Suicide Cases Research Articles

The burden of suicide across different altitudes: 11-year geodemographic analysis conducted in 221 cantons in Ecuador ranging from 0 to 4300 m of elevation.

The World Health Organization and the Global Burden of Disease study estimate that almost 800 000 people die from suicide yearly. The role of non-traditional risk factors such as climate and high-altitude exposure are poorly understood. This study aims to determine a potential relationship between altitude exposure and suicide rates among 221 cantons located at different altitudes ranging from 0 to 4300 m. We conducted an 11-year, country-wide, population-based analysis on age- and gender-standardised suicide rates in Ecuador, based on the official data from the National Institute of Statistics, using all available self-harm death codes (ICD-10 codes X60-X84). A total of 11 280 cases of suicide were reported during 2011-2021. Suicide rates were higher among men (11.48/100 000). In terms of elevation, suicide rates were significantly higher among people from high-altitude cantons (3.7/100 000) versus those from low-altitude cantons. When applying the International Society Mountain Medicine categorisation, suicide rates were significantly higher at moderate- (4.3/100 000), high- (3.6/100 000) and very-high-altitude cantons (4.4/100 000) when compared with low-altitude locations (2.5/100 000). Ecuador is one of the few countries that has a vast range of cantons located at different altitudes. We found that living at higher elevations is positively associated with greater suicide rates. Although the rates are significantly greater as elevation increases, a clear linear relationship is not apparent, likely because of the interplay of socioeconomic factors, including urbanicity. The effect of chronic hypobaric hypoxia on mood cannot be ruled out, although the existence of causal mechanisms remains to be elucidated.

Assisted suicide in Switzerland, a model in the international discussion about medical aid in dying: framework conditions andlong-term development of a new societal and medical-ethical phenomenon

In the observation period between 1999 and 2022, the Swiss Federal Statistical Office recorded 14 170 assisted suicide (AS) cases. During this 24-year period, the annual number of cases increased significantly: While only 63 cases were observed in 1999, the number of cases in 2022 amounted to almost 1600, corresponding to 2.1 % of all deaths in Switzerland. The most common underlying disease group for AS was cancer, accounting for 40 % of cases. AS is mainly chosen by women (unchanged over time at 58 % of cases) and is primarily a geriatric phenomenon: In 2022, the median age of those who opted for assisted dying was 81 years; the median age of those who chose AS due to cancer was 77 years, while the median age of those who died with non-cancer-related AS was 84 years.

The Problem of Suicide in the Republic of Tajikistan

Suicide is a serious public health problem. Suicide is one of the leading causes of death in the Republic of Tajikistan. This article presents reports on suicide cases in the country, taking into account cultural and ethnic aspects, and suggests preventive approaches to improving the suicidal situation in the Republic of Tajikistan.

National trends in pediatric drowning — insights from the Israeli Ministry of Health registry-based cohort

This study analyzes the epidemiology of pediatric drowning in Israel from 2010 to 2022, focusing on differences across age groups, sex, and regions. We conducted a retrospective cohort study using data from the Ministry of Health’s administrative databases, covering all children aged 0–17 years who were seen in the emergency department, discharged after hospitalization, or died at the scene due to drowning, excluding cases of intentional harm or suicide. The primary outcome was the annual drowning rate per 100,000 children, categorized by age, sex, and region, along with hospitalization duration, intensive care unit admissions, and mortality rates. A total of 2101 drowning incidents were identified, with 9% resulting in death. Higher drowning rates were found in younger children (1–4 years) and teenagers (15–17 years), with notable differences by sex. Drowning rates were higher in coastal regions and more frequent during winter and spring. An increase in drowning rates was observed over the last 3 years of the study (2020–2022). Children hospitalized for more than 3 days had significantly higher mortality rates, both in general wards and intensive care units.Conclusions: Pediatric drowning is a persistent public health concern in Israel, with distinct seasonal, regional, age-specific, and sex-specific patterns in incidence and mortality. This study underscores the need for a comprehensive prevention strategy that includes year-round public education, environmental safety measures, and targeted interventions for high-risk groups to reduce drowning incidents and fatalities among children effectively.What is Known:• Pediatric drowning represents a significant public health challenge globally, with varying rates.• In Israel, pediatric drowning is the second leading cause of death from all injury-related deaths. Thus far, the measures and interventions to reduce fatalities were not proven effective enough.What is New:• Pediatric drowning in Israel, with a 9% mortality rate, revealed a biphasic rate varied by sex and is higher in coastal regions and during winter and spring.• There was a notable increase in drowning incidents during the last 3 years of the study period (2020–2022), coinciding with the COVID-19 pandemic.

Problematika Kesehatan Mental di Era Disrupsi dan Solusinya dalam Al-Qur’an- Hadis

Fundamental changes take the form of technological evolution that looks for loopholes to influence human life. The current era of revolutionary transformation has triggered widespread mental health disorders in Indonesia which continue to increase. It is noted that the majority of suicide cases in Indonesia are young people and the biggest factor is mental health. Because mental health greatly influences a person's quality of life. Currently we have entered the disruption phenomenon, which is a major part of the global scale. Where in the era of disruption there is a mental health crisis. It can be seen that cases of young people are increasing. The aim of this research is to find out mental health in the era of disruption and the solutions in the Al-Qur-an and Hadith. The method used in this research is library research, namely a series of activities relating to library data collection methods. This research uses a qualitative approach and then describes it descriptively. For the results, the solution is to build one's foundation with the Al-Qur'an, multiply good works and avoid evil (amar ma'ruf nahi munkar). Build a good relationship with Allah by remembering Him more (dhikr). Then develop relationships with others and their environment. The source of a human's strength lies in his self-esteem. Self-esteem is the most important axis in strengthening mental health.

Insulin-Related Suicides-3 Cases.

Insulin is a pancreas-produced hormone, which is essential for normal life. In persons with diabetes, who lack sufficient production of endogenous insulin, the availability of exogenously-produced and administered insulin represents an extremely valuable, life-preserving medical advancement. Unfortunately, as with many other medications, overdosage with insulin can and does occur, sometimes in an intentional suicidal manner. Another possible insulin-related suicidal action involves the intentional cessation of insulin therapy by someone who relies on insulin for survival. In this case series, we present 3 cases of insulin-related suicides, including two related to intentional insulin overdose and one where a known diabetic purposefully stopped taking insulin in order to commit suicide.

Understanding the characteristics of suicide in Gunungkidul Regency, Yogyakarta, Indonesia: A retrospective analysis

Purpose: This research aims to identify the characteristics of suicide in Gunungkidul Regency, Yogyakarta. Method: The approach used is a retrospective study, based on retrospective data obtained from the Gunungkidul Regency Resort Police in 2017–2022. Result: The results of the analysis show that of the total 173 suicide cases, 53.2% occurred in the elderly group. The majority of suicide cases involved individuals working as farmers (72.3%), with the primary method used being hanging (100%). Motives for suicide varied, including chronic illness (23.7%), depression (10.4%), and a combination of physical illness and depression (6.9%). Conclusion: Increasing access to social support, physical and mental health services in this area, as well as focusing more specifically on prevention efforts linked to recognizing suicide motives, are some of the implications of this research. Apart from providing health assistance to individuals experiencing depression, it also cultivates a new social culture that can effectively shield people from depression, loneliness, feelings of burdensomeness, and other issues.

Delayed neurological complication of organophosphate intoxication

Organophosphate are one of the most commonly used pesticide in India and across the global, because of easy accessibility it is often misused as homicidal and suicidal cases that carry high rate of mortality and morbidity. It often affects the body by acting on synaptic cleft and interfere acetylcholine present inside the clefts. Early manifestation includes the increased secretion across the body with decrease heart rate. Here we had a case series of patients presented with delayed neurological complication of organophosphorus compounds (OPC).

Suicide by different methods in Toronto: A quantitative study examining of 23-years of coronial records

The objective of the study is to understand the characteristics of people who died by different suicide methods in Toronto, Canada. Suicide cases were identified by the Office of the Chief Coroner of Ontario (1998–2020). Demographic and clinical variables were retrieved. All suicide deaths were classified into different groups based on suicide method. Bivariate analyses and multinomial logistic regressions were performed to compare their demographic and clinical characteristics. Hanging (N = 1721), jumping from height (N = 1280), and poisoning (N = 955) were the most common suicide methods in Toronto. Those who died by hanging were more likely to be married or in common law relationships, live with others, experience employment/financial/academic-related stressors and die at home. People who died by jumping from height had a higher likelihood of having a psychiatric and/or emergency department visit in the past week and having schizophrenia or related disorders/symptoms. People who died by poisoning had higher odds of being female and leaving suicide notes. They were also more likely to have previous suicide attempts, experience depression and/or bipolar disorder and have physical conditions. Specific suicide prevention strategies should be designed and implemented to account both for commonalities and differences among people who die by different suicide methods.

Attitudes of Emergency Department Staff Toward Individuals Who Have Attempted Suicide and Associated Factors.

To determine the attitudes of emergency department (ED) staff toward people who have attempted suicide and the factors associated with these attitudes. This study was conducted between January and February 2023 and included 147 participants working in an ED in a city in Türkiye. Data were collected using a personal information form and the Attitude Scale Towards Attempted Suicide Cases for Evaluating Emergency Medical Teams (ASETSA). Participants' mean years of experience in emergency services was 4.63 years (SD = 3.97 years) and mean perceived level of competence in intervening in suicidal behavior was 6.08 (SD = 2.16). Total mean ASETSA score of participants was 114.68 (SD = 12.31). Factors such as marital status, educational level, profession, working unit, working shift, having received training on how to approach a person who has attempted suicide, existence of a written procedure in the department, years of ED experience, and perceived level of competence in intervening in suicidal behavior were associated with positive attitudes toward people who have attempted suicide. It is recommended that formal education curricula address how to approach people who have attempted suicide, that randomized controlled trials regarding the impact of in-service training be performed, and that studies evaluating the contribution of trainings to improvements in patient outcomes be conducted. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

A retrospective review of isotretinoin treatment-related mental health and sexual function outcomes in a tertiary acne clinic.

Isotretinoin is the gold standard treatment for severe acne, but it has been controversially linked to psychiatric and sexual disorders. Using the well-validated PHQ-9 and CADI scoring systems, we demonstrated significantly improved mental health outcomes following completion of isotretinoin treatment for acne in our patient cohort over a 3-year period. We report no cases of suicidal ideation, suicide or erectile dysfunction.

Age-stratified risk of suicide in patients with schizophrenia.

Schizophrenia is associated with an increased risk of suicide. Few studies have investigated the risk of suicide across different ages, likely due to limitations around sample size. From the National Health Insurance Research Database in Taiwan, this study identified 195,787 patients with schizophrenia from January 1, 2000, to December 31, 2019. During the study period, 3848 patients died from suicide. We calculated the standardized mortality ratio (SMR) for suicide stratified by age. In this age-stratified, nested case-control study, risk set sampling was used to match each case with 4 living controls by age, sex, and the year of the first diagnosis with schizophrenia. Conditional logistic regression was used for estimating age-stratified risk profiles. The SMR was the highest in the <25 years age group (52.8) and inversely correlated with age. Unemployment was associated with an increased risk of suicide in the 25 to 34, 35 to 44, 45 to 54, and 55 to 64 years age groups. Depressive and sleep disorders before suicide were more common among suicide cases with schizophrenia than among controls across all age groups. Drug-induced and alcohol-induced mental disorders were significantly associated with suicide but were observed only in the age group younger than 54. Heart disease, pneumonia, and moderate or severe renal disease were risk factors for suicide in the age groups less than 65. The risk factors for suicide differ by age. This study's findings can be used to optimize health-care interventions for preventing suicide in patients with schizophrenia.

Dysregulated zinc homeostasis and microadenomas in the anterior pituitary: pathological insights into suicide risk.

Suicide is a significant public health problem influenced by various risk factors, including dysregulation of the hypothalamus-pituitary-adrenal (HPA) axis. Zinc (Zn), essential for pituitary function in hormone synthesis and release, has been linked to suicide, with studies noting reduced serum levels and altered brain transport mechanisms. Despite Zn's crucial role in pituitary function and its involvement in suicidal behavior, information on pituitary Zn in suicide is scarce. Tumor cells modify Zn dynamics in tissues, and a previous report suggests microadenomas in the anterior pituitary as a risk factor for suicide. Histopathological analysis with hematoxylin-eosin stain and histochemical techniques to assess Zn homeostasis were carried out on anterior pituitary postmortem samples from 14 suicide completers and 9 non-suicidal cases. Pituitary microadenomas were identified in 35% of suicide cases and none in the non-suicidal cases. Furthermore, compartmentalized Zn (detected via dithizone reactivity), but not free Zn levels (detected via zinquin reactivity), was lower in the suicide cases compared to the non-suicidal group. This is the first report of a potential association between disrupted Zn homeostasis and microadenomas in the anterior pituitary as a feature in suicide and provides critical insights for future neuroendocrine Zn-related research.

Penerapan Aplikasi Mentari (Mental Health Remaja Indonesia) Assessment Pendeteksi Dini Kesehatan Mental Emosional Dan Perilaku Pada Remaja

Introduction: Indonesia is a developing country with a fairly large number of mental sufferers. The prevalence of emotional mental disorders with symptoms of depression and anxiety in the population continues to increase so that the tendency to self-harm and suicide continues to increase. Suicide cases in Indonesia can reach 10,000 or the equivalent of every hour there is a suicide case Objective: Participants in this activity totaled 187 people with an age range of 12 to 15 years Method: implementation of the MENTARI assessment application on adolescent mental health Result: The results obtained after using the MENTARI application were that the majority of teenagers had emotional, behavioral and peer problems. Conclusion: Many things and conditions can cause pressure (stress) during adolescence. They are faced with various changes that are occurring within themselves as well as development targets that must be achieved according to their age.

The forensic aspects of suicide and neurotrophin factors: a research study.

Introduction: Suicide represents a significant public health problem whose neurobiology is not yet fully understood. In many cases, suicidal behavior and psychiatric spectrum disorders are linked, in particular, to major depression. An emerging pathophysiological hypothesis underlines the role of neurotrophic factors, proteins involved in neurogenesis, in synaptic plasticity in response to stressors. Our research aims to evaluate the degree of expression of brain neurotrophic factor (BDNF) in brain areas involved in depressive disorder in suicidal subjects. Furthermore, we want to evaluate the expression of glial cell line-derived neurotrophic factor (GDNF) in suicidal subjects. Methods: We selected twenty confirmed cases of suicide among subjects with a clinical history of depressive pathology and possible psychopharmacological treatment, compared to ten controls of individuals who died of non-suicidal causes. For all selected cases and controls, immunohistochemical investigations were performed using a panel of antibodies against the BDNF and GDNF antigens on samples from the various brain areas. Results and discussion: The results show that BDNF was under-expressed in the cerebral parenchyma of subjects who died by suicide compared to controls, while there was an overexpression of GDNF in suicide victims, these data could be useful for a clinical application as potential markers for suicidal risk, to assess the severity of depression and development of specific pharmacological therapies for depression.

Identification of psychological stress from speech signal using deep learning algorithm

Psychological activities have various dimensions in which they correlate with their respective behavior generated by the human body. Understanding the relationship of psychological events with the help of external action units is one of the research subjects to explore various human behavior and their dependencies. Existing work applied various deep learning algorithms to outline the correlation between psychological activities with human emotions. The study of psychological analysis in the medical field is very time-consuming and costly. It requires constant monitoring of the patient for a period of time and various interrogation sessions to finalize the emotional severity of an individual. Few skilled specialists and the lack of medical knowledge of human emotions drive the need for computer vision approaches to emphasize emotion recognition, particularly in disorders. The proposed study specifically assesses the use of speech signals to identify psychological disorders in terms of stress characteristics and uses a deep learning model that incorporates feed-forward networks and long short-term memory (LSTM) to identify the degree of psychological disease. The study made use of a standard speech dataset that was gathered from a variety of patients using a standard questionnaire format. The survey was conducted throughout a few Indian states. Speech samples were taken from patients whose cortisol levels were higher than 10 %. To assess the relationship between speech and psychological activity, speech signals from each patient have been gathered. The spectrogram of the speech signal's Mel filter bank coefficients has been analyzed, and the characteristics that cause stress and those that don't have it have been further divided into categories. The suggested model classifies stress and non-stress features in 150 voice dataset subjects with an average accuracy of 98 %. The model is found to be robust for various applications such as preventing suicidal cases, improving decision-making in the diagnosis of depression patients, improves the overall mental healthcare system.

The relationship between online searches and suicide.

In this study, we examined the relationship between 131 suicide related Google search terms, grouped into nine categories, and the number of suicide cases per month in Ecuador from January 2011 to December 2021. First, we applied time-series analysis to eliminate autocorrelation and seasonal patterns to prevent spurious correlations. Second, we used Pearson's correlation to assess the relationship between Google search terms and suicide rates. Third, cross-correlation analysis was used to explore the potential delayed effects between these variables. Fourth, we extended the correlation and cross-correlation analyses by three demographic characteristics - gender, age, and region. Significant correlations were found in all categories between Google search trends and suicide rates in Ecuador, with predominantly positive and moderate correlations. The terms 'stress' (.548), 'prevention' (.438), and 'disorders' (.435) showed the strongest associations. While global trends indicated moderate correlations, sensitivity analysis revealed higher coefficients in men, young adults, and the Highlands region. Specific patterns emerged in subgroups, such as 'digital violence' showing significant correlations in certain demographics, and 'trauma' presenting a unique temporal pattern in women. In general, cross correlation analysis showed an average negative correlation of -.191 at lag 3. Google search data do not provide further information about users, such as demographics or mental health records. Hence, our results are simply correlations and should not be interpreted as causal effects. Our findings highlight a need for tailored suicide prevention strategies that recognize the complex dynamics of suicide risk across demographics and time periods.

Accuracy of ICD-10 codes for suicidal ideation and action in pediatric emergency department encounters.

According to the ideation-to-action framework of suicidality, suicidal ideation and suicidal action arise via distinct trajectories. Studying suicidality under this framework requires accurate identification of both ideation and action. We sought to assess the accuracy of ICD-10 codes for suicidal ideation and action in emergency department (ED) encounters. Accuracy of ICD-10 coding for suicidality was assessed through chart review of clinical notes for 205 ED encounters among patients 6-18 years old at a large academic pediatric hospital between June 1, 2016, and June 1, 2022. Physician notes were reviewed for documentation of past or present suicidal ideation, suicidal action, or both. The study cohort consisted of 103 randomly selected "cases," or encounters assigned at least one ICD-10 code for suicidality, and 102 propensity-matched "non-cases" lacking ICD-10 codes. Accuracy of ICD-10 codes was assessed using sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Against a gold standard chart review, the PPV for ICD-10 suicidality codes was 86.9%, and the NPV was 76.2%. Nearly half of encounters involving suicidality were not captured by ICD-10 coding (sensitivity=53.4%). Sensitivity was higher for ideation-present (82.4%) than for action-present (33.7%) or action-past (20.4%). Many cases of suicidality may be missed by relying on only ICD-10 codes. Accuracy of ICD-10 codes is high for suicidal ideation but low for action. To scale the ideation-to-action model for use in large populations, better data sources are needed to identify cases of suicidal action.

Gunshot injuries in Central Europe – Epidemiology and outcome in Germany, Switzerland and Austria – an analysis based on the TraumaRegister DGU®

BackgroundFirearms are of special interest in trauma research due to high lethality and criminal value. Strong correlation between guns per capita and fire-arm related deaths has been shown. Most of existing literature regarding gun-shot fatalities are from the U.S. and data for Central Europe is lacking. Thus, the aim of this study was to assess the legal frameworks regarding gun-ownership in Germany (DE), Austria (A) and Switzerland (CH), and to retrospectively analyze data from the TraumaRegister DGU® regarding the epidemiology, injury severity, intention and outcome of gunshot-related deaths in these countries. MethodsAll patients from TR-DGU who sustained a gunshot injury in the time period from 1st January 2009 to 31st December 2019 were considered for analysis. Only cases admitted to level 1 or 2 trauma center in Germany, Switzerland, or Austria were included. Predicted mortality was calculated using the RISC-II. Further, the legal framework for firearm posession were explored. ResultsThe legal frameworks do not differ significantly between the countries. However, only ex-military men from Switzerland are allowed to keep their automatic (military) weapon at home. We assessed 1312 gunshot fatalities (DE 1,099, A 111, CH 102) of which most were due to suspected suicide (A 72.1 %, CH 64.7 %, and DE 56.6 %, p = 0.003). Act of suspected violent crime or accidental gunshots were rare in all three countries. Amongst all gunshot fatalities, Austria showed the highest mean age (57.6 years), followed by DE (53.4 years) and CH (49.4 years; p < 0.01). Gunshot fatalities amongst all assessed countries due to suspected suicide showed a peak at the age of 60 years and above, whereas suspected violent crime delicts with gunshots were mainly seen in younger age groups. The highest mortality was found in suspected suicide cases, showing a mortality of 82.1 % (predicted 65.2 %) in Switzerland, 75.3 % (predicted 65.8 %) in Austria and 63.7 % (predicted 56.2 %) in Germany. ConclusionGunshot wounds are still rare in central Europe, but gunshot-related suicide rates are high. Gun ownership laws may have an impact on gunshot wounds due to suspected suicide. Injury patterns differ compared to countries where a high incidence of gun ownership is seen.

Out-of-hospital cardiac arrest - does location affect ROSC?

Abstract Introduction Out-of-hospital cardiac arrest (OHCA) is a significant public health problem, with hundreds of thousands of cases occurring annually in the UE and the USA. While overall survival rates remain low, studies indicate that the location of OHCA plays a critical role in survival outcomes. The discrepancy in survival rates between public and non-public locations can be stark, with public OHCA showing a notably higher chance of the return of spontaneous circulation (ROSC). This exploratory study aims to investigate the effect of OHCA location (public vs non-public) on ROSC in Poland. Methods The study was a retrospective analysis of patient records, focusing on cases handled by the Polish EMS from January 2021 to June 2022. This research utilized data from the National Emergency Medical Services. From a total of 4,925,214 EMS calls, 54,190 patients diagnosed with cardiac arrest (CA, ICD 10-I46), where paramedics initiated CPR on-site, were initially selected from the database. The study excluded patients whose CAs were due to suicide attempts, criminal acts, trauma and cases that lacked initial rhythm data of CA. Ultimately, data from 33,636 patients were analyzed. Data preprocessing was performed with Python 3.10.6 and STATISTICA 13.3. The α value used for statistical inference was 0.05. Results A higher frequency of CAs was in public places among younger individuals (p &amp;lt; 0.001). In public locations, we have also observed a lower prevalence of diabetes and higher incidences of myocardial infarction and return of spontaneous circulation (ROSC) in cases of CA (31.53 vs 35.79%). The odds of ROSC were modulated by age depending on the CA location – each subsequent increase in age by one year decreased the odds by 1.62% in at-home cases (p &amp;lt; 0.001) or by 0.40% upon public incidence (p ≈ 0.009). (Table 1). In multi-factor-adjusted logistic regression models, it is evident that the initial rhythm of VF/pVT significantly increases the likelihood of ROSC by more than 3.7 times compared to the Asystole/PEA rhythm, regardless of location. Obesity notably decreases ROSC chances in home incidents, unlike public cases. In public location CAs, conditions like stroke or myocardial infarction significantly increased ROSC odds. Additionally, the impact of age on ROSC probability varies with the location of the cardiac arrest, showing different rates of decrease with each additional year of age in home versus public incidents. Conclusion Patients with OHCA were statistically more likely to achieve ROSC if the CA occurred in a public location. In addition, if the initial rhythm was VF/pVT, the odds of ROSC were almost four times higher for both public and non-public locations. The odds of ROSC decreased with each additional year of age, regardless of the location of the CA. In addition, the presence of myocardial infarction increased the odds of ROSC in public locations. In non-public locations, obesity was associated with decreased odds of ROSC.