Characteristics of Suicidal Behavior in a Turkish Sample

Background: Suicidal behavior is one of the most important problems in psychiatric clinics. Several sociodemographic and clinical characteristics may have different effects on suicidal behavior. Aims: To examine the sociodemographic and clinical characteristics of a sample of 144 suicide attempters admitted to a Turkish emergency clinic for a suicide attempt. Methods: All subjects were interviewed by a consultant psychiatrist. For all individuals, data on DSM-IV psychiatric diagnoses, sociodemographic data, Beck’s Hopelessness Scale (BHS), Becks’s Suicidal Ideation Scale (SIS), and Beck’s Suicidal Intention Scale (BSIS) were collected. Results: The majority of suicide attempters were females characterized by low educational status and low religious orientation. Drug overdose was the most common method of suicide attempt and conflict within the family was the most fre uent psychological stress factor. Three- uarters of attempters (74.6%) met DSM-IV criteria for at least one psychiatric diagnosis. Of these, 28.5% met criteria for major depressive disorder. Suicide attempters with depression tended to be immigrant, urban dwellers with high scores on the suicide intent scale. Conclusions: In the present study, the findings are useful in showing the risk factors related to suicidal behavior.

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Hippocampal Subfield Volumes in Major Depressive Disorder Adolescents with a History of Suicide Attempt

BioMed Research International ◽

10.1155/2021/5524846 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Qi Zhang ◽

Su Hong ◽

Jun Cao ◽

Yi Zhou ◽

Xiaoming Xu ◽

...

Keyword(s):

Major Depressive Disorder ◽

Suicide Attempt ◽

Depressive Disorder ◽

Suicidal Behavior ◽

Clinical Characteristics ◽

Suicide Attempts ◽

Healthy Controls ◽

Major Depressive ◽

Suicide Attempters ◽

Functional Studies

Suicidal behavior is a leading cause of death and often commences during adolescence/young adulthood (15~29 years old). The hippocampus, which consists of multiple functionally specialized subfields, may contribute to the pathophysiology of depression and suicidal behavior. We aimed to investigate the differences of hippocampal subfield volume between major depressive disorder (MDD) patients with and without suicide attempts and healthy controls in adolescents and young adults. A total of 40 MDD suicide attempters (MDD+SA), 27 MDD patients without suicide attempt (MDD-SA), and 37 healthy controls (HC) were recruited. High-resolution T1 MRI images were analyzed with the automated hippocampal substructure module in FreeSurfer 6.0. Volume differences among the groups were analyzed by a generalized linear model controlling for intracranial cavity volume (ICV). The relationship between hippocampal subfield volumes and clinical characteristics (HAM-D and SSI scores) was assessed using two-tailed partial correlation controlling for ICV in MDD+SA and MDD-SA. We found that MDD-SA had significantly smaller bilateral hippocampal fissure volume than HC and MDD+SA. No significant correlation was observed between hippocampal subfield volume and clinical characteristics (HAM-D and SSI scores) in MDD+SA and MDD-SA. Adolescent/young adult suicide attempters with MDD suicide attempters have larger bilateral hippocampal fissures than depressed patients without suicide attempts, independently from clinical characteristics. Within the heterogeneous syndrome of major depressive disorder that holds a risk for suicidality for subgroups, hippocampal morphology may help to explain or possibly predict such risk, yet longitudinal and functional studies are needed for understanding the biological mechanisms underlying.

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Reassessment of Suicide Attempters at Home, Shortly After Discharge from Hospital

Crisis ◽

10.1027/0227-5910/a000041 ◽

2010 ◽

Vol 31 (6) ◽

pp. 303-310 ◽

Cited By ~ 9

Author(s):

Bas Verwey ◽

Jeroen A. van Waarde ◽

Molla A. Bozdağ ◽

Iris van Rooij ◽

Edwin de Beurs ◽

...

Keyword(s):

Suicide Attempt ◽

General Hospital ◽

Hospital Environment ◽

Initial Assessment ◽

Suicide Attempters ◽

Systematic Assessment ◽

Suicide Intent ◽

Initial Hospital ◽

Discharge From Hospital ◽

At Home

Background: Assessment of suicide attempters in a general hospital may be influenced by the condition of the patient and the unfavorable circumstances of the hospital environment. Aims: To determine whether the results of a reassessment at home shortly after discharge from hospital differ from the initial assessment in the hospital. Methods: In this prospective study, systematic assessment of 52 suicide attempters in a general hospital was compared with reassessment at home, shortly after discharge. Results: Reassessments at home concerning suicide intent, motives for suicide attempt, and dimensions of psychopathology did not differ significantly from the initial hospital assessment. However, patients’ motives for the suicide attempt had changed to being less impulsive and more suicidal, worrying was significantly higher, and self-esteem was significantly lower. A third of the patients had forgotten their aftercare arrangements and most patients who initially felt no need for additional help had changed their mind at reassessment. Conclusions: Results from this group of suicide attempters suggest that a brief reassessment at home shortly after discharge from hospital should be considered.

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Chromosome 22 Deletions and Suicidal Behavior in Schizophrenia

Neuropsychobiology ◽

10.1159/000513645 ◽

2021 ◽

pp. 1-8

Author(s):

Ali Bani-Fatemi ◽

Christopher Adanty ◽

Nasia Dai ◽

Ariel Graff ◽

Philip Gerretsen ◽

...

Keyword(s):

Suicide Attempt ◽

Suicidal Behavior ◽

Copy Number ◽

Rating Scale ◽

Copy Number Variant ◽

Chromosome 22 ◽

Suicide Attempters ◽

Severity Rating ◽

Neuropsychiatric Diseases ◽

Significant Difference

Background: Studies have shown that the overall copy number variant (CNV) load is associated with schizophrenia. Schizophrenia is a mental disorder that is frequently associated with suicidal behavior. Methods: We recruited 263 patients with schizophrenia from the Centre for Addiction and Mental Health. The Columbia Suicide Severity Rating Scale was used to assess the presence of lifetime suicide attempt. Genotyping was completed using the Illumina Omni 2.5 chip. We tested the association between deletion events on chromosome 22 with suicide attempt in our schizophrenia sample. Results: There was no significant difference between suicide attempters and non-attempters considering the presence/absence of deletion events on chromosome 22. Conclusion: Although our results did not show a significant association between deletions on chromosome 22 and suicide attempt in schizophrenia, CNV studies may reveal important, novel insights and open further investigation for the treatment of neuropsychiatric diseases.

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The Psychological State of Family Members Who Have Experienced Various Forms of Suicide of a Loved One (Single Attempt, Chronic Suicide, Completed Suicide)

Counseling Psychology and Psychotherapy ◽

10.17759/cpp.2018260105 ◽

2018 ◽

Vol 26 (1) ◽

pp. 56-75 ◽

Cited By ~ 1

Author(s):

E.V. Borisonik ◽

A.B. Kholmogorova

Keyword(s):

Suicide Attempt ◽

Coping Strategies ◽

Suicidal Behavior ◽

Suicide Attempts ◽

Family System ◽

Well Being ◽

Psychological State ◽

Symptoms Of Depression ◽

Completed Suicide ◽

The Family

The suicidal behavior of a member of a family influences the emotional well-being of his/her relatives. This paper presents the results of a pilot study of emotional well-being, coping strategies and characteristics of the family system among relatives of persons with suicidal behavior. The study involved 40 people, the total sample was divided into three subgroups: relatives of patients who survived the first suicide attempt (n = 16); relatives of patients after multiple suicide attempts (n = 10); relatives of persons who committed suicide (n = 14). In the first part of the study, the symptoms of emotional distress were analyzed for the entire sample. Relatives of people with different forms of suicidal behavior are at risk of depression: two-thirds of the combined sample showed increased symptoms of depression. The coping strategies of positive redefinition and personal growth are negatively correlated with symptoms of depression. In the second part of the study, we analyzed differences between subgroups. The severity of the symptoms of depression is significantly higher in the subgroup of relatives of people with completed suicide compared to relatives of those who survived a single suicide attempt, the indicators of hardiness and cohesion of the family system are lower in the families of people with multiple suicide attempts compared to other forms of suicidal behavior.

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Few Sex Differences in Hospitalized Suicide Attempters Aged 70 and Above

10.20944/preprints201712.0064.v1 ◽

2017 ◽

Author(s):

Stefan Wiktorsson ◽

Therese Rydberg Sterner ◽

Madeleine Mellqvist Fässberg ◽

Ingmar Skoog ◽

Anne Ingeborg Berg ◽

...

Keyword(s):

Sex Differences ◽

Suicide Attempt ◽

Physical Disability ◽

Cultural Context ◽

Clinical Characteristics ◽

Depression And Anxiety ◽

Research Attention ◽

Suicide Attempters ◽

Somatic Illness ◽

Health Assessments

Relatively little research attention has been paid to sex issues in late life suicidal behaviour. The aim was to compare clinical characteristics of women and men aged 70+ who were hospitalized after a suicide attempt. We hypothesized higher depression and anxiety scores in women, and we expected to find that men would more often attribute the attempt to health problems and compromised autonomy. Participants (56 women and 47 men, mean age 80) were interviewed by a psychologist. In addition to psychiatric and somatic health assessments, participants responded to an open-ended question concerning attributions of the attempt.  There were no sex differences in depression and anxiety, but women were more likely to report that they found their situation hopeless (67.9% vs. 43.8%, p = 0.02). At least one serious physical disability was noted in 60.7% of the women and 53.2% of the men (p = 0.55). Proportions attributing their attempt to somatic illness did not differ (women, 14.5% vs. men 17.4%, p = 0.79), and similar proportions attributed the attempt to reduced autonomy (women, 21.8% vs. men, 26.1 %, p = 0.64). The unexpected lack of sex differences might be influenced by cultural context in which sex norms play a part.

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Repetitive negative thinking about suicide: Associations with lifetime suicide attempts

Clinical Psychology in Europe ◽

10.32872/cpe.5579 ◽

2021 ◽

Vol 3 (3) ◽

Author(s):

Tobias Teismann ◽

Thomas Forkmann ◽

Johannes Michalak ◽

Julia Brailovskaia

Keyword(s):

Suicide Attempt ◽

Suicidal Behavior ◽

Suicide Ideation ◽

Suicide Attempts ◽

Clinical Sample ◽

Cross Sectional Study ◽

Repetitive Negative Thinking ◽

Cross Sectional ◽

Suicide Attempters ◽

Negative Thinking

Background Repetitive negative thinking has been identified as an important predictor of suicide ideation and suicidal behavior. Yet, only few studies have investigated the effect of suicide-specific rumination, i.e., repetitive thinking about death and/or suicide on suicide attempt history. On this background, the present study investigated, whether suicide-specific rumination differentiates between suicide attempters and suicide ideators, is predictive of suicide attempt history and mediates the association between suicide ideation and suicide attempts. Method A total of 257 participants with a history of suicide ideation (55.6% female; Age M = 30.56, Age SD = 11.23, range: 18–73 years) completed online measures on suicidality, general and suicide-specific rumination. Results Suicide-specific rumination differentiated suicide attempters from suicide ideators, predicted suicide attempt status (above age, gender, suicide ideation, general rumination) and fully mediated the association between suicide ideation and lifetime suicide attempts. Conclusion Overall, though limited by the use of a non-clinical sample and a cross-sectional study design, the present results suggest that suicide-specific rumination might be a factor of central relevance in understanding transitions to suicidal behavior.

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Mapping the genetic architecture of suicide attempt and suicide death using polygenic risk scores for clinically-related psychiatric disorders and traits

Psychological Medicine ◽

10.1017/s0033291721004700 ◽

2021 ◽

pp. 1-9

Author(s):

Ikuo Otsuka ◽

Hanga Galfalvy ◽

Jia Guo ◽

Masato Akiyama ◽

Dan Rujescu ◽

...

Keyword(s):

Suicide Attempt ◽

Psychiatric Disorders ◽

Suicidal Behavior ◽

Statistical Power ◽

Small Sample ◽

European Ancestry ◽

Risk Scores ◽

Suicide Attempters ◽

Polygenic Risk ◽

Suicide Death

Abstract Background Suicidal behavior is moderately heritable and a consequence of a combination of the diathesis traits for suicidal behavior and suicide-related major psychiatric disorders. Here, we sought to examine shared polygenic effects between various psychiatric disorders/traits and suicidal behavior and to compare the shared polygenic effects of various psychiatric disorders/traits on non-fatal suicide attempt and suicide death. Methods We used our genotyped European ancestry sample of 260 non-fatal suicide attempters, 317 suicide decedents and 874 non-psychiatric controls to test whether polygenic risk scores (PRSs) obtained from large GWASs for 22 suicide-related psychiatric disorders/traits were associated with suicidal behavior. Results were compared between non-fatal suicide attempt and suicide death in a sensitivity analysis. Results PRSs for major depressive disorder, bipolar disorder, schizophrenia, ADHD, alcohol dependence, sensitivity to environmental stress and adversity, educational attainment, cognitive performance, and IQ were associated with suicidal behavior (Bonferroni-corrected p < 2.5 × 10−4). The polygenic effects of all 22 psychiatric disorders/traits had the same direction (p for binomial tests = 4.8 × 10−7) and were correlated (Spearman's ρ = 0.85) between non-fatal suicide attempters and suicide decedents. Conclusions We found that polygenic effects for major psychiatric disorders and diathesis-related traits including stress responsiveness and intellect/cognitive function contributed to suicidal behavior. While we found comparable polygenic architecture between non-fatal suicide attempters and suicide decedents based on correlations with PRSs of suicide-related psychiatric disorders/traits, our analyses are limited by small sample size resulting in low statistical power to detect difference between non-fatal suicide attempt and suicide death.

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Suicide attempters: Clinical characteristics and management

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.2242 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S601-S601

Author(s):

E. Gattoni ◽

A. Feggi ◽

C. Gramaglia ◽

P. Bergamasco ◽

I. Coppola ◽

...

Keyword(s):

Depressive Symptoms ◽

Suicide Attempt ◽

Clinical Characteristics ◽

Depressive Disorders ◽

Attempted Suicide ◽

Rating Scale ◽

Suicide Attempts ◽

Suicidal Risk ◽

Suicide Attempters ◽

History Of

BackgroundSuicide attempts, defined as self-inflicted, potentially injurious behaviors with a nonfatal outcome, and with evidence of intent to die are extremely prevalent. Literature suggests that suicide is more common among males, while attempted suicide is more frequent among females. Depression, mental disorders, substance use disorders and history of suicidal behavior are important risk factors for suicide: the risk of suicide attempt is 3 to 12 times higher in psychiatric patients than in the general population.AimThe aim of our study was to compare severity of depressive symptoms in a sample of suicide attempters with a diagnosis of bipolar and related disorders or depressive disorders and in a sample of sex- and diagnosis-matched patients who do not commit a suicide attempt. The severity of attempted suicide and the suicidal risk in the hospital will be assessed as well.Material and methodsWe collected a sample of inpatients who committed a suicide attempt during 2015. For each attempter, we selected another sex- and diagnosis-matched patient with no history of attempted suicide. Socio-demographic and clinical characteristics of the sample were gathered. Assessment included: Montgomery-Asberg Depression Rating Scale (MADRS) for severity of depressive symptoms in both groups, Suicide Intent Scale (SIS) for the severity of attempted suicide and the suicidal risk with a nurse assessment for suicide.ResultsData collecting is still ongoing. We expected to find more severe symptoms in patients who attempted suicide. Clinical implication will be discussed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Challenges in Assessing Intent to Die: Can Suicide Attempters Be Trusted?

OMEGA - Journal of Death and Dying ◽

10.2190/5867-6510-3388-3517 ◽

2007 ◽

Vol 55 (1) ◽

pp. 57-70 ◽

Cited By ~ 28

Author(s):

Stacey Freedenthal

Keyword(s):

Risk Assessment ◽

Suicide Attempt ◽

Circumstantial Evidence ◽

Accurate Assessment ◽

Secondary Gain ◽

Suicide Attempters ◽

Suicidal Intent ◽

Suicide Intent ◽

Suicide Note

Assessing a person's intent to die in a suicide attempt is crucial for risk assessment and research, yet suicidal intent is notoriously difficult to measure. People who intended to die when they hurt themselves may deny it, and others may feign intent for secondary gain. Additionally, ambivalence, memory gaps, impulsivity, and fluidity of intent can hinder accurate assessment of intent. Circumstantial evidence, such as a suicide note, may illuminate true intentions but also has substantial limitations. This article summarizes disparate challenges to the measurement of suicidal intent; describes strengths and weaknesses of circumstantial indicators; reviews evidence from studies using the Suicide Intent Scale to show that subjective and circumstantial indicators do not strongly correlate with each other; and concludes with a call to place more trust in individuals whose disclosures of suicidal intent are questionable, even if the possibility for manipulation exists.

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Identifying Distinguishable Clinical Profiles Between Single Suicide Attempters and Re-Attempters

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.754402 ◽

2021 ◽

Vol 12 ◽

Author(s):

Marlehn Lübbert ◽

Lydia Bahlmann ◽

Sebastian Josfeld ◽

Jessica Bürger ◽

Alexandra Schulz ◽

...

Keyword(s):

Suicidal Ideation ◽

Suicide Attempt ◽

Personality Traits ◽

Suicidal Behavior ◽

Emotional Abuse ◽

Specific Treatment ◽

Individual Characteristics ◽

Heterogeneous Group ◽

Suicide Attempters ◽

Clinical Profiles

More than 800,000 individuals die from suicide each year in the world, which has a devastating impact on families and society. Ten to twenty times more attempt suicide. Previous studies showed that suicide attempters represent a heterogeneous group regarding demographic characteristics, individual characteristics of a suicidal attempt, and the assumed clinical factors, e.g., hopelessness or impulsivity, thus differently contributing to the likelihood of suicidal behavior. Therefore, in the present study, we aim to give a comprehensive clinical description of patients with repeated suicide attempts compared to single attempters. We explored putative differences between groups in clinical variables and personality traits, sociodemographic information, and specific suicide attempt-related information. A sample of patients with a recent suicide attempt (n = 252), defined according to DSM-5 criteria for a suicidal behavior disorder (SBD), was recruited in four psychiatric hospitals in Thuringia, Germany. We used a structured clinical interview to assess the psychiatric diagnosis, sociodemographic data, and to collect information regarding the characteristics of the suicide attempt. Several clinical questionnaires were used to measure the suicide intent and suicidal ideations, depression severity, hopelessness, impulsivity, aggression, anger expression, and the presence of childhood trauma. Univariate and multivariate statistical methods were applied to evaluate the postulated risk factors and, to distinguish groups based on these measures. The performed statistical analyses indicated that suicide attempters represent a relatively heterogeneous group, nevertheless associated with specific clinical profiles. We demonstrated that the re-attempters had more severe psychopathology with significantly higher levels of self-reported depression, suicidal ideation as well as hopelessness. Furthermore, re-attempters had more often first-degree relatives with suicidal behavior and emotional abuse during childhood. They also exhibited a higher degree of specific personality traits, i.e., more “urgency” as a reaction to negative emotions, higher excitability, higher self-aggressiveness, and trait anger. The multivariate discriminant analysis significantly discriminated the re-attempters from single attempters by higher levels of self-aggressiveness and suicidal ideation. The findings might contribute to a better understanding of the complex mechanisms leading to suicidal behavior, which might improve the early identification and specific treatment of subjects at risk for repeated suicidal behavior.

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