Substances used in deliberate self-poisoning 1985-1997: trends and associations with age, gender, repetition and suicide intent

Background: Rates of deliberate self-poisoning have increased in recent years. While over-the-counter availability and prescribing patterns may influence trends in substances used in overdose, these may also be related to clinical characteristics of patients. We investigate trends in substances used for self-poisoning and the influence of age, gender, suicidal intent and repetition status on the substances used. Method: Data collected by the Oxford Monitoring System for Attempted Suicide were used to review trends and patterns of self-poisoning between 1985 and 1997. Results: There were substantial increases in self-poisoning with paracetamol and antidepressants. While the increase in antidepressant self-poisoning closely paralleled local prescribing figures during 1995–97, SSRI antidepressant overdoses occurred somewhat more often than expected compared with tricyclic overdoses. Paracetamol overdoses were more common in first-timers and young people, whereas overdoses of antidepressants and tranquillizers were more common in repeaters and older people. Self-poisoning with gas and non-ingestible poisons was associated with high suicidal intent. Conclusions: There have been marked changes in the substances used for self-poisoning, which seem primarily to reflect availability, as do the influences of age and repeater status on choice of substances used. Degree of suicidal intent may also influence choice of method of self-poisoning. Accepted: 31 January 2001     

精神病自杀行为相关危险因素的关联研究

目的:深入了解精神病自杀人群的社会危险因素。方法:采用病例-对照研究方法,收集患者临床资料,并分析其与自杀行为的关系。结果:精神疾病患者自杀行为与性别,婚姻状况,发病年龄,疾病类型和负性生活事件有关。女性自杀率高于男性;自杀组患者的已婚率高于未自杀组,且平均发病年龄高于未自杀组;抑郁症和精神分裂症是与自杀关系较为密切的精神疾患。结论:已婚和负性生活事件是精神疾病患者发生自杀行为的危险因素,抑郁症、精神分裂症也是自杀行为的重要危险因素。     

不同性别抑郁症患者自杀意念的相关危险因素比较

目的 研究抑郁症患者自杀意念相关因素的性别差异,为自杀的干预和预防提供更多的证据.方法 依据DSM-IV抑郁症诊断标准入组122例有自杀意念的抑郁症患者和129例无自杀意念的抑郁症患者,进行不同性别间各项目的比较分析.结果 男女抑郁症患者在婚姻、文化程度、职业、收入水平和生活事件、艾森克人格测验的内外倾向、神经质和掩饰性方面差异有统计学意义.结论 男性与女性抑郁症患者的自杀意念危险因素存在一定差异,健全的人格,积极的应对方式,良好的家庭环境,在自杀预防中有重要意义.     

长期住院精神分裂症患者伴自杀意念的临床分析

目的：分析长期住院精神分裂症患者伴自杀意念的临床特征,并筛选相关影响因素。方法：依据有无自杀意念,将93名长期住院精神分裂症患者分成自杀意念组（N＝32）和无自杀意念组（N＝61）,比较2组人口社会学和临床特征的组间差异,并对自杀意念的影响因素进行Logistic回归分析。结果：自杀意念组的可支配月收入、共病躯体疾病、汉密尔顿抑郁－17项版本量表（ HAMD－17）、精神分裂症病人生活质量量表（ SQLS）和家庭关怀度指数量表（ APGAR）评分明显高于无自杀意念组（P＜0．05）。回归分析显示, HAMD－17总分（OR＝0．897,P＝0．005）、 SQLS总分（OR＝0．949,P＝0．030）和APGAR总分（OR＝1．411,P＝0．001）与自杀意念独立相关。结论：抑郁症状、生活质量和家庭功能是长期住院精神分裂症患者自杀意念的影响因素。     

Suicide: A review of calls to an adolescent peer listening phone service

Calls about suicide to a teen peer listening phone service over a period of 5 1/2 years are described. The majority of those calling about suicide were females. The phone contacts were of longer duration and later in the evening than calls about other concerns. Those concerned with suicide also discussed other serious issues such as selfesteem, family problems, substance use, and abuse and were less likely to be calling “just to talk.”     

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。     

Suicide risk in Iraq and Afghanistan veterans with mental health problems in VA care

Suicide rates among U.S. military personnel and veterans are a public health concern, and those with mental health conditions are at particular risk. We examined demographic, military, temporal, and diagnostic associations with suicidality in veterans. We conducted a population-based, retrospective cohort study of all Iraq and Afghanistan war veterans who screened positive for posttraumatic stress disorder (PTSD) and/or depression, received a suicide risk assessment, and endorsed hopelessness about the present or future after their last deployment and between January 1, 2010 and June 29, 2014 (N = 45,741). We used bivariate and multivariate logistic regression analyses to examine variables associated with having endorsed suicidal thoughts and a plan. Multiple factors were associated with suicidality outcomes, including longer time from last deployment to screening (proxy for time to seeking VA care), an alcohol use disorder diagnosis, further distance from VA (rurality), and being active duty during military service. Hispanic veterans were at decreased risk of having suicidal ideation and a plan, compared to their white counterparts. In high-risk veterans, some of the strongest associations with suicidality were with modifiable risk factors, including time to VA care and alcohol use disorder diagnoses. Promising avenues for suicide prevention efforts can include early engagement/intervention strategies with a focus on amelioration of high-risk drinking.     

A genome-wide association study of suicide severity scores in bipolar disorder

BackgroundSuicide claims one million lives worldwide annually, making it a serious public health concern. The risk for suicidal behaviour can be partly explained by genetic factors, as suggested by twin and family studies (reviewed in (Zai et al. 2012)). Recently, genome-wide association studies (GWASs) of suicide attempt on large samples of bipolar disorder (BD) patients from multiple sites have identified a number of novel candidate genes. GWASs of suicide behaviour severity, from suicidal ideation to serious suicide attempt, have not been reported for BD.MethodsWe conducted a GWAS of suicide behaviour severity in three independent BD samples:212 small nuclear families with BD probands from Toronto, Canada, 428 BD cases from Toronto, and 483 BD cases from the UK. We carried out imputation with 1000 Genome Project data as reference using IMPUTE2. Quality control and data analysis was conducted using PLINK and R. We conducted the quantitative analyses of suicide behaviour severity in the three samples separately, and derived an overall significance by a meta-analysis using the METAL software.ResultsWe did not find genome-wide significant association of any tested markers in any of the BD samples, but we found a number of suggestive associations, including regions on chromosomes 8 and 10 (p < 1e-5).ConclusionsOur GWAS findings suggest that likely many gene variants of small effects contribute collectively to the risk for suicidal behaviour severity in BD. Larger independent replications are required to strengthen the findings from the GWAS presented here.