Incidence Of Completed Suicide Research Articles

Rate and Causes of Suicide in Ilam: A Report of the Suicide Registry.

Objective: Suicide is one of the most important health problems in the world. Financial, academic, social, and environmental difficulties along with genetic, physical, and mental disorders affect suicide attempts. This study aimed to find risk factors for completed suicide in Ilam province according to the suicide registry in Ilam province. Method : This was a prospective study and was performed based on suicide case registration data, pre-determined checklist data, and death registration data in Ilam province from March 2019 to September 2020. Logistic regression models and the Chi-square test were used to determine the relationship between completed suicide and its risk factors. Results: Among 1,410 attempted suicides, 66 (4.7 %) were executed. Rate of completed suicides was higher in men (6.5%) compared to women (4.5%), (p = 0.005), age groups over 65 years (P < 0.001), retirees and farmers (P = 0.009), illiterate people (P < 0.001), villagers (P = 0.02), people motivated due to physical problems (P = 0.016), suicide by physical methods (P < 0.001) and self-immolation (P < 0.001). Logistic regression showed that incidence of completed suicide was significantly higher in the age group over 65 years, illiterate people, people using physical methods, villagers, and men. Multivariate logistic regression also showed that men and individuals using physical methods of suicide were significantly more successful in suicide. Conclusion: Men, the elderly, illiterates, villagers, and people who used physical suicide methods were in high-risk groups. Despite lower prevalence of suicide, a higher rate of completed suicide was demonstrated. To decrease completed suicide rates, we must pay attention to these groups.

Incidence of completed suicide and suicide attempts in a global prospective study of Huntington's disease.

Risk of death from suicide in Huntington's disease is notably elevated relative to that in the general population, although the incidence within HD populations has not been precisely defined. Robust incidence estimates of suicidal behavior can serve as references for HD therapeutic research and post-marketing surveillance to help evaluate the suicidality risk of novel therapeutics. To estimate the incidence rate of completed suicide and suicide attempt in the global, prospective HD cohort study Enroll-HD that records these events per protocol. A total of 20 912 participants were available for analysis (HD gene-expansion carriers (HDGECs) n = 15 924; non-HDGECs n = 4988) representing a collective observation period of 53 390 participant-years. Each observed event was subject to clinical review and evaluation. We generated incidence rates (events per 100 000 person-years) for suicides and suicide attempts using all available data, as well as by year of study and geographical region. Proportionate mortality statistics for suicide and respective 95% confidence intervals were also generated. The overall incidence rate of suicide in HDGECs was 72 per 100 000 person-years, and 8 per 100 000 person-years in non-HDGECs. Proportionate mortality attributable to suicide in HDGECs was 4.6%. For suicide attempts, the global overall incidence rate observed in HDGECs was 306-375 per 100 000 person-years, and 23-38 per 100 000 person-years in non-HDGECs. The incidence estimates calculated here can be used as a reference to help evaluate drug safety and may also be useful in assessing progress in clinical care for HDGECs once therapeutic interventions become widely available.

The Association of 5α-Reductase Inhibitor With Suicidality

Using a large nationwide cohort, this study aimed to determine the risk of suicide after the use of a 5α-reductase inhibitor, an antiandrogenic medication commonly used in the treatment of lower urinary tract symptoms. A retrospective population-based cohort study was performed using the Korean National Health Insurance Service database. The study consisted of 51,466 men 60 years or older who underwent health examinations between 2005 and 2006. Individuals using a 5α-reductase inhibitor were compared with nonusers based on drug exposure between 2003 and 2006. Individuals using a 5α-reductase inhibitor were additionally divided into tertiles based on cumulative 5α-reductase inhibitor exposure. The incidence of completed suicide was documented during 7 years of follow-up, starting January 1, 2007. No significant risk of suicide was observed among 5α-reductase inhibitor users compared with 5α-reductase inhibitor nonusers (hazard ratio = 1.02, 95% confidence interval = 0.70-1.48). Cumulative 5α-reductase inhibitor exposure was also not associated with increased risk of suicide (p for trend = .543). 5α-Reductase inhibitor use was not associated with an elevated risk of suicide during a long-term follow-up period. A limitation of this study is that possible drug exposure after the index date was not accounted for. Although 5α-reductase inhibitor may increase the risk of depressive symptoms, the present data indicate that the drug is safe in terms of long-term suicide risk.

Suicide in a rural area of coastal Kenya

BackgroundSuicide accounts for approximately 1.4% of deaths globally and is the 15th leading cause of death overall. There are no reliable data on the epidemiology of completed suicide in rural areas of many developing countries, yet suicide is an indicator of the sustainable development goals on health.MethodsUsing data collected between 2008 and 2016 from the Kilifi Health and Demographic Surveillance System in rural Kenya, we retrospectively determined the incidence rate and risk factors for completed suicide.ResultsDuring the period, 104 people died by suicide, contributing to 0.78% (95% CI = 0.74–1.10) of all deaths. The mean annual incidence rate of suicide was 4.61 (95% CI = 3.80–5.58) per 100,000 person years of observation (pyo). The annual incidence rate for men was higher than that of women (IRR = 3.05, 95% CI = 1.98–4.70, p < 0.001) and it increased with age (IRR = 2.73, 95% CI = 2.30–3.24, p < 0.001). People aged > 64 years had the highest mean incidence rate of 18.58 (95% CI = 11.99–28.80) per 100,000 pyo. Completed suicide was associated with age, being male, and living in a house whose wall is made of scrap material, which is a proxy marker of extreme poverty in this region (OR = 5.5, 95% CI = 4.0–7.0, p = 0.02). Most cases (76%) completed suicide by hanging themselves. Spatial heterogeneity of rates of suicides was observed across the enumeration zones of the KHDSS.ConclusionsSuicide is common in this area, but the incidence of completed suicide in rural Kenya may be an underestimate of the true burden. Like in other studies, suicide was associated with older age, being male and poverty, but other medical and neuropsychiatric risk factors should be investigated in future studies.

Suicide: Psychological Assessment and Management

Suicide is the 10th leading cause of death, claiming more than twice as many lives each year as does homicide. Every year one million people commit suicide, accounting for 1 to 2 percent of total global mortality. Suicide is a leading cause of premature death, especially among young adults. It is the fifth highest cause of year of life lost in the developed world. According to World Health Organization statistics, the annual world-wide incidence of completed suicide was 16 per 100000persons in 2000. This means that globally one person commits suicide every minute (WHO, 2012)1. As the largest continent in the World, Asia accounts for about 60% of World suicides, with China, India, and Japan accounting for about 40% of the World's suicides. According to research study, in Asian continent Bangladesh, China, Hong Kong, Japan, South Korea, Sri Lanka, and Taiwan had relatively higher suicide rates (>13.0/100, 000), with Bangladesh having the highest (39.6/100, 000). Suicide is estimated to represent two percent of the total global burden of disease. Suicide is an important issue in the Indian context. More than one lakh (one hundred thousand) lives are lost every year to suicide in our country. In the last two decades, the suicide rate has increased from 7.9 to 10.3 per 100, 000. The majority of suicides (37.8%) in India are by those below the age of 30 years. The fact that 71% of suicides in India are by persons below the age of 44 years imposes a huge social, emotional and economic burden on our society (Shukla et al., 1990)2.

Suicide and suicide attempts in people with severe mental disorders in Butajira, Ethiopia: 10year follow-up of a population-based cohort.

BackgroundPeople with severe mental disorders (SMD) are at higher risk of suicide. However, research into suicide attempts and completed suicide in people with SMD in low- and middle-income countries is mostly limited to patients attending psychiatric facilities where selection bias is likely to be high.MethodsA population-based cohort of 919 people with SMD from rural Ethiopia (who received standardized clinician diagnoses of schizophrenia (n = 358) major depressive disorder (n = 216) and bipolar I disorder (n = 345)) were followed up annually for an average of 10 years. The Longitudinal Interval Follow-up Evaluation chart was administered by psychiatrists and used to evaluate systematically suicidal behavior and risk factors, which may be amenable to intervention.ResultsOver the follow-up period, the cumulative risk of suicide attempt was 26.3% for major depression, 23.8% for bipolar I disorder and 13.1% for schizophrenia, (p < 0.001). The overall incidence of completed suicide was 200.2/100,000 person-years (CI = 120.6, 312.5). Hanging was the most frequent method used (71.5%) for both attempters and completers. Most people who completed suicide were successful on the first attempt (84.2%), but the case-fatality rate for suicide attempt was 9.7%. In the adjusted logistic regression model, being currently married (Adjusted OR) =2.17, 95% CI = 1.21, 3.91), and having a diagnosis of bipolar I disorder (Adjusted OR = 2.59, 95% CI = 1.57, 4.26) or major depression (Adjusted OR = 2.71, 95% CI = 1.60, 4.58) were associated significantly with increased risk of suicide attempts.ConclusionIn this sample of people with SMD from a rural setting, the rate of suicide was high. Initiatives to integrate mental health service into primary care need to focus on limiting access to suicide methods in people with SMD in addition to expanding access to mental health care.

Lithium, anticonvulsants and suicidal behavior in bipolar disorder

Background: Lithium has been found to be effective in reducing suicide rates during long term treatment of patients with bipolar disorders. Data on the efficacy of anticonvulsant mood stabilizers in reducing suicide risk are sparse. Method: Charts of 140 bipolar patients treated continuously for a minimum of 6 months during a 23-year period of private practice by the senior author were extracted from nearly 4000 patient records. Data extracted from the charts were incidence of completed suicide, number of suicide attempts, and number of hospitalizations for suicidal ideation or behavior per 100 patient-years of either ‘on’ or ‘off’ lithium or anticonvulsant mood stabilizer monotherapy. Results: Only one completed suicide (during a period off of lithium) occurred in the patients studied. Incidence of non-lethal suicidal behavior was not different during treatment with lithium, compared with anticonvulsants. Being on a mood stabilizer significantly protected against suicidal behavior. The relative protective effect was more modest than in reports from other treatment settings. Limitations: This was a retrospective chart review study of naturalistically treated patients. Conclusions: Treatment of patients with bipolar disorder with either lithium or anticonvulsant mood stabilizers was associated with reduced risk of suicidal behavior. This study did not find evidence for a difference in the protective effect of the two types of mood stabilizing medications against non-lethal suicidal behavior in the naturalistic setting of private practice.

Evaluating Suicide Risk in the Medically III Patient

Common medical conditions, treatments, medications, and depression can increase the risk of suicide, which is the eighth leading cause of death in the United States. Health care providers are in key positions to prevent suicide because most people seek medical treatment for physical symptoms and they give clues before they commit suicide. Unfortunately, suicide risk typically remains undetected because suicide clues, including depression, are overlooked. This article reviews assessment of suicide risk, incidence of completed suicide, and interventions in primary care settings. Suicide lethality, therapeutic strategies, and referrals are considered. Depression is discussed because it is the most common precipitant of suicide in primary care.

Social disorganization and completed suicide

It has been found in Edinburgh, Scotland that the incidence of completed suicide is very common in areas of the city where there is a high degree of social disorganization, such as overcrowding and juvenile delinquency. A study in the city of Buffalo in the United States failed to replicate this finding. It appears possible, therefore, that the types of people who kill themselves (at least as determined by ecological studies) may differ considerably in Edinburgh and in Buffalo. The implications of this study are important since preventative measures for suicide would have to differ for the two countries were this true. Overcoming social disorganization would be expected, for example, to have an ameliorative effect on suicidal behavior in Edinburgh but not in Buffalo.

Association between a full moon and completed suicide.

Pokorny (1964) investigated whether a sample of completed suicides in Texas were clustered around the incidence of a full moon rather than a new moon. He found no association for the total sample, or for subgroups by sex and race. It was felt to be of interest to examine this association in a northern state since such correlations may differ in the North and the South. For example, although completed suicides show a seasonal variation in the United States as a whole, they do not in Los Angeles. A listing of all the completed suicides recorded in Erie County from 1964 to 1968 was 0btained.l The sex of each suicide was identified and the date of the suicidal act. The number occurring in the 7 days centered around the full moon was compared with the number expected by chance. Of the 399 completed suicides, 102 occurred during the weeks surrounding the full moon; the expected number was 93.25. (Of the 1827 days in the 5-yr. period, 427 constituted those around the time of the full moon.) The difference, though in the direction of a positive association, did not reach statistical significance (x2 = 1.07, df = 1). The data were examined for males and females separately and the association, though positive for both sexes, did not reach statistical significance (for males x2 = 0.22 and for females xk 1.41, df = 1). The association for the total sample was significant for 1967 only (this was produced by the presence of a strong association for the females). However, the association was positive for only 4 of the 5 yr. in the period examined. Thus, the present data appear to confirm those of Pokorny. There does not appear to be a reliable and significant association between the phase of the moon and incidence of completed suicide.

The relationship between attempted suicide and committed suicide.

The statistical relationship between attempted suicide and completed suicide was studied by (1) a review of 15 published follow-up studies of attempters that provided information on the incidence of completed suicide, and (2) a review of 9 published studies of committed suicide that provided data on the frequency of prior suicide attempts. The results of these studies were compared and tabulated. The limitations and methodologie deficiencies of the studies were discussed and suggestions were made for more reliable and comprehensive future research. The incidence of completed suicide in the follow-up studies of attempted suicides ranged from 0.03 per cent in one short-term study to 22.0 per cent in the longest follow-up study. The incidence of completed suicide among attempters was many times that occurring in the general population. Studies of groups who have committed suicide have found the incidence of prior suicidal attempts to vary from 8.6 per cent to 62.0 per cent. The incidence of prior suicide attempts among those who completed suicide was many times that of the general population. The clinical prognostic value of a history of attempted suicide and of the presence of those social and psychological factors associated with a high suicide risk was discussed. These data support the concept that attempted suicide and committed suicide involve two different, though overlapping, populations. The aim of this paper was to clarify the nature and extent of the overlapping.