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Completed Suicide (completed + suicide)
Selected AbstractsToxicology and Circumstances of Completed Suicide by Means Other than Overdose,JOURNAL OF FORENSIC SCIENCES, Issue 2 2009Shane Darke Ph.D. Abstract:, To determine the prevalence and circumstances of psychoactive substances amongst nonoverdose completed suicide, 1436 consecutive cases autopsied at the NSW Department of Forensic Medicine over the period 1/1/1997,12/31/2006 were analyzed. Substances were detected in 67.2% of cases, and illicit drugs in 20.1%. Alcohol was present in 40.6% of cases. Males were more likely to be positive for alcohol, cannabis, and psychostimulants, and females for pharmaceuticals. Illicits were associated with younger age. Alcohol was most prominent amongst toxicity cases, as were opioids, psychostimulants amongst gunshot cases, and pharmaceuticals amongst drownings. Cases in which drug and alcohol histories were noted were more likely to have a substance detected. Alcohol was more common where a suicide note was left and where relationship problems were involved. Pharmaceuticals were more common where a previous attempt was noted. Licit and illicit substances are strongly associated with suicide, even when the method does not involve drug overdose. [source] Completed suicide among psychiatric in-patients with depression in an Australian mental hospitalINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 1 2000Ajit Shah Abstract Up to 45% of completed psychiatric in-patient suicides have a diagnosis of depression. Twenty-two completed psychiatric in-patient suicides with depression, over a 21-year period, in a large psychiatric hospital in Melbourne, Australia, were examined. The characteristics, including demographic and clinical data, for the completed suicides with depression were compared with a comparison group of ,alive' in-patients with depression. Completed suicide among psychiatric in-patients with depression was associated with male sex, suicidal thoughts during admission, and fluctuating suicidal ideation or continuous absence of suicidal ideation. Over 40% of completed suicides occurred whilst on approved leave and over 20% after absconding from the hospital. Violent methods (including jumping in front of trains, trams and road traffic, jumping of buildings, hanging and drowning) were used in over 65% of completed suicides. Psychiatric units should be developed away from readily available methods of suicide. In-patients with suicidal thoughts during the admission and unstable suicidal ideation should be carefully observed to avoid absconding and suicide, and should be carefully assessed prior to granting of leave. Copyright © 2000 Whurr Publishers Ltd. [source] Suicide and Alcohol: Do Outlets Play a Role?ALCOHOLISM, Issue 12 2009Fred W. Johnson Background:, The purpose of this study was to determine whether the number of alcohol outlets in local and adjacent areas, in particular bars, was related over time to completed suicide and suicide attempts. There is evidence both from studies of individuals and time series aggregate studies, mostly at the national level, of substantial alcohol involvement in suicide, but no small-area, longitudinal studies have been carried out. The present study is the first that is both longitudinal and based on a large number of small spatial units, California zip codes, a level of resolution permitting analysis of the relationship between local alcohol access and suicide rates over time. Method:, Longitudinal data were obtained from 581 consistently defined zip code areas over 6 years (1995,2000) using data from the California Index Locations Database, a geographic information system that contains both population and place information with spatial attributes for the entire state. Measures obtained from each zip code included population characteristics (e.g., median age) and place characteristics (e.g., numbers of retail and alcohol outlets) which were related in separate analyses to (i) suicide mortality and (ii) the number of hospitalizations for injuries caused by suicide attempts. The effect of place characteristics in zip code areas adjacent to each of the 581 local zip codes (spatial lags) was also assessed. Analysis methods were random effects models corrected for spatial autocorrelation. Results:, Completed suicide rates were higher in zip code areas with greater local and lagged bar densities; and higher in areas with greater local but not lagged off-premise outlet densities. Whereas completed suicide rates were lower among blacks and Hispanics, completed suicide rates were higher among low income, older whites living in less densely populated areas, that is, rural areas. Rates of suicide attempts were higher in zip code areas with greater local but not lagged bar densities, and higher among low income younger whites living in smaller households and in rural areas. Rates of attempted suicide were also higher among blacks. Completed suicide and suicide attempt rates were lower in zip code areas with greater local restaurant densities; there were no lagged effects for restaurants. Conclusions:, Bar densities in particular appear related to suicide, meaning, because this is an aggregate-level spatial analysis, that suicides, both attempted and completed, occur at greater rates in rural community areas with greater bar densities. Because the suicide rate is highest in rural areas, this study suggests that although the number of completed and attempted suicides is no doubt greater in absolute numbers in urban areas, the suicide rate, both completed and attempted, is greater in rural areas, which draws attention, perhaps much needed, to the problems of rural America. [source] Safety of sertindole versus risperidone in schizophrenia: principal results of the sertindole cohort prospective study (SCoP)ACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2010S. H. L. Thomas Thomas SHL, Drici MD, Hall GC, Crocq MA, Everitt B, Lader MH, Le Jeunne C, Naber D, Priori S, Sturkenboom M, Thibaut F, Peuskens J, Mittoux A, Tanghøj P, Toumi M, Moore ND, Mann RD. Safety of sertindole versus risperidone in schizophrenia: principal results of the sertindole cohort prospective study (SCoP) Objective:, To explore whether sertindole increases all-cause mortality or cardiac events requiring hospitalization, compared with risperidone. Method:, Multinational randomized, open-label, parallel-group study, with blinded classification of outcomes, in 9858 patients with schizophrenia. Results:, After 14147 person-years, there was no effect of treatment on overall mortality (sertindole 64, risperidone 61 deaths, Hazard Ratio (HR) = 1.12 (90% CI: 0.83, 1.50)) or cardiac events requiring hospitalization [sertindole 10, risperidone 6, HR = 1.73 (95% CI: 0.63, 4.78)]: Of these, four were considered arrhythmia-related (three sertindole, one risperidone). Cardiac mortality was higher with sertindole (Independent Safety Committee (ISC): 31 vs. 12, HR=2.84 (95% CI: 1.45, 5.55), P = 0.0022; Investigators 17 vs. 8, HR=2.13 (95% CI: 0.91, 4.98), P = 0.081). There was no significant difference in completed suicide, but fewer sertindole recipients attempted suicide (ISC: 68 vs. 78, HR=0.93 (95% CI: 0.66, 1.29), P = 0.65; Investigators: 43 vs. 65, HR=0.67 (95% CI: 0.45, 0.99), P = 0.044). Conclusion:, Sertindole did not increase all-cause mortality, but cardiac mortality was higher and suicide attempts may be lower with sertindole. [source] Deliberate self-harm in older adults: a review of the literature from 1995 to 2004INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 8 2007Jenifer Chan Abstract Background The prevention of suicide is a national and international policy priority. Old age is an important predictor of completed suicide. Suicide rates in old age differ markedly from country to country but there is a general trend towards increasing rates with increasing age. In 1996 Draper reviewed critically the evidence on attempted suicide in old age in the 10 years between 1985 and 1994. The review highlighted a need for prospective controlled studies in older people with more representative samples as well as studies examining the interaction of risk factors, precipitants, motivations, psychopathology and response to treatment. The aim of this paper is to update this review and to summarise the advances in our understanding of DSH in later life. Method We have critically reviewed relevant studies published between 1995 and 2004 to summarise the advances in our understanding of factors associated with deliberate self-harm in later life. Results The main advances in understanding have been to clarify the effect of personality and cultural factors, service utilisation pre and post attempt, and the (lesser) impact of socio-economic status and physical illness. Methodological weaknesses continue to include inadequate sample sizes performed on highly selected populations, inconsistent age criteria and lack of informant data on studies relating to role of personality. Conclusions Future studies should include prospective, cross-cultural research with adequate sample sizes and which are population-based. Such approaches might confirm or refute the results generated to date and improve knowledge on factors such as the biological correlates of deliberate self-harm, service utilisation, costs and barriers to health care, and the interaction of these factors. Intervention studies to elucidate the impact of modifying these factors and of specific treatment packages are also needed. Copyright © 2007 John Wiley & Sons, Ltd. [source] Elderly suicide and the 2003 SARS epidemic in Hong KongINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 2 2006Sau Man Sandra Chan Abstract Background Hong Kong was struck by the community outbreak of Severe Acute Respiratory Syndrome (SARS) in 2003. In the same year, the elderly suicide rate in Hong Kong showed a sharp upturn from a previous downward trend. Methods Secondary analyses using Poisson Regression Models on the suicide statistics from the Census and Statistics Department of the Hong Kong Government were performed. Results In a Poisson Regression Model on the annual suicide rates in elders aged 65 and over in years 1986,2003, 2002 served as the reference year. Suicide rates in 1986,1997 were significantly higher than the reference year, with an Incident Rate Ratio (IRR) of 1.34 to 1.61. However, rates in 1998,2001 did not differ from the reference year significantly, representing stabilization of suicide rates for 4 years after 1997. The elderly suicide rate increased to 37.46/100,000 in 2003, with an IRR of 1.32 (p,=,0.0019) relative to 2002. Such trend is preserved when female elderly suicide rates in 1993,2003 were analyzed, while suicide rates in elderly men and younger age groups did not follow this pattern. Discussions Mechanistic factors such as breakdown of social network and limited access to health care might account for the findings. These factors could have potentiated biopsychosocial risk factors for suicide at individual levels, particularly in elderly. Female elders, by way of their previous readiness to utilize social and health services instituted in the past decade, are thus more susceptible to the effects of temporary suspension of these services during the SARS epidemic. Conclusions The SARS epidemic was associated with increased risk of completed suicide in female elders, but not in male elders or the population under 65 years of age. Copyright © 2006 John Wiley & Sons, Ltd. [source] Psychosocial assessment of patients who attend an accident and emergency department with self-harmJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 2 2005W. BARR phd rmn cqsw It has been recommended that all patients attending hospital accident and emergency departments in the United Kingdom (UK) with self-harm should be offered adequate psychosocial assessment to identify those at risk of completed suicide or repeated self-harm. This paper focuses on the extent to which this recommendation has been implemented in a large district general hospital in Wales, and compares the characteristics and hospital management of patients who received no specialist assessment with those who were assessed by a psychiatric liaison nurse or a psychiatrist. Data were routinely collected as part of the hospital annual audit procedure and confirm previous findings that guidelines for the general hospital management of self-harm patients have not been well implemented. Whilst we found some evidence that certain high risk patient groups were more likely to receive specialist assessment, this was far from universal. We conclude that if there is to be a reduction in the rate of suicide in Wales and the UK as a whole, it is crucial that services for people who self-harm are more appropriately targeted on patients who are at greatest risk. [source] Suicide-related behavior after psychiatric hospital discharge: implications for risk assessment and management,BEHAVIORAL SCIENCES & THE LAW, Issue 6 2006Jennifer L. Skeem Ph.D. Suicide-related behavior (SRB), including suicide attempts and instrumental SRB, occurs far more often than completed suicide and exacts a toll on patients, their loved ones, and society. Nevertheless, few prospective studies of SRB have been conducted. In this study, 954 patients were interviewed in a psychiatric hospital and then followed for one year after discharge. During this one-year period, nearly one-quarter of patients (23%) engaged in SRB, with the rate of suicide attempts (18%) three times greater than the rate of instrumental SRB (5%). Risk factors for SRB were demographic (White ethnicity, female gender), clinical (past SRB, depression, impaired functioning), and contextual (unemployment, large social networks). In contrast with other studies, there was no "peak" in the risk of SRB shortly after hospital discharge. Instead, patients' rate of SRB was relatively constant over the one-year follow-up. Implications for risk assessment and management in acute inpatient settings are discussed. Copyright © 2006 John Wiley & Sons, Ltd. [source] Suicides and suicide ideation in the Bible: an empirical surveyACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2005H. J. Koch Objective:, The aim of this review is to summarize all data on suicidal behaviour reported in the Bible and to discuss basic implications for medical ethical positions. Method:, All books of the Jerusalem Bible, including the apocrypha accepted in the Catholic canon, were searched for all cases of suicide, attempted suicide and suicidal ideation clearly identifiable as such. Results:, The Bible including the apocrypha reports about 10 completed suicides and 11 cases of suicide attempt or ideation. The Bible considers human life as a divine gift but suicide per se is neither condemned nor approved. Those suffering from suicidal thoughts are treated with respect and support is offered. Conclusion:, Theological teaching on suicide was influenced for centuries by the biased negative opinion of the early fathers of the church and scholastic savants, but these opinions are not substantiated by a thorough reading of the Bible. [source] Completed suicide among psychiatric in-patients with depression in an Australian mental hospitalINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 1 2000Ajit Shah Abstract Up to 45% of completed psychiatric in-patient suicides have a diagnosis of depression. Twenty-two completed psychiatric in-patient suicides with depression, over a 21-year period, in a large psychiatric hospital in Melbourne, Australia, were examined. The characteristics, including demographic and clinical data, for the completed suicides with depression were compared with a comparison group of ,alive' in-patients with depression. Completed suicide among psychiatric in-patients with depression was associated with male sex, suicidal thoughts during admission, and fluctuating suicidal ideation or continuous absence of suicidal ideation. Over 40% of completed suicides occurred whilst on approved leave and over 20% after absconding from the hospital. Violent methods (including jumping in front of trains, trams and road traffic, jumping of buildings, hanging and drowning) were used in over 65% of completed suicides. Psychiatric units should be developed away from readily available methods of suicide. In-patients with suicidal thoughts during the admission and unstable suicidal ideation should be carefully observed to avoid absconding and suicide, and should be carefully assessed prior to granting of leave. Copyright © 2000 Whurr Publishers Ltd. [source] Reducing Suicidal Ideation in Depressed Older Primary Care PatientsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2006Jürgen Unützer MD OBJECTIVES: To determine the effect of a primary care,based collaborative care program for depression on suicidal ideation in older adults. DESIGN: Randomized, controlled trial. SETTING: Eighteen diverse primary care clinics. PARTICIPANTS: One thousand eight hundred one adults aged 60 and older with major depression or dysthymia. INTERVENTION: Participants randomized to collaborative care had access to a depression care manager who supported antidepressant medication management prescribed by their primary care physician and offered a course of Problem Solving Treatment in Primary Care for 12 months. Participants in the control arm received care as usual. MEASUREMENTS: Participants had independent assessments of depression and suicidal ideation at baseline and 3, 6, 12, 18, and 24 months. Depression was assessed using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (SCID). Suicidal ideation was determined using the SCID and the Hopkins Symptoms Checklist. RESULTS: At baseline, 139 (15.3%) intervention subjects and 119 (13.3%) controls reported thoughts of suicide. Intervention subjects had significantly lower rates of suicidal ideation than controls at 6 months (7.5% vs 12.1%) and 12 months (9.8% vs 15.5%) and even after intervention resources were no longer available at 18 months (8.0% vs 13.3%) and 24 months (10.1% vs 13.9%). There were no completed suicides in either group. Information on suicide attempts or hospitalization for suicidal ideation was not available. CONCLUSION: Primary care,based collaborative care programs for depression represent one strategy to reduce suicidal ideation and potentially the risk of suicide in older primary care patients. [source] | ||||||||||