The Balkan Piedmont: male suicide rates pre-war, wartime, and post-war in Serbia and Montenegro.

The epidemiology of suicide in Serbia and Montenegro from 1989 to 2003, a period of civil war, is presented. Following the break-up of former Yugoslavia, Serbia and Montenegro underwent a period of war from 1991-1994 and another in 1999. During the war years, the number of suicides increased, reaching its peak in 1993. Male suicides outnumbered female suicides by a ratio of 2:1. Male suicides decreased slightly after the war of 1991-1994 only to rise in 1997 and continue at this higher level throughout the nineties. In Serbia alone, male suicide reached its peak in 2002 (nearly 29/100,000). The methods of suicide changed significantly, with the use of firearms doubling during and after the war years. Speculations are offered about the findings, many consistent with Durkheim's classical hypothesis concerning suicide and unpopular wars.     

Political Beliefs,Region of Residence,and Openness to Firearm Means Safety Measures to Prevent Suicide

Firearms account for approximately half of all suicides in the United States and are highly lethal, widely available, and popular; thus, are an ideal candidate for targeted means safety interventions. However, despite their value as a suicide prevention tool, firearm means safety strategies are not widely utilized, possibly due to factors which impede openness to their use. This study examines the relationship between region, political beliefs, and openness to firearm means safety in a sample of 300 American firearm owners. Overall, firearm owners were more willing to engage in means safety for others than for themselves and to store firearms safely than temporarily remove them from the home. Social policy views and region were significantly associated with openness to firearm means safety measures, however, economic policy views were not. This study provides further context for the development and implementation of efficacious means safety measures capable of overcoming potential barriers to their use.     

The Age Structures and Marital Status Differences of Married and Not Married Male Suicide Rates: 12 Developed Countries

Male suicide rates, circa 1960, specific to age and marital status for 12 developed countries show married men with lower suicide rates than not married men. This results in differences in the age structures of married and not married suicide rates. We test three explanations of lower married than not married suicide rates: 1) Gibbs and Martin's (1964 Gibbs , J. P. & Martin , W. T. ( 1964 ). Status integration and suicide: A sociological study . Eugene , OR : University of Oregon Books . [Google Scholar]) marital status integration hypothesis; 2) marital status differences in norms regarding the acceptability of suicide; and 3) Durkheim's societal integration theory. All three explanations are supported by multivariate regressions. The strongest support is for societal integration. The models explain over 80% of the variance in both married and not married male age-specific suicide rates. These regression equations generate predicted suicide rates and these predicted rates are then used to see if they account for the observed age structures of married and not married men. They do in 19 of 24 tests.     

Differential Suicide Rates in Typologies of Child Sex Offenders in a 6-year Consecutive Cohort of Male Suicides

ABSTRACT

Earlier research identified 3 typologies of Child Sex Offenders [CSO] with high rates of suicide. To test this finding suicide rates of 3 types of CSO were compared in a 6-year cohort of regional suicides. All male suicides were identified from Coroners” inquest files and CSO data drawn from police records to calculate CSO suicide rates. The results show that suicide in “Multi-criminal” CSO is 12 times higher than the general population but not statistically significantly. Two significant results were “Sex Only” CSO suicides were 183 times the general population and 15 times the Multi-criminal CSO rates, with no suicides amongst the Violent CSO's. Implications for suicide prevention and child protection are presented.     

Geographic Variation in Suicide Rates: Relationships to Social Factors,Migration, and Ethnic History

Geographic variation in suicide rates is thought to be the result of interactions between two major components: the social organization combined with cultural tradition and biological or genetic factors. The present study examined regional patterns of suicide rates in European Russia. Our study looked at ethnic and national formations with respect to suicide patterns. The results indicated that the suicide rates vary greatly among the regions of the Russian Federation, with suicides more common in the northern regions of European Russia than in the south of the country. The south and north gradient of suicide distributions in Russia resemble that of other European countries. Throughout the Middle ages the north and northwest territory of present-day Russia has been an area of intensive interethnic contacts between the Old Slavs, which have colonized this territory, and native people of Finno-Ugrian and Baltic origin. The results indicated that the historical prevalence of the Finno-Ugrian component in the north of the country has possibly led to its higher suicide rate.     

Suicide in Vietnam Veterans: The Suicide Wall

ABSTRACT

Although official data have reported an average number of suicides in the veterans of the Vietnam War, the veterans themselves estimate that the death toll from suicide may be 8 to 10 times the official toll. Attention is drawn to a website honoring those veterans of the war who have committed suicide: www.suicidewall.com     

The General Public's Views on Suicide and Suicide Prevention,and their Perception of Participating in a Study on Attitudes towards Suicide

The aim of the presented study was to investigate whether common myths about suicide still prevail, what people in general think are the most common causes for suicide, whether suicide can be prevented, and if so, how. How subjects perceived their participation in a study on attitudes towards suicidal behavior, was also investigated. The Attitudes Towards Suicide questionnaire was sent to a random sample of 1,000 Norwegians. The data were analyzed both quantitatively and qualitatively. The results showed that the common myths still prevail, that people in general mainly assign intrapersonal causes to suicide, with the belief that suicide can be prevented, and that they perceived their participation in the study positively. The value of the general public in suicide prevention and the need for increased openness and competence building were emphasized.     

Addressing the Cultural Challenges of Firearm Restriction in Suicide Prevention: A Test of Public Health Messaging to Protect Those at Risk

Objectives. Reducing access to firearms as a suicide prevention strategy is limited in the US today because of divergent cultural attitudes and political contentiousness surrounding gun restrictions. This research examined the effects of culturally-specific suicide prevention messages on the likelihood of restricting firearm access during periods of suicide risk.

Methods. Focus groups and key informant interviews were conducted with rural gun owners in order to develop a suicide prevention message that highlighted the importance of restricting access to firearms during periods of risk without threatening second amendment concerns. The effectiveness of this gun culture message, relative to standard suicide prevention messaging and a control condition, was then tested with a national sample of gun owners.

Results. Relative to all other conditions, respondents who received our culturally-specific message in conjunction with standard suicide prevention content reported the greatest likelihood of taking steps to restrict access to firearms. This tendency was enhanced for individuals who were more politically conservative, lived in more rural areas, and supported gun rights to a stronger degree.

Conclusions. Findings underscore the importance of attending to cultural factors in public health messaging. Messaging that respects the values of gun owners could hold promise in promoting firearm restriction for suicide prevention.     

Suicide Attempt and Melancholic Depression in a Male with Erotomania: Case Report

ABSTRACT

Erotomania is a delusional disorder, which is more common among women. A case of erotomania in a 34-year-old male associated with depression and suicidal behavior is presented. At the time he attempted suicide his erotomania fulfilled the diagnostic criteria of “pure” erotomania, described by de Clérambault. A depressive picture with melancholic features emerged four months later. Antidepressant medication was given and two months later he became euthymic. The erotomanic delusion disappeared in the third month of the euthymic state. In this case primary erotomania was associated with a depressive illness, presumably unipolar depression. The patient developed delusional guilt and suicidal ideation before the unequivocal change in his mood. To the authors' knowledge this is the first reported case where the erotomanic symptomatology led to suicidal attempt.     

National Registration System of Suicide Behaviors in Iran: Barriers and Challenges

The present article describes the process of developing a national suicide registry in Iran and evaluates the obstacles in this respect. We established a systematic and uniform portal data collection system in the country and evaluated it from March 2009 for a year. The quality of database and data registration challenges were assessed from different aspects. A total number of 41,109 suicide attempts and 1,338 completed suicides were reported from an area that covered 83.6% of Iran's population in 2009. The rate of suicide attempt was 65.8 per 100,000 people. This study revealed some of the obstacles and challenges of implementing a national registration system. Nationwide suicide registry can serve as a solid foundation for conceptual work, data collection, and preventive interventions. A concerted effort between various organizations is required to efficiently collect data on suicide behaviors.     

Suicide and attempted suicide in general practice, 1979-1986

Using data from the Continuous Morbidity Registration Sentinel Stations over the period 1979-1986, the authors tried to determine the incidence and the characteristics of patients in general practice who attempted or committed suicide. Almost half of the suicide attempts and suicides had contacted their general practitioner (GP) shortly before the suicidal act. A minority of these cases were recognized by the GP as having a high suicide risk. In almost 70% of the suicides and 58% of the suicide attempters the GPs reported the existence, currently or previously, of a depressive episode. About half of both the suicides and the suicide attempters had been treated or seen by mental health professionals or social workers. Given the fact that suicide and suicide attempt are relatively rare events in general practice, and given the fact that for the patients who contact their GP shortly before the suicidal act, it is not at all certain whether they present clearly recognizable signs of suicide risk at that time, the authors conclude that GPs cannot play an important role in the prevention of suicidal behaviour.     

Suicide rate,prevalence of diagnosed depression and prevalence of working physicians in Hungary

Based on the well-known relationship between depression and suicide, we investigated the regional distribution of the suicide rate, rate of diagnosed depression and prevalence of working physicians in Hungary. A strong significant positive correlation was found between the rate of working physicians and rate of diagnosed depression, and both parameters showed a strong significant negative correlation with the suicide rate. The more physicians per 100,000 inhabitants, the better is the recognition of depression and the lower is the suicide rate in the given region. The rate of working doctors was significantly higher in the counties located in western Hungary, which may have a role in the lower suicide mortality in this area of the country.     

Suicide in Ireland: Statistical,social and clinical considerations

The objective of this research was to examine whether the Holmes-Rahe Social Readjustment Rating Scale, a life event scale, can be used to identify suicide attempters. The Holmes-Rahe Social Readjustment Rating Scale's ability to identify suicide attempters was tested in 1183 subjects (478 suicide attempters, 197 psychiatric inpatients, and 508 healthy controls) using the Fisher Linear Discriminant Analysis and traditional psychometric methods. The Fisher Linear Discriminant Analysis outperformed traditional psychometric approaches (area under the curve: 0.85 vs. 0.78; p < 0.05) and indicated that this scale may be used to identify suicide attempters. The life events that better characterized suicide attempters were change in frequency of arguments, marital separation, and personal injury. The Holmes-Rahe Social Readjustment Rating Scale may help identify suicide attempters.     

Suicide as a crime in the UK: legal history,international comparisons and present implications

Suicide was a crime in England and Wales until 1961. This paper compares the English legal treatment of suicide with that in other Western countries. The delayed English decriminalization of suicide is a likely result of the nature of English common law, rather than a reflection of actual public opinion and medico-legal practice. This subject remains of interest. Coronership, the cornerstone of English suicide certification, developed out of anti-suicide legislation, and important biases result from this. The Church of England may still deny ordinary burial rites to certain suicide victims. Assisted suicide, to be distinguished from euthanasia and suicide pacts, became a separate offence in 1961. Legislative reform regarding these issues, similarly to that regarding suicide, is likely to lag behind the development of public opinion and medical practice.     

Suicide in Denmark, 1922–1991: the choice of method

The authors describe methods of suicide registered in Denmark during the last 70 years. The preferred method was initially hanging then later poisoning, first mainly with household gas, later with other agents, especially overdoses of medicine. In recent years there has, however, also been an increasing number of hangings, drownings and other methods of suicide, and there seems to be an increasing inclination towards selecting more violent methods. The Danes’ choice of method for committing suicide differ somewhat from that in the other Scandinavian countries; in particular, there have been far more cases of self-poisoning in Denmark.     

Suicide,ethnicity and psychiatric in-patient care: A case-control study

Abstract

This study compares patients with controls concerning sociodemographic variables and describes Swedish and foreign-born patients concerning psychiatric disorders. suicide risk. history of attempted suicide, suicide method, number of parasuicides and time from discharge to suicide. It is based on 59 psychiatric in-patients who had committed suicide, of whom 46 were native Swedes and 13 foreign-born, and on a random sample of 630 controls living in the same area of Stockholm, Sweden. There was an excess suicide risk for being foreign-born with a crude odds ratio of 1.94 (CI = 1.01?3.76) in an unconditional logistic regression. In the final model, single living, having a somatic disease and being unemployed were major risk factors for committing suicide. There were no differences between Swedes and those of foreign birth concerning distribution of certain background variables (i.e., suicide risk, diagnoses and quality of care assessed via clinical records). Only 39% of the patients were classified as high risk by the doctor-in-charge at admission. This is significantly lower p<0.001) than the retrospectively rated risk. Planned aftercare was considered as satisfactory for about half of the patients. About two-thirds of the patients did not participate in aftercare or almost immediately discontinued the contact. More attention is necessary in order to motivate the patients to take part in aftercare and there is a need for better co-operation between hospital and out-patient clinics.     

Suicide, Ethnicity and Psychiatric In-Patient Care: A Case-Control Study

This study compares patients with controls concerning sociodemographicvariables and describes Swedish and foreign-born patients concerningpsychiatric disorders, suicide risk, history of attempted suicide, suicidemethod, number of parasuicides and time from discharge to suicide. It isbased on 59 psychiatric in-patients who had committed suicide, of whom 46were native Swedes and 13 foreign-born, and on a random sample of 630controls living in the same area of Stockholm, Sweden. There was an excesssuicide risk for being foreign-born with a crude odds ratio of 1.94 (CI = 1.01 – 3.76) in an unconditional logisticregression. In the final model, single living, having a somatic disease andbeing unemployed were major risk factors for committing suicide. There wereno differences between Swedes and those of foreign birth concerningdistribution of certain background variables (i.e., suicide risk, diagnosesand quality of care assessed via clinical records). Only 39% of thepatients were classified as high risk by the doctor-in-charge at admission.This is significantly lower (p < 0.001) than theretrospectively rated risk. Planned aftercare was considered as satisfactoryfor about half of the patients. About two-thirds of the patients did notparticipate in aftercare or almost immediately discontinued the contact.More attention is necessary in order to motivate the patients to take partin aftercare and there is a need for better co-operation between hospitaland out-patient clinics.     

Suicide and suicide attempts in general hospital psychiatry: Clinical and statistical study

Abstract Thirty-six psychiatric patients with completed suicide, 162 with attempted suicide and 154 patients referred for suicidal behavior, four of whom died, were investigated and classified according to the ICD-10. Thirty-six patients with completed suicide among 9085 new psychiatric patients (1969-92) gave a suicide rate of 82.6/100 000 per year. Schizoaffective and depressive disorder in psychiatric patients with completed suicide and schizophrenia, depressive disorder and adjustment disorders in patients with attempted suicide were significantly more frequent than in 312 controls. Intrafamilial conflicts, divorce or loss of love and death or severe disease of family member were the most common precipitants. Loneliness from living alone in males, losing a spouse and intrafamilial conflicts within a large family of three generations in females were supposed to be risk factors. A high referral rate of 48% in attempted suicide indicated the important role of consultation-liaison psychiatry in emergency medicine.