, Miyuki; Ojima, Toshiyuki; Takeshima, Tadashi; Matsubara, Miyuki; Mitoku, Kazuko; Ogata, Yukiko

2018-01-01

Objective　The number of deaths by suicide after the Great East Japan Earthquake was surveyed based on demographic statistics. In particular, this study examined whether or not there were excessive deaths due to suicide (excluding people who were injured in the earthquake) after the Great East Japan Earthquake disaster. This examination surveyed municipalities in coastal and non-coastal areas of Iwate, Miyagi, and Fukushima prefectures (referred to below as the "three prefectures").Methods　The demographic statistics questionnaire survey information supplied by Article 33 of the Statistics Act (Ministry of Health, Labour and Welfare's published statistics Vol. 0925 No.4, September 25 th , 2014) were used as the basic data with particular reference to the information on the deaths from January 1 st , 2010 to March 31 st , 2013. The information obtained included the date of death, the municipality where the address of the deceased was registered, the gender of the deceased, age at the time of death, and cause of death codes (International Classification of Disease Codes 10 th revision: ICD-10). Additionally, information was gathered about the population based on the resident register from 2009 to 2013 and the 2010 National Census; the number of deaths by suicide was then totalled by period and area. The areas were classified as municipalities within three prefectures and those located elsewhere using the municipality where the address of the deceased was registered.Results　The SMR for suicides did not show a tendency to increase for coastal or non-coastal areas throughout the two-year period after the earthquake disaster (from March 2011 to February 2013).　The SMR for the three prefectures 0-1 years after the disaster compared with the year before the disaster was 0.92 and for 1-2 years after the disaster was 0.93. Both these values were significantly low. Looking at both the non-coastal and coastal areas from each of the three prefectures, the SMR for suicides

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.…

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.

Military Suicide Research Consortium

DTIC Science & Technology

2016-10-01

just prior to the time of death: An analysis with implications for understanding suicidal behavior. Journal of Abnormal Psychology , 124(2), 460-461...suicidal behavior. Journal of Abnormal Psychology , 123(4), 835-840. doi: 10.1037/a0037480 Johnson, L. L., O’Connor, S.S., Kaminer, B., Jobes, D. A...Journal of Clinical and Consulting Psychology ; Journal of Abnormal Psychology ; International Journal of Psychology ; Archives of Suicide Research

After Suicide: Meeting the Needs of the Survivors.

ERIC Educational Resources Information Center

Bernhardt, Gregory R.; Praeger, Susan G.

Suicide is the tenth leading cause of death in the United States, with 30,000 documented cases per year. It is the eighth leading cause of death in children and the third leading cause of death in adolescents. For every suicide a minimum of five family members or significant others are affected. These survivors go through a difficult period of…

[Suicide in Paris and Ile-de-France].

PubMed

Lecomte, D; Hatton, F; Jougla, E; Le Toullec, A

1995-01-01

A study carried out in collaboration between the Institute of Forensic Medicine of Paris and the INSERM (SC8) concerned all the suicide occurred in Paris region over 1990; 455 suicides in Paris and 1,229 in the suburbs of Paris (overall, 1,684 suicides observed in Paris area for the same period). For Paris city, the rate of suicide reaches 23.3 per 100,000 subjects. This frequency increases up to 40 years and falls after this age with a further rise between 75 and 85 years. Suicide represents 17% of the total mortality for adolescents and young adults living in Paris, with a large over-representation of males (277 males, 178 females). Suicide is more frequent before 45 years in Paris than in France but this tendency is reversed after 45 years. It represents the first cause of violent deaths among young population (15-34 years) living in Paris and is, after AIDS, the second cause of death. In Paris suburbs, it constitutes the second cause of mortality after traffic accidents. The mode of suicide in Paris is essentially poisoning, then hanging and jumping from high place. In contrast, outside Paris, the hanging is more frequently used than poisoning and firearms. The contribution of the Institute of Forensic Medicine of Paris is essential for the knowledge of these voluntary deaths, a large part of them being unknown in the National statistic of causes of death. This underestimation is extremely important: only 68% of the suicides are known by the Official Statistic in Paris region and 26% for Paris city.(ABSTRACT TRUNCATED AT 250 WORDS)

Perinatal suicide in Ontario, Canada: a 15-year population-based study.

PubMed

Grigoriadis, Sophie; Wilton, Andrew S; Kurdyak, Paul A; Rhodes, Anne E; VonderPorten, Emily H; Levitt, Anthony; Cheung, Amy; Vigod, Simone N

2017-08-28

Death by suicide during the perinatal period has been understudied in Canada. We examined the epidemiology of and health service use related to suicides during pregnancy and the first postpartum year. In this retrospective, population-based cohort study, we linked health administrative databases with coroner death records (1994-2008) for Ontario, Canada. We compared sociodemographic characteristics, clinical features and health service use in the 30 days and 1 year before death between women who died by suicide perinatally, women who died by suicide outside of the perinatal period and living perinatal women. The perinatal suicide rate was 2.58 per 100 000 live births, with suicide accounting for 51 (5.3%) of 966 perinatal deaths. Most suicides occurred during the final quarter of the first postpartum year, with highest rates in rural and remote regions. Perinatal women were more likely to die from hanging (33.3% [17/51]) or jumping or falling (19.6% [10/51]) than women who died by suicide non-perinatally ( p = 0.04). Only 39.2% (20/51) had mental health contact within the 30 days before death, similar to the rate among those who died by suicide non-perinatally (47.7% [762/1597]; odds ratio [OR] 0.71, 95% confidence interval [CI] 0.40-1.25). Compared with living perinatal women matched by pregnancy or postpartum status at date of suicide, perinatal women who died by suicide had similar likelihood of non-mental health primary care and obstetric care before the index date but had a lower likelihood of pediatric contact (64.5% [20/31] v. 88.4% [137/155] at 30 days; OR 0.24, 95% CI 0.10-0.58). The perinatal suicide rate for Ontario during the period 1994-2008 was comparable to international estimates and represents a substantial component of Canadian perinatal mortality. Given that deaths by suicide occur throughout the perinatal period, all health care providers must be collectively vigilant in assessing risk. © 2017 Canadian Medical Association or its licensors.

Suicide: Issues of Prevention, Intervention, and Facilitation.

ERIC Educational Resources Information Center

Nelson, Franklyn L.

1984-01-01

Discusses the concept of suicide intervention which allows for the possibility of death facilitation as well as prevention. A proposed suicide intervention model is contrasted with the goals and methods of existing suicide prevention and crisis counseling services. (JAC)

Suicidal behaviour and suicide prevention in later life.

PubMed

Draper, Brian M

2014-10-01

Despite a general decline in late life suicide rates over the last 30 years, older people have the highest rates of suicide in most countries. In contrast, non-fatal suicidal behaviour declines with age and more closely resembles suicide than in younger age groups. There are difficulties in the detection and determination of pathological suicidal ideation in older people. Multiple factors increase suicide risk ranging from distal early and mid-life issues such as child abuse, parental death, substance misuse and traumatic life experiences to proximal precipitants in late life such as social isolation and health-related concerns. Clinical depression is the most frequently identified proximal mental health concern and in many cases is a first episode of major depression. Recent studies have identified changes on neuroimaging and neurocognitive factors that might distinguish suicidal from non-suicidal depression in older people. Strategies for suicide prevention need to be 'whole of life' and, as no single prevention strategy is likely to be successful alone, a multi-faceted, multi-layered approach is required. This should include optimal detection and management of depression and of high risk individuals as available evidence indicates that this can reduce suicidal behaviour. How best to improve the quality of depression management in primary and secondary care requires further research. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Unplanned Complex Suicide-A Consideration of Multiple Methods.

PubMed

Ateriya, Navneet; Kanchan, Tanuj; Shekhawat, Raghvendra Singh; Setia, Puneet; Saraf, Ashish

2018-05-01

Detailed death investigations are mandatory to find out the exact cause and manner in non-natural deaths. In this reference, use of multiple methods in suicide poses a challenge for the investigators especially when the choice of methods to cause death is unplanned. There is an increased likelihood that doubts of homicide are raised in cases of unplanned complex suicides. A case of complex suicide is reported where the victim resorted to multiple methods to end his life, and what appeared to be an unplanned variant based on the death scene investigations. A meticulous crime scene examination, interviews of the victim's relatives and other witnesses, and a thorough autopsy are warranted to conclude on the cause and manner of death in all such cases. © 2017 American Academy of Forensic Sciences.

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

[Experiences of Individuals With Suicidal Ideation and Attempts].

PubMed

Rendón-Quintero, Eduardo; Rodríguez-Gómez, Rodolfo

2016-01-01

Suicide is a major public health problem. It covers about half of violent deaths and results in approximately one million deaths annually. Although completed suicide rates in Colombia are relatively low when compared with other countries, suicidal behavior, represented not only by completed suicide, is a significant mental health problem. To understand life experiences of a group of subjects related to the phenomenon of ideation and suicide attempt. A qualitative study with a psychodynamic approach. In-depth interviews were conducted in order to explore thought processes, emotions, motivations and experiences that underlie and accompany the suicide attempt. Five women and 3 men were interviewed. The average age was 29 years. The exploration of subjective experiences in the present study showed that loneliness and psychic pain were linked to hopelessness, pessimism and discouragement. Also, the illusion of death represents an invitation to suicide attempt. It is important to consider the subjective assessment that patients with suicidal risk make of their depression and stressful life situations. Additionally, the concepts of loneliness and psychic pain have a leading role in the interaction between discourse and the experiences of the participants interviewed. Copyright © 2015 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

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

PubMed Central

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

2012-01-01

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

Analysis of suicide mortality in Brazil: spatial distribution and socioeconomic context.

PubMed

Dantas, Ana P; Azevedo, Ulicélia N de; Nunes, Aryelly D; Amador, Ana E; Marques, Marilane V; Barbosa, Isabelle R

2018-01-01

To perform a spatial analysis of suicide mortality and its correlation with socioeconomic indicators in Brazilian municipalities. This is an ecological study with Brazilian municipalities as a unit of analysis. Data on deaths from suicide and contextual variables were analyzed. The spatial distribution, intensity and significance of the clusters were analyzed with the global Moran index, MoranMap and local indicators of spatial association (LISA), seeking to identify patterns through geostatistical analysis. A total of 50,664 deaths from suicide were registered in Brazil between 2010 and 2014. The average suicide mortality rate in Brazil was 5.23/100,000 population. The Brazilian municipalities presenting the highest rates were Taipas do Tocantins, state of Tocantins (79.68 deaths per 100,000 population), Itaporã, state of Mato Grosso do Sul (75.15 deaths per 100,000 population), Mampituba, state of Rio Grande do Sul (52.98 deaths per 100,000 population), Paranhos, state of Mato Grosso do Sul (52.41 deaths per 100,000 population), and Monjolos, state of Minas Gerais (52.08 deaths per 100,000 population). Although weak spatial autocorrelation was observed for suicide mortality (I = 0.2608), there was a formation of clusters in the South. In the bivariate spatial and classical analysis, no correlation was observed between suicide mortality and contextual variables. Suicide mortality in Brazil presents a weak spatial correlation and low or no spatial relationship with socioeconomic factors.

Characterizing Suicide in Toronto: An Observational Study and Cluster Analysis

PubMed Central

Sinyor, Mark; Schaffer, Ayal; Streiner, David L

2014-01-01

Objective: To determine whether people who have died from suicide in a large epidemiologic sample form clusters based on demographic, clinical, and psychosocial factors. Method: We conducted a coroner’s chart review for 2886 people who died in Toronto, Ontario, from 1998 to 2010, and whose death was ruled as suicide by the Office of the Chief Coroner of Ontario. A cluster analysis using known suicide risk factors was performed to determine whether suicide deaths separate into distinct groups. Clusters were compared according to person- and suicide-specific factors. Results: Five clusters emerged. Cluster 1 had the highest proportion of females and nonviolent methods, and all had depression and a past suicide attempt. Cluster 2 had the highest proportion of people with a recent stressor and violent suicide methods, and all were married. Cluster 3 had mostly males between the ages of 20 and 64, and all had either experienced recent stressors, suffered from mental illness, or had a history of substance abuse. Cluster 4 had the youngest people and the highest proportion of deaths by jumping from height, few were married, and nearly one-half had bipolar disorder or schizophrenia. Cluster 5 had all unmarried people with no prior suicide attempts, and were the least likely to have an identified mental illness and most likely to leave a suicide note. Conclusions: People who die from suicide assort into different patterns of demographic, clinical, and death-specific characteristics. Identifying and studying subgroups of suicides may advance our understanding of the heterogeneous nature of suicide and help to inform development of more targeted suicide prevention strategies. PMID:24444321

Preventing recurrent suicidal behaviour.

PubMed Central

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

1999-01-01

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

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.

Suicide

MedlinePlus

... death in the United States. People may consider suicide when they are hopeless and can't see any other solution to their problems. Often it's related to serious depression, alcohol or substance abuse, or a major stressful ...

Combining the Suicide Intent Scale and the Karolinska Interpersonal Violence Scale in suicide risk assessments.

PubMed

Stefansson, J; Nordström, P; Runeson, B; Åsberg, M; Jokinen, J

2015-09-23

High suicide intent, childhood trauma, and violent behavior are risk factors for suicide in suicide attempters. The aim of this study was to investigate whether the combined assessment of suicide intent and interpersonal violence would provide a better prediction of suicide risk than an assessment of only suicide intent or interpersonal violence. This is a cohort study involving 81 suicide attempters included in the study between 1993 and 1998. Patients were assessed with both the Suicide Intent Scale (SIS) and the Karolinska Interpersonal Violence Scale (KIVS). Through the unique personal identification number in Sweden, patients were linked to the Cause of Death Register maintained by the Swedish National Board of Health and Welfare. Suicides were ascertained from the death certificates. Seven of 14 patients who had died before April 2013 had committed suicide. The positive predictive value for the Suicide Intent Scale alone was 16.7 %, with a specificity of 52 % and an area under the curve of 0.74. A combined assessment with the KIVS gave higher specificity (63 %) and a positive predictive value of 18.8 % with an AUC of 0.83. Combined use of SIS and KIVS expressed interpersonal violence as an adult subscale gave a sensitivity of 83.3 %, a specificity of 80.3 %, and a positive predictive value of 26 % with an AUC of 0.85. The correlation between KIVS and SIS scores was not significant. Using both the the SIS and the KIVS combined may be better for predicting completed suicide than using them separately. The nonsignificant correlation between the scales indicates that they measure different components of suicide risk.

Surveillance for Violent Deaths -
National Violent Death Reporting System, 18 States, 2014.

PubMed

Fowler, Katherine A; Jack, Shane P D; Lyons, Bridget H; Betz, Carter J; Petrosky, Emiko

2018-02-02

In 2014, approximately 59,000 persons died in the United States as a result of violence-related injuries. This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) regarding violent deaths from 18 U.S. states for 2014. Results are reported by sex, age group, race/ethnicity, marital status, location of injury, method of injury, circumstances of injury, and other selected characteristics. 2014. NVDRS collects data from participating states regarding violent deaths. Data are obtained from death certificates, coroner/medical examiner reports, law enforcement reports, and secondary sources (e.g., child fatality review team data, supplemental homicide reports, hospital data, and crime laboratory data). This report includes data from 18 states that collected statewide data for 2014 (Alaska, Colorado, Georgia, Kentucky, Maryland, Massachusetts, Michigan, New Jersey, New Mexico, North Carolina, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, Utah, Virginia, and Wisconsin). NVDRS collates documents for each death and links deaths that are related (e.g., multiple homicides, a homicide followed by a suicide, or multiple suicides) into a single incident. For 2014, a total of 22,098 fatal incidents involving 22,618 deaths were captured by NVDRS in the 18 states included in this report. The majority of deaths were suicides (65.6%), followed by homicides (22.5%), deaths of undetermined intent (10.0%), deaths involving legal intervention (1.3%) (i.e., deaths caused by law enforcement and other persons with legal authority to use deadly force, excluding legal executions), and unintentional firearm deaths (<1%). The term "legal intervention" is a classification incorporated into the International Classification of Diseases, Tenth Revision (ICD-10) and does not denote the lawfulness or legality of the circumstances surrounding a death caused by law enforcement. Suicides occurred at higher rates among males, non-Hispanic American Indian/Alaska Natives

Childhood Suicide and Myths Surrounding It.

ERIC Educational Resources Information Center

Greene, Dorothea B.

1994-01-01

Dispels five misconceptions surrounding the suicide of children: that children under the age of six do not commit suicide; that suicide in latency years is extremely rare; that psychodynamically and developmentally true depression is not possible in childhood; that child cannot understand finality of death; and that children are cognitively and…

Suicide in National Collegiate Athletic Association (NCAA) Athletes

PubMed Central

Rao, Ashwin L.; Asif, Irfan M.; Drezner, Jonathan A.; Toresdahl, Brett G.; Harmon, Kimberly G.

2015-01-01

Background: The National Collegiate Athletic Association (NCAA) has recently highlighted mental health concerns in student athletes, though the incidence of suicide among NCAA athletes is unclear. The purpose of this study was to determine the rate of suicide among NCAA athletes. Hypothesis: The incidence of suicide in NCAA athletes differs by sex, race, sport, and division. Study Design: Retrospective cohort study. Level of Evidence: Level 3. Methods: NCAA Memorial Resolutions list and published NCAA demographic data were used to identify student-athlete deaths and total participant seasons from 2003-2004 through 2011-2012. Deaths were analyzed by age, sex, race, division, and sport. Results: Over the 9-year study period, 35 cases of suicide were identified from a review of 477 student-athlete deaths during 3,773,309 individual participant seasons. The overall suicide rate was 0.93/100,000 per year. Suicide represented 7.3% (35/477) of all-cause mortality among NCAA student athletes. The annual incidence of suicide in male athletes was 1.35/100,000 and in female athletes was 0.37/100,000 (relative risk [RR], 3.7; P < 0.01). The incidence in African American athletes was 1.22/100,000 and in white athletes was 0.87/100,000 (RR, 1.4; P = 0.45). The highest rate of suicide occurred in men’s football (2.25/100,000), and football athletes had a relative risk of 2.2 (P = 0.03) of committing suicide compared with other male, nonfootball athletes. Conclusion: The suicide rate in NCAA athletes appears to be lower than that of the general and collegiate population of similar age. NCAA male athletes have a significantly higher rate of suicide compared with female athletes, and football athletes appear to be at greatest risk. Clinical Relevance: Suicide represents a preventable cause of death, and development of effective prevention programs is recommended. PMID:26502423

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.

[Some aspects of suicide in the years 1980-1996].

PubMed

Chodorowski, Zygmunt; Ciechanowicz, Robert; Anand, Jacek Sein

2009-01-01

The reduction of suicide death index in 1981 year and 1989 year, that is in the period of temporary and definitive "Solidarity" victory confirms Emile Durkheim theory that revolution processes increase social integration and prevent suicide decisions. In the years 1991-1994 the number of suicide deaths in Poland was distinctly lower than in other countries of the Soviet Block and republics of the Soviet Union.

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

Law enforcement suicide: a national analysis.

PubMed

Violanti, John M; Robinson, Cynthia F; Shen, Rui

2013-01-01

Previous research suggests that there is an elevated risk of suicide among workers within law enforcement occupations. The present study examined the proportionate mortality for suicide in law enforcement in comparison to the US working population during 1999, 2003-2004, and 2007, based on Centers for Disease Control and Prevention's National Institute for Occupational Safety and Health National Occupational Mortality Surveillance data. We analyzed data for all law enforcement occupations and focused on two specific law enforcement occupational categories-detectives/criminal investigators/ police and corrections officers. Suicides were also explored by race, gender and ethnicity. The results of the study showed proportionate mortality ratios (PMRs) for suicide were significantly high for all races and sexes combined (all law enforcement--PMR = 169, 95% CI = 150-191, p < 0.01, 264 deaths; detectives/criminal investigators/police--PMR = 182, 95% CI = 150-218, p < 0.01, 115 deaths; and corrections officers-PMR = 141, 95% CI = 111-178, p < 0.01, 73 deaths). Detectives/criminal investigators/police had the higher suicide risk (an 82% increase) compared to corrections officers (a 41% increase). When analyzed by race and sex, suicide PMRs for Caucasian males were significantly high for both occupations-detectives/ criminal investigators/police (PMR = 133; 95% CI = 108-162, p < 0.01; corrections officers--PMR = 134, 95% CI = 102-173, p < 0.01). A significantly high (PMR = 244, p < 0.01, 95% CI = 147-380) ratio was found among Hispanic males in the law enforcement combined category, and a similarly high PMR was found among Hispanic detectives/criminal investigators/police (PMR = 388, p < 0.01, 95% CI = 168-765). There were small numbers of deaths among female and African American officers. The results included significantly increased risk for suicide among detectives/criminal investigators/police and corrections officers, which suggests that additional study could provide

Assisted Suicide, Euthanasia, and Suicide Prevention: The Implications of the Dutch Experience.

ERIC Educational Resources Information Center

Hendin, Herbert

1995-01-01

A study illustrates how legal sanction promotes a culture that transforms suicide into assisted suicide and encourages choosing death when faced with serious illness. The question of extending legal euthanasia to those not physically ill complicates the issue. Also, doctors may feel they can end a terminally-ill patient's life without consent.…

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

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 Interventions Targeted toward At-Risk Youth

ERIC Educational Resources Information Center

Langhinrichsen-Rohling, Jennifer; Lamis, Dorian A.; McCullars, Adrianne

2012-01-01

Suicide is currently the third leading cause of death among youth; it has been named a public health concern. A number of programs have been developed to prevent suicide; many of these involve intervening with youth who are known to be at-risk because of their depression, expressed suicide ideation, or previous suicide attempts. This paper serves…

Nocturnal Sleep Disturbances: Risk Factors for Suicide

MedlinePlus

... sleep problems to be associated with death by suicide, even after adjusting for depression and symptoms of anxiety. Further, they showed a ... still have been found to increase risk of suicide among the elderly (Bernert, ... by depression, are associated with suicide ideation among the elderly ( ...

Population density and suicide in Scotland.

PubMed

Stark, Cameron; Hopkins, Paddy; Gibbs, Diane; Belbin, Alan; Hay, Alistair

2007-01-01

Suicide rates among men have increased in Scotland while falling in neighbouring countries. A national suicide prevention strategy has been produced. Previous work found that some rural areas of Scotland had higher than average rates of male suicide and undetermined deaths. This article describes the association between population density and suicide and undetermined death rates in Scotland. Anonymised information on deaths from suicide and undetermined cause in Scotland were obtained from the General Registrar Office for 1981-1999, including information on postcode sector. Each postcode sector was assigned a deprivation and population density score. Loglinear models were used to examine the effects of time period (grouped into four periods), deprivation quintiles, population density (grouped into four categories) and their interactions in each sex in three age groups. A significance level of 5% was used throughout. Adjusted rate ratios and 95% confidence intervals were based on models that included only significant factors and interactions. In men, there were higher rate ratios in the most densely populated and least densely populated quartiles, with intermediate rate ratios in other areas. There was no association with population density in women aged less than 25 years, a similar pattern to men in 25-44 year old women, and lower rates in rural areas in older women. Higher levels of deprivation were associated with higher rate ratios of suicide in both sexes and all age groups. Rate ratios over time increased in younger men and women, remained stable in older men, and declined in older women. Deprivation is associated with higher rates of suicide and undetermined deaths at all levels of population density and in all age groups. The highest rates of suicide among men are in the most and least densely populated areas, after adjusting for deprivation. The effect is different among women, with no effect among younger women, and lower rates among older women in areas

Clinical contact preceding suicide.

PubMed

Obafunwa, J O; Busuttil, A

1994-06-01

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

State Firearm Laws and Interstate Firearm Deaths From Homicide and Suicide in the United States: A Cross-sectional Analysis of Data by County.

PubMed

Kaufman, Elinore J; Morrison, Christopher N; Branas, Charles C; Wiebe, Douglas J

2018-03-05

Firearm laws in one state may be associated with increased firearm death rates from homicide and suicide in neighboring states are uncertain. To determine whether counties located closer to states with lenient firearm policies have higher firearm death rates. This cross-sectional study of firearm death rates by county for January 2010 to December 2014 examined data from the US Centers for Disease Control and Prevention for firearm suicide and homicide decedents for 3108 counties in the 48 contiguous states of the United States. Each county was assigned 2 scores, a state policy score (range, 0-12) based on the strength of its state firearm laws, and an interstate policy score (range, -1.33 to 8.31) based on the sum of population-weighted and distance-decayed policy scores for all other states. Counties were divided into those with low, medium, and high home state and interstate policy scores. County-level rates of firearm, nonfirearm, and total homicide and suicide. With multilevel Bayesian spatial Poisson models, we generated incidence rate ratios (IRR) comparing incidence rates between each group of counties and the reference group, counties with high home state and high interstate policy scores. Stronger firearm laws in a state were associated with lower firearm suicide rates and lower overall suicide rates regardless of the strength of the other states' laws. Counties with low state scores had the highest rates of firearm suicide. Rates were similar across levels of interstate policy score (low: IRR, 1.34; 95% credible interval [CI], 1.11-1.65; medium: IRR, 1.36, (95% CI, 1.15-1.65; and high: IRR, 1.43; 95% CI, 1.20-1.73). Counties with low state and low or medium interstate policy scores had the highest rates of firearm homicide. Counties with low home state and interstate scores had higher firearm homicide rates (IRR, 1.38; 95% CI, 1.02-1.88) and overall homicide rates (IRR, 1.32; 95% CI, 1.03-1.67). Counties in states with low firearm policy scores had lower

Improving suicide mortality statistics in Tarragona (Catalonia, Spain) between 2004-2012.

PubMed

Barbería, Eneko; Gispert, Rosa; Gallo, Belén; Ribas, Gloria; Puigdefàbregas, Anna; Freitas, Adriana; Segú, Elena; Torralba, Pilar; García-Sayago, Francisco; Estarellas, Aina

2016-07-20

Monitoring and preventing suicidal behaviour requires, among other data, knowing suicide deaths precisely. They often appear under-reported or misclassified in the official mortality statistics. The aim of this study is to analyse the under-reporting found in the suicide mortality statistics of Tarragona (a province of Catalonia, Spain). The analysis takes into account all suicide deaths that occurred in the Tarragona Area of the Catalan Institute of Legal Medicine and Forensic Sciences (TA-CILMFS) between 2004 and 2012. The sources of information were the death data files of the Catalan Mortality Register, as well as the Autopsies Files of the TA-CILMFS. Suicide rates and socio-demographic profiles were statistically compared between the suicide initially reported and the final one. The mean percentage of non-reported cases in the period was 16.2%, with a minimum percentage of 2.2% in 2005 and a maximum of 26.8% in 2009. The crude mortality rate by suicide rose from 6.6 to 7.9 per 100,000 inhabitants once forensic data were incorporated. Small differences were detected between the socio-demographic profile of the suicide initially reported and the final one. Supplementary information was obtained on the suicide method, which revealed a significant increase in poisoning and suicides involving trains. An exhaustive review of suicide deaths data from forensic sources has led to an improvement in the under-reported statistical information. It also improves the knowledge of the method of suicide and personal characteristics. Copyright © 2016 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

Gender Differences Related to Attitudes Toward Suicide and Suicidal Behavior.

PubMed

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

2016-02-01

This descriptive study examined gender differences related to attitudes toward suicide among randomly selected urban residents. Data was collected using a standardized questionnaire through face-to-face interview. Our findings revealed that men hold more pro preventive attitudes to help persons with suicidal thoughts (80.3 %, p = 0.05) and agreed that suicidal attempts are impulsive (78.6 %, p = 0.01). However, they hold permissive attitude to help persons with incurable diseases and expressing death wishes to die (66 %, p = 0.05). A majority of men (78.6 %) than women agreed that "suicidal attempt is essentially a cry for help" (χ (2) = 11.798, p = 0.05). These gender differences need to be taken into consideration when developing appropriate programs to prevent suicide. Further, decriminalizing the law, high-quality research and raising awareness about suicide prevention among the general population is crucial in developing countries like India.

Suicide Attempts among Depressed Adolescents in Primary Care

ERIC Educational Resources Information Center

Fordwood, Samantha R.; Asarnow, Joan R.; Huizar, Diana P.; Reise, Steven P.

2007-01-01

Although depression is strongly associated with suicide attempts and suicide deaths, most depressed youth do not make an attempt, indicating the need to identify additional risk factors. We examined suicide attempts among 451 depressed primary care patients, 13 to 21 years of age. In bivariate analyses, youth classified as suicide attempters…

Assessing Legal Strains and Risk of Suicide Using Archived Court Data

ERIC Educational Resources Information Center

Cook, Thomas Bradley; Davis, Mark S.

2012-01-01

Relatively little is known about legal entanglements and suicide risk. This matched case-control study estimated the risk of suicide associated with legal strains using online court archives, a novel source of exposure data. Court records linked to suicide deaths (N = 315), controls (N = 630), and unintentional injury and poisoning deaths (N =…

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.

Is Hinduism ambivalent about suicide?

PubMed

Vijayakumar, Lakshmi; John, Sujit

2018-05-01

Hinduism is one of the oldest religions in the world and has over 1.1 billion adherents comprising about 16% of the global population living mainly in India and Nepal. The stand of Hinduism on suicide has been ambiguous through the ages, on one hand, condemning general suicides, while condoning religious suicides on the other. This ambiguity is reflected in contemporary India and among the Indian diaspora. To examine the stand of Hinduism as a religion in the context of suicide. A selected review of literature covering the major Hindu religious texts, cultural practices and suicide. People who follow Hinduism have a suicide rate of about 21 per 100,000 population compared to the global average of 11.4. Hindu countries have higher rates of suicide compared to Islamic and Christian countries, but these rates are lower when compared to Atheist and Buddhist countries. This is reflected in the Indian diaspora as well with reports from Fiji, the Caribbean, Malaysia and the United Kingdom, indicating that suicide was disproportionately high among those of Indian origin. However, a strong faith in Hinduism acts as protective factor. The Hindu belief in karma fosters a sense of acceptance of the vicissitudes of life with equanimity, and the belief in the cycle of births and deaths renders suicide meaningless, as one's soul continues after death. Their religious beliefs makes the Hindus tolerate and accept hardships and calamities stoically. In certain situations, the Hindu religion acts as a protective factor, whereas at other times, it may increase the risk of suicide. It is important to understand these different nuances in the Hindu religion in formulating a culturally appropriate suicide prevention strategy.

Surveillance for Violent Deaths —
National Violent Death Reporting System, 18 States, 2014

PubMed Central

Jack, Shane P.D.; Lyons, Bridget H.; Betz, Carter J.; Petrosky, Emiko

2018-01-01

Problem/Condition In 2014, approximately 59,000 persons died in the United States as a result of violence-related injuries. This report summarizes data from CDC’s National Violent Death Reporting System (NVDRS) regarding violent deaths from 18 U.S. states for 2014. Results are reported by sex, age group, race/ethnicity, marital status, location of injury, method of injury, circumstances of injury, and other selected characteristics. Reporting Period Covered 2014. Description of System NVDRS collects data from participating states regarding violent deaths. Data are obtained from death certificates, coroner/medical examiner reports, law enforcement reports, and secondary sources (e.g., child fatality review team data, supplemental homicide reports, hospital data, and crime laboratory data). This report includes data from 18 states that collected statewide data for 2014 (Alaska, Colorado, Georgia, Kentucky, Maryland, Massachusetts, Michigan, New Jersey, New Mexico, North Carolina, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, Utah, Virginia, and Wisconsin). NVDRS collates documents for each death and links deaths that are related (e.g., multiple homicides, a homicide followed by a suicide, or multiple suicides) into a single incident. Results For 2014, a total of 22,098 fatal incidents involving 22,618 deaths were captured by NVDRS in the 18 states included in this report. The majority of deaths were suicides (65.6%), followed by homicides (22.5%), deaths of undetermined intent (10.0%), deaths involving legal intervention (1.3%) (i.e., deaths caused by law enforcement and other persons with legal authority to use deadly force, excluding legal executions), and unintentional firearm deaths (<1%). The term “legal intervention” is a classification incorporated into the International Classification of Diseases, Tenth Revision (ICD-10) and does not denote the lawfulness or legality of the circumstances surrounding a death caused by law enforcement. Suicides

Gauging Media Influence on Adolescent Suicide Rates

ERIC Educational Resources Information Center

Siegel, Darren; McCabe, Paul C.

2009-01-01

The "Morbidity and Mortality Weekly Report" published by the Centers for Disease Control (CDC) reported that in 2004, suicide was the third leading cause of death among 10- to 24-year olds and accounted for 4,599 deaths. From 2003 to 2004, suicide rates of females age 10-14 years and 15-19 years and males age 15-19 years increased significantly.…

On the Relationship Between Suicide-Prevention and Suicide-Advocacy Groups.

ERIC Educational Resources Information Center

Battin, Margaret Pabst

Numerous advocacy groups concerned with "death with dignity" have formed in response to medical advances which extend the process of dying. Natural death legislation and the Living Will are but two examples of suicide advocacy for the terminally ill. These groups are emerging world-wide and range from conservative insistence on passive…

Suicide in men with testis cancer.

PubMed

Alanee, S; Russo, P

2012-11-01

Depression, anxiety and aggression are documented in testis cancer patients and can result in death from suicides; however, their risk of suicide is not defined. We report suicide rates among testis cancer patients in the USA and determine factors associated with higher rates. We used the Surveillance, Epidemiology, and End Results (SEER) database maintained by the National Cancer Institute to identify patients diagnosed with testis cancer between 1995 and 2008. Multivariate analysis was used to assess factors affecting suicide rate. Among 23,381 patients followed for 126,762 person-years, suicide rate was 26.0 per 100,000 person-years, with the average corresponding rate in the US population aged 25-44 years being 21.5 per 100,000 person-years; the calculated standardised mortality ratio for death by suicide was 1.2 [95% confidence interval (CI): 1.1-2.1]. The standardised mortality ratio for suicide was 1.5 (95% CI: 1.1-2.1) in ages less than 30 years, and 1.8 (95% CI: 1.3-2.4) in men of races other than White and Black. Other patient and disease characteristics were not predictive. In conclusion, patients with testis cancer have a 20% increase in the risk of suicide over that of the general population, and races other than White and Black and younger patients may commit suicide at higher rates. © 2012 Blackwell Publishing Ltd.

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.

Accident or Suicide? Single-Vehicle Car Accidents and the Intent Hypothesis.

ERIC Educational Resources Information Center

Peck, Dennis L.; Warner, Kenneth

1995-01-01

Brief case studies of single-vehicle car crashes are used to explore the relationship between this method of death and the intent to commit suicide. The author attempts to determine what criteria can be used to determine whether suicide was the intent, and how death by automobile crash can be determined a suicide. (JPS)

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

PubMed

Eskin, Mehmet

2017-06-01

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

Suicide by blunt head trauma - Two cases with striking similarities.

PubMed

Park, Hyejin; Lee, Bongwoo; Yoon, Connie

2015-10-01

There have been several forensic pathological studies on the distinction between falls from height and homicidal blows in blunt head trauma, but few studies have focused on suicidal blows. Self-inflicted blunt head trauma is usually a part of a complex suicide with more than one suicidal method applied. Actually, no reports on suicide indicate blunt head trauma to be the singular cause of death in recent publications. Cases with self-inflicted blunt trauma are often challenging for those involved in the investigation because they are confronted with findings that are also found in homicides. A refined guideline to differentiate suicidal blows from homicidal blows in blunt head trauma allows for a more accurate representation of the events surrounding death. This paper presents two cases of suicide by self-inflicted blunt head trauma in which blunt head trauma from repeatedly hitting the decedent's head with a hammer was considered to be the only cause of death. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Unusual cause of aborted sudden cardiac death in a teen athlete: homozygosity for the 4G allele of the plasminogen activase inhibitor type 1 gene.

PubMed

Phillips, Susie B; Batlivala, Sarosh; Knudson, Jarrod D

2015-10-01

Common aetiologies of sudden cardiac death in children include coronary anomalies, channelopathies, and cardiomyopathies. Less frequently, hypercoagulable states cause sudden arrest. We report an unusual case of aborted sudden cardiac death in a teenager, ultimately found to have homozygosity for the 4G allele of the plasminogen activase inhibitor type 1 gene.

Manifest dream content as a possible predictor of suicidality.

PubMed

Glucksman, Myron L

2014-12-01

The prediction of suicidal intent remains a clinical problem. This presentation illustrates that a distinction may be made between the manifest dream reports of patients who are potentially or acutely suicidal and those who are not. A review of the literature reveals that the manifest dream reports of clinically depressed, non-suicidal individuals differ from those who are depressed and acutely suicidal. The former contain themes of loss, disappointment, rejection, helplessness, hopelessness, failure, and death. The latter contain themes of dying, death, destruction, and violence directed toward the dreamer or others, as well as hopelessness and helplessness. The author collected manifest dream reports from three clinically depressed, non-suicidal patients and three clinically depressed, potentially or acutely suicidal patients. There are apparent differences between the themes of manifest dream reports in the clinically depressed, non-suicidal patients and the clinically depressed, potentially or acutely suicidal patients. The former contain themes of death, loss, rejection, vulnerability, hopelessness, and helplessness. The latter contain themes of active harm or violence (specifically toward the dreamer), dying or being dead, aloneness, vulnerability, hopelessness, and helplessness. Clinical cases and corresponding manifest dream reports are presented. Although this is a preliminary study, it is possible that manifest dream content may be used as one of the predictors of suicidality, in conjunction with latent dream content, diagnosis, life circumstance, and clinical status.

The Literacy Educator's Role in Suicide Prevention

ERIC Educational Resources Information Center

Fisher, Douglas

2005-01-01

Suicide, the second leading cause of death for adolescents in the United States, is preventable. Nearly 80% of individuals who commit suicide have demonstrated signs well in advance. Adolescent suicide prevention efforts require collaboration with teachers--individuals who know students well. Literacy educators have a role in suicide…

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