Suicidal childhood deaths with firearms in Antalya, Turkey

The purpose of this study was to determine the characteristics of suicidal childhood deaths with the use of firearms that occurred from 2000 to 2009 in Antalya. The autopsy reports of the Antalya branch of the Turkish Forensic Medicine Council and judicial records were reviewed retrospectively. There were 60 suicidal deaths between 0 and 18 years of age. Firearms were used in 20 cases (11 males, 9 females). The shotgun (n = 15) was the most frequently used weapon. The site of bullet entries were the chest (n = 6), abdomen (n = 5), right temple (n = 5), mouth (n = 2) and neck (n = 2). Most suicides (n = 16) were in the home. In contrast to many other studies, the most frequently used weapon for suicides was the shotgun in this study.

Burn assault with paint thinner ignition: an unexpected burn injury caused by street children addicted to paint thinner

The frequency of assault by burning among all burn patients varies from country to country. Assault by burning, although uncommon, is a serious form of trauma and a significant source of morbidity and mortality. The aim of this retrospective study was to identify the epidemiologic features, current etiological factors, and the mortality of nine patients admitted to our burn unit between January 1999 and January 2009 after unexpected burn assault by paint thinner ignition caused by street children addicted to paint thinner. The circumstances of this injury and preventive measures are discussed.

Testing the length of time theory of recall decay: examining substance use report stability with 10 years of national longitudinal survey of youth data

AIM

This article examines whether the proportion of recanters increases (or decreases) as a function of time o test length of time theory.

SAMPLE

2,221 US respondents in the National Longitudinal Survey of Youth child data. Bivariate and logistic regression analyses were used.

RESULTS

Among recanters, 50% of cigarette and alcohol users recanted use by 4 years, and 50% of marijuana users recanted by 3 years. Predictors of recanting was being Black or Hispanic and younger age. The theory was not supported. Further research is needed to identify potential reasons why adolescents recant their use is such a short time span. The study's limitations are noted.

Time patterns of inpatient suicides

Abstract Objective. Time patterns of suicides have been investigated in many population-based studies, but there are no studies exploring time patterns of suicides during psychiatric inpatient stay up to now. Methods. All inpatient suicides (1998-2007) of a psychiatric university hospital were identified by the German psychiatric basic documentation system (DGPPNBADO). Descriptive and univariate analyses were performed to analyse time patterns of inpatient suicides. Results. No significant differences could be found for the occurrence of the 37 inpatient suicides due to season (χ(2)=1.595, P=0.696), month (χ(2)=4.838, P=0.958) or weekday (χ(2)=5.189, P=0.550) of suicide. Furthermore, we could not find an unequal distribution of suicides due to month of birth (χ(2)=12.622, P=0.337). 78.4% of inpatient suicides occurred within 50 days after admission. Fourteen inpatients committed suicide around public holidays, two around their birthday. Conclusions. Apart from a notably enhanced risk of suicide in the period after admission, we could not find any time patterns to be of high relevance to inpatient suicides. There may be more relevant risk factors than cyclic or temporal variations.

Suicidal and homicidal deaths: a comparative and circumstantial approach

The incidence of suicide and homicide is on the increase worldwide, including India. One million people die annually due to suicides and homicides alone. A comparison of the results between suicides and homicides was performed. From a total of 5773 medicolegal deaths reported at an Apex medical centre of Nagpur University over a period of three years 1998-2000, only 241 cases (4.2%) were homicidal deaths in comparison to 1127 cases (19.5%) of suicidal deaths with suicide rate of 23.1/100,000 per year and homicide rate of 4.9/100,000 per year. Poisoning, burning, hanging and drowning forms the major methods of suicide in contrast to blunt trauma, sharp trauma, burning, and strangulation in homicide. Combined methods were more common in homicide as compared to suicide. Predominance of male was present in all methods of suicide and homicide, except burning. In general, male predominance was seen in both suicidal and homicidal deaths with peak age 21-30 years in suicides in contrast to 31-40 years in homicides. At younger age 11-20 years, the victims of suicide outnumbered the victims of homicide; but at extremes of ages below 10 years and above 60 years, homicides were relatively more common than suicides. Married victims were predominant in both types of deaths. Quarrel and revenge were the common precipitating cause/motive for homicide in comparison to chronic illness and mental illness for suicide. Majority of the accused were having close family relationship with the victims of suicide in contrast to homicides in which most of the assailant were having no family relationship with the victims. 'Acquaintance' were the accused in majority of the victims of homicides in contrast to 'self' in suicides. Most of the victims of homicide were killed outdoor in contrast to victim's own domicile in suicides. In both suicidal and homicidal deaths, most of the victims were found in summer season, but the peaks were noticed in the months of April and May in suicidal deaths and October in homicidal deaths.

Suicide in India: a four year retrospective study

Suicide is one of the ten leading causes of death in the world, accounting for more than a million deaths annually. The purpose of the study was to identify the risk groups. In the four-year period from January 2000 to December 2003, 588 suicide victims were autopsied. Information was obtained by interviewing the acquaintances of the victim, perusal of hospital records and the autopsy findings. All the cases were analyzed as to sex, age, and methods of suicide, seasonal variation, diurnal variation and other sociological aspects. The present study depicts a suicidal rate of 11.76 per 100,000 population. Males and females were almost equally the sufferers. The largest number of victims were found in the age group of 21-30 years. Hanging and poisoning constituted the two major modes of suicides (63%). Majority of the victims were mentally sound, married and were from rural background. Victims were mostly drawn from low socioeconomic status (48%). Less educated or illiterates were usually the victims. Suicidal note was detected in 5% of cases. Suicidal tendency and alcohol intake could not be encountered in most of the cases. Indoor incidence was almost double of the outdoor incidence, mostly seen in rainy season (43%) and occurred almost equally during day and night. Financial burden (37%) and marital disharmony (35%) were the principal reasons for the suicide.

Epidemiology of Suicide by Hanging in Transkei, South Africa

To describe the epidemiology of suicide by hanging, in Transkei region of South Africa. This is a record review of the autopsy register from 1993 to 2003. There is an increasing trend of hangings from 5.2 per 100,000 to 16.2 in 2003. The highest was in the 20- to 29-year age group. The least number of hangings of 2.2 per 100,000 was in those over 70 years of age. Males (86.4%) outnumber females. The ratio of male to female suicide is 6.4:1. The 2 youngest suicide victims were also males aged 9 years. Peak of these hangings is in May and November and least in September. There is increasing trend of hanging especially among young adults between 20 and 29 years old.

Suicide in Blantyre, Malawi (2000-2003)

In an attempt to identify at risk individuals, we analysed available information for individuals who committed suicide in Blantyre, Malawi. A retrospective audit of suicides autopsied at the Queen Elizabeth Central Hospital and the University of Malawi College of Medicine mortuaries between January 2000 and December 2003 was analysed by age, sex, residential location, and mode of suicide. Eighty-four suicide cases (65 males, 19 females) represented 17% of all autopsies. The major mode of suicide in Blantyre was chemical poisoning using an agricultural pesticide, accounting for 66 cases (79%)-49 males (76%), 17 females (89%). There were no cases of poisoning by therapeutic medicines, self-immolation or incised wounds. The majority of cases were from one major urban area, Limbe, and one peri-urban area, Chileka. The demographics of suicide in Malawi differ from those reported for other African countries (e.g., lower proportion of females, no use of therapeutic medicine in poisoning, few gunshots). This audit highlights a need for investigations into the sale and use of agricultural pesticides. A prospective study of social and demographic factors around suicide should be undertaken to target groups at highest risk.

A study on the incidence of suicide by hanging in the sub-region of Transkei, South Africa

BACKGROUND

Transkei is a former black homeland in South Africa. It is a historical place and well known for spearheading the freedom fight of South Africa because most of the African National Congress leaders are from this region. It was therefore deprived of development by the apartheid government and is now a poverty stricken area. Transkei is characterized by the lack of infrastructure, and hence a, high rate of unemployment. The majority of individuals are dependent on either the income of migrant mineworkers or subsistence farming at home.

OBJECTIVE

To estimate the incidence of suicides in the sub-region of Transkei.

METHOD

This is a retrospective record review of deaths due to hanging during the period of January 1993-December 2000 at the Umtata General Hospital. All medico-legal autopsies were recorded in a register at the mortuary. The names, addresses, age, and causes of deaths are found recorded in the register. The catchment areas of these autopsies are Umtata and Nqgeleni magisterial areas which have a population of about 300,000. All autopsy records were collected and analyzed manually.

RESULTS

There has been an increasing trend of hanging since 1993, with an overall suicidal death rate increasing from 23.7 per 100,000 in 1993 to 38.6 per 100,000 in 2000. It is observed to be higher in November 32 (13%) and least in September 12 (5%). Over half the deaths 32 (51%) due to hanging were young adults (16-30 years) and 8 (13%) adolescents less than 15 years of age. Twelve (19%) deaths were 31-45 year olds and 5 (7%) were over 61 years.

CONCLUSION

There is increasing incidence of deaths due to hanging in Transkei. Nearly two-thirds of them were young adults less than 30 years.

RECOMMENDATION

Suicidal tendency in terms of young adults is emerging as an important mental health issue that needs to be addressed. There is need of a well-planned prospective study to be carried out in Transkei.

Changing patterns of female suicide: 1986–2000

A study was undertaken of the rates and methods of female suicide observed at the Forensic Science Centre in South Australia over a 15 year period from 1986 to 2000. A total of 609 cases of female suicide were found (age range= 13-88 yrs; mean= 44 yrs), with 249 drug overdoses, 114 hangings, 100 deaths due to carbon monoxide (CO) toxicity, 40 drownings, 35 firearm deaths and 71 miscellaneous deaths (including deaths due to self-immolation, jumping from heights and incised wounds). The most common age range was 26-50 yrs in all categories except for drowning where victims tended to be older. While overall suicide rates in females remained unchanged, with no changes in the rates at different ages, significant increases in hanging and CO deaths occurred over all age groups (p < 0.05), with significant falls in drug overdose deaths in the 10-25 year age group (p < 0.01), and significant overall falls in suicides due to gunshot wounds (p < 0.05). No changes were observed in female suicides due to drowning. This study has demonstrated, therefore, that although no changes in overall suicide rates for females occurred, there have been alterations in the types of methods being used. Although drug related deaths remained the largest category, hanging deaths, which were once uncommon in females, have increased markedly.

Suicidal deaths in childhood and adolescence

Suicide has been reported as the second or third most common cause of death in children and adolescents worldwide. In this study, cases of under the age of 19 years submitted to the Institute of Forensic Medicine, First Specialization Board between 1996 and 2000 as suicides by the Board were evaluated retrospectively. The cases included in this study were the cases bearing locally questionable components, so had been submitted to the evaluations by the Board in order to eradicate the doubts. A total of 43 cases were investigated regarding age, gender, cause of death, manner of death, place of death, time of death, and the risk factors. Of the 43 cases evaluated, 31 cases were female and 12 cases were male. The notable suicide method was found to be firearms. Although it was clear that that not all of the suicide cases in this age group had been submitted to the Institute of Forensic Medicine, the most striking result of this study, nevertheless, was that girls constituted the 72% of suicidal deaths in this age group.

Suicide in children and adolescents at a province in Turkey

Despite the well-documented increases in the rate of completed suicide among children, accurate knowledge of the characteristics of these suicides is limited. We examined all suicides by children and adolescents in Diyarbakir during 1999 and 2001. All of the cases were analyzed regarding the age, sex, method and location of suicide, time of year, and predictive factors. There were 56 children aged 11 through 19 years. Adolescents between 15 and 19 years of age constituted the overwhelming number (87%) of all the childhood suicides. Female children and adolescents predominated among the suicide victims (71%). The most frequent means of suicide were firearms (43%), hanging (28%), and jumping (16%), respectively. The majority of suicides occurred at the decedent's home (88%). Reasons identified were mainly psychiatric disorders, followed by troubles within the family. A prior suicide attempt or a note that was left by the decedent and elucidated the reason for the suicide was rare. There was no seasonal difference in rates of suicides.

Seasonal distribution of suicide in alcoholism

OBJECTIVE

To investigate the seasonal distribution of suicide in alcohol dependence and to make a comparison with unnatural death in alcoholism and suicide in other diagnostic groups.

METHOD

Multiaxial ratings of all patients admitted to the Department of Psychiatry in Lund enabled the selection of patients with alcohol dependence (n=1312) during 1949-1969. When followed up to 1997 a total of 102 (99 men) alcoholic patients had taken their own life. Reference groups were patients with severe depression and autopsy cases with other diagnoses.

RESULTS

The alcoholic patients showed a peak during the second quarter of the year (34%, P < 0.05). Other diagnostic groups of suicide and unnatural death in alcoholism did not show any overrepresentation in the spring.

CONCLUSION

Male alcoholics showed a spring peak of suicide as opposed to other diagnostic groups.

Suicide in children, adolescents and young adults

As suicides of children, adolescents and young adults occur very seldom and only few case reports and more comprehensive studies are available in forensic literature, the autopsy records of the Bonn Institute of Forensic Medicine and the database of the Bonn police authorities from 1989 to 1998 were retrospectively analysed for this phenomenon. This search revealed 37 respective suicides involving 23 male (62%) and 14 female (38%) victims. The ages ranged from 10 to 21 years with the prevalence sharply increasing in adolescents and young adults. Independent from sex, the victims almost unexceptionally applied hard suicide methods like hanging, running over by a train or jump from the height. As for the psychological background, current conflicts with a sweetheart, within the family or at school on the background of mental illness or chronically disturbed family structures were encountered as prevailing factors.