The Serious Suicide Attempts Approach for Understanding Suicide: Review of the Psychological Evidence

2020 ◽  
pp. 003022282098123
Author(s):  
Yossi Levi-Belz ◽  
Yari Gvion ◽  
Alan Apter
Keyword(s):  
Risk Factors ◽  
Suicide Attempts ◽  
Suicidal Risk ◽  
Suicide Attempters ◽  
Mental Pain ◽  
Pain Communication ◽  
Suicide Behavior ◽  
Interpersonal Difficulties ◽  
Communication Difficulties ◽  
Psychological Evidence

The study of survivors of a serious suicide attempt (SSA)––an attempt that would have been fatal had it not been for the provision of rapid and effective emergency treatment––can help researchers understand the suicidal mind. Serious suicide attempters are epidemiologically very similar to those who died by suicide, and thus can serve as valid proxies for studying suicides. In this paper, our objective was to briefly review the main risk factors that may facilitate more dangerous suicide behavior with high levels of intent. Our review highlights several dimensions of risk factors for SSAs, including psychopathology, mental pain, communication difficulties, decision-making impulsivity, and aggression. Several studies have indicated that the interaction between some of these dimensions, especially between mental pain and interpersonal difficulties, may serve as major catalysts for SSAs. Suicidal risk assessment should incorporate a designated evaluation of these risk factors as part of suicide prevention models.

Intent, lethality and psychological characteristics of medically serious suicide attempters

2011 ◽  
Vol 26 (S2) ◽  
pp. 1625-1625 ◽  
Author(s):  
Y. Levi ◽  
N. Horesh ◽  
A. Apter
Keyword(s):  
Suicide Attempts ◽  
Psychological Variables ◽  
Self Disclosure ◽  
Suicide Attempters ◽  
Mental Pain ◽  
Pain Communication ◽  
Suicide Intent ◽  
Communication Difficulties ◽  
Suicidal Person ◽  
Highly Correlated

IntroductionThe study of near fatal suicide attempters may provide insight into the minds of persons who die by suicide. Such attempts are characterized by high suicide intent, together with high medical lethality. The ability to fully understand the specific psychological profiles associated with severe of suicide intent can provide insights for suicide prevention.Objectives & aimsThe objective of the present study was to investigate the relationship of suicide intent to lethality among medically serious suicide attempters. Our aim was to examine specific psychological variables related to the subjective and objective components within suicide intent.Methods102 suicide attempters belonged to one of two groups: 35 subjects who made medically serious suicide attempts were compared with 67 non- medically serious suicide attempters. All were interviewed and completed questionnaires covering mental pain, communication difficulties, and seriousness of the suicide intent.ResultsThe objective component of the suicide intent scale (SIS) was highly correlated the lethality, as well as to communication difficulties, such as self disclosure while the subjective component of the SIS was related to mental pain variables such as depression and hopelessness. A significant interaction between mental pain and communication difficulties was found to predict severity of the objective suicide intent.ConclusionsThe suicidal person whom suffers from depression and hopelessness and cannot signal his pain to others because of communication difficulties can be a risk for a serious suicide attempt - which is more planned, with more precautions against discovery and without communication before or during the attempts.

Mental Pain, Communication Difficulties, and Medically Serious Suicide Attempts: A Case-Control Study

2014 ◽  
Vol 18 (1) ◽  
pp. 74-87 ◽  
Author(s):  
Yossi Levi-Belz ◽  
Yari Gvion ◽  
Netta Horesh ◽  
Tsvi Fischel ◽  
Ilan Treves ◽  
...  
Keyword(s):  
Case Control Study ◽  
Suicide Attempts ◽  
Case Control ◽  
Mental Pain ◽  
Pain Communication ◽  
Communication Difficulties ◽  
Control Study

Risk factors for suicide attempts in patients with bipolar disorder misdiagnosed with major depressive disorder: results from a national survey in China

2020 ◽  
Author(s):  
Lin Chen ◽  
Yu-Yu Xu ◽  
Jing-Ge Du ◽  
Li-Min Xin ◽  
Su-Li Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bipolar Disorder ◽  
Suicidal Ideation ◽  
Clinical Characteristics ◽  
Suicide Attempts ◽  
Multiple Logistic Regression ◽  
Regression Analyses ◽  
Major Depressive ◽  
Suicide Attempters ◽  
Depressive Episodes

Abstract Background: Bipolar disorder (BD) is a kind of mental disorder with the greatest risk of suicide, but it is often misdiagnosed as major depressive disorder (MDD) clinically. This study aimed to analyze the sociodemographic factors and clinical characteristics associated with suicide attempts (SA) in patients with BD misdiagnosed with MDD in China. Methods: A total of 1487 MDD patients were consecutively enrolled in 13 mental health centers in China. Data on patients’ sociodemographic and clinical characteristics were collected using a standardized protocol. Of these, 306 BD patients were misdiagnosed with MDD according to the Mini International Neuropsychiatric Interview (MINI). Suicide attempters and non-attempters were classified by the suicidality module of the MINI. Multiple logistic regression analyses were performed to assess the association between the independent variables of interest and SA in BD patients misdiagnosed with MDD. Results: Of the 306 BD patients misdiagnosed with MDD, 225 (73.5%) were non-attempters and 81 (26.5%) were attempters. Compared to non-attempters, attempters were older (Z =2.2, p = 0.03) and had more admissions(χ2 =6.1, p = 0.013), more frequent depressive episodes, more atypical characteristics (e.g. increased appetite, weight gain, and more sleep time)(χ2 = 5.8, p = 0.016), more suicidal ideation (χ2 = 27.3, p < 0.001), more psychotic symptoms (χ2 = 7.4, p = 0.006) and more seasonal depressive episodes (χ2 = 5.6, p = 0.018). Multiple logistic regression analyses revealed that attempters were characterized by more suicidal ideation (OR = 5.7, 95% CI: 2.6–12.5) and frequent depressive episodes (OR = 2.4, 95% CI: 1.3–4.6). The limitations of this study include its cross-sectional design and data collection by suicide attempters’ retrospective recall. Conclusions: The findings of this study suggest that BD patients misdiagnosed with MDD are at a higher risk of suicide, and more frequent depressive episodes and suicidal ideation are risk factors for attempted suicide. Early identification of and interventions for these risk factors might reduce the risk of suicide in BD patients misdiagnosed with MDD.

Aggression–impulsivity, mental pain, and communication difficulties in medically serious and medically non-serious suicide attempters

2014 ◽  
Vol 55 (1) ◽  
pp. 40-50 ◽  
Author(s):  
Yari Gvion ◽  
Netta Horresh ◽  
Yossi Levi-Belz ◽  
Tsvi Fischel ◽  
Ilan Treves ◽  
...  
Keyword(s):  
Suicide Attempters ◽  
Mental Pain ◽  
Communication Difficulties

scholarly journals Risk Factors for Serious Suicide Attempts: Difference Between Older and Younger Attempters in the Emergency Department

2021 ◽  
Vol 11 ◽  
Author(s):  
Dong Wook Kim ◽  
Seo Eun Cho ◽  
Jae Myeong Kang ◽  
Soo Kyun Woo ◽  
Seung-Gul Kang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Emergency Department ◽  
Suicide Attempt ◽  
Old Age ◽  
Rating Scale ◽  
Suicide Attempts ◽  
Interpersonal Stress ◽  
Suicide Attempters ◽  
Male Sex

Objective: Suicide attempts of the older adults are known to be more serious than that of the younger adults. Despite its major social impact in South Korea, the behavioral mechanism of serious suicide attempt (SSA) in old people remains to be elucidated. Thus, we investigated the risk factors for SSA in older and younger suicide attempters in the emergency department.Methods: Demographic data, clinical information, and the level of seriousness of suicide with Risk Rescue Rating Scale were compared between older (age ≥65) and younger (age &lt;65) adults who visited the emergency department for a suicide attempt. Regression analyses were performed to identify the risk factors for SSA in these two groups.Results: Among 370 patients, 37 were older adults (10%; aged 74.41 ± 6.78), more likely to have another medical disease (p &lt; 0.001), and a higher suicide completion rate (16.2 vs. 5.4%, p = 0.023). In the younger group, old age (B = 0.090, p &lt; 0.001), male sex (B = −0.038, p = 0.019), and impression of schizophrenia (B = 0.074, p = 0.027) were associated with a higher risk-rescue ratio and interpersonal stress condition was associated with a lower risk-rescue ratio (B = −0.045, p = 0.006). In the older group, however, no variables were included significant in the regression model for the Risk Rescue Rating Scale.Conclusions: Demographic and clinical factors such as old age, male sex, interpersonal stress, and impression of schizophrenia were associated with lethality in the younger suicide attempters. However, no factors were associated with SSA in the older adult group. Different mechanisms may underly the lethality in old age suicide.

Suicide attempters: Clinical characteristics and management

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.

Common Risk Factors in Adolescent Suicide Attempters Revisited

Crisis ◽  
1999 ◽  
Vol 20 (1) ◽  
pp. 15-22 ◽  
Author(s):  
Jérôme Laederach ◽  
Werner Fischer ◽  
Philippa Bowen ◽  
François Ladame
Keyword(s):  
Risk Factors ◽  
Adolescent Suicide ◽  
Suicide Attempts ◽  
Professional Life ◽  
University Hospitals ◽  
Suicide Attempters ◽  
Common Risk Factors ◽  
Elevated Frequency ◽  
Clear Predominance ◽  
Adolescent Suicide Attempters

The principle risk factors for suicide attempts in adolescents discussed in the literature are examined on the basis of data from a study carried out at the Geneva University Hospitals. 148 adolescents aged between 15 and 19 years form the sample. The results concerning mental disorders at the time of the suicide attempt confirm the clear predominance of affective disorder as well as the elevated frequency of comorbidity. Other main risk factors include suicidal behavior in family members and among acquaintances, poor state of health, poor integration into school or professional life, as well as sexual abuse.

Elderly suicide attempters by self-poisoning in Korea

2011 ◽  
Vol 23 (6) ◽  
pp. 979-985 ◽  
Author(s):  
Yoo-Ra Kim ◽  
Kyoung Ho Choi ◽  
Youngmin Oh ◽  
Hae-Kook Lee ◽  
Yong-Sil Kweon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Suicide Attempt ◽  
Suicide Attempts ◽  
Age Groups ◽  
Retrospective Chart Review ◽  
The Elderly ◽  
Health Concern ◽  
Female Ratio ◽  
Suicide Attempters ◽  
Elderly Suicide

ABSTRACTBackground: Suicide is a major public health concern. The elderly have the highest rate of suicide and they make more lethal suicide attempts and have fewer psychiatric interventions than young people. Furthermore, they have old-age specific psychosocial difficulties. The present study investigated psychosocial risk factors and characteristics of an index suicide attempt of the elderly suicide attempters.Methods: Subjects included 388 patients who were admitted to the emergency room following self-poisoning. Two age groups were defined: younger patients (aged less than 65 years) and older patients (aged over 65 years). Data including demographic factors, suicidal risk factors and information about the current suicide attempt were obtained from a retrospective chart review.Results: The number of suicide attempters over the age of 65 years old was 57, and their mean age was 73.5 ± 7.5 years. The elderly patients had more underlying medical illnesses than the under-65 group (p < 0.001). Depression was the most common psychiatric diagnosis. Psychotropics were the most commonly ingested drugs in both groups, but the use of pesticides was more notable in the elderly. The elderly suicide attempters had higher risk-rating scores (p < 0.001) and lower rescue-rating scores (p = 0.014) than the under-65 group. Male-to-female ratio of the elderly group was nearly 1:1 unlike the under-65 group (p = 0.004).Conclusion: Elderly suicide attempters had different psychosocial stressors such as physical illness and more lethal suicide attempts. Our study suggests the need for development of specific preventive strategies and management guidelines for the elderly suicide attempters.

Statistical Review of the Suicide Attempts Rates Committed on Polish Railway Tracks between the years 2013-2016

2021 ◽  
Vol 21 ◽  
Author(s):  
Marta Makara-Studzinska ◽  
Adam Czabański ◽  
Katarzyna Gronowska ◽  
Jerzy Leszek ◽  
Elizaveta V. Mikhaylenko ◽  
...  
Keyword(s):  
Risk Factors ◽  
Suicide Attempts ◽  
Alcohol Intoxication ◽  
Health Issues ◽  
Significant Group ◽  
Statistical Review ◽  
Railway Tracks ◽  
Suicide Behavior ◽  
And Behavior ◽  
Railway Suicide

Abstract: Suicides on railway tracks are one of the most drastic ones. No research concerning this phenomenon has been done to this date in Poland. This article focuses on the connection between suicidal behaviors on Polish railway tracks and sociodemographic traits and presents risk factors. Background: The suicide behavior is largely spread among many European countries. Of these, Poland ranks 22nd in terms of suicide attempts. This study aims to highlight the suicide attempts rates on Polish railways lines and their main risk factors. Limitations: Limited number of available statistical data before 2013. Method: Statistical review of the available Central Police headquarters database and analyses of the influence of the risk factors on people’s awareness during the suicide attempts and their geographical distribution in Poland during the years 2013 - 2016. The prevalence of railway suicides in individual voivodeships (provinces) in Poland have been indicated in a 3D map. Results: There were 834 cases of railway suicide fatalities across the entire country. Of the total suicide statistics by any means, 3.75% are railway related. The average known age of those committing railway suicides were: 37.9 years for men (n = 627) and 34.6 for women (n = 155). In most cases, suicides were committed by bachelors (54.3%). The largest group of people who committed suicide had a primary level of education (42.0%). Among the suicides, a significant group are unemployed (45.2%). Alcohol intoxication have been established as responsible for a person’s lower awareness of his actions in 70.9% of cases. Almost 63.3% of people had a higher propensity for suicidal ideation and behavior, resulting in their being treated for mental health issues. Conclusion: Alcohol intoxication, illegal narcotics and psychotropic medication are responsible for a person’s lower awareness during his ore her actions, in most of the cases of suicide on Polish railway lines.

Risk Factors Associated With Various Severities of Suicidal and Non-Suicidal Self-Harm Among Israel Defense Forces Soldiers—A Nested Case–Control Study

2022 ◽  
Author(s):  
Nizan Shakarchy ◽  
Lucian Tatsa-Laur ◽  
Ron Kedem ◽  
Ariel Ben Yehuda ◽  
Leah Shelef
Keyword(s):  
Mental Health ◽  
Soviet Union ◽  
Former Soviet Union ◽  
Suicide Attempts ◽  
Average Frequency ◽  
Case Control ◽  
Care Physician ◽  
Suicide Attempters ◽  
Suicide Behavior ◽  
Nested Case Control

ABSTRACT Objective Severe suicide attempt is a major risk factor for completed suicide. The aim of the present study was to focus on suicide behavior and timing to gain better understanding of these populations. Method The nested case–control retrospective study based on medical records of 246,866 soldiers, who demonstrated suicide attempts of varying severity, including death by suicide were compared with soldiers who did not demonstrate such behavior. Results Risk for death by suicide was associated with males, military seniority of less than 12 months. High frequency of visits with mental health care professionals was associated with being severe suicide attempters (SAs). Moderate suicide attempts were associated with being a male, visiting a primary care physician frequently, and belonging to one of the two latest immigrant groups in Israel (Ethiopians and former Soviet Union). Mild suicide attempts were associated with having a psychiatric diagnosis on the enlistment day, visiting a mental health care professional at high or average frequency, visiting a primary care physician at high or average frequency, being a male, and being born in the former Soviet Union. While the proportion of males demonstrating suicidal behavior was higher than the females’, severe SAs were higher among females. There was a clear tendency of female suicide attempters at all levels to act toward the end of their military service. Conclusions Although half of the SAs were females, their characteristics may be similar to those of the male SAs, contrary to the sex differences in suicide behavior among civilians.

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