Suicide in Ethiopian Immigrants in Israel: A Case for Study of the Genetic-Environmental Relation in Suicide

Girard (1993) suggests that age and gender specific suicide patterns can be predicted by economic progress. However, human development, especially the empowerment of women, is also an integral part of advancement. India consists of 24 states, at various stages of development, with diverse suicide patterns. Statistical analyses were conducted on suicide data from 14 Indian states (1997). Human development factors did predict suicide rates for both genders, but there was no significant relationship between suicide rates and economic factors. Moreover, when human development and economic factors were used as multinomial logit estimators, they failed to clearly predict probabilities of specific age and gender suicide patterns. Findings support the view that explanations for disparity in suicide rates appear to be more complicated for less developed nations than they are for developed countries.     

Motives for Suicide Attempts--the Views of the Patients

This study was designed to investigate the motives patients give for attempting suicide and the associations between these motives and diagnosis, various psychiatric features, suicidal intent and socio-demographic characteristics. The Motives for Parasuicide Questionnaire (MPQ), comprising 14 suggested motives, was presented to 53 patients at a psychiatric ward that specialized in suicide attempters. Escape motives were very common, whereas interpersonal motives were rare. Patients with substance abuse, anxiety, or personality disorders more often chose communicating motives and mentioned higher numbers of motives than those with mood or adjustment disorders. Hopelessness was positively associated with a stated wish to die and with escape motives, and negatively correlated to communicating/unclear motives. Suicidal intent was related to some motives. The psychiatric disorder or mental state seems to be more important than socio-demographic characteristics for the choice of motives. Further studies are required to investigate the associations between psychiatric features and motives, as well as the clinical usefulness of such assessments.     

CLINICAL NOTE

Regional cerebral hypoperfusion is found in depression. Favorable therapeutic effect of antidepressant drugs usually leads to flow normalization. In our patients, cerebral blood flow correlated well with clinical findings. Clinical and scintigraphic improvement was observed after 3 weeks of therapy in all patients. On follow up after 6 months, psychiatric and scintigraphic normalization was noted in all but one patient who committed suicide shortly after the last examination. In the described case, a tendency toward baseline clinical and scintigraphic findings was observed after initial partial response to medication. Noncompliance to medication was suspected and confirmed after her suicide.     

Suicidal Callers to a National Helpline in the UK: A Comparison of Depressive and Psychotic Sufferers

Little information is available on the profile of suicidal mentally ill sufferers seeking help from helplines. In this article we describe the profile and experience with services of suicidal people calling SANELINE, a national mental health helpline in the UK. Analyses were conducted on 1,331 calls made during 1996-1997 by callers who resided in London. Sixty-one percent of all callers were female. Half of all callers were suffering from depression and 32% from psychosis. Psychotic sufferers were significantly more likely not to have been complying with treatment, to have wanted information about medication, and to have been dissatisfied with the local services. Suicidal psychotic sufferers were more likely than non-suicidal ones to have inquired about mental health laws or about state benefits. On the other hand, depressive sufferers were more likely to have wanted information about social support groups, and to have complained about the lack of services in their area of residence. The findings suggested the need to target male sufferers, to meet the information needs of suicidal people with psychosis or depression, and to increase awareness about available sources of help.     

The Psychometric Properties and Correlates of the Reynolds' Suicide Ideation Questionnaire with Kuwaiti and American Students

In samples of Kuwaiti (n = 460) and American (n = 273) college students, the Reynolds Suicide Ideation Questionnaire (SIQ) proved to have good internal consistency and concurrent validity with measures of anxiety, optimism, pessimism, death obsession, obsession-compulsion, and ego-grasping. The SIQ was factorially complex in both samples, but the eight critical items showed a similar two-factor pattern in both samples. It is important to note that in spite of the great differences between Kuwait and US students and their cultures, the findings were quite similar. By and large, the psychological correlates of the SIQ may have cross-cultural generality.     

Comparisons of Prisoners Who Make or Do Not Make Suicide Attempts and Further Who Make One or Multiple Attempts

Suicidal behavior among prisoners is a major problem. The objective of this study was to compare prisoners who have made an attempt at suicide vs non-attempters and further to compare single vs multiple suicide attempts. Among 1,537 prisoners, 200 (13%) had a lifetime history of attempting suicide and 92 (6%) had made multiple attempts. Those who had made multiple or single attempts were compared on socio-demographic, developmental, personality, forensic, and psychiatric variables. In a re-analysis we also compared non-attempters with attempters in this larger sample. The comparison showed that prisoners who had made multiple attempts had experienced significantly more childhood trauma, were more introverted, less resilient, had a history of self-mutilation, and had more suicidal ideation. Anger and hostility scores and criminal and violence histories significantly differentiated prisoners who had attempted from those who had never attempted but they did not differentiate multiple from single attempters. Having a history of multiple attempts may be indicative of more severe psychopathology in prisoners, as found in other populations. These findings may be helpful in predicting which prisoner is at increased risk of exhibiting suicidal behavior while incarcerated and after release.     

Self-Injurious Behaviors and Adult Attachment: A Review of the Literature

Self-injurious behaviors (SIB) continue to afflict a significant segment of the clinical and general population, sometimes with fatal consequences. The development of SIB seems to share developmental pathways and mechanisms similar to attachment insecurity. To date, no reviews have explored their relationship. A search of publication databases PubMed and PsychInfo from 1969 through April 2018 was conducted and 17 papers met inclusion criteria. Of the 17 articles identified, 13 reported a positive relationship and 1 reported a negative relationship between attachment insecurity and SIB. Both attachment anxiety and avoidance seem to play a role in the risk for SIB, possibly through different mechanisms and likely with different impacts on the choice for either self-harm or suicide attempts.     

Prevalence,demographic and clinical correlates of suicide attempts in Chinese medicated chronic inpatients with schizophrenia

The high prevalence of suicide in schizophrenia may be related to its demographic and clinical characteristics. Because suicide prevalence and its associations with clinical variables are less well characterized in Chinese than European patients with schizophrenia, we assessed the suicide attempts in 520 Chinese inpatients with schizophrenia. The suicide attempt data were collected from medical case notes and interviews with the patients and their family members. Patients were rated on the Positive and Negative Syndrome Scale (PANSS), the Simpson and Angus Extrapyramidal Symptom Rating Scale (SAES), and the Abnormal Involuntary Movement Scale (AIMS). Smoking severity was evaluated using clinician-administered questionnaires and the Fagerstrom Test for Nicotine Dependence (FTND). We found a suicide attempt rate of 9.2% in these schizophrenic inpatients. The attempters were single, had a significantly younger age but more hospitalizations, had higher depressive symptoms, and began smoking at an earlier age, smoked more cigarettes each day and had higher FTND total scores than patients without suicide attempts. The logistic regression analysis also indicated that suicide attempts were associated with the number of hospitalizations, depressive symptoms and FTND total scores. These results suggest that Chinese inpatients with schizophrenia attempt suicide more often than the general population. Further, some demographic and clinical variables are risk factors for suicide attempts in schizophrenia.     

Mortality in persons with mental disorders is substantially overestimated using inpatient psychiatric diagnoses

Mental disorders are associated with premature mortality, and the magnitudes of risk have commonly been estimated using hospital data. However, psychiatric patients who are hospitalized have more severe illness and do not adequately represent mental disorders in the general population. We conducted a national cohort study using outpatient and inpatient diagnoses for the entire Swedish adult population (N = 7,253,516) to examine the extent to which mortality risks are overestimated using inpatient diagnoses only. Outcomes were all-cause and suicide mortality during 8 years of follow-up (2001–2008). There were 377,339 (5.2%) persons with any inpatient psychiatric diagnosis, vs. 680,596 (9.4%) with any inpatient or outpatient diagnosis, hence 44.6% of diagnoses were missed using inpatient data only. When including and accounting for prevalent psychiatric cases, all-cause mortality risk among persons with any mental disorder was overestimated by 15.3% using only inpatient diagnoses (adjusted hazard ratio [aHR], 5.89; 95% CI, 5.85–5.92) vs. both inpatient and outpatient diagnoses (aHR, 5.11; 95% CI, 5.08–5.14). Suicide risk was overestimated by 18.5% (aHRs, 23.91 vs. 20.18), but this varied widely by specific disorders, from 4.4% for substance use to 49.1% for anxiety disorders. The sole use of inpatient diagnoses resulted in even greater overestimation of all-cause or suicide mortality risks when prevalent cases were unidentified (∼20–30%) or excluded (∼25–40%). However, different methods for handling prevalent cases resulted in only modest variation in risk estimates when using both inpatient and outpatient diagnoses. These findings have important implications for the interpretation of hospital-based studies and the design of future studies.     

Psychosocial predictors and outcomes of loneliness trajectories from childhood to early adolescence

Using latent class growth analysis, we were interested in investigating how experiences of loneliness emerge in distinct developmental patterns over the course of middle childhood and adolescence (NICHD Study of Early Child Care, N = 832). Second, we examined the role of demographic, mental health, and behavioral variables in association with these discrete patterns of loneliness. Loneliness was measured at 3 time points: age 9, age 11, and age 15. Results indicated five discrete trajectories of loneliness from middle childhood to adolescence. Most children exhibited a stable and low level of loneliness over time. The remaining children were split among moderate increasing, high increasing, decreasing, and chronic loneliness groups. Ethnicity, income, age 7 social skills, age 7 depression, and age 7 aggression were associated with trajectory membership. In addition, the loneliness trajectories predicted self-reports of social skills deficits, depression, aggression, and suicidal ideation at age 15.