Female Suicide Attempters Research Articles

Risk Factors Associated With Various Severities of Suicidal and Non-Suicidal Self-Harm Among Israel Defense Forces Soldiers-A Nested Case-Control Study.

Severe suicide attempt is a major risk factor for completed suicide. The aim of the present study was to focus on suicide behavior and timing to gain better understanding of these populations. The nested case-control retrospective study based on medical records of 246,866 soldiers, who demonstrated suicide attempts of varying severity, including death by suicide were compared with soldiers who did not demonstrate such behavior. Risk for death by suicide was associated with males, military seniority of less than 12 months. High frequency of visits with mental health care professionals was associated with being severe suicide attempters (SAs). Moderate suicide attempts were associated with being a male, visiting a primary care physician frequently, and belonging to one of the two latest immigrant groups in Israel (Ethiopians and former Soviet Union). Mild suicide attempts were associated with having a psychiatric diagnosis on the enlistment day, visiting a mental health care professional at high or average frequency, visiting a primary care physician at high or average frequency, being a male, and being born in the former Soviet Union. While the proportion of males demonstrating suicidal behavior was higher than the females', severe SAs were higher among females. There was a clear tendency of female suicide attempters at all levels to act toward the end of their military service. Although half of the SAs were females, their characteristics may be similar to those of the male SAs, contrary to the sex differences in suicide behavior among civilians.

Gender differences in death during hospitalization following a survived suicide attempt in Taiwan from 1998 to 2015: a cross-sectional study

Background: This study examines gender differences in death during hospitalization following a survived suicide attempt. The outcome of death during hospitalization following a survived suicide attempt and yearly rate of suicide attempts ending in hospitalization is examined. Methods: Data on 53,670 hospitalized patients injured by suicide attempt between January 1, 1998, and December 31, 2015, were collected from the National Health Insurance Database. From 1998 to 2015, 24,052 male patients and 29,618 female patients were screened and matched by age, gender, and filing date. Multinomial logistic regression was used to analyze the risk of death in terms of gender differences and suicide and hospitalization. p < 0.05 was considered statistically significant. Results: The risk of death during hospitalization after a survived suicide attempt of hospitalized male suicide patients was 1.694 times that of females (adjusted odds ratio (AOR) = 1.694, 95% confidence interval (CI) = 1.569–1.829). The risk of suicide and hospital death for male patients older than 65 years was 3.608 times that of male patients aged 10–24 years (AOR = 3.608, 95% CI = 2.914–4.468) and 6.648 times that of females (AOR = 6.648, 95% CI = 5.105–8.658). Every 1-point increase in the Charlson Comorbidity Index score of male suicide patients increased the risk of suicide hospital death by 5.6%, which indicates that the number or severity of the complications experienced by hospitalized male suicide patients was higher than that of women. Conclusions: Although men comprised a smaller proportion of hospitalized individuals following a survived suicide attempt, they also arrived in more critical condition and were more likely to die during their hospitalization. The increasing trend of female suicide attempt hospitalization rates is greater than that of males and yearly rate of suicide attempts ending in hospitalization is examined.

Gender differences in prevalence and clinical correlates of anxiety symptoms in first-episode and drug-naïve patients with major depressive disorder

AimGender differences in major depressive disorder (MDD) are commonly reported; however, gender differences in first-episode and drug-naïve (FEDN) patients with major depressive disorder remain unclear. This study aimed to examine potential gender differences in the prevalence and clinical correlates of comorbid anxiety in FEDN patients with MDD. MethodsA cross-sectional study was conducted with1718 FEDN patients with MDD. Patients' demographic and clinical data were collected and analyzed using standardized clinical evaluation forms. The Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA) and Positive and Negative Syndrome Scale (PANSS) were used to evaluate depression, anxiety and psychotic symptoms, respectively. ResultsThere were no gender-based differences in the comorbidity rates of MDD and anxiety disorders (male: 10.2% vs. female:12.7%, P = 0.123). The prevalence of MDD with severe anxiety symptoms in male patients was similar to that of female patients (80.8%vs. 80.1%, P = 0.749). Male MDD patients were younger, had earlier age of onset, and were less likely to be married. In both the male and female groups, HAMD scores, HAMA scores, suicide attempts, and psychotic symptoms in patients with severe anxiety symptoms were higher than those patients without severe anxiety symptoms (all p ≤ 0.001). Furthermore, binary logistic regression analysis showed that psychotic symptoms and suicide attempts significantly predicted severe anxiety symptoms in both male and female patients with MDD, while body mass index(BMI)significantly predicted severe anxiety symptoms in MDD females only. ConclusionOur study showed that there were no gender differences in the prevalence of comorbid anxiety in FEDN patients with MDD. Suicide attempts and psychiatric symptoms were associated with severe anxiety symptoms in both men and women with MDD, whereas BMI was only correlated with severe anxiety symptoms in women.

Temporal Trends in Suicidal Ideation and Attempts Among US Adolescents by Sex and Race/Ethnicity, 1991-2019

Disparities by sex and racial/ethnic group in suicide death rates are present in US adolescents. Whether disparities in suicide death extend to groups targeted for suicide prevention efforts, namely, those with suicidal ideation or nonfatal suicide attempts, is unknown. To examine differences in temporal trends between suicidal ideation and suicide attempts in US adolescents from 1991 through 2019 by sex and race/ethnicity subgroups. A cross-sectional analysis of the national Youth Risk Behavior Survey, weighted to represent US adolescents from 1991 to 2019, included 183 563 US high-school students in grades 9 to 12. Data were analyzed from September 16, 2020, through April 12, 2021. Calendar year, sex, race/ethnicity, and interactions of sex and race/ethnicity. Survey-weighted prevalence estimates, annual percentage changes (APCs) and average APC in the survey-weighted prevalence of suicidal ideation and nonfatal suicide attempts, constructed from self-reported suicidal ideation, plan, and attempts in each survey year, by sex, race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, non-Hispanic Asian or Pacific Islander and Native Hawaiian, American Indian/Alaska Native), and their interactions (sex × race/ethnicity). In 183 563 (unweighted) included adolescents (mean [SD] age, 16.07 [1.23] years; 94 282 females [weighted percentage, 49.4%; 95% CI, 48.8%-50.1%]), the prevalence of suicidal ideation decreased from 1991 to 2019 (from 19.4% to 15.8%; 95% CI, 0.7%-0.9%), whereas the prevalence of nonfatal suicide attempts increased from 1991 to 2019 (from 7.3% to 8.9%; 95% CI, 1.0%-1.4%). Joinpoint regression indicated a -3.1% (95% CI, -3.7% to -2.6%) annual decrease in suicidal ideation between 1991 and 2009, followed by a 3.4% annual increase (95% CI, 1.9% -4.8%) between 2009 and 2019. Decreasing followed by increasing trends in suicidal ideation showed modestly different turning points in female (1991-2009, 2009-2019), White (1991-2009, 2009-2019), Hispanic (1991-2007, 2007-2019), and Black (1991-2005, 2005-2019) adolescents. Although no significant trends were observed in suicide attempts from 1991 through 2019, male (68.4% increase; 95% CI, 0.2% -1.2%) and Black (79.7% increase; 95% CI, 0.1%-1.5%) adolescents had greater increases in the prevalence of suicide attempts. Interaction of sex and race/ethnicity revealed increases in suicidal ideation in White females from 2009 to 2019 (APC, 4.3%; 95% CI, 1.5%-7.1%), Black females from 2005 to 2019 (APC, 3.4%; 95% CI, 1.4%-5.4%), and Hispanic females from 2009 to 2019 (APC, 3.3%; 95% CI, 1.0%-5.6%) and suicide attempts in White females from 2009 to 2019 (APC, 3.1%; 95% CI, 0.3%-6.0%). The findings of this study show apparent sex and racial/ethnic differences in trends in suicidal ideation and suicide attempts. Increases in suicidal ideation since 2009 were observed in female individuals; changes in male and Black adolescents represented the largest increase in the prevalence of suicide attempts between 1991 and 2019. Evidence-based suicide prevention programs need to be tailored by sex and race/ethnicity, calling for greater diversification of health care system, school, and community prevention approaches.

Evaluation of risk factors for Suicide Attempts in Turkey's East: A Five-Year Study.

Objectives:Suicide attempt has different risk factors for each community. In the study we aimed to reveal the causes of suicide attempt in Turkey’s Eastern part and to make suggestions to prevent suicide.Methods:For this study, 130 patients who were admitted to the Emergency Department of the University Hospital due to suicide attempt between January 2013 and December 2017 were included. Our University Hospital is the largest hospital in the East of Turkey. The data were obtained from hospital records and files of judicial investigations. Clinical progress records were obtained from the hospital archive. Investigation files were received from local judicial units.Results:Fifty six percent of the patients (n = 73) were female. 48% of female cases (n = 35) were married. There was major depressive disorder in 34% (n = 44) of the cases. Medicine taking was the most frequent suicide method with 63% (n = 82). The main reason for suicide was parental conflicts for female cases; and psychiatric and financial problems for males.Conclusion:Family therapy for married individuals would reduce suicide attempts in females. Psychiatric history is an important risk factor and it should be ensured that these patients are followed up regularly by the health institutions and their relatives. To prevent drug abuse, there should not be too much medicine in homes. If medicine is available at home, it should be kept in a safer environment.

Evaluation of Female Suicide Attempts in Cases Presenting to Adult Emergency Service with Suicide Attempts

Evaluation of Female Suicide Attempts in Cases Presenting to Adult Emergency Service with Suicide Attempts

Evaluation of the Frequency of Suicidal Thoughts and Attempts and Related Factors in Female Adolescents with Anorexia Nervosa

Objective: Although anorexia nervosa (AN) has been associated with increased suicidal attempts, clinical variables that that influence this relationship still remains to be elucidated. The aim of this study is to examine the frequency of suicide attempts in females with AN, and the general psychopathology and associated clinical variables in patients with anorexia nervosa who do and do not attempt suicide.Methods: In this study, archive files and reports of 43 females with AN admitted to the department of child and adolescent psychiatry between 2015 and 2020 were analyzed retrospectively. Participants' socio-demographic variables (age, peer relationships, psychiatric comorbidity, abuse history, history of suicidal thought and/or plan, family history of AN, etc.) and clinical (subtypes of AN, clinical features, response to treatment, the presence of suicidal ideation/attempts, etc.) characteristics were investigated. Also, the Children's Depression Inventory (CDI) and the State-Trait Anxiety Inventory (STAI) were used.Results: Our results revealed that 18.8% of patients with restricting AN, 81.3% of patients with purging or binging/purging AN, and 37.2% of the entire sample had at least one suicidal attempt, and 39.5% of the patients engaged in nonsuicidal self-injury behaviors. Further, binge-eating/purging AN type, more severe forms of AN, treatment resistance and poor insight or lack of insight, the presence of physical and emotional abuse, domestic violence, and the existence of psychiatric comorbidity markedly elevated the risk of suicide.Conclusion: The present study shows that patients with AN should be investigated not only for problems with eating and weight but also for possible non-suicidal self-harm behaviors, suicidal attempts.

Suicide Attempts Among 1,437 Adolescents Aged 12-17 Years Attending Junior High Schools in Ghana.

Background: Emerging research on suicidal behaviors among adolescents in Ghana has been conducted mainly among senior high school students. Aims: We aimed to estimate the 12-month prevalence of suicide attempts and describe some of the general and gender-specific associated factors among adolescents attending junior high schools (JHSs) in Ghana. Method: We analyzed data from the 2012 Ghana Global School-Based Student Health Survey. The sample consisted of 1,437 adolescents aged 12-17 years. We performed bivariate and multivariable analyses to assess the associations between 12-month suicide attempts and some psychosocial factors. Results: The overall 12-month prevalence estimate of suicide attempts was 27.6%, with comparable estimates between males (26.4%) and females (28.8%). In the final adjusted multivariable models, bullying victimization (AOR = 2.57; 95% CI = 1.53, 4.31), alcohol use (AOR = 1.94; 95% CI = 1.10, 3.41), and having no close friends (AOR = 0.36; 95% CI = 0.17, 0.75) were associated with increased odds of suicide attempts among males, whereas anxiety (AOR = 2.57; 95% CI = 1.54, 4.29) and being sexually active (AOR = 2.42; 95% CI = 1.25, 4.68) were associated with increased odds of suicide attempts in females. Limitations: The correlational nature of this study did not allow for causal inferences. Conclusion: The study underscores adolescent suicide attempts as a public health concern in Ghana.

Neurocognitive vulnerability to youth suicidal behavior

Neurocognitive deficits have been associated with suicidal behavior in adults with major depressive disorder (MDD), but it is unclear if similar impairments are linked to youth suicidal behavior. This study compared neurocognitive functioning in suicidal and non-suicidal youth with a lifetime history of MDD and explored whether neurocognitive functioning predicted future suicide attempts.Neurocognition was examined using the Cambridge Neuropsychological Test Automated Battery (CANTAB) and Iowa Gambling Task (IGT) in 309 youths ages 12–15 (117 suicide attempters; 132 suicidal ideators; 60 never-suicidal). Prospective analyses included 284 youths (41 youth with a future attempt; 243 without a future attempt). Multivariate analysis of variance (MANOVA) yielded a significant group-by-sex interaction effect [Wilks’ Λ = 0.901, F (16, 560) = 1.87, p = .021] for the primary neurocognitive outcomes, guiding the decision to stratify the sample by sex. Female suicide attempters and ideators were slower to respond correctly to both positive and negative emotion words than never-suicidal controls on tests of affective bias. Male suicide attempters and ideators made significantly more total and between errors than never-suicidal subjects. Exploratory analyses found that total commission errors on the Affective Go/No-Go (AGN) test significantly predicted future suicide attempts in females, and that higher strategy scores on Spatial Working Memory (SWM) tests predicted future male attempts. Study findings identified sex-specific neurocognitive deficits that differentiate suicidal and non-suicidal youth with histories of MDD. Extended longitudinal studies are needed to elucidate the temporal association between neurocognitive impairments and suicidal behavior and frame targets for early preventive interventions.

109 Near-fatal suicide attempts among Canadian Youth: A CPSP Study

Abstract Background Suicide is the second leading cause of death among Canadian adolescents. Youth who make near fatal suicide attempts, such as those requiring intensive care unit (ICU) level care, are the closest proxy to those that die by suicide; however, there is limited data on this group. Objectives To evaluate the minimum incidence rate and patterns of presentation of youth (under 18 years of age) admitted to the ICU for medically serious self-inflicted injury. Design/Methods From January 2017 to December 2018, over 2,700 paediatricians/subspecialist members of the Canadian Paediatric Surveillance Program were electronically surveyed on a monthly basis regarding cases of medically serious self-harm. Participants completed a detailed questionnaire about the reported case and descriptive statistics were used for analyses. Results Ninety-four cases (71 female; mean age 15.2 years) of confirmed (n=87) and suspected/probable (n=7) medically serious self-harm were reported. The majority (87%) of cases were reported from 4 out of 13 provinces and territories in Canada (Alberta, British Columbia, Ontario, Quebec). There were 11 deaths by suicide (M>F; p<.05). Medication ingestion was the most common method of self-harm among females (76% F vs. 52% M; p=.03) compared with hanging among males (14% F vs. 39% M; p=.009). More females than males had a prior suicide attempt (62% F vs. 32% M; p=.07) and a history of non-suicidal self-injury (NSSI) (65% F vs. 14% M; p<.05), although only history of NSSI reached significance. More females than males had a past psychiatric diagnosis (77% F vs. 55% M; p=.05), and past use of mental health services (69% F vs. 30% M; p<.001), although only service use reached significance. Half of the youth left evidence of intent (54%) and 33% of parents of included youth were aware that their child was considering suicide. Family conflict was the most common precipitating factor for suicide attempt in both females and males (46%). Conclusion These Canadian findings are consistent with international epidemiologic data that observe a gender paradox of higher rates of suicide attempts in females and greater mental health care engagement but increased suicide mortality in males with decreased involvement with mental health care. This study suggests that family conflict is a potential target for suicide prevention interventions among youth. Future research focusing on gender-specificity in risk factor identification and effectiveness of primary prevention interventions among youth is warranted.

Association of Geomagnetic Disturbances and Suicide Attempts in Taiwan, 1997-2013: A Cross-Sectional Study.

Background: A previous study in Japan found that monthly mean K index values were related to the monthly number of male, but not female, suicides. Correlations between geomagnetic disturbances and suicide/depression have also been reported in countries such as Canada, South Africa, Finland, Australia, Russia, and Japan. We have previously shown that stronger geomagnetism is linked to a higher standardized mortality ratio for suicide. To date, however, no published studies have reported the correlation between geomagnetic disturbances and suicide attempts in Taiwan. Methods: Data on the monthly number of suicide attempts in Taiwan from January 1997 to December 2013 were obtained. We performed a multivariable analysis, with the number of suicide attempts as the response variable and monthly Kp10 index, F10.7 index, sulfur dioxide, carbon monoxide, ozone, fine particulate matter (PM2.5), temperature, humidity, unemployment rate, and cosmic rays as the explanatory variables. Results: The multivariable analysis showed that Kp10 index, temperature, humidity, unemployment rate, and cosmic rays were associated with the number of male suicide attempts and that Kp10 index, F10.7 index, carbon monoxide, temperature, humidity, and unemployment rate were associated with the number of female suicide attempts. Conclusion: This is the first article reporting statistically significant relationships between the monthly number of male and female suicide attempts and the monthly mean Kp10 value in Taiwan.

Sex differences in binge drinking and suicide attempts in a nationally representative sample

ObjectivePrevalence of suicide continues to present a major public health problem, particularly among women. Identifying risk factors for suicide is vital to reduce the number of suicide deaths per year. Alcohol use is a well-known risk factor for suicidal behavior, but the association between binge drinking and suicide attempts across genders is less clear. MethodsThe current study used combined 2008–2014 National Survey on Drug Use and Health data (n = 269,078) to examine the association between binge drinking and suicidal ideation and suicide attempts across sex. ResultsLogistic regression analyses revealed that binge drinking was associated with suicide attempts in females (OR = 1.37, 95% CI: 1.09–1.73) but not in males (OR = 1.07, 95% CI: 0.80–1.43). Binge drinking was not associated with suicidal ideation in either males or females. ConclusionsIdentifying and addressing binge drinking in women may be useful as part of a suicide prevention strategy.

Leptin, Anxiety Symptoms, and Hypothalamic-Pituitary-Adrenal Axis Activity among Drug-Free, Female Suicide Attempters

Background: Dysregulation of leptin secretion and functioning of the hypothalamic-pituitary-adrenal (HPA) axis may be involved in the pathophysiology of suicide. Preclinical and clinical studies have shown interactions between the HPA axis and leptin. There is also evidence for a negative relationship between leptin and anxiety in humans. However, these possible associations have not been studied in individuals with attempted suicide. Objectives: To examine the relationship between leptin, HPA axis activity, and anxiety in individuals with a recent suicide attempt. Method: Sixty-nine individuals with a recent suicide attempt (n = 37 females; n = 32 males) were recruited and subjected to the Dexamethasone Suppression Test (DST), lumbar puncture, and evaluation with the Comprehensive Psychopathological Rating Scale from which the Brief Scale for Anxiety (BSA) was derived. Leptin was analyzed in cerebrospinal fluid (CSF) and cortisol in serum. Leptin was corrected for body mass index (BMI) by dividing CSF-leptin by BMI (CSF-leptin/BMI). Due to gender-related differences in leptin secretion and HPA axis activity, calculations were made for males and females separately. Results: Significant differences were only found among females; CSF-leptin/BMI levels correlated significantly and negatively with BSA (p < 0.05), pre-DST cortisol, and post-DST serum cortisol at 8 a.m. and 3 p.m. (all p < 0.05). Furthermore, CSF-leptin/BMI was significantly lower in nonsuppressors of dexamethasone as compared to suppressors (p < 0.05). Conclusions: These findings suggest that in females with a recent suicide attempt, low CSF leptin may be related to symptoms of anxiety and a hyperactive HPA axis.

Clinical characteristics of veterans with gambling disorders seeking pain treatment

ObjectivesTo examine the relationships between gambling disorder, pain, and suicide attempts among US military veterans using Veterans Health Administration (VHA) pain-related services. MethodsRetrospective cohort analysis of 221,817 veterans using pain services was included in the analysis. First, differences in sociodemographic and clinical characteristics (i.e., psychiatric comorbidities and pain-related variables) were analyzed according to gambling disorder. Second, we performed logistic regression analyses to assess the association between gambling disorder and suicide attempts. ResultsFemale sex, depressive, alcohol, drug and tobacco use disorders are positively associated with gambling disorders, while severe pain score is negatively associated with gambling disorders. Logistic regression analysis showed that gambling disorder diagnosis was associated suicide attempt in veterans who received a visit for pain in VHA in the past year. ConclusionsOur findings suggest that gambling disorder in female veterans and suicide attempts in veterans with gambling disorder should not be underestimated and warrants further consideration. Moreover, the result that veterans with severe pain may be less likely to have a diagnosis of gambling disorder needs to be confirmed.

Can Suicide Attempt be Related to Problem Drinking: Cohort Study.

Alcohol consumption is a well-established risk factor in suicidal behaviour, but there is still discussion about which factor might imply greater suicide risk-acute alcohol intoxication or being a problems drinkers. The aim of this study was to analyse the association between a suicide attempt and the drinking pattern and to evaluate the risk factors for suicide attempt among problem drinkers versus non-problem drinkers. We found that problem drinking (CAGE ≥2) is an important issue in suicide attempts. Factors predicting suicide attempt among problem drinkers were male gender, younger age, being married or in a partnership status, low education and acute alcohol intoxication prior a suicide attempt. A cohort study was performed including all cases of patients (n = 425) hospitalized in the Lithuanian University of Health Sciences after a suicide attempt. Participants completed a self-administered questionnaire that included questions on sociodemographic characteristics, the nature of the suicide attempt, the question of alcohol consumption prior to the suicide attempt and a CAGE questionnaire screening for problem drinking (CAGE ≥ 2). Two-thirds (70.9%) of male and 43.2% of female suicide attempters were problem drinkers. Problem drinking versus non-problem drinking increased the risk of suicide attempt especially according to gender (3.2 times for male), age (1.08 times for younger age), marital status (among married or in a partnership-1.58 times), education level (among < 12 years-2.04 times) and acute alcohol intoxication prior a suicide attempt (8.15 times-among intoxicated). Our results highlight that being a problem drinker as well as the use of alcohol at the time of the event is an important issue in suicide attempt,.

The Effect of Resilience and Stress Coping Styles on Suicide Attempts in Females Reporting Spouse-Related Abuse

Background: Spouse-related abuse involves a wide range of behaviors by the partner and has many debilitating consequences for the victim, such as suicide attempt. Objectives: The aim of this study was to predict the effect of resilience and stress coping styles on the likelihood of suicide attempt in females reporting spouse-related abuse. Methods: The present descriptive comparative study was conducted on 150 female victims of spouse-related abuse in the city of Ilam, Iran, during year 2016. They were matched in two groups with and without a history of suicide attempt over the past 12 months. Data collection tools included the world health organization violence against women instrument, the connor-davidson resilience scale, and the coping inventory for stressful situations. Purposive and snowball methods were used. The obtained data was analyzed using the SPSS-21 software. Results: No significant differences were observed between the two groups in terms of the frequency and severity of exposure to different forms of violence. The mean scores of resilience (P < 0.001; -13.03 to -6.34) and problem-oriented coping style (P = 0.004, -7.65 to -1.46) were significantly higher in females without a history of suicide attempt compared to the other group. For every unit increase in the resilience score, the likelihood of not attempting suicide increased by 1.134, and for every unit increase in the avoidance style score, the likelihood of not attempting suicide decreased by 0.931. This effect remained significant with the addition of demographic variables. Conclusions: A high level of resilience and the use of problem-oriented coping have a major role in reducing the likelihood of suicide attempt in females subjected to violence. Introducing couples to coping strategies, problem solving, and anger management is an integral part of life skills education.

The Cumulative Incidence of Self-Reported Suicide-Related Thoughts and Attempts in Young Canadians.

To estimate the cumulative incidence of self-reported suicide-related thoughts (SRTs) and suicide attempts (SAs) in males and females from 11 to 25 years of age in Canada. A cohort study was conducted by linking cycles 2 to 8 from the National Longitudinal Survey of Children and Youth, a representative survey of Canadians aged 11 to 25 years conducted from 1996 to 2009. The 11- to 25-year cumulative incidence of self-reported SRTs and SAs (with suicidal intent) was estimated in males and females using a novel application of a counting process approach to account for discontinuous risk intervals between survey cycles. The risk of SRTs was 29% (95% confidence interval [CI], 26% to 31%) in females and 19% (95% CI, 16% to 23%) in males. The risk of SAs was 16% (95% CI, 14% to 19%) in females and 7% (95% CI, 6% to 8%) in males. Over 70% of SRTs and SAs first occur between 11 and 16 years of age and 30% between 11 and 13 years of age, respectively. The risk of SRTs and SAs is high in young Canadians, with most events first occurring in early to mid-adolescence and possibly earlier. Females are at a higher risk compared to males. This research underscores the need for better longitudinal surveillance of SRTs and SAs in the population. A counting process framework could be useful for future research using existing longitudinal surveys suffering from design limitations relating to gaps in respondent follow-up. Furthermore, these findings have implications for younger SRT and SA risk management by clinicians and earlier implementation of suicide prevention programs.

Challenges of Combining Perspectives.

. Background: Asylum seekers have increased risk of suicide and suicidal behavior, with differences related to origin, gender, and age. There are barriers to communication in clinical encounters between asylum seekers and clinicians. There is insufficient knowledge about how communication in the clinical encounter affects the suicide risk in female asylum seekers. Aims: To explore the documented communication between female asylum-seeking suicide attempters and clinicians and how it affects treatment. Method: The medical records of 18 asylum-seeking women who had attempted suicide were analyzed with content analysis. Results: Communication between patients and clinicians was affected by: the unbearable realities of the women; difficulties for clinicians in decoding languages of distress, and understanding trauma and subjective meanings of suicide; challenges of combining patients' and clinicians' perspectives; and a sense of shared powerlessness. Limitations: The medical records did not give direct access to the patient's experience, only to the patient as documented by the clinician. Conclusion: The results suggest that clinicians working with asylum seekers who have attempted suicide need to develop an understanding of social and cultural factors and of trauma issues. A question for further study is how an enhanced integration of context and subjectivity in psychiatric practice would equip clinicians for the specific challenges encountered.

Mental disorders and suicide attempt in rural China

The prevalence of various mental disorders and their age and gender specific characteristics among suicide attempters remains unclear in rural China. This study using 1:1 paired case-control design included 409 suicide attempters and 409 paired controls matched on age, gender and place of residence. Mental disorders were assessed using the Structured Clinical Interview for DSM-IV-TR Axis I Disorders. The prevalence of mental disorders was 32.3% for suicide attempters and 4.9% for paired controls. Mental disorder constituted a significant risk factor for suicide attempt with an adjusted odds ratio of 7.16 (95%CI: 3.65–14.04). The prevalence of mental disorders was higher among male than female suicide attempters. Major depressive disorder was most common in female suicide attempters while alcohol use disorder was most common in the males. The prevalence of mental disorders seemed to increase with age. Suicide attempters of higher ages were more prone to have mood disorders, especially a major depression. Suicide attempters with mental disorders differed from those without mental disorders on a number of socio-economic characteristics and suicidal behavior features. These insights should be taken into account in strategies and efforts to improve mental health care and ultimately to reduce suicidal behavior among residents in rural China.

Premenstrual dysphoric disorder and suicide attempts as a correlation among women in reproductive age.

Women likely attempt suicide more than men and sex hormones or menstrual cycle may be associated with female suicide attempts. There are debates regarding the correlation of premenstrual dysphoric disorder (PMDD) and suicidal behaviors. The objective of this study was to examine if PMDD was associated with suicidal attempts as sex hormones are contributed in its pathogenesis. As a case-control study 120 fertile woman with regular menstrual cycles attempting suicide and admitted to a general hospital were compared with a matched control group of 120 women selected among those accompanying other patients in other wards. Psychiatric interview based on DSM-5 criteria was conducted for diagnosing PMDD. There was a significantly higher frequency of PMDD in suicide attempters than in the controls (P = 0.001); while no remarkable difference was seen in frequency of premenstrual syndrome (PMS) between the two groups (P = 0.294) and attempting suicide was not related to the menstrual cycle (P = 0.52). This study suggests that PMDD may be associated with suicidal attempts, however it is not related to menstrual cycle. No relationship was found between PMS and suicidal acts.