Beck Suicide Intent Scale Research Articles

Sociodemographic profile and intention of deliberate self-harm among patients admitted in a tertiary care hospital, Chittagong, Bangladesh

Introduction: Deliberate self-harm (DSH) is an act with nonfatal outcome, in which an individual deliberately initiates a nonhabitual behavior that, without intervention from others, will cause self-harm, or deliberately ingests a substance in excess of prescribed or generally recognized therapeutic dosage. Here, the objective of the present study was to demonstrate the sociodemographic profile and intention of DSH in our context. Methods: This prospective observational study was done during 1 year. A total of 51 cases were recruited. Sociodemographic data were collected and intension to DSH was assessed using Beck's Suicide Intent Scale. All patients were followed up until discharge, and data were analyzed using the SPSS-20. Results: Among all 51 cases female were the most common 48 (94.1%), Muslims were more 41 (80.4%), 31 (60.8%) were from urban origin, most were homemaker, 20 (39.2%) were single, 16 (31.4%) were poor, and most were at age group

A study of psychosocial factors in attempted suicides attending a tertiary care hospital in Kanchipuram, South India

Introduction: Suicide attempt is a self-injurious behavior with a non-fatal outcome. An insight into psychosocial factors and methods used can be used to device effective preventive strategies. Aims: The aim is to study the psycho-social factors and to find the frequency of different methods used in attempted suicides. Materials and Methods: This study is a descriptive, cross-sectional, hospital-based analysis of attempted suicides. 44 consecutive attempted suicides admitted in the emergency ward and referred to the Psychiatry department were taken into the study. A Semi-structured intake Performa consisting of socio-demographic data, detailed history of current suicide attempt, and access to means were noted. MINI (Mini International Neuropsychiatric Interview), Hamilton Depression rating scale, Beck's suicide intent scale, and Barratt's impulsiveness scale were used to screen the patients. SPSS 20 was used for statistical analysis. Results: In the study it was found that majority of people who attempted suicide were of young age, females, married, fully employed, belonged to class IV socioeconomic status and attempts were made equally during day and night. The most common method was drug-overdose followed by poisoning with Organo-Phosphorous compounds. Mental illness was found only in 34% individuals, of which most common was depression. And one-fourth of the individuals had contact with General Practitioner within one month of the suicide attempt. Conclusion: The need for psycho-education and social skills training in adolescents and young adults is implicated in the study. Awareness among the general physicians about suicide prevention would help in bringing down the number of attempts as would strict control of, over the counter drugs and storage of organo-phosphorous compounds. Keywords: Suicide, Methods, Depression, Drug overdose.

Correlates of suicide and temporal variations in subjects with suicide attempt

BACKGROUND: Suicide Attempt is a self-inflicted, potentially injurious behavior with a nonfatal outcome for which there was evidence of intent to die. Life changes could act as a stressor causing enhanced susceptibility for suicidal risk. Suicide is a complex public health problem due to interactive social, cultural, biological and psychological risk factors. AIM: To study suicide intent and it's association stressful life events in subjects with suicide attempt. MATERIAL AND METHODS: The study was cross-sectional, non-interventional study which included 102 patients. Semi-structured Performa including socio-demographic and clinical history details, Presumptive Stressful Life Events Scale (PSLES) [Singh et al., 1984] was used for assessment of psycho-social and adverse life events and Beck suicide Intent Scale was used for assessment of suicide intent. Data obtained was analyzed using appropriate statistical tool. RESULTS: Statistically significantly higher suicide intent was present in males (P = 0.001), age group 31-45 years (P = 0.043), Earning group (P = 0.008), family income CONCLUSION: Male gender in age group 31-45 years had higher suicide intent The earning group had higher suicide intent as compared to non earning group. Higher suicide intent was present in subjects having positive family history of suicide and history of prior suicide attempt. Study reported strong co-relation between Stressful life events and suicide intent score. Stressful life event score was significantly higher in subjects having psychiatric illness and past history of suicide attempt.

Impulsivity Kills Some Who Did Not Plan to Die by Suicide: Evidence From Chinese Rural Youths.

This study aimed to compare the mental disorders, psychological factors, and suicidal intent between high- and low-impulsivity Chinese rural young suicides. Rural young women and men aged 15 to 34 years who died by suicide and various risk factors were examined. The data were obtained using psychological autopsy method with instruments as Dysfunctional Impulsivity Scale, the Structured Clinical Interview for DSM-III-R, Beck Hopeless Scale, Social Support Index, Coping Response Inventory, Hamilton Depression Rating Scale, and Beck Suicide Intent Scale. Compared with low-impulsivity suicides, the high-impulsivity suicides were younger, had less mental disorders, owned less social support, scored lower on approach coping and higher on avoidance coping, and scored a lower score on the Suicide Intent Scale. Characteristics of high-impulsivity suicides differed significantly from low-impulsivity suicides in rural China. It was important to develop different prevention and intervention strategies to reduce the suicide rate in China.

Electrodermal reactivity and suicide

Electrodermal Activity (EDA) refers to changes in electrical conductance of the skin. Electrodermal hyporeactive individuals are those who show an unusual rapid habituation to identical non-significant stimuli. Previous findings suggested that electrodermal hyporeactivity has a high sensitivity and a high negative predictive value for suicide. The aim of the present study is to test the effectiveness and the usefulness of the EDOR® (ElectroDermal Orienting Reactivity) Test as a support in the suicide risk assessment of depressed patients.One thousand five hundred and seventy three patients with a primary diagnosis of depression, whether currently depressed or in remission, have been recruited at 15 centres in 9 different European countries. Depressive symptomatology was evaluated through the Montgomery-Asberg Depression Scale. Previous suicide attempts were registered and the suicide intent of the worst attempt was rated according to the first eight items of the Beck Suicide Intent Scale. The suicide risk was also assessed. During the EDOR® Test two fingers are put on gold electrodes and a moderately strong tone is presented through headphones now and then during the test. The EDOR® Test is able to register the electrodermal responses to those tones, along with the blood volume in the fingers. Each patient is followed up for one year in order to assess the occurrence of suicidal behaviors.Expected results would be that patients realizing a suicide attempt with a strong intent or committing suicide should be electrodermally hyporeactive in most cases and non-hyporeactive patients should show only few indications of death intent or suicides. Preliminary findings will be presented.Disclosure of interestThe participating centres received funding for this study by EMOTRA AB, Sweden.

EUDOR-A multi-centre research program: A naturalistic, European Multi-centre Clinical study of EDOR Test in adult patients with primary depression

BackgroundElectrodermal reactivity has been successfully used as indicator of interest, curiosity as well as depressive states. The measured reactivity depends on the quantity of sweat secreted by those eccrine sweat glands that are located in the hypodermis of palmar and plantar regions. Electrodermal hyporeactive individuals are those who show an unusual rapid habituation to identical non-significant stimuli. Previous findings suggested that electrodermal hyporeactivity has a high sensitivity and a high specificity for suicide. The aims of the present study are to test the effectiveness and the usefulness of the EDOR (ElectroDermal Orienting Reactivity) Test as a support in the suicide risk assessment of depressed patients and to assess the predictive value of electrodermal hyporeactivity, measured through the EDOR Test, for suicide and suicide attempt in adult patients with a primary diagnosis of depression.Methods and design1573 patients with a primary diagnosis of depression, whether currently depressed or in remission, have been recruited at 15 centres in 9 different European countries. Depressive symptomatology was evaluated through the Montgomery-Asberg Depression Scale. Previous suicide attempts were registered and the suicide intent of the worst attempt was rated according to the first eight items of the Beck Suicide Intent Scale. The suicide risk was also assessed according to rules and traditions at the centre. The EDOR Test was finally performed. During the EDOR Test, two fingers are put on gold electrodes and direct current of 0.5 V is passed through the epidermis of the fingers according to standards. A moderately strong tone is presented through headphones now and then during the test. The electrodermal responses to the stimuli represent an increase in the conductance due to the increased number of filled sweat ducts that act as conductors through the electrically highly resistant epidermis. Each patient is followed up for one year in order to assess the occurrence of intentional self-harm.DiscussionBased on previous studies, expected results would be that patients realizing a suicide attempt with a strong intent or committing suicide should be electrodermally hyporeactive in most cases and non-hyporeactive patients should show only few indications of death intent or suicides.Trial registrationThe German Clinical Trials Register, DRKS00010082. Registered May 31st, 2016. Retrospectively registered.

A gender-specific analysis of suicide methods in deliberate self-harm

Background: Deliberate self-harm (DSH) is a major public health concern. Gender differences in suicide methods are a controversial realm with various regional and cultural variations. This study compared and assessed the methods used in DSH attempters as undertaken by men and women, and investigated the possible role of gender and other clinical variables in the selection of suicide method. Materials and Methods: Two hundred subjects fulfilling the inclusion and exclusion criteria were recruited in the study. The sociodemographic details were recorded in the semi-structured pro forma. Detailed assessment of psychiatric morbidity and DSH was done by clinical interview and validated by Mini International Neuropsychiatric Interview-Plus 5.0 and Beck Suicide Intent Scale. Data were analyzed using SAS version 9.2 and SPSS version 17.0. The sample was disaggregated by gender to compare the known correlates of suicide risk on the two most common methods of suicide – poison consumption and drug overdose using multivariate analyses. Results: The analysis revealed that majority of the attempters were in the age group of 11–40 years (91%). Females (63%) outnumbered males (37%); poisoning was the most common type of method (50.5%), followed by drug overdose (35%). There were no statistical differences between the two genders with respect to other sociodemographic variables. Males from urban/semi-urban background (odds ratio [OR] = 4.059) and females living alone (OR = 5.723) had high odds ratio of attempting suicide by poison consumption. Females from urban/semi-urban background (P = 0.0514) and male subjects from nuclear families had an increased odds ratio (OR = 4.482) to attempt suicide by drug overdose. There were no statistical differences when the two genders were compared for other variables such as intentionality, lethality, impulsivity, and number of attempts. Conclusions: It appears that gender differences among DSH attempters appear less pronounced in the Indian setting compared to the worldwide literature on the subject. Nevertheless, the unique, gender-specific characteristics pertaining to DSH attempters in our population emphasize the need for gender-specific interventions in future clinical treatment.

Intérêt de la mesure de la létalité perçue par le patient après une intoxication médicamenteuse volontaire

ObjectivesAims of this preliminary study were to assess characteristics of expected lethality by the patient at the time of a deliberate self-poisoning, and relationship between expected lethality and recurrence of suicidal related behaviour. Materials and methodsWe included 124 consecutive cases in a prospective study and descriptive data including Beck Suicide Intent Scale (SIS) and medical lethality score. In response to “how dangerous did you think the drugs were when you took them?” patients rated on a Visual Analog Scale (VAS) from 0=would be harmless, to 10=certain to cause death. The follow-up took place 32–38 months after the patients were discharged. ResultsOf 106 patient included, 70 were women. First-ever attempter were 31%. Fifteen per cent of the cases were medically serious. VAS mean score was 51mm (SD 26; CI 95%: 47–56), median 51.5mm (IQ 35.5). Median score was higher for men (59mm; P=0.02). High VAS scores (i.e. higher than median score) were associated with a premeditated behaviour (OR 29; P<0.0001), when low VAS scores were associated with impulsive behaviour (P<0.0001). There was no association between VAS and medical lethality (P=0.19). SIS scores were low (mean score 8.6, SD 5.3). Three factors were extracted from a factorial analysis of the SIS. Correlations between VAS and SIS, and VAS and first factor patient's subjective thoughts F1 conception were strong (rhôs=0.77, P<0.0001; rhôs=0.78, P<0.0001), when only moderate between VAS and F2 preparation of the behaviour second factor (rhôs=0.50, P<0.0001), and weak between VAS and F3 precaution against discovery third factor (rhôs=0.18, P=0.05). Fifty-seven of the index cases were followed by a further episode of suicide related behavior. We found no evidence of relationship between recurrence and expected lethality scores (P=0.80) for either men (P=0.54) or women (P=0.54), with the exception of first-ever attempter subgroup (P<0.01) where a high score was associated with recurrence (OR 5.6; P=0.01). ConclusionExpected lethality scores determined distinct populations in terms of suicidal intent and impulsivity of the behaviour. The very good acceptability of the measure and its ease to use could give it a place as part of the clinical assessing process of subjective dimension of the wish to die. For researchers this measure could help to better determine suicide related behaviours subgroups and to make comparisons between studies easier.

Profile of Young Suicide Attempt Survivors in a Tertiary Care Hospital in Puducherry.

Context:Puducherry has the highest suicide prevalence rate in India by 2014, predominantly among the 14–30 years age group.Aims:The aim of the present study is to study the characteristics of adolescent and youth suicide attempters in Puducherry and measure the suicide intent.Settings and Design:An observational study of 6 months duration was conducted in the Department of Psychiatry, at Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India.Materials and Methods:Modified version of World Health Organizations SUicide PREvention Multisite Intervention Study on Suicidal questionnaire was used to collect sociodemographic data and Beck's suicide intent scale was used to measure the suicide intent scores. International Classification of Diseases-10 was used for diagnosis.Statistical Analysis:Statistical Package for the Social Sciences version 13 was used for descriptive analysis and correlation statistics. P value was set as <0.05.Results:Of 56 eligible participants, 40 formed the sample, their mean age was 18. 13 (±2.50), more females (1.1:1), rural, literate, lower socioeconomic status (67.5%), mostly single (90%), living in nuclear (95%), and Hindu (87.5%). One hundred percent had psychosocial stressors before suicide attempt. Acute stress disorder/adjustment disorder was the most common diagnosis. Emotionally unstable and anankastic personality traits were seen in 12%. Pesticide ingestion (45%) was the most common suicide method. Sixty percent attempted suicide within <30 min of suicidal contemplation. Statistical associations were found between the alleged purpose, seriousness, attitude toward living/dying, conception about medical rescuability, and the overall suicide intent.Conclusions:Adolescent and youth suicide attempts occur due to psychosocial stressors rather than due to the past or on-going mental health disorders with above personality traits suggest poor coping skills and resilience taken to deal with stressful situations by younger people.

Suicide and self-harm related internet use in patients presenting to hospital with self-harm: a cross-sectional study

BackgroundEvidence that the internet might be being used in planning suicidal acts, promoting suicidal behaviour, and accessing help, adds a new dimension to suicide prevention. Yet research into the frequency and type of internet use before suicide is lacking. We investigated self-harm related to internet use among patients who presented to hospital with self-harm. MethodsData on self-harm presentations to the emergency departments of an adult hospital (Jan 1, 2013, to Dec 31, 2015) and a children's hospital (Sept 1, 2013, to Nov 30, 2015) in a large city in the South West of England were obtained from a local self-harm surveillance register. Patients who had psychosocial assessments (65% of adult and 82% of children's hospital presentations) were asked during the assessment about internet use associated with their presentation. Beck Suicide Intent (BSI) scale was used to assess suicidal intent. Multivariable logistic regression models were performed to investigate the association between internet use and sociodemographic characteristics, clinical characteristics, and repeat presentation within 6 months. The self-harm register has ethics approval. Findings1192 first presentations to the adult hospital (mean age 35 years, SD 14·7) and 312 to the children's hospital (14, 1·1) had data recorded about internet use, age, and sex. Prevalence of self-harm related to internet use was 8·4% (n=100) among adult presentations (8·9% men, 8·0% women) and 26·0% (n=81) among children's presentations (26·3% boys, 25·9% girls). In both samples, self-harm related to internet use was associated with high intent (BSI >8) (odds ratio for adults 2·6, 95% CI 1·6–4·4; children 2·0, 0·9–4·3) but not repeat presentation (0·9, 0·5–1·8; 0·6, 0·2–1·3). InterpretationThe findings indicate that self-harm related to internet use is likely to become increasingly relevant as the internet-native generation matures and might be a proxy marker for intent. The inclusion of questions about internet use in clinical self-harm assessments could provide an alternative means by which to explore complex issues. More generally, assessments may require updating in light of technological advancements. However, further research, which differentiates between types of internet use and explores the impact of asking about internet use, is necessary. FundingNone.

Validation of a Spanish version of the Columbia-Suicide Severity Rating Scale (C-SSRS)

ObjectiveTo examine the psychometric properties of a Spanish version of the C-SSRS (Sp-CSSRS). MethodData are from a naturalistic, cross-sectional, multicentre, validation study, including 467 psychiatric outpatients, 242 of whom had a history of suicide attempt. The study measures were: C-SSRS; the Hamilton Depression Rating Scale (HDRS); the Beck Suicide Intent Scale; the Medical Damage Scale. ResultsConstruct validity: Pearson coefficient between the C-SSRS severity (C-Sev) and intensity (C-Int) of ideation subscale scores was 0.44 (p<0.000) for the total sample. Likewise, Pearson coefficient between C-Sev score and HDRS item 3 was 0.56 (p<0.000). For the sub-sample of patients with suicide attempt, significant Pearson correlations were found between the C-Sev and the Beck Suicide Intent Scale scores (r=0.22; p=0.001). Discriminant validity: Significant differences were found in C-Sev and C-Int scores between patients with and without suicide attempt (p<0.000). The C-Sev score discriminated between patients based on HDRS item 3 (p<0.009). Sensitivity to change: Linear regression showed that a one-unit decrease in HDRS item 3 corresponded to a decrease of 5.08 units in the C-Sev score (p=0.141). A one-unit change in HDRS item 3 corresponded to a change of 13.51 on the C-Int assessments (p=0.007). Cronbach's alpha was 0.53 for C-Int. The principal component analysis identified 2 components that explain 55.66% of the total variance (C-Int). ConclusionThe data support that the Sp-C-SSRS is a reliable and valid instrument for assessing suicidal ideation and behaviour in daily clinical practice and research settings.

Factors associated with suicide methods among non-fatal suicide attempters in a general hospital

Background: Suicide is a major public health concern. A number of socio-demographic and clinical variables interplay in determining the chosen method and hence influence the outcome of suicidal behavior. Materials and Methods: Two hundred subjects fulfilling the inclusion and exclusion criteria were recruited in the study. The socio-demographic details were recorded in the semi structured proforma. Detailed assessment of Psychiatric morbidity and attempted suicide was done by clinical interview and validated by M.I.N.I.-Plus 5.0 and Beck Suicide Intent Scale. Data was analyzed using SAS Version 9.2 & SPSS Version 17.0. Results: In the present study, the three most common method of attempting suicide was by poison consumption (50.5%), followed by drug overdose (35%) and hanging (9.5%). Most of the study participants who attempted suicide by poison consumption and drug overdose were in the age group of 11-40 years (P= 0.010 and P=0.050) and female gender had the highest risk of attempting suicide by poison consumption (P=0.005). Most of the subjects in the drug overdose group belonged to urban domicile (P=0.023). Majority of the attempters were first time attempters with low intentionality, low lethality and high impulsivity. Psychosocial factors played an important precipitating role and the most common psychiatric morbidity was adjustment disorder followed by MDD. The influence of alcohol prior to the attempt was significant in the poison consumption group (P=0.040). Conclusions: There are various demographic, clinical and psychosocial factors that play a determinantal role in the choice of method in non-fatal suicide attempters and understanding the interplay of these factors can help devising better preventive strategies in the future.

Association between immigration status and inpatient psychiatric admission after attempted suicide: Results from a hospital-based observational study

IntroductionAcute suicidality or a condition after attempted suicide frequently leads patients to both voluntary or involuntary inpatient admission. Emergency room psychiatrists decide whether such patients can be treated on an outpatient basis.ObjectivesTo identify if immigration status is associated with the decision whether a patient needs a hospital admission.AimsTo detect social determinants of hospital-based health resource uses.MethodsA cross-sectional study including data from 323 patients treated in a general hospital's emergency room after a suicidal attempt during year 2014.ResultsSeventy-six patients were admitted to the hospital (23.5%). Hospitalization frequencies for immigrant and non-immigrant individuals were 6.3% and 26.5% (P = 0.002). No significant association was found between psychiatric admission and history of a diagnosed psychiatric disorder, previous suicidal attempts, previous emergency room care use, family support or current drug use. A subgroup of patients (n = 37; 9%) answered Beck's suicidal intent scale (SIS), a measure of risk in suicidal attempters. Mean SIS was found to be higher among hospitalized than discharged patients (8.5 vs. 16.5; P = 0.01). No significant difference was found in mean SIS between immigrant and non-immigrant patients (9.3 vs. 9.1; P = 0.3).ConclusionsThese preliminary results call for consideration. The highly significant lower rate of psychiatric admission among immigrant patients, without significant differences in mean SIS score in regard to non-immigrants, needs further study.Disclosure of interestThe authors have not supplied their declaration of competing interest.

A Descriptive Analysis of Psychosocial Factors Associated With Non- fatal Adolescent Suicide Attempts

Introduction: Adolescence is the tender, vulnerable transition period with umpteen challenges and individual vulnerability. Various Psychosocial factors play a determinantal role in the genesis of adolescent suicide attempts and the present descriptive study tries to analyze some common psychosocial factors in cases of non-fatal adolescent suicide attempters. Method: Fifty subjects were recruited in the study. Detailed assessment of psychiatric morbidity and attempted suicide was done by clinical interview and validated by M.I.N.I.- KID, Beck Suicide Intent Scale and Adolescent Suicide Assessment Protocol-20. Psychosocial factors associated with the attempt were documented with the semi-structured proforma and descriptive statistical analysis was done with the help of SPSS version 15. Results: Majority of the suicide attempters were in the age group of 18-19 years and females (54%) outnumbered males (46%). Most of the subjects were single (88%), Hindu (86%) by religion, belonged to middle socioeconomic class (82%) and were from the urban background (80%). Two third of them belonged to nuclear family and half of them were students. In our evaluation of various psychosocial factors, 76% of subjects were found to have psychosocial stressor, in that 10% had two or more stressors. Family related factors were the most common (60%) followed by college related factors (26%) in which most common was love failure (12%). Conclusion: A sizeable proportion of subjects had various psychosocial factors associated with non-fatal adolescent suicide attempts and emphasis on these factors can help in prevention and hence monitoring of at-risk adolescents.

Stressful life events, hopelessness, and suicidal intent in patients admitted with attempted suicide in a tertiary care general hospital.

Background:Suicide is a psychiatric emergency. Stressors in life and social variables (like marital status, family, and social support) are among the determinants of suicide. Hopelessness and suicidal intent are among the psychological variables that have shown promise in the prediction of suicide.Aims and Objectives:To assess stressful life events, hopelessness, suicidal intent, and sociodemographic variables in patients of attempted suicide.Materials and Methods:Fifty consecutive patients admitted with attempted suicide were interviewed. Presumptive Stressful Life Event Scale, Beck Hopelessness Scale, and Beck Suicidal Intent Scale were used along with a semistructured pro forma for interview. Data were analyzed with statistical tests.Results:Sixty-six percent of the participants were females, 72% were less than 30 years of age. Sixty-six percent of the patients had stressful life event score between 101 and 200 with the mean score of 127. The stressful life event score in those who considered they are in need of psychiatric help was significantly high. Most of the patients had mild (34%) and moderate (40%) degrees of hopelessness, and the mean score was 9.64. The mean suicidal intent in the participants was 25.14, when correlated with hopelessness score significant positive correlation was found.Conclusion:Lethality of the attempt increases with the increase in hopelessness.

Sleep disturbance as a proximal predictor of suicidal intent in recently hospitalized attempters

ObjectivesInsomnia and short self-reported sleep duration are associated with suicidality, adjusting for concurrent depression. Yet, it is unknown whether they correlate with attempters' suicidal intent and the lethality of suicidal acts. This cross-sectional study in hospitalized suicide attempters aimed to investigate whether temporally proximal self-reported sleep disturbance predicts suicidal intent or exerts mediatory effects. MethodsAttempters were retrospectively assessed for insomnia severity (Athens Insomnia Scale [AIS]) and average night sleep duration (ANSD) for 2 weeks preceding attempt. The effects of insomnia or ANSD on suicidal intent (Beck's Suicide Intent Scale [BSIS]) were explored in multiple regressions. Mediatory effects were investigated in structural equation models (SEMs). ResultsA total of 127 adults (59.8% females) were interviewed within two weeks post–suicide attempt. Major psychiatric diagnoses included affective, psychotic, and alcohol-related disorders. Of the participants, 38.6% had current major depression (MDE). A total of 62.2% reported insomnia (AIS ≥ 6); 42.5% reported short ANSD (≤5 hours). BSIS was predicted by AIS (p = 0.034), short ANSD (p = 0.015), or insomnia with short ANSD (p = 0.006). In SEMs, indirect effects of current MDE, affective disorder, and alcohol-related disorder diagnoses on BSIS via AIS tested significant; both AIS and short ANSD partially mediated the effect of age on BSIS. ConclusionInsomnia, short ANSD, and, in particular, insomnia with short ANSD proximally predicted suicidal intent in recent attempters. The effects of current depression and affective and alcohol-related disorder diagnoses on suicidal intent were partially mediated by insomnia; both insomnia and short ANSD partially mediated the effect of age on suicidal intent. Therefore, management of sleep disturbance in at-risk subjects is important, as it may reduce unfavorable outcomes of suicidal acts.

Do Personality Traits Such as Impulsivity and Hostility-Aggressiveness Predict Severity of Intent in Attempted Suicide? Findings From a Record Based Study in South India.

Background:Little is known about the association of personality traits with intent in attempted suicide.Aims:Our objectives were to assess the levels of selected personality factors among suicide attempters and to examine their association with suicide intent.Materials and Methods:A chart review of 156 consecutive suicide attempters was carried out. All participants were administered the Beck Suicide Intent Scale, Barratt Impulsivity Scale-11, Buss-Perry Aggression Questionnaire, and Past Feelings and Acts of Violence Scale to assess suicide intent, trait impulsivity, hostility-aggression, and violence, respectively. Pearson's product moment correlation was the used as the test of association. Stepwise linear regression was used to identify predictors of suicide intent.Results:Suicide intent was significantly correlated with verbal aggression (Pearson r = 0.90, P = 0.030), hostility (Pearson r = 0.316, P < 0.001), and nonplanning impulsivity (r = -0.174, P = 0.049). High hostility and low motor impulsivity emerged as significant predictors of suicide intent.Conclusion:Personality traits such as hostility and to an extent, impulsivity are accurate predictors of intentionality in attempted suicide. Clinicians should focus on these personality attributes during a routine evaluation of suicide attempters. They can also be considered as potential targets for suicide prevention programs.

Risk among Combat Veterans with Post-traumatic Stress Disorder: The Impact of Psychosocial Factors on the Escalation of Suicidal Risk

The purpose of this study was to (a) evaluate the influence of post-traumatic stress disorder (PTSD) and other comorbid disorders on suicidal risk among combat veterans and (b) evaluate the impact of psychosocial factors on the escalation of suicidal risk. Data were gathered from a random and representative sample of 215 Kosovo War veterans. Subjects were assessed for the presence of lifetime and current psychiatric disorders according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Revision (DSM-IV TR) using the following questionnaires: Harvard Trauma Questionnaire (HTQ), Beck's Depression Inventory (BDI) and Beck's Suicide Intent Scale (BSIS). Suicidal ideations were observed in 44 (20.5%) of the 215 subjects. High suicide risk was found in 31.8% veterans diagnosed with PTSD and comorbid major depressive disorder. In addition, high suicide risk was also observed in the group of unemployed veterans, veterans dissatisfied with social/economic attainment and veterans dissatisfied with living conditions. Our study showed that socioeconomic factors contributes to the deterioration of symptoms of major depression, PTSD and other comorbid disorders, with a direct impact of worsening suicidal ideations and suicidal behavior among war veterans.

Association between personality factors and suicide intent in attempted suicide: Gender as a possible mediator?

Gender appears to be a factor closely related to key suicide-related constructs. The study aims to assess gender differences in personality factors among suicide attempters and to examine the role of gender in mediating the relationship between suicide attempts and selected personality attributes in the same group. A chart review of 156 consecutive suicide attempters was carried out. All participants were administered the Beck Suicide Intent Scale (BSIS), Barratt Impulsivity Scale-11 (BIS-11), Buss-Perry Aggression Questionnaire (BPAQ) and Past Feelings and Acts of Violence (PFAV) Scale. The suicidal intent and impulsiveness did not differ significantly between men and women, although men had significantly greater PFAV scores (t = 3.361, p = 0.001). BPAQ showed a significant difference between the genders (F = 3.621, p = 0.008; Wilk's Λ = 0.950, partial η(2) = 0.100), mainly for physical aggression (F = 11.006; p = 0.001; partial η(2) = 0.076) and anger (F = 4.298; p = 0.040; partial η(2) = 0.031). Certain differences seem to be present between Indian male and female suicide attempters with regard to baseline personality attributes and their role in predicting suicide intent. The import of personality traits as potential targets for suicide prevention is worth exploring further.

Risk factors associated with purchasing pesticide from shops for self-poisoning: a protocol for a population-based case–control study

IntroductionPesticide self-poisoning is one of the most frequently used methods of suicide worldwide, killing over 300 000 people annually. Around 15–20% of pesticide self-poisonings occur soon after the person has...