Risk Factors For Completed Suicide Research Articles

Prevalence and risk factors for attempted suicide in the elderly: a cross-sectional study in Shanghai, China.

Previous studies have thoroughly investigated the prevalence and risk factors for completed suicide. In marked contrast is the lack of a better understanding of attempted suicide in the elderly. The aim of this study was to estimate the prevalence of attempted suicide in the elderly and examine the associated factors. Using a multi-stage cluster sampling approach, a cross-sectional survey of 8,399 elderly house-dwelling residents was conducted in Shanghai, China. The two-week prevalence of attempted suicide in the elderly was 0.75%. In the bivariate analysis, having no caregivers, depressive, anxiety, sad, fear, obsessive-compulsive and anger symptom, and lower scores on the Barthel Index of Activities of Daily Living and the Lawton Instrumental Activities of Daily Living Scale were significantly associated with an increased risk of attempted suicide in the elderly. In the multivariate analysis, sad and fear symptoms were significantly and independently associated with a higher risk of attempted suicide in the elderly. The two-week prevalence of attempted suicide in the elderly is relatively high when compared with the annualized or lifetime prevalence reported in China and foreign settings. Elderly individuals with certain mental symptoms should be targeted for suicide prevention and provided with timely mental health support.

Predicting Suicide Risk in Trauma Exposed Veterans: The Role of Health Promoting Behaviors.

IntroductionReturning veterans of the wars in Iraq and Afghanistan experience high rates of post-traumatic stress disorder (PTSD) and suicidal behavior. Suicidal ideation is among the strongest risk factors for completed suicide. Some research suggests an association between PTSD and suicidal ideation, and that health-promoting behaviors—behaviors that sustain or increase well-being—play a role in this association. The current study examined whether health-promoting behaviors moderate the association between PTSD severity and suicidal ideation.MethodsVeterans of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF; N = 108) completed measures of PTSD symptoms, trauma exposure, suicidal ideation, and health-promoting behaviors.ResultsModerated regression was used to test the hypothesis. Results indicated that health promoting behaviors, β = -.06, p = .001, and PTSD symptoms, β = .36, p < .001, were significantly related to suicidal ideation. Consistent with our main hypothesis, the health promoting behaviors x PTSD interaction term was significantly associated with suicidal ideation, β = -.09, p = .001. The overall model accounted for 13% of the variance in suicidal ideation. Among individuals with high PTSD symptom severity, those who engaged in more health promoting behaviors reported less suicidal ideation than those who engaged in fewer health promoting behaviors.ConclusionsHealth-promoting behaviors could be important for reducing suicidal ideation among veterans with high levels of PTSD symptoms. It is recommended that future research examine health promotion interventions as a means of reducing suicidal ideation.

The Relation of Self-Compassion and Anger Control Dimensions With Suicide Ideation in University Students

Background: Suicide ideation is one of the strongest risk factors for completed suicide. There have been many reports of significant increases in suicide and suicide attempts in university students. Objectives: This study was performed to determine the relationship of self-compassion and anger control dimensions with suicide ideation. Patients and Methods: The method of this study was descriptive and correlation. The statistical population comprised students of Mohaghegh Ardabili university in the second semester of the 2012 - 2013 school year. One hundred and fifty subjects were selected from this population by random multistage clustering. They were asked to answer questionnaires about suicide ideation, self-compassion, and multidimensional anger. The collected data were analyzed by Pearson correlation coefficient and multiple regression tests. Results: The results of the Pearson correlation coefficient tests showed that suicide ideation was negatively correlated with self-compassion (r = -0.19; P < 0.05) and mindfulness components (r = -0.20; P < 0.05), but it was positively correlated with self-judgment (r = 0.39; P < 0.001), isolation (r = 0.28; P < 0.004), over-identification (r = 0.49; P < 0.001), anger arousal (r = 0.39; P < 0.001), anger-provoking situations (r = 0.24; P < 0.001), hostile outlook (r = 0.32; P < 0.001) and anger (r = 0.45; P < 0.001). The regression analysis results also showed that 24% of the variance of suicide ideation can be explained by self-compassion and 24% by anger-control dimensions. Conclusions: Based on the results, improving self-compassion and anger-control skills are suggested as ways to decrease suicide ideation.

Suicide Attempt as a Risk Factor for Completed Suicide: Even More Lethal Than We Knew

While suicide attempt history is considered to robustly predict completed suicide, previous studies have limited generalizability because of using convenience samples of specific methods/treatment settings, disregarding previous attempts, or overlooking first-attempt deaths. Eliminating these biases should more accurately estimate suicide prevalence in attempters. This observational retrospective-prospective cohort study using the Rochester Epidemiology Project identified 1,490 (males, N=555; females, N=935) Olmsted County residents making index suicide attempts (first lifetime attempts reaching medical attention) between January 1, 1986, and December 31, 2007. The National Death Index identified suicides between enrollment and December 31, 2010 (follow-up 3-25 years). Medical records were queried for sex, age, method, and follow-up care for index attempt survivors. Coroner records yielded data on index attempt deaths. During the study period, 81/1,490 enrollees (5.4%) died by suicide. Of the 81, 48 (59.3%) perished on index attempt; 27 of the surviving 33 index attempt survivors (81.8%) killed themselves within a year. Males were disproportionately represented: 62/81 (11.2% of men, 76.5% of suicides) compared with 19/81 (2.0% of women, 23.5% of suicides). Of dead index attempters, 72.9% used guns, yielding an odds ratio for gunshot death, compared with all other methods, of 140 (95% CI=60-325). When adjusted for covariates, survivors given follow-up psychiatric appointments had significantly lower likelihood of subsequent suicide (odds ratio=0.212, 95% CI=0.089-0.507). At 5.4%, completed suicide prevalence in this community cohort of suicide attempters was almost 59% higher than previously reported. An innovative aspect of this study explains the discrepancy: by including index attempt deaths-approximately 60% of total suicides-suicide prevalence more than doubled. We contend that counting both index and subsequent attempt deaths more accurately reflects prevalence. Our findings support suicide attempt as an even more lethal risk factor for completed suicide than previously thought. Research should focus on identifying risk factors for populations vulnerable to making first attempts and target risk reduction in those groups.

English

The objective of this study was to identify trends of completed suicide based on gender and age groups. Population data of complete suicide in Sri Lanka during 2005 to 2014 were collected from the Sri Lanka Police Statistics Department. One-way analysis of variance (ANOVA), chi-square test and descriptive statistics were used to analyze the data. Risk factors of completed suicide is significantly depending with age (Chi-square= 15581.28, 2 0.05,70=90.5) and gender (Chi-square= 2109.71, 2 0.05, 27=40.1). Risk factors of completed suicide in Sri Lanka during the last decades have not been changed significantly. Key words: Suicide, mental health, risk factors, public health.

For Self-Harm, Approaches Using Cognitive-Behavioral Therapy Are the Most Effective

Self-harm, regardless of suicidal intent, is a growing problem. It is often repeated, results in frequent emergency-department visits, and is the strongest risk factor for completed suicide. Researchers have now updated a previous meta-analysis on the efficacy of psychotherapeutic interventions for self-harm. There were 29 randomized, controlled studies (8480 adults; mean age, 26), and each included treatment had to …

Perinatal suicide associated with depression diagnosis and absence of active treatment in 15-year UK national inquiry

ABSTRACT FROM: Khalifeh H, Hunt IM, Appleby L, et al . Suicide in perinatal and non-perinatal women in contact with psychiatric services: 15 year findings from a UK national inquiry....

Effect of Socioeconomic Status on the Linkage Between Suicidal Ideation and Suicide Attempts.

Previous suicide attempts are a leading risk factor for completed suicide. To identify specific characteristics of those at high risk for attempts, we investigated associations with socioeconomic status (SES). Data from the 2013 Korean Community Health Survey (KCHS) included adults who reported suicidal ideation (N=220,245). Attempts in the past 12months were assessed. Associations of demographic, socioeconomic, and suicide-related behavioral factors were analyzed using multiple logistic regression. Among those with suicidal ideation, 862 (3.9%) had attempted suicide. After stratification by age and gender, results showed that low education and unemployed young adult men and women had significantly higher rates of attempts. The lowest income level was associated with significantly higher rates of attempts in only young adult women. Among those with the lowest and highest income, the association between ideation and attempts was attenuated, whereas it was enhanced among other income groups.

Issues Most Important to Parents After Their Children's Suicide Attempt: A Pilot Delphi Study.

Suicide is the third leading cause of death for people aged 15-24 and results in 4,600 lives lost each year. One important risk factor for completed suicide is a nonlethal suicide attempt. To date, little research has been conducted on the needs of parents of adolescents who have made a nonlethal suicide attempt. The goal of this pilot study was to describe the most important concerns of parents whose children have made a nonlethal suicide attempt from the perspective of adolescent mental health professionals. A two-round Delphi technique was utilized with an interdisciplinary panel of adolescent mental health experts to gain consensus on what issues are most important to parents after their children's suicide attempt. Panelists described the following as most important to parents after their children's nonlethal suicide attempt: keeping their children safe; identifying what caused or triggered the suicide attempt; strategies to prevent another suicide attempt; and communication and building trust for the future. An advanced understanding of the issues most important to parents whose children have made a nonlethal suicide attempt has implications for clinicians in creating acceptable and useful interventions aimed at preventing youth suicide.

Association between BDNF levels and suicidal behaviour: a systematic review protocol.

BackgroundSuicide is a worldwide public health concern that claims close to 1 million lives each year. Suicidal behaviour is a significant risk factor for completed suicide and is much more prevalent than completed suicide. Many internal and external factors contribute to the risk of suicidal behaviour. Recent research has focused on biological markers in suicide risk, including brain-derived neurotrophic factor (BDNF). BDNF is a protein involved in the growth, function, and maintenance of the nervous system. It has been implicated in psychiatric disorders and suicide. While some evidence suggests that reduced levels of BDNF are associated with suicide, the precise relationship has yet to be determined. The aim of this study is to review the literature examining the relationship between levels of BDNF and suicidal behaviour.MethodsA predefined search strategy will be implemented to search the following electronic databases: PubMed/MEDLINE, Excerpta Medica Database (EMBASE), PsycINFO, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) from inception. The articles will be screened by two independent authors (RE and SP) using predetermined inclusion and exclusion criteria. Discrepancies will be resolved by consensus, or by a third author (ZS) in cases of disagreement. The primary outcome will be the association between levels of BDNF and suicidal behaviour. A meta-analysis will be conducted if appropriate. Quality of evidence and risk of bias will be evaluated.DiscussionThe findings of this review will assist in identifying and treating individuals at increased risk of suicide.Systematic review registrationPROSPERO CRD42015015871.Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-015-0047-x) contains supplementary material, which is available to authorized users.

Association between body mass index and suicidal behaviors: a systematic review protocol.

BackgroundSuicide is among the leading causes of death worldwide. Suicide attempts and suicidal ideation are more common than completed suicide and are associated with psychological distress. These behaviors are considered risk factors of completed suicide. Considering the psychosocial stigma and medical comorbidities associated with obesity, an accumulating body of studies have investigated body mass index (BMI) as a potential risk factor of suicide. However, several cohort studies have demonstrated an inverse relationship between BMI and completed suicide, suggesting a protective effect of increasing BMI against completed suicide. The association between BMI and attempted suicide is more equivocal, with several studies reporting both positive and negative relationships between BMI and attempted suicide. The primary objective of this study is to systematically review the literature to determine the association between BMI and suicidal behavior (including completed suicide, attempted suicide, suicidal ideation) in an adult population (18 years and older). The secondary objective is to explore whether sex, age, and the method used in suicide modify the relationship between BMI and suicidal behavior.Methods/designAn electronic search will be conducted using PubMed/MEDLINE, PsycINFO, CINAHL, and EMBASE using a predefined search strategy; databases will be searched from their inception. Two authors (SP and RE) will independently screen articles using predefined inclusion and exclusion criteria and will extract pertinent data using a pilot tested extraction form. At all levels of screening, discrepancies between the two authors will be resolved by consensus, and in the case of disagreement, by consulting a third author (ZS). The primary outcomes include the association between BMI and completed suicide, attempted suicide, and suicidal ideation. If appropriate, a meta-analysis will be conducted. Risk of bias and quality of evidence will be assessed.DiscussionThe results of this systematic review will inform health care professionals and researchers about whether BMI has a significant role in suicidal behavior and psychological well-being.Systematic review registrationPROSPERO CRD42014014739.Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-015-0038-y) contains supplementary material, which is available to authorized users.

Hospitalisation for chronic obstructive pulmonary disease and risk of suicide: a population-based case–control study

ObjectivesTo examine risk of suicide among individuals with hospitalised chronic obstructive pulmonary disease (COPD) and to profile differences according to sex, age, psychiatric history, and recency and frequency of COPD...

English

BACKGROUND: Alcohol dependence is a potent risk factor for completed suicide but data are limited on factors that distinguish risk within this high risk population. AIM: To study the risk factors for suicide attempts among male alcohol dependents. METHODS: This was a case control study conducted from January to July in the Year 2014. Cases and controls were recruited from Department of Psychiatry, Rajah Muthiah Medical College, using various tools such as semi structured proforma, Short term Alcohol dependence Data questionnaire, Beck's suicidal Intent scale, Hamilton Depression Rating scale. RESULTS: Descriptive analysis of the cases show that mean age of suicide was Around 35 years of which 43.3% had poor educational qualification, 50% of cases. Belong to low income group, 60% of the cases belong to joint families rather than Nuclear families, 36.7% had attempted suicide in the morning hours, 70%. Had attempted suicide in their home, 60% were hospitalized and treated, 90%. Were intoxicated at the time of attempt, 56.7% self-poisoned, 43% attempted, hanging, and about 53.3% had previous suicidal attempts. There was significant, difference between cases and controls regarding the level of dependence, Stressful life events and depression. CONCLUSION: The study concluded that Alcohol dependent individuals with Poor educational status - (up to primary school completion) and who live in joint families are at higher risk for suicide .Stressful life events (family conflict, financial loss ,unfulfilled commitments) and higher degree of dependence with Co - morbid depressive disorder is also one of the major risk factor in the study

Does the legalization of medical marijuana increase completed suicide?

Introduction: Suicide is among the 10 most common causes of death in the United States. Researchers have identified a number of factors associated with completed suicide, including marijuana use, and increased land elevation. Colorado is an ideal state to test the strength of these associations. The state has a completed suicide rate well above the national average and over the past 15 years has permitted first the medical and, as 2014, the recreational use of marijuana. Objectives: To determine if there is a correlation between medical marijuana use, as assessed by the number of medical marijuana registrants and completed suicides per county in Colorado. Methods: The number of medical marijuana registrants was used as a proxy for marijuana use. Analysis variables included total medical marijuana registrants, medical marijuana dispensaries per county, total suicide deaths, mechanism of suicide death, gender, total suicide hospitalizations, total unemployment, and county-level information such as mean elevation and whether the county was urban or rural. Analysis was performed with mixed model Poisson regression using generalized linear modeling techniques. Results: We found no consistent association between the number of marijuana registrants and completed suicide after controlling for multiple known risk factors for completed suicide. Conclusion: The legalization of medical marijuana may not have an adverse impact on suicide rates. Given the concern for the increased use of marijuana after its legalization, our negative findings provide some reassurance. However, this conclusion needs to be examined in light of the limitations of our study and may not be generalizable to those with existing severe mental illness. This finding may have significant public health implications for the presumable increase in marijuana use that may follow legalization.

Completed and Attempted Suicides Among 18,154 Subjects With Schizophrenia Included in a Large Simple Trial

To characterize subgroups of subjects with schizophrenia from the Ziprasidone Observational Study of Cardiac Outcomes (ZODIAC) trial who either completed or attempted suicide and those who did not. The ZODIAC, conducted between February 2002 and March 2007, was an open-label, randomized, large simple trial of patients with schizophrenia (N = 18,154) followed up for 1 year by unblinded investigators providing usual care in 18 countries; the primary outcome measure was nonsuicide mortality. Every report on a completed or attempted suicide was independently adjudicated using a predefined algorithm. Primary analysis for the current report examined the association between completed or attempted suicides and the baseline variables using descriptive statistics and multivariate logistic regression models. Usage of "hard" or "soft" methods for attempted or completed suicide and distribution of suicide-related events by geographical region were also summarized. Overall incidences of subjects who either completed (35/18,154) or attempted (108/18,154) suicide were low, as were rates per person-time on assigned treatment analysis (0.24 for completed and 0.74 for attempted suicides per 100 person-years of exposure). The highest suicide-related mortality was seen among subjects recently diagnosed with schizophrenia. Among all potential baseline risk factors for completed suicide examined, the variables most associated with completed suicide were history of suicide attempts (OR = 2.6; 95% CI, 1.33-5.12) and usage of antidepressant medication (OR = 3.5; 95% CI, 0.84-14.85). History of > 5 hospitalizations in the past (OR = 2.1; 95% CI, 1.35-3.31) and history of suicide attempts (OR = 5.0; 95% CI, 3.21-7.76) were the variables most associated with attempted suicide among potential baseline risk factors for suicide attempts. Our results, obtained in a large prospective randomized study, confirm current clinical understanding regarding completed or attempted suicide in schizophrenia and the associated risk factors. ClinicalTrials.gov identifier: NCT00418171.

Altitude is a risk factor for completed suicide in bipolar disorder

Bipolar disorder (BD) is a severe brain disease that is associated with a significant risk for suicide. Recent studies indicate that altitude of residence significantly affects overall rate of completed suicide, and is associated with a higher incidence of depressive symptoms. Bipolar disorder has shown to be linked to mitochondrial dysfunction that may increase the severity of episodes. The present study used existing data sets to explore the hypothesis that altitude has a greater effect of suicide in BD, compared with other mental illnesses. The study utilized data extracted from the National Violent Death Reporting System (NVDRS), a surveillance system designed by the Centers for Disease Control and Prevention (CDC) National Center for Injury Prevention and Control (NCIPC). Data were available for 16 states for the years 2005–2008, representing a total of 35,725 completed suicides in 922 U.S. counties. Random coefficient and logistic regression models in the SAS PROC MIXED procedure were used to estimate the effect of altitude on decedent’s mental health diagnosis. Altitude was a significant, independent predictor of the altitude at which suicides occurred (F=8.28, p=0.004 and Wald chi-square=21.67, p<0.0001). Least squares means of altitude, independent of other variables, indicated that individuals with BD committed suicide at the greatest mean altitude. Moreover, the mean altitude at which suicides occurred in BD was significantly higher than in decedents whose mental health diagnosis was major depressive disorder (MDD), schizophrenia, or anxiety disorder. Identifying diagnosis-specific risk factors such as altitude may aid suicide prevention efforts, and provide important information for improving the clinical management of BD.

Mental Pain, Communication Difficulties, and Medically Serious Suicide Attempts: A Case-Control Study

Medical severe suicide attempts (MSSA) are epidemiologically very similar to individuals who complete suicide. Thus the investigation of individuals who have made MSSAs may add to our understanding of the risk factors for completed suicide. The aim of this study was to assess the role of mental pain and communication difficulties in MSSA. A total of 336 subjects were divided into 4 groups: 78 meeting criteria for MSSA compared with116 subjects who made a medically non-serious suicide attempt (MNSSA), 47 psychiatric controls with no history of suicidal behavior, and 95 healthy controls. Mental pain variants (e.g., hopelessness), facets of communication difficulties (e.g., self-disclosure), as well as socio-demographic and clinical characteristics were assessed. The MSSA had significantly higher communication difficulties than the other 3 groups. Moreover, the interaction between mental pain and communication difficulties explained some of the variance in suicide lethality, above and beyond the contribution of each component alone. This report underlines the importance of mental pain for suicide attempts in general while difficulties in communication abilities play a critical role in differentiating MSSA from MNSSA. The co-existence of unbearable mental pain with difficulties in communication significantly enhances the risk for more lethal forms of suicidal behavior.

Going around in a Circle: A Norwegian Study of Suicidal Experiences in Old Age.

Depression has repeatedly been found to be a risk factor for completed suicide, particularly when coupled with a pervasive sense of hopelessness. The aim of this study was to evaluate depressed older persons' suicidal experiences. Data were collected by means of individual in-depth interviews with nine informants living in two districts of Norway. A hermeneutic analysis was performed. One main theme: Going around in a circle and two themes: being alone without meaning in life and struggling to achieve reconciliation emerged from the analysis. An important implication for mental healthcare practice is the need to develop a person's ability to shape and take control of her/his life. The healthcare organisation must be committed to a plan that sets out strategies enabling suicidal individuals to avoid the negative experience of meaninglessness. It was concluded that suicidal depressed elderly persons need help to escape from their desperate situation. More research is urgently required in order to prevent suicide in depressed elderly persons whose emotional pain is unbearable.

Tentatives de suicide chez les adolescents français de 17 ans : données de l’étude ESCAPAD 2008

BackgroundSuicide among children and adolescents is a major public health issue. It is one of the leading causes of death in youths. A previous suicide attempt is a well-established risk factor for completed suicide. Since 1998, hospitalisation has been recommended for all children or adolescents who have attempted suicide by the French sanitary agency. We aim to estimate the frequency of suicide attempts during childhood and adolescence and the frequency of hospitalisation after a suicide attempt. MethodA cross-sectional sample of adolescents aged 17 years was recruited in 2008 (ESCAPAD Study). Analyses were conducted on 38,236 participants who responded to the question: “During your life, have you ever attempted suicide?”. Bivariate statistical analyses compared sociodemographics characteristics and perceived relationships in the family according to the presence of a history of suicide attempt. ResultsIn our sample of French adolescents aged 17 years, 8.2% (n=3146) reported at least one history of suicide attempt. Three out of four adolescents reporting a history of suicide attempt were women (sex-ratio 1:3). Adolescents who were out of school at 17 years old (Odds ratio=2.24 [CI 95%: 1.83–2.75]; P<0.001) and those who had repeated at least one grade in school (Odds ratio=1.97 [CI 95%: 1.83–2.12]; P<0.001) were more likely to report a history of suicide attempt. Those whom parents were unemployed (Odds ratio=1.41 [CI 95%: 1.24–1.61]; P<0.001) were also more likely to report a history of suicide attempt. Family discord and negative relationship with parents were also associated with an increased frequency of history of suicide attempt. Only 25% of adolescents reporting a history of suicide attempt were hospitalised after this suicide attempt. DiscussionThe results of this study have to be considered given some methodological limitations: data are retrospective and collected by questionnaires completed by the adolescents themselves. Similar results on the association between negative relationships in family and suicidal behaviours in depressed adolescents have been previously shown by Consoli et al. (2013) in the ESCAPAD study.

Increased use of lethal methods and annual increase of suicide rates in Korean adolescents: comparison with adolescents in the United States

The lethality of the suicide method is a strong risk factor for completed suicide. We examined whether the annual change in the pattern of suicide methods was related to the annual change in suicide rates among adolescents in South Korea and the United States. We analyzed annual data for the 2000-2009 period for South Korea and the 2000-2008 period for the United States to examine time trends in the suicide rates and suicide methods of adolescents aged 10-19years in two countries. Data on suicide methods were obtained from the World Health Organization (WHO) mortality database. Suicide rates among adolescents in the United States have remained relatively steady since 2000, whereas the suicide among Korean adolescents has increased. Between 2000 and 2009, the most common suicide method among Korean adolescents was jumping for boys and girls, whereas it was hanging for girls and firearms for boys in the United States. Along with the annual increase in suicide rates in South Korea, the incidences of jumping among males and hanging (and recently jumping) among females have increased steadily, whereas suicide by self-poisoning steadily decreased. In the United States, between 2000 and 2008, the proportion of suicides committed by hanging increased, whereas those committed using firearms steadily decreased, particularly among adolescent females. These findings suggest that the increased use of lethal suicide methods is reflected in the increase in suicide rates in Korean adolescents. The most fruitful approach to addressing the rises in jumping suicides among Korean adolescents and hanging suicides among adolescents in the United States may be through population-based initiatives to reduce the physical availability (e.g., limiting access to or fencing off tall structures) and the social acceptability (e.g., effective and responsible regulations for reporting suicide) of these methods.