The timing of deliberate self harm behaviour

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

BACKGROUND

Many studies have investigated the impact of a wide range of social events on suicide-related behaviour. However, these studies have predominantly examined national events. The aim of this study is to provide a statistical evaluation of the relationship between mass gatherings in some relatively small urban sub-populations and the general suicide rates of a major city.

METHODS

The data were gathered in the Ukrainian city of Dnipropetrovsk, with a population of 1 million people, in 2005-2010. Suicide attempts, suicides, and the total amount of suicide-related behaviours were registered daily for each sex. Bivariate and multivariate statistical analysis, including negative binomial regression, were applied to assess the risk of suicide-related behaviour in the city's general population for 7 days before and after 427 mass gatherings, such as concerts, football games, and non-regular mass events organized by the Orthodox Church and new religious movements.

RESULTS

The bivariate and multivariate statistical analyses found significant changes in some suicide-related behaviour rates in the city's population after certain kinds of mass gatherings. In particular, we observed an increased relative risk (RR) of male suicide-related behaviour after a home defeat of the local football team (RR = 1.32, p = 0.047; regression coefficient beta = 0.371, p = 0.002), and an increased risk of male suicides (RR = 1.29, p = 0.006; beta =0.255, p = 0.002), male suicide-related behaviour (RR = 1.25, p = 0.019; beta =0.251, p < 0.001), and total suicide-related behaviour (RR = 1.23 p < 0.001; beta =0.187, p < 0.001) after events organized by the new religious movements.

CONCLUSIONS

Although football games and mass events organized by new religious movements involved a relatively small part of an urban population (1.6 and 0.3%, respectively), we observed a significant increase of the some suicide-related behaviour rates in the whole population. It is likely that the observed effect on suicide-related behaviour is related to one's personal presence at the event rather than to its broadcast. Our findings can be explained largely in terms of Gabennesch's theory of the 'broken-promises effect' with regard to intra- and interpersonal conflict and, in terms of crowd behaviour effects.

Seasonal differences in the day-of-the-week pattern of suicide in Queensland, Australia

Various temporal patterns of suicide events, according to time of day, day of week, month and season, have been identified. However, whether different dimensions of time interact has not been investigated. Using suicide data from Queensland, Australia, this study aims to verify if there is an interaction effect between seasonal and day-of-the-week distribution. Computerized suicide data from the Queensland Suicide Register for those aged 15+ years were analyzed according to date of death, age, sex and geographic location for the period 1996-2007. To examine seasonal differences in day-of-the-week pattern of suicide, Poisson regressions were used. A total of 6,555 suicides were recorded over the whole study period. Regardless of the season, male residents of Brisbane had a significantly marked day-of-the-week pattern of suicide, with higher rates between Mondays and Thursdays. When seasonal differences were considered, male residents in Brisbane showed a Monday peak in summer and a wave-shape pattern with a peak on Thursday and a nadir on Saturdays in winter. Whilst males have distinctive peaks in terms of days of the week for summer and winter, females do not show similar patterns.

[Temporal dimensions of suicide: hypothesis]

In this article, the author examines the temporal dimensions of suicide by taking into account the multiple existing approaches-circadian physiology, psychiatric or sociological epidemiology of suicide-however promoting a socio-anthropological perspective. From this perspective, suicide is examined as a social phenomenon inscribed in time. By beginning with a concern that is characteristic of anthropology of time, knowingly the relation between time of nature and time of society, the author addresses a key issue of the study of suicide already elaborated by Durkheim, in the relation between change that is a basic expression of the passage of time and suicide. After presenting different scientific contributions on the subject, the author proposes an hypothesis allowing integration of the influence of time related to natural phenomenon (cosmobiological rhythms) and the relation of time to social phenomenon (politico-economic rhythms) in relation with suicide and this, according to Gabennesch's theory of "failed promises."

Variations in time of hospital presentation for deliberate self-harm and their implications for clinical services

BACKGROUND

Variation in number, characteristics and management of deliberate self-harm (DSH) patients presenting to hospital during the 24-h cycle and day of the week may have implications for patient services. We have investigated how patient characteristics and clinical management of DSH episodes vary according to hour and day of presentation.

METHODS

Time of presentation was studied in 5348 DSH patients who presented to a general hospital following 9101 episodes during a 6-year period. Patient characteristics were identified through routine clinical monitoring.

RESULTS

Presentations varied markedly during the 24-h cycle, ranging from a peak between 8 pm and 3 am (average hourly rate of 6.6% of all episodes) to a low between 4 am and 10 am (1.4%). The majority (72.0%) occurred outside office hours. DSH associated with alcohol use and interpersonal problems was more frequent during the late evening or night, and at the weekend. A greater proportion of daytime presentations involved high suicide intent (although a larger number of high intent acts presented at other times), and more were admitted and assessed.

LIMITATIONS

This study was based on DSH presentations to one hospital. Time and date of presentation and of psychosocial assessment, not time of DSH, were available for analysis.

CONCLUSIONS

Peak times for DSH presentations are at night and the weekend, suggesting that specialist DSH services in general hospitals should be available 24 h a day, 7 days a week. Time of presentation should not be used as a proxy measure of suicide intent.

TPH gene polymorphism and aging: indication of combined effect on the predisposition to violent suicide

Findings relating serotonin to suicidal behavior suggest the role of genes for tryptophan hydroxylase (TPH) in the genetic substrate of this disorder. Association of Tph1 gene and suicidality, despite considerable research efforts, remains controversial. Polymorphism A218C in intron 7 of Tph1 gene was studied in violent suicide victims (N = 247) and controls (N = 320) of Slavic (Croatian) origin, with specific consideration of the influence of subjects' age. The frequency of, allegedly less active, CC genotype was increased in older (above 65 years) victims as compared to controls (P = 0.0126 and 0.0008, for comparison with age-specific and integral control samples, respectively), while there were no differences between victims under 65 years and controls. Excess of the CC genotype in elderly victims of violent suicide points to the possible combined effect of the respective genetic factor and physiological changes during aging on the predisposition to this disorder.