The Mediating Role of Depressive Symptoms, Hopelessness, and Perceived Burden on the Association Between Pain Intensity and Late-Life Suicide in Rural China: A Case–Control Psychological Autopsy Study

Background: Few studies have investigated the roles of psychosocial factors such as depressive symptoms and hopelessness on the relationship between pain and suicide with inconsistent results. The study aimed to analyze the impact of pain intensity on suicide death and to estimate the degree to which depressive symptoms, hopelessness, and perceived burden may explain the association in Chinese rural elderly.Methods: Using a 1:1 matched case–control design, we collected data from 242 elderly suicide cases and 242 living community controls by psychological autopsy method in rural China, including sociodemographic characteristics, pain intensity, depression, hopelessness, perceived burden, physical diseases, and social support. Conditional logistic regression was employed to assess the association between pain intensity and completed suicide. Mediation analysis using the KHB method was applied to explore the mediation effects from depressive symptoms, hopelessness, and perceived burden.Results: The result of multivariable logistic regression showed that unemployment [odds ratio (OR) = 5.06, 95% confidence interval (CI): 1.76–14.49], higher levels of hopelessness (OR = 7.72, 95% CI: 3.49–17.10), depressive symptom (OR = 15.82, 95% CI: 4.53–55.25), and severe pain (OR = 3.46, 95% CI: 1.31–9.13) were significantly associated with elevated suicide risk in older adults in rural China. Depressive symptoms, hopelessness, and perceived burden significantly mediated 43.71% of the pain–suicide association (p = 0.020), with 17.39% due to depressive symptoms, 17.63% due to hopelessness, and 8.69% due to perceived burden.Conclusions: Regular screening of pain, depressive symptoms, hopelessness, and perceived burden using simple but sensitive questions or scales for older adults with pain is vital for the prevention and early detection of suicide risk in Chinese rural areas. Moreover, the importance of pain management and psychological interventions targeted on depressive symptoms and hopelessness should be emphasized.

Psychological Autopsy and Forensic Considerations in Completed Suicide of the SARS-CoV-2 Infected Patients. A Case Series and Literature Review

Our paper aims to present three cases of committed suicide in SARS-CoV-2 infection during the quarantine period. We investigated if there is a role for the infection itself in triggering the suicidal act or if it is augmented by other risk factors such as fear, psychosocial stress, lifestyle changes, and social isolation. To this goal, we analyzed the clinical, paraclinical, histopathological, toxicological records, mental health conditions, psychological, social, cultural, and economic aspects in detail. One patient committed suicide at home, by hanging, while the other two during hospitalization in the red zone, within the Sibiu County Emergency Clinical Hospital, hanging and falling from a height, respectively. The autopsy was carried out within the restricted area for COVID-19 in Sibiu County Forensic Medicine Service. Patients’ medical histories were analyzed based on the available medical reports. Additionally, we interviewed a family member, applying the so-called psychological autopsy method, based on open-ended questions and standardized instruments (questionnaire) to point out the motives and behavioral changes that might explain the committed suicide. With this data, we could fulfill a design to elucidate and outline the reasons for the suicidal act. Our findings showed that the mental state deteriorated progressively, both in preexisting depressive and non-depressive backgrounds. Furthermore, we highlight the COVID-19 psychological impact in the suicidal acts. Further on, we reviewed the risk factors presented in the literature that are associated with mental health problems and behavioral changes such as stress, anxiety, depressions, sleep disorders, impulsivity, loneliness.

Psychological Autopsy: A Method to Assist in the Identification of Risk and Protective Factors for Intimate Partner Femicide

The most common form of violence experienced by women is that perpetrated by intimate partners, and the gendered nature of intimate partner femicide (IPF) has received particular attention. Few studies to date have delved into the limitations associated with methods used in IPF research, and particularly the methods used to study homicide victims (rather than homicide perpetrators). This article outlines dominant methodologies used to study IPF, and considers a novel method of investigation—the “psychological autopsy”—that may help to improve existing knowledge about IPF.

Analysis of the Actual Situation of Suicide Among Firefighting Officials

This study analyzed the various methods of and reasons for committing suicide among 90 firefighters within a 10 year period (2010-2019). The study discovered that: the suicide rate per 100,000 people has gradually decreased in the general public and police, while the number of suicides among firefighters continues to increase; the suicide rate arranged in increasing order by province, was Gyeonggi < Seoul < Jeonnam < Gyeongbuk < Busan whereas the suicide rate in terms of the number of staff followed the order of Jeonnam < Ulsan < Chungbuk < Gyeonggi < Seoul; the highest suicide rates were found among firefighters in the Sobangjang (fire sergeant) position, who were in their 40s, and who had served fewer than 10 years; the reasons for committing suicide were family discord, depression, hopelessness, debt, and job stress in that order; those in their 20s and 50s committed suicide due to depression while family discord appeared to be the cause for those in their 30s and 40s. To prevent firefighters from committing suicide, we need to initiate a dedicated psychological counseling organization, run a firefighters’ suicide prevention program at the fire academy, and strengthen the psychological autopsy for firefighters’ suicide and statistics management, etc.

Psychological Autopsy Studies of Suicide in South East Asia

Background: Psychiatric disorders have been identified as an important risk factor for suicide. However, different psychological autopsy studies have revealed different prevalences at different times and places. Objective: We aimed to see the distribution of psychological autopsy studies and the prevalence of mental disorders among suicides and identify major risk factors in Southeast Asian countries. Method: We scrutinized psychological autopsy studies published in the World Health Organization (WHO) South-East Asia (SEA) region countries. We also searched the available bibliographies to identify the studies in the region so that all the possible articles could be included. Results: Out of the 11 countries, 14 psychological autopsy studies were identified in five SEA countries (Bangladesh [1], India [9], Indonesia [1], Nepal [1], and Sri Lanka [2]). Seven studies (50%) used a case-control study design, and eight (57.1%) were carried out in urban settings. The prevalence of psychiatric disorders in case-control studies was from 37% to 88%. Stressful life event was identified as a major risk factor in all the case-control studies. Conclusion: Psychological autopsy studies have not been conducted in 6 out of 11 countries of the SEA region. The presence of pre-existing psychiatric morbidity and stressful life events were the two most common risk factors noted across settings, even though there is wide heterogeneity in samples, study design, instruments, and study settings.

Double Dealing Homunculus, Jung, and Fascistic Proclivities

Fascism is a system of government merging the most extreme features of both authoritarianism and totalitarianism, and is classically considered to be at the far-right end of the political continuum, and sees racial hygiene, political violence, battle, and expansionism as means that can attain national rejuvenation. Emergence of Fascism in the last century in Europe, which had been raised up from somewhat democratic settings, has not been overlooked by intellectuals, who are in search of origins and physiognomies of Fascism. While many of researchers appreciate Fascism as a sociological phenomenon that demands psychological autopsy, there are investigators, as well, who are in search of developmental, biological, political, economical or administrative backgrounds of Fascism. In this regard, the connection between Jung and Fascism, also, was an intricate story that has been reflected again in a number of new studies. In the present article, Fascism, as a political dogma in the spectrum of authoritarianism, though not an unfamiliar administrative scheme in the globe and history, has been looked over psychosocially, along with some remarkable standpoints of some of the most known intellectuals, who were studying Fascism, Fascists, and masses in close proximity.