scholarly journals Rethinking pathways to completed suicide by female prisoners

2015 ◽  
Vol 10 (4) ◽  
pp. 245-255 ◽  
Author(s):  
Sophie Oakes-Rogers ◽  
Karen Slade

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.

Crisis ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 155-160 ◽  
Author(s):  
Jin Kim ◽  
Han Joon Kim ◽  
Soo Hyun Kim ◽  
Sang Hoon Oh ◽  
Kyu Nam Park

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.


2006 ◽  
Vol 21 (6) ◽  
pp. 396-400 ◽  
Author(s):  
Slavko Ziherl ◽  
Bojan Zalar

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.


2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S118-S119
Author(s):  
Heidi Taipale ◽  
Markku Lähteenvuo ◽  
Antti Tanskanen ◽  
Ellenor Mittendorfer-Rutz ◽  
Jari Tiihonen

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.


2012 ◽  
Vol 43 (2) ◽  
pp. 179-187
Author(s):  
Randy A. Sansone ◽  
Joy Chang ◽  
Bryan Jewell

Background: While a number of previous studies have examined limited forms of self-harm behavior, such as suicidal ideation/attempts/completions, or one specific behavior such as cutting or burning oneself (most frequently in psychiatric populations), few studies have examined the lifetime prevalence of multiple self-harm behaviors in a single non-psychiatric population and no study has done so among obstetrics/gynecology outpatients. Method: Using a cross-sectional consecutive sample of 370 women presenting to an obstetrics/gynecology outpatient clinic and a self-report survey methodology, we examined the lifetime prevalence of 22 self-harm behaviors. Results: In this sample, the most frequently self-reported self-harm behaviors were: engaged in emotionally abusive relationships (24.7%), abused alcohol (22.0%), been promiscuous (21.0%), attempted suicide (18.3%), and tortured self with self-defeating thoughts (16.7%). Four of these preceding behaviors were also the most commonly reported 5 of 22 behaviors in 3 previous studies of self-harm behavior in different clinical populations. Conclusions: It appears that the most frequently reported lifetime self-harm behaviors are relatively common across various non-psychiatric clinical populations of adults, albeit in different proportions, with some exceptions (i.e., suicide attempts in the present sample).


Author(s):  
Ellaisha Samari ◽  
Shazana Shahwan ◽  
Edimansyah Abdin ◽  
YunJue Zhang ◽  
Rajeswari Sambasivam ◽  
...  

This study examined differences between young people with mental illness who engage in deliberate self-harm with and without suicidal intent, as well as socio-demographic and clinical factors that are related to the increased likelihood of suicide attempt amongst self-harming young people. A total of 235 outpatients with mental illness who had engaged in deliberate self-harm were recruited from a tertiary psychiatric hospital in Singapore. Participants completed a self-report questionnaire which collected information on their socio-demographic background, self-harm history, diagnosis, depressive symptoms and childhood trauma. A total of 31.1% had reported a history of attempted suicide. Multiple logistic regression conducted found that engaging in self-harm ideation between 1 and 7 days (OR = 4.3, p = 0.30), and more than 1 week (OR = 10.5, p < 0.001) (versus no engagement in any self-harm ideation at all), were significantly associated with greater likelihood of attempted suicide. This study reports a relatively high prevalence rate of reported suicide attempts amongst young people with mental illness who engaged in self-harm. Identifying self-harm behaviors and treating it early could be the first step in managing potential suicidal behaviors among those who engage in self-harm.


2011 ◽  
Vol 38 (11) ◽  
pp. 1103-1114 ◽  
Author(s):  
Margaret S. Andover ◽  
Heather T. Schatten ◽  
Donna M. Crossman ◽  
Peter J. Donovick

Neuropsychological functioning has not yet been investigated among prisoners who engage in self-injurious behaviors, specifically attempted suicide and nonsuicidal self-injury (NSSI). The purpose of this study was to investigate neuropsychological functioning in prisoners with and without histories of NSSI and attempted suicide. The sample consisted of 173 male prisoners referred for neuropsychological evaluation. Of participants, 56% reported a history of self-injury. Performance on the neuropsychological domains of intelligence, memory, attention, motor functioning, and executive functioning was assessed. No group differences were found among those with NSSI, with NSSI and suicide attempts, and with no history of deliberate self-harm, although functioning was poor in all domains. Implications of the high prevalence of self-injury in this prison sample, as well as implications of impaired functioning on the treatment of self-injurious behaviors, are discussed.


Author(s):  
Hassen Al-Amin ◽  
Rajvir Singh ◽  
Mohamad Abdulrazzak ◽  
Suhaila Ghuloum

Abstract The aims of this study were to retrospectively assess the profiles of subjects with suicide attempts and self-harm in Doha, Qatar; and whether the available data were complete. We reviewed all the records of fatal and non-fatal suicides together with accidental self-ham cases seen in the major Emergency Department in Doha, over a one-year period. There was 37 completed suicide, mostly male expatriates in mid 30 s who died by hanging. In cases with suicide intent (N = 270), more males were admitted to Psychiatry than women. Overdose was the common method and the majority had mood disorders. In self-harm cases with no suicide intent (N = 150) the majority were not seen by Psychiatry. The profiles of suicide cases in Qatar are similar to those reported internationally. However, there is a major need to establish a comprehensive system to register and assess all self-harm patients in Qatar.


Neurology ◽  
2019 ◽  
Vol 93 (1) ◽  
pp. e97-e105 ◽  
Author(s):  
Giulia Giannini ◽  
Matthieu Francois ◽  
Eugénie Lhommée ◽  
Mircea Polosan ◽  
Emmanuelle Schmitt ◽  
...  

ObjectiveTo determine the postoperative attempted and completed suicide rates after subthalamic nucleus deep brain stimulation (STN-DBS) in a single-center cohort and to determine factors associated with attempted and completed suicide.MethodsWe retrospectively included all patients with Parkinson disease (PD) who underwent bilateral STN-DBS surgery at the Grenoble University Hospital between 1993 and 2016. For each patient who committed or attempted suicide, 2 patients with PD with STN-DBS without any suicidal behaviors were matched for age (±1 year), sex, and year of surgery (±2 years). Clinical data were collected from medical records. Detailed preoperative and postoperative neuropsychological evaluations, including frontal and Beck Depression Inventory (BDI) scores, were gathered.ResultsA total of 534 patients with PD were included. Completed and attempted suicide percentages were 0.75% (4 of 534) and 4.11% (22 of 534), respectively. The observed suicide rate in the first postoperative year (187.20 of 100,000 per year, 1 of 534) was higher than the expected National Observatory on Suicide Risks rate adjusted for age and sex (standardized mortality ratio 8.1). This rate remained similar over the second and third postoperative years. In a comparison of the 26 patients completing/attempting suicide and the 52 controls, the first group showed more frequent history of suicidal ideation/suicide attempts and psychotic symptoms, higher percentage of family psychiatric history, higher psychiatric medication use, and higher preoperative frontal and BDI scores on neuropsychological evaluations.ConclusionsSuicide behaviors can occur after STN-DBS, especially during the first 3 years. A careful multidisciplinary assessment and long-term follow-up are recommended to recognize and treat this potentially preventable risk for mortality.


2016 ◽  
Vol 175 (3) ◽  
pp. 493-500 ◽  
Author(s):  
A. Egeberg ◽  
P.R. Hansen ◽  
G.H. Gislason ◽  
L. Skov ◽  
L. Mallbris

2003 ◽  
Vol 18 (4) ◽  
pp. 161-165 ◽  
Author(s):  
Stefan Fruehwald ◽  
Patrick Frottier ◽  
Teresa Matschnig ◽  
Reinhard Eher

AbstractPurposeSuicide rates in correctional institutions have been increasing during the last decades. There has been little interest in whether suicidal ideation and intent has been documented by non-medical prison staff (reports of attempted suicide, suicide threats, self-harm), and whether these signs of suicidality had the consequence of adequate intervention efforts.MethodsThe personal files of inmates who committed suicide in the 29 Austrian jails and prisons during the last 25 years (1975–1999) were included. We analysed personal characteristics, criminological data, circumstances of custody and information about psychiatric disorders and treatment.ResultsOf a total of 250 suicides, 220 personal files were available and included. Suicide attempts were known in 50% of all suicides and 37% had expressed suicidality. In >20%, non-medical staff had documented signs of suicidality, but no further preventive action (e.g. referral to psychiatric care) had taken place.ConclusionsSigns of suicidality play an important role in vulnerability profiles for jail and prison suicides and should have the minimal consequence of further psychiatric care.


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