Causes Of Suicide Attempts Research Articles

Demographic and clinical profile of adolescents suicide attempters admitted to an emergency department during the COVID-19 pandemic - a retrospective cohort study using hospital information system.

The prevalence of suicidal attempts among adolescents during COVID-19 significantly increased compared with pre-pandemic estimates. The aim of the study was to explore the demographic and clinical profile of adolescent suicide attempters admitted to the emergency department during the COVID-19 pandemic. The retrospective analysis included, on the basis of electronic medical records in the CliniNet system, sociodemographic and clinical data of patients aged 10-18 years with a diagnosis of suicide attempt. Follow-up period: from March 20, 2020 to May 16, 2023. During the COVID-19 pandemic, there were 425 emergency department visits among adolescents aged 11-17 due to a suicide attempt, with the largest number in the 15-17 (69%) age range. The percentage of emergency department visits was higher among females (80%) and urban residents (75.3%). Self-poisoning was the most common cause of suicide attempts (52.4%), followed by self-harm (41.4%), hanging (3.2%) and jumping from a height (2.1%). The most common toxic substances in self-poisonings were antidepressants and antipsychotics, followed by paracetamol. About 70% of visits were associated with adolescent mental disorders, of which depressive disorder was the most common. One death per 425 visits was recorded (0.2%). Adolescents attempting suicide during COVID-19 were most likely female, aged 15-17, city dwellers, undergoing psychiatric treatment mainly for depressive disorders. The mental health consequences of the pandemic may be more long term, and further monitoring will be needed in the years to come.

Factors affecting patients who attempted suicide in the emergency department due to the prolonged pandemic of COVID-19.

This study examined the characteristics of patients who attempted suicide in the emergency department before and during the COVID-19 pandemic. We compared data from patients in the emergency department following suicide attempts between January 2018 and December 2021. The patients were categorized into two groups: "pre-COVID-19" and "during COVID-19" pandemic. The findings revealed an increasing trend of suicide attempts during the study period. Suicide attempts were reported at 1,107 before the COVID-19 pandemic and 1,356 during the COVID-19 pandemic. Patients who attempted suicide during the COVID-19 pandemic were younger (38.0±18.5 years vs. 40.7±18.4 years, P<0.01), had a smaller proportion of men (36% vs. 44%, P<0.01), and had fewer medical comorbidities (20.2% vs. 23.6%, P<0.05). The group during the COVID-19 pandemic reported better hygiene conditions (50.5% vs. 40.8%, P<0.01) and lower alcohol consumption (27.7% vs. 37.6%, P<0.01). Patients who attempted suicide during the COVID-19 pandemic had higher rates of use of psychiatric medications and previous suicide attempts. The most common reasons for the suicide attempt were unstable psychiatric disorders (38.8%), poor interpersonal relationships (20.5%), and economic difficulties (14.0%). Drug poisoning (44.1%) was the most common method of suicide attempts. Subgroup analysis with patients who attributed their suicide attempts to COVID-19 revealed a higher level of education (30.8%) and employment status (69.2%), with economic difficulties (61.6%) being the primary cause of suicide attempts. These findings suggest that the prolonged duration of the COVID-19 pandemic and its effects on social and economic factors have influenced suicide attempts.

The Relationship Between Suicidal Behavior, Neurocognitive Functions, and Insight in Patients with Schizophrenia.

In schizophrenia, the relationship between suicide and cognition is unclear. We aimed to assess cognitive functions and insight in schizophrenia patients with and without suicide attempts. In our study consisting of 77 patients, 36 of the patients had attempted suicide at least once in their lives and the remaining 41 had never attempted suicide. Sociodemographic data scale, Beck Cognitive Insight Scale, and Cambridge Neurophysiological Assessment Battery were applied. In this study, patients with schizophrenia who attempted suicide had higher Beck Cognitive Insight Scale self-reflectiveness scores (P = .004), lower Beck Cognitive Insight Scale self-certainty scores (P = .040), and higher Beck Cognitive Insight Scale total score (P = .004). Delay aversion (P = .003) and risk-taking scores (P = .044) of Cambridge Neurophysiological Assessment Battery Cambridge gambling task were higher in patients who attempted suicide. In logistic regression analysis, as independent factors, the number of hospitalizations increased the risk of suicide 1.5 times per hospitalization (P = .021), Cambridge gambling task delay aversion increased the risk of suicide 8.4 times per score (P = .044), and the Beck Cognitive Insight Scale self-certainty score was shown as the factor that decreased the risk of suicide by 0.78 times (P = .024). The causes of suicide attempts in schizophrenia still preserve its uncertainty. Our results proposed a statistically significant relationship between cognitive insight and increased suicide attempts. This study also sustains that cognitive impulsivity is associated with suicidal behavior in patients with schizophrenia.

Epidemiology of Suicide by Hanging in Fars Province, Iran (2011-2019): A Population-based Cross-sectional Study.

Hanging is a common method of attempted suicide. This study investigated the epidemiological profile of attempted and completed suicides by hanging in southern Iran. This cross-sectional study was performed on 1167 suicide attempts by hanging between 2011 and 2019. All data related to suicide attempts by hanging were collected from the Fars Suicide Surveillance System. The trends in suicide cases and the mean age of attempted and completed suicides were plotted. The chi-square test was used to identify suicide-related factors. Crude rates of incidence, mortality, and standardized fatality during the study period were calculated. Finally, logistic regression was used to identify the predictors of death in individuals who attempted suicide. The mean age of those who attempted suicide was 33.21±16.82 years; the majority were male (80.5%). The rate of attempted and completed suicide by hanging were 3.50 and 2.79 per 100 000 people, respectively. The case-fatality rate was calculated as 79.34%. The results of our study indicated an increasing trend in suicide attempts by hanging. The likelihood of death was 2.28 times higher in individuals with a previous history of suicide attempts and 1.85 times higher in those with a psychological disorder. The findings of this study suggest an increasing trend in attempted and completed suicide by hanging, especially among individuals with a history of suicide attempts and psychological disorders. It is necessary to take action to reduce the rate of suicide attempts and identify the underlying causes of suicide attempts by hanging.

The relationship between causes of suicidal attempts in Iran and individual and social variables: a retrospective study

ObjectiveDetermine the prevalence of suicide attempts and the relationships between the different causes of attempts with sociodemographic and clinical characteristics among individuals in Iran.MethodsA retrospective review of data about suicide attempts from poisoning care centers in Babol city between 2017 and 2021. Multinomial regression analysis (with mental illness being the reference variable) was used to determine the factors associated with the different causes of suicide attempts (addiction, romantic relationship problems, and economic problems).ResultsThe overall prevalence of completed suicide in the population sampled was 10.8% (95% confidence interval 9.5–12.1) (244/2,263). Relative to mental disorder, given that other variables in the model are held constant the following were associated with suicide attempts. A previous history of suicide attempts was associated with increasing the relative risk ratio of attempting suicide while having no positive history of smoking was associated with reducing the relative risk ratio of a suicidal attempt. However, the use of multiple drugs to attempt suicide was associated with an increased relative risk ratio of attempting suicide with romantic relationship problems and addiction as causes of suicide attempts. The first year of data collection (2017) and the female gender were both associated with an increased relative risk ratio of having a suicide attempt due to romantic relationships and economic problems. A family history of suicide was associated with an increased relative risk ratio of suicide attempts due to romantic relationship problems. However, using Pesticides-aluminum phosphide and detergent and javel water to attempt reduced the relative risk ratio of attempting due to romantic relationship problems. Age, self-employment, middle income, and married were associated with an increased relative risk ratio of suicide attempts among individuals due to addiction. However, staying longer at the emergency department was associated with a reduced relative risk ratio of having had a suicide attempt due to addiction.ConclusionsThis study highlights the interplay between romantic hardships, addiction, economic hardships as reasons for suicide attempts and various sociable variables in a population in Northern Iran. The most associated reason for suicide attempts was romantic relationship hardships. Therefore, interventions such as sessions on conflict resolution, boundary setting, and management of grieving would greatly benefit this society and reduce the rate of suicide, especially among individuals with a history of suicide attempts.

Suicidal tendency through poisoning and its outcome among young population. An alarming mental health issue.

Introduction: Among low-middle-income and underdeveloped countries of the world around 75% of overall mortality among the young population is through suicidal mechanisms. Mechanism of such acts varies among underdeveloped countries; one common mechanism is through intake of different poisons. Most of cases are not recorded properly and many of those people die before reaching hospitals and are never registered.&#x0D; Objectives: To evaluate the frequency of suicidal acts among youth through different poisonous agents and their outcomes.&#x0D; Methodology: This descriptive study was conducted at department of neurosurgery and Intensive care unit (ICU). Between January 2018 to June 2018, all cases of attempted suicide through ingestion of some poison, initially registered at accident and emergency department and later verified from medicolegal and intensive care unit were included for the current study. &#x0D; Results: A total of 221 cases were reported, mostly from Hyderabad city. Rat killer poison, Black stones, and Organophosphate are most common poisons used for ingestion. Most case were registered during month of March and April. Black stone and organophosphate have higher mortality as compared to others. Domestic issues and broken relationships followed by poverty were the most prevailing cause of suicidal attempts. The incidence rate of suicidal attempts through poison ingestion in the Sindh youth population is 2.351 with a 0.030 mortality rate.&#x0D; Conclusion: Collaborative efforts between nongovernmental organization, legislative bodies and designated medicolegal hospital having indigenous intensive care unit and neurosciences institute is needed if youth is to be salvage. Those survive needs prolong social support. &#x0D; Keywords: Youth, Suicide, Poison, Organophosphorus&#x0D;

English

BACKGROUND Psychiatric illness is the most common cause of suicidal attempt which increases the risk further if left untreated. Suicide attempt is one of the forms of suicidal behaviour, which includes suicide ideas, suicide plans and suicide attempts, as these increase the risk further. The purpose of this study was to assess the prevalence and psychiatric comorbidity among suicide attempters. METHODS In this cross-sectional study, samples were collected from patients visited to outpatient department (OPD)/in-patient department (IPD) at a tertiary care center. A total of 50 sample size of both sex with age group of 18 - 65 years are considered. Severity of suicide attempts was assessed by using suicide risks form scale. RESULTS Depression is found to be the most common cause of suicide attempt among mood disorders followed by anxiety disorders, personality disorders and substance use disorders respectively. CONCLUSIONS Our study proved the presence of psychiatric co-morbidity among suicide attempters. Co-morbidity worsens the suicidal risk further as assessed. KEY WORDS Psychiatric Comorbidity, Suicide Attempts.

QUINALPHOS POISONING: A SURVIVOR'S CASE

Quinalphos is an organophosphorous compound that is highly toxic in nature and an inhibitor of cholinesterase. It is an insecticide available in liquid form, in different amounts such as 25% emulsifiable concentrate, 35% emulsifiable concentrate and commonly used for crops such as cotton, mustard, paddy, etc. The minimum dosage for use is 150-1500 ml. Organophosphate poisoning has been a leading cause of suicide attempts in developing countries. This study sheds light on a case in which quinalphos was mistakenly swallowed, causing side-effects of cholinesterase such as dry mouth, diarrhea, and salivation. Agri-farmers in contact with OP pesticides on a daily basis should be provided with information and guidance on the use of products to avoid damage.

The Epidemiological Study of the Children Committing Suicide with Toxic Substances Admitted to the Emergency and Pediatric Wards in Iran (2013-2016)

Introduction: Poisoning is the most common method of non-fatal suicide. In recent years, poisoning caused by the use of medications and chemicals has increased. The present study aimed to investigate the rate of suicide using toxic compounds in Iranian children.Methods: This retrospective study was conducted using the data of 83 children aged 5-16 years who attempted suicide using toxic substances and were admitted to the pediatric and toxicology departments of Imam Reza Hospital in Mashhad, Iran. Results: Among 500 suicide cases, 83 committed suicide using toxic substances, and 8.4% of the suicides were committed by children aged 5-7 years. In addition, 60% of the suicide cases were aged 14-16 years. In total, 45.5% of the children committed suicide with prior planning (statistically significant). The peak time of referral to the emergency department was between 6-12 PM, and more than 90% of the patients were admitted with stable vital signs. The most commonly used toxic substance was organophosphate. During admission, psychiatric counseling was not provided to 36.1% of the patients, and the clinical outcomes also showed the use of non-lethal doses. Conclusion: According to the results, it is of utmost importance to assess the underlying causes of suicide attempts in early childhood (e.g., prior planning and antisocial behaviors), especially with the increased age of children to 14-16 years in such incidents.

Inhibition of mesenchymal stromal cells’ chemotactic effect to ameliorate paraquat-induced pulmonary fibrosis

BackgroundParaquat (PQ) poisoning is one of the leading causes of suicide attempts in China signature by acute onset of respiratory distress with massive matrix production resulting in progressive pulmonary fibrosis. There is no specific antidote and mortality remains high without effective treatment available. The cellular mechanisms underlying PQ-induced pulmonary fibrosis remain largely unknown. ObjectivesTo determine the origin of mesenchymal stem cells (MSCs) migrated to the lung after PQ exposure and their roles in PQ-induced pulmonary fibrosis, to further explore the possible mechanisms involved in these processes, and to help finding novel therapies. MethodsWe used a combination of lineage tracking techniques to investigate the contributions of several cells of MSCs, marked by Nestin or CXCL12, and traced their co-expression of α-smooth muscle actin (α-SMA), a marker for fibrosis, or their co-location with matrix production, marked by collagen-1 production (Col1-GFP) following PQ exposure. Then, we used a CXCL12flox/flox; Prx1-Cre mice and a pharmacologic agent AMD3100 to selectively deplete chemotactic mechanism of the MSCs, and tested pro-fibrotic pathways, fibrotic processes and survival of mice after PQ exposure. ResultsOur results showed that after paraquat exposure, the residential Nestin + MSCs were quickly expanded and contributed to extracellular matrix production. Moreover, when we used a CXCL12flox/flox; Prx1-Cre mice to selectively deplete chemotactic mechanism of the MSC, we found that PQ exposure in these mice failed to activate pro-fibrotic pathways including TGF-β, Wnt and EGFR signaling. Furthermore, when the chemotactic effect of MSCs via CXCL12 was blocked by a pharmacologic agent, AMD3100, it alleviated the development of the fibrotic process and improved survival rate in mice exposed to PQ. ConclusionCollectively, our data suggest paraquat intoxication rapidly activated Nestin + MSCs and that blocking chemotactic effects of MSCs by perivascular CXCL12 inhibition may effectively protect pulmonary injury following paraquat exposure. Our results revealed a novel mechanism for post-PQ lung injury and indicated a novel therapeutic option to attenuate fibrosis induced by paraquat.

Clinical profile and outcome of children presenting with poisoning or intoxication: a hospital-based study

Background: Poisoning is a common preventable cause of morbidity and mortality in children. Most of the poisoning in children less than 5 years of age is accidental. Not much of Indian data is available particularly from this part of the country. So, authors conducted a retrospective hospital record-based study to know clinical profile and outcome of children presenting with poisoning in our set up. The objective was to study clinical profile, outcome of childhood poisoning and intoxication in Jammu District (Jammu and Kashmir) IndiaMethods: This was a retrospective hospital record-based study done in patients who were admitted in pediatric wards and pediatric intensive care unit (PICU) of SMGS Hospital Jammu with history of ingestion of poison or intoxication or envenomation from January 2017 to December 2017. The data collected was analyzed with SPSS 12.0 software. Demographic and etiological factors were retrospectively recorded and analyzed.Results: There were 227 children enrolled in study with an incidence of 0.99%. Male: female ratio was 1.2:1. Most of the children were asymptomatic and majority of them arrived to the hospital in less than 2 h. The majority of our patients 115 (50.66%) were in the 13-18 years age group. Organophosphorus poisoning was the commonest poisoning seen in 51 (57.30%) patients followed by snake bite 29 (55.77%), insect bite 17 (32.69%), Phenol 14 (77.78%), kerosene 11 (12.36%) and rat poison 10 (11.23%). Alcohol problem occurred in 9 (24.32%) cases. The most frequent cause of suicide attempt were school problems, followed by conflict in the family. Route of poisoning was ingestion in 173 (76.21%) cases followed by bites 53 (23.35%) and inhalation in 1 (0.44%) case. Vomiting 105 (46.25%) was the predominant clinical feature. Aspiration pneumonia 17 (43.59%) followed by respiratory failure 7 (17.95%) were the most common complications. During treatment 67 (27.91%) received gastric lavage and 28 (12.33%) received antidotes. Overall survival was 210 (92.51%), among remaining cases 2 (0.88%) cases died in hospital and 15 (6.61%) cases left against medical adviceConclusions: Parental health education will decrease the occurrence of childhood poisoning. Along with the parents and teachers, media also should take active steps to educate the rural population about the preventive measures from bite, stings and handling of poisonous agents.

Sakarya İlinde gerçekleşen intihar girişimi vakalarının değerlendirilmesi/Evaluation of suicide attempts in Sakarya

Amaç : Bu araştırmada 2009-2010 yılları arasında Sakarya’da hastanelerin acil servisine intihar girişimi nedeniyle başvuran vakaların değerlendirilmesi amaçlanmıştır. Yöntem: Bu çalışma Ocak 2009 ve Aralık 2010 tarihleri arasında Sakarya’da bulunan tüm devlet ve özel hastanelerin acil servislerine intihar girişimi nedeniyle başvuran hastaların (n=1566) verileri incelenerek gerçekleştirilmiştir. Bulgular : İki yıl için 15 yaş ve üzeri kaba intihar girişim hızı kadın ve erkeklerde sırasıyla 100000 nüfusta 191.98 ve 51.88’dir. Toplam 1566 vakanın 1236 (%78.9)’sı kadın, 330 (%21.1)’u erkektir ve çoğu 15-24 yaş grubundadır. Hem kadınlarda ve hem de erkeklerde en sık başvurulan intihar şekli ise ilaç ve toksik madde kullanımı idi ve sıklık erkek ve kadınlarda sırasıyla %93.8, %96.8 idi. Tekrarlanan intihar girişim sıklığı kadınlarda %17.2 ve erkeklerde %13.9 bulunmuştur. Sonuç : Bu araştırmada intihar girişim sıklığı kadınlarda erkeklerden daha yüksek bulunmuştur. Ayrıca tekrarlayan intihar girişimi sıklığı araştırma grubunda topluma göre çok yüksek bulunmuştur. İntihar girişimlerini önlemek için risk faktörlerinin ve çözüm yollarının belirlenmesine yönelik topluma dayalı analitik ve müdahale epidemiyolojik araştırmaların yapılmasına ihtiyaç vardır.

Understanding Suicide Attempts Among Gay Men From Their Self-perceived Causes

Gay men are at higher risk of suicidality. This paper describes the causes of suicide attempts as perceived by the men themselves and analyzes their impact on severity and recidivism. Mental health surveys conducted among gay men in Geneva, Switzerland, from two probability-based time-space samples in 2007 and 2011, were merged to yield a combined sample N = 762. Suicide ideation, plans, and attempts were assessed, and respondents who had ever attempted suicide answered open questions about perceived causes which were coded and categorized for analysis within the framework of cultural epidemiology. In all, 16.7% of the respondents reported a suicide attempt in their lifetime (59.5% of them with multiple attempts). At their latest attempt, over two thirds asserted intent to die, and half required medical assistance. There was a wide variety of perceived causes, with most individuals reporting multiple causes and many of the most common causes cited at both the first and most recent subsequent attempts. Social/inter-personal problems constitute the most prominent category. Problems with love/relationship and accepting one's homosexuality figure consistently among the top three causes. Whereas the former tend to be associated with weaker intent to die, the latter are associated with the strongest intent to die and reported at multiple attempts. Problems with family are among the most common perceived causes at first attempt but not at the most recent subsequent attempt. Nevertheless, they tend to be related to the strongest intent to die and the greatest medical severity of all the perceived causes. Ten percent of men attempting suicide cited depression as a cause. Although it tended to be associated with weaker intent to die, depression was most likely to be reported at multiple attempts. Respondent-driven assessment yielded both common and idiosyncratic causes of suicide and their distinct effects. Some of these perceived causes are not prominent in the current literature, yet they have important implications for understanding risk and preventing suicide among gay men.

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.

Analysis of sociodemographic data of the patients presented to a state hospital because of suicide attempt

Suicide is a universal problem with a significant cause of death. The suicide event can be seen in patients with mental health disorder such as depression, anxiety or personality disorder and in normal people reacting stressful life circumstances. Thus, the suicide risk factors in the region must be analysed to determine the social, the cultural and the public requirements of the region. Dr. Ersin Arslan Government Hospital is a region hospital. The social status and the characteristics of the patients that admitted to Dr. Ersin Arslan Government Hospital Emergency Service after suicide attempt in 2013 were determined. The patients were characterized as follows; 52.16% were them in 15-24 age interval, 64.18% of them woman, 37.98% of them graduated from elementary school. 73.03% of women and 77.18% of men were unemployed. The most common cause of suicide attempts for men and for women were family related problems. However, family related problems were more often reason for suicide attempts for women (52.43%) than for men (36.24%). The second most common cause of suicide attempts for woman patients was marriage (22.1%). In The South eastern Region, as a result of dominant male ideology, gender inequality processes and this creates significant risk factor for suicide attempts for women. The second most common reason for men was alcohol-substance abuse (16.78%). Also, this characteristic draws attention to alcohol-substance abuse in the region.

SPECTRUM OF ACUTE PHARMACEUTICAL AND CHEMICAL POISONING IN NORTHERN BANGLADESH

Background: Acute poisoning is a major public health problem in Bangladesh. It is a common method for suicide. A clear picture regarding clinical presentation, most commonly used toxic agents, background factors and outcome of poisoned patients is necessary in every region. The aim of this study was to investigate frequency and outcome of acute pharmaceutical and chemical poisoning cases in Northern Bangladesh. Methods: This was a retrospective descriptive study on poisoned patients with 18 years of age and above who were admitted to Rangpur Medical College Hospital during 1st December 2011 to 30th November 2012. Results: During the study period, a total of 956 patients were investigated. Males slightly outnumbered females (51.6%). The majority of patients (92%) were in the 18-40 year age-group. Regarding occupation, housewives were the most frequent (33.6%) followed by farmers (31.7%) and students (20.9%). Organophosphate compounds (OPC) were the most commonly used toxic agents (73.5%). Most of poisoning cases occurred following suicidal attempts (88%). Familial disharmony was the main cause of suicidal attempts (92.3%). Univariate Analysis showed that age less than 40 years, being married, living in rural areas and educational attainment below secondary level were significantly associated with an increased risk of poisoning (P<0.001). Conclusion: All tertiary hospitals should be well equipped with antidotes of OPCs and other supportive treatments in Bangladesh. Furthermore, strong rules must be applied to prevent the distribution of benzodiazepines without prescription. In addition, people with age of less than 40 years, housewives and farmers, rural residents and those with less educational attainment should be targeted for prevention and educational programs against deliberate self-poisoning.

Les facteurs liés aux tentatives de suicide dans une population tunisienne de patients atteints de schizophrénie

The mortality rate in schizophrenia is 4.5 times higher than in the general population. Suicide is one of the main causes of premature death in this affection. Life time prevalence of this behavior ranges from 10 to 15%, which represents a risk 20 to 50 times higher than in the general population. In addition, 40 to 93% of patients who committed suicide had attempted suicide previously. Thus, assessment of correlated variables with suicide attempts is a fundamental issue for developing preventive and therapeutic strategies in suicidal behavior. To the best of our knowledge, no systematic study has yet investigated suicide attempts in an Arabic Muslim population with schizophrenia, although many authors have demonstrated cultural differences in socio-demographic and clinical variables related to suicide attempts within many geographic areas around the world.The objectives of this study were to assess the frequency and characteristics of lifetime suicide attempts in Tunisian schizophrenic outpatients and to determine the correlated socio-demographic, clinical and therapeutic variables.A total of 134 patients with a DSM-IV diagnosis of schizophrenia who attended the outpatient department of the university psychiatric hospital of Tunis were included. The main demographic and lifetime clinical variables considered were: gender, marital status, family history of psychiatric disorders and suicide attempts, age at time of recruitment, age at onset of illness, duration of untreated psychosis defined as the interval between the onset of the illness and the first antipsychotic treatment, the type and dose of current treatment, dose of antipsychotic drugs converted to chlorpromazine equivalents, extrapyramidal side effects assessed with the Simpson Angus rating scale, number of hospitalizations, comorbid substance abuse, cigarette smoking, severity of psychopathology measured with the Positive And Negative Syndrome Scale (PANSS), and history of at least one suicide attempt. A suicide attempt was defined as a self-destructive act carried out with at least some intent to end one's life. We also assessed the number, the used methods and the causes of suicide attempts. We subdivided the sample into two sub samples according to the presence or absence of suicidal attempts. We analyzed and compared the demographic, clinical and therapeutic variables.Out of the 134 patients, 45 (32%) had attempted suicide at least once. Half of them (49%) had attempted suicide more than once. The number of suicide attempts varied from one to five with an average of 1.8. The most used methods were medication overdose (n=18, 23.4%), followed by organophosphate poisoning (n=11, 14.3%), defenestration (n=9, 11.7%) and hanging or using sharp objects (n=7, 9.1% for each of them). The main reported reasons of suicide attempts were depressive symptoms (n=46, 60%) including depressed mood and hopelessness, stressful life events (bereavement, divorce, separation) (n=35, 46%) and presence of delusions and/or auditory hallucinations (n=25, 32.5%). No differences were found between the two groups regarding the different socio-demographic variables. Significant differences were found with respect to a duration of untreated psychosis equal to or more than one year (P<0.001), smoking in men (P=0.03), positive symptoms score on the PANSS (P<0.001), scores of Simpson-Angus scale (P=0.029) and poor medication compliance (P=0.02).Demographic variables as suggested by other studies are less valuable predictors of suicide attempts in patients with schizophrenia. Interventions for reducing such behavior should focus on clinical variables and integrate an early diagnosis of the disease, reduce positive psychotic symptoms and tobacco consumption, correct extrapyramidal signs and improve medication compliance.

Análisis de los intentos de autolisis en un área de salud. 2008-2010

ObjectiveThe aim of this study is to determine the sociodemographic and psychopathological features and risk factors associated with suicide attempts. DesignA descriptive cross-sectional study based on medical records. Emergency Primary Care Centres (Jumilla, Yecla) and Hospital Emergency Departments (Yecla, Murcia, Spain). ResultsThe suicide attempt rate increases in younger people (average of 36.4 years old). Suicide attempts are higher among women (67%). In terms of psychopathological data, suicide attempts were characterised by a higher prevalence of depression and anxiety disorder (30%), and substance abuse (13%). The percentage of patients who had made a previous suicide attempt was 37%. Self-poisoning was the most recurrent method of suicide attempt, present in at least 80% of the cases. Gender was a significant factor in the cause of suicide attempt (P=.042) and psychopathology (P=.011). The geographic origin of the patient is significantly associated with the suicide method used (P=.000). ConclusionsSuicide treatment protocols and suicide prevention programs must be developed, as well as recording the risk factors in the patient history.

Chinese demented inpatients admitted following a suicide attempt: a case series

Suicide attempt is rarely reported in dementia. This study explores the clinical and phenomenological aspects as well as the treatment of Chinese demented patients who have attempted suicide. During a 1-year period, demented patients admitted to a geropsychiatric unit as a result of suicide attempt were investigated for factors related to suicide attempt, such as motives and method. In this 1-year survey, seven demented patients (11.7% of all demented patients) were admitted immediately following a suicide attempt. All seven patients had mild or moderate dementia. Three had significant clinical depression symptoms on admission. In all patients, delusions were the primary cause of suicide attempt. Their suicidal ideations were improved with antipsychotic and antidepressant treatment. These cases, taken together, suggest that suicide attempt can occur in patients with dementia. It is important for clinicians to be aware of the risk of suicide in patients with dementia, especially those associated with delusions, even if they have no major depression or suicide attempt history. Antidepressants and antipsychotics may play a critical role in the treatment of suicide attempt in dementia.

Perceived causes of suicide attempts by U.K. South Asian women.

Perceived causes of suicide attempts were examined in 180 ethnic South Asian women living in the London area. The 3 factors endorsed most frequently and strongly as causes of suicide attempts in South Asian women were violence by the husband, being trapped in an unhappy family situation, and depression.