Trends in Adult Parasuicide in an Urban Environment

This study reports on a cohort of 389 adult in-hospital parasuicides. The female to male ratio was 2,5:1,3. Age peaked between 20–29 years with a decline corresponding with age advance. An increase in and a lowering of age in parasuicide were found. Most patients were married and had a history and family history of psychological problems including inordinate drug/alcohol consumption. Self-poisoning by overdose predominated, with benzodiazepines, antidepressants, and non-narcotic analgesics being most common. A sex-linked difference in choice of method was evident. Adjustment disorders with depressed mood associated with interpersonal problems with a key person, substance abuse and social problems, and affective disorders were the most common psychiatric diagnoses. Increased subintentional parasuicide numbers were found. Results are discussed in terms of the implications these findings have for a clearer understanding of parasuicidal behaviour.

Family Characteristics of Indian Parasuicide Patients: A Controlled Study

In this article a controlled study of the family structure of a South African Indian parasuicide population is described. Twenty subjects from a local general hospital were scored on the Suicidal Intent Scale (SIS) and the Family Assessment Device (FAD). Twenty matched medical patients without a history of parasuicide were selected from the same hospital as a control group. They were matched for age, sex, educational standard, ethnic group and socio-economic status. All subjects were scored on the Family Assessment Device (FAD). Subjects from both groups were re-tested between six to eight weeks after the initial assessment. Analyses of variance indicated significant differences between the two groups on indicators of family interactional pathology. This seems to be compounded by family stresses emanating from socio-cultural transition. The results of the study support the view that family therapy should be implemented in the treatment of parasuicide. The unique population under study provides cross-cultural data relevant to parasuicide research and invites possibilities for further investigation.

Cross-Cultural Indicators of Help-Seeking Behaviour in Aggressive General Hospital Patients

In this study the authors researched cross-cultural identification of aggressive behaviour disturbances as identifying factors for patients' family members to seek professional help for the patients. Patients ( N = 40), mainly Zulu-speaking were drawn from the outpatient clinic of a large academic general hospital. In all 23 (57,5%) of the patients and 25 (62,5%) of the relatives were urbanized. A comparison was made between what the patients' families considered problematic as opposed to formal professional diagnostic and aetiological considerations in the same patients. Several trends emerged from the results. It was demonstrated that the behavioural disturbances formed the most important set of identifying criteria for the family of the index patient. It held true for people in various stages of urbanization. Cognitive, mood and perceptual disturbances were of a lesser identifying value to families. Predictably, there were some differences between urban and rural families. Rural families were more attuned to the patient's problems but generally remained more tolerant of the aggressive behaviour and were less ready to seek professional help. These findings, some known from clinical observations and anecdotal communications, have seldom been objectively analysed — particularly in Africa. Implications for management, along with various related cross-cultural issues, are discussed.