Suicide among Viennese minors, 1946-2002

Poisoning in children and adolescents in Kermanshah city, Iran

BACKGROUND

Poisoning among children and adolescents is a public health problem worldwide. To take preventive measures, the pattern of this problem should be determined. This study aimed to describe the demographic characteristics of poisoning in children and to investigate the relationship between the types of poisoning and demographic factors in children in Kermanshah province.

METHODS

This cross-sectional, descriptive-analytical study was conducted on 250 children and adolescents under 18 years of age who were referred to Mohammad Kermanshahi Pediatric Hospital in Kermanshah province due to poisoning during 2019-2022. The demographic and epidemiological data of patients were extracted from their medical files and analyzed.

RESULTS

Out of 250 cases of poisoning, 173 (69.2%) cases were unintentional, 96 (55.5%) of whom were boys. Further, 77 (30.8%) cases of poisoning were intentional, of whom 49 (63.6%) were girls. There was a significant difference between gender and intentional and unintentional poisonings (p-value = 0.005). The median age of unintentional poisoning was 3 (IQR = 2.5) and that of intentional poisoning was 14 (IQR = 2). Most cases of poisoning were in cities, 145 (83.8%) of them were unintentional and 66 (85.7%) were intentional. Most cases of intentional and unintentional poisonings occurred in spring 2017 (35.1%) and autumn 2016 (34.6%), respectively. The most common causes of poisoning were narcotics (n = 36, 34.3%) and drugs (n = 35, 33.3%) in the age group 0-3 years and drugs (n = 46, 66.9) in the age group 11-18 years.

CONCLUSIONS

The most common causes of poisoning were narcotics and drugs in children and drugs in adolescents. To prevent poisoning in children, parents are required to increase their knowledge of the safe storage of narcotics and drugs, such as not storing methadone in a water bottle. Targeted evaluation and preventive measures are also needed in adolescent poisoning.

Child suicides in Sweden, 2000-2018

Although child mortality is decreasing in Sweden, an increase in suicide rates has been previously observed among children and adolescents collectively. To increase knowledge about trends, demographics, and means in child suicides, data including all child (< 18 years) suicides in Sweden in 2000 through 2018 were retrieved from the Swedish National Board of Forensic Medicine. In all, a total of 416 child suicides were found in a 19-year period, accounting for an annual suicide rate of 1.1/100,000 child population. The number of suicides increased with 2.2% by each successive year during the study period (p < 0.001). The mean age in both sexes was 16 years; boys accounted for 55% and girls for 45% of all study cases. The majority of the children who died by suicide (96%) were teenagers (13-17 years old) and suicides in children younger than 10 years were uncommon. Suicide methods were 59% hanging, 20% lying/jumping in front of a moving object, 8% jumping from a height, 7% firearm injury, 4% poisoning, and 2% other methods. Sex differences were significant (p < 0.001) only for firearms being preferably used by boys. The vast majority of firearms used were licensed long-barreled weapons.Conclusion: The number of child suicides in Sweden is relatively low but increasing. Most of the children used a violent and highly lethal method. Prevention of premature mortality is an urgent concern with an emphasis on resolutely reducing the availability of suicide means. What is Known: • Suicide is a significant cause of death globally among children, bringing tragic consequences for young individuals, their family, and the entire society. • Suicide rates and distribution of suicide methods in children differ between countries and settings, but studies of time trends are scarce. What is New: • Increasing number of minors' suicides and the predominance of violent methods emphasize the importance of prevention strategies tailored for a child population. • Even in a setting of very restrictive firearm laws, firearm suicides in children must not be overlooked.

Association Between Means Restriction of Poison and Method-Specific Suicide Rates

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

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

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

BACKGROUND

Previous epidemiological analyses indicated a decreasing trend of suicide rates for 10-19-year-olds in Austria for the period 1970-2001. However, data from the new millennium are missing. This epidemiological update reports on youth suicide in Austria, covering the period 2001-2014 in order to inform suicide preventive interventions targeting adolescents.

METHODS

The data on registered suicides among Austrian minors (10-19 years) and the population size were obtained from Statistics Austria. Chi-squared tests were used to analyze the associations between the suicide methods used and sex, as well as between suicide methods and Austrian federal states. Spearman correlations were calculated to assess time trends in the suicide rates. One-way ANOVA was used to investigate annual suicide rates of age groups 10-14, 15-19, and 10-19 years across the nine Austrian federal states.

RESULTS

The total average suicide rate for Austrian minors was 4.57 per 100,000. The male-female ratio was 3.5:1. The total youth suicide rate and male suicide rate significantly declined from 2001 to 2014, whereas there were no significant changes in female rates. More than one third of suicides among Austrian youth occurred through hanging, whereas jumping in front of a moving object was the second-most common suicide method. A spring peak was found, with most suicides occurring in April and May.

CONCLUSION

Suicide rates among minors in Austria continue to decrease. The present findings help to inform the ongoing implementation of the National Austrian Suicide Prevention Plan (SUPRA).

The influence of reported ADHD and substance abuse on suicidal ideation in a non-clinical sample of young men

This study intended to determine whether former and current ADHD symptomatology is associated with suicidal ideation in a non-clinical sample of 18 year old males. We performed a cross sectional descriptive study of 3280 men during the examination for military service. The investigation included a screening for substance abuse, past (WURS) and current (ADHD symptom checklist) ADHD symptomatology and an interview about suicidal ideations. We found a correlation of suicidal ideations with a history of ADHD symptomatology. ADHD symptoms were strongly consistent over time. These results indicate that a history of (diagnosed or undiagnosed) ADHD could be a predictor for suicidal ideations. Surveying a history of ADHD in primary care might help identify subjects at risk for suicidal tendencies.

Suicidal ideation and temperament: an investigation among college students

BACKGROUND

Suicide is a major health problem accounting for up to 1.5 percent of all deaths worldwide and represents one of the most common causes of death in adolescents and young adults. A number of studies has been performed to establish risk factors for suicide in patients with psychiatric disorders including temperamental features. This study set out to assess the relationship between suicidal ideation and temperament in young adults.

METHODS

A cross-sectional sample of healthy college students (n=1381) was examined using a self-rating questionnaire. Suicidal ideation, social background, educational status, substance abuse, and affective temperament according to TEMPS-M were assessed. Predictors of lifetime suicidal ideation were examined in multivariate logistic regression analyses.

RESULTS

Suicidal ideation was reported by 12.5% of all subjects at some point in their life and was higher in nicotine dependents, youth with alcohol related problems and users of illicit substances as well as in youth with lower educational status. Lifetime suicidal ideation was associated with the anxious, depressive and cyclothymic temperament in both sexes and the irritable temperament in males. These results remained significant after adjustment for smoking status, frequency of alcohol consumption, drug experience and educational status in a multivariate logistic regression analysis.

LIMITATIONS

The use of self-rating instruments always reduces objectivity and introduces the possibility of misreporting.

CONCLUSIONS

Considering the fact that many subjects completing suicide have never been diagnosed with mental disorders it might be reasonable to include an investigation of temperament in screenings for risk of suicide. This might be especially useful for health care professionals without mental health care background.

Predictors of suicidal behavior in a high school student population: a cross-sectional study

AIM

To examine high school students' suicidal behavior and to identify predictors of suicide attempt among adolescents in Timis County, Romania. We hypothesized that suicide attempt is associated with other health-risk behaviors.

METHODS

In this cross-sectional study we included 2908 high school students in grades 9 to 12. The students were asked to complete an anonymous structured questionnaire during a normal class. We examined the relationship between having attempted suicide and engaging in other health-risk or problem behaviors.

RESULTS

During the previous 12 months, 15.4% of the students had had suicidal ideation, 7.5% had made a suicide plan and 6.1% reported that they had attempted suicide. Based on logistic regression multivariate analysis, attempted suicide was associated with feeling sad or hopeless almost every day for two or more consecutive weeks (OR = 4.74; 95% CI: 3.07-7.31), being forced to have sexual intercourse (OR = 3.18; 95% CI: 1.83-5.50), being physically aggressed by his or her father (OR = 4.28; 95% CI: 1.96-9.34), performing poorly at school (OR = 4.22; 95% CI: 1.51-11.74), having an impaired relationship with parents (OR = 2.45; 95% CI: 1.17-5.12), not eating for 24 hours or more to lose weight or to avoid gaining weight during the past 30 days (OR = 2.23; 95% CI: 1.40-3.53), being female (OR = 1.91; 95% CI: 1.21-2.99) and carrying a weapon (OR = 2.44; 95% CI: 1.53-3.90).

CONCLUSION

This study suggests that suicide attempts are associated with other risk behaviors. These behaviors may help to evaluate suicide risk and should be considered when establishing preventive programs.

Completed suicide in childhood

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

Genetics of suicide: a systematic review of twin studies

OBJECTIVES

Convergent evidence from a multitude of research designs (adoption, family, genomescan, geographical, immigrant, molecular genetic, surname, and twin studies of suicide) suggests genetic contributions to suicide risk. The present account provides a comprehensive and up-to-date review of the twin studies on this topic.

METHODS

A total of 32 studies (19 case reports, 5 twin register-based studies, 4 population-based epidemiological studies, 4 studies of surviving co-twins) located through extensive literature search strategies are summarized and discussed here. This literature corpus was published between 1812 and 2006 in six languages and reports data from 13 countries.

RESULTS

A meta-analysis of all register-based studies and all case reports aggregated shows that concordance for completed suicide is significantly more frequent among monozygotic than dizygotic twin pairs. The results of co-twin studies rule out exclusively psychosocially based explanations of this pattern. Population-based epidemiological studies demonstrate a significant contribution of additive genetic factors (heritability estimates: 30-55%) to the broader phenotype of suicidal behavior (suicide thoughts, plans and attempts) that largely overlaps for different types of suicidal behavior and is largely independent of the inheritance of psychiatric disorders. Nonshared environmental effects (i.e. personal experiences) also contribute substantially to the risk of suicidal behavior, whereas effects of shared (family) environment do not.

CONCLUSIONS

The totality of evidence from twin studies of suicide strongly suggests genetic contributions to liability for suicidal behavior. To further research progress in this area, an extensive discussion of design limitations, shortcomings of the literature and further points is provided, including sources of bias, gaps in the literature, errors in previous reviews, age and sex effects and twin-singleton differences in suicide risk, and notes from a history-of-science view.

Surname study of suicide in Austria: differences in regional suicide rates correspond to the genetic structure of the population

OBJECTIVES

There is convergent evidence from adoption, family, geographical, immigrant, molecular genetic, twin and, most recently, surname studies of suicide for genetic contributions to suicide risk. Surnames carry information about genetic relatedness or distance and, in patrilineal surname systems, are a close substitute for Y-chromosome markers and haplotypes, since surname transmission is similar to the transmission of the nonrecombining part of the Y chromosome. This study investigated whether differences in regional suicide rates correspond to the genetic structure of the Austrian population.

METHODS

Differences in district-level standardized suicide rates 1988-94 between the five major surname regions identified for Austria were analyzed. The surname regions used in the analysis reflect the contemporary population structure and closely follow the natural borders found in the topography of Austria, less so its administrative division into nine states.

RESULTS

Surname region accounted for a significant (P < 0.001) and substantial (38%) portion of the variance in district-level suicide rates. Adjusting the suicide rates for a set of five social and economic indicators that are established ecological correlates of suicide prevalence (income, and rates of the divorced, unemployed, elderly and Roman Catholics) left the results essentially unchanged.

CONCLUSIONS

Regional differences in suicide rates within Austria correspond to the genetic structure of the population. The present evidence adds to related findings from geographical and surname studies of suicide that suggest a role for genetic risk factors for suicidal behavior. Genetic differences between subpopulations may partially account for the geography of suicide. Study limitations and directions for future research are discussed.

Suicidal ideation among Viennese high school students

OBJECTIVE

Suicidality spans a spectrum ranging from suicidal thoughts to suicidal acts, and suicidal ideation is more prevalent in youth populations, suggesting important developmental issues. We assessed the prevalence of lifetime suicidal ideation and associated psychosocial factors among Viennese high school students.

METHOD

An anonymous self-report survey assessing demographic characteristics and the major psychiatric risk factors of teenage suicide was completed by students at three Viennese high schools (n = 214; mean age 15.4 years).

RESULTS

Eighty-one (37.9%) high school students reported having had suicidal thoughts at some point in their lives, girls significantly more often than boys (48.5% vs. 29.1%, P = 0.004). Furthermore, lifetime suicidal ideation in Viennese high school students was associated with living in broken-home families, cigarette smoking, substance problems (alcohol/drugs), self-reported depression, and high school type (the highest prevalence was in grammar school). After adjusting for confounders, we found that female gender, substance problems, school type and cigarette smoking were significantly associated with lifetime suicidal ideation in Viennese high school students.

CONCLUSIONS

The psychosocial factors associated with adolescent suicidal ideation require attention in the contexts of suicide prevention and mental health promotion.

Learning by doing: a novel approach to improving general practitioners' diagnostic skills for common mental disorders

INTRODUCTION

Two strategies have been proposed to increase the rather low recognition rate of common mental disorders in primary care: (1) the use of screening instruments and (2) extensive psychiatric training for general practitioners. We have chosen a "middle-of-the-road" approach to teach general practitioners by means of a time-saving psychiatric training programme how to make their own psychiatric diagnoses. This pilot study aimed at assessing the acceptance of this programme, its impact on general practitioners' knowledge of 12 ICD-10 disorders - depressive, anxiety and alcohol-related disorders - and the short-term persistence of the knowledge acquired.

METHODS

The training programme consisted of two 3-hour sessions four weeks apart. An educational instrument, a short interview named TRIPS (Training for Interactive Psychiatric Screening), a shortened and adapted form of PRIME-MD, was used to train single-handed general practitioners in Vienna, Austria. TRIPS had to be used by the participants in daily practice in between sessions. Five weeks after the second training session a follow-up evaluation was held to assess the persistence of the knowledge acquired. The perceived usefulness of TRIPS was assessed by a short questionnaire. Knowledge was assessed by a separate 15-item questionnaire.

RESULTS

Of the 31 participating general practitioners 26 attended all three sessions. There was a significant increase in the mean number of correctly answered questions between baseline (5.5 of 15) and session two (9.8; p<0.0001), and a further increase between the second and the follow-up session (11.3; p<0.05). Also, general practitioners rated TRIPS as a practical and useful tool for family practice and stated that its use met with patients' approval.

CONCLUSION

The format chosen was successful in its intended educational endpoints. According to participants TRIPS is appropriate for the family practice situation and is accepted by patients.

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

OBJECTIVES

Shooting as method of suicide has increased considerably in Austria over recent decades and represented 23.5% of all suicides among men during the period 1990-2000. It is thought that the availability of guns could lead to their use in acts of suicide, and therefore we investigated the numbers of gun licenses (which constitutes ownership of guns and permission to carry a gun) in the nine Austrian counties and their correlation with suicides by shooting and other methods.

METHODS

We studied registered suicides, including the method used, between 1990 and 2000 in Austria and the numbers of gun licenses held in the nine counties of Austria in the same period.

RESULTS

We found a strong correlation between the average gun license rate for the period 1990-2000 and suicides by shooting (r = 0.967), and only very weak correlation, and for some of the years under investigation a negative correlation, with other methods of committing suicide (r = 0.117) and the suicide rate in general (r = 0.383).

CONCLUSIONS

As shooting as a method of suicide has increased in Austria in recent decades, and is a highly lethal method, the finding that the shooting suicide rate is related to the extent of gun ownership deserves attention, especially as there is evidence that restriction of gun ownership is an important factor in suicide prevention.

Suicide in Austrian children and young adolescents aged 14 and younger

INTRODUCTION

Research on suicide in childhood and early adolescence is sparse. We investigated suicide cases of children and young adolescents in terms of prevalence, gender differences, suicide methods and monthly distribution during a period of 32 years.

METHODS

Registered suicides aged 14 or younger occurring between 1970 and 2001 (n = 275) in Austria were studied.

RESULTS

The mean suicide rate for 10 to 14-year-olds was 1.4 per 100,000 with a male-female ratio of 3.1:1. The total child and young adolescent suicide rate and boys' suicide rates decreased over the study period. However, there was no significant fluctuation in girls' suicide rates. Hanging was the predominant suicide method in both genders. Use of this method decreased steadily over the study period, whereas the percentage of suicides by other methods, i.e., jumping and firearms suicides increased. Greater number of suicides in children and young adolescents was observed during the months of April/May and October/November.

CONCLUSION

Suicide rates of children and young adolescents in Austria are on the decrease, in accordance with a reported decrease in the general suicide rate in Austria.