Availability and accessibility of medications and toxic substances and suicidal behavior

2016 ◽  
Vol 33 (S1) ◽  
pp. S596-S596
Author(s):  
M. Arsenyan ◽  
S. Sukiasyan ◽  
T. Hovhannisyan
Keyword(s):  
Suicidal Behavior ◽  
Significant Influence ◽  
Crucial Role ◽  
Attempted Suicide ◽  
Conflict Situation ◽  
Toxic Substances ◽  
Suicide Method ◽  
Teenage Girls ◽  
Competing Interest ◽  
Suicidal Crisis

IntroductionScientific research indicates that accessibility of suicide means has a significant influence on the choice of method. Since the choice of suicide method largely depends on availability of suicide means, the lethality of method at hand plays a crucial role in a period of suicidal crisis.AimsWe aimed to reveal the associations between accessibility and availability of medications and toxic substances and suicidal behavior of teenage girls in Armenia.ObjectiveOur objectives were to determine whether accessibility and availability of medications and toxic substances have any impact on development of suicidal behavior among teenage girls in Armenia and whether toxicity and quantity of medications and toxic substances at hand or purchased by attempters are associated with severity of outcome.MethodsA qualitative analysis of patient histories of 26 teenage girls, hospitalized in the ICU, Toxicology Center “Muratsan”, Yerevan, RA, diagnosed as having acute deliberate self-poisoning was performed.ResultsIn majority of cases, conflict situation preceded suicidal behavior and decision on attempting suicide was impulsive. Being emotionally distressed teenage girls reached for medications and toxic substances readily available in the household or bought medications from a pharmacy.ConclusionThe vast majority of teenage girls attempted suicide by medications and toxic substances at hand. Admittedly, both, type of medication and quantity of pills or amount of toxic substances utilized, affected the severity of outcome. Hence, the availability and accessibility of medications and toxic substances played a crucial role in development of suicidal behavior and severity of outcome.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Child and adolescent violence: oral story of women who attempted suicide

2019 ◽  
Vol 72 (6) ◽  
pp. 1450-1456
Author(s):  
Cíntia Mesquita Correia ◽  
Nadirlene Pereira Gomes ◽  
Normélia Maria Freire Diniz ◽  
Isabela Carolyne Sena de Andrade ◽  
Cátia Maria Costa Romano ◽  
...  
Keyword(s):  
Suicidal Behavior ◽  
Attempted Suicide ◽  
Physical Violence ◽  
Qualitative Approach ◽  
Suicide Method ◽  
Psychological Violence ◽  
Adolescent Violence ◽  
Information Center ◽  
History Of ◽  
The City

ABSTRACT Objective: To unveil expressions of intrafamily violence experienced in childhood and/or adolescence by women who attempted suicide. Method: This is a study with a qualitative approach based on Oral Story. Participants were ten women with a history of suicide attempt, who experienced intrafamily violence in childhood and/or adolescence. The research was carried out at the Center for the Study and Prevention of Suicide, linked to a Toxicological Information Center in the city of Salvador, Bahia, Brazil. Results: From the orality of women, the study allowed the emergence of the following representative categories of intrafamily abuse experienced in childhood and/or adolescence: psychological violence, rejection, neglect, physical violence and sexual violence. Final considerations: The study alerts to intrafamily violence as an aggravation related to suicidal behavior, offering elements that help in the identification of their expressions, which will raise awareness to suicidal behavior and consequently suicide prevention.

scholarly journals A case report on attempted suicide by hanging of an adolescent girl

2018 ◽  
Vol 6 (2) ◽  
pp. 78-80
Author(s):  
Kashyap Narsingh Shakya ◽  
Anwesh Bhatta ◽  
Bikash Bhandari
Keyword(s):  
Risk Factors ◽  
Case Report ◽  
Young People ◽  
Suicidal Behavior ◽  
Crucial Role ◽  
Adolescent Girl ◽  
Attempted Suicide ◽  
Suicidal Attempt

Suicidal attempt by hanging is a growing problem during adolescence. Globally, 8.5 % of all deaths among young people is accounted for by suicide. It is preventable, provided the risk factors and pre-suicidal behavior are identified for averting such a tragic happening. Pediatricians have crucial role to play in this.

scholarly journals An Analysis of Suicide Attempts in Jaén Province (Andalusia-Spain)

2015 ◽  
Vol 4 (1) ◽  
pp. 14-26 ◽  
Author(s):  
David Sánchez-Teruel ◽  
José A. Muela-Martínez ◽  
Ana García-León
Keyword(s):  
Emergency Departments ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Age Groups ◽  
Toxic Substances ◽  
Suicide Method ◽  
Hospital Discharges ◽  
Self Harm ◽  
Electronic Medical Record Systems ◽  
The Relationship

AimSuicide is the leading cause of non-accidental death in Spain across both sexes and all age groups; however, data on suicide attempts by region are heterogeneous and little reported. This study aimed to examine the socio-demographic and epidemiological variables most strongly related to suicide attempts in Jaén province.MethodData on people who had attempted suicide over a 26-month period (2009–2011) were collected from the emergency departments of two hospitals via their electronic medical record systems specific to the Autonomous Community of Andalusia (Spain). Descriptive and frequency statistics were obtained and the relationship among variables was examined.ResultsSuicide attempters were aged 24 to 53 years, being primarily women (65.25%). The most frequent suicide method was medication ingestion (85.55%); thus, ingestion of toxic substances has become the preferred method among women (LR(3) = 14.731; p = .02). The hospitals discharged the patients (46.44%) or referred them to mental health services in the area (20.08%) following a suicide attempt. There were more hospital discharges when the attempt involved ingestion of toxic substances or self-harm (LR(12) = 20.603; p = .05), and in winter and spring (LR(12) = 69.772; p < .001).ConclusionThe need for emergency departments to have prevention and intervention procedures in place, specifically designed for suicide attempts and at-risk individuals, is discussed.

Emergency Department Admission and Mortality Rate for Suicidal Behavior

Crisis ◽  
2014 ◽  
Vol 35 (6) ◽  
pp. 406-414 ◽  
Author(s):  
Raimondo Maria Pavarin ◽  
Angelo Fioritti ◽  
Francesca Fontana ◽  
Silvia Marani ◽  
Alessandra Paparelli ◽  
...  
Keyword(s):  
Emergency Department ◽  
Metropolitan Area ◽  
Suicidal Behavior ◽  
Mortality Risk ◽  
Illicit Drugs ◽  
Attempted Suicide ◽  
Cox Model ◽  
Emergency Department Admission ◽  
Completed Suicide

Background: The international literature reports that for every completed suicide there are between 8 and 22 visits to an Emergency Department (ED) for attempted suicide/suicidal behavior. Aims: To describe the characteristics of admission to emergency departments (EDs) for suicide-related presenting complaints in the metropolitan area of Bologna; to estimate the risk for all-cause mortality and for suicide; to identify the profiles of subjects most at risk. Method: Follow-up of patients admitted to the EDs of the metropolitan area of Bologna between January 2004 and December 2010 for attempted suicide. A Cox model was used to evaluate the association between sociodemographic variables and the general mortality risk. Results: We identified 505 cases of attempted suicide, which were more frequent for female subjects, over the weekend, and at night (8:00 p.m./8:00 a.m.). The most used suicide methods were psychotropic drugs, sharp or blunt objects, and jumping from high places. In this cohort, 3.6% of subjects completed suicide (4.5% of males vs. 2.9% of females), 2.3% within 1 year of the start of follow-up. The most common causes of death were drug use and hanging. In the multivariate analysis, those who used illicit drugs 24 hr prior to admission to the ED (hazard ratio [HR] = 3.46, 95% CI = 1.23–9.73) and patients who refused the treatment (HR = 6.74, 95% CI = 1.86–24.40) showed an increased mortality risk for suicide. Conclusion: Deliberate self-harm patients presenting to the ED who refuse treatment represent a specific target group for setting up dedicated prevention schemes.

Stakeholder Perspectives on the Stigma of Suicide Attempt Survivors

Crisis ◽  
2017 ◽  
Vol 38 (2) ◽  
pp. 73-81 ◽  
Author(s):  
Lindsay L. Sheehan ◽  
Patrick W. Corrigan ◽  
Maya A. Al-Khouja ◽  
Keyword(s):  
Suicide Attempt ◽  
Health Professionals ◽  
Attempted Suicide ◽  
Community Based Participatory Research ◽  
Public Stigma ◽  
Suicide Method ◽  
Community Based ◽  
Stakeholder Perspectives ◽  
Personal Experiences ◽  
Prejudice And Discrimination

Abstract. Background: Past scholarly efforts to describe and measure the stigma surrounding suicide have largely viewed suicide stigma from the perspective of the general public. Aims: In the spirit of community-based participatory research (CBPR), the current study brought together a diverse stakeholder team to qualitatively investigate the suicide stigma as experienced by those most intimately affected by suicide. Method: Seven focus groups (n = 62) were conducted with suicide attempt survivors, family members of those who died by suicide, and suicide loss therapists. Results: Themes were derived for stereotypes (n = 30), prejudice (n = 3), and discrimination (n = 4). People who attempted suicide were seen as attention-seeking, selfish, incompetent, emotionally weak, and immoral. Participants described personal experiences of prejudice and discrimination, including those with health professionals. Conclusion: Participants experienced public stigma, self-stigma, and label avoidance. Analyses reveal that the stigma of suicide shares similarities with stereotypes of mental illness, but also includes some important differences. Attempt survivors may be subject to double stigma, which impedes recovery and access to care.

Outreach Psychiatric Emergency Service

Crisis ◽  
2020 ◽  
Vol 41 (5) ◽  
pp. 375-382
Author(s):  
Remco F. P. de Winter ◽  
Mirjam C. Hazewinkel ◽  
Roland van de Sande ◽  
Derek P. de Beurs ◽  
Marieke H. de Groot
Keyword(s):  
General Practitioner ◽  
General Hospital ◽  
Suicidal Behavior ◽  
Emergency Service ◽  
Attempted Suicide ◽  
Emergency Services ◽  
Psychiatric Emergency ◽  
Psychiatric Emergency Services ◽  
Psychiatric Emergency Service ◽  
Suicidal Patients

Abstract. Background: Outreach psychiatric emergency services play an important role in all stages of a suicidal crisis; however, empirical assessment data are scarce. This study describes characteristics of patients assessed by these services and involved in suicidal crises. Method: During a 5-year period, detailed information from psychiatric emergency service assessments was recorded; 14,705 assessments were included. Characteristics of patients with/without suicidal behavior and with/without suicide attempts were compared. Outcomes were adjusted for clustering of features within individual patients. Results: Suicidal behavior was assessed in 32.2% of patients, of whom 9.2% attempted suicide. Suicidal behavior was most commonly associated with depression or adjustment disorder and these patients were referred to the service by a general practitioner or a general hospital, whereas those who attempted suicide were less likely to be referred by a general practitioner. Those who attempted suicide were more likely to be female and have had a referral by a general hospital. Self-poisoning by medication was the most common method of attempting suicide. Limitations: Bias could be due to missed or incomplete assessments. Primary diagnoses were based on clinical observation at the time of the assessment or on the primary diagnosis previously recorded. In addition, suicidal behavior or attempted suicide might have been underestimated. Conclusions: Suicidal behavior is commonplace in assessments by psychiatric emergency services. Suicidal patients with/without a suicide attempt differed with respect to demographic features, primary diagnoses, and referring entities, but not with respect to treatment policy. About 40% of the suicidal patients with/without an attempt were admitted following assessment.

Suicidal Behavior in Four Ethnic Groups in The Hague, 2002–2004

Crisis ◽  
2009 ◽  
Vol 30 (2) ◽  
pp. 63-67 ◽  
Author(s):  
Irene Burger ◽  
Albert M. van Hemert ◽  
Willem J. Schudel ◽  
Barend J.C. Middelkoop
Keyword(s):  
Suicide Attempt ◽  
Ethnic Groups ◽  
Suicidal Behavior ◽  
Emergency Service ◽  
Attempted Suicide ◽  
Public Health Problem ◽  
Specific Rate ◽  
Completed Suicide ◽  
The Hague ◽  
Psychiatric Department

Background: Suicidal behavior is a severe public health problem. Aims: To determine the rates of attempted and completed suicide among ethnic groups in The Hague, The Netherlands (2002–2004). Methods: By analyzing data on attempted and completed suicide (from the psychiatric department of general medical hospitals; the psychiatric emergency service and the municipal coroners). Results: Turkish and Surinamese females aged 15–24 years were at highest risk for attempted suicide (age-specific rate 545 / 100,000 and 421 / 100,000 person-years, respectively). Both rates were significantly higher than in the same age group of Dutch females (246 / 100,000 person-years). Turkish (2%) and Surinamese (7%) had lower repeat suicide-attempt rates than did Dutch (16%) females aged 15–24. Significantly lower suicide-attempt rates were found for Surinamese than for Dutch females aged 35–54 years. Differences were not explained by socioeconomic living conditions. The ratio fatal/nonfatal events was 4.5 times higher in males than in females and varied across age, gender, and ethnicity strata. Completed suicide was rare among migrant females. No completed suicides were observed in the Turkish and Surinamese females aged 15–24 years. Conclusions: The study demonstrates a high risk of attempted suicide and a low risk of completed suicide among young Turkish and Surinamese females.

Incidence of Completed and Attempted Suicide in Trabzon, Turkey

Crisis ◽  
2002 ◽  
Vol 23 (1) ◽  
pp. 3-10 ◽  
Author(s):  
Mustafa Bilici ◽  
Mehmet Bekaroğlu ◽  
Çiçek Hocaoğlu ◽  
Serhat Gürp&inodot;nar ◽  
Cengiz Soylu ◽  
...  
Keyword(s):  
Suicide Risk ◽  
Attempted Suicide ◽  
Medical Center ◽  
Study Data ◽  
Public Prosecutor ◽  
Suicide Method ◽  
Hospital Data ◽  
State Institute ◽  
The Public ◽  
Completed Suicide

Summary: Objective: Studies of completed and attempted suicide in Turkey are based on data of State Institute of Statistics (SIS) and emergency clinics of the large hospitals. This study seeks (1) to find, independent of the SIS and hospital data, the annual incidences of completed and attempted suicide in Trabzon, Turkey; (2) to examine the associated factors between the incidence of completed and attempted suicide. Method: The data are derived by using a method specially designed for this study. Data sources include emergency clinics in all hospitals, village clinics, the Forensic Medical Center of Trabzon, the Governorship of Trabzon, “mukhtars” (local village representatives) of neighborhoods, the Office of the Public Prosecutor of Trabzon, the Police Headquarters and Gendarmerie, and the local press organs. Results: The incidences of completed and attempted suicide per 100,000 inhabitants turned out to be 2.60 and 31.5, respectively, whereas the SIS reported the incidence of completed suicide to be 1.11 per 100,000 inhabitants in Trabzon in 1995. Conclusion: Our results demonstrate that SIS data are inadequate for suicide research in Turkey. Our findings show that the risk of completed and attempted suicide is high in young, unmarried, and unemployed persons, and that these groups must be carefully evaluated for suicide risk. The study highlights the need for culture-specific research on suicidal behavior in Turkey.

Suicide Attempts During Adolescence: Systematic Hospitalization and Crisis Treatment

Crisis ◽  
1999 ◽  
Vol 20 (1) ◽  
pp. 41-48 ◽  
Author(s):  
Jérôme Ottino
Keyword(s):  
Attempted Suicide ◽  
Suicide Attempts ◽  
Psychiatric Treatment ◽  
Health Workers ◽  
Inpatient Unit ◽  
Theoretical Hypothesis ◽  
Initial Resistance ◽  
Provision Of Care ◽  
Suicidal Crisis

This paper deals with an inpatient unit that recently opened in Geneva, specializing in the treatment of patients aged 16-21 years who had attempted suicide or felt the desire to commit suicide. This particular center was established because of the significant weaknesses found in the provision of care to adolescents who had attempted suicide. Despite the growing interest of health workers in this area of study over recent years, the frequency of suicide among the young has not decreased and there are numerous recurrences of the suicide attempts. Further, all efforts to improve the adolescents' compliance with psychiatric treatment have failed to date. The number of drop-outs from treatment is still very high. Thus, the objectives of our inpatient unit are as follows: (1) to overcome initial resistance to treatment and to improve long-term compliance; (2) to decrease the number of recurrent attempts as a consequence of the above, thus increasing life expectancy; (3) to offer the adolescents who have tried (or have contemplated) committing suicide an improved quality of life, after first helping them overcome the suicidal crisis. To achieve these goals, the therapeutic team of the unit proposes short stays during which the work with the adolescents consists of a very intensive psychoanalytic-oriented crisis intervention. Numerous practical aspects of our therapeutic approach in the inpatient unit are related here in detail, always with reference to our theoretical hypothesis.

Suicide attempt in alcohol use disorder and Wernicke encephalopathy: A case report

2016 ◽  
Vol 33 (S1) ◽  
pp. S599-S599
Author(s):  
L. Espinosa ◽  
A. Fortea ◽  
G. Oriolo ◽  
M. Balcells ◽  
C. Oliveras
Keyword(s):  
Risk Factor ◽  
Alcohol Use ◽  
Suicidal Behavior ◽  
Alcohol Use Disorder ◽  
Blood Analysis ◽  
Wernicke Encephalopathy ◽  
Suicidal Attempts ◽  
Competing Interest ◽  
Concomitant Condition ◽  
Image Volume

BackgroundThe relation between alcohol dependence and suicidal behavior is well known and alcohol consumption is a risk factor to take in consideration in order to prevent suicidal attempts. Wernicke encephalopathy (WE) is a common acute neurological disorder caused by thiamine deficiency frequently associated with alcohol use disorder and often infra-diagnosed. Just few cases are reported about the possible correlation between suicidal behaviour and Wernicke encephalopathy.ObjectiveTo describe the possible association between suicidal attempts and Wernicke encephalopathy.MethodsWe report the case of a 57 year old man, with past diagnosis of disthymia and amphetamine abuse disorder, and a history of bariatric surgery, who was hospitalized in the intensive care unit (ICU) of hospital clinic for a suicidal attempt by mean of metro railway precipitation. He presented two episodes of psychomotor agitation in the context of an abstinence syndrome that reverted with midazolam continuous perfusion and clonazepam 8 mg per day. Consequently to medical improvement, he was moved to Psychiatry Unit of Addictive Behavior and finally diagnosed with alcohol use disorder.ResultsIn the physical exam, bilateral nystagmus and cerebellar ataxia were observed. Signs of malnutrition were detected in the blood analysis. In a brain magnetic resonance image, volume deficits in the mammillary bodies, thalamus, cortex and corpus callosum, as well as peri-aqueductal altered signal were observed, all signs compatible with Wernicke encephalopathy diagnoses.ConclusionsWernicke encephalopathy is a frequent concomitant condition in patients with alcohol use disorder. The consequent cognitive decline could represent an independent added risk factor for suicidal behavior.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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