Factors Predicting Successful Suicide Among Adolescents:Multiple Attempts And Index Methods, A Retrospective Cohort Study

Background: While suicide among adolescents has emerged as a significant social problem, few studies have examined the relationship between changes in suicide methods and suicide success following multiple attempts. This study aimed to investigate the relationship between changing suicide methods and successful suicide among adolescents after repeated attempts.Methods: This retrospective study analyzed the psychiatric history of patients (n=227) between 10 and 18 years of age who visited a pediatric emergency center between January 2007 and February 2021 for suicide attempts. Results: Out of a total of 227 patients, 80 achieved successful suicide attempts, including emergency hospitalization or death. A significant association was observed between successful suicide in patients with multiple attempts who chose drug intoxication (DI) as the index method (p=0.010) and patients with multiple attempts who chose DI as a suicide method (p=0.001). No statistically significant outcomes for changing methods and number of suicide attempts were evident.Conclusions: This study emphasizes the importance of identifying index methods as well as suicide methods among adolescent patients with multiple suicide attempts. This study identified predictors affecting the successful suicide of adolescents. Identifying the index method and the changed method among adolescent patients with multiple suicide attempts are significant predictors of successful suicide. Identifying the index method and changed method of suicide is expected to help in interviewing adolescents with multiple suicide attempts.

Religion and the Stigma of Suicide: A Quantitative Analysis Using Nationwide Survey Data from Hungary

Objective: To examine the effect of religion on negative attitudes and beliefs about suicide. Methods: We use data from a large nationwide survey conducted in Hungary covering more than 3000 individuals. Suicide-related stigmas are captured with three Likert-type measures that we combine into an overall indicator. Religion is measured by denomination (Catholic vs. Protestant) and church attendance (at least weekly vs. never or less than weekly). We employ logistic regression and the SPSS statistical software. Results: People attending religious services frequently have greater odds of stigmatizing self-killing than those reporting no or infrequent attendance. Compared to Protestants, Catholics are significantly less condemning of suicide. The two measures of religion also work in tandem, with denomination modifying the impact of church attendance. In particular, while church attendance strongly increases the odds of negative attitudes among Catholics, it has practically no effect among Protestants. Discussion and Conclusions: The results presented are in keeping with our expectations and suggest that a social climate that stigmatizes suicide without providing for people a strong community network that pressures individuals toward conforming to fundamental moral principles can be especially harmful for mental health.

Child suicides in Sweden, 2000–2018

Although child mortality is decreasing in Sweden, an increase in suicide rates has been previously observed among children and adolescents collectively. To increase knowledge about trends, demographics, and means in child suicides, data including all child (< 18 years) suicides in Sweden in 2000 through 2018 were retrieved from the Swedish National Board of Forensic Medicine. In all, a total of 416 child suicides were found in a 19-year period, accounting for an annual suicide rate of 1.1/100,000 child population. The number of suicides increased with 2.2% by each successive year during the study period (p < 0.001). The mean age in both sexes was 16 years; boys accounted for 55% and girls for 45% of all study cases. The majority of the children who died by suicide (96%) were teenagers (13–17 years old) and suicides in children younger than 10 years were uncommon. Suicide methods were 59% hanging, 20% lying/jumping in front of a moving object, 8% jumping from a height, 7% firearm injury, 4% poisoning, and 2% other methods. Sex differences were significant (p < 0.001) only for firearms being preferably used by boys. The vast majority of firearms used were licensed long-barreled weapons.Conclusion: The number of child suicides in Sweden is relatively low but increasing. Most of the children used a violent and highly lethal method. Prevention of premature mortality is an urgent concern with an emphasis on resolutely reducing the availability of suicide means. What is Known:• Suicide is a significant cause of death globally among children, bringing tragic consequences for young individuals, their family, and the entire society.• Suicide rates and distribution of suicide methods in children differ between countries and settings, but studies of time trends are scarce. What is New:• Increasing number of minors’ suicides and the predominance of violent methods emphasize the importance of prevention strategies tailored for a child population.• Even in a setting of very restrictive firearm laws, firearm suicides in children must not be overlooked.

Factores predisponentes y métodos de suicidio: Mini-revisión de la actualidad

Suicide is a major global public health problem, especially among young and middle-aged adults. According to the WHO, worldwide, approximately 800 000 people commit suicide every year. Some predisposing factors for suicide are related to the personal sphere and are universal, such as biological conditions or psychiatric pathology, childhood adversities, as well as social and community perspective: housing situation, religion, social integration and support, unemployment, stress. The highest frequencies of occurrence have been found in males and in the age groups between 15 and 25 years, or over 65 years. Regarding suicide methods, there is a predilection for hanging in most countries, and although suicide methods do not differ much from one country to another, it should be considered that they vary according to the access to lethal methods. Men are reported to commit suicide more frequently using violent methods. A greater recognition of the risk factors and suicide methods used is necessary to raise awarenes among the population and prevention.

Suicide Cause and Method from 2009-2017 in Turkey

Background: This study was planned to investigate the cause, method, age group and gender of suicides between 2009 and 2017 in Turkey. Methods: Data on suicide deaths between the years 2009-2017 were obtained from the death data of the Turkish Statistical Institute. Results: Suicide data were evaluated according to age group, gender, reason and method. The most common suicide methods among people living in Turkey were hanging oneself, using a firearm and throwing oneself from a high place whereas common causes and unknown causes were found to be illness and economic problems. Gender showed statistical significance in the cause of suicide in all suicide methods (illness, economic problems, job failure). According to age groups the reasons were family disharmony, emotional relationship and not being able to marry the desired person, Education failure were found to be statistically significant. Less used methods to commit suicide in Turkey were determined as using firearms, using natural gas or LPG, throwing from a train or motor vehicle. Conclusion: It is a very sad situation for an individual to end his/her life conspiratorially. Appropriately collected suicide information can guide the design of suicide prevention strategies. Because previous suicide attempts seem to be an important risk factor for future attempts and death by suicide.

Impact of COVID-19 Lockdown on Lethality of Suicide Cases

Background: Studies show that the COVID-19 pandemic has promoted distress and stress-related symptoms in the general population. It has also increased the suicide rate in vulnerable groups who cannot handle the social and psychological consequences of the pandemic and the measures in place to halt it. Objective: In this study, we compared the lethality of suicide attempts and the methods chosen between the three months before the COVID-19 pandemic and three months during curfew and lockdown in Saudi Arabia. Methods: This is a retrospective, causal-comparative study conducted at King Saud Medical City in Riyadh, Saudi Arabia. A total of 62 suicide attempt cases between January 2020 and June 2020 were included in this study. The scale for assessment of the lethality of suicide attempts (SALSA) was used for comparison, and cross-tabulation was used for the data of suicide methods. Results: There was a significant difference (P = 0.003) in the total SALSA score before and during the COVID-19 lockdown. The scores of lethality of suicide attempts were high during the lockdown. No significant difference was found in the suicide methods selected between the two time periods. However, the use of psychotropic medication overdose and self-immolation were prominent during the lockdown period. Conclusions: Our findings suggest that the lockdown during the COVID-19 pandemic is likely associated with increased lethality of suicide attempts as well as an increased suicide rate. The development of appropriate mental health services is required.

Suicide methods in South Asia over two decades (2001–2020)

Background: Suicide is a global preventable public health problem. About a quarter of all suicides in the world occur in South Asia. As means restriction is an important suicide prevention strategy, gaining knowledge of the common suicide methods and their changing trends in each country and region is crucial. Aims: We aimed to assess the suicide methods in South Asian countries over the last two decades. Methods: A search was performed in PubMed, PubMed Central, Scopus, and Google Scholar with the search terms. Original articles of quantitative studies, published in the English language, from 2001 to 2020, with full-accessible text, that rank different methods of suicide in eight South Asian countries, were included. Results: A total of 68 studies were found eligible for review. The Maximum number of studies were found from India ( n = 38), followed by Bangladesh ( n = 12), Pakistan ( n = 9), Sri Lanka ( n = 6), and Nepal ( n = 3). Hanging ( n = 40, 55.8%) and poisoning ( n = 24, 35.3%) were the two most common suicide methods reported, in that order. Hanging followed by poisoning were the commonest suicide methods in Bangladesh, India, and Pakistan while in Sri Lanka, poisoning was the preferred method to hanging. There is a decline in suicide by poisoning and an increase in suicide by hanging in Sri Lanka, Bangladesh, and India. Although hanging is still the commonest method in Pakistan, the use of firearms is growing in recent years (2011–2020). Conclusions: There is a steady decline in the incidence of suicides by poisoning following pesticide regulations in South Asian countries. However, there is heterogeneity of study methods, probable under-reporting of suicide, and lack of robust suicide data.

Predictive Factors Associated With Methods of Suicide: The Korean National Investigations of Suicide Victims (The KNIGHTS Study)

Background: Because the suicide mortality depends on the lethality of suicide methods, the identification and prediction of suicide methods are important for suicide prevention.Methods: Examination data of suicide decedents were collected based on police reports. Suicide decedents were divided into groups according to the suicide methods (hanging, gas poisoning, pesticide poisoning, jumping, drug poisoning, and drowning) they used. Predictive factors for each suicide method in comparison to other suicide methods were identified.Results: Among 23,647 subjects, hanging was the most common method of suicide. Regarding gas poisoning, the history of previous suicide attempt was a risk factor and being age of 65 or older was a protective factor. Being age of 65 or older showed a highly strong association with suicide by pesticide poisoning. Being age of 18 or younger and the presence of schizophrenia were associated with jumping. A history of psychiatric outpatient treatment was a risk factor for drug poisoning. Regarding suicide by drowning, schizophrenia was a risk factor, while being age of 65 or older was a protective factor.Limitations: Only eight out of a total of 17 regions in South Korea were examined and included in the data of this study. Also, the methods of suicide were defined as one method that directly caused the death, which could undermine other less fatal methods used.Conclusions: There were differences in predictive factors according to the method of suicide. Predicting the method of suicide in people at high risk for suicide stands to be an important strategy for suicide prevention in clinical settings.

Uncommon suicide methods in the detention regime in Milan (1993–2019): Forensic contribution on autopsy cases

We analysed the recorded cases of suicides committed other than by hanging in prison in Milan. A retrospective analysis was conducted on 25,512 autopsies performed from 1993 to 2019, selecting all the suicides in prison but our attention was focused solely on cases where an alternative mode to hanging was used. From a total of 97 suicide events in prison, 15 were consistent with the established search criteria: 6 victims died from plastic bag suffocation, 4 by direct inhalation of butane gas, 2 associated plastic bag suffocation to inhalation of butane gas, one committed suicide with an edged weapon, one by self-burning and, finally, one by voluntary ingestion of a food to which he was allergic, with the intent of inducing an anaphylactic shock. Our analysis has shown that the landscape of prison suicides is diverse, not limited solely to hanging. Therefore, it is necessary for the forensic scientific community to raise awareness of potentially unusual suicide methods in prisons and, in the same way, for the Penitentiary Administration to put adequate preventive measures and strategies in place.