Elderly suicide in Singapore

The suicide rate in Singapore has remained at 9-11 per 100,000 over the past decade. Comparing the age specific suicide rate, elderly people (60 years and above) have a much higher rate (21.3 per 1000,000) than the young (5 per 100,000). The data also indicate that elderly men are more prone to kill themselves than elderly women. Risk factors in elderly suicide and preventive measures are discussed.     

Attempted suicide in Adelaide and Perth: changing rates for males and females, 1971-1987

OBJECTIVE: Official rates of attempted suicide in Perth, in 1971-1972 and 1986-1987, were examined, with the aim of documenting changes in the age and sex distribution of persons who attempted suicide over the 15-year period. In addition a survey of all patients presenting to the Royal Adelaide Hospital between 1986 and 1988 aimed to determine whether or not the official figures accurately reflect the number of presentations for attempted suicide. DESIGN AND SETTING: Rates of attempted suicide were calculated from the Hospital Morbidity Data for hospitals in the Perth Statistical Division and from the Inpatient Separations Information System (ISIS) for hospitals in the Adelaide Statistical Division. Rates were expressed for each sex as annual age-specific rates per 100,000 population. The data were age-standardised by the direct method. A survey was completed of all patients presenting to the Royal Adelaide Hospital between 1986 and 1988 after attempted suicide. The findings were compared with the official figures for the Royal Adelaide Hospital and were used to estimate the actual rate of attempted suicide in the Adelaide Statistical Division. RESULTS: In Perth the rate of attempted suicide for males increased from 93 per 100,000 in 1971-1972 to 137 per 100,000 in 1986-1987. The increase was most striking in the age groups 15-19 and 40-44 years. The rates for females decreased from 214 per 100,000 to 195 per 100,000. In Adelaide, from 1986 to 1987, between one-fifth and one-third of persons who attempted suicide and presented to the Royal Adelaide Hospital were not recorded in the ISIS. In 1988, two-thirds were not recorded. We estimated that the real rate of attempted suicide for males in Adelaide was about 180 per 100,000 and for females was about 250 per 100,000. CONCLUSIONS: Our understanding of the epidemiology of attempted suicide is largely based on data which are now out of date. The Perth findings of a 47% rise in rate among males and a 9% fall among females suggest that attempted suicide is no longer a behaviour more associated with females than males. The Adelaide survey data demonstrate that official rates for attempted suicide underestimate the extent of the phenomenon in the community by a significant margin. An attempted suicide register is suggested as a method of overcoming this problem.     

Effect of Age and Sex on Stroke Mortality of Young and Middle-aged Adults in China, 2002–2019, and Predictions to 2030

Objective This study aimed to examine the trends in stroke mortality among young and middle-aged adults in China.Methods Data were obtained from the China national vital registration system. Significant changes in mortality were assessed by Joinpoint regression. Age-period-cohort analysis was used to explain the reasons for the changes. Future mortality and counts were predicted by the Bayesian age-period-cohort model.Results Between 2002 and 2019, a total of 6,253,951 stroke mortality in young ...     

425例自杀的法医学分析

目的 探讨社会死亡案件中自杀案例的法医学问题。方法 资料为425例自杀案件。对自杀者的年龄、性别、自杀方式及自杀原因做统计分析。结果 兰州市1987年至2002年期间自杀人数呈明显上升趋势，2001年自杀率为9．7／10万人口。自杀者中男性多于女性，以15～44岁人群自杀人数最多，自杀方式以缢死、服毒、高坠、割血管四种常见。社会心理因素导致自杀所占自杀比例最大。结论 自杀问题不容忽视，自杀现象的研究对建立有效的预防自杀、干预自杀措施有很大帮助，同时为社会公共卫生问题的研究及自杀死亡的法医学鉴定提供参考。     

Increased risk of suicide in persons with AIDS

The rate of suicide has been reported to be higher in persons with chronic and life-threatening illnesses (eg, cancer, Huntington's disease, and renal failure). We studied the rate of suicide in 1985 in New York City residents diagnosed with the acquired immunodeficiency syndrome (AIDS). There were 668 suicides in New York City residents in 1985, yielding a rate of 9.29 per 100,000 person-years. In men aged 20 to 59 years without a known diagnosis of AIDS, the rate was 18.75 per 100,000 person-years. There were 3828 individuals who lived with the diagnosis of AIDS for some part, or all, of 1985. There were 12 suicides in men aged 20 to 59 years from this group who lived 1763.25 person-years with a diagnosis of AIDS. This yields a suicide rate of 680.56 per 100,000 person-years. Thus, the relative risk of suicide in men with AIDS aged 20 to 59 years was 36.30 times (95% confidence limits, 20.45 to 64.42) that of men aged 20 to 59 years without this diagnosis, and 66.15 times (95% confidence limits, 37.38 to 117.06) that of the general population. We conclude that AIDS represents a significant risk factor for suicide.     

城市居民3年自杀情况分析研究

目的探讨上海市杨浦区1997～1999年居民自杀死亡的综合因素。方法通过对3年内在公安局所登记的区域内自杀死亡居民资料,分析不同年龄、性别、自杀方式,以及与自杀相关因素的特点。结果杨浦区居民3年间平均自杀率为8.6/10万, 25～34岁青年组（12.1/10万）及65岁以上老年组（20.3/10万）,为高自杀年龄段,但需引起重视的是16岁以下的自杀率（2.8/10万）呈上升趋势,男女自杀率比例为1.25:1,男性自杀方式以自缢、跳楼等激烈性方法为多,女性以非激烈性方法为多（χ2=4.87,P<0.05）。因疾病原因自杀者在<55岁年龄中以精神疾病为主,>55岁年龄中以躯体疾病为多（χ2=12.17,P<0.01）。结论城市青少年和青壮年年龄段自杀率呈上升趋势,且男性自杀率大于女性,提示必须重视社会干预,减少自杀发生率。     

Suicide risk among recently released prisoners in New South Wales, Australia

OBJECTIVE: To determine the risk of suicide and drug overdose death among recently released prisoners. DESIGN, SETTING AND PARTICIPANTS: Retrospective cohort study of 85 203 adult offenders who had spent some time in full-time custody in prisons in New South Wales between 1 January 1988 and 31 December 2002. MAIN OUTCOME MEASURES: Association between time after release and risk of suicide and overdose death. RESULTS: Of 844 suicides (795 men, 49 women), 724 (86%) occurred after release. Men had a higher rate of suicide than women both in prison (129 v 56 per 100,000 person-years) and after release (135 v 82 per 100,000 person-years). The suicide rate in men in the 2 weeks after release was 3.87 (95% CI, 2.26-6.65) times higher than the rate after 6 months. Male prisoners admitted to the prison psychiatric hospital had a threefold higher risk than non-admitted men both in prison and after release. No suicides among women were observed in the 2 weeks after release. No increased risk of suicide was observed among Aboriginal Australians in the first 2 weeks after release. Of 1674 deaths due to overdose, 1627 (97%) occurred after release. Drug-related mortality in men was 9.30 (95% CI, 7.80-11.10) times higher, and in women was 6.42 (95% CI, 3.88-10.62) times higher, in the 2 weeks after release than after 6 months. CONCLUSIONS: Prisoners are at a heightened risk of suicide and overdose death in the immediate post-release period. After 6 months post-release, the suicide rate approaches the rate observed in custody.     

Deaths as a result of work-related injury in Australia, 1982-1984

A comprehensive study of deaths of work-related injuries which occurred throughout Australia in the years 1982-1984 was undertaken by means of coroners' records. Of 16,246 coroner-certified deaths that were attributed to trauma or to acute poisoning (excluding deaths of suicide or medical misadventure), the coroners' files were located for 15,462 (95.2%) deaths. From the files, a total of 1738 fatalities was judged to be work-related during the three-year period; of these, 1544 fatalities occurred in persons who were employed in the civilian labour force, which gave an average annual fatality incidence of 8.06 fatalities per 100,000 persons in the labour force. The death rate was much higher in men (12.05 fatalities per 100,000 men) than it was in women (1.34 fatalities per 100,000 women), increased with age, and was highest for the traditionally-dangerous occupations (such as mining, transport and rural occupations). The distribution of work fatalities by the main cause of death, and the nature of the injury event is described.     

Suicide mortality in the Maryland state prison system, 1979 through 1987

Prisoners are reported to have a higher suicide rate than the community. We studied suicides in the Maryland prison system to determine the level of risk and risk factors for inmate suicide. There were 37 male inmate suicide deaths between 1979 and 1987 (39.6 suicides per 100,000 male inmates), which is significantly higher than the age- and race-adjusted male suicide rate in the general population of Maryland (22.0 per 100,000). Risk of male inmate suicide was increased for the following characteristics: white race (relative risk [RR], 2.0; 95% confidence interval [CI], 1.1 to 3.9), age 25 to 34 years (RR, 1.8; 95% CI, 1.0 to 3.4), major crime committed against person (RR, 3.4; 95% CI, 1.7 to 6.7), life sentence (RR, 4.7; 95% CI, 2.2 to 10.0), and classification to the major maximum security institution in the prison system (RR, 5.1; 95% CI, 2.7 to 9.8). The methods of suicide chosen by inmates were hanging (86%), cutting wound (5%), antidepressant overdose (5%), and fall from height (3%). We conclude that inmate suicide represents a significant correctional health and public health problem. Specific implications for prevention of inmate suicide are examined.     

The pattern of completed suicides seen in Kuala Lumpur General Hospital 1999

A study was done on 76 suicide cases managed by the Forensic Pathology Department of Hospital Kuala Lumpur (HKL) from January till December 1999 to explore the pattern of suicide and psychiatric history. The Chinese contributed 52% (n=40) of cases followed by the Indians (29%, n=22) and the Malays (12%, n=9). After the age of sixty, 84.6% of the subjects were Chinese. The common methods of suicide were poisoning (39%), hanging (34%) and jumping from height (22%). Four out of 12 case-notes traced had documented psychiatric history i.e. schizophrenia. Conclusion: the suicide rate for Kuala Lumpur is estimated at 7.4 per 100,000. The Indians has the highest suicide rate of 21.1 per 100,000 in keeping with other local studies. The suicide rate for the Chinese is 8.6 per 100,000, but it increased to 23 per 100,000 among the elderly Chinese. The suicide rate for Malays is 2.6 per 100,000, higher than what was cited in previous local studies. The incidence of jumping from height as a suicide method had doubled over the last 2 decades.     

Changes in Notified Incidence of Pulmonary Tuberculosis in China, 2005–2020

Objective To evaluate the trend of notified incidence of pulmonary tuberculosis(PTB) in China at different periods by population and region and to explore the effect of TB prevention and control in recent years.Methods Using pooled data on TB cases reported by the TB Information Management Reporting System(TBIMS) from 2005 to 2020, we calculated the annual percentage change(APC) using the Joinpoint regression model.Results From 2005 to 2020, a total of 16.2 million cases of PTB were reported in ...     

Aboriginal health.

OBJECTIVE: To inform health care workers about the health status of Canada's native people. DATA SOURCES: A MEDLINE search for articles published from Jan. 1, 1989, to Nov. 31, 1995, with the use of subject headings "Eskimos" and "Indians, North American," excluding specific subject headings related to genetics and history. Case reports were excluded. Material was also identified from a review of standard references and bibliographies and from consultation with experts. STUDY SELECTION: Review and research articles containing original data concerning epidemiologic aspects of native health. Studies of Canadian populations were preferred, but population-based studies of US native peoples were included if limited Canadian information was available. DATA EXTRACTION: Information about target population, methods and conclusions was extracted from each study. RESULTS: Mortality and morbidity rates are higher in the native population than in the general Canadian population. The infant mortality rates averaged for the years 1986 to 1990 were 13.8 per 1000 live births among Indian infants, 16.3 per 1000 among Inuit infants, and only 7.3 per 1000 among all Canadian infants. Age-standardized all-cause mortality rates among residents of reserves averaged for the years 1979 to 1983 were 561.0 per 100,000 population among men and 334.6 per 100,000 among women, compared with 340.2 per 100,000 among all Canadian men and 173.4 per 100,000 among all Canadian women. Compared with the general Canadian population, specific native populations have an increased risk of death from alcoholism, homicide, suicide and pneumonia. Of the aboriginal population of Canada 15 years of age and older, 31% have been informed that they have a chronic health problem. Diabetes mellitus affects 6% of aboriginal adults, compared with 2% of all Canadian adults. Social problems identified by aboriginal people as a concern in their community include substance abuse, suicide, unemployment and family violence. Subgroups of aboriginal people are at a greater-than-normal risk of infectious diseases, injuries, respiratory diseases, nutritional problems (including obesity) and substance abuse. Initial data suggest that, compared with the general population, some subgroups of the native population have a lower incidence of heart disease and certain types of cancer. However, knowledge about contributing factors to the health status of aboriginal people is limited, since the literature generally does not assess confounding factors such as poverty. CONCLUSIONS: Canadian aboriginal people die earlier than their fellow Canadians, on average, and sustain a disproportionate share of the burden of physical disease and mental illness. However, few studies have assessed poverty as a confounding factor. Future research priorities in native health are best determined by native people themselves.     

Trends in parasuicide and unemployment among men in Edinburgh, 1968-82

Between 1968 and 1982 annual unemployment and annual incidence of parasuicide among men in Edinburgh were positively and highly significantly correlated (r = 0.77). Similarly, they were found to be correlated across the city wards in 1971 (r = 0.76) and, even more strongly, 1981 (r = 0.95). Throughout the period the incidence of parasuicide among the unemployed was nearly always more than 10 times higher than among the employed. Men unemployed for more than a year were at much higher risk than those out of work for shorter periods. These findings were considered to be consistent with the view that unemployment, especially if long term, increases the incidence of parasuicide. The official prediction of an increase in long term unemployment has important implications.     

潍坊市2000~2014年苯丙酮尿症筛查资料回顾分析

目的 了解潍坊市2000~2014年苯丙酮尿症(PKU)的筛查和确诊患儿情况。方法 查阅潍坊市15年来新生儿疾病筛查年报和患儿病历档案,对PKU筛查和确诊患儿情况进行统计分析。结果 潍坊市PKU筛查覆盖率呈逐年上升趋势,2012年达到最高的99.15%;共确诊患儿136例,检出率为1.22/万,以经典型为主,男性居多,农村患儿数多于城市;规范治疗率69.85%,患儿治疗前后的血苯丙氨酸水平差异有统计学意义(P<0.05)。结论 潍坊市PKU筛查推广工作取得了明显成效,但需加强资料统计工作,实施安全有效治疗、规范随访,可较好改善患儿预后。     

Discussion Based on Analysis of the Suicide Rate and the Average Disposable Income per Household in Japan

Objective:

Suicide is one of the major social issues in Japan. According to a report of the National Policy Agency, there were approximately 22 000 to 24 000 annual suicides between 1994 and 1997 and there have been over 30 000 annual suicides in Japan since 1998. For these reasons, we think it is important to discuss the economic factor related to suicides in recent years.

Method:

In this study, we examined suicide rates and the average disposable income per household in Japan in the last 15 years (ie 1994–2008) and discussed the statistical analysis of the average disposable income per household and the associated suicide rates.

Results and Discussion:

During the research period, annual suicide rates per 100 000 population in Japan ranged from 16.9 to 25.5 among the total population, from 23.1 to 38.0 among men, and from 10.9 to 14.7 among women. The annual average disposable income per household (ten thousand yen) ranged from 424.0 to 549.9. The average disposable income per household was related to the suicide rate among the total population and among men. The average disposable income per household was not related to the suicide rate among women.

Conclusion:

We believe that this discussion will be useful in developing specific suicide preventive measures.     

Increased suicide rate before and during the war in southwestern Croatia

BACKGROUND: This paper analyzes the impact of war, with special regard for the intensity of changes in the suicide rate in wartime in the southwestern region of Croatia. The investigated region has an area of 7,993 km2 with a population of 322,964. Most of the population lives in the city of Rijeka, the regional center. METHODS: During the 10-year period from 1986-1995, a total of 4,172 deaths were investigated at the Institute of Forensic Medicine in Rijeka. Official reports based on forensic autopsies performed on the corpses note 602 cases of suicide, which have been confirmed by police investigation and forensic examination. As the investigated 10-year period encompasses two distinctly specific intervals-the peacetime 1986-1990 interval and wartime 1991-1995-the differences in respective quantitative and qualitative features of suicides during these two intervals were analyzed. RESULTS: A total of 262 suicides were committed in peacetime at the rate of 16.22/100,000 inhabitants, as opposed to 340 suicides in wartime at a rate of 19.61/100,000 inhabitants. This increase in the wartime suicide rate was primarily due to the 83% increase in the number of suicide victims <40 years of age. The number of suicides by firearms in wartime was almost fourfold the number in peacetime. CONCLUSIONS: Wartime conditions had a direct impact on the change of quantitative and qualitative features of suicides.     

“Is this a dagger I see before me?” — an audit of stabbings and gunshot wounds in Limerick

Background According to a recent study in Cardiff, the incidence of stab wounds is 14 per 100,000 population per annum. No such figures are available for Ireland. Aim To evaluate the incidence, type of injury, medical consequences and outcome of patients with stab or gunshot wounds presenting to the Mid-Western Regional Hospital, Limerick, over a 12 month period. Method A retrospective case study of all stab and gunshot wounds presenting over a 12 month period. Results Out of 62,000 new presentations to the Accident and Emergency (A&E) department, 101 (0.16%) were stabbings, giving an incidence of 33 per 100,000 population. Twenty-six patients required surgical intervention. There were three deaths. There were 10 gunshot wounds, of which 40% required surgical intervention, with no mortalities. Conclusion The incidence of stab wounds presenting to our institution is high. Although constituting a small percentage of presentations to the A&E department they result in considerable morbidity and surgical activity.     

Risk of suicide among persons with AIDS. A national assessment.

OBJECTIVE--We sought to describe the rate, risk, trends, methods, and distribution of suicide among persons with the acquired immunodeficiency syndrome (AIDS) in the United States. DESIGN--We used National Center for Health Statistics multiple-cause mortality data from 1987 through 1989 to identify suicides among persons with AIDS (PWAs) and public-access AIDS surveillance data to determine person-years of observation of PWAs. PATIENTS--Residents of the United States with death certificates indicating suicide. MAIN OUTCOME MEASURE--Death certificates indicating both AIDS and suicide. RESULTS--In 1987 through 1989, a total of 165 suicides among PWAs occurred in 45 states and the District of Columbia. All but one case were male. Among males the rate was 165 per 100,000 person-years of observation, 7.4-fold higher than among demographically similar men in the general population. Self-poisoning with drugs was both the most common method (35%) and the method with the highest standardized mortality ratio (35). Suicide risk for PWAs decreased significantly (P < .05) from 1987 to 1989. CONCLUSION--Persons with AIDS have an increased risk of suicide, and assessment of such risk should be a standard practice in their care. These assessments should be carefully considered when potentially lethal medications are prescribed. The declining trend in suicide rates between 1987 and 1989 is encouraging; possible causes include emerging therapies for human immunodeficiency virus/AIDS, better psychiatric care for these patients, and lessened social stigma against PWAs.     

Drug-abusing Offenders with Co-morbid Mental Disorders: Gender Differences in Problem Severity, Treatment Participation, and Recidivism

Objective This study examined the gender differences in drug‐related problems and predictors of recidivism among a sample of 1444 offenders with co‐morbid drug abuse and mental disorders participating in California’s Proposition 36 Program.Methods Background characteristics and problem severity in multiple key life areas were assessed at intake by using Addiction Severity Index,and drug treatment participation,mental health diagnoses and arrests were based on official records.Results Women demonstrated greater problem severity than men in family relationships,health,psychological health,and sexual and physical abuse history.Men on the other hand had greater criminal history,high rates of attention disorder,and psychotic disorder.More men than women were rearrested during the year after treatment admission.Logistic regression analyses showed that for the combined sample,male,young age,cocaine use(relative to methamphetamine),drug abuse severity,methadone treatment,arrest history and fewer prior treatment history were associated with higher recidivism at 12‐month follow‐up;lower education,cocaine use,and arrest history were related to women’s recidivism,while young age,outpatient treatment,and arrest history were predictors of men’s recidivism.Conclusion Although the specific type of mental disorder did not seem to be predictive of recidivism,the high rates of mental health disorder and arrest of this population is problematic.Intervention strategies taking into consideration gender‐specific problems and needs can improve outcomes for both.