Reported childhood trauma and suicide attempts in schizophrenic patients

Childhood traumas are associated with suicidal behavior but this aspect has not been examined in relation to schizophrenia. In this study, 50 chronic schizophrenic patients who had attempted suicide were compared with 50 chronic schizophrenic patients who had never attempted suicide for their scores on the 34-item Childhood Trauma Questionnaire (CTQ). It was found that schizophrenics who had attempted suicide reported significantly higher CTQ scores for emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect than schizophrenics who had never attempted suicide. Therefore, childhood trauma may be a risk factor predisposing schizophrenic patients to attempt suicide.     

Absolutism in the diary of a suicide

The incidence of three words indicative of irrational thinking (perfect, always, and never) did not increase in the diary of a suicide over the course of the year preceding her suicide.     

Depression, hopelessness, and self-esteem: accounting for suicidality in adolescent psychiatric inpatients

The present study was designed to examine depression, hopelessness, and self-esteem as related to suicidal behavior in three groups of depressed adolescent psychiatric inpatients. Depressed adolescents who had never attempted suicide were compared to depressed adolescents who had attempted suicide once and to depressed adolescents who had attempted suicide on several different occasions. Results showed that suicidal adolescents experienced significantly greater depression and hopelessness than did the nonsuicidal adolescents. However, all three groups of depressed adolescents reported similar low levels of self-esteem. Measures of depression and hopelessness were useful in classifying the adolescents based on their suicidal behavior. Results suggest that the treatment of suicidal adolescents could benefit from strategies that focus on reducing feelings of depression and hopelessness.     

Young suicide attempters compared with a control group: psychological, affective, and attitudinal variables

Suicide attempters admitted to a general hospital psychiatric ward completed questionnaires to elicit information following their suicide attempt. Compared to normal controls who had never attempted suicide, suicide attempters were significantly more hopeless, depressed, and hostile. The suicide attempts seemed to occur in response to stress. A crisis intervention model was suggested as the most appropriate way of managing these patients.     

Risk Factors for Attempting Suicide in Heroin Addicts

In order to examine risk factors for attempting suicide in heroin dependent patients, a group of 527 abstinent opiate dependent patients had a psychiatric interview and completed the Childhood Trauma Questionnaire. Patients who had or had never attempted suicide were compared on putative suicide risk factors. It was found that 207 of the 527 heroin abusers (39.3%) had attempted suicide. Attempters were younger; more were female, reported childhood trauma, a family history of suicidal behavior, a history of aggression, treatment with antidepressant medication, and alcohol and cocaine dependence. Logistic regression revealed that a family history of suicidal behavior, alcohol dependence, cocaine dependence, and treatment with antidepressant medication were significant predictors of attempting suicide. These results suggest that attempting suicide is common among opiate dependent patients and that both distal and proximal risk factors may play a role.     

Revisiting the association of aggression and suicidal behavior in schizophrenic inpatients

Our study investigated the association of aggression and suicidal behavior in schizophrenic inpatients. Eight thousand nine hundred one admissions for schizophrenia (1998-2007) to a psychiatric university hospital were included. Schizophrenic suicides (n = 7)/suicide attempters (n = 40) were compared to suicides (n = 30)/suicide attempters (n = 186) with other diagnoses and to schizophrenic non-attempters regarding aggression. Logistic regression analysis was performed to explore risk factors for attempted suicide. Schizophrenic suicides/suicide attempters did not differ from other suicides/suicide attempters or from schizophrenic non-attempters with regard to aggression. Risk of inpatient suicide attempt was increased for patients with attempted suicide at admission, high school graduation, and disorganized subtype. Aggression could not be found to be a predictor of attempted suicide. Aggression seems to have a minor role for suicidal behavior in schizophrenia.     

Manifest Predictors of Past Suicide Attempts in a Population of Icelandic Adolescents

Past suicide attempts have been found to be a major risk factor for both repeated attempts and completed suicide. The utility of this is, however, limited by the fact that the majority of all suicide attempts never come to professional attention. This paper explores the possibility of using manifest indicators to predict which individuals in a population of adolescents have attempted suicide. Using logistic regression, manifest predictors in the categories of school, leisure, peer and parent relations, consumption, and contact with suicidal behavior could identify either a quarter of the population containing three quarters of all suicide attempters or 2% of the population where two thirds of those predicted actually had attempted suicide. It is thus concluded that manifest predictors can complement psychiatric screening methods by efficiently reducing the number to be screened.     

Childhood trauma and suicidal behavior in male cocaine dependent patients.

A consecutive series of 100 male cocaine dependent patients were interviewed about suicidal behavior and completed the 34-item Childhood Trauma Questionnaire (CTQ) to determine whether childhood trauma is associated with suicidal behavior in cocaine dependent men. Patients who had attempted suicide (n = 34) reported significantly higher scores for childhood emotional abuse, physical abuse, sexual abuse, and emotional and physical neglect than patients who had never attempted suicide (n = 66). In this study, various childhood traumas were found to be significantly associated withsuicidal behavior among adult male cocaine dependent patients.     

Suicide and the military justice system.

The United States military is sensitive to suicide. There are military policies that direct the formation of active suicide prevention programs. The U.S. military emphasizes a humanitarian approach. Modern military law, however, may view suicidal behavior as deviant. The prosecution of this behavior, although theoretically possible, has never occurred until recently. The U.S. military has now convicted soldiers for attempted suicide and assisted suicide. This article reviews these recent court decisions and suggests revisions in the military law.     

Suicide attempts in runaway youths

This study explored suicidal behavior in 291 adolescents who were using runaway shelters in St. Louis. Thirty percent of the runaways reported having attempted suicide in the past. The suicide attempters had significantly more behavioral and mental health problems, and reported having more family members and more friends with problems, than nonattempters. A logistic regression showed that youths' substance use, behavior problems, family instability, and sex all helped to explain their suicide attempts. Most of the attempters made their first attempt by their midteens. One-quarter made their latest attempt shortly before entering the shelter, and one-fifth stated that they would still consider suicide. The great majority of attempts were not preplanned, but one-third followed troubles or arguments at home and feelings of confusion and depression. Remarkably, half of the teenage suicide attempters never received any professional help following their attempt.     

Hopelessness as a predictor of attempted suicide among first admission patients with psychosis: a 10-year cohort study

Little is known about the longitudinal relationship of hopelessness to attempted suicide in psychotic disorders. This study addresses this gap by assessing hopelessness and attempted suicide at multiple time-points over 10 years in a first-admission cohort with psychosis (n = 414). Approximately one in five participants attempted suicide during the 10-year follow-up, and those who attempted suicide scored significantly higher at baseline on the Beck Hopelessness Scale. In general, a given assessment of hopelessness (i.e., baseline, 6, 24, and 48 months) reliably predicted attempted suicide up to 4 to 6 years later, but not beyond. Structural equation modeling indicated that hopelessness prospectively predicted attempted suicide even when controlling for previous attempts. Notably, a cut-point of 3 or greater on the Beck Hopelessness Scale yielded sensitivity and specificity values similar to those found in nonpsychotic populations using a cut-point of 9. Results suggest that hopelessness in individuals with psychotic disorders confers information about suicide risk above and beyond history of attempted suicide. Moreover, in comparison with nonpsychotic populations, even relatively modest levels of hopelessness appear to confer risk for suicide in psychotic disorders.     

Psychiatric and substance use disorders as risk factors for attempted suicide among adolescents: a case control study

The objective of this research was to test substance-related and non-substance-related psychiatric disorders as predictors of attempted suicide among adolescents. Ninety-six psychiatrically disordered suicide attempters were matched one-to-one to 96 psychiatrically disordered non-attempters on age, race, gender, and the presence/absence of major depression. Conditional logistic regression was used to test psychiatric risk factors for their power to predict attempted suicide among adolescents. Bipolar disorder, cocaine use disorders, and conduct disorder were found to be predictive of attempted suicide in univariate testing. Bipolar disorder, inhalant use disorders, cocaine use disorders, and hallucinogen use disorders were found to be predictive of attempted suicide, after adjusting for all other covariates. Loglinear analyses revealed high odds ratios associated with the comorbidities of alcohol use disorder with conduct disorder and drug use disorders with conduct disorder in both groups. Higher rates of cocaine use disorder/conduct disorder, hallucinogen use disorder/conduct disorder, and alcohol use disorder/ conduct disorder were found among suicide attempters. Evaluation of these particular comorbid conditions should be part of the adolescent suicide risk assessment.     

Alcohol use disorders and risk factor interactions for adolescent suicidal ideation and attempts.

Four hundred eighty-two adolescents who were diagnosed with at least one mental disorder were studied to determine the predictors of suicidal ideation and suicide attempts. Major depression was predictive of suicidal ideation and suicide attempts for both genders. Chronic stress was found predictive of male suicidal ideation, while low self-esteem and high family dysfunction were found to be predictive of suicidal ideation in females. Statistical trends suggest that females with comorbid alcohol use/conduct disorder were approximately three times more likely to have attempted suicide than those with only one of these conditions. Clinicians working with adolescents should be aware that, while depression remains the number one clinical risk forsuicidal behavior, risk factors for suicidal ideation may be different than those for attempted suicide and may vary by gender.     

Frequency of Suicidal Thought and Self-Destructive Behavior among Females

ABSTRACT: The focus of the present investigation was to examine the importance of a control group in suicide research and to develop an instrument to disguish between levels of suicidal thought among subjects who had a history of attempted suicide and among a comparison group of nonsuicidal individuals. The sample was comprised of female university students ranging in age from 18 to 25 years. A 31-item questionnaire designed by the investigator was given to 199 students, 20 of whom were found to have histories of one or more previous suicide attempts. The remaining 179 nonsuicidal subjects were divided into two categories based on the frequency of expressed suicidal thought. Fifty individuals were randomly selected from each of these two groups. The three groups (individuals who had attempted suicide, individuals who had not attempted suicide but who thought about suicide on a frequent basis, and individuals who had not attempted suicide and who thought about suicide on an infrequent basis) were compared on the variables of motivation for suicidal thoughts, history of self-destructive behaviors, probability of a future suicide attempt, and age of first suicidal considerations. A chi-square analysis was performed on each of these items in order to assess the extent to which the items discriminated among the three comparison groups. The differences among the three groups on each of the items were found to be statistically significant at less than the .01 level. The results of the study have provided support for the necessity of a distinction between groups within a nonsuicidal comparison population and for the suggestion that there may be a quantitative relationship between the frequency of suicidal thought and the likelihood of attempted suicide.     

Perspectives in suicidology: families, mental illness, and suicide

The ways in which the key words "family," "mental illness," and "suicide" are interpreted in the context of research into suicide will influence the formation of theories, the interpretation of results, and the development of suicide prevention strategies. It is argued that there is no general agreement about the meaning of these words.     

A population-based study of the association between pathological gambling and attempted suicide

The association between pathological gambling and attempted suicide was examined using data from a prevalence study conducted in Edmonton, Alberta, Canada. The sample size was 7,214, the questionnaire was the Diagnostic Interview Schedule, and diagnoses were made on a lifetime basis according to DSM-III criteria. Logistic regression analysis was performed, with attempted suicide as the dependent variable. The odds ratio for pathological gambling was statistically significant (odds ratio = 4.91; 95% confidence interval = [1.41,17.1]) when major depression was the only comorbid mental disorder in the model. As terms for additional mental disorders were included, pathological gambling ceased to be statistically significant. It was concluded that a history of pathological gambling is associated with previous attempted suicide, and that the association may be due to a common factor--"mental illness."     

Community Reactions to Attempted and Completed Child Suicide1

In order to assess community reactions to attempted and completed child suicide, 180 shoppers were asked to read a short newspaper article about a 10-year-old who either (a) attempted suicide, (b) completed suicide, (c) completed suicide after having previously attempted, (d) was psychiatrically hospitalized, (e) died of a viral illness, or (f) died of an accident. Subjects then completed a 9-item Likert scale designed to assess their reactions. A2 × 6 (Gender of Victim × Type of Incident) multivariate analysis of variance indicated a significant effect only for type of incident. Families of psychiatrically hospitalized adolescents received milder reactions than families of suicide attempters, in terms of (a) other's assessment of their psychological health, (b) how long they were expected to be sad and depressed after the incident, and (c) how tense respondents expected to feel while visiting them. Apparently, families of suicide attempters must face many of the same negative community reactions as families whose loved ones actually die by suicide, whereas families who have a loved one psychiatrically hospitalized face less problematic reactions from others in the community.     

Adolescent alcohol use and suicide indicators among adolescents in Hawaii

Research on suicide has focused on gender, age, ethnicity, and psychiatric profiles. However, few studies have examined alcohol use and its relationship to suicide among Native Hawaiians and other Asian American/Pacific Islanders. This study analyzes data from the 1997 and 1999 Hawaii Youth Risk Behavior Survey to examine whether alcohol problems increase the risk for suicide indicators (as evidenced by responses to questions asking whether an individual has considered, planned, attempted, or required treatment for a suicide attempt). Drinking pattern was the best predictor for all suicide indicators. School and community-based programs can help to increase an adolescent's knowledge about the consequences of alcohol use and prevention of suicide.     

Mental Disorders and Socioeconomic Status: Impact on Population Risk of Attempted Suicide in Australia

The population attributable risk (PAR) of mental disorders compared to indicators of socioeconomic status (SES) for attempted suicide was estimated for Australia. For mental disorders, the highest PAR% for attempted suicide was for anxiety disorders (males 28%; females 36%). For SES, the highest PAR% for attempted suicide in males was for occupation (males 31%; females 16%) and education level (males 19%; females 8%), following adjustment for age and mental disorders. The study results suggest that one third of suicide attempts in both males and females are attributable to anxiety disorders, the same proportion attributable to low educational or occupational status.     

Incidence of near-death experiences following attempted suicide

Near-death experiences (NDEs), profound subjective experiences occurring during a close brush with death and containing transcendental or mystical elements, have been reported to reduce suicidal ideation, despite their "romanticization" of death. Among 61 consecutive hospital admissions for attempted suicide, 16 patients (26.2%) reported NDEs precipitated by the attempt. NDEs were not significantly associated with any demographic factors. In light of the frequency of NDEs following attempted suicide, further studies are indicated in regard to the effect of those experiences on subsequent suicidal behavior.