Suicides and Suicide Attempts in Emergency Medicine

Crisis ◽  
2002 ◽  
Vol 23 (2) ◽  
pp. 68-73 ◽  
Author(s):  
Frank-Gerald Pajonk ◽  
Kai Arist Simon Gruenberg ◽  
Heinzpeter Moecke ◽  
Dieter Naber
Keyword(s):  
Emergency Medicine ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Demographic Data ◽  
Age Groups ◽  
Severity Of Illness ◽  
Emergency Physicians ◽  
Completed Suicide ◽  
The City ◽  
Commit Suicide

Summary: Objective: In emergency medicine, suicides and attempted suicides represent a major challenge for emergency physicians (EPs) and paramedics, both in terms of psychiatric and somatic treatment. To date no investigations have been performed to determine prevalence rates, method of suicide or attempted suicide, and the problems faced by EPs when treating these patients. This investigation presents a first evaluation of the complete emergency protocols from a major German city focusing on suicide and parasuicide. Methods: A retrospective analysis of all EP protocols from 1995 in the city of Hamburg was performed. All protocols were evaluated with respect to suicide parasuicide and suicidal ideation. Demographic data and information on method of suicide or attempted suicide, severity of illness, and underlying psychiatric disorder were extracted from the protocols. Results: A total of 26,347 emergency protocols were evaluated. Suicide and attempted suicide were considered either certain, probable, or possible in 743 cases (2.8%). Suicide was committed in 171 cases and attempted were made by 572 individuals. More men committed suicide in all age groups. By far the highest number of suicide attempts were by young men between 18 and 39 years of age. Hanging was the most commonly used method of completed suicide (41%), followed by jumping from a height (21%). The methods of intoxication with medication (54%) and illegal drugs (17%) clearly prevailed in suicide attempts. Documentation of suicides and attempted suicides was revealed to be unsatisfactory. Underlying psychiatric disorders were scarcely recorded. Conclusion: In emergency medicine, the incidence of suicide or the attempt to commit suicide is small, yet disturbing. The frequency assessed may be too low as result of methodology. There is a need to improve the education of emergency physicians and paramedics in this area, and there is a need for data to be collected in a prospective design.

Risk of suicide after attempted suicide in the population of Slovenia from 1970 to 1996

2006 ◽  
Vol 21 (6) ◽  
pp. 396-400 ◽  
Author(s):  
Slavko Ziherl ◽  
Bojan Zalar
Keyword(s):  
Suicide Attempt ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Categorical Variables ◽  
Frequency Table ◽  
Completed Suicide ◽  
The Republic ◽  
And Gender ◽  
Log Linear ◽  
Commit Suicide

AbstractObjective:All suicide attempts cannot predict suicide, therefore we examined those characteristics of suicide attempt which could most accurately predict completed suicide.Subject and methods:Subjects were all individuals registered as committed suicides (N = 16,522) or attempted suicides (N = 15,057) in the register of suicides of the Republic of Slovenia between 1970 and 1996. Log linear analysis of a frequency table was used to uncover relationship between categorical variables.Results:The model we found fit between variables: mode, number of repetitions and type, then between number of repetitions, type and gender, and between mode, type and gender.Discussion:The risk of suicide in those who previously attempted suicide is approximately 773 times higher than the risk of suicide without a previous suicide attempt. Those who attempt suicide by hanging (hanging being in Slovenia the most frequent mode of completed suicide) are at even greater risk to commit suicide.Conclusion:Our data suggests that clinicians should heighten their awareness that any suicide attempt can in some 20% predict suicide. Someone who has attempted suicide by hanging is at the highest risk of suicide.

Analysis of Deliberate Self-Wrist-Cutting Episodes Presenting to the Emergency Department

Crisis ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 155-160 ◽  
Author(s):  
Jin Kim ◽  
Han Joon Kim ◽  
Soo Hyun Kim ◽  
Sang Hoon Oh ◽  
Kyu Nam Park
Keyword(s):  
Emergency Department ◽  
Medical Records ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Psychiatric Interview ◽  
Clinical Variables ◽  
Completed Suicide ◽  
Number Of Patients ◽  
Group A ◽  
Efficacy Of Treatment

Abstract. Background: Previous suicide attempts increase the risk of a completed suicide. However, a large proportion of patients with deliberate self-wrist cutting (DSWC) are often discharged without undergoing a psychiatric interview. Aims: The aims of this study were to investigate the differences in the characteristics and outcomes of patients with DSWC and those with deliberate self-poisoning (DSP) episodes. The results of this study may be used to improve the efficacy of treatment for DSWC patients. Method: We retrospectively reviewed the medical records of 598 patients with DSWC and DSP who were treated at the emergency department of Seoul Saint Mary's Hospital between 2008 and 2013. We assessed sociodemographic information, clinical variables, the reasons for the suicide attempts, and the severity of the suicide attempts. Results: A total of 141 (23.6%) patients were included in the DSWC group, and 457 (76.4%) were included in the DSP group. A significantly greater number of patients in the DSWC group had previously attempted suicide (p = .014). A total of 63 patients (44.7%) in the DSWC group and 409 patients (89.5%) in the DSP group underwent psychiatric interviews. Conclusion: More DSWC patients had previously attempted suicide, but fewer of them underwent psychiatric interviews compared with the DSP patients.

The Prevalence of Suicidal Behaviours among Secondary School Adolescents in the Limpopo Province, South Africa

2003 ◽  
Vol 33 (2) ◽  
pp. 126-132 ◽  
Author(s):  
S. N. Madu ◽  
M. P. Matla
Keyword(s):  
South Africa ◽  
Drug Abuse ◽  
Secondary School ◽  
Attempted Suicide ◽  
Demographic Data ◽  
Limpopo Province ◽  
Suicidal Thoughts ◽  
Drug Overdoses ◽  
Commit Suicide

The aim of this study was to investigate the prevalence of suicidal behaviours among secondary school adolescents in the Limpopo Province. The participants in this study were 435 secondary school adolescents from Polokwane and surrounds. Two hundred and forty-three (56%) participants were female, and 192 (44%) were male. They were aged between 15 and 19 years, with a mean age of 17.25 years ( SD = 1.34). A questionnaire was used to record participants' demographic data and suicidal behaviours, including suicidal thoughts and threats, plans, and attempts to commit suicide). Thirty-seven percent of the secondary school adolescents surveyed indicated having thought of taking their own lives; 17% had made threats or informed others about their suicidal intentions; 16% had made plans to take their own lives but did not carry them through; 21% reported having attempted to take their own lives. These results indicate that a higher percentage of males than females had attempted suicide. The most frequent method used for attempting suicide was self-poisoning (44% of the attempters), followed by drug overdoses (25.3%), hanging (22%), self-stabbing (2.2%), and other methods, such as, jumping from heights, starvation, and drug abuse (6.6%).

scholarly journals Effective Causes of Suicide in Zahedan (in 2015)

2016 ◽  
Vol 9 (6) ◽  
pp. 211
Author(s):  
Narges Forghani ◽  
Mahmooud Bulaq
Keyword(s):  
Attempted Suicide ◽  
Suicide Attempts ◽  
Age Groups ◽  
Economic Conditions ◽  
Poor People ◽  
Main Question ◽  
Middle Income ◽  
Income Levels ◽  
Dangerous Behavior ◽  
Education And Employment

<span lang="EN-US">The present study aims to examine the effective causes of suicide in Zahedan city, Iran 2014-2015. In fact, suicide is a dangerous behavior to end the life, which would impose a social problem and cost a lot of harm to individuals, families and society. The main question is that what are the factors contributing to the suicide? Important assumptions include: marriage and having children reduces the suicide attempts. Education and employment could reduce the incidence of suicide attempts and suicide attempts are higher at a young age. This study makes use of fieldwork and analytical methods. The population of this research included people who committed suicide during nine months, from Azar 2014 to September 2015 and have been referred to Khatamolanbia (PBUH) hospital, Imam Ali (AS) hospital and Zahedan's forensic medicine. The findings suggest that all of 71 samples were Muslims; 36 persons were women (50.7%) and 35 persons were men (49.3%).There isn't any relationship between mental disorders and suicide attempts. The incidence of suicide among people 16 to 30 years old with 83.2% is much more than other age groups. Suicide attempts rates among educated people are less than under diploma with 66.2%. There is no significant relationship between marital status and suicide, but suicide (67.6%) among those without children is more than people with a family. Suicide attempts among people with higher-income levels and favorable socio-economic conditions and poor people with 15.5%, is much less than middle-income and good-income with 84.5%. 29.6% of those surveyed, that is 21 people, who attempted suicide had died. </span>

scholarly journals S210. COMPARATIVE EFFECTIVENESS OF ANTIPSYCHOTICS FOR RISK OF ATTEMPTED OR COMPLETED SUICIDE AMONG PERSONS WITH SCHIZOPHRENIA

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S118-S119
Author(s):  
Heidi Taipale ◽  
Markku Lähteenvuo ◽  
Antti Tanskanen ◽  
Ellenor Mittendorfer-Rutz ◽  
Jari Tiihonen
Keyword(s):  
Drug Use ◽  
Comparative Effectiveness ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Antipsychotic Therapy ◽  
Completed Suicide ◽  
Hazard Ratios ◽  
Persons With Schizophrenia ◽  
Swedish Cohort

Abstract Background Suicidal attempts and suicide are rather common phenomena in persons with schizophrenia whom are 6–14 times more likely to die due to suicide than the general population. Very little is known on effectiveness of antipsychotics in preventing suicide attempts and completed suicides among patients with schizophrenia. Whether all antipsychotics are effective in preventing attempted or completed suicides also remains unclear. The objective of our study was to investigate comparative effectiveness of antipsychotics for risk of attempted or completed suicide among all patients with schizophrenia in Finland and Sweden. Methods Two nationwide register-based cohort studies were conducted including all individuals with schizophrenia in Finland (N=61889) and Sweden (N=29823). The Finnish cohort included all persons treated for schizophrenia in inpatient care (1972–2014), with follow-up for drug use and outcomes during 1996–2017. The Swedish cohort included all persons with treatment contact due to schizophrenia in inpatient or specialized outpatient care, sickness absence, or disability pension (2006–2013), with follow-up for drug use and outcomes during 2006–2016. The main exposure included the ten most commonly used antipsychotic monotherapies, and also adjunctive pharmacotherapies (antidepressants, mood stabilizers, lithium, benzodiazepines and related drugs were investigated). The main outcome measure was attempted or completed suicide which was analyzed with within-individual models by comparing use and non-use periods in the same individual. Sensitivity analyses were conducted by between-individual models, with attempted suicide (hospitalization only) as an outcome, and by censoring first 30 days from each exposure. Results are reported as hazard ratios (HRs) with 95 % confidence intervals (95% CI). Results Compared with no use of antipsychotics, clozapine was the only antipsychotic therapy consistently associated with a decreased risk of suicidal outcomes. Hazard ratios (HRs) and 95% CI for attempted or completed suicide were 0.64 (95% CI 0.49–0.84) in the Finnish cohort, and 0.66 (0.43–0.99) in the Swedish cohort, and for attempted suicide 0.60 (0.46–0.79) in the Finnish cohort and 0.62 (0.40–0.95) in the Swedish cohort. No other antipsychotic was associated with a reduced risk of attempted and/or completed suicide than clozapine. Regarding adjunctive pharmacotherapies, benzodiazepines and Z-drugs were associated with an increased risk of suicide attempts or deaths (HRs for benzodiazepines 1.29–1.30 and 1.33–1.62 for Z-drugs, not reaching statistical significance in the Swedish cohort). Discussion The results from two large nationwide cohorts provide the first evidence on comparative real-world effectiveness of specific antipsychotics in the prevention of severe suicidal behavior. Clozapine was the only pharmacological treatment associated with a substantially decreased risk of attempted or completed suicide and should be considered as a first-line treatment for patients with suicidal ideation or behavior.

scholarly journals Rethinking pathways to completed suicide by female prisoners

2015 ◽  
Vol 10 (4) ◽  
pp. 245-255 ◽  
Author(s):  
Sophie Oakes-Rogers ◽  
Karen Slade
Keyword(s):  
Attempted Suicide ◽  
Suicide Attempts ◽  
Interpersonal Trauma ◽  
Small Sample ◽  
Traumatic Experience ◽  
Content Type ◽  
Female Prisoners ◽  
Completed Suicide ◽  
Direct Trauma ◽  
Self Harm

Purpose – The purpose of this paper is to explore the role of trauma experience in pathways to self-harm or attempted suicide in female prisoners who died through self-inflicted death in England and Wales. Design/methodology/approach – Quantitative study using the Prison and Probation Ombudsmen’s independent reports on deaths in custody. In total, 32 cases of female self-inflicted death in custody were coded on the presence of direct or interpersonal trauma, presence of superficial self-harm (SSH), near-lethal self-harm (NLSH), suicide attempts and recent significant life event. The number of previous suicide attempts (PSAs) and age at time of death was recorded. Findings – Direct trauma is linked with repeated suicide attempts but recued the likelihood of SSH prior to suicide. Neither interpersonal trauma nor age increased likelihood of pre-suicide behaviours. NLSH was not predicted by either traumatic experience. Amongst these completed suicide cases, 56 per cent were not reported as having experienced trauma, 46 per cent had no recorded PSAs and 12 per cent also had no previous self-harm reported. Research limitations/implications – The small sample limited statistical power and specificity of classifications. Provides support for direct trauma in developing capacity for repeated suicidal behaviour as indicated in theoretical models of suicide (Joiner, 2005; O’Connor, 2011). Practical implications – Different pathways to suicide likely to exist for female prisoners and importance of trauma intervention services. Originality/value – Using cases of completed suicide in female prisoners to investigate the pathway to suicide from trauma through previous self-harm and attempted suicide.

scholarly journals Socio-demographic characteristics of persons with psychiatric disorders who committed suicide

2017 ◽  
Vol 70 (1-2) ◽  
pp. 18-24
Author(s):  
Dragana Ljusic ◽  
Dragan Ravanic ◽  
Ivan Soldatovic ◽  
Snezana Filipovic-Danic ◽  
Mirjana Stojanovic-Tasic ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Medical Condition ◽  
Demographic Characteristics ◽  
Private Source ◽  
Police Records ◽  
The Republic ◽  
The City ◽  
Methods Of Suicide

Introduction. Psychiatric disorders represent an important risk factor for death by suicide. The aim of this study was to assess the incidence of psychiatric disorders among the persons who committed suicide in the territory of the City of Nis in the period 2001 - 2010. Additionally, this study aimed to compare the socio-demographic characteristics between persons with and without psychiatric disorders. Material and methods. This retrospective study included 524 persons who committed suicide (330 with and 194 without psychiatric disorders) in the period 2001 - 2010. Data on socio-demographic characteristics, previous suicide attempts, and methods of suicide were obtained from medical and police records (Police Directorate for the City of Nis, and Statistical Office of the Republic of Serbia). Results. We studied the incidence of suicides among the persons with psychiatric disorders compared to persons without any medical condition in the studied period. Depression (104, 31.5%) and personality disorders (103, 31.2%) were the most common psychiatric disorders among the persons who committed suicide, whereas only 21 persons (6.36%) had schizophrenia. Persons with psychiatric disorders had a higher level of education, more of them were divorced, had a private source of income and more frequently attempted suicide compared to persons without any diseases (p<0.001). The most common methods of suicide were hanging and poisoning in both investigated groups. Conclusion. Depression was the most common disorder registered among the persons with psychiatric disorders who committed suicide. It is necessary to develop a national strategy for suicide prevention for groups at high risk of suicide.

scholarly journals What is the motivation of young emergency physicians to pursue an academic career in Emergency Medicine?

2021 ◽  
Author(s):  
Delphine Douillet ◽  
François Javaudin ◽  
Saïd Laribi ◽  
Philippe Le Conte ◽  
Emmanuel Montassier ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Academic Career ◽  
Research Training ◽  
Demographic Data ◽  
Participation Rate ◽  
Motivational Factors ◽  
University Hospital ◽  
Clinical Activity ◽  
Emergency Physicians ◽  
Multicenter Prospective Observational Study

Abstract Background The study aims were to assess the motivation behind embarking on a university hospital career in Emergency Medicine, as well as any potential motivational barriers and levers. Methods We carried out a multicenter prospective observational study. All interns from the first year to the fourth year of a residency program in Emergency Medicine as well as young emergency physicians at 5 universities in the west of France were interviewed. A questionnaire with 37 questions was developed based on the literature and in line with the Delphi method. The questionnaires were self-administered online. This questionnaire assessed 4 aspects: demographic data, overall motivational factors, specific motivational factors, and motivational barriers and levers. Results The participation rate was 70%, with 193 answers. A median of 3 (2–4) out of 6 was the result for motivation to pursue an academic career in Emergency Medicine. Twenty respondents (10%) showed a genuine motivation for an academic career, rating this item at 5 or 6 (out of 6). The most motivated students were those who had received research training (first-level master’s degree, Master 1) (OR, 3.2 [95%CI: 1.3 to 3.9]). Among them, the most important potential levers were the possibility to devote at least 50% of the time to clinical activity, the time dedicated to missions, clear recruitment prospects, and supervision/guidance in preparing for an academic career. Conclusions Ten percent of the young emergency physicians who responded to this questionnaire have a high motivation for an academic career, which suggests that there is a large potential reserve of academics in emergency medicine. There are several levels to maintain this motivation and transform it into commitment in the academic course.

Suicide attempts and suicides in Bolivia from 2007 to 2012: pesticides are the preferred method – females try but males commit suicide!

2014 ◽  
Vol 26 (3) ◽  
pp. 361-367 ◽  
Author(s):  
Erik Jørs ◽  
Mette Christoffersen ◽  
Nikoline Høgsgaard Veirum ◽  
Guido Condarco Aquilar ◽  
Rafael Cervantes Morant ◽  
...  
Keyword(s):  
Young Adults ◽  
Low Income ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Age Groups ◽  
Low Income Countries ◽  
Psychiatric Ward ◽  
Crime Statistics ◽  
Sources Of Information ◽  
Hospital Data

Abstract Background: Suicide attempts and suicides constitute a significant burden on communities and health systems, especially in low income countries. However, many low income countries lack epidemiological information on which to base future preventive strategies. This study reports on gender and age profiles as well as the likely background and means used for suicide attempts and suicides in Bolivia. Method: This study presents 1124 cases from four different sources of information: (i) emergency ward data with suicide attempts by poisoning from the year 2007, (ii) psychiatric ward data including suicide attempts from July 2011 to July 2012, (iii) newspaper articles reporting attempted suicides and suicides from 2009 to 2011, and (iv) the National Statistics on Crime reporting suicides from the years 2010–2011. Data on age was stratified into three age groups: adolescents aged 10–19 years, young adults aged 20–29 years, and older adults aged above 29 years. Data from the hospital wards and Crime Statistics were pooled to compare characteristics of suicide attempts with suicides concerning age and gender. Data on age, gender, methods used, and reasons were analyzed using IBM SPSS version 21. Results: Hospital data showed that more females (403/657, 61%) than males (254/657, 39%) attempted suicide, and females attempted suicide at a younger age than males (p<0.05). In contrast to this, more males (208/293, 70.5%) than females (85/293, 29.5%) committed suicide, and furthermore it was most prevalent among young adults aged 20–29 years of both genders, as observed from the Crime Statistics. The dominant method was pesticide poisoning varying from 400 out of 657 (70.5%) of the hospital poisoning cases to 65 out of 172 (37.8%) of the newspaper cases. Newspaper data showed a higher mortality rate (65/77, 85.1%) among those using violent methods such as hanging and jumping compared to non-violent methods (43/84, 50.9%) such as ingesting chemicals and drugs (p<0.05). The reasons were related to interpersonal problems, economic problems, depression, and unwanted pregnancies. Many cases of suicide seemed to be hidden due to cultural and religious reasons. Conclusion: More females attempted suicide, whereas more males realized suicide. Suicide attempts were most numerous among adolescents in contrast to suicides being most prevalent in the older age groups. Self-poisoning with pesticides was the most popular method used. Access to potential suicide materials should be restricted and psychosocial interventions initiated to prevent suicides.

Suicide in Hong Kong

1985 ◽  
Vol 19 (3) ◽  
pp. 287-292 ◽  
Author(s):  
W. H. Lo ◽  
T. M. Leung
Keyword(s):  
Hong Kong ◽  
Additional Data ◽  
Suicide Attempts ◽  
Age Groups ◽  
Sex Distribution ◽  
Completed Suicide ◽  
Younger Age ◽  
Police Records ◽  
History Of ◽  
Few Data

Coroners' statistics indicated there were 684 suicides for the whole of Hong Kong in 1981. This gave a crude suicide rate of 18.1 per 100,000 population aged 15 years and over and constituted 2.7% of all deaths reported in that year. Only a few data were recorded in all coroners' files but additional data were obtained from police records on 168 of these suicides. The age and sex distribution among the suicides as well as the effect of marital and employment status on suicide rates were found to be similar to western countries. Jumping from a height was the most common method of suicide (47.2%) followed by hanging (30.8%). Psychiatric illness and chronic physical disability were two most important precipitating causes of suicide (39.8% and 35.7% respectively). Twenty per cent had a history of previous attempts with one-third occurring within six months of their completed suicide. Over 40% had communicated their suicide intention to others, while 19% left a note. ‘Psychiatric’ cases as a group had special features: there were more in the younger age groups, more with records of previous suicide attempts and more chose readily available methods.

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