The epidemiology of suicide in Israel: international and intranational comparisons

A comparison of overall rates of completed suicide is made between Israel and selected European and North American countries. Rates for Israel are generally lower. A second comparison is made among different national-religious groups in Israel. Rates are higher for Jews than for the Muslim minority. An explanation is attempted for both sets of findings.     

Recent life events, social adjustment, and suicide attempts in patients with major depression and borderline personality disorder

This study investigated the impact of recent life events and social adjustment on suicide attempter status in 34 patients with major depression, 24 patients with borderline personality disorder, and 22 patients with co-morbid major depression and borderline personality disorder. Suicide attempters reported more recent life events and scored lower on a measure of social adjustment in their families and overall social adjustment, compared with non-attempters. Borderline disordered and borderline or depressed patients were more likely to have attempted suicide than patients with major depression only. Recent life events did not predict attempter status. Lower social adjustment in the immediate family and lower overall social adjustment were predictive of suicide attempter classification, regardless of diagnosis. Borderline disordered patients low on overall social adjustment were over 16 times more likely to have attempted suicide than patients diagnosed with major depression only. Recent life events may elevate suicide risk in groups already at high risk for suicide completion, whereas high levels of social adjustment may be protective against stress-related suicidal behavior.     

中国自杀未遂的流行特征及影响因素研究

自杀是一个严重的社会问题和公共卫生问题。但目前尚未完全了解自杀的影响因素以及预防自杀的方法。流行病学研究表明自杀未遂是自杀的重要预测因素,了解自杀未遂的特征以及影响因素将有助于减少自杀行为的发生。本文对自杀未遂的流行特征以及影响因素进行了综述。     

The prevalence of suicidal behaviors, attitudes and associated social experiences in an urban population

The development of an epidemiological study of mental health, social background factors, suicidal behaviors (suicidal ideas, deliberate self-harm, and attempted suicide), values concerning suicide, and experience of suicide in others is described. 679 adult respondents in a stratified random sample of residents of a large Canadian city were interviewed. Results indicate a more accepting attitude to suicide than reported in previous studies; considerable experience of suicide in others; and a much higher rate of suicidal ideas and action than has been reported in previous work. Thirteen percent of the sample had made plans for suicide in their lifetime, 6% had deliberately harmed themselves, and a further 4% had attempted suicide in their lifetime. In the past year, 4% had made plans for suicide, and 2% had deliberately harmed themselves or had attempted suicide.     

Trends in attempted suicide in Denmark, 1976-1980

The object of the present study was to estimate proportions and changes in the incidence of suicide attempts in Denmark. Case sheets concerning all admissions in 1976-1979 (total 6,650) at the Department of Psychiatry, Odense University Hospital (the catchment area of which provides a representative sample of the Danish population), were examined with a view to establishing the reasons for admission. Rates of suicide attempts by age and sex in 1976-1979 were calculated, and estimated rates of the suicide attempts in 1980 added. Trend analysis showed an increase in the mean rates from 1976 to 1979 of 48%, followed by a decrease in 1980 of 13%. There were high increases among the adolescents, but the increase was above all due to the fact that more and more men attempted suicide; the study suggests as a new phenomenon more male than female suicide attempters. We stress the fact that incidences calculated on the basis of hospital admissions only underestimate the real proportions of self-destructive behavior.     

Dimensions of Perfectionism,Hopelessness, and Attempted Suicide in a Sample of Alcoholics

This study assessed whether specific dimensions of perfectionism and hopelessness were elevated in individuals who had made a serious suicide attempt in comparison to individuals with no history of suicide attempts. A sample of 39 inpatients with alcoholism who had made a serious suicide attempt and a matched sample of 39 inpatients with alcoholism but no history of suicide attempts completed the Multidimensional Perfectionism Scale, the Hopelessness Scale, ratings of achievement and social hopelessness, and the Beck Depression Inventory. The attempter group had higher scores on socially prescribed perfectionism, generalized hopelessness, achievement hopelessness, social hopelessness, and depression. A discriminant function analysis revealed that depression, social hopelessness, socially prescribed perfectionism, and other-oriented perfectionism were unique discriminators of the suicide groups. The results are discussed in terms of the importance of social personality variables in attempted suicide.     

Suicide and attempted suicide: their relation to subjective social stress indicators

We investigated the relationship between the subjective perception of external stress and suicidal behavior, using a stress model which indicated that the probability of suicide and attempted suicide, as a reaction to stress, increases when social support systems fail or malfunction. We conceived the subjective perception of social stress as expressions of worry or dissatisfaction regarding cardinal life domains such as economic, security, or political situations. We defined support systems in terms of national solidarity expressed as positive (or improved) attitudes regarding the relations between various segments of the population, and we derived the data regarding the subjective indicators from continuing surveys of representative samples of urban Israeli population during the years 1967 through 1979. Eight stress indicators and three solidarity indicators were included, and our findings generally supported the theoretical model. However, the findings regarding men conformed best in relation to suicide, whereas those regarding women confirmed the theoretical model mainly in relation to attempted suicide. Contrary to the model, female suicide rates decreased in times of stress. Feelings of social solidarity in the population were found to reduce suicidal behavior of both men and women.     

Suicide attempts and stressful life events among female victims of intimate partner violence living in poverty in Nicaragua

This article describes a study of 136 female intimate partner violence victims living in poverty in Nicaragua. The paper aimed to analyze the relationship between experiencing stressful life events (SLE) and perceived social support with suicide attempts, and to evaluate the differences in the SLE experienced by female suicide attempters versus non‐attempters. The results showed the existence of a high level of SLE among the interviewees, and that women who have attempted suicide have experienced substantially more of these events. Experiences of violence and less social support were especially related to suicide attempts among the interviewees.     

Predictive and concurrent validity of the Suicidal Ideation Questionnaire among American Indian adolescents

Suicide is currently the second leading cause of death for ages 15–24 years; reports indicate that 6–8% of American teens have attempted suicide. Rates of suicide and suicide attempts are at least as high, if not higher, for American Indian adolescents and young adults. The Suicidal Ideation Questionnaire (Junior High School Version) (SIQ-JR) could be used to identify young people who may be at risk for attempting suicide, since this questionnaire focuses on suicidal ideation, a major risk factor for suicide attempt. However, little is known about the predictive validity of the SIQ-JR, particularly in American Indian adolescent populations. A suicide attempt cluster at an American Indian boarding school provided the unique opportunity to examine the performance of the SIQ-JR in a group of American Indian high school students who had taken the SIQ-JR approximately 2 months prior to the outbreak of attempts. The SIQ-JR proved to be an excellent predictor of future suicide attempts when compared to other measures of distress: anxiety, depression, and alcohol use. The SIQ-JR is an effective screener for suicide risk in this American Indian adolescent population.     

Protective Factors for Suicidal Black Females

The purpose of this study is to evaluate the extent to which a model of social support may help explain the low suicide rate of Black females. The data are taken from the National Institute of Mental Health's Epidemiologic Catchment Area Study 1980–1985 (United States). The LISREL model examines the direct and indirect effects of the background characteristics on attempted suicide as mediated by emotional state. Results indicate evidence that for Black and White males and females, finding emotional and psychological support in friends and family members helps to safeguard against suicide. The most substantial finding is that for all race/sex categories, seeking support from friendship and familial resources is negatively related to attempted suicide, whereas seeking support from professional resources is associated with an increase in the likelihood of a suicide attempt. This increased likelihood of attempted suicide may be reflecting populations members' resistance to seeking professional help until their emotional state has severely deteriorated.     

Suicidality and psychosis: beyond depression and hopelessness

The present study examined recent suicide attempters with and without psychotic disorders in order to understand factors that contribute to suicide ideation during and following the suicide attempt. Patients with psychotic disorders endorsed higher levels of suicide ideation than patients without psychotic disorders. Even when depression, hopelessness, substance abuse, and social problem solving were controlled for, there was a significant association between psychotic disorder and suicide ideation. During the follow-up period, patients with psychotic disorders subsequently attempted suicide at a significantly higher rate than patients without psychotic disorders. The clinical relevance of these findings is discussed.     

Factors of Early Suicide after Discharge: A National Linkage Study for Suicide Victims in Taiwan

Patients recently discharged from psychiatric inpatient care have a higher suicide rate. The study aimed to identify the characteristics associated with early suicide of those patients discharged from psychiatric wards in Taiwan. The results indicated that among 672 suicide victims who died within one year post‐discharge from psychiatric wards in Taiwan between 2000 and 2004, diagnosis of schizophrenia, shorter disease duration, and co‐morbidity with cancer were all significantly associated with suicide occurring within one month of discharge. Clinical diagnosis of psychiatric disorders, recent psychiatric diagnosis, and co‐morbidity with severe physical illnesses should receive special monitoring for potential suicide after discharge.     

Trends in Hanging and Firearm Suicide Rates in Australia: Substitution of Method?

This study examined the increase in the rate of suicide by hanging and an apparently simultaneous decrease in the rate of suicide by firearm as hypothetical evidence that Australian males have substituted one method of suicide for another. Trends in hanging and firearm suicide rates were examined from 1975 to 1998 for all Australian males and from 1971 to 1998 for a subset of Australian male youth, as well as a group of Australian males aged over 64 years at the time of their death. When the firearm suicide rate for Australian males declined the hanging rate increased simultaneously, with no statistical difference in the rate of change of the two methods. A similar pattern of simultaneous divergence in hanging and firearm suicide rates of a 15- to 24-year-old subgroup occurred at a not dissimilar rate over a longer time period. Rates of suicide by hanging were found to have begun increasing prior to the decline in firearm suicide. The declining rate of firearm suicide in the 15- to 24-year-old subgroup coincided with an increase in the overall suicide rate. Relationships between trends in hanging and firearm suicide differed between states and between urban and non-urban areas within Queensland, with the firearm suicide rate falling more rapidly in urban areas, especially following the introductions of restrictions to weapon purchases. Individual suicide method choice may be related to independent changes in the social acceptability of each method, as well as to an increasing prevalence of suicide in younger males, who are more likely to use the hanging method. The functioning and effect of social acceptability remains unclear, however. Intervention and prevention strategies should focus on challenging the social acceptability of hanging, especially among males aged 15 to 24 years.     

Suicide attempts as social goal-directed systems of joint careers, projects, and actions

In the present study we examined to what extent persons who attempt suicide describe their attempt in terms of social, joint processes. Psychotherapists interviewed 40 patients hospitalized in a general hospital for a few days after an attempted suicide. The content of the interviews was analyzed for the level of systemic processes the patients referred to (that is, action, project, and career). The most common processes to which the patients referred were relationship careers and projects and conflicts and argumentative actions. Our analysis indicates that a social process can be found at all levels of the patient's organization of the suicide attempt, within a system of goal-directed action, project, and career.     

The Predictors of Suicidality in Previous Suicide Attempters following Case Management Services

Suicide attempts constitute a serious clinical problem. People who have attempted suicide are at an elevated risk for additional suicide attempts, but there is limited evidence regarding the predictors of suicidality of suicide attempters following case management services. In the present study the indicators of suicidality after case management were examined. A total of 1,056 subjects who had recently attempted suicide were recruited from January 1, 2011, to June 30, 2011. The suicide prevention center of Kaohsiung City in Taiwan provided case management services and followed up on suicide attempt cases for 6 months. The salient factors for repeat suicide attempts were estimated using a logistic regression analysis. The results showed that multiple factors, including a “willingness to receive mental health services during a crisis,” “social support,” “a history of mental disorders,” and “a history of suicide,” could predict repeat suicide attempts with hazard ratios (0.58, 0.54, 3.84, 1.51) and 95% confidence interval (0.39–0.86, 0.36–0.83, 2.41–6.10, 1.03–2.21). The four factors mentioned above were the most accurate predictors of subsequent suicidality when case management services were utilized after 6 months of follow‐up. The findings of our study could help clarify future strategies for suicide prevention.     

Neighborhood predictors of hopelessness among adolescent suicide attempters: preliminary investigation

The role of neighborhood factors in predicting hopelessness among adolescent suicide attempters was examined in this study. Forty-eight adolescents who attempted suicide were administered measures of hopelessness and depression. Family socioeconomic status (SES) was calculated based on family demographics and characteristics of neighborhood context were examined using a geocoding software package. Adolescents who lived in neighborhoods with weak social networks reported higher levels of hopelessness, even after controlling for SES and depression. These preliminary findings suggest that environmental context may play a role in the emotional status of adolescents who attempt suicide.     

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 attempts among drug abusers.

The relationship between substance abuse and suicide is indicated by the high rate of attempted suicide among alcoholics and drug abusers as well as the increased likelihood of repeated attempts in these populations. This study reports on the psychological characteristics of male drug suicide attempters who are in treatment for their addiction problem. Data collected from 166 veterans included background information, symptoms, mood, social functioning, and attitude measures. Of the drug abuse patients, 26 percent reported having made a suicide attempt. These subjects were found to be significantly more depressed, angry, insecure, and anxious than the nonsuicide-attempt drug abusers. Treatment staff need to be sensitized to the possibility of repeated suicide attempts among substance abuse patients.     

Suicide Risk and MMPI Scores,Especially as Related to Anxiety and Depression*

ABSTRACT: Thirty-seven depressive patients were examined, nine of whom had attempted to commit suicide. An MMPI profile and check list was compiled on each patient in order to assess the risk of suicide. It was demonstrated that anxiety and depression are correlated with an increased risk. The specific type of fear is not important; it appears together with social maladjustment, is compressed, and then finds its expression in the cry for help that a suicidal tendency represents.     

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.