Cases Of Attempted Suicide Research Articles

Mental health and depression among school going adolescents: excerpts from a school based study of Nadia district, West Bengal

Background: Adolescence is the gateway to health promotion and marked as the transition period between childhood and adulthood. They suffer from various psychosocial problems atany point of their life. Depression during adolescence is considered as an important public health emergency.Aims and Objectives: To assess the presence of some mental health symptoms by Beck’s Depression Inventory (BDI) among school going adolescents and also to find out the prevalence of depression along with associated factors.Materials and Methods: A crosssectional, descriptive epidemiological study was conducted among adolescents of class VII to IX of an English medium school of Kalyani in Nadia district between July and August, 2016. Information on socio demographic variables along with responses on the questions related to various aspects of mental health was gathered by validated BDI and Global school health survey questionnaire. Depression was classified based on the scores obtained and a scale was used.Results: A total of 167adolescents were assessed, mean age of 13.63 years with more boys (110). Mental health analysis revealed nine attempted suicide cases. Nearly half of the pupil reported of punishment feelings (71) and self-criticism (68). The prevalence of overall depression was 34.2%, mild one topped the list. Level of depression was significantly more in higher age group, class VII and among those adolescents who did not stay with their parents (P<.01).Conclusion: The present study provides a composite scenario of mental health status and depression among adolescents. The findings reveal that depression is gradually increasing in respondents. This study also demonstrated the need for secondary prevention and raises deep concern. School based training programme and quarterly counselling under psychiatrist’s guidance in a holistic approach may manage the problem to a great extent.Asian Journal of Medical Sciences Vol.8(5) 2017 64-69

Attempted suicide in Podgorica, Montenegro: higher rates in females and unemployed males

BackgroundA change in suicide attempts is associated with comprehensive changes in mental and physical health and social environment. Attempted suicide and suicide are one of the biggest problems nowadays worldwide, not only in the field of mental health but also in the field of public health. The aim of the research was to determine the number of attempted suicides as well as the influence of clinical and demographic variables on the attempted suicide rate.MethodsThe data on the attempted suicide were analysed in the period 2012–2016 based on the data from the Emergency Ward of the Clinical Centre of Montenegro in Podgorica. The rate of attempted suicides as well as the unemployment rate was calculated. The statistical analysis included descriptive statistics of the raw data and relative numbers, Chi-squared test, Fisher’s test and Spearman coefficient.ResultsThe average age of males who attempted suicide was 38.35 ± 14.11, min 15 and max 88 years of age, and the age of women was 38.97 ± 16.81, min 16 and max 93 years of age. Women attempted suicide more frequently (p < 0.05). Female/male ratio during the investigation period slightly declined (1.93 in 2012 vs. 1.29 in 2016). The attempted suicide rates ranged from 103 per 100,000 residents in 2016 to 142 per 100,000 residents in 2015. Crude attempt rate was the highest in women in 2012 (102.42 per 100,000 residents) and for men in 2014 and 2015 (84.48 vs. 83.06 per 100,000 residents). Poisoning with psychotropic drugs was the dominant manner of attempt (93.2%), while the largest number of attempts was in the late spring and summer (May, June and July). Attempted suicide rate in man was associated with higher unemployment rate.ConclusionsAlthough women make the majority of attempted suicide cases, there has been a decline in the value of the rate for women and a rise for men. The attempted suicide rates in Podgorica belong to lower rates compared to the WHO European multicentre study on parasuicide. Poisoning with psychotropic drugs was the predominant manner, while the highest number of attempted suicides was in the late spring and summer (May, June and July). Unemployment influences men to attempt suicide much more frequently.

Retrospective Study of Relationship Between Alcohol Use and Risk of Suicide Attempt

Background: It is important to investigate the relationship between alcohol use and risk of suicide attempt which has important implications for management and prevention of further suicidal behavior. Methods: One year’s worth of data (June 2014 to May 2015) was obtained retrospectively from case records of patients who had attempted suicide. Results: In the year sampled, there were 1600 attempted suicide cases, of which 809 were referred to a psychiatrist for a risk-factor evaluation. Males were 397 (49.1%), out of which 147 patients were found to be using alcohol. Out of 147 patients 146 (99.3%) suicide attempt were linked to alcohol use. Those who age &lt;30 years were 83(56.5%) and age &gt;30 years were 64 (43.5%). 60 (40.8%) were using alcohol from less than 5years, 43(29.3%) were using alcohol from 5-10 years, 44(29.9%) were using alcohol for more than 10 years. 120(81.6%) had dependence pattern of alcohol use, 109(74.1%) were under intoxication, where as 18(12.2%) were in withdrawal state at the time of suicide attempt, 105 (71.4%) were attempted suicide without their awareness. and 83(56.5%) were having alcohol induced depression. Conclusion: This study from the case records elucidates relationship between alcohol use and suicide attempt which will help further in suicide prevention.

Suicide attempts by exposure to toxic agents registered in a Toxicological Information and Assistance Center in Fortaleza, Ceará, Brazil, 2013.

to describe cases of suicide attempts by exposure to toxic agents registered by the Toxicological Information and Assistance Center in Fortaleza, Ceará, Brazil. this is a descriptive study using secondary data of the cases registered in 2013. 410 cases were registered; 56.2% of the individuals were female and 79.7% were between 12 and 39 years old; most of them (86.4%) lived in urban areas and 67.2%, in Fortaleza; in 94.9% of the cases, the exposure took place in the individual's own home; the toxic agents most commonly used were pesticides (42.9%), especially for agricultural use (30.2%), medicines (39.5%) and house cleaning products (3.4%); of 16 suicide attempts that resulted in death, 15 were caused by agricultural pesticides. the study shows that the intake of toxic agents, especially of agricultural pesticides, is a common method used in suicide attempts; the integration between actions of promotion and prevention are essential.

A Clinical Study of Psychiatric Morbidity and Quality of Life among Suicide Attempted Patients

Risk of suicide is more common in patients with psychiatric disorders and poor quality of life. The aim of this study was to find out the prevalence of psychiatric morbidity and its relationship with suicide attempters. Materials and Method- The cross sectional study was carried out in Psychiatric department of MNR Medical College and Hospital. A total 70 cases of first suicide attempts were included in this study. Psychiatric morbidity and quality of life were analysed by Schedule for clinical assessment in neuropsychiatric (SCAN), Montgomery Asberg’s depression rating scale (MADRS), Hamilton anxiety rating scale (HAM-A) and WHOQOL-BREF version. Statistical analysis was done by SPSS 20.0 software. Result- Among 70 cases, 92.85% of the suicide attempters had one or more psychiatric disorders compared to 21.43% among the controls. Major psychotic disorder was mood disorder (56.92%), followed by Neurotic and somatoform disorders (36.92%) and substance related disorders (32.3%). Schizophrenia and other psychotic disorders were diagnosed in 7.69% of cases. Quality of life score was assessed by WHOQOL-BREF questionnaire. The mean of total score in suicide attempters was 57.44 and in control group was 73.67. Conclusion- In the present study suicide attempters had higher psychotic morbidity and poor quality of life in comparison to the control groups.

Review of health and risk-behaviours, mental health problems and suicidal behaviours in young Europeans on the basis of the results from the EU-funded Saving and Empowering Young Lives in Europe (SEYLE) study.

An estimated 800 000 suicide deaths occur worldwide. The global suicide rate is 11.4 per 100 000 population; 15.0/100 000 for males and 8.0/100 000 for females. Globally, suicide is the second leading cause of death in 15-29 year olds. In a collaborative effort to reduce the high rates of suicide and mental health problems among youth across Europe, the European Union 7th Framework funded the Saving and Empowering Young Lives in Europe (SEYLE) project. SEYLE is a randomized controlled trial (RCT) aimed to promote mental health and healthy lifestyles, while preventing psychopathology and suicidal behaviours among adolescents. The epidemiological data on 11,110 pupils in the age group 14-16 years, with a mean age of 14.8 years (SD ± 0.8), who were recruited from 168 schools across 10 European Union countries: Austria, Estonia, France, Germany, Hungary, Ireland, Italy, Romania, Slovenia and Spain, with Sweden as the coordinating centre showed the following prevalences: alcohol use (13.4%), smoking (30.9%), physical inactivity (32.8%), pathological Internet use (4.4%) and sleeping on average 7.7 hours per night. In terms of reproductive health, the prevalence of sexual debut was 18.8% for the total sample. Pupils aged .16 years had a higher prevalence (38%) of sexual debut compared to those aged .15 years (13.2%). Males had a higher prevalence (21.3%) than females (16.9%). Three clusters of adolescents were identified: 57.8% with low frequency of all risk-behaviours; 13.2% with high frequency of all risk behaviours; and 29% so-called 'invisible' risk group, which did not show any striking externalised riskbehaviours, but scored positive for high use of Internet/TV/videogames, sedentary behaviour and reduced sleep. When comparing pupils in the "invisible" risk group with those in the high-risk group, similar prevalence rates of anxiety (8% vs. 9.2%), subthreshold depression (33.2% vs. 34%), depression (13.4% vs. 14.7%) and suicidal thoughts (42.2% vs. 44%) were observed. Pupils meeting the criteria of depression and subthreshold depression were 10.5% and 32%, respectively. Prevalence rates for anxiety and subthreshold anxiety was 5.8% and 29.2%, respectively. Lifetime prevalence of deliberate self-injurious behaviours (D-SIB) was 27.6%, with higher rates reported for occasional D-SIB (19.7%) compared to repetitive D-SIB (7.8%). Suicidal ideation was present in approximately one third of the sample (32.3%). More than four percent (4.2%) of the sample reported attempting suicide during their lifetime, with a significantly higher prevalence among girls (5.1% vs. 3.0%, p<0.05). In comparing the effectiveness of the three active SEYLE interventions, based on three specific preventive strategies directed towards teachers and school staff, professionals and pupils in comparison to a control group, the intervention empowering pupils, called the Youth Aware of Mental Health (YAM) showed significant results in preventing new cases of suicide attempts, severe suicidal ideation with plans and depression. More than a 50% reduction of incident cases of suicide attempts (OR: 0.45 [0.24 - 0.85]; p=0.014), and of incident cases of severe suicidal ideation and plans (OR: 0.50 [0.27 - 0.92]; p=0.025), as well as a significant reduction by 30% of incident cases with moderate to severe depression (OR: 0.71 [0.52- 0.97]; p=0.031) was observed.

Tentativa de suicídio na cidade de Paracatu, Noroeste de Minas Gerais

Organização Mundial da Saúde (OMS) divulgou dados do primeiro Relatório Global para Prevenção do Suicídio, em 2014, revelando que mais de 800 mil pessoas dão fim à própria vida todos os anos no mundo. O levantamento diz ainda que a cada 40 segundos uma pessoa comete suicídio e cerca de 75% dos casos ocorrem em países de baixa e média renda, sendo considerado, então, um problema de saúde pública. Em Minas Gerais, de acordo com o DATASUS, nos anos de 2005 a 2009 a mortalidade por suicídios teve média de 5,28 por 100.000 habitantes. O presente estudo teve como objetivo fazer um levantamento dos dados dos pacientes atendidos no Hospital Municipal de Paracatu-MG que tentaram o autoextermínio levantando as variáveis relacionadas às causas e meios utilizados analisando a transição dos perfis mais incidentes. Trata-se se um estudo retrospectivo com corte transversal baseado na análise de prontuários, tendo uma amostra de 84 fichas de atendimento com relato de tentativas de autocídio registradas em 2012. Os resultados apontaram uma maior numero em mulheres, as substâncias mais utilizadas foram medicamentos e raticidas e a faixa etária predominante foi de 16-25 anos. Para esses pacientes o suicídio é um ato impulsivo, constado que a maioria não o efetivou. Os pacientes reincidentes foram encaminhados para órgãos responsáveis por acompanhamento psicológico. Faz-se necessário o encaminhamento de todos os pacientes que deram entrada no centro de urgência por tentativa de suicídio para a reinserção do indivíduo no meio social e familiar. Conclui-se que há um alto número de registro de tentativas de suicídio em Paracatu havendo a necessidade de aplicação de planos de cuidado para prevenção do autoextermínio e interinstitucionalização com encaminhamentos para melhor acompanhamento psicológico dos pacientes.

Suicide and suicide attempts by the elderly in film: related factors as shown in feature films

Abstract Objective: to analyze cases of suicide and suicide attempts by elderly persons in feature films. Method: a survey of specialized internet cinema portals was carried out. A total of 19 feature films produced between 1950 and 2014 were identified. After the authors watched the films, synopses were written describing the circumstances of the suicide and dialogue that described the profile of the elderly character was transcribed. Results: films that described suicide among the elderly were classified as follows: male gender in 13 films (68%), depression with hopelessness in 12 (63%), existence and efficiency of health services, physical illness and absence of familiar support in ten (for each category) (53%), cognitive rigidity in eight (42%), suicidal thinking in seven (37%), dysfunctional assumptions and a self-perception of negativity in six (32%), problem-solving deficits in five (26%) and a lack of social support in five (26%). Conclusion: the portrayal of suicide among the elderly in films helps to raise awareness of this subject and prevent it.

Cosmopolitanism and the relevance of 'zombie concepts': the case of anomic suicide amongst Alevi Kurd youth.

Against Beck's claims that conventional sociological concepts and categories are zombie categories, this paper argues that Durkheim's theoretical framework in which suicide is a symptom of an anomic state of society can help us understand the diversity of trajectories that transnational migrants follow and that shape their suicide rates within a cosmopolitan society. Drawing on ethnographic data collected on eight suicides and three attempted suicide cases of second-generation male Alevi Kurdish migrants living in London, this article explains the impact of segmented assimilation/adaptation trajectories on the incidence of suicide and how their membership of a 'new rainbow underclass', as a manifestation of cosmopolitan society, is itself an anomic social position with a lack of integration and regulation.

Formas utilizadas para tentativa de suicídio e características sociodemográficas de pacientes atendidos no serviço de emergência de um hospital de ensino

Aims: To assess the methods used in suicide attempts and sociodemographic characteristics of suicidal patients treated at the emergency department of a teaching hospital.Methods: Cross-sectional retrospective study, with active search for electronic medical records of patients treated at the emergency department of a public teaching hospital in the countryside of Rio Grande do Sul, Brazil, from January to December 2015. All cases of suicide attempt were included, regardless of the suicide methods used. Successful suicide cases were not investigated. The statistical analyses included descriptive statistics, univariate analysis, and Pearson’s chi-square test.Results: A total of 233 patients treated at the emergency department were referred for psychiatric evaluation, and 122 of them had attempted suicide. The mean age of the suicidal patients was 36.8±14.3 years, (minimum of 14 years and maximum of 88 years) and 74 (60.6%) of them were female. The most common suicide attempt methods were ingestion of medications (72 cases, 59%) and of pesticide (14 cases, 11.5%). Of all patients, 119 (97.5%) lived in Santa Cruz do Sul, predominantly in the urban area (103 patients, 84.4%). Of the 50 (41.0%) referrals, 32 (64.0%) were sent to the Center for Psychosocial Care, 7 (14%) to the Center for Children’s and Adolescents’ Psychosocial Care, 6 (12%) were admitted to a mental health unit, and 5 (10%) were sent to Psychosocial Care Center for Alcohol and Drug Abuse. Sixty-six (54.1%) patients had no electronic medical records of their outcome after discharge and 6 (4.9%) were lost to follow-up.Conclusions: Most of the treated suicidal patients were young adult females. The most common method of suicide attempt was the ingestion of medications, followed by the ingestion of pesticides.

Risk of self-harm and nonfatal suicide attempts, and completed suicide in patients with psoriasis: a population-based cohort study.

Psoriasis is a common inflammatory skin disease, and inflammation may affect suicidal behaviour. Current data on the incidence and risk of suicidal behaviour in patients with psoriasis are scarce. We investigated the association between psoriasis and the risk of self-harm and suicide attempts and suicides. All Danish patients aged ≥ 18 years with mild or severe psoriasis (cases) from 1 January 1997 to 31 December 2011 were matched on age, sex and calendar time 1 : 5 with healthy controls. The outcome was a diagnosis of self-harm or a nonfatal suicide attempt, or completed suicide. Incidence rates per 10 000 person-years were calculated, and incidence rate ratios (IRRs) and confidence intervals (CIs) were estimated by Poisson regression models. The study cohort comprised 408 663 individuals, including 57 502 and 11 009 patients with mild and severe psoriasis, respectively. In total 280 cases of self-harm or suicide attempts, and 574 suicides occurred during follow-up. There was no increased risk of self-harm or suicide attempts in patients with mild psoriasis (IRR 1·01, 95% CI 0·17-2·01), but this risk was significantly increased in severe psoriasis (IRR 1·69, 95% CI 1·00-2·84). There was no increased risk of suicides in mild (IRR 1·05, 95% CI 0·84-1·32) or severe psoriasis (IRR 0·78, 95% CI 0·45-1·36). Similar results were found when suicides were confirmed by official forensic investigations, and when psoriasis was compared with atopic dermatitis. We found limited evidence to suggest an increased risk of self-harm and nonfatal suicide attempts in patients with psoriasis. Importantly, after adjustment for psoriatic arthritis this risk was no longer significantly increased. The risk of completed suicide was also not increased, regardless of psoriasis severity.

Case report of autointoxication with nutmeg committed by a suicide attempter

Introductionautointoxication with nutmeg in an emergency setting is a rare, but potentially a life-threatening event. Despite the low incidence of ‘tentamen suicidii’ (TS) with nutmeg, this substance is cheap and readily available. Early recognition of a suicide attempt with nutmeg poisoning can be extremely difficult, especially when nobody witnessed the nutmeg intake. Worldwide there are only a few cases reporting TS with nutmeg.ObjectivesTo present a case of TS with nutmeg committed by a suicide attempter.aimsTo review available literature on TS with nutmeg.Methodsa case report is presented and discussed, followed by a literature review.ResultsFive published cases of suicide attempts with nutmeg were found while searching through PUBMED and Embase. Our case describes a 57-year-old female, diagnosed with borderline personality disorder, who has been admitted to the emergency department in a state of agitation, diminished cognition, respiratory difficulties and hemodynamic instability. Electrocardiography showed a fast sinus arrhythmia with no uschemic or hypertropic changes. Blood sampling, serum and urine toxicology did not reveal any abnormalities. in view of the complexity of her condition, she admitted to have taken a large dose of nutmeg. The patient was kept for observation, offered reassurance, and rehydratation.ConclusionThe presentation of inexplicable clinical state accomplished by disturbances of central nervous, respiratory and hemodynamic systems in the population of patients with attempting suicide should alert the physician to the rare but probably underreported possibility of nutmeg autointoxication.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Personality disorders and suicide attempts

IntroductionThe personality disorders are defined according to the DSM-5 like “an enduring maladaptive patterns of behavior, cognition and inner experience, exhibited across many contexts and deviating markedly from those accepted by the individual's cultures. These patterns develop in adolescence and the beginning of adulthood, and are associated with significant distress or disability”. The personality disorders can be a risk factor for different processes of the psychiatric pathology like suicide. The personality disorders are classified in 3 groups according to the DSM-5:– cluster A (strange subjects): paranoid, schizoid and schizotypal;– cluster B (immature subjects): antisocial, bordeline, histrionic and narcissistic;– cluster C (frightened subjects): avoidant, dependent and obsessive-compulsive.AimsTo describe the influence of personality disorders in suicide attempts.MethodologyExhibition of clinical cases.ResultsIn this case report, we exhibit three clinical cases of suicide attempts which correspond to a type of personality disorder belonging to each of the three big groups of the DSM-5 classification, specifically the paranoid disorder of the cluster A, the disorder borderline of cluster B and the obsessive compulsive of cluster C.ConclusionsThe personality disorders have a clear relation with the suicide attempts, increasing this influence in some of them, especially the borderline personality disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Risk factors of suicide among patients admitted with suicide attempt in Tata main hospital, Jamshedpur.

More than one lakh lives are lost every year due to suicide in India. In the last three decades (from 1975 to 2005), the suicide rate has increased by 43%. Jamshedpur is an Industrial town, which is rapidly growing and having population with mixed cultural background. Recently, there has been increasing trend in a number of suicide attempt across various age groups; there are around 300 cases of suicide attempt admitted to Tata Main Hospital each year. To study the risk factors associated with suicide attempts. The study was carried out in the Tata Main Hospital, Jamshedpur. Over a period of 6 months, we gathered data of 101 suicide attempters referred from medical, surgical departments and casualties and taken up for the study. Data were collected on specific pro forma was prepared to collect various others risk factors. More number of female patients compared to male, younger age, lower-middle income group, urban background, school educated, and unemployed were more represented in this study. In 70% of patients, psychiatric disorder was found, but few among them had prior treatment. Increased family conflicts, marital problems, financial difficulties, and perceived humiliations are some of the risk factors. The early identification and treatment of vulnerable populations with risk factors for suicide across the lifespan will help in planning and implementing strategies for prevention.

Therapeutic equivalence of antipsychotics and antidepressants - A systematic review.

The number of newly approved generic psychotropic drugs increases every year and, in many countries, their sales exceed the sales of brand-name counterparts. In order for any generic drug to receive an approval of regulatory authorities, its bioequivalence with the corresponding reference product must be demonstrated. Moreover, generic drugs must meet the same quality standards as reference drugs. However, many psychiatrists express concerns about use of generic drugs. We carried out a systematic analysis of the relevant literature indexed in PubMed and Cochrane databases. The MeSH term "generic" was combined with terms describing antipsychotic and antidepressive drugs, including their pharmaceutical names and relevant mental disorders. All 26 articles including either clinical studies or case reports have been qualified for a detailed analysis. No cases describing switches between two generics were found. Therapeutic equivalence studies evaluating antipsychotics included clozapine, olanzapine, and risperidone. The clinical status was judged to have worsened in 15.7% patients treated with clozapine. The number of relapses before and after the switch was not significantly different in patients treated with olanzapine. Two case reports showed clinical state deterioration after switch to generic risperidone. The clinical outcome after conversion to a generic antidepressant was evaluated only in one retrospective study. That study analyzed the outcomes of treatment with citalopram and revealed mental state deterioration in 11.6% of patients. Only single reports describe cases of impaired efficacy or adverse events after the switch to a generic antidepressant, including fluoxetine, mirtazapine, and venlafaxine. No cases of suicidal attempt after the switch were reported. Although the overall number of described cases is rather modest, health professionals should be aware of possible changes in the therapeutic effectiveness after changing to a generic medicine.

A Case of Suicidal Attempt with Chlorantraniliprole

A desperate man will do just about anything! and in this desperation to end his life he would take recourse to whatever means is most easily available to him. India still having a predominantly agricultural population, the most commonly used chemical for attempted suicide is Organophosphorus. A new form of insecticide called Chlorantraniliprole has been recently launched in India and soon enough we encountered a patient presenting to us with history of ingesting 1 full bottle (175ml) of the chemical. As such we would like to report the first case of self-harm using Chlorantraniliprole in this part of the world.

The Causes and Prevention of Suicide Attempts in Southern Punjab Pakistan

Objective: This study is an effort to know the causes of suicide attempts and to know as how media can play a role in preventing such attempts. The literature review shows that media coverage of suicide attempt cases effects teenagers more negatively as compared to the elders. Studies also show that teenagers also copycat the suicide attempts made by the celebrities. It is not the only factor. Because the contagious suicide is not confined just to exposure of media, but attempters who personally know such people who have attempted suicide are more inclined to copy this tragic phenomenon.&#x0D; Methodology: The theoretical framework of this study is based on the work of Emile Durkheim. Purposive sampling technique was used to collect data from survival of suicide attempts. (Sample Size: 50).&#x0D; Results: The result show that there are several reasons for committing suicide in southern Punjab such as parental conflict, failure in love, price hike, corruption and worse law &amp; order situation prevailing in the country.&#x0D; Implications: In light of findings of the study, it is suggested that professional help and counseling techniques can be helpful for attempters. Media can play a vital role in this regard by careful coverage of suicide attempts cases.&#x0D; Objective: This study is an effort to know the causes of suicide attempts and to know as how media can play a role in preventing such attempts. The literature review shows that media coverage of suicide attempt cases effects teenagers more negatively as compared to the elders. Studies also show that teenagers also copycat the suicide attempts made by the celebrities. It is not the only factor. Because the contagious suicide is not confined just to exposure of media, but attempters who personally know such people who have attempted suicide are more inclined to copy this tragic phenomenon.&#x0D; Methodology: The theoretical framework of this study is based on the work of Emile Durkheim. Purposive sampling technique was used to collect data from survival of suicide attempts. (Sample Size: 50).&#x0D; Results: The result show that there are several reasons for committing suicide in southern Punjab such as parental conflict, failure in love, price hike, corruption and worse law &amp; order situation prevailing in the country.&#x0D; Implications: In light of findings of the study, it is suggested that professional help and counseling techniques can be helpful for attempters. Media can play a vital role in this regard by careful coverage of suicide attempts cases.

Caracterização de tentativas de suicídios por substâncias exógenas

ResumoEste artigo apresenta o perfil das vítimas de tentativas de suicídio por intoxicações exógenas ocorridas no município de Barra do Garças, no Estado do Mato Grosso, no período de 2008 a 2013. Trata-se de um estudo epidemiológico descritivo e transversal dos casos registrados pelo Sistema de Informação de Agravos de Notificação (SINAN). Foram registrados um total de 164 tentativas de suicídio por intoxicações exógenas. Os agentes tóxicos de maior frequência foram os medicamentos (50%) e os agrotóxicos (26,2%). As tentativas foram mais frequentes entre o gênero feminino (71,1%) e na faixa etária de adultos (81%). Informações sobre o uso racional de medicamentos, maior controle sobre a venda de agrotóxicos e a realização de programas sociais de apoio e de atendimento às vítimas poderiam contribuir para a diminuição dos casos.

A genome-wide copy number variant study of suicidal behavior.

Suicide and suicide attempts are complex behaviors that result from the interaction of different factors, including genetic variants that increase the predisposition to suicidal behaviors. Copy number variations (CNVs) are deletions or duplications of a segment of DNA usually larger than one kilobase. These structural genetic changes, although quite rare, have been associated with genetic liability to mental disorders, such as autism, schizophrenia, and bipolar disorder. No genome-wide level studies have been published investigating the potential role of CNVs in suicidal behaviors. Based on single-nucleotide polymorphism array data, we followed the Penn-CNV standards to detect CNVs in 1,608 subjects, comprising 475 suicide and suicide attempt cases and 1,133 controls. Although the initial algorithms determined the presence of CNVs on chromosomes 6 and 12 in seven and eight cases, respectively, compared with none of the controls, visual inspection of the raw data did not support this finding. Furthermore we were unable to validate these findings by CNV-specific real-time polymerase chain reaction. Additionally, rare CNV burden analysis did not find an association between the frequency or length of rare CNVs and suicidal behavior in our sample population. Although our findings suggest CNVs do not play an important role in the etiology of suicidal behaviors, they are not inconsistent with the strong evidence from the literature suggesting that other genetic variants account for a portion of the total phenotypic variability in suicidal behavior.

Review of toxicity and trends in the use of tiagabine as reported to US poison centers from 2000 to 2012.

Tiagabine is a novel antiepileptic that acts by increasing synaptic and extracellular gamma-aminobutyric acid concentrations. Information concerning overdose of tiagabine is limited. After introduction, an increasing number of off-label uses suggested that tiagabine use would increase. However in 2005 and 2008, warnings from the Food and Drug Administration (FDA) were issued on the risk of seizures in non-epileptic and increased suicide ideation. We evaluated the temporal trends associated with these two warnings as well as clinical outcomes from tiagabine overdose. A retrospective review of all single substance tiagabine exposures in National Poison Data System (NPDS) from 2000 to 2012. A total of 2147 patients had ingested tiagabine, with a mean of 165 year(-1). This was disproportionally distributed, with a steep rise leading up to 2004 (max 559 year(-1)) and then a significant decline (p < 0.05) between 2005 and 2006. The number of cases reported to NPDS mirrored the sales of tiagabine. Clinical effects were predominantly neurological, with the most commonly reported effects being drowsiness (27%), agitation (19%), confusion (12%), seizures (11%), and tachycardia (10%). In all, 758 patients (35%) showed a major or moderate medical outcome, with no deaths reported. A disproportionate share of the major outcomes was in the suicide attempt group (73%). The majority of patients (75%) were treated in a health-care facility (HCF). The HCF usage is likely due to high rate of symptomatic patients (59%) and the large proportion of suicide attempt cases. The frequency of tiagabine cases in NPDS mirrored pharmaceutical sales, with steep declines temporally related to the 2005 FDA warning.