Suicide in rural communities

The public image of rural areas being characterized by social stability, integration, and supportive interpersonal networks has been challenged with recent evidence showing a large increase in the suicide rate in these areas. Increases have been reported for a number of European countries, including Sweden, Denmark, Scotland, and Ireland. This paper reviews the evidence relating to those groups at risk of suicide. The group at most risk of committing suicide in rural areas is males between the ages of 25 and 60, who are unemployed and live alone, and who have a history of psychological disturbance. These findings are discussed in relation to the psychological implications of socio-economic changes brought about by changes in the Common Agriculture Policy of the European Community.     

Suicide Attempters in Norway

ABSTRACT: A personal follow-up study is presented of 74 patients consecutively admitted to a Norwegian psychiatric hospital who had attempted suicide during the six months prior to admission. The mean observation time subsequent to discharge was eight years. Of these 74 patients, 5 later committed suicide (6.8 percent) and 16 (26 percent of the living) repeated the suicide attempt. The clinical and social course for the living patients is described. A previous report of a similar follow-up study on patients in a psychiatric department had demonstrated a much lower frequency of subsequent suicide and suicide attempts and a higher percentage of clinical cure and social rehabilitation. These differences are discussed and ascribed mainly to the greater proportion of psychotic patients in the hospital sample (82 percent versus 34 percent).     

Suicide in nurses.

The worldwide English language literature on suicide in nurses is reviewed in this article. There is evidence from several countries that female nurses are at increased risk of suicide. Very little information is available about the specific causes. Increased risk in nurses has been statistically associated with smoking and negatively related to extent of caffeine consumption. Unlike some other high-risk occupational groups, it is unclear to what extent access to means for suicide contributes to nurses' risk. The methodological issues and specific needs of research concerning suicide in nurses are discussed.     

Suicide notes in alcoholism

Alcoholism is associated with a vast number of suicides. The most systematic study of suicide among alcoholics is the work of Eli Robins and George Murphy. The suicide notes in these studies have remained unanalyzed to date. The present analysis suggested that these suicide notes of alcoholics did not differ from those of nonalcoholics; core themes in their deaths are unbearable psychological pain, cognitive constriction, indirect expressions, rejection-aggression, and identification-aggression. Although caution is in order in accepting the null hypothesis, we can at least suggest that further study is needed.     

Suicide in Later Life

SUMMARY

This paper outlines the suicide trends of different groups in Australian society, highlighting the continuing very high rates among elderly men in particular. Risk factors and protective factors are examined. As up to 90% of those who complete suicide have a depressive disorder at the time, this paper concentrates on the detection and treatment of depression. Treatment of depression at a broad community level may offer the best hope of suicide prevention. Survivors face intense unpleasant emotions, and sometimes allocate blame, which can be painful and divisive for all concerned.     

Suicide in Ibsen's Plays

ABSTRACT: The suicides and homicides in Ibsen's plays are examined in relation to Hendin's hypotheses about Scandinavian suicide. In general, the suicides had dependency loss characteristics; the victim-precipitated homicides had characteristics of guilt over transgression, as expected. However, elements of suicide as a vehicle for preserving or restoring an ideal self-image were also present in many of the characters, suggesting that Hendin's conclusions about the Scandinavians may be oversimplifications.     

Suicide Prediction

ABSTRACT: Methodological problems intrinsic to suicide prediction are discussed. The research on suicide predictive signs derived from attributes of the suicidal person, his behavior, and his surroundings, and on predictive instruments is reviewed. The results of these researches are equivocal, in that neither single signs, standard psychological tests, specially devised tests, clinical judgments, nor scales are found to be able to predict suicide at useful levels. Scales are shown to offer the best predictive potential, but to date their construction has not been systematic. It is proposed that scales might be better constructed and prediction improved if investigators were to consider the focus, duration, inclusion-exclusion, interactions and subgroupings, and generalizability of suicidal indices.     

Temperamental Vulnerability and Suicide Risk After Attempted Suicide

The aim was to extend recent findings of suggested temperamental features in attempted suicide and to explore possible domains of vulnerability to suicide risk after attempted suicide. Fifty-four psychiatric inpatients hospitalized after a suicide attempt underwent lumbar puncture for analysis of CSF 5-HIAA concentration and also completed the Karolinska Scales of Personality (KSP) before discharge from the hospital. Suicide attempters scored high on Somatic Anxiety, Psychic Anxiety, and Muscular Tension, and low on Socialization, findings that support recent findings in suicide attempters followed up after an emergency room visit. Five patients committed early suicide, i.e., within 3 years, and the overall long-term suicide mortality after attempted suicide was 13%. There were significant correlations between survival time among early suicides and CSF 5-HIAA (r = .87;p = .054), and the following KSP scale t scores: Somatic Anxiety (r = ?.96;p < .05), Impulsivity (r = ?.88; p < .05), and Socialization (r = .90; p < .05). KSP Socialization showed correlations with CSF 5-HIAA (r = .89; p = .046) among the early suicides. Features of temperamental vulnerability to suicide risk after attempted suicide might involve anxiety proneness, impulsivity, low socialization, and low CSF 5-HIAA.     

Reporting of Suicide

ABSTRACT: This limited study based on publicly available statistics provides strong support for the belief that underreporting of suicide in Canada may be considerable. If this is true, it immediately justifies a greatly increased effort to refine and upgrade the ascertainment procedures so as to make the recorded statistics of more value in assessing the size and epidemiological relationships of the public health problem. From this study has also emerged the idea that, in any given community, there may exist some “general tendency” to violent and unrestrained behavior—a tendency that influences the rates for both suicide and comparable accidents in a similar direction. To explore this and similar concepts adequately requires greater refinement and reliability of the basic statistical data.