Suicide In Men Research Articles

Cholesterol, CSF 5-HIAA, violence and intent in suicidal men

Associations between suicide, violent behaviour and both hypocholesterolaemia and low 5-hydroxyindolacetic acid (5-HIAA) in the cerebrospinal fluid (CSF) have been suggested. The relationships between lipids, the serotonergic system, suicidal and aggressive behaviors are complex. We explored relationships between serum cholesterol, CSF 5-HIAA, the planning subscale of suicide intent and violence of attempted suicide method in 13 medication-free male suicide attempters and eight healthy volunteers. Serum high-density lipoprotein cholesterol (HDL-C) levels were significantly lower in suicide attempters than in controls. HDL-C showed a significant positive correlation with the planning subscale of suicide intent in non-violent suicide attempters. A positive association was observed between CSF 5-HIAA and serum cholesterol in suicides. The role of cholesterol may be different in planned non-violent suicide attempts compared with violent suicide attempts.

Starting out - I was scared about saying the wrong thing to a suicidal man

Starting out - I was scared about saying the wrong thing to a suicidal man

Psychodynamische Hypothesen zur Suizidalität bei älteren Männern

Old men are overrepresented in the whole of all suicides. In contrast, only very few elderly men find their way to specialised treatment facilities. Elderly accept psychotherapy more rarely than younger persons. Therefore presentations on the psychodynamics of suicidality in old men are rare and mostly casuistical. By means of a stepwise reconstructable qualitative case comparison of five randomly chosen elderly suicidal men with ideal types of suicidal (younger) men concerning biography, suicidal symptoms and transference, psychodynamic hypothesis of suicidality in elderly men are developed. All patients came into psychotherapy in a specialised academic out-patient clinic for psychodynamic treatment of acute and chronic suicidality. The five elderly suicidal men predominantly were living in long-term, conflictuous sexual relationships and also had ambivalent relationships to their children. Suicidality in old age refers to lifelong existing intrapsychic conflicts, concerning (male) identity, self-esteem and a core conflict between fusion and separation wishes. The body gets a central role in suicidal experiences, being a defensive instance modified by age and/or physical illness, which brings up to consciousness aggressive and envious impulses, but also feelings of emptiness and insecurity, which have to be warded off again by projection into the body. In transference relationships there are on the one hand the regular transference, on the other hand an age specific turned around transference, with their counter transference reactions. The chosen methodological approach serves the systematic finding of hypotheses with a higher degree in evidence than hypotheses generated from single case studies.

Gender difference in suicide, household production and unemployment

This article aims to explain why men's suicide rate is generally higher than women's and why the former tends to fluctuate with unemployment. Adopting Hamermesh and Soss's suicide model (1974), with a two-period household production model, I argue that (1) the gender gap in suicide rate increases with the unemployment rate, because unemployed men suffer a larger ‘human capital loss’, due to the division of labour within their household and (2) men's suicide rate is generally higher than women's because of the shorter expected life of the former. Both international and US evidences support this hypothesis.

When things fall apart: Gender and suicide across the life-course

Young men are often considered to be at particular risk of suicide, but such claims are partial and potentially misleading. Drawing on official statistics and an innovative, qualitatively driven, mixed method sociological autopsy of individual suicides, the authors of this paper argue that the vulnerability of 'young' men to suicide is often exaggerated and that insufficient attention is paid to the diverse social circumstances of suicidal men and women across the life course. Detailed analysis of 100 case files selected from a single coroner's office in the UK reveals that patterns of suicide can be seen to map on to conventional features of a socially structured life course, with young people in crisis, mid-life gendered patterns of work and family and older people in decline. Particular attention is drawn to suicide among those in mid-life and to the role of the social bond, especially in the form of attachment. Relationship breakdown is considered in some detail because it is central to understanding the demography of suicide and the significance of social bonds.

Platelet serotonin and serum cholesterol concentrations in suicidal and non-suicidal male patients with first episode of psychosis

Suicidal behavior is a major health risk in psychiatric disorders, especially in schizophrenia, and up to 10% patients will commit suicide. The neurobiology of suicide is still unclear. Suicidality has been related to a decreased central serotonergic (5-hydroxytryptamine, 5-HT) function and reduced cholesterol levels. Platelet 5-HT was used as a peripheral marker of the central serotonergic synaptosomes. The hypothesis was that suicidal patients in the first episode of psychosis will have different serum cholesterol and platelet 5-HT concentrations than non-suicidal patients in the first episode of psychosis. The aim of this study was to evaluate serum cholesterol and platelet 5-HT concentrations in suicidal and non-suicidal men in the first episode of psychosis and in healthy male controls. Venous blood samples were collected within 24 hours of admission, and serum cholesterol and platelet 5-HT were determined enzymatically and fluorimetrically. Platelet 5-HT and serum cholesterol concentrations were significantly lower in suicidal than in non-suicidal patients in the first episode of psychosis, and than in healthy controls. Our results suggest that lower concentrations of serum cholesterol and platelet 5-HT in patients with the first episode of psychosis might be useful biological markers of suicidality.

Reduction in the suicide rate during Advent—a time series analysis

Research has shown that there are different seasonal effects in suicide. The aim of this study is to demonstrate that the decrease in suicide rate at the end of the year is extended over the last weeks of the year and represents a specific type of seasonal effect. Suicide data were extracted from individual records of the Swiss mortality statistics, 1969–2003. The data were aggregated to daily frequencies of suicide across the year. Specifically, the period October–February was examined using time-series analysis, i.e., the Box–Jenkins approach with intervention models. The time series models require a step function to account for the gradual drop in suicide frequencies in December. The decrease in suicide frequencies includes the whole Advent and is accentuated at Christmas. After the New Year, there is a sharp recovery in men's suicide rate but not in women's. The reduction in the suicide rate during the last weeks of the year exceeds the well-recognised effect of reduced rates on major public holidays. It involves valuable challenges for suicide prevention such as timing of campaigns and enhancement of social networks.

Polymorphisms Linked to Risk of Suicidality in Men

Polymorphisms Linked to Risk of Suicidality in Men

SEX DIFFERENCES IN SURVIVING SUICIDE ATTEMPTS BY JUMPING: A REVIEW1

Suicidal men and women who use jumping as their method for suicide appear to jump from similar heights. Data from suicidal jumpers from the Aurora Bridge in Seattle indicate that women have been more likely to survive than were men.

The experience of suicidal, substance‐abusing men with severe personality disorders in the emergency department

AbstractThis qualitative study examines the experience of suicidal, substance‐abusing men with severe personality disorders presenting to an emergency department (ED). Semi‐structured interviews were conducted with ED patients (n = 25), ED physicians (n = 5), ED nurses (n = 6), other ED staff (n = 6) and family physicians (FPs) (n = 7). Interviews were tape‐recorded, transcribed verbatim and managed using a comprehensive qualitative software program N6. Transcripts were coded using an iterative process and team involvement to capture emergent themes. Negative expectations were found to be held by participants from all perspectives, patients, ED staff and FPs, and these overarching negative expectations appear to interact with prior negative experiences and current negative behaviours to foster negative outcomes from these encounters. The suicidal men, ED staff and FPs offered suggestions, both systemic and within the ED interactions between providers and patients, that could minimize negative outcomes. Copyright © 2007 John Wiley & Sons, Ltd.

Sex Differences in Surviving Suicide Attempts by Jumping: A Review

Suicidal men and women who use jumping as their method for suicide appear to jump from similar heights. Data from suicidal jumpers from the Aurora Bridge in Seattle indicate that women have been more likely to survive than were men.

SUICIDALITY IN MEN IN PSYCHODYNAMIC PSYCHOTHERAPY

Based on the evidence of empirical gender differences in attempted suicide and suicide, this paper develops psychodynamic hypotheses on gender‐specific biographic, intra‐psychic and treatment aspects of suicidality among men. ‘Forming Types by Understanding’ is a qualitative method, based on a systematic analysis of similarity and differential reference points to develop ideal types of suicidal men. A random sample of 20 suicidal men who were receiving out‐patient psychodynamic psychotherapy was studied. Four ideal types of suicidal men were identified: (1) ideal type ‘disconnected’: a predominance of disconnected feelings that is associated with rejection experiences; (2) ideal type ‘hurt’: aggressive conflicts and the realization of disillusioned life reality combined with experiences of real loss and real trauma; (3) ideal type ‘stormy’: an attached‐symbiotic transference offer mobilizes unrealistic wishes to help against a background of unresolved dependency conflicts; and (4) ideal type ‘object dependent’: concrete facts are important in relationships; in case of separation, real repossession of the woman must occur, a lack of emotional experience is compensated. The danger of suicidality, especially in the early stage of psychotherapy, is particularly acute for patients who cannot reach their therapists emotionally and vice versa. Disturbance of the early experience of inseparability from the mother, gender‐specific conflicts in the development of separation and individuation, and failed triangulation are of central psychodynamic importance.

Fragmented Pathways to Care

Using qualitative methods, this study examined how, and under what circumstances, suicidal men used mental health services. In particular, the analyses focused on fragmented pathways to care. Fifteen men with a history of suicidal and aggressive behaviors and a diagnosis of borderline personality disorder and/or antisocial personality disorder participated in semistructured interviews that consisted of questions about their mental health status and experiences with mental health and addiction services. Interviews were taped and transcribed. An iterative, inductive qualitative analytic process was used. Men followed a cyclical pattern wherein negative experiences with health care providers were said to be followed by avoidance of health care settings, crisis, and then by involuntary service utilization. Men identified five health care provider and three personal practices, and two types of episodes they believed to contribute to their fragmented pathways to care. Implementation of specialized interventions, and providing patients with more information and more opportunity to participate in decisions, may improve interactions between patients and providers and improve patients' mental health status.

Comparison of the Effects of Four Suicide Prevention Programs for Family and Friends of High‐Risk Suicidal Men Who Do Not Seek Help Themselves

Callers to a suicide prevention center concerned about high risk men were randomly invited to participate in one of four programs: Information Session, Information Session with Telephone Follow-up, Rapid Referral to mental health and abuse programs, or Telephone Support. Comparison of pre-test, 2 month post-test and 6 months follow-up with 131 participants found that after third party participation, the third party participant reported that the suicidal men had significantly less suicidal ideation, fewer suicide attempts, and less depressive symptoms. Family and friends had less psychological distress, used more positive coping mechanisms, and reported their communication with the suicidal man was more helpful. The Telephone Support was considered the most useful program.

Cerebral and coronary air embolism: an intradepartmental suicide attempt

Uncooperative but alert on arrival, a 21-year-old suicidal man was found suddenly unconscious with agonal respirations 2 h into his Emergency Department evaluation. Initially admitted for ingesting multiple pills and self-inflicting a deep wrist laceration, the patient now had a Glasgow Coma Scale score of 3, a dense left-sided hemiplegia, and an electrocardiogram suggestive of acute myocardial infarction. This constellation of physical findings, together with an echocardiogram revealing bi-ventricular gas artifact, led to a diagnosis of coronary and cerebral air emboli. The patient was urgently resuscitated and then underwent hyperbaric oxygen therapy. Subsequent examination confirmed a full recovery. This article details this unprecedented case, as well as clinically relevant aspects of air embolism.

Increased corticotropin-releasing hormone immunoreactivity in monoamine-containing pontine nuclei of depressed suicide men.

A number of clinical investigations and postmortem brain studies have provided evidence that excessive corticotropin-releasing hormone (CRH) secretion and neurotransmission is involved in the pathophysiology of depressive illness, and several studies have suggested that the hyperactivity in CRH neurotransmission extends beyond the hypothalamus involving several extra-hypothalamic brain regions. The present study was designed to test the hypothesis that CRH levels are increased in specific brainstem regions of suicide victims with a diagnosis of major depression. Frozen tissue sections of the pons containing the locus coeruleus and caudal raphe nuclei from 11 matched pairs of depressed suicide and control male subjects were processed for radioimmunocytochemistry using a primary antiserum to CRH and a ([125])I-IgG secondary antibody. The optical density corresponding to the level of CRH-immunoreactivity (IR) was quantified in specific pontine regions from the film autoradiographic images. The level of CRH-IR was increased by 30% in the locus coeruleus, 39% in the median raphe and 45% in the caudal dorsal raphe in the depressed suicide subjects compared to controls. No difference in CRH-IR was found in the dorsal tegmentum or medial parabrachial nucleus between the subject groups. These findings reveal that CRH-IR levels are specifically increased in norepinephrine- and serotonin-containing pontine nuclei of depressed suicide men, and thus they are consistent with the hypothesis that CRH neurotransmission is elevated in extra-hypothalamic brain regions of depressed subjects.

Love and Achievement Motives in Women's and Men's Suicide Notes

It is often assumed that women kill themselves because of love and men because of achievement problems. The authors evaluated the suicide notes of 56 U.S. adult women and men with regard to love and achievement motives. Love themes were significantly more common than achievement themes, independent of sex and age. This suggests that, at least for U.S. adults who leave suicide notes, relationship concerns may be a dominant component of the motivation for suicide.

Aftermath: Systems Thinking, Sustainability and Terrorism

-the of this world that we can inspect and analyze is always finite. We always have to say the rest of the world does not influence this part, and it is never true. The world is totally connected. Jacob Bronowski (1978, p. 96) None of us will escape the after-effects of the terrorist acts of September 11th-those events have changed the world. Now- * Passenger planes can become bombs. * Steel buildings hundred stories high can fall. * An entire industry-Airlines-can come close to collapse, laying off over 100,000 workers, teetering on the edge of bankruptcy, in just three days. * And thousands of families can lose loved ones without warning in time of peace. And these are only the most obvious effects. We don't yet know all the longterm effects on our psyches, our dreams, our visions of ourselves as individuals and as people. But is the structure of our well-being-emotional and economic-so fragile that it can be devastated by suicidal men with box knifes? Are freedom, individualism, and the free-market spirit that Americans hold so dear simply flimsy images on house of cards, or are they sustainable cultural values? Are the notions of sustainability and our strongly held desire to preserve the environment still useful to us in this new world? To answer these questions, we take short tour of systems thinking and the roots of sustainability that offer one framework for understanding our increasingly complex post-September 11th world. The United States is society of individuals from all races and cultures. We believe in protecting the rights of individuals acting in their own self-interests and we create institutions and free markets where people pay the price for, and can earn the benefits of, those actions. Our democratic society protects people's rights and imposes on them personal responsibility (and punishments) when they do wrong. We have come to this vision of culture after long struggle for independence and bloody internal strife during the Civil War when the North and the South fought for the right to create the dominant set of values of the United States of America. We are in similar struggle now, on global scale, as we move from grouping of nations to world community, the Global Village that Marshall McLuhan predicted. America, Afghanistan, Australia-all nations are more than mere collections of people; they represent cultures and dynamics that have qualities that go far beyond those of the individuals that reside there. Just as whole is more than the sum of its parts, societies are more than the sum of their individual citizens. These whole cultures arise from the organizing relationships of the parts. (In fact, though, quantum physics shows us that there really are no parts at all. What we call a part is merely pattern in an inseparable web of relationships.) When people or ideas or organisms or events are drawn together in unique combinations, something new is born with new qualities not present before; scientists call this synergy. The totality of this new bundle of combinations, this synergy, is system. Systems nest within other Even an individual cell is system with nucleus, fluid, proteins, DNA, RNA, membrane. Complete organisms themselves (with cells, bacteria, and other systems within them) are Many organisms together form larger systems-like the Olympic Rainforest, or the river and environmental ecosystems that support Pacific West Coast salmon. Some people even feel that memes-or symbols and ideas-can combine to form living systems. Systems overlap and influence one another. And systems are self-stabilizing; they all possess quality called autopoiesis- literally, the capacity of self-making. The capacity of autopoiesis brings system that has been jolted by some new force back into equilibrium. Just like individual humans, systems want to continue to exist. Systems thinking1 is the science of understanding how systems work. …

The course of post-crisis suicidal symptoms: how and for whom is suicide "cathartic"?

We investigated suicide "catharsis" as evidenced by decreased suicidality following a suicide attempt. Past research has examined this issue with mixed results (Bronisch, 1992; Davis, 1990; van Praag & Plutchik, 1985). In the present study, we examined Modified Scale for Suicide Ideation (MSSI) scores for 198 suicidal men during suicidal crisis, prior to entry into a treatment study, and again at 1-month and 12-month follow-ups. Patients were divided into ideators, single attempters, and multiple attempters. We found evidence for decreased suicidality, but interpreted it as the gradual action of interpersonal support, rather than as emotional catharsis. Also, multiple attempt status affected the long-term course of post-crisis suicidality.

Rational and Assisted Suicidal Communication on the Internet: A Case Example and Discussion of Ethical and Practice Issues

The development of ethical and practice guidelines related to mental health service on the Internet has lagged behind the movement of practitioners into this area. Even for clinicians who are not offering services on the Web, the Internet has led to confusion and concern about proper roles and responsibilities. This article discusses an actual experience we had with a self-described rationally suicidal man with multiple sclerosis (MS). After presenting some background on MS, we report initial interactions with the man verbatim and summarize subsequent correspondence in an analysis of the man's claim that his decision to die was well reasoned and that he should be allowed a physician's assistance.