Female Suicide Attempters Research Articles

The association between sexual assault and suicidal activity in a national sample.

Sexual violence is a potential key risk factor for adolescent suicidal behavior but has not been studied extensively. Thus, the current study examined the extent to which sexual assault predicted suicide attempts among adolescent students in the national Youth Risk Behavior Surveillance System survey (2007 data). Gender differences in suicidal behavior overall and among sexual assault victims were examined. The results supported that students with sexual assault histories were significantly more likely (odds ratio [OR]=6.4) to have reported at least one suicide attempt in the past year than students who did not report sexual assault histories. Male students with a sexual assault history reported suicide attempts requiring medical attention more frequently than male attempters without sexual assault histories, as well as both groups of female suicide attempters. Implications of the findings for suicide prevention and intervention programs are discussed.

Shame-proneness in attempted suicide patients

BackgroundIt has been suggested that shame may be an important feature in suicidal behaviors. The disposition to react with shame, “shame-proneness”, has previously not been investigated in groups of attempted suicide patients. We examined shame-proneness in two groups of attempted suicide patients, one group of non-suicidal patients and one group of healthy controls. We hypothesized that the attempted suicide patients would be more shame-prone than non-suicidal patients and healthy controls.MethodsThe Test of Self-Conscious Affect (TOSCA), which is the most used measure of shame-proneness, was completed by attempted suicide patients (n = 175: 105 women and 3 men with borderline personality disorder [BPD], 45 women and 22 men without BPD), non-suicidal psychiatric patients (n = 162), and healthy controls (n = 161). The participants were convenience samples, with patients from three clinical research projects and healthy controls from a fourth research project. The relationship between shame-proneness and attempted suicide was studied with group comparisons and multiple regressions. Men and women were analyzed separately.ResultsWomen were generally more shame-prone than men of the same participant group. Female suicide attempters with BPD were significantly more shame-prone than both female suicide attempters without BPD and female non-suicidal patients and controls. Male suicide attempters without BPD were significantly less shame-prone than non-suicidal male patients. In multiple regressions, shame-proneness was predicted by level of depression and BPD (but not by attempted suicide) in female patients, and level of depression and non-suicidality in male patients.ConclusionsContrary to our hypothesis and related previous research, there was no general relationship between shame-proneness and attempted suicide. Shame-proneness was differentially related to attempted suicide in different groups of suicide attempters, with significantly high shame-proneness among female suicide attempters with BPD and a negative relationship between shame-proneness and attempted suicide among male patients. More research on state and trait shame in different groups of suicidal individuals seems clinically relevant.

Genetic epistasis in female suicide attempters

Complex behaviors such as suicidal behavior likely exhibit gene-gene interactions. The main aim of this study is to explore potential single nucleotide polymorphisms combinations with epistatic effect in suicidal behavior using a data mining tool (Multifactor Dimensionality Reduction). Genomic DNA from peripheral blood samples was analyzed using SNPlex Technology. Multifactor Dimensionality Reduction was used to detect epistatic interactions between single nucleotide polymorphisms from the main central nervous system (CNS) neurotransmitters (dopamine: 9; noradrenaline: 19; serotonin: 23; inhibitory neurotransmitters: 60) in 889 individuals (417 men and 472 women) aged 18 years or older (585 psychiatric controls without a history of suicide attempts, and 304 patients with a history of suicide attempts). Individual analysis of association between single nucleotide polymorphisms and suicide attempts was estimated using logistic regression models. Multifactor Dimensionality Reduction showed significant epistatic interactions involving four single nucleotide polymorphisms in female suicide attempters with a classification test accuracy of 60.7% (59.1%-62.4%, 95% CI): rs1522296, phenylalanine hydroxylase gene (PAH); rs7655090, dopamine receptor D5 gene (DRD5); rs11888528, chromosome 2 open reading frame 76, close to diazepam binding inhibitor gene (DBI); and rs2376481, GABA-A receptor subunit γ3 gene (GABRG3). The multivariate logistic regression model confirmed the relevance of the epistatic interaction [OR(95% CI)=7.74(4.60-13.37)] in females. Our results suggest an epistatic interaction between genes of all monoamines and GABA in female suicide attempters.

Indepth Interviews with 244 Female Suicide Attempters and Their Associates in Northern China

Attempted suicide, a deliberate self-directed behavior situated within the unique social world of an individual, is a major risk factor for suicide. Efforts aimed at addressing female suicide must be based on understanding their perceived causes and the meaning of this behavior. This study describes the perceived causes of suicidal behaviors to determine preventive measures of female suicide in China. An in-depth interview about the process and causes of suicidal behavior as well as a detailed structured and a standardized diagnostic interview were administered to 244 female attempters treated at general hospitals and, separately, to their relatives. The perceived three most frequent causes of the attempts were interpersonal conflict (87%), psychological problems (33%), and conflict between others that affected the subject (27%). On average 2.2 causes were identified for each case. The identification in the in-depth interviews of psychological problems as a cause of the attempt was concordant with the results of the independent psychiatric exam identifying a current DSM-IV mental disorder in 38% of cases (Kappa=0.64). Preventive measures of improving interpersonal and problem-solving skills should be developed and assessed for addressing female suicide in China besides expansion of psychiatric services.

Analyses of Etiologic and Sociodemografic Properties of the Intoxicated Cases in Van City and its Environs

The purpose of this retrospective hospital-based study was to evaluate clinical and epidemiologic characteristics of acute poisoning cases. All poisonings cases admitted to the emergency department of the Yuzuncu Yil University Training Hospital, Van, Turkey, between June 1999 and May 2005, were evaluated in the study. Etiologic and sociodemografic properties of the intoxicated cases were investigated. There were males 32.6 % and females 67.3 % in the study. 74.6 % of the cases were suicidal and 25.4 % of them accidental. The highest suicidal attempts were seen in the age group 16-25 years and were mostly occurred during spring. The vast majority of the suicide attempters were also young females. Central nervous system drugs (21.8%), carbamates (17.1%), analgesics (10.3%) and organophosphorus components (10%) were most used agents among intoxicated patients. Half of the patients was treated and released from emergency department without hospitalization. Only 6.4% of the cases admitted to critical care. The percentage of the cases that need intensive care unit was highest in central nervous system drugs. Mortality rate was 1.6% and was mostly due to opioid and organophosphorus-related poisonings. Based on the study it was suggested that there was a greater incidence of suicide attempts in younger females. Organophosphorus and carbamate containing chemicals are major causative agents for intoxications particularly in females.

Personality Patterns of Suicide Attempters: Gender Differences in Ukraine

In the present study, an attempt has been made to investigate the complete 'pattern' of a suicide attempter (SA) within the set of Big Five traits. Two models were used: M1, which includes the five main dimensions of Big Five in the analysis; and M2, which includes facets of those dimensions which were identified as important in M1. The study consisted of a group of SA (men - 326, women - 299) and a group of healthy volunteers (HV) (men - 143, women - 190) with a similar age range. Discriminant analysis (DA) showed that the factors most significant in discriminating the personality pattern of a male SA are (in decreasing order): (E) Extraversion, (N) Neuroticism, (C) Conscientiousness and (O) Openness; and for a female SA these factors were (E) Extraversion, (C) Conscientiousness and (A) Agreeableness. In M2 for men, the largest contribution to pattern recognition is (N3) Depression. Moreover, in M2 for men significant characteristics were (in descending order): (E6) Positive Emotions, (O1) Fantasy, (E4) Activity, and also (N2) Angry Hostility, (C3) Dutifulness, (C4) Achievement Striving, (C2) Order and (O6) Values; and for women: (E4) Activity, (C6) Deliberation, (C2) Order, (A6) Tender-Mindedness, (E5) Excitement Seeking, (E6) Positive Emotions, (C4) Achievement Striving, (A2) Straightforwardness, (C5) Self-Discipline and (E1) Warmth. Analysis of the obtained data demonstrates that suicide attempts amongst males, can largely be associated with personality variables reflecting negative emotions; while female suicide attempts are primarily associated with variables regarding activity and self-regulation.

Association of polymorphisms in HTR2A, HTR1A and TPH2 genes with suicide attempts in alcohol dependence: A preliminary report

We investigated a relationship between selected polymorphisms: rs6313 in HTR2A, rs6295 in HTR1A and rs1386494 in TPH2, and suicidal behaviour in 150 alcohol-dependent patients. There was a significant association between more frequent C102C genotype in HTR2A and suicide attempts in alcoholic females. No differences in genotype distribution in HTR1A and TPH2 SNPs were found between patients with and without suicide attempts.

P03-460 - Seasonality of suicide attempts: Association with gender

IntroductionSome studies suggest seasonality of suicide attempts in females, but not males. Only few studies investigated whether gender differences in seasonality of suicide attempts reflect gender differences in the choice of method, with inconsistent results.Objectives/aimsTo analyze the association of gender with seasonality in suicide attempts by persons living in two Northern Bavarian regions (city of Nuremberg and region of Wuerzburg) between 2000 and 2004.MethodsThe sample consisted of 2269 suicide attempters (882 males and 1387 females). The overall seasonality was assessed using the chi2 test for multinomials. Moreover, the ratio of observed to expected number of suicide attempts (OER) with 95% confidence intervals within each season was calculated.ResultsOverall distribution of suicide attempts differed significantly between seasons for women (chi2 = 9.19; df = 3; p = 0.03), but not for men. Female suicide attempts showed a trough in the spring (OER = 0.9; 95% C.I. = 0.8 – 1.0) which was restricted to female low-risk suicide attempts (OER = 0.87; 95% C.I. = 0.77 – 0.98). No seasonality was found for men. Seasonality of high-risk methods was more pronounced than that of low-risk methods; however, no significant gender differences were found.The overall distribution of the sub-types of suicidal acts (parasuicidal gestures, suicidal pauses, suicide attempts in the strict sense) showed seasonality neither for males nor for females.ConclusionsWhereas seasonality was absent in male suicide attempters, the frequency of low-risk suicide attempts in females was 13.1% lower than expected in the spring.

Changes in rates, methods and characteristics of suicide attempters over a 15-year period: comparison between Stockholm, Sweden, and Würzburg, Germany

To investigate age and sex-specific changes in rates, methods used and characteristics of suicide attempters receiving medical care, over a 15-year period in two European WHO catchment areas (Stockholm, Sweden; and Würzburg, Germany). The data for this study were obtained from the WHO/EURO Multicentre Study on Suicidal Behaviour for the period 1989-2003. Sex-specific, person-based suicide attempt rates were calculated for each year separately for the age groups 15-24 and 25 or above. The Chi-square test for trend was applied to estimate changes in proportions of socio-demographic and socio-economic variables. Significantly, increasing trends in suicide attempt rates occurred in young females, and in males and females aged 25 or above in Würzburg. On the contrary, men 25years and above showed a significant decrease in suicide attempt rates in Stockholm. Young females in Würzburg tended to use less violent methods for their attempts whereas in Stockholm young females were increasingly inclined to attempt suicide using violent methods. In Stockholm, young female suicide attempters tended to be more often economically inactive, particularly due to an increasing proportion of students. Young females in Würzburg were often less well educated, as were their young male counterparts. This contrasted with trends in the education of men and women of 25 or above in Stockholm. The results of this study suggest temporal changes in trends, methods used and in the social profile of suicide attempters.

The Role of Depression in the Differential Effect of Childhood Parental Divorce on Male and Female Adult Offspring Suicide Attempt Risk

In previous studies by our group, we found that female offspring of parental divorce and parental remarriage are more susceptible to suicide attempt than male offspring. In this study, we examine whether these findings remain even after controlling for offspring depression. The sample consists of respondents from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions. Multivariable regressions controlled for offspring depression, parental depression, age, race/ethnicity, income, and marital status. Our previous findings that female offspring of parental divorce and parental remarriage are more likely to report a lifetime suicide attempt than male offspring remained even after controlling for offspring depression. Findings suggest that focusing on engaging female offspring who demonstrate symptoms of depression is not sufficient to reduce suicide attempt risk in this group as many at risk individuals will remain unrecognized.

Adolescent Suicide Attempts in Bærum, Norway, 1984–2006

There are presently few international studies that examine adolescents' own experience of both triggering and the underlying reasons behind their suicide attempts. To present the rates, triggering factors, and underlying reasons for such behavior. The 23-year (1984-2006) surveillance study reported includes all general hospital-treated suicide attempters aged between 13 and 19 years (n = 254) living in the municipality of Bærum, a suburb on the outskirts of Oslo, Norway. Suicide attempt rates for both sexes decreased during the period of study. The female suicide attempt rate was on average 3.5 times higher than the male rate. An average of 8.2% of the suicide attempters made a repeat attempt within the following year. Overall, the most commonly reported trigger was a relational conflict (50.2%), and the most commonly reported underlying reason was a dysfunctional family situation (43.6%), followed by mental health problems (22.8%). The main gender difference for both triggers and underlying reasons was that relational conflicts were reported significantly more often by girls than by boys as triggers (55.0% versus 32.7%), and dysfunctional family issues were reported significantly more often by girls than by boys (47.1% versus 30.8%) as underlying reasons for the attempt. Mental health problems were reported less frequently as an underlying reason by girls than boys (21.2% versus 28.8%). A family-oriented intervention embracing the extended family system seems warranted in a majority of the cases in our study.

P03-282 - Attention of suicide attempts in psychiatric emergency

Introductioninterconsultation mode of observation from the emergency service is a subtype of demand related in large part with suicide attempts. the initial priority is to ensure the absence of organic complications resulting from suicide attempts, so it is usual in the course of 24 hours is appropriate to the request for psychiatric assessmentAimsdescription of demographic and clinical profile associated with suicide attempts treated in the emergency departmentMethodsare selected interconsultations motivated suicide attempts over 4 consecutive months in the emergency department of a tertiary hospital. the results were analyzed using SPSS 14Resultsis selected from all those applications that relate to suicide attempts, resulting in a sample of 48 patients. the percentage of sex femininity is 73% and the average age is 38 years. respect to outstanding personal psychiatric history of affective disorders with 74%, substance abuse accounts for 37% and 10% psychotic history. 52% had made previous suicide attempts of low lethality and in 6% serious previous attempts. regarding the method used highlights with a 57% intake of drugs and second toxic and ingestion of alcohol and drugs.Conclusionsevidenced a higher prevalence in female suicide attempts and low lethality, both of previous attempts like those presented today. only 10% of cases, held an admission to a psychiatric inpatient unit. the relationship with affective disorders, as well as with substance abuse is widely recognized in the literature

Emergency Departments Are Underutilized Sites for Suicide Prevention

Each year approximately 1,000,000 people die by suicide, accounting for nearly 3% of all deaths and more than half (56%) of all violent deaths in the world (Krug, Dahlberg, Mercy, Zwi, & Lozano, 2002). Suicide ideation and suicide attempts are strongly linked to death by suicide and powerfully predict further suicidal behavior (Institute of Medicine, 2002). There are an estimated 100–200 suicide attempts for each completed suicide in young people, and 4 attempts for each completed suicide in the elderly (Institute of Medicine, 2002). Emergency departments (EDs) are the most important site, epidemiologically speaking, for treating those who make suicide attempts. EDs in the United States, for example, record over 500,000 suicide-related visits annually (Larkin, Smith, & Beautrais, 2008). The majority of suicide attempt patients are discharged after medical stabilization and psychosocial evaluation, but carry a significant risk of recidivism (Larkin, Smith, & Beautrais, 2008). Similarly, ED patients who present with suicide ideation (without attempt) have risks of returning to the ED with further ideation or with suicide attempts which are as high as those who present with attempts (Larkin, Beautrais, Gibb, & Laing, 2008). In addition, a significant fraction of those who present to EDs for nonmental health reasons often have occult or silent suicide ideation (estimated at 8–12%) (Claassen & Larkin, 2005). The worldwide economic tsunami and sky-rocketing healthcare costs have ensured that mental health-related visits and presentations for suicidal behavior will continue to rise in the foreseeable future. The closure of psychiatric inpatient facilities, reductions in inpatient beds, moves to treat people in the community, and increased costs of general practitioner visits have coincided with – and likely account for – increased ED attendances by psychiatric and suicidal patients who previously might have been admitted or seen in primary care. The ED is now the default, de facto option for urgent and acute contact for suicidal patients within the health system – and in many countries the ED is the only access to 24/7 healthcare (Fields et al., 2001).

Seasonality of suicide attempts: association with gender

Some studies suggest seasonality of suicide attempts in females, but not in males. The reasons for this gender difference remain unclear. Only few studies addressed the question whether gender differences in seasonality of suicide attempts reflect gender differences in the choice of method for suicide attempts, with inconsistent results. So, this study aimed to analyze the association of gender with seasonality in suicide attempts by persons living in two Northern Bavarian regions [city of Nuremberg (480,000 inhabitants) and region of Wuerzburg (270,000 inhabitants)] between 2000 and 2004. We addressed this question by focussing on the frequency of suicide attempts in relation to the seasons. The sample consisted of 2,269 suicide attempters (882 males and 1,387 females). The overall seasonality was assessed using the chi(2) test for multinomials. Moreover, the ratio of observed to expected number of suicide attempts (OER) with 95% confidence intervals within each season was calculated. As a result, overall distribution of suicide attempts differed significantly between seasons for women (chi(2) = 9.19, df = 3, P = 0.03), but not for men. Female suicide attempts showed a trough in the spring (decline compared to the expected value by 10%; OER = 0.9, 95% CI = 0.8-1.0). This trough was restricted to female low-risk suicide attempts (decline by 13%; OER = 0.87, 95% CI = 0.77-0.98). No seasonality was found for men. Seasonality of high-risk methods was more pronounced than that of low-risk methods; however, no significant gender differences were found concerning this aspect. The overall distribution of the sub-types of suicidal acts (parasuicidal gestures, suicidal pauses, suicide attempts in the strict sense) showed seasonality neither for males nor for females. Whereas seasonality was absent in male suicide attempters, the frequency of low-risk suicide attempts in females was 13.1% lower than expected in the spring.

Attempted suicide predicts suicide risk in schizophrenia spectrum psychosis

Background: People with schizophrenia have an increased risk of suicide and attempted suicide is suggested to be an important risk factor. Aim: Our objective was to assess the cumulative survival, predictive values and odds ratios of attempted suicide for suicide in a long-term cohort of patients with schizophrenia spectrum psychosis with and without previous attempted suicide. Method: Inpatients (n=224) hospitalized with schizophrenia spectrum psychosis were followed for a mean of 25 years. All patients were followed up for causes of death. Information on suicide attempt before the end of the observation period was retrieved from medical records. Results: Eight percent died by suicide during the follow-up. Eighteen percent of suicide attempters died by suicide. Two percent of non-attempters died by suicide. There was a strong association between previous suicide attempt and suicide in men and women. Odds ratio for attempters vs. non-attempters was 10. Suicide risk was almost three times higher in male than female suicide attempters. Conclusion: Previous attempted suicide is an important risk factor for suicide in both men and women with schizophrenia spectrum psychosis, particularly in male suicide attempters. The suicide risk remains high over a long period. Continuous assessment of risk factors and appropriate treatment are crucial for this patient group to prevent suicide.

Suicide risk factors and mediators between childhood sexual abuse and suicide ideation among male and female suicide attempters

The current study examined the manner in which childhood sexual abuse (CSA) history relates to risk factors for suicidal behavior among recent suicide attempters (n = 166). Men who recently attempted suicide and endorsed a CSA history had higher scores on measures of hopelessness and suicide ideation than men without a CSA history. Men with a CSA history were also more likely to have made multiple suicide attempts and meet diagnostic criteria for posttraumatic stress disorder and borderline personality disorder. In contrast, there were fewer group differences as a function of CSA history among the female suicide attempters. Hopelessness was a significant mediator between CSA history and suicide ideation in both men and women.

Mental Disorders and Socioeconomic Status: Impact on Population Risk of Attempted Suicide in Australia

The population attributable risk (PAR) of mental disorders compared to indicators of socioeconomic status (SES) for attempted suicide was estimated for Australia. For mental disorders, the highest PAR% for attempted suicide was for anxiety disorders (males 28%; females 36%). For SES, the highest PAR% for attempted suicide in males was for occupation (males 31%; females 16%) and education level (males 19%; females 8%), following adjustment for age and mental disorders. The study results suggest that one third of suicide attempts in both males and females are attributable to anxiety disorders, the same proportion attributable to low educational or occupational status.

Epidemiological Trends in Attempted Suicide in Adolescents and Young Adults Between 1996 and 2004

Notwithstanding the epidemiological studies indicating an increased risk of attempted suicide among adolescents and young adults, there is a scarcity of international studies that examine long-term epidemiological trends in rates and characteristics of this vulnerable group. This article describes the results of a 9-year monitoring study of suicide attempts in adolescents and young adults referred to the Accident and Emergency Department of the Gent University Hospital (Belgium). Between January 1996 and December 2004, trends, sociodemographic, and methodrelated characteristics of suicide attempts were assessed by a psychiatrist on data sheets. Attempted suicide rates declined from 1996 to 2001 and then rose until 2004, but did not exceed previous rates. During the 9 years of monitoring, there was a preponderance of female suicide attempters, except for 1997. Rates of attempts and of fatal suicide were negatively correlated. Significantly more males than females deliberately injured themselves. Younger attempters, especially females, significantly more often poisoned themselves with analgesics. In nearly one in five attempts, alcohol was used in combination with other methods, and alcohol intake was more commonly observed in older suicide attempters. Nearly half of the adolescents were identified as repeaters. The results of this study warrant further monitoring of trends and characteristics of young suicide attempters.

Affective temperaments, as measured by TEMPS-A, among nonviolent suicide attempters

Background The aim of this study was to investigate the role of affective temperaments in suicidal behavior. Method Using the standardized Hungarian version of the full-scale 110-item version of the TEMPS-A autoquestionnaire we compared the affective temperament-profiles of 150 consecutively investigated nonviolent suicide attempters (106 females and 44 males) and 302 age, sex and education matched normal controls (216 females and 86 males). Results Compared to controls, both female and male suicide attempters scored significantly higher in the four of the five affective temperaments, containing more or less depressive component (depressive, cyclothymic, irritable and anxious). On the other hand, however, no significant difference between the suicide attempters and controls was found for the hyperthymic temperament. Significantly higher rate of suicide attempters (90.0%) than controls (21.5%) have had some kind of dominant (mean score + 2SD or above) affective temperament. Compared to controls, depressive, cyclothymic, irritable and anxious temperaments were significantly more frequent and hyperthymic temperament was nonsignificantly less common among suicide attempters. Conclusions The findings support the strong relationship between depression and suicidal behavior even on temperamental level, and suggest that hyperthymic temperament does not have predisposing role for suicidal behavior at least in the case of nonviolent suicide attempters. Limitation As only nonviolent suicide attempters were studied, our findings should pertain only for this patient-population.

Socio‐Cultural Features and Sex Profile of the Individuals with Serious Suicide Attempts in Southeastern Turkey: A One‐Year Survey

Our objective was to elucidate potential causes of higher rates of suicide attempts in females compared to males in southeastern Turkey through a 1-year survey. Gender-related differences observed in 96 subjects who attempted suicide by poisoning for the first time were as follows: in comparison to male, females were predominantly within the age interval of 15-24 years, experienced more stressful events in the previous week before suicide attempt, had lower education level, and had a lower rate of employment. One year after the suicide attempt, unfavorable attitude of family, lack of support, persisting unfavorable lifestyle comparable with that prior to the first attempt, and higher rates of domestic violence were more pronounced in females compared to males. These findings might be contributing factors to the higher suicide attempt rates observed in females compared to the males.