Suicide In Young Men Research Articles

Patterns of Suicide in the Context of COVID-19: Evidence From Three Australian States.

Aims: We aimed to determine whether there has been a change in the number of suicides occurring in three Australian states overall, and in age and sex subgroups, since the COVID-19 pandemic began, and to see if certain risk factors for suicide have become more prominent as likely underlying contributing factors for suicide.Method: Using real-time data from three state-based suicide registers, we ran multiple unadjusted and adjusted interrupted time series analyses to see if trends in monthly suicide counts changed after the pandemic began and whether there had been an increase in suicides where relationship breakdown, financial stressors, unemployment and homelessness were recorded.Results: Compared with the period before COVID-19, during the COVID-19 period there was no change in the number of suicides overall, or in any stratum-specific estimates except one. The exception was an increase in the number of young males who died by suicide in the COVID-19 period (adjusted RR 1.89 [95% CI 1.11–3.23]).The unadjusted analysis showed significant differences in suicide in the context of unemployment and relationship breakdown during the COVID-19 compared to the pre-COVID-19 period. Analysis showed an increase in the number of suicides occurring in the context of unemployment in the COVID-19 period (unadjusted RR 1.53 [95% CI 1.18–1.96]). In contrast, there was a decrease in the number of suicides occurring in the context of relationship breakdown in the COVID-19 period (unadjusted RR 0.82 [95% CI 0.67–0.99]). However, no significant changes were identified when the models were adjusted for possible over-dispersion, seasonality and non-linear trend.Conclusion: Although our analysis found no evidence of an overall increase in suicides after the pandemic began, the picture is complex. The identified increase in suicide in young men indicates that the impact of the pandemic is likely unevenly distributed across populations. The increase in suicides in the context of unemployment reinforces the vital need for mitigation measures during COVID-19, and for ongoing monitoring of suicide as the pandemic continues.

CSF and plasma testosterone in attempted suicide

Very few studies have assessed testosterone levels in the cerebrospinal fluid in suicide attempters. Aggressiveness and impulsivity are common behavioural traits in suicide attempters. Dual-hormone serotonergic theory on human impulsive aggression implies high testosterone/cortisol ratio acting on the amygdala and low serotonin in the prefrontal cortex. Our aim was to examine the CSF and plasma testosterone levels in suicide attempters and in healthy volunteers. We also assessed the relationship between the testosterone/cortisol ratio, aggressiveness and impulsivity in suicide attempters.28 medication-free suicide attempters and 19 healthy volunteers participated in the study. CSF and plasma testosterone sulfate and cortisol levels were assessed with specific radio-immunoassays. The Karolinska Scales of Personality was used to assess impulsivity and aggressiveness. All patients were followed up for cause of death. The mean follow-up period was 21 years.Male suicide attempters had higher CSF and plasma testosterone levels than age- matched male healthy volunteers. There were no significant differences in CSF testosterone levels in female suicide attempters and healthy female volunteers. Testosterone levels did not differ significantly in suicide victims compared to survivors. In male suicide attempters, the CSF testosterone/cortisol ratio showed a significant positive correlation with both impulsivity and aggressiveness. Higher CSF testosterone levels may be associated with attempted suicide in young men through association with both aggressiveness and impulsivity, a key endophenotype in young male suicide attempters.

Changes in risk factors for young male suicide in Newcastle upon Tyne, 1961-2009.

Aims and methodTo ascertain differences in patterns of suicide in young men over three decades (1960s, 1990s and 2000s) and discuss implications for suicide prevention. Data on suicides and open verdicts in men aged 15–34 were obtained from coroner's records in Newcastle upon Tyne and analysed using SPSS software.ResultsAn increase in suicide rates from the first to the second decade was followed by a fall in the third decade. This was associated with an increasing proportion of single men, those living alone, unemployment, consumption of alcohol, use of hanging, previous suicide attempt and history of treatment for mental illness.Clinical implicationsThis study highlights the need for more interventions and focus to be given to young males in the suicide prevention area and is of high importance in the field of public health. Areas that could be tackled include reducing access to means of suicide, reducing alcohol use, support for relationship difficulties, engagement with mental health services and management of chronic illness.

Changes in the geography of suicide in young men: England and Wales 1981–2005

BackgroundSuicide rates changed considerably in men aged <45 years in England and Wales between 1980 and 2005. The impact of these changes on the geographic distribution of suicide is unknown.MethodsMapping...

Suicidal Behaviour in Adolescence

Adolescent suicide and suicidal behaviours have become major public health issues in recent years. Suicide is widely recognized as a major cause of mortality in young people, and nonfatal suicidal behaviours in young people are associated with considerable morbidity. Suicidal behaviour in adolescence covers a wide spectrum of phenomena for which an exact definition and an understanding of the interrelations remain controversial.1 The epidemiology of youth suicide is a fascinating story. The 20th century produced a steady rise in the incidence of suicide in young males punctuated by decreases during the World Wars; however, since the 1 990s, rates of suicide in young men have steadily declined. This was partly due to an increased number of cars with catalytic converters and to declines in rates of unemployment and divorce.2 Some researchers, especially in the United States, have strongly supported the important role of selective serotonin reuptake inhibitors use in explaining the reduction of adolescent suicide,3'4 a claim refuted by Biddle et al.2 Following the introduction of the black box warning, there was a new rise in adolescent suicide, which some authors attributed to reduced prescriptions of these agents, although Wheeler et al5 have vigorously disputed this interpretation. One other major epidemiologic finding in recent years has been the finding that, in China, southern India, and Singapore, the accepted sex differences for suicide are reversed, and that young females are more at risk for suicide than males.6 In these young females, mental illness seems to be less of a factor in their suicides than has been reported in the West7 and most fatalities are due to pesticide ingestion. Undoubtedly, the restriction of the use of pesticides is a very important preventative measure in these countries.8 It has become increasingly clear that family genetic studies play an important role in understanding suicide and that, especially in youth, suicide is inherited distinctively from any concurrent psychiatric illness.9 It has also become increasingly apparent that genetic transmission is more characteristic of suicide in youth than that of suicide in older people. The biological mechanism that may be involved is probably related to serotonin metabolism and low turnover of 5-hydroxyindoleacetic acid as measured in the cerebral spinal fluid, which in turn is related to aggression and impulsivity.10 This, combined with a genetic predisposition for a heightened stress reaction via genetic mechanisms in the hypothalamo-pituitary-adrenal axis, provides a plausible basis for beginning to understanding suicide in youth. Psychological risk factors that have been the focus of recent attention include overgeneralized autobiographical memory associated with interpersonal relationships,12 deficits in problem solving,13 as well as high levels of impulsiveaggressiveness. 14 Additional potential precursors of suicidal behaviour in depressed adolescents are other early development traits, such as temperament and emotional regulation.15 Adolescent suicidal behaviour also seems to be related to just about all types of serious psychiatric disorder, including: eating disorders,16 schizophrenia,17 and, of course, all forms of depression, especially bipolar disorder. Social risk factors for adolescent suicide include parental separation, divorce, and family discord, as well as child abuse and imitation.18 Media reporting and, naturally, alcohol and drug abuse are also important facilitators of suicide among young people. Bullying and peer victimization are extremely dangerous precipitators19,20 and, together with the understudied effects of immigration, are reviewed more extensively in this issue's In Review.21,22 A new social force impinging on youth suicide is the Internet.2 As an increasingly popular source of information, concerns have been raised about the existence of websites that promote suicide23 as well as suicide websites that have been claimed to have facilitated suicide pacts among strangers. …

Suicide rates in young men in England and Wales in the 21st century: time trend study

Objectives To explore trends in suicide in young people to investigate the recent observation that after year on year rises in the 1970s, 1980s, and early 1990s, rates in young...

Domestic Violence, Separation, and Suicide in Young Men with Early Onset Alcoholism: Reanalyses of Murphy's Data

Partner violence and partner separation at the time of completed suicide were investigated in 42 male alcoholics originally described by Murphy (1992). Half of the men had domestic violence histories. Partner-violent men were younger, had an earlier age of onset of alcoholism, and were more likely to be separated from their partner at the time of death than partner-nonviolent men. Loss of a close personal relationship, often a domestic partner, is common during the last year of life among alcoholic men completing suicide. Domestic violence appears to typify many of their domestic relationships, particularly among younger men and men with early onset alcoholism.

Increasing rates of suicide in young men in England during the 1980s: the importance of social context

Attempts to explain rising rates of suicide among young men in Britain and elsewhere during the 1980's have identified the characteristics of those people who kill themselves. Little, however, is known about the impact that changes in social context may have had on changing rates of suicide during this time. Changes in aggregate levels of unemployment, poverty, marriage and the proportion of adults living alone during the 1980s were derived from data collected in the UK National Census of 1981 and 1991. In an ecological analysis these changes were compared with changes in age-adjusted rates of suicide in men aged 15 to 44, in 364 county districts of England between the beginning and end of the 1980s. Areas experiencing the lowest increase in rates of suicide were those that experienced the smallest rise in the proportion of people living alone, the greatest increase in unemployment and highest levels of social deprivation. In addition to investigating the effect that characteristics of people have in determining the risk of suicide in individuals who kill themselves, further attention needs to be paid to the impact that social context may have on mediating these risks.

Premature mortality in Australia 1983‐1992, the first decade of the AIDS epidemic

To determine the trends in premature mortality due to selected causes in Australia and in selected States for the whole population and for adults aged 25 to 44 years. Analysis of data from the Australian Bureau of Statistics and the National AIDS Registry for the 10 years from 1983 to 1992. Premature mortality was measured in terms of years of potential life lost before the age of 75 years (YPLL-75). Trends in premature mortality due to AIDS were compared with those for lung cancer, melanoma of the skin, breast cancer, diabetes mellitus, acute myocardial infarction, cerebrovascular disease, traffic accidents and suicide. There have been marked increases in premature mortality due to AIDS and suicide in young men and an increase in deaths due to breast cancer in young women over the past decade. The overall number of potential years of life lost has remained constant, partially because these increases have been counterbalanced by declines in deaths from traffic accidents, acute myocardial infarction and cerebrovascular disease. The increasing trend in premature mortality due to AIDS is strongest in New South Wales, followed by Victoria and Queensland, with smaller increases in the other States and Territories. Apparent advances in medical care have reduced premature deaths from acute myocardial infarction and stroke and public health measures are likely to have reduced traffic accident deaths; but at the same time there have been serious increases in HIV, suicide and breast cancer among young adults.

Lung cancer in lifelong non-smokers. Edinburgh Lung Cancer Group.

The Edinburgh Lung Cancer Group registered 3070 new patients with lung cancer in the five years 1981-5 from a catchment population of 950,000. After review only 74 (2%) were classified as lifelong non-smokers. They differed significantly from the 2996 smokers with lung cancer in that far more were female (77% v 26%) and their mean age was higher (75.4 v 68.0 years). More were in the worst Karnofsky performance categories and fewer patients underwent surgery. The stages of disease were similarly distributed in the two groups and the five year survival was equally poor (5%). Histological cell type was determined in 59 of the 74 patients. All histological cell types were present. More non-smokers had adenocarcinoma than smokers (42% v 13%) and fewer had squamous cell carcinoma (32% v 49%) or small cell carcinoma (15% v 24%). Lung cancer in lifelong non-smokers is uncommon and the diagnosis should therefore always be questioned.

Suicidutvecklingen i Sverige

In Sweden, with about 8,500,000 inhabitants, it has been estimated that around 200,000 inhabitants have death thoughts every year, about 20,000 make suicide attempts, 2,000 commit suicide, and about 200 of these commit suicide while in psychiatric treatment. During the past 30 years, the suicide rate has been rather stable. However, by means of a birth cohort analysis it has been demonstrated that the risk for suicide in young men 20-24 years old has increased 3.5 times, and the corresponding risk for females 15-19 years old has increased 3 times. The male to female ratio has also decreased, from 3.4 to 2.6. However, suicides are still most common in elderly men. As in many other countries, the number of suicides during psychiatric treatment has increased dramatically from about 30 a year in the beginning of the fifties to around 200 a year. There are many reasons for this. Dramatic decreases in the number of hospital beds in combination with an increasing number of patients admitted and changing patterns...

Suicide among young men: psychiatric illness, deviant behaviour and substance abuse

The role of psychiatric illness versus social and behavioural risk factors for suicide in young men was analysed in a longitudinal study of 50,465 conscripts. Data collected in 1969-1970 on social background, personality characteristics, use of alcohol and drugs, psychological assessment and psychiatric diagnosis were linked to records from the national psychiatric case register and the national cause-of-death register through 1983. A total of 247 deaths from suicide occurred in the cohort during the follow-up. By means of multivariate analysis, the role of different social and behavioural characteristics was assessed in relation to that of psychiatric diagnoses, with suicide as dependent variable. A psychiatric diagnosis in inpatient care (n = 2247) was the strongest predictor of suicide, with an odds ratio (OR) of 11.3 (8.3-15.4), controlling for social and behavioural risk factors. Schizophrenia was the diagnosis with the highest suicide risk: OR = 13.3 (8.2-21.6). A psychiatric diagnosis at conscription (n = 5877) was not associated with a significantly increased risk of suicide. Several indicators of poor social background, deviant behaviour, substance abuse and disrupted interpersonal relations were associated with a significantly increased suicide risk, also after controlling for psychiatric illness. Although mental illness requiring inpatient treatment was the most powerful predictor of suicide, less than half the cohort had received such treatment. Social and behavioural risk factors are thus important for prevention on the population level.

Predictors of completed suicide in a cohort of 50,465 young men: role of personality and deviant behaviour.

Suicide seems to be increasing in young people in various countries and causes the greatest loss of years of life under the age of 65 in the Swedish population. Data from a national survey of 50,465 conscripts in Sweden were used in a prospective follow up study to assess personality and behavioural predictors of suicide in young men. Altogether 247 completed suicides occurred in the cohort during 13 years' follow up. Baseline data on social conditions, psychological assessments, and psychiatric diagnoses of the conscripts were entered into a Cox regression model with suicide as the outcome variable. Several early indicators of antisocial personality (poor emotional control, contact with a child welfare authority or the police, and lack of friends) were strongly predictive of suicide. None of the few conscripts who had a diagnosis of schizophrenia or affective psychosis committed suicide. A diagnosis of neurosis was associated with a twofold increase in the suicide rate and personality disorder with a threefold increase. Although the risk of suicide is difficult to assess in an unselected population owing to the low base rate of suicide, the predictors identified in the study may help to identify those at high risk in units where people with deviant behaviour and personality disorders cluster.