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Suicide Rates (suicide + rate)

Distribution by Scientific Domains

Medical Sciences	84%
Psychology	10%

Selected Abstracts

Comparison of suicide in people aged 65,74 and 75+ by gender in England and Wales and the major Western countries 1979,1999

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 1 2005
Colin Pritchard
Abstract Background The factors most strongly associated with suicide are age and gender,more men than women, and, more people over 65 kill themselves. As a number of Governments have targets to reduce suicide levels we compare elderly suicide rates over a 20-year period in England and Wales. And the major Western countries focusing upon age and gender. Method WHO mortality data were used to calculate three-year average General Population Suicide Rates (GPSR) for 1979,1981 to 1997,1999 and rates of people aged 65,74 and 75+ suicide by gender to provide ratios of change and a statistical comparison of England and Wales and the Major Western countries over the period. Results Male GSPR: ,65,74' suicide ratios fell significantly in six countries and in three for the ,75+'. Female GSPR: ,65,74' suicide ratios fell in every country except Spain. Proportionately, there were more suicides in the over 65s in countries with an ,extended family' tradition, Spain, Italy, Germany, France and Japan, than in the five ,secular' countries. England and Wales male ,65,74' suicide fell significantly more than Canada, France, Germany, Italy, Japan, Spain, Netherlands and the USA, and did significantly better than the other countries for all female senior citizen suicides. Conclusion Suicide of the over-65s has improved in seven countries, especially in England and Wales, who had the greatest proportional reduction, which reflects well upon the psycho-geriatric and community services. However, in all countries, male 65,74 rates did not match the female out so extra efforts are needed to improve male rates. Copyright © 2004 John Wiley & Sons, Ltd. [source]

Nonmarital Fertility and the Effects of Divorce Rates on Youth Suicide Rates

JOURNAL OF MARRIAGE AND FAMILY, Issue 4 2006
Steven F. Messner
Using pooled, time-series data for a sample of 15 developed nations, we assess the effect of divorce rates on gender-specific suicide rates for youths aged 15 , 19 with models of relative cohort size, lagged nonmarital fertility, and an interaction term for divorce rates and nonmarital fertility. The results reveal that, for young men, relative cohort size is positively related to suicide rates, and divorce rates interact with lagged nonmarital fertility. The interaction effect indicates that increases in divorces are especially consequential for suicide cohorts of male youths who were born in periods of high nonmarital fertility. For female youths, only divorce rates exert a significant effect on suicide rates, and it is a positive, main effect. [source]

Suicide after hospitalization in the elderly: a population based study of suicides in Northern Finland between 1988,2003

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 2 2008
Kaisa Karvonen
Abstract Objective Elderly people commit suicide more often than people under the age of 65. An elevated risk is also attached to depression and other axis I psychiatric disorders. However, little is known about the preferred suicide method, effect of primary psychiatric diagnosis, and length of time between discharge from psychiatric hospitalization and suicide. The lack of information is most apparent in the oldest old (individuals over 75 years). Methods On the basis of forensic examinations, data on suicide rates were separately examined for the 50,64, 65,74 and over 75 year-olds (Total n,=,564) with regard to suicide method, history of psychiatric hospitalization and primary diagnoses gathered from the Finnish Hospital Discharge Register. Study population consisted of all suicides committed between 1988 and 2003 in the province of Oulu in Northern Finland. Results Of the oldest old, females had more frequent hospitalizations than males in connection with psychiatric disorders (61% vs 23%), of which depression was the most common (39% vs 14%). In this age group, 42% committed suicide within 3 months after being discharged from hospital and 83% used a violent method. Both elderly males and females were less often under the influence of alcohol, but used more often violent methods than middle-aged persons. Conclusions Suicide rates within the first 3 months following discharge from hospital in the 65,74 and the over 75 year olds were substantial and should influence post-hospitalization treatment strategies. To reduce the risk of suicides in elderly patients discharged from hospital, close post-hospitalization supervision combined with proper psychoactive medication and psychotherapy, are possible interventions. Copyright © 2007 John Wiley & Sons, Ltd. [source]

Deliberate self-harm in older adults: a review of the literature from 1995 to 2004

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 8 2007
Jenifer 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 Kong

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 2 2006
Sau 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]

Suicidality among Finnish anaesthesiologists

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 8 2009
P. M. LINDFORS
Background: Suicide rates among physicians have constantly been reported to be higher than in the general population and anaesthesiologists appear to lead the suicide statistics among physicians. Methods: A cross-sectional questionnaire study was sent to all working Finnish anaesthesiologists (n=550) investigating their suicidality (ideation and/or planning and/or attempt). The response rate was 60%. Results: One in four had at some time seriously been thinking about suicide. Respondents with poor health (crude odds ratios 11.2 and 95% confidence interval 3.8,33.0), low social support (10.5, 4.0,27.9), and family problems (6.5, 3.4,12.5) had the highest risk of suicidality. The highest risks at work were conflicts with co-workers (4.1, 2.3,7.1) and superiors (2.1, 1.2,3.6), on-call-related stress symptoms (3.9, 1.9,8.3) and low organizational justice (1.9, 1.1,3.2). If a respondent had several risk factors, the risk of suicidality doubled with each cumulating factor. Conclusions: The reported level of suicidal ideation among Finnish anaesthesiologists is worth concern. It should be of utmost importance to screen the risk factors and recognize suicidal physicians in order to help them. Interpersonal relationships, decision-making procedures, and on-call-burden should be focused on when aiming to prevent suicidality among physicians. [source]

Bipolar depression: phenomenological overview and clinical characteristics

BIPOLAR DISORDERS, Issue 6 2004
Philip B Mitchell
Objectives:, There has been increasing interest in the depressed phase of bipolar disorder (bipolar depression). This paper aims to review the clinical characteristics of bipolar depression, focusing upon its prevalence and phenomenology, related neuropsychological dysfunction, suicidal behaviour, disability and treatment responsiveness. Methods:, Studies on the prevalence of depression in bipolar disorder, the comparative phenomenology of bipolar and unipolar depression, as well as neuropsychology and brain imaging studies, are reviewed. To identify relevant papers, a literature search using MEDLINE and PubMed was undertaken. Results:, Depression is the predominant mood disturbance in bipolar disorder, and most frequently presents as subsyndromal, minor or dysthymic depression. Compared with major depressive disorder (unipolar depression), bipolar depression is more likely to manifest with psychosis, melancholic symptoms, psychomotor retardation (in bipolar I disorder) and ,atypical' symptoms. The few neuropsychological studies undertaken indicate greater impairment in bipolar depression. Suicide rates are high in bipolar disorder, with suicidal ideation, suicide attempts and completed suicides all occurring predominantly in the depressed phase of this condition. Furthermore, the depressed phase (even subsyndromal) appears to be the major contributant to the disability related to this condition. Conclusions:, The significance of the depressed phase of bipolar disorder has been markedly underestimated. Bipolar depression accounts for most of the morbidity and mortality due to this illness. Current treatments have significant limitations. [source]

Characteristics of spousal homicide perpetrators: a study of all cases of spousal homicide in Sweden 1990,1999

CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 2 2004
Professor Henrik Belfrage PhD
Background In Sweden 20 000 cases of assault against women are reported to the police every year. Method All data on the perpetrators of spousal homicide in Sweden between 1990 and 1999 were investigated (n = 164). A control group of all other perpetrators of homicide in Sweden during the same period, i.e. cases of homicide not committed in the context of spouse violence (n = 690) was used. All verdicts, as well as all material in the police investigations, including interviews with all of the police investigators, were analysed. Copies of police examinations of the suspects, and forensic reports from the autopsies, were also examined. Data on all registered criminality were collected from the National Police Register, and in cases where the perpetrators had been subject to forensic psychiatric examinations, those reports were obtained from the Swedish National Board of Forensic Medicine. In addition, the Psychopathy Checklist: Screening Version scores were rated from the forensic psychiatric examinations. Results There was a four times higher suicide rate among the spousal homicide perpetrators (24%, n = 40) compared with the perpetrators in the control-group (6%, n = 39, chi-squared = 55,42df = 1 , p < 0.001). Consequently, suicidal ideation must be considered as an important risk factor for spousal homicide. In 79% of the cases the spousal homicide perpetrators were subject to forensic psychiatric examinations. All except 5% were diagnosed with at least one psychiatric diagnosis, and 34% were sentenced to forensic psychiatric treatment. If it is assumed that the psychiatric morbidity was high in the 24% of the perpetrators who committed suicide, then 80% of all perpetrators of spouse homicide during the study period can be characterized as mentally disordered. ,Psychopathic' perpetrators, who generally are over-represented in most violent criminality, were comparatively uncommon. Only seven (4%) in the study group met the diagnostic criteria for psychopathy as measured with the PCL:SV. Discussion The group of spouse killers studied here fits the dysphoric/borderline group of spouse assaulters. This is a group that may benefit from treatment. Perhaps police officers could help identify this kind of spouse assaulter before a fatality occurs. Copyright © 2004 Whurr Publishers Ltd. [source]

Attention deficit hyperactivity disorder and suicide: a review of possible associations

ACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2004
A. James
Objective:, To review the evidence of a possible association between attention deficit hyperactivity disorder (ADHD) and suicide. Design:, We searched the electronic data bases: Medline, Psych LIT, between 1966 and March 2003 looking for articles on ADHD, attention deficit disorder, hyperactivity and suicide. Results:, An association of ADHD and completed suicide was found, especially for younger males. However, the evidence for any direct or independent link was modest with an overall suicide rate from long-term follow-up studies of ADHD of 0.63,0.78%. The estimated relative risk ratio, compared with US national suicide rates (males 5,24 years) is 2.91 (95% confidence interval 1.47,5.7, ,2 = 9.3, d.f. = 1, P = 0.002). ADHD appears to increase the risk of suicide in males via increasing severity of comorbid conditions, particularly conduct disorder (CD) and depression. Conclusion:, Identification of those at risk, particularly males with comorbid ADHD, depression and CD, may represent a useful clinical means of reducing completed suicide. [source]

A revisit on older adults suicides and Severe Acute Respiratory Syndrome (SARS) epidemic in Hong Kong

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 12 2008
Y. T. Cheung
Abstract Background The Severe Acute Respiratory Syndrome (SARS) outbreak in 2003 had an enormous impact on Hong Kong society and the suicide rate was also at its historical high, 18.6 per 100,000. The most significant increase was found among the older adults aged 65 or above. Methods Poisson Regression Models were used to examine impact of the SARS epidemic on older adults suicides in Hong Kong. A complete set of the suicide statistics for the period 1993,2004 from the Coroners' Court were made available for the analysis. Chi-square test was used to compare the profile of the older adult suicide cases in the pre-SARS, peri-SARS and post-SARS periods. Results It showed an excess of older adults suicides in April 2003, when compared to the month of April of the other years. A trough, instead of the usual summer peak, was observed in June, suggesting some of the older adults suicides might have been brought forward. On a year basis, the annual older adult's suicide rates in 2003 and 2004 were significantly higher than that in 2002, suggesting the suicide rate did not return to the level before the SARS epidemic. Based on the Coroners' suicide death records, overall severity of illness, level of dependency and worrying of having sickness among the older adult suicides were found to be significantly different in the pre-SARS, peri-SARS and post-SARS periods. Conclusion The SARS epidemic was associated with an increase in older adults' suicide rate in April 2003 and some suicide deaths in June 2003 might have been brought forward. Moreover, an increase in the annual older adults' suicide rate in 2003 was observed and the rate in 2004 did not return to the level of 2002. Loneliness and disconnectedness among the older adults in the community were likely to be associated with the excess older adults' suicides in 2003. Maintaining and enhancing mental well being of the public over the period of epidemic is as important as curbing the spread of the epidemic. Attention and effort should also be made to enhance the community's ability to manage fear and anxiety, especially in vulnerable groups over the period of epidemic to prevent tragic and unnecessary suicide deaths. Copyright © 2008 John Wiley & Sons, Ltd. [source]

Elderly suicide and the 2003 SARS epidemic in Hong Kong

Financial Debt and Suicide in Hong Kong SAR,

JOURNAL OF APPLIED SOCIAL PSYCHOLOGY, Issue 12 2007
Paul S. F. Yip
The presence of indebtedness is known to be a risk factor that can trigger stressed persons to contemplate suicide. This study compares the profiles of suicides with and without debt problems based on 2002 Coroner's Court death files. The category of men aged 25,39 has seen a 70% increase in suicide rate since 1997, and the number using carbon monoxide poisoning has increased from 1% of the total deaths in 1997 to about 26% of the total deaths in 2002. Suicides associated with debt problems seem to involve fewer mental and physical problems with formal job attachment than do suicides without debt problems. Gambling is a significant contributing factor to unmanageable indebtedness. [source]

Suicide and Alcohol: Do Outlets Play a Role?

ALCOHOLISM, Issue 12 2009
Fred 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]

National trend of antidepressant consumption and its impact on suicide rate in Hungary,

PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 4 2008
Réka Viola MSc Pharm
Abstract Purpose The aim of this study was to analyse the changes in the amount and structure of Hungarian antidepressant consumption at national and regional level, furthermore to investigate the possible relationship between antidepressant sales and trends in suicide rates using regional data. Method Retrospective analysis of antidepressant sales data was performed on a 12 years period (1993,2004), applying the ATC/DDD methodology developed by WHO. Linear regression model was set up to investigate the trends in antidepressant utilisation. The association between antidepressant consumption and suicide rates was measured by Pearson correlation. Results The nationwide utilisation of antidepressants revealed more than five-fold increase in the studied 12 year period. The usage of tricyclic antidepressants (N06AA) decreased to one third of the previous value, while the usage of selective serotonin reuptake inhibitors (N06AB) multiplied by 21. The consumption of ,other antidepressants' (N06AX) was found very low (3.66 DDD/1000inhabitants/day in 2004). There was not found any significant correlation between increased antidepressant consumption and decreased suicide rates at regional level by our statistical analysis (rmin,=,,0.160; rmax,=,,0.314). Conclusion Further investigation is required to identify determinants that have contributed to recent decline in suicide rate in Hungary. Copyright © 2008 John Wiley & Sons, Ltd. [source]

Latest news and product developments

PRESCRIBER, Issue 9 2007
Article first published online: 3 SEP 200
Clinical trials flatter anti-TNFs in RA The efficacy of anti-TNF agents in clinical trials is not matched by experience in daily practice in patients with rheumatoid arthritis, say Dutch investigators (Ann Rheum Dis online: 10 April 2007; doi:10.1136/ard.2007.072447). They compared outcomes from a systematic review of trials of etanercept (Enbrel), infliximab (Remicade) and adalimumab (Humira) and a national postmarketing surveillance scheme (DREAM). In 5 of 11 comparisons, the response rate in DREAM was significantly lower than that in RCTs. Responses among DREAM patients who met the inclusion criteria for clinical trials were significantly greater than among noneligible patients and comparable with those of patients participating in the trials. The authors conclude that patients in trials have more severe disease and therefore a response to treatment that is not matched in daily practice. Methadone prescriptions double in 10 years Methadone treatment for opiate addicts has more than doubled in the past 10 years, according to an audit of opiate substitution in England by the National Treatment Agency for Substance Misuse (www.nta.nhs.uk). The total number of methadone prescriptions increased from 970 900 in 1995 to over 1.8 million in 2004. The introduction of buprenorphine (Subutex) has not reduced methadone prescribing , 96 per cent of responding centres prescribed methadone and 88 per cent prescribed buprenorphine. Seventy-two per cent of centres prescribe benzodiazepines to opiate addicts, causing the NTA some concern. GPs were involved in prescribing management in about 60 per cent of centres. Next NICE guidelines The Department of Health has referred eight topics to NICE for the development of clinical guidelines: preventing venous thromboembolism, acute coronary syndromes, chest pain, social complications during pregnancy (eg drug misuse), benign prostatic hyperplasia, constipation in children, neonatal jaundice and metastatic disease of unknown primary origin. Errors with children , Every step of drug treatment for children, from prescribing to writing notes, is associated with a substantial level of error, say US investigators (Quality and Safety in Health Care 2007;16:116-26). Their systematic review of 31 studies reporting medication errors in paediatrics found that 3-37 per cent were associated with prescribing errors, 5-58 per cent with dispensing errors, 72-75 per cent with errors of administration, and 17-21 per cent with documentation errors. Suggestions for remedial strategies were not evidence based, the authors found. , and transplant patients Errors in medication are common among outpatients who have received liver, kidney or pancreas transplants, a second US study has found (Arch Surg 2007;142:278-83). Twelve months' follow-up of 93 patients revealed a total of 149 errors of drug treatment, with a frequency of 15 in 219 visits over a four-week period. One-third of errors were associated with adverse events including hospital admission and graft rejection. Patients were taking an average of 11 medicines; analysis showed that over half of errors originated with the patients and 13 per cent were associated with prescribing. Paracetamol pack benefit challenged A new study has challenged accepted wisdom that reducing the OTC pack size of paracetamol cut the suicide rate (PLoS Medicine 2007;4:e105). In 1998, pack sizes of paracetamol were limited to 16 in general sale outlets and 32 in pharmacies. Suicide rates subsequently decreased but, though widely assumed, a causal link has not been established. Researchers from London and the Office of National Statistics have now examined mortality trends from suicide associated with antidepressants, aspirin, compound paracetamol preparations and nondrug poisoning. They found that all fatal suicides declined at similar rates after the pack size reductions. While not excluding the possibility that restricting easy access to paracetamol may have helped, these data suggest that other factors were also important. CV risk with ibuprofen among aspirin users Ibuprofen, but not naproxen, is associated with a higher risk of cardiovascular events and heart failure than lumiracoxib (Prexige) in high-risk patients, according to a new analysis of the TARGET trial (Ann Rheum Dis online: 5 April 2007; doi:10.1136/ard.2006.066001). TARGET comprised two studies comparing naproxen or ibuprofen with lumiracoxib in a total of 18 325 patients with OA. This post-hoc analysis stratified patients by their cardiovascular risk; the primary end-point was a composite of cardiovascular mortality, nonfatal myocardial infarction and stroke at one year. Among those at high risk who were taking aspirin, ibuprofen was associated with an increased risk of the composite end-point compared with lumiracoxib (2.14 vs 0.25 per cent). The risk was similar for naproxen and lumiracoxib (1.58 vs 1.48 per cent). In high-risk patients not taking aspirin, the risk was similar for ibuprofen and lumiracoxib, but lower for naproxen than lumiracoxib. Congestive heart failure was more common in patients taking ibuprofen than lumiracoxib (1.28 vs 0.14 per cent); the risk was similar with naproxen and lumiracoxib. The authors emphasise that their findings should be considered hypothesis-generating. CVD guidelines criticised The second edition of the guidelines of the Joint British Societies on preventing cardiovascular disease have been harshly criticised for failing to meet international quality standards (Int J Clin Pract online doi: 10.1111/j.1742-1241.2007.01310.x). Kent GP Dr Rubin Minhas evaluated the guidelines against the criteria of the Appraisal of Guidelines and Research (AGREE) Collaboration. He identified areas of weakness including stakeholder involvement, rigour of development, applicability (by not considering cost) and editorial independence from the pharmaceutical industry. The guidelines should not be recommended for clinical practice, he concludes. OTC naproxen? The MHRA is consulting on switching naproxen 250mg to pharmacy-only status for the treatment of period pain in women aged 15-50. The change would offer an alternative to ibuprofen, currently the only other OTC medicine with this indication. Responses should be submitted by 23 May. The Agency is currently considering responses to its consultation on switching tranexamic acid to OTC status for heavy menstrual bleeding. Diabetes costs The total cost of prescribing for diabetes in England has doubled in only five years, official statistics show. The NHS Information Centre (www.ic.nhs.uk) report shows that spending in primary and secondary care in 2006 was £561 million, up 14 per cent on 2005. Growth was due to increased prescribing of oral hypoglycaemic agents (notably the glitazones , up by one-third over 2005) and the higher costs of insulins. Pharmacists may give flu jabs PCTs may consider using pharmacists to administer flu vaccines to some at-risk groups in the 2007/08 season, according to Department of Health plans. Flu vaccination payment for patients with diabetes, coronary heart disease, and stroke and TIA is provided under the Quality Outcomes Framework. The Department suggests that PCTs consider contracting a local enhanced service from pharmacists to reach other patients at increased risk, such as those with chronic liver disease, multiple sclerosis and related conditions, hereditary and degenerative disease of the CNS and carers. Copyright © 2007 Wiley Interface Ltd [source]

Where is help sought for depression or suicidal ideation in an elderly population living in a rural area of Japan?

PSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 5 2004
SHINJI SAKAMOTO phd
Abstract, Although suicide is increasingly becoming a social problem in Japan, especially among the elderly, little early intervention or suicide prevention is done. A project was begun which, since 1999, has aimed to detect depression at an early stage as a suicide prevention measure in a model area of Town A, which had a high suicide rate. In order to promote early intervention and prevention in a community, it is important to know where residents seek help if they become depressed or have suicidal ideation. Therefore, in the present study, help-seeking behavior using case vignettes was investigated. Data from 230 residents (82 men, 148 women) in the model area of Town A, aged 65 or over, were analyzed in the present study. If participants were unable to answer by themselves due to physical condition, public health nurses read out each item and wrote in their answers. The relationship between help-seeking behavior and demographic variables, psychosocial variables, depressive symptoms and so forth, were examined. The results show that participation in mental health workshops facilitated consultation with specialists (e.g. primary care doctors and nurses). The expected effects of psychoeducation on the general public and specialists were considered. [source]

Suicides on farms in South Australia, 1997,2001

AUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 6 2008
Keith Miller
Abstract Objective:,Despite much having been written, both nationally and internationally, about rural suicides, no one in Australia knows either the number of residents on farms or the suicide rate for this group of people. This paper seeks to determine the number of residents on farms in South Australia, along with the suicide rate. Design, setting and participants:,A retrospective audit review of the files of suicides completed between the 1 January 1997 and 31 December 2001 was undertaken in the South Australian Coroner's Office. There were 1033 cases examined for sociodemographic details and 380 files were explored in detail. Results:,Estimating both the number of agricultural establishments in South Australia and the resident population on farms for 2001, and determining the number of suicides on farms between 1997 and 2001, the farm suicide rate was found to be 33.8 for men, 6.7 for women and 21.6 per 100 000 for persons, much higher than the rural suicide rate for South Australia in 2001 (23.8 for men, 5.6 for women and 14.5 per 100 000 for persons) according to the Australian Bureau of Statistics. Conclusions:,This study provides an estimate of the number of farm residents in South Australia in 2001, the number and rate of suicides on farms in South Australia in 2001, and shows that this rate is significantly higher than the overall rate of suicide in South Australia in 2001. [source]

Ecological studies and the big puzzle of falling suicide rates

ACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2009
Jørgen G. Bramness
No abstract is available for this article. [source]

Influence of psychotherapist density and antidepressant sales on suicide rates

ACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2009
N. D. Kapusta
Objective:, Antidepressant sales and suicide rates have been shown to be correlated in industrialized countries. The aim was to study the possible effects of psychotherapy utilization on suicide rates. Method:, We assessed the impact of antidepressant sales and psychotherapist density on suicide rates between 1991 and 2005. To adjust for serial correlation in time series, three first-order autoregressive models adjusted for per capita alcohol consumption and unemployment rates were employed. Results:, Antidepressant sales and the density of psychotherapists in the population were negatively associated with suicide rates. Conclusion:, This study provides evidence that decreasing suicide rates were associated with both increasing antidepressant sales and an increasing density of psychotherapists. The decrease of suicide rates could reflect a general improvement in mental health care rather than being caused by antidepressant sales or psychotherapist density alone. [source]

Consistency of immigrant and country-of-birth suicide rates: a meta-analysis

ACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2008
M. Voracek
Objective:, Multifaceted evidence (family, twin, adoption, molecular genetic, geographic and surname studies of suicide) suggests genetic risk factors for suicide. Migrant studies are also informative in this context, but underused. In particular, a meta-analysis of the associations of immigrant (IMM) and country-of-birth (COB) suicide rates is unavailable. Method:, Thirty-three studies, reporting IMM suicide rates for nearly 50 nationalities in seven host countries (Australia, Austria, Canada, England, the Netherlands, Sweden and the USA), were retrieved. Results:, Total-population IMM and COB suicide rates were strongly positively associated (combined rank-order correlation across 20 eligible studies: 0.65, 95% CI: 0.56,0.73, P < 10,9). The effect generalized across both sexes, host countries and study periods. Conclusion:, Following the logic of the migrant study design of genetic epidemiology, the correspondence of IMM and COB suicide rates is consistent with the assumption of population differences in the prevalence of genetic risk factors for suicide. [source]

Attention deficit hyperactivity disorder and suicide: a review of possible associations

Lower suicide risk with long-term lithium treatment in major affective illness: a meta-analysis

ACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2001
Leonardo Tondo
Objective:,To compare suicide rates with vs. without long-term lithium treatment in major affective disorders. Method:,Broad searching yielded 22 studies providing suicide rates during lithium maintenance; 13 also provide rates without such treatment. Study quality was scored, between-study variance tested, and suicide rates on vs. off lithium examined by meta-analyses using random-effects regression methods to model risk ratios. Results:,Among 5647 patients (33,473 patient-years of risk) in 22 studies, suicide was 82% less frequent during lithium-treatment (0.159 vs. 0.875 deaths/100 patient-years). The computed risk-ratio in studies with rates on/off lithium was 8.85 (95% CI, 4.12,19.1; P<0.0001). Higher rates off-lithium were not accounted for by treatment-discontinuation. Conclusion:,Suicide risk was consistently lower during long-term treatment of major affective illnesses with lithium in all studies in the meta-analysis, including the few involving treatment-randomization. [source]

Psychiatric morbidity among patients with cancer of the esophagus or the gastro-esophageal junction: a prospective, longitudinal evaluation

DISEASES OF THE ESOPHAGUS, Issue 6 2007
H. Bergquist
SUMMARY., Cancer of the esophagus is often diagnosed at a late stage and is related to severe morbidity and a low 5-year survival rate. Previous studies have reported low health-related quality of life and high suicide rates for these patients. The occurrence of psychiatric morbidity and thus the potential need for psychological support may vary over time after diagnosis. This has not been adequately studied in patients with newly diagnosed cancer of the esophagus or gastro-esophageal junction. The present study therefore aimed to prospectively evaluate the prevalence of psychiatric morbidity in 94 consecutive patients (median age 66, range 45,88 years) with all stages of disease. Psychiatric morbidity was evaluated with the Hospital Anxiety and Depression Scale (HADS) questionnaire at inclusion and 1, 2, 3, 6 and 12 months later. At inclusion, 42% of the patients had HADS scores indicating possible or probable anxiety disorder and/or depression. At all follow-ups except at 3 months, proportions of patients with possible/probable anxiety disorder were significantly lower than at inclusion. Among patients with a duration of tumor-specific symptoms exceeding 6 months pre-diagnosis, larger proportions of patients with a possible/probable anxiety disorder were found at the 1- and 6-month follow ups. The prevalence of possible/probable depression was greater among patients treated with a palliative intent than among those with a curative intent at inclusion. Patients who died during the study period scored worse for depression compared to the survivors. Apart from this, the proportion of patients with possible/probable psychiatric morbidity (anxiety and/or depression) was relatively stable over time and was unrelated to patient characteristics or clinical background, including the treatment regime. In conclusion, psychiatric morbidity is common among esophageal cancer patients, both at inclusion and over time, regardless of the cancer therapy given. The findings stress the importance of monitoring the patients' mental health and of offering adequate psychological care when needed. [source]

Self-esteem and suicide rates in 55 Nations

EUROPEAN JOURNAL OF PERSONALITY, Issue 1 2009
Armand Chatard
Abstract Using recent data from the International Sexuality Description Project (ISDP), we examined whether national differences in self-esteem across 55 nations are reflected in suicide rates. Results indicate that suicide is especially common in nations with relatively low levels of self-esteem. This relation is consistent across sex lines, age of suicide and independent from several other relevant factors such as economic affluence, transition, individualism, subjective well-being, and neuroticism. These findings provide support for the predictive validity of self-esteem scores as assessed in the ISDP survey. They also contribute to a growing body of research documenting negative consequences associated with low self-esteem. Possible implications for suicide prevention strategies are discussed. Copyright © 2008 John Wiley & Sons, Ltd. [source]

Does Deinstitutionalization Increase Suicide?

HEALTH SERVICES RESEARCH, Issue 4 2009
Jangho Yoon
Objectives. (1) To test whether public psychiatric bed reduction may increase suicide rates; (2) to investigate whether the supply of private hospital psychiatric beds,separately for not-for-profit and for-profit,can substitute for public bed reduction without increasing suicides; and (3) to examine whether the level of community mental health resources moderates the relationship between public bed reduction and suicide rates. Methods. We examined state-level variation in suicide rates in relation to psychiatric beds and community mental health spending in the United States for the years 1982,1998. We categorize psychiatric beds separately for public, not-for-profit, and for-profit hospitals. Principal Findings. Reduced public psychiatric bed supply was found to increase suicide rates. We found no evidence that not-for-profit or for-profit bed supply compensates for public bed reductions. However, greater community mental health spending buffers the adverse effect of public bed reductions on suicide. We estimate that in 2008, an additional decline in public psychiatric hospital beds would raise suicide rates for almost all states. Conclusions. Downsizing of public inpatient mental health services may increase suicide rates. Nevertheless, an increase in community mental health funding may be promising. [source]

A revisit on older adults suicides and Severe Acute Respiratory Syndrome (SARS) epidemic in Hong Kong

Suicide after hospitalization in the elderly: a population based study of suicides in Northern Finland between 1988,2003

Elderly suicide and the 2003 SARS epidemic in Hong Kong

Comparison of suicide in people aged 65,74 and 75+ by gender in England and Wales and the major Western countries 1979,1999

Trends in suicide from drug overdose in the elderly in England and Wales, 1993,1999

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 5 2002
Rajen Shah
Abstract Background Drug overdose is a common method of suicide in the elderly. Hence, an understanding of current trends in epidemiology of these deaths is important when considering measures to decrease suicide rates. Methods Analysis of the Office for National Statistics (ONS) database of deaths from overdose and poisoning. Suicide and undetermined deaths from drug overdose between 1993,1999 in the over 65 year olds were studied. Socio-demographic data from the four drug groups most commonly used in overdose were extracted, and age and sex specific mortality rates calculated. Enumeration districts were ranked into five quintiles based on their Carstairs scores, and death rates in each quintile for men and women calculated. Results There were 1864 deaths from drug overdose during the study period. Suicide and undetermined death rates from drug overdose remained stable between 1993,1999. Drugs most commonly used in overdose were (in order) paracetamol (and related compounds), benzodiazepines, antidepressants, and opiates. Women comprised 62% of deaths. Death rates increased with age, with highest rates in men over 75 (37.7 deaths per million). Benzodiazepines showed the most marked increase with age. Co-proxamol comprised 32% of deaths from paracetamol compounds, and 95% of antidepressant deaths were due to tricyclic antidepressants. There was no association in women between Carstairs area deprivation and suicide rates; in men rates were highest in the most deprived areas. Conclusion Suicides in the over 65 year olds may be decreased by changes in prescription practice. Paracetamol, co-proxamol, tricyclic antidepressants and benzodiazepines should be prescribed with caution to the elderly with depression or at high risk of depression. Copyright © 2002 John Wiley & Sons, Ltd. [source]