Characteristics of suicide attempters with a high lethality means

2017 ◽  
Vol 41 (S1) ◽  
pp. s889-s889
Author(s):  
C.T. Lee ◽  
S.Y. Lee ◽  
K.U. Lee ◽  
H.K. Lee ◽  
Y.S. Kweon
Keyword(s):  
Clinical Judgment ◽  
Suicide Risk ◽  
Suicide Attempts ◽  
Demographic Variables ◽  
Suicide Attempters ◽  
Exact Test ◽  
Factors Associated ◽  
History Of ◽  
Competing Interest ◽  
Lethal Means

IntroductionSuicide attempts with higher lethality increase the likelihood of suicide completion. Accumulating knowledge on risk factors contributing to higher suicide lethality may help clinicians to allocate their limited resources to more endangered people.ObjectivesTo explore the factors associated with higher lethality in suicide attempts.MethodsAll suicide attempters, who visited the emergency department of Uijeongbu St. Mary's hospital from January 2014 to December 2015, were reviewed retrospectively. We compared between the high vs. the low lethality group, of which had been recorded based on clinical judgment using t-test or Chi2/Fisher's exact test with two-sided P-value of 0.05.ResultsAmong the 753 suicide attempters, the assessed lethality was recorded in 736 cases. Low and highly lethal attempters were 426 (57.9%) and 310 (42.1%), respectively. For demographic variables, the high lethality attempters were significantly more likely to be older (48.3 vs. 44.78; P = 0.009), unemployed (61.0% vs. 56.5%; P = 0.042, without religion (90.9% vs. 84.9%; P = 0.017). For clinical variables, the high lethality attempters were significantly more likely have hopelessness (67.7% vs. 58.2%; P = 0.013) and a history of schizophrenia (4.5% vs. 1.4%; P = 0.023, while they did display any difference for mood disorders. The low lethality suicide attempts were more frequent in patients with comorbid personality disorders (9.2% vs. 4.9%; P = 0.031).ConclusionsThese results are in line with literatures reporting higher suicide risk in people, who are old, unemployed, not having a religion, psychotic and hopeless. These may have been moderated by committing a higher lethal means of suicide at least in part and warrants additional investigations.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Optimizing the assessment of suicide attempters with a decision tree

2016 ◽  
Vol 33 (S1) ◽  
pp. S602-S603
Author(s):  
J. Lopez-Castroman ◽  
D. Delgado-Gomez ◽  
P. Courtet ◽  
E. Baca-Garcia
Keyword(s):  
Decision Tree ◽  
Suicide Attempts ◽  
Clinical Information ◽  
Relevant Information ◽  
Test Set ◽  
Adaptive Tests ◽  
Suicide Attempters ◽  
History Of ◽  
Competing Interest ◽  
Set Up

BackgroundOptimizing psychiatric assessments could help to standardize the use of structured instruments in clinical practice. In recent years, several research groups have applied Computerized Adaptive Tests (CATs) to simplify assessments in depression, anxiety and also suicidal behaviors. We aimed to construct a shortened test to classify suicide attempters using a decision tree methodology that allows the integration of relevant clinical information, namely the history of past suicide attempts, in the construction of the test.MethodsThe sample was composed of 902 adult participants in three subsamples: first-time suicide attempters, psychiatric inpatients that never attempted suicide and healthy controls. The performance of a decision tree built using the items of a previously developed scale for suicidal risk was examined. The history of past suicide attempts was used to separate patients in the decision tree. The data was randomly divided in a training set and a test set. The test set, that contained 25% of the data, was used to determine the accuracy of the decision tree. Twenty-five cross-validations of this set up were conducted.ResultsThe first four items of the decision tree classified correctly 81.4% of the patients.ConclusionAs a result of a methodology based on decision trees that, contrary to CATs, can incorporate relevant information in building the test we were able to create a shortened test capable of separating suicidal and non-suicidal patients. Using all the information that is available improves the precision and utility of instruments adapted for psychiatric assessments.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Attempted suicide in people with co-occurring bipolar and substance use disorders

2017 ◽  
Vol 41 (S1) ◽  
pp. S466-S467
Author(s):  
S. Ben Mustapha ◽  
W. Homri ◽  
L. Jouini ◽  
R. Labbane
Keyword(s):  
Suicide Risk ◽  
Suicide Attempts ◽  
Type I ◽  
Addictive Behaviors ◽  
Co Morbidity ◽  
History Of ◽  
Competing Interest ◽  
The Impact ◽  
Control Study

Aims Study the impact of SUD co-morbidity on suicide risk in patients with BD.MethodsCase-control study during a period of six months from July 2015 to December 2015. One hundred euthymic patients with BD (type I, II or unspecified) were recruited in the department of psychiatry C Razi Hospital, during their follow-up. Two groups were individualized by the presence or not of a SUD co-morbidity.ResultsThe average age of patients with SUD was 44.02 years that of the patients without SUD was 44.12 years.The sex ratio of patients with SUD was 5.25 and that of patients without SUD were 0.61.Twenty-six percent of patients with SUD comorbidity had a history of suicide attempts. Fourteen percent of patients without SUD had a history of suicide attempts.The association between SUD and history of suicide attempts was not significant (P = 0.134).The average suicide attempts were 3.08 for patients with addictive behaviors and 2.00 for patients without SUD.The association between SUD and the number of suicide attempts was not significant (P = 0.375).The means of suicide attempts used were drugs in 12% of cases, 3% of cases by phlebotomy, 3% of cases by hanging, 3% of cases immolation, 2% of cases of organophosphate ingestion, 3% of cases by defenestration, 3% of cases by the precipitation front of a vehicle and 1% of cases by drowning.ConclusionsCo-morbid SUD in individuals with BD is significantly associated with suicide attempts. Individuals with this co-morbidity should be targeted for intensive suicide prevention efforts.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Attempted suicide attention at an emergency room: A hospital-based descriptive approach

2016 ◽  
Vol 33 (S1) ◽  
pp. S603-S603
Author(s):  
D. Torres ◽  
G. Martinez-Ales ◽  
M. Quintana ◽  
V. Pastor ◽  
M.F. Bravo
Keyword(s):  
Emergency Room ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Psychiatric Hospitalization ◽  
Study Results ◽  
History Of ◽  
Competing Interest ◽  
Reported Data ◽  
Medium Cost ◽  
Rule Out

IntroductionSuicide causes 1.4% of deaths worldwide. Twenty times more frequent, suicide attempts entail an important source of disability and of psychosocial and medical resources use.ObjectiveTo describe main socio-demographical and psychiatric risk factors of suicide attempters treated in a general hospital's emergency room basis.AimsTo identify individual features potentially useful to improve both emergency treatments and resource investment.MethodsA descriptive study including data from 2894 patients treated in a general hospital's emergency room after a suicidal attempt between years 2006 and 2014.ResultsSixty-nine percent of the population treated after an attempted suicide were women. Mean age was 38 years old. Sixty-six percent had familiar support; 48.5% had previously attempted a suicide (13% did not answer this point); 72.6% showed a personal history of psychiatric illness. Drug use was present in 38.3% of the patients (20.3% did not answer this question); 23.5% were admitted to an inpatient psychiatric unit. Medium cost of a psychiatric hospitalization was found to be 4900 euros.ConclusionThis study results agree with previously reported data. Further observational studies are needed in order to bear out these findings, rule out potential confounders and thus infer and quantify causality related to each risk factor.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Neuropsychological deficits in past suicide attempters with varying levels of depression severity

2014 ◽  
Vol 44 (14) ◽  
pp. 2965-2974 ◽  
Author(s):  
J. G. Keilp ◽  
S. R. Beers ◽  
A. K. Burke ◽  
N. M. Melhem ◽  
M. A. Oquendo ◽  
...  
Keyword(s):  
Working Memory ◽  
Major Depression ◽  
Rating Scale ◽  
Suicide Attempts ◽  
Past History ◽  
Clinical State ◽  
Suicide Attempters ◽  
History Of ◽  
Attention Memory ◽  
Interference Processing

BackgroundOur previous work identified deficits in interference processing and learning/memory in past suicide attempters who were currently depressed and medication-free. In this study, we extend this work to an independent sample studied at various stages of illness and treatment (mild symptoms, on average) to determine if these deficits in past suicide attempters are evident during a less severe clinical state.MethodA total of 80 individuals with a past history of major depression and suicide attempt were compared with 81 individuals with a history of major depression and no lifetime suicide attempts on a battery of neurocognitive measures assessing attention, memory, abstract/contingent learning, working memory, language fluency and impulse control.ResultsPast attempters performed more poorly in attention, memory and working memory domains, but also in an estimate of pre-morbid intelligence. After correction for this estimate, tests that had previously distinguished past attempters – a computerized Stroop task and the Buschke Selective Reminding Test – remained significantly worse in attempters. In a secondary analysis, similar differences were found among those with the lowest levels of depression (Hamilton Depression Rating Scale score <10), suggesting that these deficits may be trait markers independent of current symptomatology.ConclusionsDeficits in interference processing and learning/memory constitute an enduring defect in information processing that may contribute to poor adaptation, other higher-order cognitive impairments and risk for suicidal behavior.

Suicide attempts preceding completed suicide

1998 ◽  
Vol 173 (6) ◽  
pp. 531-535 ◽  
Author(s):  
Erkki T. Isometsä ◽  
Jouko K. Lönnqvist
Keyword(s):  
Suicide Attempt ◽  
Suicide Prevention ◽  
Suicide Risk ◽  
Suicide Attempts ◽  
Early Recognition ◽  
Preventive Measure ◽  
Time Interval ◽  
Psychological Autopsy ◽  
Autopsy Study ◽  
History Of

BackgroundThis study investigated three questions with major implications for suicide prevention: the sensitivity of the history of previous suicide attempt(s) as an indicator of suicide risk, the time interval from a preceding suicide attempt to the fatal one, and switching of suicide methods by those eventually completing suicide.MethodThe lifetime history of suicide attempts and the methods the victims (n=1397) used were examined in a nationwide psychological autopsy study comprising all suicides in Finland within a 12-month research period in 1987–1988.ResultsOverall, 56% of suicide victims were found to have died at their first suicide attempt, more males (62%) than females (38%). In 19% of males and 39% of females the victim had made a non-fatal attempt during the final year. Of the victims with previous attempts, 82% had used at least two different methods in their suicide attempts (the fatal included).ConclusionsMost male and a substantial proportion of female suicides die in their first suicide attempt, a fact that necessitates early recognition of suicide risk, particularly among males. Recognition of periods of high suicide risk on the grounds of recent non-fatal suicide attempts is likely to be important for suicide prevention among females. Subjects completing suicide commonly switch from one suicide method to another, a finding that weakens but does not negate the credibility of restrictions on the availability of lethal methods as a preventive measure.

Suicide in prisons and remand centres

2021 ◽  
pp. 227-232
Author(s):  
Marco Sarchiapone ◽  
Miriam Iosue
Keyword(s):  
General Population ◽  
Suicide Risk ◽  
Suicide Attempts ◽  
Individual Vulnerability ◽  
High Prevalence ◽  
Common Causes ◽  
Prevention Programmes ◽  
History Of ◽  
Self Harm ◽  
High Level

Suicide is one of the most common causes of death in custodial settings worldwide, accounting for around 10% of prisoners’ deaths. Suicide attempts and suicidal ideation are also more common among prisoners compared to the general population. The high prevalence of suicidal behaviours among prisoners is likely the result of a complex interaction between individual vulnerability and the high level of stress and deprivation caused by the condition of confinement. Among prisoners and inmates, the prevalence of well-established suicide risk factors, such as a history of self-harm, psychopathological conditions, aggressive personality traits, and childhood trauma, is higher than in the general population. Moreover, the loss of freedom and autonomy, social isolation, lack of purposeful activity, and victimization are prison-specific stressors that showed to increase the suicide risk among inmates. Given this complexity, comprehensive multifactored prevention programmes involving the administrative, custodial, and clinical staff are the most effective in preventing suicide.

Psychiatric comorbidity and suicide risk in patients with psoriasis

2016 ◽  
Vol 33 (S1) ◽  
pp. S395-S396 ◽  
Author(s):  
M. Pompili ◽  
M. Innamorati ◽  
D. Erbuto ◽  
A. Costanzo
Keyword(s):  
Suicidal Ideation ◽  
Suicide Risk ◽  
Psychiatric Comorbidity ◽  
Rating Scale ◽  
Suicide Attempts ◽  
The Other ◽  
Depression And Anxiety ◽  
Melanoma Patients ◽  
Competing Interest ◽  
Hamilton Rating Scale

IntroductionPsoriasis has a significant impact on the mental and emotional functioning.ObjectiveIt has been reported that the risk of psychiatric comorbidity increases with the severity of the disorder, and the most frequent associations appear to be those with depression and anxiety.AimsTo analyze the association between psoriasis, mental disorders and suicidal ideation in a sample of patients affected by psoriasis. To investigate the differences between psoriasis patients and patients with other dermatologic diseases.MethodsParticipants were 242 consecutive patients (142 women and 100 men), 112 patients with psoriasis (46.3%), 77 with melanoma (31.8%) and 53 with allergy (21.0%). All patients were administered a structured sociodemographic interview and the following measures: the Hamilton Rating Scale for Depression (HAM-D) and the Hamilton Rating Scale for Anxiety (HAM-A). We also assessed current and previous suicidal ideation and previous suicide attempts.ResultsPatients with psoriasis (compared to other groups of patients) more frequently had a comorbid mood disorder (16.1% vs 3.9% and 0.0%, respectively for patients with melanoma and patients with allergy; χ22 = 14.98; P < 0.001), past suicidal ideation (33.9% vs 15.6% and 18.9%, respectively for patients with melanoma and patients with allergy; χ22 = 2.05; P < 0.01) and attempts (6.3% vs 0.0% and 0.0%, for the other groups of patients; χ22 = 8.37; P < 0.05). Patients with psoriasis reported higher HAM-D scores than melanoma patients.ConclusionsThe clinical evaluation of patients with psoriasis should include the assessment of psychiatric comorbidities and the routinely assessment of suicide risk.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Examining Time Perspective Orientation in Suicide Ideation and Suicide Attempts

2019 ◽  
Vol 38 (8) ◽  
pp. 627-646
Author(s):  
Arezoo Shahnaz ◽  
Boaz Y. Saffer ◽  
E. David Klonsky
Keyword(s):  
Psychological Functioning ◽  
Suicide Risk ◽  
Time Perspective ◽  
Suicide Ideation ◽  
Suicide Attempts ◽  
Time Perspectives ◽  
The Past ◽  
History Of ◽  
Negative Orientation ◽  
Two Measures

Introduction: Time perspective orientation (TPO) refers to the way an individual psychologically and behaviorally connects to temporal concepts of past, present, and future. Previous studies have hypothesized that certain types of time perspectives, such as a negative orientation towards the past, predict negative psychological functioning and outcomes, including suicide risk. The current study examines whether differences in TPOs are linked to suicidal thoughts or suicidal acts using two measures of time perspective. Methods: We recruited a large online U.S.-based sample comprised of three groups: participants with (a) a history of suicide attempts (attempters; n = 107), (b) a history of suicide ideation but no history of attempts (ideators; n = 164), and (c) no history of ideation or attempts (nonsuicidal; n = 194). Results: A Positive Past (d = 0.71) and Negative Past (d = 0.89) orientation yielded large differences between individuals with a history of suicide ideation and nonsuicidal participants, where Positive Past was elevated among nonsuicidal participants and Negative Past among ideators. These differences were not accounted for by depression or anxiety. However, TPO differences between individuals with a history of suicide ideation and individuals with a history of attempts ranged from negligible to small (d range = 0.03—0.33). Discussion: The findings suggest that time perspective may be robustly associated with the development of suicide ideation, but only minimally related to suicide attempts among ideators.

scholarly journals Bipolar disorder first episode and suicidal behavior: are there differences according to type of suicide attempt?

2009 ◽  
Vol 31 (2) ◽  
pp. 114-118 ◽  
Author(s):  
Fernando Silva Neves ◽  
Leandro Fernandes Malloy-Diniz ◽  
Izabela Guimarães Barbosa ◽  
Paulo Marcos Brasil ◽  
Humberto Corrêa
Keyword(s):  
Bipolar Disorder ◽  
Logistic Regression ◽  
Suicidal Behavior ◽  
Suicide Attempts ◽  
First Episode ◽  
Mean Square ◽  
Suicide Attempters ◽  
Lifetime History ◽  
Bipolar Ii ◽  
History Of

OBJECTIVE: The objective of this study was to test the hypothesis that the polarity of the first mood episode may be a marker for suicidal behavior, particularly the violent subtype. METHOD: One hundred and sixty-eight patients diagnosed with bipolar disorder (DSM-IV) were grouped according to type of first episode: depression or manic/hypomanic. Groups were compared for demographic and clinical variables. We performed logistic regression in order to test the association between first episode polarity and suicidal behavior. RESULTS: We found that depressed patients have a lifetime history of more suicide attempts. However, univariate analysis of number of suicide attempts showed that the best model fits the bipolar II subtype (mean square = 15.022; p = 0.010) and lifetime history of psychotic episodes (mean square = 17.359; p = 0.021). Subgrouping the suicide attempts by subtype (violent or non-violent) revealed that manic/hypomanic patients had a greater tendency toward attempting violent suicide (21.2 vs. 14.7%, X² = 7.028, p = 0.03). Multiple logistic regression analysis confirmed this result. CONCLUSION: Depressed patients had more suicide attempts over time, which could be explained by the higher prevalence of bipolar II subtype in this group, whereas manic/hypomanic patients had a lifelong history of more frequent violent suicide attempts, not explained by any of the variables studied. Our results support the evidence that non-violent suicide attempters and violent suicide attempters tend to belong to different phenotypic groups.

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