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Menon V, Varadharajan N, Bascarane S, Subramanian K, Mukherjee MP, Kattimani S. Psychological autopsy: Overview of Indian evidence, best practice elements, and a semi-structured interview guide. Indian J Psychiatry 2020; 62:631-643. [PMID: 33896967 PMCID: PMC8052872 DOI: 10.4103/psychiatry.indianjpsychiatry_331_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 05/19/2020] [Accepted: 08/29/2020] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND No review has been attempted, so far, on Indian psychological autopsy (PA) literature. There is also a dearth of interview guides which is at the heart of a PA procedure. MATERIALS AND METHODS Electronic searches of MEDLINE through PubMed, PsycINFO, and Google scholar databases were carried out from inception till February 2020 to identify relevant English language peer-reviewed articles from India, as well as global literature that provided information on best practice elements in PA. Abstracts generated were systematically screened for eligibility. Relevant data were extracted using a predesigned structured proforma, and a semi-structured interview guide was developed. RESULTS A total of 18 original articles, one case report, and three reviews/expert opinion articles which tried to give a description of PA procedure were found from India. Most Indian studies are of suicide PA (SPA), done to assess risk factors associated with suicide. There was a wide variation in reported rates of psychiatric morbidity among suicide decedents, while the other major risk factor for suicide in the Indian setting was stressful life events. An optimal approach to PA involves systematically collecting information from key informants and other sources using a narrative interviewing method, supplemented with psychological measures, and is probably best carried out within 1-6 months after the death. CONCLUSION There have been limited attempts to standardize PA. Most Indian studies use SPA. We propose a semi-structured PA interview guide, suitable for both research and investigational purposes.
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Affiliation(s)
- Vikas Menon
- Department of Psychiatry, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India
| | - Natarajan Varadharajan
- Department of Psychiatry, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India
| | - Sharmi Bascarane
- Department of Psychiatry, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India
| | - Karthick Subramanian
- Department of Psychiatry, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
| | | | - Shivanand Kattimani
- Department of Psychiatry, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India
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Aslan M, Radhakrishnan K, Rajeevan N, Sueiro M, Goulet JL, Li Y, Depp C, Concato J, Harvey PD. Suicidal ideation, behavior, and mortality in male and female US veterans with severe mental illness. J Affect Disord 2020; 267:144-152. [PMID: 32063566 DOI: 10.1016/j.jad.2020.02.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 12/20/2019] [Accepted: 02/06/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND We compared male and female American veterans with schizophrenia or bipolar disorder regarding clinical characteristics associated with lifetime suicidal ideation and behavior. Subsequent mortality, including death by suicide, was also assessed. METHODS Data from questionnaires and face-to-face evaluations were collected during 2011-2014 from 8,049 male and 1,290 female veterans with schizophrenia or bipolar disorder. In addition to comparing male-female characteristics, Cox regression models-adjusted for demographic information, medical-psychiatric comorbidities, and self-reported suicidal ideation and behavior-were used to examine gender differences in associations of putative risk factors with suicide-specific and all-cause mortality during up to six years of follow-up. RESULTS Women overall were younger, more likely to report a history of suicidal behavior, less likely to be substance abusers, and had lower overall mortality during follow-up. Among women only, psychiatric comorbidity was paradoxically associated with lower all-cause mortality (hazard ratio [HR]=0.53, 95% CI, 0.29-0.96, p = 0.037 for 1 disorder vs. none; HR=0.44, 95% CI, 0.25-0.77, p = 0.004 for ≥2 disorders vs. none). Suicide-specific mortality involved relatively few events, but crude rates were an order of magnitude higher than in the U.S. general and overall veteran populations. LIMITATIONS Incomplete cause-of-death information and low statistical power for male-female comparisons regarding mortality. CONCLUSIONS Female veterans with SMI differed from females in the general population by having a higher risk of suicide attempts. They also had more lifetime suicide attempts than male veterans with same diagnoses. These differences should inform public policy and clinical planning.
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Affiliation(s)
- Mihaela Aslan
- VA Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, CT, United States; Department of Medicine, Yale School of Medicine, New Haven, CT, United States
| | - Krishnan Radhakrishnan
- VA Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, CT, United States; College of Medicine, University of Kentucky, Lexington, KY, United States
| | - Nallakkandi Rajeevan
- VA Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, CT, United States; Yale Center for Medical Informatics, Yale School of Medicine, New Haven, CT, United States
| | - Melyssa Sueiro
- Research Service, Bruce W. Carter Veterans Affairs (VA) Medical Center, Miami, FL, United States
| | - Joseph L Goulet
- Yale Center for Medical Informatics, Yale School of Medicine, New Haven, CT, United States; Pain, Research, Informatics, Multimorbidities, & Education Center, West Haven, CT, United States
| | - Yuli Li
- VA Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, CT, United States; Yale Center for Medical Informatics, Yale School of Medicine, New Haven, CT, United States
| | - Colin Depp
- VA San Diego Healthcare System, San Diego, CA, United States; Department of Psychiatry, UC San Diego, La Jolla, CA, United States
| | - John Concato
- VA Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, CT, United States; Department of Medicine, Yale School of Medicine, New Haven, CT, United States
| | - Philip D Harvey
- Research Service, Bruce W. Carter Veterans Affairs (VA) Medical Center, Miami, FL, United States; Department of Psychiatry, University of Miami Miller School of Medicine, Miami, FL, United States.
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Smartphone Applications for Mindfulness Interventions with Suicidality in Asian Older Adults: A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122810. [PMID: 30544738 PMCID: PMC6313610 DOI: 10.3390/ijerph15122810] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 12/05/2018] [Accepted: 12/06/2018] [Indexed: 11/16/2022]
Abstract
Elderly suicide is a rising concern. Despite the advent of mobile technology, there remained a gap in the evidence base as to whether smartphone applications could be used for mindfulness intervention for suicidality in Asian older adults. This paper aimed to review recent research relevant to smartphone applications that could be used in providing mindfulness interventions for suicidality to Asian older adults. The inclusion criteria for this review were papers published in peer-reviewed journals from 2008 to 2018 with the usage of specific search terms, namely, ‘smartphone application’, ‘mobile application’, and ‘mindfulness’, assessed against the inclusion criteria and screened by an experienced Asian clinician to be of clinical utility for mindfulness intervention for suicidality with Asian older adults. Initial search on databases yielded 236 results. A total of 35 full text papers that fit the inclusion criteria were assessed for eligibility and 10 papers were included in the current review. This review highlighted the paucity of rigorous empirically validated research into effective smartphone applications that can be used for mindfulness interventions for suicidality with Asian older adults.
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Schlichthorst M, King K, Turnure J, Sukunesan S, Phelps A, Pirkis J. Influencing the Conversation About Masculinity and Suicide: Evaluation of the Man Up Multimedia Campaign Using Twitter Data. JMIR Ment Health 2018; 5:e14. [PMID: 29449203 PMCID: PMC5832906 DOI: 10.2196/mental.9120] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 12/04/2017] [Accepted: 12/14/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND It has been suggested that some dominant aspects of traditional masculinity are contributing to the high suicide rates among Australian men. We developed a three-episode documentary called Man Up, which explores the complex relationship between masculinity and suicide and encourages men to question socially imposed rules about what it means to be a man and asks them to open up, express difficult emotions, and seek help if and when needed. We ran a three-phase social media campaign alongside the documentary using 5 channels (Twitter, Facebook, Instagram, YouTube, and Tumblr). OBJECTIVE This study aimed to examine the extent to which the Man Up Twitter campaign influenced the social media conversation about masculinity and suicide. METHODS We used Twitter insights data to assess the reach of and engagement with the campaign (using metrics on followers, likes, retweets, and impressions) and to determine the highest and lowest performing tweets in the campaign (using an aggregated performance measure of reactions). We used original content tweets to determine whether the campaign increased the volume of relevant Twitter conversations (aggregating the number of tweets for selected campaign hashtags over time), and we used a subset of these data to gain insight into the main content themes with respect to audience engagement. RESULTS The campaign generated a strong following that was engaged with the content of the campaign; over its whole duration, the campaign earned approximately 5000 likes and 2500 retweets and gained around 1,022,000 impressions. The highest performing tweets posted by the host included video footage and occurred during the most active period of the campaign (around the screening of the documentary). The volume of conversations in relation to commonly used hashtags (#MANUP, #ABCMANUP, #LISTENUP, and #SPEAKUP) grew in direct relation to the campaign activities, achieving strongest growth during the 3 weeks when the documentary was aired. Strongest engagement was found with content related to help-seeking, masculinity, and expressing emotions. A number of followers tweeted personal stories that revealed overwhelmingly positive perceptions of the content of the documentary and strongly endorsed its messages. CONCLUSIONS The Man Up Twitter campaign triggered conversations about masculinity and suicide that otherwise may not have happened. For some, this may have been game-changing in terms of shifting attitudes toward expressing emotions and reaching out to others for help. The campaign was particularly effective in disseminating information and promoting conversations in real time, an advantage that it had over more traditional health promotion campaigns. This sort of approach could well be adapted to other areas of mental (and physical) health promotion campaigns to increase their reach and effectiveness.
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Affiliation(s)
- Marisa Schlichthorst
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia
| | - Kylie King
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia
| | | | - Suku Sukunesan
- Department of Business, Technology and Entrepreneurship, Faculty of Business and Law, Swinburne University of Technology, Melbourne, Australia
| | - Andrea Phelps
- Phoenix Australia, Centre for Posttraumatic Mental Health, The University of Melbourne, Parkville, Australia
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia
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Choo CC, Harris KM, Chew PKH, Ho RC. What predicts medical lethality of suicide attempts in Asian youths? Asian J Psychiatr 2017; 29:136-141. [PMID: 29061412 DOI: 10.1016/j.ajp.2017.05.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 04/06/2017] [Accepted: 05/06/2017] [Indexed: 11/20/2022]
Abstract
This study explores youth suicide attempts in Singapore using multiple databases of comprehensive archival records. Three years of medical records related to suicide attempters (N=666) who were admitted to the emergency department of a large teaching hospital in Singapore were subjected to retrospective analysis. Compared to other age groups, a peak in suicide attempts (n=207) was observed in youths aged between 15 and 24 years old (76.3% females; 23.7% males, mean age=19.30, SD=2.89). The model using recognized risk and protective factors was significant in predicting medical lethality, and correctly classified 62.8% of high lethality cases. Only resolution of precipitant made a unique statistical significant contribution. Analysis was separately conducted for males and females. Implications of the findings are discussed.
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Affiliation(s)
- Carol C Choo
- College of Healthcare Sciences, James Cook University, Singapore.
| | - Keith M Harris
- School of Medicine, University of Tasmania, Australia; University of Queensland, Australia
| | - Peter K H Chew
- College of Healthcare Sciences, James Cook University, Singapore
| | - Roger C Ho
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Abstract
PURPOSE Males feature prominently in suicide statistics, but relatively little work has been done to date to explore whether endorsement of dominant masculinity norms heightens the risk of or is protective against suicidal thinking. This paper aimed to further knowledge in this area. METHODS We used baseline data from 13,884 men (aged 18-55) in the Australian Longitudinal Study on Male Health (Ten to Men) cohort. These men filled in self-complete questionnaires in 2013/14 which covered a range of topics, including conformity to dominant masculinity norms and suicidal thinking. We conducted logistic regression analyses to estimate the strength of association between these two variables. RESULTS After controlling for other key predictors of suicidal thinking, one characteristic of dominant masculinity-self-reliance-stood out as a risk factor for suicidal thinking (AOR 1.33; 95% CI 1.25-1.42). CONCLUSIONS It suggests that one particular element of dominant masculinity-being self-reliant-may place men at increased risk of suicidal thinking. This finding resonates with current theories of how suicidal thinking develops and leads to action. It also has implications for the full gamut of suicide prevention approaches that target males in clinical settings and in the general population, and for our broader society. Further work is needed, however, to confirm the direction of the relationship between self-reliance and suicidality, and to unpack the means through which self-reliance may exert an influence.
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Sher L. Commentary: Help-Seeking Patterns and Attitudes to Treatment amongst Men Who Attempted Suicide. Front Public Health 2016; 4:88. [PMID: 27242982 PMCID: PMC4861817 DOI: 10.3389/fpubh.2016.00088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 04/22/2016] [Indexed: 11/24/2022] Open
Affiliation(s)
- Leo Sher
- James J. Peters Veterans’ Administration Medical Center, Bronx, NY, USA
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- *Correspondence: Leo Sher,
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Bacopoulou F, Petridou E, Korpa TN, Deligeoroglou E, Chrousos GP. External-cause mortality among adolescents and young adults in Greece over the millennium's first decade 2000-09. J Public Health (Oxf) 2013; 37:70-7. [DOI: 10.1093/pubmed/fdt115] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kokkevi A, Rotsika V, Arapaki A, Richardson C. Adolescents' self-reported suicide attempts, self-harm thoughts and their correlates across 17 European countries. J Child Psychol Psychiatry 2012; 53:381-9. [PMID: 21895649 DOI: 10.1111/j.1469-7610.2011.02457.x] [Citation(s) in RCA: 159] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Suicide is a leading cause of death among adolescents in Europe. Self-harm thoughts and behaviours are documented precursors of completed suicide. It is therefore of great importance to investigate the prevalence of suicide thoughts and attempts and their correlates, with the aim of preventing this major life-threatening public health problem. This study provides cross-national European data on self-reported suicidal thoughts and attempts among adolescents. METHODS Data were obtained from 45,806 high school students aged 15-16 years from 17 countries that participated in the European School Survey Project on Alcohol and Other Drugs (ESPAD) 2007 school survey. The standardised methods of the ESPAD survey ensure comparability across countries. Students completed an anonymous questionnaire in their classrooms. The prevalences of suicidal thoughts and attempts are reported as well as their sociodemographic and psychosocial correlates identified in logistic regression. RESULTS The median prevalence of any lifetime self-reported suicide attempt was 10.5% across the participating countries (range 4.1%-23.5%). The median of frequent self-harm thoughts (at least five times) was 7.4% (range 2.1%-15.3%). Suicidal behaviour and thoughts had significant associations with gender, substance use, family integrity and socioeconomic status. Countries with higher prevalence of substance use tended to have a weaker association between substance use and self-reported suicide attempts. CONCLUSION Although self-reported self-harm thoughts and suicide attempts vary in prevalence within Europe, there are common correlates across countries. These have an important impact on understanding the phenomenon of suicide among young people and in guiding prevention.
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Affiliation(s)
- A Kokkevi
- A'Department of Psychiatry, Medical School, Athens University, University Mental Health Research Institute, Soranou tou Efesiou 2, Athens, Greece.
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Hooghe M, Vanhoutte B. An ecological study of community-level correlates of suicide mortality rates in the Flemish region of Belgium, 1996-2005. Suicide Life Threat Behav 2011; 41:453-64. [PMID: 21707729 DOI: 10.1111/j.1943-278x.2011.00047.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
An ecological study of age-standardized suicide rates in Belgian communities (1996-2005) was conducted using spatial regression techniques. Community characteristics were significantly related to suicide rates. There was mixed support for the social integration perspective: single person households were associated with higher suicide rates, while religious participation was unrelated and both immigration and the presence of non-European inhabitants had a negative impact. Deprivation had a positive relation with suicide. Population density had a negative influence on suicide rates. Areas with older populations had higher suicide risks than expected. A spatial contagion effect of neighboring communities was present for men. In the conclusion, hypotheses are presented on why an aging population could be associated with higher suicide rates in the community.
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Affiliation(s)
- Marc Hooghe
- Department of Political Science, University of Leuven, Leuven, Belgium.
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Kaess M, Parzer P, Haffner J, Steen R, Roos J, Klett M, Brunner R, Resch F. Explaining gender differences in non-fatal suicidal behaviour among adolescents: a population-based study. BMC Public Health 2011; 11:597. [PMID: 21794184 PMCID: PMC3160991 DOI: 10.1186/1471-2458-11-597] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2010] [Accepted: 07/28/2011] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND While suicide is the second leading cause of death among young people in most industrial countries, non-fatal suicidal behaviour is also a very important public health concern among adolescents. The aim of this study was to investigate gender differences in prevalence and emotional and behavioural correlates of suicidal behaviour in a representative school-based sample of adolescents. METHODS A cross-sectional design was used to assess suicidal behaviour and various areas of emotional and behavioural problems by using a self-report booklet including the Youth Self-Report. One hundred sixteen schools in a region of Southern Germany agreed to participate. A representative sample of 5,512 ninth-grade students was studied. Mean age was 14.8 years (SD 0.73); 49.8% were female. RESULTS Serious suicidal thoughts were reported by 19.8% of the female students and 10.8% of the females had ever attempted suicide. In the male group, 9.3% had a history of suicidal thoughts and 4.9% had previously attempted suicide. Internalizing emotional and behavioural problems were shown to be higher in the female group (difference of the group means 4.41) while externalizing emotional and behavioural problems slightly predominated in male students (difference of the group means -0.65). However, the total rate of emotional and behavioural problems was significantly higher in the adolescent female group (difference of the group means 4.98). Using logistic regression models with suicidal thoughts or attempted suicide as dependent variables, the pseudo-R2 of gender alone was only 2.7% or 2.3%, while it was 30% or 23.2% for emotional and behavioural problems measured by the YSR syndrome scales. By adding gender to the emotional and behavioural problems only an additional 0.3% of information could be explained. CONCLUSIONS The findings suggest that gender differences in non-fatal suicidal behaviour among adolescents can to a large extent be explained by the gender differences in emotional and behavioural problems during this age.
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Affiliation(s)
- Michael Kaess
- Department of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.
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Petrović B, Kocić B, Nikić D, Nikolić M, Bogdanović D. The Influence of Marital Status on Epidemiological Characteristics of Suicides in the Southeastern Part of Serbia. Cent Eur J Public Health 2009; 17:41-6. [DOI: 10.21101/cejph.a3493] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Burns A, Goodall E, Moore T. A study of suicides in Londonderry, Northern Ireland, for the year period spanning 2000–2005. J Forensic Leg Med 2008; 15:148-57. [DOI: 10.1016/j.jflm.2007.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2007] [Accepted: 08/02/2007] [Indexed: 11/25/2022]
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Houle J, Mishara BL, Chagnon F. An empirical test of a mediation model of the impact of the traditional male gender role on suicidal behavior in men. J Affect Disord 2008; 107:37-43. [PMID: 17707084 DOI: 10.1016/j.jad.2007.07.016] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2007] [Revised: 06/14/2007] [Accepted: 07/11/2007] [Indexed: 11/28/2022]
Abstract
BACKGROUND Men die by suicide three to four times more often than women in Western countries. The adverse impact of the traditional male gender role as well as men's reluctance to seek help are possible explanations of this gender gap, but these hypotheses have not been well documented empirically. METHODS This study compares two groups of men who experienced comparable severely stressful life events during the preceding 12 months: 40 men admitted to hospital emergency following suicide attempts, and 40 men with no history of suicide attempts. Structured interviews were conducted to measure adherence to the traditional male gender role, help seeking behaviour, social support, suicide acceptability and mental health. RESULTS ANOVAS indicated that attempters are more likely to adhere to the traditional masculine gender role and regression analysis revealed that this relationship persists even when the presence of mental disorders is statistically controlled. Sequential regression analysis support the mediation model and show that the effects of the traditional male gender role on suicidal behavior are mediated through protective and risk factors for suicide, namely mental state, help seeking and social support. CONCLUSIONS The traditional male gender role appears to increase the risk of suicidal behavior in men by undermining their mental state and by inhibiting the protective factors of help seeking and social support. This study underscores the importance of encouraging men to seek help.
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Affiliation(s)
- Janie Houle
- Research Centre, Centre Hospitalier de l'Université de Montréal, Centre for Research and Intervention on Suicide and Euthanasia, Université du Québec à Montréal, Canada.
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Payne S, Swami V, Stanistreet DL. The social construction of gender and its influence on suicide: a review of the literature. JOURNAL OF MENS HEALTH 2008. [DOI: 10.1016/j.jomh.2007.11.002] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Oner S, Yenilmez C, Ayranci U, Gunay Y, Ozdamar K. Sexual differences in the completed suicides in Turkey. Eur Psychiatry 2007; 22:223-8. [PMID: 17344031 DOI: 10.1016/j.eurpsy.2007.01.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2006] [Revised: 12/30/2006] [Accepted: 01/08/2007] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to determine whether there is a difference between men and women in terms of suicide age, suicide method and suicide reason in Turkey. This study recruited 17,327 cases that had committed suicide between 1990 and 2000. Of all the cases who committed suicide during a period of 11 years, 61.1% were men, 38.9% women. The highest suicide score fell into the age group 15-24 (P<0.001). The most frequently used methods for suicide were self-hanging (48.2%) and use of firearms (19.2%) (P<0.001). The proportion of those committing suicide taking chemicals (drugs, etc.) was higher in women than in men (P<0.001). The most frequently seen reasons for suicide were illness and (33.8%) unsatisfactory relationships (33.0%) (P<0.001, each one). Women committed suicide much more because of unsatisfactory relationships, whereas for men it was due to illness (20.8% and 14.6%, respectively). There were significant differences between men and women in terms of suicide age, suicide method and suicide reason in Turkey. When evaluating suicide cases it is essential that the differences between sexes be taken into consideration.
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Affiliation(s)
- Setenay Oner
- Department of Biostatistics, Eskisehir Osmangazi University Medical Faculty, 26480 Eskisehir, Turkey.
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Trends of youth suicide in Europe during the 1980s and 1990s – gender differences and implications for prevention. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/j.jmhg.2006.02.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
AIMS Despite recent small reductions in overall suicide rates, rates among those aged 25-44 have remained high. The aim of this paper was to examine the evidence for a link between alcohol misuse/consumption and suicidal behaviour, explore the reasons for this association, and consider the implications for reducing rates of suicidal behaviour. METHODS A medline search was performed to find relevant research evidence. RESULTS There is evidence to suggest alcohol misuse predisposes to suicidal behaviour through its depressogenic effects and promotion of adverse life events, and both behaviours may share a common genetic predisposition. Acute alcohol use can also precipitate suicidal behaviours through induction of negative affect and impairment of problem-solving skills, as well as aggravation of impulsive personality traits, possibly through effects on serotonergic neurotransmission. CONCLUSIONS Effective interventions for problem drinking may help reduce suicide rates. At a public health level, reducing overall alcohol consumption may be beneficial, and the measures shown to be most effective in this regard are those that aim to restrict availability of alcohol.
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Affiliation(s)
- John Brady
- General Adult Psychiatry, Holywell Hospital, 60 Steeple Road, Antrim BT41 2RJ, Northern Ireland.
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Hunt K, Sweeting H, Keoghan M, Platt S. Sex, gender role orientation, gender role attitudes and suicidal thoughts in three generations. A general population study. Soc Psychiatry Psychiatr Epidemiol 2006; 41:641-7. [PMID: 16732400 DOI: 10.1007/s00127-006-0074-y] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/10/2006] [Indexed: 10/24/2022]
Abstract
BACKGROUND Suicide and other suicidal behaviours are markedly (though differently) patterned by gender. The increase in young male suicide rates in many countries has heightened interest in whether suicidal behaviours and ideation (thoughts) are related to masculinity. Relatively little research has explored the relationship between gender role attitudes and orientation and suicidal behaviours and ideation. Most research in this area has been conducted with young people. OBJECTIVE We investigated whether gender role orientation (masculinity and femininity scores) and gender role attitudes were related to the reporting of serious suicidal thoughts in three generations (early adulthood, and early and late middle age) in a community sample. METHODS Subjects (653 men and women aged around 23 years, 754 aged around 43 years, 722 aged around 63 years) completed home interviews with nurses as part of an ongoing longitudinal community-based study of social factors and health. These included measures of suicidal ideation (thoughts), attitudes to traditional gender roles, and a validated measure of gender role orientation (masculinity and femininity scores). RESULTS The prevalence of serious suicidal thoughts was higher in early adulthood (10% men, 15% women) than in early (4% men, 8% women) and late (6% men, 5% women) middle age. In early adulthood only sex was significantly related to suicidal thoughts, with women at higher risk (adjusted OR 1.74, 95% CI 1.01-3.00). In early middle age masculinity scores were negatively related to suicidal thoughts (adjusted OR for each unit increase in score 0.65: 95% CI 0.46-0.93), and more traditional views on gender roles were positively associated with suicidal thoughts (adjusted OR 1.48: 95% CI 1.07-2.04). In late middle age trends were in the same direction as in early middle age, but were not statistically significant. Femininity scores were unrelated to serious suicidal thoughts at any age. CONCLUSION The high rates of suicidal thoughts amongst men and women in early adulthood point to the importance of understanding mental health problems at this age. The results raise a number of questions and suggest that suicide researchers should pay more attention to gender roles and attitudes in older adults.
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Affiliation(s)
- Kate Hunt
- MRC Social and Public Health Sciences Unit, University of Glasgow, 4 Lilybank Gardens, Glasgow, SCO, G12 8RZ, UK
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Rutz EM, Wasserman D. Trends in adolescent suicide mortality in the WHO European Region. Eur Child Adolesc Psychiatry 2004; 13:321-31. [PMID: 15490280 DOI: 10.1007/s00787-004-0406-y] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/22/2004] [Indexed: 11/27/2022]
Abstract
Trends in adolescent suicide rates (15-19 years) from 1979 to 1996 were compared with suicide trends in individuals of 20 years and over in 30 countries and with trends in rates of deaths due to undetermined causes in adolescents in 17 countries of the WHO European Region. In 21 of the 30 studied countries, male adolescent suicide rates increased during the study period (highest increases in Belarus, Kazakstan and Ireland) accompanied by far less increases or decreases in suicide rates of males of 20 years and over. Part of the observed increases in Sweden, Ireland and Greece can be attributed to improved suicide statistics, while increases in Finland, Belgium, Bulgaria and the United Kingdom can be even higher due to the rising classification of deaths as "undetermined". In Portugal, decreasing suicide trends seem to be misinterpreted by ignoring the vast increases in rates of undetermined deaths. Female adolescent suicide rates rose less markedly than in males in 18 countries, with the exception of strong increases in Norway, Ireland. Increases in female adolescent suicide rates were marginally affected by changes in classification practices and were accompanied primarily by declining suicide rates in females of 20 years and over.
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Affiliation(s)
- Ellenor Mittendorfer Rutz
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), 17177 Stockholm, Sweden.
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Pajonk FG, Gruenberg KAS, Moecke H, Naber D. Suicides and suicide attempts in emergency medicine. CRISIS 2003. [PMID: 12500891 DOI: 10.1027//0227-5910.23.2.68] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE In emergency medicine, suicides and attempted suicides represent a major challenge for emergency physicians (EPs) and paramedics, both in terms of psychiatric and somatic treatment. To date no investigations have been performed to determine prevalence rates, method of suicide or attempted suicide, and the problems faced by EPs when treating these patients. This investigation presents a first evaluation of the complete emergency protocols from a major German city focusing on suicide and parasuicide. METHODS A retrospective analysis of all EP protocols from 1995 in the city of Hamburg was performed. All protocols were evaluated with respect to suicide parasuicide and suicidal ideation. Demographic data and information on method of suicide or attempted suicide, severity of illness, and underlying psychiatric disorder were extracted from the protocols. RESULTS A total of 26,347 emergency protocols were evaluated. Suicide and attempted suicide were considered either certain, probable, or possible in 743 cases (2.8%). Suicide was committed in 171 cases and attempted were made by 572 individuals. More men committed suicide in all age groups. By far the highest number of suicide attempts were by young men between 18 and 39 years of age. Hanging was the most commonly used method of completed suicide (41%), followed by jumping from a height (21%). The methods of intoxication with medication (54%) and illegal drugs (17%) clearly prevailed in suicide attempts. Documentation of suicides and attempted suicides was revealed to be unsatisfactory. Underlying psychiatric disorders were scarcely recorded. CONCLUSION In emergency medicine, the incidence of suicide or the attempt to commit suicide is small, yet disturbing. The frequency assessed may be too low as result of methodology. There is a need to improve the education of emergency physicians and paramedics in this area, and there is a need for data to be collected in a prospective design.
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Affiliation(s)
- Frank-Gerald Pajonk
- Department of Psychiatry and Psychotherapy, University Hospital Hamburg-Eppendorf, Germany.
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Abstract
Suicidal behaviour is a major public health problem. There is no one explanatory theory of suicidal behaviour, and various combinations of sociological and biological/medical interventions are required to reduce associated mortality and morbidity. The importance of primary prevention varies from community to community, and may have an impact at the population level. However, individual suicidal persons always require optimum assessment and management and that is usually provided by primary care and emergency physicians. This paper provides an overview of issues to be addressed in the assessment and management of suicidal patients.
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Affiliation(s)
- Robert D Goldney
- Department of Psychiatry, Adelaide University, The Adelaide Clinic, South Australia, Australia.
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Abstract
BACKGROUND The suicide rate in young people in the United Kingdom has increased over the last decade. As there is a paucity of information about the characteristics of young suicides we have undertaken a detailed investigation of suicides in people aged 15-24 years by means of the psychological autopsy approach. METHODS The sample consisted of 27 subjects (25 males, two females) whose deaths received a verdict of suicide (N=24) or undetermined cause (N=3). Information was collected from informant interviews, coroners' inquest notes, medical records and psychiatric case notes. A sub-sample of 22 male subjects was compared with an age-matched sample of male deliberate self-harm (DSH) patients. RESULTS Psychiatric disorders were diagnosed in 19 (70.4%) subjects. These were most commonly depressive disorders (55.5%). Very few individuals were receiving treatment for their disorders. Substance abuse disorders were uncommon but a substantial proportion of individuals had problems with alcohol or drug misuse. Personality disorders were present in 29.6% of subjects and disorders or personality trait accentuation in 55.6%. Comorbidity of psychiatric disorders was found in a third of subjects. The suicides were often the end-point of long-term difficulties extending back to childhood or early adolescence. In addition to mental disorders, relationship and legal difficulties were identified as relatively common contributory factors to the suicides. In comparison to deliberate self-harm patients, male suicides were more likely to use dangerous methods and live alone. LIMITATIONS Several potential informants could not be interviewed and there was no general population control sample. CONCLUSIONS The process leading to suicide in young people is often long term, with untreated depression in the context of personality and/or relationship difficulties being a common picture at the time of death. The prevention of suicide in the young clearly requires multiple strategies.
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Affiliation(s)
- K Houston
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK
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Affiliation(s)
- L Appleby
- School of Psychiatry and Behavioural Sciences, University of Manchester, Withington Hospital, West Didsbury, UK
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