Suicide as an indicator of quality of life: apparent conflict between microeconomic and macroeconomic approaches.

While a low incidence of suicide may indicate a high quality of life for individuals, the reverse may be true at the societal level.     

Suicide and homicide rates: their relationship to latitude and longitude and to the weather

The variation of suicide and homicide rates in the major standard metropolitan statistical areas of the United States was explored to see whether regional variations in temperature and precipitation could account for some of the variation. Controls for temperature eliminated the North-South variation in suicide rates, but not the North-South variation in homicide rates or the East-West variation in suicide rates. Only the correlation between precipitation and homicide rates survived controls for latitude and longitude.     

Suicide, schizophrenia, and schizoid-type psychosis: role of life events and childhood factors

The first objective was to identify the provoking events of suicide in patients with schizophrenia or schizoid-type disorder, and to assess the humiliation component of these events. The second objective was to verify if quality of care during childhood is a vulnerability factor for suicide in patients with schizophrenia or schizoid-type psychosis. Thirty-three cases of suicide with a diagnosis of schizophrenia or schizoid-type psychosis were compared with 34 living patients with a similar diagnosis. The psychological autopsy method was used. The assessments were made with the Structured Clinical Interview for the Diagnostic and Statistical Manual for Axis I mental disorders, the Life Events and Difficulties Schedule, and the Child Experiences and Child Abuse Interview. The suicide group (SG) experienced more often a recent severe event, usually of a humiliation nature, than the control group (CG). It also experienced more severe events associated with aggressive behavior or with psychiatric impairment. Contrary to expectations, the CG had worse scores than the SG for quality of care during childhood. In conclusion, suicide in schizophrenia is related both to environmental stress and to psychiatric impairment.     

Serial homicide: an investigation of behavioural consistency

To examine if serial homicide offenders are consistent across their crimes, a model was developed empirically that could be used to distinguish between crimes that were instrumental and those that were expressive. The first known three offences in each series of 69 US serial homicides committed by 23 offenders, were examined and the instrumental and expressive themes determined. Three models were then explored that test for consistency across these themes. The most liberal model was found to classify all of the offences effectively and to reveal complete consistency across the three crimes for all offenders. The implications of these results for offender profiling and further study of serial homicide are discussed. Copyright © 2005 John Wiley & Sons, Ltd.     

Health care utilization by low-income clients of a community clinic: an archival study

An archival study was done of 500 medical records from a community clinic serving a low income predominantly Hispanic area of Los Angeles. The data collected included demographic characteristics and presented symptoms or reasons for visit, as well as diagnosis and treatment. The greatest number of patient visits were made for family planning services. A large porportion of the patients who received initial family planning services failed to return to the clinic for follow ups or additional supplies. A total of 208 pregnancy tests were performed in 151 of the 500 cases sampled. Of these, 152 were positive. The most frequently stated reason for requesting pediatric services was for physical exams, accounting for 30% of the visits. It should be noted that the discontinuity of care and insufficient utilization of preventive care seen in these results deserve serious attention by medical clinic administrators. The rate of patients who do not return for family planning after the initial visit is worrisome. A greater effort to attract women to family planning services at the time they request pregnancy verification could reduce the need for abortion of unwanted pregnancy. The data also indicate that changes in the wording of certain questions commonly asked of clients may be needed. This study allowed service providers to obtain important information about their performance, their needs, and the future direction that their services might take. This type of analysis is relatively low in cost and can yield important benefits, espicially if done on a periodical base in a search for policy implications.     

Pathological narcissism and serial homicide: Review and case study

Serial homicide, as a psychopathological condition, has been described as long ago as 1886. The traits and characteristics of serial murderers are varied, as are the theories that attempt to explain their motivation. Theorists have emphasized, for example, traumatic events in early life, sexual disturbance and dynamics, and neurobiological abnormalities. In the past fifteen years, as narcissistic disturbance in general has been better understood, a relationship has been noted between pathological narcissism and serial homicide. Narcissistic personality disorder, narcissistic injury, underlying feel-ings of inadequacy and humiliation, self-glorifying compensatory fantasies, and the erection of narcissistic defenses have all been mentioned as important factors in un-derstanding the serial killer. An illustrative case report, which encompasses many of these characteristics, is presented here along with a review of clinical research, theory, and findings.     

Religion/spirituality and quality of life of international tertiary students in New Zealand: an exploratory study

Previous research links religion/spirituality to beneficial health outcomes, but the majority of these studies used samples from populations with long-term illness or older people. The present study explored whether the links between religion/spirituality and quality of life can be observed in a sample of younger adults, and also whether religion/spirituality could function as a coping mechanism in international tertiary students who are often subjected to significant stressors related to acculturation and being away from their families. The sample consisted of 218 domestic and 164 international students at a New Zealand university who were given the quality of life inventory and the additional special module about spirituality/religion/personal beliefs, both developed by the World Health Organization in collaboration with many member states. Religion/spirituality was significantly correlated with psychological quality of life in both groups, and social quality of life in international students. The results also show that religion/spirituality might function as a coping mechanism in international students in response to stressors of acculturation.     

Assisted Suicide,Euthanasia, and Suicide Prevention: The Implications of the Dutch Experience

What impact would legalization of assisted suicide and euthanasia have on our ability to treat suicidal patients and to prevent suicide? Information from a study of the Dutch experience illustrates how legal sanction promotes a culture that transforms suicide into assisted suicide and euthanasia and encourages patients and doctors to see choosing death as a preferred way of dealing with serious or terminal illness. The extension of the right to euthanasia to those who are not physically ill further complicates the problem. So too does the tendency of doctors in such a culture to begin to feel that they can make decisions about ending the life of competent terminally ill patients without consulting the patient. “Normalizing” suicide as a medical option lays the groundwork for a society that turns euthanasia into a “cure” for suicidal depression.     

Physiological Reactions to a Suicide Film: Suicide Attempters,Suicide Ideators,and Nonsuicidal Patients

A film about two teenagers who commit suicide was shown to three groups of psychiatric inpatients: 17 who had attempted suicide, 20 who had expressed suicidal thoughts, and 10 who were not suicidal. Anxiety before and after the film was evaluated with psychometric (anxiety rating scale) and physiological tools (heart and respiration rate, blood pressure, electromyogram). Values noted before and after screening, and the degree of change in these values, were compared. In addition, psychomotor agitation was rated at several points during the film. Most results were negative. The suicide attempters had significantly lower postscreening heart rates and a significantly lesser change in heart and respiration rates than the other two groups. The suicide attempters revealed an increase in psychomotor agitation until the discovery of the suicide and a decrease thereafter, whereas the agitation of the nonsuicidal patients continued to increase from the start to the end of the film. The study suggests that on some parameters, suicide attempters reveal less anxiety than nonsuicidal psychiatric patients following exposure to a simulated suicide. The reaction of suicide ideators falls somewhere between the two groups.     

Comparing personality scales across time: an illustrative study of validity and consistency in life-span archival data

The goals of this study were: (a) to examine whether personality scales, meaningful in contemporary terms, could be derived from archival data; and (b) to use these scales to aid our understanding of the relation of personality to mortality. NEO PI-R data and a battery of archival items, taken from Terman's Life Cycle Study, were collected on two new samples (sample 1 mean age = 11.9, n = 167; sample 2 mean age = 22.2, n = 203). Measurement invariance of the archival scales was assessed, and validity was examined using both rational analyses and associations with the Five Factor Model. It was demonstrated that interpretable scales can be derived from 50- to 70-year-old archival data. The archival adult personality data were then used to predict mortality. Conscientiousness remains the strongest personality predictor of longevity. Criteria for establishing the validity of archivally derived scales are suggested.     

Juvenile homicide: The need for an interdisciplinary approach

Most of the empirical literature on juvenile homicide has emerged from the clinical experience of mental health professionals who have diagnosed and/or treated youngsters who killed. After a critical review of this literature, data on 787 juvenile homicide offenders are presented and discussed. These data indicate that intrafamilial killings represent but a small fraction of all homicides perpetrated by juveniles and that there are clear differences between intrafamilial and extrafamilial juvenile homicides.     

“自杀”：一个重要的伦理问题

自杀现已成为人类死亡十大原因之一 ,而且呈现出低龄化的趋势 ,越来越引起社会的关注。因而 ,从政治、经济、社会、疾病、文化等多视角来寻找自杀的外部原因 ,对探究这个重要的伦理问题是有益的。     

The Opinions of GP's Patients About Suicide,Assisted Suicide,Euthanasia, and Suicide Prevention: An Italian Survey

A survey about opinions on end‐of‐life issues of a population represented by 1,171 people in the waiting room of general practitioners' surgeries was conducted in a province of northern Italy. Most subjects did not consider suicide as a reasonable option even in cases of a serious and incurable disease. Moreover, subjects did not consider euthanasia as a possible option either; however, they did express an opposite attitude when considering euthanasia in a third‐person perspective. People with a personal history of suicidal behavior appear to present as a different population, overall expressing more open attitudes.