Suicide Intent Scale Research Articles

Serum serotonin as a potential risk factor in female suicide attempts by poisoning, in different menstrual cycle phases

Background Suicide is a major public and mental health concern worldwide today. It lies behind exceeding numbers of deaths every year. This necessitates studying the causes and risk factors involved in suicidal behavior. Suicide attempts are found to be more common in women, with higher risk during the low estrogen phases of the menstrual cycle. Serotonin is a neurotransmitter that is proved by many studies to be involved in suicidal behavior. A relation between circulating estrogen levels and serotonergic function is supposed by some studies to explain the link between female suicide attempts and low estrogen phases of the menstrual cycle. Aim The aim of this work was to study serum serotonin level as a potential risk factor in female suicide attempts in the different menstrual cycle phases. Also, this study aimed to investigate the potential correlation between serum serotonin and estrogen levels. Patients and methods This cross-sectional study was carried out on two groups: the suicidal group that included women with suicide attempts who came to Tanta Poison-Control Center during the period from the beginning of July 2015 to the end of December 2015, and the control group that included 25 nonsuicidal apparently healthy female volunteers. The menstrual cycle phase was assessed for those women; the serum serotonin level was estimated by specific ELISA techniques, and the suicidal intent of the suicidal group was assessed by Pierce’s suicidal intent scale. Results and conclusion This study demonstrated that the suicide attempters had significantly lower serum serotonin levels. This significance was observed to be in the menstrual and the whole luteal phases. A significant inverse correlation was found between serum serotonin levels and Pierce’s suicidal intent scale for the women who attempted suicide in the late luteal and menstrual phases. Also, a significant positive correlation was found between serum estrogen and serotonin levels.

Attempted Suicide and Seriousness of Intent.

This descriptive research was conducted to estimate the method of suicide and suicidal intent among hospitalised suicide attempters at Pakistan Ordinance Factory (POF) Hospital, Wah Cantt, from December 2012 to June 2013. Data were collected from 49 hospitalised suicide attempters through purposive sampling technique by using Suicidal Intent Scale. Majority of suicide attempters (92%) used self-poisoning as the method of suicide regardless of their gender, age, occupation, past medical history, past psychiatric history, and history of suicide and psychiatric illness in their families. Additionally, most of them (43%) reported high level of suicidal intent, while 16 (33%) reported medium suicidal intent and 12 (24%) reported mild suicidal intent. Keeping in view the fact that majority of suicide attempters used self-poisoning as a method and most of them reported high level of suicidal intent, it is important to plan preventive measures.

Suicide Risk Assessments: Influences on Clinicians’ Professional Judgment and Confidence in Decision-Making

Suicide Risk Assessments: Influences on Clinicians’ Professional Judgment and Confidence in Decision-Making

A gender-specific analysis of suicide methods in deliberate self-harm

Background: Deliberate self-harm (DSH) is a major public health concern. Gender differences in suicide methods are a controversial realm with various regional and cultural variations. This study compared and assessed the methods used in DSH attempters as undertaken by men and women, and investigated the possible role of gender and other clinical variables in the selection of suicide method. Materials and Methods: Two hundred subjects fulfilling the inclusion and exclusion criteria were recruited in the study. The sociodemographic details were recorded in the semi-structured pro forma. Detailed assessment of psychiatric morbidity and DSH was done by clinical interview and validated by Mini International Neuropsychiatric Interview-Plus 5.0 and Beck Suicide Intent Scale. Data were analyzed using SAS version 9.2 and SPSS version 17.0. The sample was disaggregated by gender to compare the known correlates of suicide risk on the two most common methods of suicide – poison consumption and drug overdose using multivariate analyses. Results: The analysis revealed that majority of the attempters were in the age group of 11–40 years (91%). Females (63%) outnumbered males (37%); poisoning was the most common type of method (50.5%), followed by drug overdose (35%). There were no statistical differences between the two genders with respect to other sociodemographic variables. Males from urban/semi-urban background (odds ratio [OR] = 4.059) and females living alone (OR = 5.723) had high odds ratio of attempting suicide by poison consumption. Females from urban/semi-urban background (P = 0.0514) and male subjects from nuclear families had an increased odds ratio (OR = 4.482) to attempt suicide by drug overdose. There were no statistical differences when the two genders were compared for other variables such as intentionality, lethality, impulsivity, and number of attempts. Conclusions: It appears that gender differences among DSH attempters appear less pronounced in the Indian setting compared to the worldwide literature on the subject. Nevertheless, the unique, gender-specific characteristics pertaining to DSH attempters in our population emphasize the need for gender-specific interventions in future clinical treatment.

Intérêt de la mesure de la létalité perçue par le patient après une intoxication médicamenteuse volontaire

ObjectivesAims of this preliminary study were to assess characteristics of expected lethality by the patient at the time of a deliberate self-poisoning, and relationship between expected lethality and recurrence of suicidal related behaviour. Materials and methodsWe included 124 consecutive cases in a prospective study and descriptive data including Beck Suicide Intent Scale (SIS) and medical lethality score. In response to “how dangerous did you think the drugs were when you took them?” patients rated on a Visual Analog Scale (VAS) from 0=would be harmless, to 10=certain to cause death. The follow-up took place 32–38 months after the patients were discharged. ResultsOf 106 patient included, 70 were women. First-ever attempter were 31%. Fifteen per cent of the cases were medically serious. VAS mean score was 51mm (SD 26; CI 95%: 47–56), median 51.5mm (IQ 35.5). Median score was higher for men (59mm; P=0.02). High VAS scores (i.e. higher than median score) were associated with a premeditated behaviour (OR 29; P<0.0001), when low VAS scores were associated with impulsive behaviour (P<0.0001). There was no association between VAS and medical lethality (P=0.19). SIS scores were low (mean score 8.6, SD 5.3). Three factors were extracted from a factorial analysis of the SIS. Correlations between VAS and SIS, and VAS and first factor patient's subjective thoughts F1 conception were strong (rhôs=0.77, P<0.0001; rhôs=0.78, P<0.0001), when only moderate between VAS and F2 preparation of the behaviour second factor (rhôs=0.50, P<0.0001), and weak between VAS and F3 precaution against discovery third factor (rhôs=0.18, P=0.05). Fifty-seven of the index cases were followed by a further episode of suicide related behavior. We found no evidence of relationship between recurrence and expected lethality scores (P=0.80) for either men (P=0.54) or women (P=0.54), with the exception of first-ever attempter subgroup (P<0.01) where a high score was associated with recurrence (OR 5.6; P=0.01). ConclusionExpected lethality scores determined distinct populations in terms of suicidal intent and impulsivity of the behaviour. The very good acceptability of the measure and its ease to use could give it a place as part of the clinical assessing process of subjective dimension of the wish to die. For researchers this measure could help to better determine suicide related behaviours subgroups and to make comparisons between studies easier.

Profile of Young Suicide Attempt Survivors in a Tertiary Care Hospital in Puducherry.

Context:Puducherry has the highest suicide prevalence rate in India by 2014, predominantly among the 14–30 years age group.Aims:The aim of the present study is to study the characteristics of adolescent and youth suicide attempters in Puducherry and measure the suicide intent.Settings and Design:An observational study of 6 months duration was conducted in the Department of Psychiatry, at Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India.Materials and Methods:Modified version of World Health Organizations SUicide PREvention Multisite Intervention Study on Suicidal questionnaire was used to collect sociodemographic data and Beck's suicide intent scale was used to measure the suicide intent scores. International Classification of Diseases-10 was used for diagnosis.Statistical Analysis:Statistical Package for the Social Sciences version 13 was used for descriptive analysis and correlation statistics. P value was set as <0.05.Results:Of 56 eligible participants, 40 formed the sample, their mean age was 18. 13 (±2.50), more females (1.1:1), rural, literate, lower socioeconomic status (67.5%), mostly single (90%), living in nuclear (95%), and Hindu (87.5%). One hundred percent had psychosocial stressors before suicide attempt. Acute stress disorder/adjustment disorder was the most common diagnosis. Emotionally unstable and anankastic personality traits were seen in 12%. Pesticide ingestion (45%) was the most common suicide method. Sixty percent attempted suicide within <30 min of suicidal contemplation. Statistical associations were found between the alleged purpose, seriousness, attitude toward living/dying, conception about medical rescuability, and the overall suicide intent.Conclusions:Adolescent and youth suicide attempts occur due to psychosocial stressors rather than due to the past or on-going mental health disorders with above personality traits suggest poor coping skills and resilience taken to deal with stressful situations by younger people.

Suicide and self-harm related internet use in patients presenting to hospital with self-harm: a cross-sectional study

BackgroundEvidence that the internet might be being used in planning suicidal acts, promoting suicidal behaviour, and accessing help, adds a new dimension to suicide prevention. Yet research into the frequency and type of internet use before suicide is lacking. We investigated self-harm related to internet use among patients who presented to hospital with self-harm. MethodsData on self-harm presentations to the emergency departments of an adult hospital (Jan 1, 2013, to Dec 31, 2015) and a children's hospital (Sept 1, 2013, to Nov 30, 2015) in a large city in the South West of England were obtained from a local self-harm surveillance register. Patients who had psychosocial assessments (65% of adult and 82% of children's hospital presentations) were asked during the assessment about internet use associated with their presentation. Beck Suicide Intent (BSI) scale was used to assess suicidal intent. Multivariable logistic regression models were performed to investigate the association between internet use and sociodemographic characteristics, clinical characteristics, and repeat presentation within 6 months. The self-harm register has ethics approval. Findings1192 first presentations to the adult hospital (mean age 35 years, SD 14·7) and 312 to the children's hospital (14, 1·1) had data recorded about internet use, age, and sex. Prevalence of self-harm related to internet use was 8·4% (n=100) among adult presentations (8·9% men, 8·0% women) and 26·0% (n=81) among children's presentations (26·3% boys, 25·9% girls). In both samples, self-harm related to internet use was associated with high intent (BSI >8) (odds ratio for adults 2·6, 95% CI 1·6–4·4; children 2·0, 0·9–4·3) but not repeat presentation (0·9, 0·5–1·8; 0·6, 0·2–1·3). InterpretationThe findings indicate that self-harm related to internet use is likely to become increasingly relevant as the internet-native generation matures and might be a proxy marker for intent. The inclusion of questions about internet use in clinical self-harm assessments could provide an alternative means by which to explore complex issues. More generally, assessments may require updating in light of technological advancements. However, further research, which differentiates between types of internet use and explores the impact of asking about internet use, is necessary. FundingNone.

Psychometrics of Behavioral Health Screening Scales in Military Contexts

A major task for military and civilian mental health practitioners is to screen United States service members/military personnel for an array of mental health problems (e.g., depression, alcohol abuse, suicidal ideation, posttraumatic stress disorder [PTSD]) before further assessment leading to diagnosis of mental disorders. During the assessment of such mental health problems, screening scales should be not only reliable and valid, but also have clinical utility in the military context. Busy clinicians may not have enough time to determine which screening scales meet minimal psychometric standards and proven clinical utility with predeployment or postdeployment soldiers on active duty. A sample of screening scales was identified during a thorough review of the peer-reviewed psychometric literature, textbooks on psychometrics, and the American Psychological Association PsycINFO database. Selection criteria (e.g., acceptable psychometric properties, previously used in the military context) resulted in the identification of 7 core (first-order description) screening scales recommended in the assessment of mental health problems within the military context. Core scales were organized across 4 clinical domains: general mental health functioning (e.g., Behavior and Symptom Identification Scale [BASIS]), self-harm and risk-taking behaviors (e.g., Suicide Intent Scale [SIS]), assessment of PTSD (e.g., PTSD Checklist [PCL]) and Anger Reactions (e.g., Dimension of Anger Reaction Scale [DAR]), and assessment of substance abuse/dependence (e.g., Alcohol Use Disorders Identification Test -AUDIT). For each core scale, alternative scales were also selected using similar selection criteria. Implications of the study findings for the practice of military and civilian psychologists in the Department of Defense (DoD) are discussed.

Predicting suicide following self-harm: systematic review of risk factors and risk scales.

People with a history of self-harm are at a far greater risk of suicide than the general population. However, the relationship between self-harm and suicide is complex. To undertake the first systematic review and meta-analysis of prospective studies of risk factors and risk assessment scales to predict suicide following self-harm. We conducted a search for prospective cohort studies of populations who had self-harmed. For the review of risk scales we also included studies examining the risk of suicide in people under specialist mental healthcare, in order to broaden the scope of the review and increase the number of studies considered. Differences in predictive accuracy between populations were examined where applicable. Twelve studies on risk factors and 7 studies on risk scales were included. Four risk factors emerged from the meta-analysis, with robust effect sizes that showed little change when adjusted for important potential confounders. These included: previous episodes of self-harm (hazard ratio (HR) = 1.68, 95% CI 1.38-2.05, K = 4), suicidal intent (HR = 2.7, 95% CI 1.91-3.81, K = 3), physical health problems (HR = 1.99, 95% CI 1.16-3.43, K = 3) and male gender (HR = 2.05, 95% CI 1.70-2.46, K = 5). The included studies evaluated only three risk scales (Beck Hopelessness Scale (BHS), Suicide Intent Scale (SIS) and Scale for Suicide Ideation). Where meta-analyses were possible (BHS, SIS), the analysis was based on sparse data and a high heterogeneity was observed. The positive predictive values ranged from 1.3 to 16.7%. The four risk factors that emerged, although of interest, are unlikely to be of much practical use because they are comparatively common in clinical populations. No scales have sufficient evidence to support their use. The use of these scales, or an over-reliance on the identification of risk factors in clinical practice, may provide false reassurance and is, therefore, potentially dangerous. Comprehensive psychosocial assessments of the risks and needs that are specific to the individual should be central to the management of people who have self-harmed.

Lifetime suicide intent, executive function and insight in schizophrenia and schizoaffective disorders

ObjectivesLack of insight and neurocognitive deficits are often seen in schizophrenia patients. While there are several studies investigating the relationship between suicidal ideation, executive function and insight, there are relatively fewer investigating the triangular relationship between suicide intent, insight and cognitive competence in schizophrenia. The aim of our study was to address this issue. MethodsOne hundred seventy five subjects with DSM-IV TR diagnoses of schizophrenia or schizoaffective disorder were enrolled and the diagnosis was established using the Hindi version of the Diagnostic Interview for Genetic Studies and other available information in consultation with a Board certified senior Psychiatrist. All the subjects were interviewed on Beck's cognitive insight scale and tested on the Trail Making Test. All the subjects who had lifetime history of suicide attempt were interviewed on Pierce's suicide intent scale. ResultsEver attempters scored significantly higher on Beck's cognitive insight scale (p=0.012) and outperformed non-attempters on Trail Making Test A and B (p=0.026 and p=0.012 respectively), indicating better executive functions in the former. However among ever attempters, significant relationship was not found between executive functions, insight and severity of suicide intent. ConclusionOur study suggests that good insight and better executive functioning may be significantly correlated with suicide attempts at some time during the course of illness. Patients with schizophrenia should be evaluated for potential suicidality once denial, neurocognitive deficits and other factors associated with poor insight abate.

Corpus callosum integrity is affected by mood disorders and also by the suicide attempt history: A diffusion tensor imaging study

BackgroundSome MRI studies have noted alterations in the corpus callosum (CC) white matter integrity of individuals with mood disorders and also in patients with suicidal behavior. We investigated the specific impact of suicidal behavior on CC integrity in mood disorders. MethodsCC structural changes were assessed by diffusion tensor imaging (DTI) in 121 women 18-50-year-old): 41 with bipolar disorder (BD), 50 with major depressive disorder (MDD) and 30 healthy controls (HC). Fractional anisotropy (FA) and DTI metrics were calculated for the genu, body and splenium of CC and compared in the three groups by MANCOVA. Then, they were re-analyzed relative to the suicide attempt history within the MDD and BD groups and to the suicide number/severity. ResultsFA values for the CC genu and body were lower in non-suicide attempters with BD than with MDD and in HC. Conversely, FA values for all CC regions were significantly lower in suicide attempters with BD than in HC. Finally, higher number of suicide attempts (>2) and elevated Suicidal Intent Scale score were associated with significant splenium alterations. LimitationsLimitations include the cross-sectional design (non-causal study), the potential influence of medications and concerns about the generalizability to men. ConclusionGenu and body are altered in non-suicide attempters with BD, while splenium is specifically altered in suicide attempters, independently from their psychiatric status. History of suicide attempts may be a source of heterogeneity in the association between CC alterations and BD and may partially explain the variable results of previous studies.

Thoughts and feelings associated with parasuicide: A thematic analysis

This article seeks to shed more light on what influences an individual to take their own life. By interviewing individuals who have presented at a general hospital with an act of attempted suicide, their recollections of events running up to the act have been analysed by the research team and described in this article. Nobody can be certain of an individuals' exact motives when being assessed following an act of self-harm, but by using a validated suicide intent scale and clinician judgement together, the research can reasonably claim to have included those patients whose actions were clearly intent on suicide rather than self-harm with no strong desire to end one's life. Seven in-depth interviews were conducted 7–14 days after the initial presentation, time enough to ensure recollections are accurate while not being too close to the initial act of attempted suicide as to be viewed as too soon to expect someone to reflect on a traumatic episode. A comprehensive literature search and discussion section in the article enables the reader to learn more about the issue of suicide, which is fair to say generates much debate among psychiatric, psychological, and social commentators alike.

Validation of a Spanish version of the Columbia-Suicide Severity Rating Scale (C-SSRS)

ObjectiveTo examine the psychometric properties of a Spanish version of the C-SSRS (Sp-CSSRS). MethodData are from a naturalistic, cross-sectional, multicentre, validation study, including 467 psychiatric outpatients, 242 of whom had a history of suicide attempt. The study measures were: C-SSRS; the Hamilton Depression Rating Scale (HDRS); the Beck Suicide Intent Scale; the Medical Damage Scale. ResultsConstruct validity: Pearson coefficient between the C-SSRS severity (C-Sev) and intensity (C-Int) of ideation subscale scores was 0.44 (p<0.000) for the total sample. Likewise, Pearson coefficient between C-Sev score and HDRS item 3 was 0.56 (p<0.000). For the sub-sample of patients with suicide attempt, significant Pearson correlations were found between the C-Sev and the Beck Suicide Intent Scale scores (r=0.22; p=0.001). Discriminant validity: Significant differences were found in C-Sev and C-Int scores between patients with and without suicide attempt (p<0.000). The C-Sev score discriminated between patients based on HDRS item 3 (p<0.009). Sensitivity to change: Linear regression showed that a one-unit decrease in HDRS item 3 corresponded to a decrease of 5.08 units in the C-Sev score (p=0.141). A one-unit change in HDRS item 3 corresponded to a change of 13.51 on the C-Int assessments (p=0.007). Cronbach's alpha was 0.53 for C-Int. The principal component analysis identified 2 components that explain 55.66% of the total variance (C-Int). ConclusionThe data support that the Sp-C-SSRS is a reliable and valid instrument for assessing suicidal ideation and behaviour in daily clinical practice and research settings.

PS276. Effect of alcohol use on the intent and lethality of suicide attempts: Assess the Suicidal Intent Scale(SIS) and the Risk-Rescue Rating Scale(RRRS)

PS276. Effect of alcohol use on the intent and lethality of suicide attempts: Assess the Suicidal Intent Scale(SIS) and the Risk-Rescue Rating Scale(RRRS)

Factors associated with suicide methods among non-fatal suicide attempters in a general hospital

Background: Suicide is a major public health concern. A number of socio-demographic and clinical variables interplay in determining the chosen method and hence influence the outcome of suicidal behavior. Materials and Methods: Two hundred subjects fulfilling the inclusion and exclusion criteria were recruited in the study. The socio-demographic details were recorded in the semi structured proforma. Detailed assessment of Psychiatric morbidity and attempted suicide was done by clinical interview and validated by M.I.N.I.-Plus 5.0 and Beck Suicide Intent Scale. Data was analyzed using SAS Version 9.2 & SPSS Version 17.0. Results: In the present study, the three most common method of attempting suicide was by poison consumption (50.5%), followed by drug overdose (35%) and hanging (9.5%). Most of the study participants who attempted suicide by poison consumption and drug overdose were in the age group of 11-40 years (P= 0.010 and P=0.050) and female gender had the highest risk of attempting suicide by poison consumption (P=0.005). Most of the subjects in the drug overdose group belonged to urban domicile (P=0.023). Majority of the attempters were first time attempters with low intentionality, low lethality and high impulsivity. Psychosocial factors played an important precipitating role and the most common psychiatric morbidity was adjustment disorder followed by MDD. The influence of alcohol prior to the attempt was significant in the poison consumption group (P=0.040). Conclusions: There are various demographic, clinical and psychosocial factors that play a determinantal role in the choice of method in non-fatal suicide attempters and understanding the interplay of these factors can help devising better preventive strategies in the future.

Perception of Parental Bonds and Suicide Intent Among Egyptian Adolescents.

Suicidal adolescents, compared to their nonsuicidal peers, tend to perceive their parents as less "caring" and more "controlling"-which characterizes the "affectionless control" parenting style. Research findings are inconsistent regarding the distinct influence of mother versus father parenting on youth suicide intent; moreover, the influence of parents' joint parenting styles on suicide intent has not been investigated. Using a cross-sectional design and large sample (N = 150 youth, 13-21 years old), currently hospitalized in a treatment center in Egypt for a recent suicide attempt, data were collected using the Suicide Intent Scale, Parental Bonding Instrument, and Center for Epidemiologic Studies Depression Scale. Seventy percent of youth reported high suicide intent. Mother and father parenting styles, assessed independently, were not associated with adolescent suicide intent. The joint effect of both parents' parenting style, however, was positively associated with suicide intent (Wald χ(2) = 8.79, p = .03). Suicide intent was stronger among adolescents who experienced neglectful compared with optimal parenting style (B = 1.93, Wald χ(2) = 4.28, p = .04). The findings have direct implications for mental health nursing interventions, signaling the critical need to engage both parents in family-based interventions to address youth suicidal behavior.

Association between immigration status and inpatient psychiatric admission after attempted suicide: Results from a hospital-based observational study

IntroductionAcute suicidality or a condition after attempted suicide frequently leads patients to both voluntary or involuntary inpatient admission. Emergency room psychiatrists decide whether such patients can be treated on an outpatient basis.ObjectivesTo identify if immigration status is associated with the decision whether a patient needs a hospital admission.AimsTo detect social determinants of hospital-based health resource uses.MethodsA cross-sectional study including data from 323 patients treated in a general hospital's emergency room after a suicidal attempt during year 2014.ResultsSeventy-six patients were admitted to the hospital (23.5%). Hospitalization frequencies for immigrant and non-immigrant individuals were 6.3% and 26.5% (P = 0.002). No significant association was found between psychiatric admission and history of a diagnosed psychiatric disorder, previous suicidal attempts, previous emergency room care use, family support or current drug use. A subgroup of patients (n = 37; 9%) answered Beck's suicidal intent scale (SIS), a measure of risk in suicidal attempters. Mean SIS was found to be higher among hospitalized than discharged patients (8.5 vs. 16.5; P = 0.01). No significant difference was found in mean SIS between immigrant and non-immigrant patients (9.3 vs. 9.1; P = 0.3).ConclusionsThese preliminary results call for consideration. The highly significant lower rate of psychiatric admission among immigrant patients, without significant differences in mean SIS score in regard to non-immigrants, needs further study.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Characteristics of individuals who use alcohol at the time of attempting suicide

ObjectiveThe aim of this study was to analyze the clinical characteristics of individuals who used alcohol at the time of attempting suicide.MethodsWe divided 143 individuals who attempted suicide by consuming drugs into two groups on the basis of their blood alcohol concentration level: drinker group (n = 79) and non-drinker group (n = 64). We compared epidemiological characteristics and suicidal behavior between the groups by using the Suicidal Intent Scale (SIS) and the Risk Rescue Rating Scale (RRRS). In addition, we administered the Glasgow Coma Scale (GCS) and the Acute Physiology and Chronic Health Evaluation–II (APACHE–II) to evaluate the medical lethality of the individuals who attempted suicide. We used Student's t-test, Pearson's correlation analysis, and multiple linear regression to analyze the data.ResultsThe drinker group scored lower on the SIS's planning subscale than the non-drinker group did (P = 0.022). The drinker group's blood alcohol concentration levels were negatively correlated with the rescue potential of their suicidal attempt (P = 0.031) and the APACHE-II score (P = 0.003). Higher blood alcohol concentration levels predicted poorer medical outcomes measured by the APACHE-II (P = 0.004).ConclusionOur findings support the notion that alcohol use increases suicidal impulsivity, decreases rescue potential, and worsens medical outcomes. Therefore, suicide prevention programs need to include education and counselling about the risks associated with alcohol use.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Suicide attempters: Clinical characteristics and management

BackgroundSuicide attempts, defined as self-inflicted, potentially injurious behaviors with a nonfatal outcome, and with evidence of intent to die are extremely prevalent. Literature suggests that suicide is more common among males, while attempted suicide is more frequent among females. Depression, mental disorders, substance use disorders and history of suicidal behavior are important risk factors for suicide: the risk of suicide attempt is 3 to 12 times higher in psychiatric patients than in the general population.AimThe aim of our study was to compare severity of depressive symptoms in a sample of suicide attempters with a diagnosis of bipolar and related disorders or depressive disorders and in a sample of sex- and diagnosis-matched patients who do not commit a suicide attempt. The severity of attempted suicide and the suicidal risk in the hospital will be assessed as well.Material and methodsWe collected a sample of inpatients who committed a suicide attempt during 2015. For each attempter, we selected another sex- and diagnosis-matched patient with no history of attempted suicide. Socio-demographic and clinical characteristics of the sample were gathered. Assessment included: Montgomery-Asberg Depression Rating Scale (MADRS) for severity of depressive symptoms in both groups, Suicide Intent Scale (SIS) for the severity of attempted suicide and the suicidal risk with a nurse assessment for suicide.ResultsData collecting is still ongoing. We expected to find more severe symptoms in patients who attempted suicide. Clinical implication will be discussed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

A Descriptive Analysis of Psychosocial Factors Associated With Non- fatal Adolescent Suicide Attempts

Introduction: Adolescence is the tender, vulnerable transition period with umpteen challenges and individual vulnerability. Various Psychosocial factors play a determinantal role in the genesis of adolescent suicide attempts and the present descriptive study tries to analyze some common psychosocial factors in cases of non-fatal adolescent suicide attempters. Method: Fifty subjects were recruited in the study. Detailed assessment of psychiatric morbidity and attempted suicide was done by clinical interview and validated by M.I.N.I.- KID, Beck Suicide Intent Scale and Adolescent Suicide Assessment Protocol-20. Psychosocial factors associated with the attempt were documented with the semi-structured proforma and descriptive statistical analysis was done with the help of SPSS version 15. Results: Majority of the suicide attempters were in the age group of 18-19 years and females (54%) outnumbered males (46%). Most of the subjects were single (88%), Hindu (86%) by religion, belonged to middle socioeconomic class (82%) and were from the urban background (80%). Two third of them belonged to nuclear family and half of them were students. In our evaluation of various psychosocial factors, 76% of subjects were found to have psychosocial stressor, in that 10% had two or more stressors. Family related factors were the most common (60%) followed by college related factors (26%) in which most common was love failure (12%). Conclusion: A sizeable proportion of subjects had various psychosocial factors associated with non-fatal adolescent suicide attempts and emphasis on these factors can help in prevention and hence monitoring of at-risk adolescents.