Patterns of suicide among hospitalized mentally disordered offenders

The case records of 29 mentally disordered offenders who committed suicide in a state hospital were reviewed. Information was collected on demographic and clinical characteristics; time, method and location of the suicides; and the presence of suicide indicators. Comparisons were made between the characteristics of the suicide patients and those of the current hospital population. Major findings were: 80 percent of the suicides were committed by psychotic patients and 66 percent were by patients with diagnoses which included paranoia; 48 percent of the suicide patients had been charged with or convicted of murder or attempted murder; most suicides occurred in individual patient rooms; nearly 50 percent of the patients had a history of suicide attempts; and other common indicators of suicide risk were often masked by psychotic symptomatology. Several recommendations for identifying and managing potentially suicidal patients in this population are presented.     

Association of national cancer mortality and suicide rates

Using WHO data from 1996 instead of 1990, the authors replicated and extended Knodrichin and Lester's 2001 study. Like their study, our total rates of cancer mortality and suicide in a similar sample of 37 European nations of the world were estimated to be positively associated.     

A consideration of the validity and reliability of suicide mortality data

The question of the validity and reliability of suicide statistics may be considered at three levels: (1) Are suicide deaths misidentified or differentially identified across jurisdictions or over time? (2) To what degree are suicide deaths misidentified? and (3) Is the degree to which suicides are misidentified sufficient to threaten the validity of research based on suicide statistics? There is general agreement that suicides are likely to be undercounted, both for structural reasons (the burden-of-proof issue, the requirement that the coroner or medical examiner suspect the possibility of suicide) and for sociocultural reasons. There is also substantial anecdotal and empirical evidence suggesting that the mode of death for some true suicides is in fact certified as other than suicide. Overall, it does not seem that very many true nonsuicides are incorrectly certified as suicides. There is not, however, much agreement as to the degree to which true suicides are undercounted. At least some of the inconsistencies in the findings of different investigators arise because the validity of suicide certification seems to vary from place to place. But the source of apparent conflicts in many of the findings is undoubtedly the lack of a "gold standard" against which the verdicts of any given death certification process can be measured. At best, we can estimate that the sensitivity with which coroners and medical examiners certify true suicides varies from approximately 55% to 99%. A central question in estimating the sensitivity of suicide certification is this: What proportion of true suicides are either equivocal or likely to go unsuspected by the coroner or medical examiner? Very little has been done to investigate this issue. Yet the sensitivity of suicide certification clearly varies for equivocal versus unequivocal suicides. As shown in Table 1.2, specificity is also at issue when it comes to certifying equivocal cases. The final question--whether the degree of undercounting of suicide deaths is so great that it threatens the validity of research based on official statistics--is at the crux of the general concern about suicide certification. There are examples of studies in which conclusions based on crude comparisons of reported suicide statistics appear to be invalid. For the most part, these are comparisons among nations with substantially differing death certification procedures. When official statistics are interpreted with a degree of caution and an understanding of the source and direction of biases likely to affect the published rates, however, it seems unlikely that major conclusions based on these statistics will be in error.(ABSTRACT TRUNCATED AT 400 WORDS)     

Relationships of suicide ideation with cause-specific mortality in a longitudinal study of South Koreans

Using 7-year mortality follow-up data (n = 341) from the 1998 National Health and Nutrition Examination Surveys of South Korean individuals (N = 5,414), the authors found that survey participants with suicide ideation were at increased risk of suicide mortality during the follow-up period compared with those without suicide ideation. The cause-specific analyses showed that, in men, suicide ideation was significantly associated with mortality due to cardiovascular disease, external causes, and other causes. However, there was no significant association between suicide ideation and cause-specific mortality in women. The relationship between suicide ideation and cause-specific mortality in men was not fully explained by baseline health status, socioeconomic status, health behavior, or psychosocial factors.     

Correlations for number of sunspots, unemployment rate, and suicide mortality in Japan

We studied the correlations among sunspot numbers, business cycles, and suicide mortalitites. Based on data from Japan between 1971 and 2001, a significant negative correlation between sunspot numbers and unemployment rate was found, R= -.17. The correlation between suicide mortality and unemployment rate was positive for males (R=.46) and negative for females (R =-.69). Both are statistically significant. The hypothesis that variation of sun activity may affect the economy and the unemployment rate and hence increase the male suicide mortality is raised.     

Low income, unemployment, and suicide mortality rates for middle-age persons in Japan

The relationships between age-specific suicide mortality rates and social life factors for all 47 Japanese prefectures in 1980, 1985, and 1990 were assessed by multiple regression analysis after factor analysis on 20 social life indicators. During this period, Japan experienced a secondary oil crisis in 1980-1983 and a bubble economy in 1986-1990. It was concluded that (1) low income was the major determinant which positively affected suicide mortality rate in middle-aged men during a previous 20-yr. period (1970-1990), (2) urbanization was negatively associated with male suicide mortality rates in most of the age classes in the 1980s, (3) unemployment was one of the major determinants of increased suicide mortality rate in middle-age men in the 1980s, and (4) unemployment was the major factor which was inversely associated with suicide mortality rate for elderly women from 1980 to 1990 in Japan.     

Russian Entrepreneurial Motive Patterns: A Validation of the Miner Sentence Completion Scale in Russia

This study utilises the Miner Sentence Completion Scale Form T, translated into Russian, to compare the entrepreneurial motivation of 120 Russian managers interested in entrepreneurial activity with an American sample found in Miner (1986). This contrast shows very substantial differences between the two groups. After four years a follow‐up study was conducted on the Russian sample. Of the 120 managers who originally took the MSCS, 58 men and women were found actually engaged in running their own businesses. Comparing this follow‐up sample with a similar one provided by Miner, Smith, & Bracker (1994) shows very little difference between American and Russian active entrepreneurs. Correlations of MSCS Form T with two criteria of entrepreneurial success show similar positive results for both samples. Implications for use of the test by Russian authorities are discussed.     

Social inequalities in suicide mortality: Spain and France, 1980-1982 and 1988-1990

In this study we analyzed the socioeconomic differences in mortality from suicide in the economically active male population aged 25-64 years in Spain and France in 1980-1982 and 1988-1990; in the case of Spain the data came from the Eight Provinces Study (Regidor, Gutierrez-Fisac, & Rodríguez, 1995). Individuals were grouped into four categories: professional/managerial, clerical/sales/ service, agricultural, and manual workers. For 1980-1982, among those aged 25-44, professionals and managers had the lowest risk of mortality in Spain, and clerical/sales/service workers in France. These socioeconomic differences in mortality increased in 1988-1990. In 1980-1982, among those aged 45-64, clerical/ sales/service workers had the lowest risk of mortality from suicide relative to the other occupational groups in both countries, but this difference was not maintained in 1988-1990. Thus, differences in suicide mortality for men by occupational status depended in the present study upon both the nation studied and the time period chosen for study.     

The effect of mortality salience on the attitudes toward state control: The case of Russia

Our study examined the effects of mortality salience (MS) on attitudes toward state control in different domains in Russia. Using the theory of Conservatism as Motivated Social Cognition (CMSC) and the Terror Management Theory (TMT), we put forward two alternative hypotheses. Based on the CMSC, MS would enhance the approval of state control in different spheres, while, in line with TMT, the MS effect would be dependent on pre-existing views. The participants in the study were 450 Russian students who completed a questionnaire to measure attitudes toward state control in six spheres of life (the economy, the mass media, political parties, social organisations, science and education). After a week, they were randomly assigned one of three conditions—MS, frightening, and a neutral condition—and again completed the questionnaire on political attitudes. Our results showed that MS mostly provokes “control shifting,” confirming the CMSC's hypothesis. However, a separate analysis conducted among people with different pre-existing political attitudes has revealed that “control shifting” is more pronounced for freedom-oriented participants. We discuss these findings in line with alternative views on the nature of the MS effect and specifics of socio-political context.     

Contribution of imitative suicide to the suicide rate in prisons

Suicide rates in prisons are high. Our aim was to investigate the contribution of imitative suicide to the prison suicide rate. We used Knox tests for space-time clustering in a case register of natural and self-inflicted deaths in prisons in England and Wales and model simulations to estimate the effect size. We found significant space-time clustering among 657 self-inflicted deaths in 90 prisons over 10 years but no space-time clustering among 430 deaths from natural causes in 87 prisons over this period. Model simulations with an imitation rate of 5.8% (CI 1%-11%) reproduced the observed space-time clustering.     

The epidemiology of suicide and attempted suicide

Since more than one century suicides have been registered in national statistics of death causes. They thus furnish one of the few parameters of psychiatrically relevant behaviour by means of which trends, cohort, age-group and period effects can be studied over longer periods. Since the second half of last century, the suicide rates for Swiss males--similar to those found in England and Wales--show a decrease in consecutive birth cohorts up to males born in the decade 1930-1940, and a continued decline in the total trend until about World War II. From then on the suicide rates of males in consecutive birth cohorts have been slowly increasing in the majority of European and North American countries--but not so in Sweden. Opposite to this, the predominantly low rates for females display little change. Further to the considerable differences between nations and the predominance of suicides committed by females in some Asian countries and Cuba, the changes indicate the significance of cultural and economic environmental factors. Typical period effects are mainly the result of changes in conception and conditions of life. In attempted suicide they proceed in a more sensitive and more rapid way and are about ten times higher. Such a period effect showing increases by about 300% in younger age-groups followed by a decline, attaining its peak about 1976, was ascertained in large cities of the Federal Republic of Germany. By the example of the effects of a television serial, the study of causal processes turning collective environmental factors into individual suicidal behaviour, proved that regularities are effective in learning by a process of modelling. Besides, the epidemiological data give essential hints how to treat suicidal behaviour.     

Depression, suicide, and suicide prevention in schizophrenia

Suicide is the single largest cause of premature death among individuals with schizophrenia. Furthermore, epidemiological data indicate that nearly 80% of patients with the diagnosis of schizophrenia will experience a major depressive episode at some time during their lifetime. This report reviews recent findings relative to the risk of suicide in schizophrenia, including data from the Chestnut Lodge longitudinal study of schizophrenia subtypes and symptom domains. Paradoxically, those patients with schizophrenia who are most likely to recover or experience a good outcome are also those at greatest risk for suicide. The reduction of morbidity and mortality in schizophrenia should include depression and suicidality as targets for both psychopharmacological and psychosocial treatment.     

An ecological study of community-level correlates of suicide mortality rates in the Flemish region of Belgium, 1996-2005

An ecological study of age-standardized suicide rates in Belgian communities (1996-2005) was conducted using spatial regression techniques. Community characteristics were significantly related to suicide rates. There was mixed support for the social integration perspective: single person households were associated with higher suicide rates, while religious participation was unrelated and both immigration and the presence of non-European inhabitants had a negative impact. Deprivation had a positive relation with suicide. Population density had a negative influence on suicide rates. Areas with older populations had higher suicide risks than expected. A spatial contagion effect of neighboring communities was present for men. In the conclusion, hypotheses are presented on why an aging population could be associated with higher suicide rates in the community.     

Motives for suicide in suicide notes from women and men

Suicide notes written by 16 adult women and 16 men were evaluated by 16 nonprofessional adult judges with regard to love or work problems as suicide motives. Consistent with current theory on gender and suicidal behavior, women and men did not differ in love or work motives.     

Poverty in Russia

This paper is intended to shed light on the extent of poverty in the Russian Federation. We present estimates of poverty lines and poverty ratios derived from subjective questions used in a data collection for a large household panel (RUSSET). We estimate poverty using a subjective approach, where the level of the poverty line is derived using the opinion of the individual, rich or poor, on poverty. This approach differs from the objective approach to poverty, which defines poverty according to the opinion of experts. Three subjective poverty lines are presented: one the Financial Satisfaction Poverty Line, two the Leyden Poverty Line, and three the Subjective Well-Being Poverty Line. The first two poverty lines are based on subjective questions regarding income and economic welfare while the last concept focuses on satisfaction with life as a whole. The results obtained are compared with each other and with results derived using objective measures and official figures.     

Living circumstances of suicide mortality in a South African city: an ecological study of differences across race groups and sexes

In this study the importance of living area circumstances for suicide mortality was explored. Suicide mortality was assessed across race and sex groups in a South African city and the influence of area-based compositional and sociophysical characteristics on suicide risk was considered. Suicide mortality rates are highest among Whites, in particular White males. Main--and independent--dimensions of the living circumstances of residential areas (i.e., socioeconomic circumstances, economic need, and matrimony) influence age-adjusted suicide rates for both sexes but minimally so for race groups. Less favorable clusters of circumstances have a protective effect.     

A case control study of suicide and attempted suicide in older adults

Risk factors for serious suicidal behavior among older adults were examined in a case control study of 53 adults aged 55 and older who died by suicide or made medically serious suicide attempts and who were compared with 269 randomly selected comparison subjects. Multivariate analyses suggested that risk of serious suicidal behavior was elevated among those with current mood disorders (OR = 179, CI = 52.8-607.6), psychiatric hospital admission within the previous year (OR = 24.4, CI = 1.9-318.7), limited social network (OR = 4.5, CI = 1.4-14.6). The predominant role of mood disorders was confirmed by population attributable risk (PAR) estimates (73.6%), suggesting that the improved detection, treatment and management of mood disorders should be the primary focus of suicide prevention strategies for older adults.