Suicide Attempts 1973–1977—Urban Hobart. A Further Five Year Follow up Reporting a Decline

1978 ◽  
Vol 12 (3) ◽  
pp. 169-173 ◽  
Author(s):  
Karl Roller ◽  
Walter Slaghuis

In urban Hobart 1968-1972 there was a steep climb in the self-poisoning rates, reaching a peak in 1972. This rise was largely attributed to an increase in self-poisonings by young males and an overall increase by females. During this period psychotropic overdoses commenced. In 1973-1977 self-poisoning and self-injury rates were calculated. Contrary to the previous five year experience rates either declined during 1973 to 1977 or fell from a previous high rate to level off at a lower rate. These changes have particularly affected both sexes under 35 years. The abuse of psychotropic substances continued to soar. A possible explanation of these changes may lie in local factors. The results are contrasted with the most recent literature.

2021 ◽  
pp. 1-9
Author(s):  
Richard T. Liu

Abstract Background Although the clinical importance of non-suicidal self-injury (NSSI) has received increasing recognition, relatively little is known about its epidemiology. The objective of this study was to estimate the lifetime prevalence of NSSI in adults and its association with sociodemographic characteristics, psychiatric disorders, and lifetime treatment for NSSI. Methods A nationally representative face-to-face survey was conducted with 7192 adults aged ≥18 years in England. Respondents were interviewed about engagement in NSSI, psychiatric illness, suicidal thoughts and behavior, and treatment history for this behavior. Results The estimated lifetime prevalence rate of NSSI was 4.86%. Younger age, growing up without biological parents in the household, being unmarried, and impoverished backgrounds were associated with NSSI. The majority of respondents with lifetime NSSI (63.82%) had at least one current psychiatric disorder. Most psychiatric conditions were associated with greater odds of lifetime NSSI in multivariate models. NSSI was strongly associated with suicidal ideation and suicide attempts, respectively, even after accounting for psychiatric disorders and sociodemographic covariates. A substantial proportion of respondents with NSSI history (30.92%) have engaged in medically severe self-harm, as indexed by requiring medical attention for this behavior. The majority of respondents with NSSI (56.20%) had not received psychiatric care for this behavior. Conclusions NSSI is prevalent in the general population and associated with considerable psychiatric comorbidity. A high rate of unmet treatment needs is evident among those with this behavior. Those at the greatest lifetime risk for NSSI may also be particularly limited in their resources to cope with this behavior.


2019 ◽  
Vol 65 (1) ◽  
pp. 5-15 ◽  
Author(s):  
Jennifer Wong ◽  
Anees Bahji ◽  
Sarosh Khalid-Khan

Background: Evidence regarding the efficacy of psychotherapy in adolescents with borderline personality disorder (BPD) symptomatology has not been previously synthesized. Objective: To conduct a systematic review and meta-analysis of the randomized controlled trials (RCTs) in order to assess the efficacy of psychotherapies in adolescents with BPD symptomatology. Methods: Seven electronic databases were systematically searched using the search terms BPD, adolescent, and psychotherapy from database inception to July 2019. Titles/abstracts and full-texts were screened by one reviewer; discrepancies were resolved via consensus. We extracted data on BPD symptomatology, including BPD symptoms, suicide attempts, nonsuicidal self-injury, general psychopathology, functional recovery, and treatment retention. Data were pooled using random-effects models. Results: Of 536 papers, seven trials (643 participants) were eligible. Psychotherapy led to significant short-term improvements in BPD symptomatology posttreatment ( g = −0.89 [−1.75, −0.02]) but not in follow-up ( g = 0.06 [−0.26, 0.39]). There was no significant difference in treatment retention between the experimental and control groups overall (odds ratio [ OR] 1.02, 95% confidence interval [CI], 0.92 to 1.12, I 2 = 52%). Psychotherapy reduced the frequency of nonsuicidal self-injury ( OR = 0.34, 95% CI, 0.16 to 0.74) but not suicide attempts ( OR = 1.03, 95% CI, 0.46 to 2.30). Conclusions: There is a growing variety of psychotherapeutic interventions for adolescents with BPD symptomatology that appears feasible and effective in the short term, but efficacy is not retained in follow-up—particularly for frequency of suicide attempts.


2021 ◽  
Vol 34 (4) ◽  
pp. e100452
Author(s):  
Alison Ann Tebbett-Mock ◽  
Madeline McGee ◽  
Ema Saito

BackgroundDialectical behaviour therapy (DBT) is an evidence-based treatment for adolescents targeting suicidal and non-suicidal self-injurious behaviours. Research supports DBT’s efficacy in inpatient settings, but implementation and sustainability are understudied.AimsThis study is a follow-up of a previous study by Tebbett-Mock et al and examines the efficacy and sustainability of an adolescent DBT inpatient unit within a psychiatric hospital in the Northeast. We hypothesised that adolescents who received DBT in our follow-up group (DBT Group 2) would not have statistical difference (ie, greater or fewer) of the following compared with the first group of patients who received DBT on the unit the year prior (DBT Group 1) and would have significantly fewer of the following compared with the treatment as usual (TAU) group: (1) constant observation hours for suicidal ideation, self-injury and aggression; (2) incidents of suicide attempts, self-injury and aggression; (3) restraints; (4) seclusions; (5) days hospitalised; (6) times readmitted to the unit within 30 days of discharge.MethodsWe conducted a retrospective chart review for adolescents receiving inpatient DBT (DBT Group 1, n=425; DBT Group 2, n=393) and a historical control group (TAU, n=376). The χ2 tests and one-way analysis of variance were conducted as preliminary analyses to examine group differences on diagnosis, gender and age. Kruskal-Wallis H tests were conducted to examine group differences on outcomes. Mann-Whitney U tests were used as post hoc analyses.ResultsPatients in DBT Group 2 were comparable to DBT Group 1 for the number of constant observation hours for self-injury (U=83 432.50, p=0.901), restraints (U=82 109, p=0.171) and days hospitalised (U=83 438.5, p=0.956). Patients in DBT Group 2 had a significantly greater number of incidents of suicide attempts compared with DBT Group 1 (U=82 662.5, p=0.037) and of self-injury compared with patients in DBT Group 1 (U=71724.5, p<0.001) and TAU (U=65649.0, p<0.001).ConclusionsResults provide support for adolescent inpatient DBT compared with TAU and highlight staff turnover and lack of training as potential barriers to sustainability and efficacy.


Author(s):  
Judit Balazs ◽  
Lili Olga Horvath

Eating disorders (EDs), especially anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED) often co-occur with suicidal behaviour and non-suicidal self-injury (NSSI). The shared epidemiological and risk factors of EDs, suicidal behaviour, and NSSI include the self-destructive and body-focused characteristics of these behaviours; body dissatisfaction, interoceptive deficits, emotion dysregulation, impulsivity, and several environmental risk factors. Compared to the general population, lifetime rates of suicidal ideation, suicide attempts, and NSSI are increased among patients with AN, BN, or BED. Risk factors play a role in the development of suicidal behaviour in patients with EDs, including comorbid psychopathology that is associated with an increased risk of suicide itself, increased impulsive behaviours including NSSI, the duration of illness, and the number of previous treatments. Being aware of the increased risk and the ED-specific risk factors of suicidal behaviour are essential for preventing suicide and treating clinical risk factors in patients with EDs.


Crisis ◽  
2008 ◽  
Vol 29 (4) ◽  
pp. 209-212 ◽  
Author(s):  
Merete Nordentoft ◽  
Jacob Branner

The objective was to examine gender differences in choice of method and suicidal intent among persons referred to a suicide prevention center. A total of 351 consecutive patients who had attempted suicide were interviewed using the European Parasuicide Study Interview Schedule I (EPSIS I) while participating in a 2-week inpatient treatment program. They were invited to a 1-year follow-up interview, and followed in the National Patient Register. Compared to women, men who had attempted suicide were older, had better self-esteem, fewer depressive symptoms, and higher total suicidal intention scores, but they were not more likely to use violent methods. Neither use of violent method nor dangerousness of the attempt was associated with suicidal intention. Although men had higher suicide intent scores than women, there were no significant gender differences in the number of repeat suicide attempts during a 1-year follow-up period. Suicidal intent was not related to dangerousness of suicide method.


Crisis ◽  
2018 ◽  
Vol 39 (5) ◽  
pp. 318-325 ◽  
Author(s):  
Barbara Stanley ◽  
Glenn W. Currier ◽  
Megan Chesin ◽  
Sadia Chaudhury ◽  
Shari Jager-Hyman ◽  
...  

Abstract. Background: External causes of injury codes (E-codes) are used in administrative and claims databases for billing and often employed to estimate the number of self-injury visits to emergency departments (EDs). Aims: This study assessed the accuracy of E-codes using standardized, independently administered research assessments at the time of ED visits. Method: We recruited 254 patients at three psychiatric emergency departments in the United States between 2007 and 2011, who completed research assessments after presenting for suicide-related concerns and were classified as suicide attempters (50.4%, n = 128), nonsuicidal self-injurers (11.8%, n = 30), psychiatric controls (29.9%, n = 76), or interrupted suicide attempters (7.8%, n = 20). These classifications were compared with their E-code classifications. Results: Of the participants, 21.7% (55/254) received an E-code. In all, 36.7% of research-classified suicide attempters and 26.7% of research-classified nonsuicidal self-injurers received self-inflicted injury E-codes. Those who did not receive an E-code but should have based on the research assessments had more severe psychopathology, more Axis I diagnoses, more suicide attempts, and greater suicidal ideation. Limitations: The sample came from three large academic medical centers and these findings may not be generalizable to all EDs. Conclusion: The frequency of ED visits for self-inflicted injury is much greater than current figures indicate and should be increased threefold.


Crisis ◽  
2003 ◽  
Vol 24 (2) ◽  
pp. 73-78 ◽  
Author(s):  
Yves Sarfati ◽  
Blandine Bouchaud ◽  
Marie-Christine Hardy-Baylé

Summary: The cathartic effect of suicide is traditionally defined as the existence of a rapid, significant, and spontaneous decrease in the depressive symptoms of suicide attempters after the act. This study was designed to investigate short-term variations, following a suicide attempt by self-poisoning, of a number of other variables identified as suicidal risk factors: hopelessness, impulsivity, personality traits, and quality of life. Patients hospitalized less than 24 hours after a deliberate (moderate) overdose were presented with the Montgomery-Asberg Depression and Impulsivity Rating Scales, Hopelessness scale, MMPI and World Health Organization's Quality of Life questionnaire (abbreviated versions). They were also asked to complete the same scales and questionnaires 8 days after discharge. The study involved 39 patients, the average interval between initial and follow-up assessment being 13.5 days. All the scores improved significantly, with the exception of quality of life and three out of the eight personality traits. This finding emphasizes the fact that improvement is not limited to depressive symptoms and enables us to identify the relative importance of each studied variable as a risk factor for attempted suicide. The limitations of the study are discussed as well as in particular the nongeneralizability of the sample and setting.


Author(s):  
David J. Lobina

The introduction of recursion into linguistics was the result of applying some of the results of mathematical logic to the study of language. In particular, recursion was introduced in the 1950s as a general property of the mechanical procedure underlying the grammar, in order to account for language’s discrete infinity and expressive power—in the 1950s, this mechanical procedure was a production system, whereas more recently, of course, it is the set-operator merge. Unfortunately, the recent literature has confused the general recursive property of a grammar with specific instances of (recursive) rules/operations within a grammar; more worryingly still, there has been a general conflation of these recursive rules with some of the self-embedded structures these rules can generate, adding to the confusion. The conflation is manifold but always fallacious. Moreover, language manifests a much more generally recursive structure than is usually recognized: bundles of the universal (Specifier)-Head-Complement(s) geometry.


2021 ◽  
Vol 9 ◽  
pp. 205031212110147
Author(s):  
Nobuhiko Sumiyoshi ◽  
Kazuhiro Oinuma ◽  
Yoko Miura

Background: Adverse reactions to metal debris are significant complications after metal-on-metal total hip arthroplasty. Recently, late appearances of adverse reactions to metal debris and subsequent need for reoperations have been reported with small-diameter head metal-on-metal devices. We retrospectively investigated mid-term clinical outcomes of small-head metal-on-metal total hip arthroplasty. Methods: We reviewed 159 hips in 139 patients who had a small-head metal-on-metal total hip arthroplasty (M2a Taper; Biomet, Warsaw, IN) with a minimum 5-year follow-up and documented postoperative complications. Results: Focal osteolysis in either the femur or acetabulum was observed in 12 hips (7.5%, 44 months after surgery on average), with pseudotumor observed in 8 hips (5%, 120 months after surgery on average). Four hips (2.5%) had dislocations (84 months after surgery on average) and six hips (3.8%, 122 months after surgery on average) underwent reoperation. Conclusion: Small-head metal-on-metal total hip arthroplasty is associated with a high degree of complications at mid-term follow-up period. Considering this, we discourage the use of metal-on-metal total hip arthroplasty regardless of head size.


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