The Role of Self-Organization in the Suicidal Process

This article describes the application of a dual-regulation model to a case example of a female suicide attempter. The model complements the traditional goal-and-feedback view with self-organizing processes, which may help to better understand the suicidal process. From this view, impulsive suicidal behavior can be interpreted as a dysfunctional pattern by which high-internal tension is reduced through self-organized processes. High tension might result from intrapersonal factors and adverse life conditions, by which self-regulation is depleted. Also concepts from social psychology (i.e., ego depletion, self-regulation failure) are consistent with this view and are discussed in context of a suicidal crisis. Identifying dysfunctional self-organization processes and acquiring strategies to strengthen self-regulation might, therefore, be important for suicide prevention.

Case Report of Autointoxication with Nutmeg Committed By a Suicide attempter

Introductionautointoxication with nutmeg in an emergency setting is a rare, but potentially a life-threatening event. Despite the low incidence of ‘tentamen suicidii’ (TS) with nutmeg, this substance is cheap and readily available. Early recognition of a suicide attempt with nutmeg poisoning can be extremely difficult, especially when nobody witnessed the nutmeg intake. Worldwide there are only a few cases reporting TS with nutmeg.ObjectivesTo present a case of TS with nutmeg committed by a suicide attempter.aimsTo review available literature on TS with nutmeg.Methodsa case report is presented and discussed, followed by a literature review.ResultsFive published cases of suicide attempts with nutmeg were found while searching through PUBMED and Embase. Our case describes a 57-year-old female, diagnosed with borderline personality disorder, who has been admitted to the emergency department in a state of agitation, diminished cognition, respiratory difficulties and hemodynamic instability. Electrocardiography showed a fast sinus arrhythmia with no uschemic or hypertropic changes. Blood sampling, serum and urine toxicology did not reveal any abnormalities. in view of the complexity of her condition, she admitted to have taken a large dose of nutmeg. The patient was kept for observation, offered reassurance, and rehydratation.ConclusionThe presentation of inexplicable clinical state accomplished by disturbances of central nervous, respiratory and hemodynamic systems in the population of patients with attempting suicide should alert the physician to the rare but probably underreported possibility of nutmeg autointoxication.Disclosure of interestThe authors have not supplied their declaration of competing interest.