History Of Previous Suicide Attempts Research Articles

Evaluation of Risk Factors Associated with Severe Suicide Attempts among Individuals Presenting at the Emergency Department

Severe suicide attempts represent critical incidents characterized by high lethality or medical acuity, posing significant risks of morbidity and mortality. Objective: To assess the risk factors linked to severe suicide attempts among those presenting in the Emergency Department. Methods: The cross-sectional study took place at the Department of Forensic Medicine, Makran Medical College, Turbat, Pakistan covering the period from 21 December 2023 to 21 March 2024. The study included 90 patients aged 18 years or older who were admitted to the ED with a documented suicide attempt. Variables related to demographic characteristics, clinical presentations, substance use history, and details of the suicide attempt. Collected data were processed and analyzed using IBM SPSS, version 27.0. Results: The majority of participants were female (56.7%), with a mean age of 31.01 ± 12.42 years. Major depressive disorder was the most prevalent (33.3%), followed by anxiety disorder (18.9%). Other conditions included abuse of narcotics (6.7%), schizophrenia (4.4%), and a history of previous suicide attempts (1.1%). The most frequently cited reasons were psychiatric illnesses (n=28, 31.1%) and family problems (n=26, 28.9%), followed by financial problems (13.3%) and romantic relationship issues (6.7%). In the study cases, suicide attempts mostly occurred between 6 am to 12 pm (38.9%) and 12 pm to 6 pm (34.4%). The majority of patients were hospitalized (61.1%). Conclusions: It was concluded that the urgent need for targeted suicide prevention initiatives, with major depressive disorder identified in 33.3% and drug poisoning as prevalent in 40.0% of suicide attempts.

Psychiatric Morbidity and Assessment of its Severity in Gynaecologic Oncology Patients: A Cross-sectional Study

Introduction: Several psychological and social factors influence the incidence, treatment, and outcome of cancer patients. Depressive symptoms are more common in cancer patients, particularly in late stages. Women in Indian settings often exhibit delayed treatment-seeking behaviour. Aim: To assess the prevalence, type, and severity of psychiatric morbidity as well as the duration, type, and stage of illness in gynaecological oncology patients. Materials and Methods: This cross-sectional study was conducted among 100 gynaecological oncology patients aged 18 to 65 years, who were attending the gynaecologic Outpatient Department (OPD) and ward at a tertiary care hospital. The study took place at Government Rajaji Hospital, Madurai, between May 2013 and November 2013. Data was collected using a semistructured questionnaire from the patient and a reliable informant, after obtaining informed consent. The data was entered into Microsoft Excel and analysed using Statistical Package for Social Sciences (SPSS) software version 20.0. Central values, dispersion, and Chi-square tests were calculated. Results: The sample comprised 100 gynaecological oncology patients, with 30 (30%) diagnosed with malignancy, 43 (43%) with a benign condition, and 27 (27%) under investigation. Among the 100 patients assessed, 34 (34%) had psychiatric morbidity. There was a significantly higher prevalence among older patients, those with more than six months’ duration of gynaecological morbidity, and those exhibiting non fatal suicidal behaviour. Conclusion: Psychiatric morbidity is highly prevalent in gynaecological oncology patients. Depression was found to be more frequent and severe in patients with cancer. A previous history of suicidal attempts and a family history of psychiatric illness are important predictors of psychiatric morbidity in this population. Future studies on a larger population should explore the biological relationship between gynaecological oncology and psychiatric illness.

Sociodemographic Characteristics and Clinical Profile of Suicide Attempters Attending the Emergency Department at a Tertiary Care Hospital in Oman: A Retrospective Study.

This study examined the sociodemographic and clinical characteristics of individuals who attended the emergency department of a tertiary care center in Muscat, Oman following a suicide attempt. A retrospective study (N=154) was conducted between January 2015 and June 2018. Information that was collected included sociodemographic variables (age, nationality, sex, marital status, and occupation), risk (medical comorbidities, psychiatric history, substance misuse, alcohol misuse, and previous history of suicide attempts), and precipitating factors, as well as the chosen methods for the suicide attempts. In all, 83.1% of the sample were Omanis, and women constituted 69.5%. The mean age of the sample was 27 years; 30% were students, 42% were unemployed, and 40.9% had a history of psychiatric disorders. Family conflict, suffering from chronic illness, and having social problems were the most common precipitating factors for the suicide attempt. The most common method used in the suicide attempt was drug overdose (48.1%), mainly involving paracetamol (acetaminophen) (40%). Significant gender differences emerged in precipitating factors, history of substance misuse, and methods of suicide. The data from this study are consistent with international trends that suggest that women and younger age groups are the most vulnerable to suicide attempts. Although in its infancy, the type of research presented here could lay the groundwork for preventive interventions and programs.

Characteristics and related factors of suicide attempts among patients admitted to an Iranian poisoning center: Implications for suicide prevention

BackgroundSuicide is a major public health concern worldwide. Iran is no exception, with suicide rates increasing in recent years. Understanding the characteristics and related factors of suicide attempts can help inform suicide prevention efforts in Iran. MethodsA cross-sectional study was conducted on patients who attempted suicide and were admitted to the poisoning emergency of an intoxication center in Shiraz, Iran, between November 2019 and January 2020. Data were collected using data sheets containing study variables completed by oral interviewers and analyzed using descriptive and inferential statistics. ResultsThe study included 302 individuals, with the majority being females (63.6%), and the mean age was 28.19 (SD 19.25) years. The majority of patients were living in urban areas (82.5%) and unmarried (60.9%). Medical drug abuse was the most common method of self-poisoning (76.5%), followed by narcotics (15.6%). Suicide attempts were predominantly carried out at night (59.9%) and on working days (78.5%). Most patients had no history of previous suicidal attempts (64.2%), psychiatric problems (64.6%), or physical illnesses (84.8%). Female gender (P = 0.017) and the presence of an underlying disease (P = 0.016) were the two risk factors significantly associated with suicide on non-working days. ConclusionOur study highlights the need for comprehensive suicide prevention strategies that consider the complex interplay of individual, sociocultural, and environmental factors that contribute to suicidal behaviors. The high proportion of female suicide attempters and the timing of suicide attempts suggest the need for gender-specific suicide prevention programs and focused suicide prevention efforts during high-risk periods. Additionally, the association between physical illnesses and suicide attempts underscores the importance of integrated mental and physical health care services.

The psychological autopsy: An overview of its utility and methodology.

The objective of this study is to provide an overview of the psychological autopsy (PA) research method, including its methodology, uses, limitations, and ethical considerations. The study conducted a PA investigation on 35 cases of suicide. Information was collected from multiple sources and reliable informants, including family members, friends, medical and mental health professionals, and other relevant individuals. Qualitative and quantitative research methods were used to analyze the collected information. The results indicated that several factors were associated with suicide, including mental health problems, life stressors, interpersonal conflicts, substance abuse, and history of previous suicide attempts. The findings have important implications for suicide prevention strategies, emphasizing the significance of addressing mental health issues and providing social support. The PA is a valuable research method for investigating and understanding suicide. Despite challenges such as recall biases and methodological limitations, it provides insights into the psychological factors associated with suicide and informs suicide prevention strategies. However, conducting psychological autopsies requires careful consideration of ethical issues. Further research is needed to replicate and extend the findings of this study.

Factors associated with transitioning from suicidal ideation to suicide attempt in the short-term: Two large cohorts of depressed outpatients

BackgroundThis study explores factors associated with transitioning from recent suicidal ideation (SI) to suicide attempt (SA) in depressed outpatients. MethodsThis is a case-control study nested in two cohorts (LUEUR and GENESE) of depressed adult outpatients recruited in France and followed up for six weeks. SI, depression, anxiety, insomnia, impulsivity, and hopelessness were assessed with validated scales. Differences between patients with SI who attempted suicide during follow up and those who did not were explored using logistic regressions. ResultsThere was a slight majority of females in both cohorts. Mean age was 47.2 years in LUEUR and 49.4 years in GENESE. Of the 3785 participants in the LUEUR cohort, 72 (2.1 %) attempted suicide within the 6-week period vs. 19 of the 2698 participants (0.7 %) in the GENESE cohort. In LUEUR, factors associated with SA within the 6-week period were lifetime history of SA (OR = 5.35, 95 % CI = 3.30–8.66), high SI at baseline (OR = 3.87, 95 % CI = 2.4–6.24), associated treatments (OR = 3.28, 95 % CI = 2.00–5.38), and less improvement over follow-up in the following symptoms: SI (OR = 3.64, 95 % CI = 1.89–7.02), depression (OR = 3.66, 95 % CI = 1.76–7.62), and anxiety (OR = 3.26, 95 % CI = 1.46–7.27). In GENESE, associated factors were lifetime history of SAs (OR = 9.93, 95 % CI = 3.83–25.80), and less improvement in SI (OR = 9.20, 95 % CI = 3.61–23.44). LimitationsHeterogeneity of cohorts prevented from performing a pooled analysis with a greater sample size. ConclusionsIn depressed outpatients, lack of improvement was strongly associated with a short-term SA, particularly in patients with a history of previous SAs. Fast acting treatment on SI and depression may help prevent SAs.

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.

Prevalence of suicide risk and its associated factors in patients presenting in antenatal clinic

Introduction: Suicide during the antenatal period is one of the major indirect causes of maternal death. This study aims to determine the prevalence of suicidal risk and its related factors among the patients attending the antenatal clinic of a tertiary care center.
 Method: This is a cross-sectional study conducted in the antenatal clinic Patan Hospital, Lalitpur, Nepal among 124 pregnant patients using purposive sampling and face-to-face interviews applying a semi-structured proforma and P4 suicide screener. Ethical approval was obtained. The percentage of patients with suicide risk was calculated and stratified into minimal, lower, and higher risk of suicide. The association between suicide risk and different sociodemographic and clinical variables was done using the Chi-square test. A p-values ≤0.05 was considered statistically significant.
 Result: The prevalence of suicide risk was 32 out of 124 patients (25.8%). When risk stratification was done a maximum of 22(17.7%) had a higher risk for suicide. The risk was associated the employment status (p=0.039), history of previous suicide attempts (p=0.04), and diagnosed mental disorder (p=0.027).
 Conclusion: Our study shows the suicide risk among antenatal females was 25.8% reaffirming the need for proper screening and referral.

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.

Analysis of Attempted Suicide in a Pediatric Setting: Extracted Notes for Clinical Practice and Complexity of Help.

Background and Objectives: Suicidality among adolescents is a global mental health issue. However, the post-suicidal care of minors is insufficient and lacks complexity, as repeated attempts occur. Further, little is known about the social (i.e., family setting) and psychological (for example, exposure to bullying, suicidality, or addiction within a close environment) backgrounds of minors who engage in suicidal behavior in Lithuania. Thus, the aim of our study was to evaluate and compare psychosocial factors that may influence minors’ decisions to attempt suicide for the first time and then repeatedly and to extract notes for future clinical practice. Materials and Methods: Data from 187 cases of suicide attempts by minors treated at the Children’s Hospital of Vilnius University Santara Clinics from January 2011 to January 2018 was obtained and analyzed. Results: The data showed that 48.7% of minors hospitalized because of a suicide attempt had a history of previous suicide attempts. Minors who attempted suicide repeatedly were more often engaged in non-suicidal self-injurious behavior (p = 0.033). Further, a small number had experienced suicide within their close surroundings (p = 0.045). The comparative analysis did not reveal any significant differences in psychosocial backgrounds between first-time attempters and those who attempted suicide for at least a second time. Conclusions: Social and psychological support after a suicide attempt in a pediatric setting is lacking efficiency, as minors who repeatedly attempt suicide suffer from similar psychosocial burdens. Complex and targeted follow-up care is needed.

The Prediction of Suicidal Ideation as a Function of Daily Mood and Anxiety Scores Collected Using mHealth Technology in Patients Undergoing Treatment for Depression

Background Suicide is one of the most common causes of death in the United States. The rates of suicide have increased by 33% in the period 1999-2019. In 2019, suicide was responsible for one death every 11 minutes. Clinically, a previous history of suicide attempts is the main risk factor, as well as the presence of comorbid conditions like depression and anxiety. Accurate and real-time prediction of suicidal thoughts may lead to improved management of patients with depression. Prediction of suicidality is difficult due to its day-to-day variability in relation to mood and anxiety symptoms. This can be overcome with the advent of mobile health (mHealth) technology that can capture granular data scores at a higher frequency than conventional therapeutic visitations. Objective The aim of this study is to predict suicidal ideation using self-reported mood and anxiety in patients undergoing treatment for depression. Methods This study will use data from the DepWatch study, an mHealth study that uses the DepWatch app developed by our research group. The objective of this longitudinal study is to develop an mHealth-based, personalized diagnostic prediction system for patients undergoing treatment for depression. Patients are followed over 12 weeks using electronic assessments conducted via the DepWatch app installed on their smartphones. The electronic assessments include the Quick Inventory of Depression Symptomatology-Self Report (QIDS-SR), conducted on a weekly basis, and weekly medication adherence and medication safety and tolerability questionnaires. The assessments include brief mood and anxiety assessments conducted on a daily basis. Generalized estimating equation modeling for a binary outcome (the presence or absence of suicidal thought), clustered by individual subjects, will be used. The key explanatory variables are the daily mood and anxiety levels (time variant). The outcome variable is suicidal ideation as determined by the self-reported subject response to question 12 (about suicidality) on the QIDS-SR scale. Variables that show significance at P values <.1 are subsequently used in the multivariate model, in addition to mood and anxiety. Results A total of 34 subjects are in the interim analysis set. The median age is 26 years, 85.3% are female, and 64.7% are White. In addition, 38.2% either have a college degree or graduate education, while 23.5% are unemployed and 41.1% are full-time employed. About half of participants (52.9%) earn less than $50,000 annually and 61% have never smoked. Univariate analysis shows statistical significance of gender, race, aggregate anxiety, and employment status at .1 significance level. In the multivariate model, only gender and employment status are significant at .05. Race is marginally insignificant (P=.068). Conclusions Suicidality and completed suicides are significant public health problems, especially in patients with depression. The mHealth technology and statistical modelling that captures daily variability in anxiety leading up to suicidal ideation can help predict suicidality. Conflicts of Interest None declared.

Level of Suicidal Ideation Among Callers to the Danish Suicide Prevention Helpline

Objective The aim of this study was to: (1) determine the proportion of callers to a national helpline for suicide prevention who were evaluated to be at risk of suicide; (2) identify characteristics associated with being at risk; (3) determine the level of suicidal ideation among callers, as measured by a clinical scale, and compared to the general population. Method Data on all calls answered at the Danish helpline for suicide prevention during 2018–2019 were analyzed. These consisted of socio-demographic covariates and items related to suicidality, including the Suicidal Ideation Attribute Scale (SIDAS). Data on SIDAS for the general population derived from a survey. Being at risk of suicide, as evaluated by the counselors, was examined as outcome in adjusted logistic regressions. Results Among 42,393 answered calls, 24,933 (59%) related to personal concerns. Of these, 47% and 14% of callers, respectively, had suicidal thoughts and concrete suicidal plans, while 53% were evaluated to be at risk. Higher risks were found when issues related to self-harm, mental health problems, eating disorders, incest, physical health problems, substance abuse, or sexual assault were mentioned. In all 37% of callers who were administered the SIDAS scale were evaluated to be at high risk of suicide compared to 1.5% in the general population. Conclusions A substantial share of callers to a national helpline for suicide prevention were evaluated to be at risk of suicide, also when using a clinical scale. This emphasizes the potential for counselors to prevent suicidal behavior. Highlights More than half of callers reaching out to the helpline were evaluated to be at risk of suicide, and 37% were identified as being at high risk using SIDAS, a clinical scale. Being woman, of younger age, having a history of previous suicide attempt as well as experiencing problems related to self-harm, mental disorders, sexual assault, substance abuse, and physical health problems was associated with risk of suicide, as evaluated by counselors. This seemingly is the first study to compare clinical scores of helpline callers to those of the general population and significantly higher levels of suicidal ideation were found among helpline callers.

Epidemiological profile of suicide attempts in a municipality in southwest Paraná, from 2017 to 2020.

This study aimed to analyze the epidemiological profile and psychological disorder of the suicide attempt cases in Francisco Beltrão, Paraná. This is an epidemiological descriptive/qualitative study of suicide attempts conducted between 2017 and 2020. This study used data from the Brazilian Information system for notifications involving suicide attempts (Sistema de Informação de Agravos de Notificação, SINAN) and 447 notifications were obtained. An analysis of the electronic medical record of these patients was performed in order to investigate the mental disorders, using a questionnaire. Of the 447 notifications, 382 were eligible for the study. Using the 95% confidence interval, there was a higher frequency of females with 71.7% aged between 18 and 35 years representing 48.4%, with 77.2% white race/color, the singles appeared in the majority with 47.6% with a history of previous suicide attempts, using exogenous intoxication as a method in the attempt with 67.5%. Regarding mental health, 66.5% of the patients had some mental disorders, with the highest prevalence of recurrent depressive disorder found in 40.6%. It was observed that there is a need for training of health professionals and implementation of programs and preventive measures aimed primarily at females aged between 18 and 35 years with mental disorders, especially with recurrent depressive disorder and with a history of previous suicide attempt.

Gender-Specific Related Factors for Suicidal Ideation During COVID-19 Pandemic Lockdown Among 5,175 Chinese Adolescents.

BackgroundSuicide was an urgent issue during the pandemic period in adolescents. However, few studies were focused on suicide during the coronavirus disease 2019 (COVID-19) pandemic lockdown.MethodsAn online survey was conducted among 5,175 Chinese adolescents from June 9th to 29th in 2020 to investigate the prevalence of suicidal ideation (SI) during COVID-19 pandemic lockdown. A gender-specific stepwise logistic regression model was used. All analyses were performed with STATA 15.0.ResultsAbout 3% of the participants had reported having SI during the COVID-19 pandemic lockdown period. The prevalence of female SI (3.64%, 95% CI: 2.97–4.45%) was higher than that of males (2.39%, 95% CI: 1.88–3.05%) (χ2 = 6.87, p = 0.009). Quarreling with parents [odds ratio (OR) = 9.73, 95% CI: 5.38–17.59], insomnia (OR = 5.28, 95% CI: 2.81–9.93), previous suicide attempt history (OR = 3.68, 95% CI: 1.69–8.03), previous SI history (OR = 2.81, 95% CI: 1.30–6.06), and feeling depressed during pandemic lockdown (OR = 2.26, 95% CI: 1.22–4.18) were positively associated with the males' SI. However, having emptiness inside (OR = 4.39, 95% CI: 2.19–8.79), quarreling with parents (OR = 3.72, 95% CI: 2.16–6.41), insomnia (OR = 3.28, 95% CI: 1.85–5.80), feeling anxious (OR = 2.62, 95% CI: 1.46–4.70), and longing for father's emotional warmth (OR = 0.38, 0.20–0.72) were associated mostly with females' SI.ConclusionsFemale adolescents, who felt emptiness from their families and their fathers' emotional warmth, were at much higher risk of having SI during COVID-19 lockdown. We must specify a suicide prevention policy and interventions for adolescents in the pandemic crisis based on gender gaps.

SUICIDE ATTEMPT IN ELDERLY: AN OVERLOOKED COMPLICATION OF LATE-LIFE DEPRESSION

Suicide attempt in the elderly is underestimated and underreported due to cultural reference. Triggering factors may be the results of stressful life events or acquired late-life depression. An elderly woman, 69-year-old, was rushed to the emergency room due to household cleaning liquid ingestion. There was a history of previous suicide attempts and severe depressive episodes before. Since there was no sign of severe intoxication, then, the patient was treated symptomatically. Comprehensive geriatric and psychiatric assessments concluded that the patient was in a depressive state. The patient was discharged with symptomatic treatment and antidepressants but two weeks later she completed the course by drowning herself in a river.

Comparison of Characteristics of Suicide Attempts Registered in Urban and Rural Areas in China.

Objective: The objective of this study is to compare the characteristics of suicide attempts registered in general hospitals in urban and rural areas in China.Methods: From January 2007 to December 2011, suicide attempts registered in hospitals in five rural counties and in the Beijing Municipality were included. Univariate and multivariate analysis were used to compare the characteristics of rural and urban suicide attempts in China.Results: A total of 5,515 episodes of suicide attempts were included, 1,966 (35.6%) of them were from rural counties and 3,549 (64.4%) were from Beijing. Compared with urban counterparts, the rural suicide attempters had lower proportion of females (61.9% vs. 72.3%), more likely reporting previous suicide attempt history (56.9% vs. 16.4%), and staying in hospital for more than 1 day (81.5% vs. 44.6%). The most common methods of suicide attempts were pesticide ingestion in rural areas (52.1%) and taking medications in urban area (39.2%). Results of multivariate analysis indicated that suicide attempt registered in rural areas, pesticide ingestion, and previous suicide attempts history were associated with longer treatment in hospitals.Conclusions: Suicide attempts registered in rural areas were different from those in urban areas in China. It is essential to improve the equipment and ability of medical resuscitation for pesticide ingestion in rural hospitals in China.

Attempted Suicide in the Older Adults: A Case Series From the Psychiatry Ward of the University Hospital Maggiore Della Carità, Novara, Italy.

Introduction: As suicide rates increase with age, it is mandatory to carefully assess old age suicidal behaviors. Our aim was to describe the main socio-demographic and clinical features of a sample of suicide attempters aged 65 years and older, and to assess differences within the sample (men vs. women; patients with vs. without a previous history of suicide attempt; patients with vs. without a previous psychiatric history).Methods: Retrospective study conducted at the Maggiore della Carità University Hospital, Novara, Italy.Results: A higher percentage of female patients in our sample were treated by or referred to mental health services, while a greater percentage of male patients required a prolonged clinical observation in the Emergency Room (ER) or in non-psychiatric wards before psychiatric admission. The percentage of patients without previous psychiatric history taking anxiolytic and sedative medications was 25%.Conclusion: It is likely that different clusters and types of suicide attempters exist. Women in our sample appeared more proactive in asking for help, and more likely to be already treated by or referred to a psychiatric service, suggesting the need to facilitate the access to psychiatric services for the male population aged 65 years and older, or to offer support and care for the non-psychiatric reasons (comorbidities, pain, and loss of autonomy) possibly underlying suicidal behavior in this specific group. The use of medications deserves more attention considering the possible critical diagnostic issues in this age group.

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Introduction:suicide is one of the ten major causes of death in India. 90%of the persons who die from suicide satisfy the criteria for one or more psychiatric disorders. Most people have notably mood, substance related, anxiety, psychotic, and personality disorders, with co-morbidity being common. A considerable proportion of suicide attempts are the result of sudden ideation. Understanding impulsive suicide attempts is necessary for effective interventions.Objectives:To study socio-demographic profile, psychiatric morbidities and to assess the risk and impulsivity of suicidal attemptsMaterials & Methods:A cross sectional study was done for 1year among 65 suicide attempted patients. Socio demographic and clinical details were obtained using semi structured proforma. Psychiatric morbidity was assessed using Brief Psychiatric Rating scale, ICD10. Suicidal risk assessment was done by Becks scale for suicidal ideation. Attempter impulsivity was measured by the total score of the Barratt Impulsiveness Scale.Results-Among 65 attempted suicide patients, majority belong to 18-25yr age group (38.46%) and were females (63.07%). 36.9% were diagnosed with adjustment disorder. History of previous suicidal attempt was present in 32.7%. Majority of individuals attempted suicide out of impulsivity (70.7%).Conclusion-The results suggested that a considerable proportion of suicide attempts were due to result of sudden inclinations and were made in relatively earlier stages of suicidal ideation. So, early identification of those at risk and appropriate interventions may be helpful.

İntihar Girişimlerinde Acil Servisten Taburcu Etme veya Psikiyatri Konsültasyonuna Yönelik Karar Verme: Retrospektif Bir Çalışma

Objective: The aim of this study is to shorten the period of hospitalization of the psychiatry patients in the emergency service and to reduce number of emergency psychiatric consultations. Material and Methods: Total 249 patients who admitted to the emergency service and evaluated by psychiatry because of suicide attempt were included in the study. The patients were scored in terms of feeling of regret, suicide method, history of previous suicidal attempt and presence of suicide family history. Following psychiatric consultations, the patients were divided to 2 groups as those who were considered for hospitalization (Group 1) and those who were recommended for outpatient psychiatry clinic control (Group 2). Results: Of the 249-psychiatry consultation, hospitalization was recommended to 94 (37.8%) patients, while outpatient psychiatry clinic control was recommended to 155 (62.2%). According to the scoring, it was found that psychiatric consultation was required in 152 (61.0%) patients, while consultation was not necessary in 97 (39.0%) patients. When psychiatric examination notes were checked, a statistically significant difference was found between Group 1 and 2 (p<0.001) and sensitivity was found to be 100%, while specificity was found as 62.5%, positive predictive value was found to be 61.8% and negative predictive value was found to be 100%. Conclusion: In our study group, we found that emergency psychiatric consultation rate may decrease 36.5% thus will be cost effective and also decrease waiting time in emergency services.

Suicidal Ideations in Patients With Obsessive-Compulsive Disorder

Background: There are many controversies about the frequency and burden of suicidality in patients with Obsessive-Compulsive Disorder (OCD). Objectives: This study was done to determine the prevalence and risk factors of current suicidal ideations in patients with OCD. Materials &amp; Methods: In this cross-sectional study, 258 outpatients with OCD (Yale-Brawn Obsessive Compulsive Scale, Y-BOCS ≥16) referring to two psychiatry clinics in Guilan, Iran, from March 2018 to September 2019 were evaluated. Suicidality score of the Brief Psychiatric Rating Scale (BPRS) ≥4 was considered for current suicidal ideation at the first visit. Beck Scale for Suicidal Ideation (BSSI) was used to evaluate the intensity of suicidal ideations a week before evaluation. Simple linear and binary logistic regression analyses were used to analyze data by SPSS v. 20. Results: Current suicidal ideation was found in 22.1% of patients. The previous history of suicide attempt (BPRS, P&lt;0.0001 and BSSI, P&lt;0.0001), a history of OCD in first-degree relatives (BPRS: P=0.004 and BSSI: P=0.010), a history of suicide attempts in first-degree relatives (BPRS: P=0.013 and BSSI: P&lt;0.0001), comorbid diagnosis of depressive or body dysmorphic disorder (BPRS, P&lt;0.0001 and BSSI, P&lt;0.0001), and higher Y-BOCS score (BPRS: P=0.043 and BSSI: P&lt;0.0001) were associated with a higher risk of having suicidal ideation. Conclusion: Suicidal thoughts are high in Iranian patients with OCD at their first visit to psychiatry clinics. The previous suicide history, positive history of OCD and suicide attempts in their first-degree relatives, the severity of OCD, and some comorbid psychological disorders are associated with a higher risk of suicidal ideation among OCD patients.