Medical Conditions and Nearly Lethal Suicide Attempts

P hysical illness has been studied as a risk factor for suicidal behavior, but little is known about this relationship among younger persons. We conducted a population‐based, case‐control study in Houston, Texas, from November 1992 through September 1995. The final sample consisted of 153 case‐ and 513 control‐subjects aged 13 to 34 years. Case patients were identified at hospital emergency departments and met criteria for a nearly lethal suicide attempt. Control subjects were recruited via a random‐digit‐dial telephone survey. Case patients were more likely than controls to report having any serious medical conditions (crude OR = 3.23; 95% CI = 2.12–4.91). After controlling for age, race/ethnicity, alcoholism, depression, and hopelessness, the adjusted odds ratio for men was 4.76 (95% CI = 1.87–12.17), whereas the adjusted odds ratio for women was 1.60 (95% CI‐0.62–4.17), suggesting that young men with medical conditions are at increased risk for nearly lethal suicide attempts. Increased efforts to identify and appropriately refer these patients are needed.     

A Gricean Interpretation of Nāgārjuna’s Catuṣkoṭi and the No-Thesis View

Nāgārjuna (c. 150–250 CE), the famous founder of the Madhyamika School, proposed the positive catu?ko?i in his seminal work, Mūlamadhyamakakārikā: ‘All is real, or all is unreal, all is both real and unreal, all is neither unreal nor real; this is the graded teaching of the Buddha’. He also proposed the negative catu?ko?i: ‘“It is empty” is not to be said, nor “It is non-empty,” nor that it is both, nor that it is neither; [“empty”] is said only for the sake of instruction’ and the no-thesis view: ‘No dharma whatsoever was ever taught by the Buddha to anyone’. In this essay, I adopt Gricean pragmatics to explain the positive and negative catu?ko?i and the no-thesis view proposed by Nāgārjuna in a way that does not violate classical logic. For Nāgārjuna, all statements are false as long as the hearer understands them within a reified conceptual scheme, according to which (a) substance is a basic categorical concept; (b) substances have svabhāva, and (c) names and sentences have svabhāva.