scholarly journals How do repeat suicide attempters differ from first timers? An exploratory record based analysis

2016 ◽  
Vol 7 (01) ◽  
pp. 91-96 ◽  
Author(s):  
Vikas Menon ◽  
Shivanand Kattimani ◽  
Siddharth Sarkar ◽  
Kaliaperumal Mathan

ABSTRACT Background: Evidence indicates that repeat suicide attempters, as a group, may differ from 1st time attempters. The identification of repeat attempters is a powerful but underutilized clinical variable. Aims: In this research, we aimed to compare individuals with lifetime histories of multiple attempts with 1st time attempters to identify factors predictive of repeat attempts. Setting and Design: This was a retrospective record based study carried out at a teaching cum Tertiary Care Hospital in South India. Methods: Relevant data was extracted from the clinical records of 1st time attempters (n = 362) and repeat attempters (n = 61) presenting to a single Tertiary Care Center over a 4½ year period. They were compared on various sociodemographic and clinical parameters. The clinical measures included Presumptive Stressful Life Events Scale, Beck Hopelessness Scale, Coping Strategies Inventory – Short Form, and the Global Assessment of Functioning Scale. Statistical Analysis Used: First time attempters and repeaters were compared using appropriate inferential statistics. Logistic regression was used to identify independent predictors of repeat attempts. Results: The two groups did not significantly differ on sociodemographic characteristics. Repeat attempters were more likely to have given prior hints about their act (χ2 = 4.500, P = 0.034). In the final regression model, beck hopelessness score emerged as a significant predictor of repeat suicide attempts (odds ratio = 1.064, P = 0.020). Conclusion: Among suicide attempters presenting to the hospital, the presence of hopelessness is a predictor of repeat suicide attempts, independent of clinical depression. This highlights the importance of considering hopelessness in the assessment of suicidality with a view to minimize the risk of future attempts.

2015 ◽  
Vol 6 (02) ◽  
pp. 171-176 ◽  
Author(s):  
Shivanand Kattimani ◽  
Siddharth Sarkar ◽  
Ravi Philip Rajkumar ◽  
Vikas Menon

ABSTRACT Background: Suicides are among the most important causes of death in the economically productive population. Characteristics of impulsive and nonimpulsive suicide attempters may differ which would have a bearing on planning preventive measures. Aims: This study aimed to characterize the clinical and psychological profile of impulsive and nonimpulsive suicide attempters. Settings and Design: This retrospective comprehensive chart-based study was conducted at a tertiary care hospital in South India. Methods: The study utilized records of patients over a period of 3 years. An attempt was considered impulsive if the time between suicidal idea and the attempt was <30 min. Stressful life events were assessed using presumptive stressful life events scale; hopelessness was evaluated using Beck Hopelessness Scale (BHS) and coping was measured using Coping Strategies Inventory Short Form. Statistical Analysis Used: Impulsive and nonimpulsive suicide attempters were compared using appropriate inferential statistical tests. Results: Of 316 patients, 151 were classified as having an impulsive suicidal attempt (47.8% of the sample). The impulsive and nonimpulsive suicide attempters did not differ on demographic characteristics. Use of natural plant products was more common in impulsive attempters (27.2% vs. 12.7%), while physical methods like hanging was less common (0.7% vs. 7.3%). Those with an impulsive attempt were more likely to have a recent contact with a health professional (24.5% vs. 4.5%). Impulsive suicide attempters had higher scores on BHS (Mann-Whitney U = 7680.5, P < 0.001), and had recollected greater number of stressors. Conclusion: Impulsive suicide attempters differ from nonimpulsive suicide attempters in clinical features like methods of attempt, presence of hopelessness, and stressors.


Author(s):  
Ravi C. Sharma ◽  
Dinesh D. Sharma ◽  
Vikesh Gupta ◽  
Rahul Gupta ◽  
Vineet Kumar ◽  
...  

Background: Suicide is the result of an act deliberately initiated and performed by a person in the full knowledge or expectation of its fatal outcome. Suicide attempts are a significant public health problem. The present study aimed to explore the variousclinical characteristics of suicideattempters in a tertiary care hospital of Shimla, Himachal Pradesh, a northern state of India.Methods: We conducted a descriptive study among patients with attempted suicide to the department of Psychiatry, Indira Gandhi Medical College (IGMC) Shimla. A structured, self-designed interview schedule and short-form revised Eyseneck personality questionnaire-Hindi (EPQRS-H) was used for data collection. Data was analyzed using Epi info software v 7.2.0.Results: There were total 77 participants in the study out of which 44 (57.1%) were females. Mean age (Standard deviation) of participants was 30.8 years (9.9 years). Relationship problems were the most common (48.1%) recent life event followed by health events (28.6%). Depression was found to be the most common diagnosis (62.3%). Pesticide consumption was the method of attempting suicide in 72.7% of females compared to 66.7% of males.Conclusions: Recent major life events especially relationship problems may lead to majority of suicide attempts. There is urgent need to focus on patients suffering from depression by health personnel as well as family members. The sale of the pesticides should be regulated to keep in check the misuse of the same.


Author(s):  
A. M. Doherty ◽  
S. Moore ◽  
N. Cobercoran ◽  
K. M. Malone

Objectives: To investigate whether high-lethality suicide attempters align to the demographic and clinical features observed in completed suicide in the national and international literature, and whether low-lethality attempters more closely align with the clinical profile of non-attempter ideators. Methods: A retrospective chart review of adult suicide ideators and attempters presenting to an urban tertiary care hospital was performed. Suicide ideators (n = 50) and attempters (n = 50) were coded for variables including demographics and clinical characteristics (e.g. psychiatric diagnosis and previous suicide attempt). Method and lethality of suicide attempt were coded using the medical Lethality Rating Scale. Results: High-lethality attempters were more likely to be younger in age than low-lethality attempters (p = 0.026) and ideators (p = 0.041). The lethality scores of suicide attempts were significantly inversely correlated with age (p = 0.017). Conclusions: Our study adds to the small but increasing body of literature investigating the characteristics of high-lethality suicide attempters and suggests younger adult age is a risk factor for a high-lethality attempt. Further understanding of this unique group would be aided by widespread agreement on the definition of a high-lethality suicide attempt and longitudinal studies of this cohort.


2020 ◽  
Vol 30 (2) ◽  
pp. 36-40 ◽  
Author(s):  
Jotirmoy Roy ◽  
Md Al Fatah Al Adiluzzaman ◽  
Md Tanvir Hasan ◽  
Dibbya Duty Roy ◽  
MMA Shalahuddin Qusar ◽  
...  

Suicide is a perplexing phenomenon of taking one’s own life. Reasons behind suicide attempts are also unique. Clinical characteristics of these patients have not been adequately studied from a psychosocial and psychiatric point in Bangladesh. This study was aimed to assess the socio- demographic profile and psychiatric morbidities in suicide attempters. This was a descriptive cross sectional study conducted from May 2017 to September 2017. A total of 101 patients were selected purposively who were admitted following suicide attempt in different departments of Rangpur Medical College Hospital (RMCH). Medical officers in the psychiatry department interviewed them by using a semi-structured questionnaire. Diagnosis was made according to DSM-IV. The results showed that the majority of the respondents were socio-economically deprived young persons. Most (42%) of them were <20 years of age with female (53%) preponderance. Among them 51% were unmarried, 73% were rural dwellers 37% were students and 58% attempts were impulsive. Among the respondents 63% had no prior suicidal thoughts, 56% resorted to poisoning, 49% attempted due to domestic quarrel, 65% suffered from psychiatric disorders where major depressive disorder (18%) was found to be one of the commonest diagnosed disorders. Psychiatric disorders and their co- morbidities are common in suicide attempt patients which calls for implementation of hospital guidelines for routine psychiatric and psychosocial assessments. Bang J Psychiatry December 2016; 30(2): 36-40


2021 ◽  
Vol 10 (38) ◽  
pp. 3370-3373
Author(s):  
Bhuvana Chandrashekarappa Revappala ◽  
Sridhar Mallanaik ◽  
Vibha Konthanur Vijayakumar ◽  
Suresh Krishnappa Kudumallige ◽  
Sarala Nedige Eshwarappa

BACKGROUND Psychiatric illness is the most common cause of suicidal attempt which increases the risk further if left untreated. Suicide attempt is one of the forms of suicidal behaviour, which includes suicide ideas, suicide plans and suicide attempts, as these increase the risk further. The purpose of this study was to assess the prevalence and psychiatric comorbidity among suicide attempters. METHODS In this cross-sectional study, samples were collected from patients visited to outpatient department (OPD)/in-patient department (IPD) at a tertiary care center. A total of 50 sample size of both sex with age group of 18 - 65 years are considered. Severity of suicide attempts was assessed by using suicide risks form scale. RESULTS Depression is found to be the most common cause of suicide attempt among mood disorders followed by anxiety disorders, personality disorders and substance use disorders respectively. CONCLUSIONS Our study proved the presence of psychiatric co-morbidity among suicide attempters. Co-morbidity worsens the suicidal risk further as assessed. KEY WORDS Psychiatric Comorbidity, Suicide Attempts.


2021 ◽  
Vol 18 (4) ◽  
pp. 429-436
Author(s):  
Santhiya K. ◽  
Jayanthi S. ◽  
Ananthasubramanian M. ◽  
Appalaraju B.

Background: Carbapenem-resistant Enterobacteriaceae (CRE) has emerged as a global threat with mortality risk ranging from 48%-71% worldwide. The emergence of MBL resistance is threatening as carbapenem is one of the last line antibiotics. A total 24 variants of NDM resistance raises a concern to the clinicians and epidemiologists worldwide. Objective: The study aims at identifying MBL resistance (NDM, IMP, VIM, GIM, SPM, and SIM) and its coexistence in clinical isolates in a single tertiary care center. Methodology: Forty five clinical isolates characterized phenotypically for Carbapenem resistance obtained from PSG Institute of Medical Science and Research (PSG IMSR), Coimbatore, between February to March 2018 were taken for analysis. Result: Out of the 45 Clinical isolates, 38 isolates (84%) were detected as MBL carriers. VIM, NDM, GIM, and SPM were the predominant resistance genes, with detection rates of 48.8%, 28.8%, 24.4%, and 22.2% respectively. Fifteen isolates were observed to harbor more than one MBL gene in coexistence. Two isolates - U42 and R714 (K. pneumoniae) were found to harbor all 5 MBL variants in combination. Conclusion: 33% of clinical isolates harboring multiple MBL variants is a concern in clinical settings. The presence of SPM and GIM gene amongst isolates in this geographical location within India is an indicator demanding continuous monitoring of these resistance determinants.


2020 ◽  
Vol 41 (S1) ◽  
pp. s263-s264
Author(s):  
Jordan Polistico ◽  
Avnish Sandhu ◽  
Teena Chopra ◽  
Erin Goldman ◽  
Jennifer LeRose ◽  
...  

Background: Influenza causes a high burden of disease in the United States, with an estimate of 960,000 hospitalizations in the 2017–2018 flu season. Traditional flu diagnostic polymerase chain reaction (PCR) tests have a longer (24 hours or more) turnaround time that may lead to an increase in unnecessary inpatient admissions during peak influenza season. A new point-of-care rapid PCR assays, Xpert Flu, is an FDA-approved PCR test that has a significant decrease in turnaround time (2 hours). The present study sought to understand the impact of implementing a new Xpert Flu test on the rate of inpatient admissions. Methods: A retrospective study was conducted to compare rates of inpatient admissions in patients tested with traditional flu PCR during the 2017–2018 flu season and the rapid flu PCR during the 2018–2019 flu season in a tertiary-care center in greater Detroit area. The center has 1 pediatric hospital (hospital A) and 3 adult hospitals (hospital B, C, D). Patients with influenza-like illness who presented to all 4 hospitals during 2 consecutive influenza seasons were analyzed. Results: In total, 20,923 patients were tested with either the rapid flu PCR or the traditional flu PCR. Among these, 14,124 patients (67.2%) were discharged from the emergency department and 6,844 (32.7%) were admitted. There was a significant decrease in inpatient admissions in the traditional flu PCR group compared to the rapid flu PCR group across all hospitals (49.56% vs 26.6% respectively; P < .001). As expected, a significant proportion of influenza testing was performed in the pediatric hospital, 10,513 (50.2%). A greater reduction (30% decrease in the rapid flu PCR group compared to the traditional flu PCR group) was observed in inpatient admissions in the pediatric hospital (Table 1) Conclusions: Rapid molecular influenza testing can significantly decrease inpatient admissions in a busy tertiary-care hospital, which can indirectly lead to improved patient quality with easy bed availability and less time spent in a private room with droplet precautions. Last but not the least, this testing method can certainly lead to lower healthcare costs.Funding: NoneDisclosures: None


Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Les R Becker ◽  
Cheryl Camacho ◽  
Sheryl J Titus ◽  
Janet L Thorne ◽  
Munish Goyal

Introduction: When sudden cardiac arrest occurs in non-resuscitation focused care settings, bedside clinicians may not intervene prior to dedicated resuscitation team arrival. As perceived self-efficacy (SE) contributes to cognitive functioning, facilitating effective intervention, we developed and evaluated a mock code training approach, First Five (FF) , to enhance bedside responders’ resuscitation task SE using an entity’s defibrillator and manikin. Self-efficacy is knowing that one can perform actions in principle and envision performing the steps to reach a goal. Hypotheses: Participants’ resuscitation SE will improve after FF training; 2) Inpatient (IP) and Ambulatory Care Center (ACC) providers will differ in their pre-SE and post-SE in response to FF training. Methods: Participants enrolled from ACCs and medical-surgical IP units at a large, urban tertiary care hospital from May 2018 to April 2019 completed a de-identified 10-point Likert-scale SE survey before and after they were trained to perform initial bedside resuscitation tasks (Figure 1 x-axis labels). Matched, complete, pre/post data for 85 in-hospital and 107 ACC participants were analyzed via repeated measures multivariate analysis of variance. Results: Patterns of reported change in the seven resuscitation task SE measures of IP personnel differed significantly from those of ACC personnel [Pillai’s Trace = .222, F(7,184)=7.483, p=.0005, partial η 2 = .222]. In both settings, post-session SE measures increased significantly from pre-session SE measures [Pillai’s Trace = .588, F(7,184)=37.438, p=.0005, partial η 2 = .588]. Moreover, though ACC providers consistently reported lower pre-training SE resuscitation task scores, post-training scores from both settings were comparable (Figure 1). Conclusions: First Five training is effective in enhancing resuscitation task SE among inpatient and ambulatory care setting providers that are not resuscitation-focused.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jamshed Ali ◽  
Osman Faheem ◽  
Pirbhat Shams ◽  
ghufran adnan ◽  
Maria Khan

Introduction: Social containment measures have been adopted globally to control COVID-19 outbreak. Reduction in hospital visits and inpatient admission rates have become cause for concern. Through this study we aimed to analyze the impact of SARS-CoV-2 virus Outbreak on cardiology inpatient admissions at a tertiary care hospital in Pakistan. Hypothesis: COVID-19 pandemic has resulted in significant decline in cardiology admissions. Methods: We conducted a retrospective study at our center. Admission log was accessed via electronic record system. Comparison was made for same months of 2019 and 2020 with regard to cardiology inpatient admissions. Results: A total of 239 patients were admitted to cardiology services in 2019 period and 106 in 2020 period with resultant reduction of 55.6%. Number of patients admitted to the coronary care unit were 179 and 78 respectively where as the numbers declined to 28 from 60 for cardiac step down. Reduction for admission numbered to 52.4% for males and 38.89% for females. 9.3% patients left against medical advice in 2019 and 3.4% in 2020. Conclusions: Our study concludes that numbers of cardiology admissions have dwindled. Possible explanation for this can be implementation of social containment and fear of acquiring infection. This has raised a question of whether a significant number of cardiovascular morbidity and mortality has occurred without seeking medical attention and has went unrecorded during the pandemic. This calls for stringent diagnostic measures in future to diagnose previously unrecorded burden.


2021 ◽  
Vol 12 (6) ◽  
pp. 75-58
Author(s):  
Tanushri Khatua ◽  
Tanima Mandal ◽  
Mita Saha ◽  
Biswajit Majumder

Background: The leading cause of death in the world is coronary heart disease (CHD). In India, CHD manifests almost a decade earlier than in Western countries. Gender differences play an important role in the pathophysiology of AMI. Body weight and family history are claimed to be the indicators of relative risk of mortality. Aims and Objective: To look for the age and gender distribution pattern in patients with recent diagnosed AMI and to find out the association of some of the risk factors like BMI, family history. Materials and Methods: A descriptive study was conducted in a tertiary care hospital with 50 recent diagnosed AMI patients of either sex as cases after considering the inclusion and exclusion criteria. The biochemical parameters were measured by validated methods. Results: On statistical analysis, 58% of total AMI cases occurred before 50 years of age; out of which 18% belong to 31 - 40 years, 40% belong to 41- 50 years. Out of total 50 AMI cases, 60% is male and 40% is female. Obesity seen in 14% cases and 56% is overweight; 16% having positive family history. Conclusion: The study indicates a trend of early age onset AMI. Increased body weight and positive family history can be the risk predictors. It is suggested that younger age males and premenopausal women should not be ignored regarding the risk of MI. Further studies are required for verification.


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