Psychological, Structural, Social and Economic Determinants of Suicide Attempt: Risk Assessment and Decision Making Strategies

2021 ◽  
pp. 003022282110034
Author(s):  
Azam Farmani ◽  
Mojtaba Rahimianbougar ◽  
Yousef Mohammadi ◽  
Hossein Faramarzi ◽  
Siamak Khodarahimi ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Suicide Attempt ◽  
Suicide Attempts ◽  
Psychological Services ◽  
Cross Sectional ◽  
Economic Determinants ◽  
History Of ◽  
Cross Sectional Design ◽  
High Level ◽  
Risk Assessment And Management

The aim of this research was to conduct a risk assessment and management of psychological, structural, social and economic determinants (PSSED) in a suicide attempt. The sample consisted of 353 individuals who had a recorded history of suicidal attempt; and 20 professional individuals by purposive sampling method within a descriptive cross-sectional design. Worksheets for RAM and AHP were used for data collection in this study. The rate of suicide attempt was 7.21 per 100,000 population in this study. Analysis showed that depression and mental disorders; personality disorders; family problems; socio-cultural and economic problems; lack of awareness; and low level of education have a high level of risk for suicide attempts. Psychiatric and psychological services; awareness and knowledge of life skills; medical services to dysfunctional families; development of community-based planning for PSSED of suicide; and employment and entrepreneurship services may lower suicide attempt risk.

Depressed Multiple-Suicide­Attempters – A High-Risk Phenotype

Crisis ◽  
2017 ◽  
Vol 38 (6) ◽  
pp. 367-375 ◽  
Author(s):  
Leo Sher ◽  
Michael F. Grunebaum ◽  
Ainsley K. Burke ◽  
Sadia Chaudhury ◽  
J. John Mann ◽  
...  
Keyword(s):  
Family History ◽  
Suicide Attempt ◽  
Suicide Attempts ◽  
Borderline Personality ◽  
Cross Sectional ◽  
Suicide Attempters ◽  
Depressed Patients ◽  
Suicide Intent ◽  
History Of ◽  
Cross Sectional Design

Abstract. Background: There is compelling evidence that suicide attempts are among the strongest predictors of suicide and future suicide attempts. Aim: This study aimed to examine psychopathology in multiple-suicide attempters. Method: We compared the demographic and clinical features of three groups: depressed patients without a history of suicide attempts (non-attempters), depressed patients with a history of one to three suicide attempts (attempters), and depressed patients with a history of four or more suicide attempts (multiple attempters). Results: We found that attempters and multiple attempters had higher levels of depression, hopelessness, aggression, hostility, and impulsivity and were more likely to have borderline personality disorder and family history of major depression or alcohol use disorder compared with non-attempters, but did not differ between each other on these measures. Multiple attempters had greater suicidal ideation at study entry and were more likely to have family history of suicide attempt compared with attempters. Importantly, multiple attempters had greater suicide intent at the time of the most medically serious suicide attempt and more serious medical consequences during their most medically serious suicide attempt compared with attempters. Limitations: The cross-sectional design of the study. Conclusion: Our data suggest that multiple-suicide attempters require careful evaluation as their behavior can have serious medical consequences.

scholarly journals Changes in the pattern of suicide attempters visiting the emergency room after COVID-19 pandemic: an observational cross sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ji-Hun Kang ◽  
Si-Won Lee ◽  
Jae-Gu Ji ◽  
Jae-Kwang Yu ◽  
Yun-Deok Jang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Suicide Attempt ◽  
Systolic Blood Pressure ◽  
Emergency Room ◽  
Suicide Attempts ◽  
Educational Background ◽  
Management Program ◽  
Cross Sectional ◽  
History Of ◽  
At Home

Abstract Background This study aimed to find out the change in the rate and pattern of suicide attempts during severe acute respiratory syndrome COVID-19 pandemic period. Methods This study was a retrospective analysis of data collected as a part of an emergency room-based post-suicide management program. The data were collected through interviews and from medical records of suicide attempts, maintained in the emergency room, from January 19 to October 31, 2020, during the “COVID-19 period,” and those who attempted suicide from January 19 to October 31, 2019 “pre-COVID-19 period.” We extracted educational background, marital status, occupation, presence of domestic partner, history of mental illness, alcohol consumption, history of previous suicide attempts; suicide attempt method and location (i.e., at home or a place other than home) at the time of attempt, and whether the attempt was a mass suicide. In addition, we compared patient severity between “COVID-19 period” and “pre-COVID-19 period” using the initial KTAS (South Korean triage and acuity scale) level, consciousness level, and systolic blood pressure. In 2012, KTAS was developed through the Ministry of Health and Welfare’s research project to establish triage system in South Korea. Results The analysis of the number of suicide attempts during “pre-COVID-19 period” and “ COVID-19 period” showed that the number of suicide attempts during “COVID-19 period” (n = 440) increased compared to the “pre-COVID-19 period” (n = 400). Moreover, the method of suicide attempts during “COVID-19 period” included overdose of drugs such as hypnotics, antipsychotics, and pesticides that were already possessed by the patient increased compared to the “pre-COVID-19 period” (P < 0.05). At the time of the visit to the emergency room, high KTAS level, low level of consciousness, and low systolic blood pressure, were observed, which were significantly different between “COVID-19 period” and “pre-COVID-19 period” (P < 0.05). Conclusion With the worldwide COVID-19 virus spread, suicide rate and suicide attempts at home have significantly increased. In addition, patient severity was higher in the “COVID-19 period” than that in the “pre-COVID-19 period.” The increasing suicide attempt rate should be controlled by cooperation between the emergency room and regional organizations.

scholarly journals History of suicide attempts and COVID-19 infection in Veterans with schizophrenia or schizoaffective disorder: moderating effects of age and body mass index

2021 ◽  
Author(s):  
Olaoluwa O. Okusaga ◽  
Rachel L. Kember ◽  
Gina M. Peloso ◽  
Roseann E. Peterson ◽  
Marijana Vujkovic ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Suicide Attempt ◽  
Body Mass ◽  
Schizoaffective Disorder ◽  
Suicide Attempts ◽  
Medical Center ◽  
Cross Sectional ◽  
Suicide Attempters ◽  
History Of ◽  
The Relationship

Introduction: Relative to the general population, patients with schizophrenia or schizoaffective disorder have higher rates of suicide attempts and mortality from COVID-19 infection. Therefore, determining whether a history of suicide attempt is associated with COVID-19 in patients with schizophrenia or schizoaffective disorder has implications for COVID-19 vulnerability stratification in this patient population. Methods: We carried out cross-sectional analyses of electronic health records (EHR) of veterans with a diagnosis of schizophrenia or schizoaffective disorder that received treatment at any United States Veterans Affairs Medical Center between January 1, 2020 to January 31, 2021. We used logistic regression to estimate unadjusted and adjusted (including age, sex, race, marital status, body mass index (BMI), and a medical comorbidity score) odds ratios (ORs) for COVID-19 positivity in suicide attempters relative to non-attempters. Results: A total of 101,032 Veterans [mean age 56.67 ± 13.13 years; males 91,715 (90.8%)] were included in the analyses. There were 2,703 (2.7%) suicide attempters and 719 (0.7%) patients were positive for COVID-19. The association between history of suicide attempt and COVID-19 positivity was modified by age and BMI, such that the relationship was only significant in patients younger than 59 years, and in obese (BMI ≥ 30) patients (adjusted OR 3.42, 95% CI 2.02 - 5.79 and OR 2.85, 95% CI 1.65 - 4.94, respectively). Conclusions: Higher rates of COVID-19 in young or obese suicide attempters with a diagnosis of schizophrenia or schizoaffective disorder might be due to elevated risk for the infection in this sub-group of patients.

scholarly journals Association of firearm exposure during youth with lifetime incidence of suicide ideation and suicide attempts

2021 ◽  
Author(s):  
Craig J. Bryan ◽  
AnnaBelle O. Bryan ◽  
Michael D. Anestis
Keyword(s):  
Suicide Attempt ◽  
Suicide Ideation ◽  
Suicide Attempts ◽  
Preliminary Evidence ◽  
Cross Sectional ◽  
Lifetime History ◽  
Firearm Availability ◽  
Childhood Home ◽  
History Of ◽  
Suicidal Thoughts And Behaviors

Abstract Background: Preliminary evidence suggests firearm availability may increase the risk for suicide ideation and attempts, two common precursors to suicide death. Little is known about which aspects of firearm availability may account for this association. The primary purpose of this study was to examine associations among multiple dimensions of firearm availability with lifetime history of suicide ideation and attempts.Methods: A cross-sectional, anonymous survey was administered to 6200 U.S. adults from March 5, 2020, to March 17, 2020. Participants were asked to report firearm availability, firearm use, and suicidal thoughts and behaviors over the lifespan. Results: Rates of lifetime suicide ideation were significantly elevated among participants reporting a firearm in their childhood home (odds ratio [OR]=1.3, 95% confidence interval [CI]=1.1-1.5). Rates of lifetime suicide attempt were significantly elevated among participants reporting a firearm in their childhood home (OR=1.8, 95% CI=1.5-2.2) and participants who first acquired a firearm before the age of 11 (OR=3.8, 95% CI=2.6-5.8). Among participant with a lifetime history of suicide ideation, rates of lifetime suicide attempt were significantly elevated among participants who first acquired a firearm before the age of 11 (OR=3.0, 95% CI=1.4-6.4), but this relationship was no longer significant when adjusting for demographics and negative affectivity (OR=2.4, 95% CI=0.96-6.0). Conclusions: Adults who were raised in a home with a firearm and/or first acquired a firearm were significantly more likely to have attempted suicide during their lives. Additional research examining the mechanisms by which early life firearm exposure might increase suicide risk across the lifespan is warranted.

scholarly journals Volumetric MRI analysis of brain structures in patients with history of first and repeated suicide attempts: a cross sectional study

2020 ◽  
Author(s):  
Milda Sarkinaite ◽  
Rymante Gleizniene ◽  
Virginija Adomaitiene ◽  
Kristina Dambrauskiene ◽  
Nijole Raskauskiene ◽  
...  
Keyword(s):  
Suicide Attempt ◽  
Left Hemisphere ◽  
Cortical Thickness ◽  
Suicide Attempts ◽  
Right Hemisphere ◽  
Brain Structures ◽  
Brain Regions ◽  
Cross Sectional ◽  
Suicide Attempters ◽  
History Of

Abstract Background Structural brain changes are found in suicide attempters, as well as in patients with mental disorders. It remains unclear whether the suicidal behavior is related to atrophy of brain regions and how the morphology of specific brain areas is changing with each suicide attempt. This cross-sectional study examined volumetric differences in brain regions among patients with history of first and repeated suicide attempts in comparison to healthy controls (HC). Methods The sample consisted of 56 adults, non-psychotic patients without cognitive impairment and any organic brain disorders hospitalized after first suicide attempt (first SA) (n=29) and more than one suicide attempt (SA>1) during the lifetime (n=27); and 54 adult volunteers without history of mental disorder and suicide attempts, designated as HC. The MRI data were collected using 1.5 T Siemens Avanto scanner. Brain cortical thickness, grey and white matter volumes were measured using FreeSurfer 6.0 automatic segmentation technique. Results In comparison to HC, patients with first SA had 3.5, 3.58 and 4.19% significantly lower mean cortical thickness of the superior and rostral middle frontal areas of the left hemisphere and superior frontal area of the right hemisphere, respectively; 4.09, 4.02 and 4.49% lower mean cortical thickness of the inferior, middle and superior temporal areas of the left hemisphere, respectively. In comparison to HC, patients after SA>1 had a significantly lower mean cortical thickness (from 4.02 to 8.33%) in ten areas of frontal cortex of the left hemisphere and seven areas of the right hemisphere; from 3.90 to 6.04% difference in six areas of temporal cortex in both hemispheres. The comparison of hippocampus volume showed a significantly lower mean volume (7.86 to 9.89%) of left and right parts in patients with SA>1, but not in patients with first SA. Conclusions Hospitalized suicide attempters had lower frontal and temporal cortical thickness and smaller parts of hippocampus than HC; these differences were significantly higher in repeated suicide attempters than in patients with first SA. Our findings suggest that repeated suicidal behavior is associated with intensifying atrophy of specific brain structures, independently of diagnosis of depressive disorders.

A Comparison of Attitudes Toward Suicide Among Individuals With and Without Suicidal Thoughts and Suicide Attempts in South Korea

Crisis ◽  
2019 ◽  
Vol 40 (1) ◽  
pp. 27-35 ◽  
Author(s):  
Sang-Uk Lee ◽  
Mina Jeon ◽  
Jong-Ik Park
Keyword(s):  
Suicide Attempt ◽  
South Korea ◽  
Suicide Prevention ◽  
Suicide Attempts ◽  
Suicidal Thought ◽  
Suicidal Thoughts ◽  
Cross Sectional ◽  
Suicidal Person ◽  
History Of ◽  
Attitudes Toward Suicide

Abstract. Background: A suicidal person can go through different stages that include suicidal thoughts and suicide attempts. For a few individuals, these can end up with suicide. However, there have been no studies investigating any differences in attitudes toward suicides among individuals with no suicidal thoughts, those with suicidal thoughts, and those with suicide attempts. Aims: This study was carried out to compare attitudes toward suicide among three different groups: individuals with a history of no suicidal thoughts, those with a history of suicidal thoughts, and those with a history of suicide attempts. Method: To examine Koreans' attitudes toward suicide, we analyzed the data from the 2013 National Suicide Survey involving 1,500 participants aged between 19 and 75 years. Results: Different attitudes toward suicide were found among the three groups. Persons reporting that they had made a suicide attempt in their life showed the most permissive attitudes toward suicide. Limitations: Since this research is based on cross-sectional data, it is difficult to eliminate the possibility of changes in attitude toward suicide completely after having a suicidal thought and suicide attempt. Conclusion: These results can be a useful source for constructing effective messages for suicide prevention campaigns and can ultimately contribute to an improvement in the public's perceptions of suicide in the future.

The Attitudes of Nursing Students towards Patients Who Attempt Suicide: A Study from Central India

2018 ◽  
Vol 3 (02) ◽  
Author(s):  
Deepak Ghormode ◽  
Pramod Gupta ◽  
S. K. Singh ◽  
Devendra Ratnani
Keyword(s):  
Nursing Students ◽  
Suicide Attempt ◽  
Suicide Attempts ◽  
Central India ◽  
Cross Sectional ◽  
Favourable Attitude ◽  
Global Health Issue ◽  
Cross Sectional Design ◽  
Suicide Prevention Training ◽  
Training Programmes

Background: Suicide being a global health issue, the attitudes and beliefs of the healthcare professionals towards these attempters have significant effect on the outcome of the treatment. Objectives: Aim of the study was to assess the attitude of nursing students towards patients with suicide attempt. Materials and Methods: The study had a cross sectional design of 284 nursing students who were randomly recruited from the two institutions. Suicide opinion Questionnaire was administered. Results: Most were young single females, from rural locality, who were pursuing either BSc Nursing or GNM courses. Very few had previous exposure to suicide prevention training programmes. More than half of the students showed favourable attitude towards patients with suicidal attempt. Majority of students showed favourable attitudes for more than half of the attitudinal statements giving importance to the mental illness, disturbed family life, and depression and risk factors for suicide attempt. Unfavourable and uncertain attitude was noticed for a few of the statements. Conclusions: The nursing students showed favourable attitude towards patients with suicide attempts. More educational and training programs are therefore needed in these students for improving the uncertain and unfavourable responses to a few of these attitudes for better management of these patients.

The death-implicit association test and suicide attempts: a systematic review and meta-analysis of discriminative and prospective utility

2021 ◽  
pp. 1-10
Author(s):  
Maya N. Sohn ◽  
Carly A. McMorris ◽  
Signe Bray ◽  
Alexander McGirr
Keyword(s):  
Risk Assessment ◽  
Suicide Attempt ◽  
Suicidal Behaviour ◽  
Implicit Association Test ◽  
Suicide Risk ◽  
Suicide Attempts ◽  
Association Test ◽  
Implicit Association ◽  
Suicide Risk Assessment ◽  
History Of

Abstract Suicide risk assessment involves integrating patient disclosure of suicidal ideation and non-specific risk factors such as family history, past suicidal behaviour, and psychiatric symptoms. A death version of the implicit association test (D-IAT) has been developed to provide an objective measure of the degree to which the self is affiliated with life or death. However, this has inconsistently been associated with past and future suicidal behaviour. Here, we systematically review and quantitatively synthesize the literature examining the D-IAT and suicide attempts. We searched psychINFO, Medline, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception until 9 February 2021 to identify publications reporting D-IAT scores and suicide attempts (PROSPERO; CRD42020194394). Using random-effects models, we calculated standardized mean differences (SMD) and odds ratios (ORs) for retrospective suicide attempts. We then calculated ORs for future suicide attempts. ORs were dichotomized using a cutoff of zero representing equipoise between self-association with life and death. Eighteen studies met our inclusion criteria (n = 9551). The pooled SMD revealed higher D-IAT scores in individuals with a history of suicide attempt (SMD = 0.25, 95% CI 0.15 to 0.35); however, subgroup analyses demonstrated heterogeneity with acute care settings having lower effect sizes than community settings. Dichotomized D-IAT scores discriminated those with a history of suicide attempt from those without (OR 1.38 95% CI 1.01 to 1.89) and predicted suicide attempt over a six-month follow-up period (OR 2.99 95% CI 1.45 to 6.18; six studies, n = 781). The D-IAT may have a supplementary role in suicide risk assessment; however, determination of acute suicide risk and related clinical decisions should not be based solely on D-IAT performance.

A Comparison of Self-Harm Presentations to Emergency Services

Crisis ◽  
2020 ◽  
Vol 41 (5) ◽  
pp. 389-397
Author(s):  
Hayley Chartrand ◽  
Bruce Tefft ◽  
Jitender Sareen ◽  
Diane Hiebert-Murphy ◽  
Laurence Y. Katz ◽  
...  
Keyword(s):  
Emergency Services ◽  
Suicide Attempts ◽  
Tertiary Care ◽  
Previous History ◽  
Adjustment Disorder ◽  
Cross Sectional ◽  
Need For Treatment ◽  
History Of ◽  
Self Harm ◽  
Cross Sectional Design

Abstract. Background: In the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, the distinction between nonsuicidal self-injury (NSSI) and suicide attempts (SA) is highlighted in the section of conditions for further study. Aims: The objective of this study was to examine the correlates of people who presented to emergency departments (ED) with NSSI compared with those who presented with SA and no self-harm or suicidal ideation (no SH or SI). Method: Data came from 4,772 presentations to ED of tertiary care hospitals in Manitoba, Canada, between January 2009 and June 2012. Chart reviews were conducted for presentations with NSSI ( n = 158), and a sample of SA ( n = 172) and no SH or SI ( n = 173). Results: NSSI was associated with borderline personality traits/disorders, previous history of SH, and aggression/impulsivity compared with no SH or SI. SA was associated with a lower likelihood of adjustment disorder ( OR = 0.58; 95 % CI [0.34, 0.99]) and previous history of NSSI ( OR = 0.30; 95 % CI [0.17, 0.53]) compared with NSSI. Limitations: A limitation of this study is its cross-sectional design. Conclusion: Given the distress associated with NSSI, the findings highlight the need for treatment plans that address all those who present to ED with SH regardless of intent.

Is suicide predictable? A classification of predictive factors in Iranian women who had multiple suicide attempts

2011 ◽  
Vol 26 (S2) ◽  
pp. 1642-1642
Author(s):  
T. Seghatoleslam ◽  
H. Habil ◽  
O. Rezaee ◽  
S. Sadr ◽  
R. Emamhadi
Keyword(s):  
Substance Abuse ◽  
Suicide Attempt ◽  
Predictive Factors ◽  
Suicide Attempts ◽  
Cross Sectional Study ◽  
Mental Illnesses ◽  
Contributing Factors ◽  
Cross Sectional ◽  
Positive History ◽  
History Of

BackgroundThe current study aims to test the hypothesis: Is suicide predictable? And try to classify the predictive factors in multiple suicide attempts.MethodA cross-sectional study was administered to 223 multiple attempters, women who came to a medical poison centre after a suicide attempt. The participants were young, poor, and single. A Regression Logistic Test was used to classify the predictive factors of suicide.ResultsWomen who had multiple suicide attempts exhibited a significant tendency to attempt suicide again. They had a history for more than two years of multiple suicide attempts, from three to as many as 18 times, plus mental illnesses such as depression and substance abuse. They also had a positive history of mental illnesses.ConclusionResults indicate that contributing factors for another suicide attempt include previous suicide attempts, mental illness (depression), or a positive history of mental illnesses in the family affecting them at a young age, and substance abuse.

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