Increase In Suicide Attempts Research Articles

In a period of economical crisis who is at risk for attempted suicide?

IntroductionAccording to Durkheim's theory, suicide attempts increase during periods of rapid economic changes and decrease again when stability is achieved, due to the social integration in the community guaranteed by occupational status. Since 2009 in Europe, it was observed an increase in the suicide rates, in line with the increase of unemployment. Although unemployment is considered a risk factor for suicide, it was observed a noticeable increase in suicide rates among Italian employed men during the last years, probably related to the specific economic scenario and to emerging difficulties in keeping an income to adequately maintain one's own family standard of living.AimTo study attempted suicides with a specific focus and attention on the current Italian economic scenario.MethodsDeterminants of emergency room visits for psychiatric reasons in patients aged > 16 years were studied prospectively from 2008 to 2015 at the AOU Maggiore della Carità Hospital, Novara, Italy. Each patient was assessed by an experienced psychiatrist with a clinical interview and socio-demographic and clinical features were gathered. Statistical significance was set at P ≤ 0.05.ResultsPreliminary results suggest an increase in suicide attempts according to the rise of the unemployment rate in Novara. Although in absolute figures most attempters are unemployed, it seems that suicide attempts are more frequent in the group of employed subjects, which includes also people under redundancy fund. This subgroup may be considered halfway between employed and unemployed attempters.ConclusionsData collection and statistical analyses are still ongoing. Implications for clinical practice will be discussed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Gender-Specific Factors Associated with Suicide Attempts among the Community-Dwelling General Population with Suicidal Ideation: the 2013 Korean Community Health Survey.

We identified traditional risk factors and investigated poorly understood risk factors for suicide attempts according to gender in a large Korean population. We analyzed the data from 6,768 males and 12,475 females with suicidal ideation obtained from the nationwide 2013 Korean Community Health Survey. The dependent variable was suicide attempts within the past year. There was a significant trend towards an increase in suicide attempts with decreasing age in both genders. Compared with those who were married, suicide attempts were significantly higher among those who were widowed, divorced, or separated for males (odds ratio [OR], 2.07; 95% confidence interval [CI], 1.34–3.20), but lower for females (OR, 0.66; 95% CI, 0.45–0.98). Current smoking and depression were significant risk factor for suicide attempts in males and females. However, monthly household income, myocardial infarction, and osteoporosis were significantly associated with suicide attempts only in males, whereas education level, recipient of National Basic Livelihood Security, family contact, leisure activity, and drinking frequency were significantly associated only in females. These findings indicate that gender difference should be considered in the assessment, prevention, and management of future suicide attempts by community policy-makers and clinicians.

Are FDA Antidepressant Warnings Linked to Rise in Youth Suicides?

Back to table of contents Previous article Next article Clinical and Research NewsFull AccessAre FDA Antidepressant Warnings Linked to Rise in Youth Suicides?Vabren WattsVabren WattsSearch for more papers by this authorPublished Online:17 Jul 2014https://doi.org/10.1176/appi.pn.2014.7b18AbstractA study on the effects of the FDA’s warnings about antidepressants’ increased risk of suicidality leads to different interpretations.The warnings issued by the Food and Drug Administration (FDA) about the increased risk of suicidality (suicidal ideation and behavior) in young people taking antidepressants may have led to unintended consequences, reported a study published June 18 in BMJ. Martin Novak/ShutterstockFrom 2003 to 2007, the FDA issued several health advisories and a black-box warning that children, adolescents, and young adults taking antidepressants were at increased risk for suicidal behavior—leading to intense media attention. Some experts have since attributed the steep decline in the number of antidepressant prescriptions to youth to these FDA warnings.“These drugs can save lives,” stated the study’s senior author Stephen Soumerai, Sc.D., a professor of population medicine at Harvard Pilgrim Health Care Institute, but in reporting about the FDA antidepressant warning, “The media concentrated more on the relatively small risk than on the significant upside,” he said.The risk of suicidality cited by the FDA was approximately 1 percent for youth treated with antidepressants. A 2007 study published in the American Journal of Psychiatry reported that the use of antidepressants by youth and young adults dropped quickly by 20 percent, without a reciprocal increase in treatment alternatives such as psychotherapy or atypical antipsychotics (Psychiatric News, June 15, 2007). These findings prompted Soumerai and colleagues to investigate whether a link exists between the FDA warnings about antidepressants and a gradual increase in suicidality among youth in the years after the warning.To assess whether such a correlation exists, the researchers collected data from 2000 to 2010 on 7.5 million patients aged 10 to 64. Patients were assessed on changes in antidepressant use, suicide attempts, and deaths by suicide before and after the FDA’s highly publicized black-box warning was issued in 2004.The analysis showed that in the second year after the warning was issued, use of antidepressants had dropped 31 percent among adolescents, 24.3 percent among young adults, and 14.5 percent among older adults. Simultaneously, there was a 21.7 percent increase in suicide attempts by psychotropic drug poisoning among adolescents and a 33.7 percent increase in attempts among young adults. The number of deaths by suicide did not change for any age group.“Our study provides the first evidence that suicide attempts increased rather than decreased after the warnings,” noted the authors. “[The] data are consistent with the Centers for Disease Control and Prevention report that showed gradual increases in completed suicides between 1999 and 2010 . . . among people aged 10 to 34 years.”Mark Olfson, M.D., M.P.H., a professor of psychiatry at Columbia University Medical Center and an expert in mood disorders, told Psychiatric News that the interpretation of the current findings should be taken with caution. “The new findings shed little light on the complex associations between anxiety and depressive disorders, antidepressant treatment, and the risk of self-harm and suicide. The measure of suicide attempts used in this study, psychotropic poisonings, is only loosely related to suicide attempts. Most suicide attempts in young people do not involve poisoning by psychotropic drugs, and most intoxications do not represent suicide attempts.”Because of the recent substantial increase in unintentional poisonings from stimulants, Olfson stated that the increase in psychotropic overdose could be a result of an underlying substance use disorder rather than suicide. “This trend [of psychotropic overuse by youth], which may be driven by complex societal factors, deserves study and clinical attention,” Olfson concluded.The current study was funded by the National Institute of Mental Health. ■An abstract of “Changes in Antidepressant Use by Young People and Suicidal Behavior After FDA Warnings and Media Coverage: Quasi-Experimental Study” can be accessed here. ISSUES NewArchived

Changes in the Frequency and Clinical Features of Suicide Attempts in the Midwestern Area of Kanagawa after the Great East Japan Earthquake

The aim of this study was to investigate the relationship between the clinical features of suicide attempts and the Great East Japan earthquake in Kanagawa. We enrolled 592 patients who attempted suicide and were hospitalized for inpatient treatment. Clinical features were compared between before the earthquake (A) and after the earthquake (B) groups. The number of suicide attempts increased from 286 to 306. The rate of increase in suicide attempts in men was the highest in the age group of 40-59years. The frequency of joblessness, family psychiatric histories, precipitating event, and alcohol intake at suicide attempt was significantly higher in the B group than in the A group. The number of patients in serious condition in the B group was significantly higher than that in the A group. Other clinical features related to suicide in people who were indirectly affected by the earthquake disaster should be investigated to develop targeted prevention strategies.

Changes in associations between psychosocial factors and suicide attempts by adolescents in Greece from 1984 to 2007

Suicide is the second commonest cause of death among adolescents and young adults aged 15-35 years in Europe. Suicide attempts are a strong risk indicator for suicide. This article examines psychosocial factors associated with self-reported suicide attempts in adolescents in Greece and whether the reported increase in suicide attempts from 1984 to 2007 was accompanied by changes in the pattern of related psychosocial factors. Data were taken from nationwide probability sample surveys of Greek high school students aged 14-18 years in 1984 (n = 10,507) and 2007 (n = 9873). Logistic regression analysis was used to relate any self-reported suicide attempts to basic sociodemographic and psychosocial variables including family and psychological characteristics, and substance use. Female gender, smoking, illicit drug use, low socio-economic status, not living with both parents, dissatisfaction with relationship with parents, visits to a doctor for psychological problems, depression, anti-social behaviour and low self-esteem were risk factors for self-reported attempted suicide by adolescents in both surveys. Significant interaction terms showed that the effects of gender and illicit drug use were smaller in 2007 than in 1984. However, low self-esteem became significantly more important. Several common psychosocial factors seem to be steadily related to self-reported suicide attempts by Greek adolescents in 1984 and 2007. However, the increase in self-reported suicide attempts between 1984 and 2007 has been accompanied by changes in the relative importance of correlates.

Suicide risk in adolescents with chronic illness: implications for primary care and specialty pediatric practice: a review

Suicide in adolescents is a global tragedy. Research-identified correlates of suicide in youth include depression, academic failure, loss of friends, social isolation, and substance abuse, among others. This review focuses on the potential link between chronic illness in adolescents and increased suicide risk. Research suggests that chronic illness is a risk factor for depression in adolescents that may induce suicide ideation and attempts; however, this risk may be increased even more in young adulthood if the underlying causes of depression are not resolved. This risk needs to be considered against the research data noting an increase in suicide attempts and completions, in each decade of life from adolescence into adulthood. Although more research is clearly needed, it can be concluded that suicide risks are seen in adolescents with chronic illness and all of these young people should be screened for depression and other risk factors for suicide on a regular basis.

A Case-Control Study of Antidepressants and Attempted Suicide During Early Phase Treatment of Major Depressive Episodes

To estimate the relative risk of suicide attempts in child and adult outpatients initiating antidepressants for major depressive episodes compared to those not treated with antidepressants. A nested matched case-control study was performed with Medicaid administrative data (January 1, 1999-December 31, 2000) of out-patients treated for a major depressive episode. Beneficiaries initiating treatment for a major depressive episode were selected, excluding those who had recently received inpatient psychiatric treatment or outpatient treatment of pregnancy, major depressive episodes, bipolar disorder, schizophrenia or other psychoses, mental retardation, dementia, or delirium or recent treatment with a mood stabilizer, antidepressant, or antipsychotic. The outcome was treatment for a suicide attempt during the first 120 days after starting treatment for a major depressive episode. Controls were matched to cases on age, sex, race/ethnicity, recent treatment of substance use disorder, severity and type of major depressive episode, and other factors. Separate analyses were performed for adults (aged 19 to 64 years) and children (aged 6 to 18 years). Among children, antidepressant treatment was associated with a significant increase in suicide attempts (odds ratio [OR] = 2.08, 95% confidence interval [CI] = 1.06 to 4.10; cases, N = 51; controls, N = 239; p = .03). Among adults, antidepressant treatment was not significantly related to risk of suicide attempts (OR = 0.85, 95% CI = 0.57 to 1.28; cases, N = 185; controls, N = 893; p = .44), although among adult males, antidepressants were associated with a significant protective effect (OR = 0.32, 95% CI = 0.12 to 0.83; cases, N = 57; controls, N = 268; p = .01). In these outpatients initiating treatment for a major depressive episode, antide-pressant treatment appears to be associated with an increased risk of treated suicide attempts in children and a decreased risk in adult males.

The Terrorist Attacks of September 11, 2001, as Psychological Toxin: Increase in Suicide Attempts

The Terrorist Attacks of September 11, 2001, as Psychological Toxin: Increase in Suicide Attempts

The Influence of Media Coverage of a Celebrity Suicide on Subsequent Suicide Attempts

To investigate the impact of media reporting of a celebrity suicide on subsequent suicide attempts. A Poisson time series autoregression analysis was conducted to examine whether there was a significant increase in suicide attempts during the 3-week period after the start of extensive media reporting of a celebrity suicide. The reporting began on May 2, 2005, and lasted about 17 days. To investigate the influence of media reporting on suicide attempts, a structured interview was conducted with 124 suicide attempters identified from 2 counties in Mid Taiwan who had exposure to the media reporting. After controlling for seasonal variation, calendar year, temperature, and humidity, there was a marked increase in the number of suicide attempts during the 3-week period after media reporting began (adjusted relative risk = 1.55, 95% CI = 1.26 to 1.91). Among 124 suicide attempters exposed to the media reports, 23.4% reported an influence from them. There was no relationship between the attempters' ages and the age of the celebrity or the method, but male attempters had a significantly higher risk for such influence. A considerably higher risk for such influence was found among subjects with a history of suicide attempt(s) in the previous year (odds ratio = 52.3, 95% CI = 5.96 to 459.1). The extensive media reporting of the suicide of a celebrity was followed by an increase in suicide attempts. The effect was particularly marked in individuals with a recent history of a suicide attempt. The results provide further support for the need for more restrained reporting of suicides as part of suicide prevention strategies and for special vigilance for contagious effects of such reporting on people who have carried out recent suicidal acts.

Factors distinguishing suicide attempters from suicide ideators in a community sample: social issues and physical health problems

Few studies have focused on factors that uniquely distinguish suicide attempters from suicide ideators. This study assesses prevalence of suicide attempts among suicide ideators within a community sample; explores demographics, employment status, mental and physical health conditions, personality, life stresses and social environment as factors that may distinguish these groups; examines effects of age and gender upon suicide attempts and associated factors; and investigates the increase in suicide attempts when multiple factors related to this behaviour are present. Data were drawn from the PATH Through Life Project, a community survey of 7485 people in Canberra, Australia. A subsample of 522 suicide ideators were used for this study. Logistic regression was used to identify factors associated with suicide attempts. Physical medical conditions (OR 1.95) and negative interactions with friends (OR 1.20) were associated with an increased likelihood of suicide attempts among suicide ideators. Age and gender interaction effects for suicide attempts were found involving physical medical condition and mastery among men (OR 3.78 and 0.83 respectively) and not being employed for those aged 40-44 years (OR 8.94). A cumulative effect was found when multiple factors associated with suicide attempts were present, and the probability of an attempt was significantly elevated. Factors distinguishing those who attempt suicide from suicide ideators involve being unemployed, physical ill health and relationship difficulties. Contrary to expectation, this study found that ideators and attempters experience comparable levels of depression and anxiety.

Affective disorders in the first-degree relatives of bipolar probands: results from the south island bipolar study

The current study was performed to document observed rates of affective disorders in the first degree relatives of probands with bipolar I or II disorder; to determine whether bipolar II probands have an excess of bipolar II relatives; and to determine whether bipolar probands with a history of one or more suicide attempts have more relatives who have also made suicide attempts. Bipolar probands with positive family histories of affective disorder were recruited from a variety of sources for a study on the molecular genetics of bipolar disorder. Probands and relatives were interviewed with the Diagnostic Interview for Genetic Studies (DIGS) and blood was obtained for DNA extraction and genetic analyses. Among 423 first-degree adult relatives of 153 bipolar probands, 7% (29) had bipolar I disorder, 7% had bipolar II disorder, and 7% had bipolar not otherwise specified (NOS) disorder, making 21% of relatives with any bipolar disorder. A further 42% of relatives had a depressive disorder and only 38% had no affective disorder. A suicide attempt by a proband was not associated with any increase in suicide attempts by relatives. We conclude that while unipolar depressive disorders are the most common affective disorders in the first-degree relatives of bipolar probands, extension of the bipolar phenotype to include bipolar spectrum disorders results in 21% of relatives having any bipolar disorder.

Natural history of affective disorders: Comorbidity as a predictor of suicide attempts

OBJECT: Comorbidity of psychiatric illnesses and substance misuse can lead to an increase in suicide attempts. METHOD: Retrospective data collection from case notes of 81 consecutive admissions to an acute psychiatric ward. Previous diagnoses, substance misuse and suicidal attempts were all examined. RESULTS: The rate of suicide attempts among all groups was 40.7%. Alcohol abuse or use of illegal drugs was reported in 69.7% of suicide attempters. More than half of the patients (66.7%) overconsumed alcohol. CONCLUSION: Clinical implication of the effect of comorbidity on suicidal behaviour and length of stay are discussed.

Pharmacotherapy in the Prevention of Suicidal Behavior

Prevention or reduction of suicide remains a serious challenge for the medical community. Psychotherapeutic and psychosocial interventions have not been shown to reduce the incidence of suicide attempts and analytic psychotherapy has been shown to increase suicidal behavior. The efficacy of pharmacotherapy in reducing suicide attempts in patients with a history of repeated suicidal behavior has been shown with low doses of the neuroleptic agent flupenthixol compared with placebo. Supporting findings have been reported with trifluoperazine. There is evidence to suggest that some antidepressants may not be neutral in their effect on suicidal behavior. Maprotiline, for example, was associated with an increase in suicide attempts compared with placebo in a large long-term treatment study despite its significant efficacy in preventing relapse of depression. Differential lethality indices taken from large community studies support the notion that noradrenergic drugs such as maprotiline, desipramine, and nortriptyline are associated with a higher than expected incidence of death from overdose, and the suicide-provoking potential may relate to some noradrenergic property. The studies of serotonergic antidepressants do not suggest that they are suicide-provoking agents; rather they appear to be neutral or protective. Prospective prophylactic studies are needed to test the ability of potential treatments for the reduction of suicidal behavior.

The current age of youthful melancholia. Evidence for increase in depression among adolescents and young adults.

The possibility of a rise in rates of depression among adolescents and young adults was first reported in the 1970s. Particular note was taken of the emergence of childhood depression and the increase in suicide attempts and death among adolescents and young adults. Data from large-sample family studies and community epidemiological surveys have been reviewed and reanalysed, using life-table statistical methodology. Evidence for secular trends are presented, and the problems of disentangling period and cohort effect are discussed. It appears that the 'baby boomers' - those born in the years after World War II - have had increased rates of depression and other related illnesses, including drug abuse and alcoholism. The theoretical aspects of this are discussed, particularly for gene-environment interactions.

Increase in suicide attempts by drug ingestion — The boston experience 1964–1974

Increase in suicide attempts by drug ingestion — The boston experience 1964–1974

Increase in suicide attempts by drug ingestion. The Boston experience, 1964-1974.

At the Massachusetts General Hospital between 1964 and 1974, there was an estimated 118% increase in emergency ward admissions for drug overdose suicide attempts and an estimated 257% increase in such attempts by individuals in the 20- to 29-year age range. Approximately 67% of overdoses seen in 1972 and 1974 occurred in individuals under age 30. An increase in drug overdose suicide attempts by males was noted. By 1972, males were making approximately as many attempts as females. Based on extrapolations from the Massachusetts General Hospital drug overdose data, and not including an estimate of non-hospital-treated suicide attempts, an estimated annual (1972) suicide attempt rate of 337/100,000 (0.38%) was obtained for Boston. The estimated suicide attempt-completed suicide ratio for the Boston area was 39:1. These estimates should be interpreted as giving an approximate order of magnitude and not as specifying precise rates.

The epidemiology of suicide attempts, 1960 to 1971.

Although the suicide rate has been relatively stable in the United States and other countries over the last decade, there has been a marked increase in suicide attempts. A review of English language studies between 1960 and 1971 documents the increases, their magnitude and characteristics. The striking international consistencies in the age, sex, personality of the attempters, as well as the social context and method of attempts, indicates that self-destruction in the young is a major public health problem for the 70s requiring new approaches at the level of primary prevention.

Premenstrual symptoms in self-referrals to a suicide prevention service.

Two studies have been made of the relationship between premenstrual tension and phase of the menstrual cycle at the time of suicide attempt. Tonks et al. (1968) reported a negative relationship. Women without premenstrual symptoms accounted for the premenstrual increase in suicide attempts. Zacco et al. (1960) reported a significant positive relationship, women with the premenstrual syndrome being more likely to attempt premenstrually.