Social support among European suicide attempters

In order to measure social support among suicide attempters, an instrument was especially designed to be included in the follow-up interview study being part of the WHO/Euro Multicentre Study on Parasuicide which is carried out in cooperation with EC Concerted Action on Attempted Suicide. In this paper, which is to be the first in a series, the theories behind the design and the methodology are discussed, and some general results presented. Judged by the level of the need for support, there are some differences between the 10 European areas under study, but judged by the individual's perception of to what degree his needs are met, somewhat to our surprise the majority of the suicide attempters in the various areas under study agree in feeling that their needs for support are met to a great extent.     

Social support in a wired world: use of online mental health forums in Norway

This study explored the use of the four major Norwegian mental-health-related online discussion forums; who participate, why, and what implications use may have. The objective was to provide a basis for proposing relevant research questions and issues for public policy attention. A total of 492 responses to a web-based questionnaire were received. The respondents, predominantly women (78%) in the age range 18--35 years, found forum participation useful for information, and social contact and support. A majority (75%) found it easier to discuss personal problems online than face-to-face, and almost half say they discuss problems online that they do not discuss face-to-face. A majority would not have participated had they not had the option of using a pseudonym. Respondents perceive discussion groups as a supplement rather than a replacement of traditional mental health services, reporting no change in the amount or type of service used. A clear majority want professionals to take an active role in these types of forum. Comments from respondents indicate that forums may have an empowering effect. We believe that online interaction can have unique benefits for people suffering from mental disorders. Professionals will need new knowledge and perceptions of their roles, and public authorities will have to decide their role in influencing the quality of services offered, and the social values conveyed, to those who seek help through the Internet.     

Social support in a wired world: Use of online mental health forums in Norway

This study explored the use of the four major Norwegian mental-health-related online discussion forums; who participate, why, and what implications use may have. The objective was to provide a basis for proposing relevant research questions and issues for public policy attention. A total of 492 responses to a web-based questionnaire were received. The respondents, predominantly women (78%) in the age range 18-35 years, found forum participation useful for information, and social contact and support. A majority (75%) found it easier to discuss personal problems online than face-to-face, and almost half say they discuss problems online that they do not discuss face-to-face. A majority would not have participated had they not had the option of using a pseudonym. Respondents perceive discussion groups as a supplement rather than a replacement of traditional mental health services, reporting no change in the amount or type of service used. A clear majority want professionals to take an active role in these types of forum. Comments from respondents indicate that forums may have an empowering effect. We believe that online interaction can have unique benefits for people suffering from mental disorders. Professionals will need new knowledge and perceptions of their roles, and public authorities will have to decide their role in influencing the quality of services offered, and the social values conveyed, to those who seek help through the Internet.     

Social disorganization and completed suicide

Summary It has been found in Edinburgh, Scotland that the incidence of completed suicide is very common in areas of the city where there is a high degree of social disorganization, such as overcrowding and juvenile delinquency. A study in the city of Buffalo in the United States failed to replicate this finding. It appears possible, therefore, that the types of people who kill themselves (at least as determined by ecological studies) may differ considerably in Edinburgh and in Buffalo. The implications of this study are important since preventative measures for suicide would have to differ for the two countries were this true. Overcoming social disorganization would be expected, for example, to have an ameliorative effect on suicidal behavior in Edinburgh but not in Buffalo.

---

Zusammenfassung In Edinburgh, Schottland, wurde gefunden, daß der vollendete Suicid in Innenstädten, wo ein hoher Grad sozialer Zerrüttung, wie Überbevölkerung und Jugenddeliquenz herrscht, sehr verbreitet ist. Eine Untersuchung in der Innenstadt von Buffalo in den Vereinigten Staaten bestätigte dies allerdings nicht. Es erscheint daher als möglich, daß die Wesensart der Leute, die sich umbringen (so wie sie wenigstens durch ökologische Untersuchungen bestimmt werden), in Edinburgh und in Buffalo verschieden ist. Die Folgerungen aus dieser Studie sind bedeutsam, da die präventiven Maßnahmen für Suicid sich in den beiden Ländern unterscheiden müßten, wenn sich das so verhielte. Man würde erwarten, daß die Überwindung der sozialen Zerrüttung sich beispielsweise in Edinburgh auf suicidales Verhalten heilsam auswirken würde, aber nicht in Buffalo.

---

Résumé A Edinburgh, en Ecosse, on a trouvé que l'incidence des suicides réussis est très fréquente dans les zones urbaines où règne une grande désorganisation sociale (surpopulation, délinquance juvénile, etc.). Une étude réalisée dans la ville de Buffalo aux USA n'a pas confirmé ce résultat. Il semble donc possible que les genres de personnes qui se tuent (du moins tels qu'ils sont déterminés par les études écologiques) diffèrent considérablement à Edinburgh et à Buffalo. Les implications de cette étude sont importantes puisque, si c'est vrai, les mesures préventives du suicide devraient alors différer dans les deux pays. On pourrait s'attendre par exemple à ce qu'une organisation sociale améliorée ait un effet favorable sur le comportement suicidaire à Edinburgh, mais pas à Buffalo.

     

贵阳市城区居民自杀的社会危险因素的调查

目的　为了探讨自杀危险因素 ,确定自杀高危人群 ,为有关部门制定防治自杀的措施提供科学依据。方法　采用病例 对照研究方法对 1995～ 1999年贵阳市城区 110例自杀死亡者进行了研究。结果　较差的职业、家庭关系不和、缺少社会活动及体育劳动锻炼 4项为自杀的危险因素 ,不同年龄、不同性别居民自杀的危险因素不同。结论　预防和控制自杀的着力点应放在预防和控制自杀的危险因素上。     

Social support in women reporting dysmenorrhea

Twenty-five women who reported dysmenorrhea were compared with a control group reporting no dysmenorrheic symptoms. An assessment of the structural and functional aspects of their social support system and ratings of somatic awareness and depression were made. Dysmenorrheic women reported less adequate social support than the control group. Although the two groups indicated similar numbers of individuals within their networks the dysmenorrheics reported a higher frequency of inadequate and geographically distant relationships. Somatic awareness but not depression scores were also elevated in the dysmenorrheic group.     

Social support and suicide in Japanese men and women - the Japan Public Health Center (JPHC)-based prospective study

Although the important role of social support in mental health is acknowledged, no prospective study has yet examined the relation of social support to suicide. Here, we investigated the association between social support and suicide in a cohort of Japanese men and women. A total of 26,672 men and 29,865 women aged 40–69 years enrolled in the Japan Public Health Center-based prospective study in 1993–1994 completed a self-administered questionnaire which included four items of social support, and were followed for death through December 2005. Hazard ratios (HRs) and 95% confidence intervals (95% CI) of suicidal death by social support index were estimated using a Cox proportional hazards regression model. A total of 180 suicidal deaths were recorded during an average of 12 years’ follow-up. Men and women with the highest level of social support had a significantly decreased risk of suicide, with HRs (95% CI) for the highest versus lowest social support group of 0.56 (0.33–0.94) and 0.38 (0.16–0.89) in men and women, respectively. Esteem support and having four or more friends were associated with a lower risk of suicide in women [0.32 (0.13–0.77)] and in both sexes [men: 0.56 (0.36–0.88); women: 0.65 (0.32–1.30)], respectively, whereas confident support was not. These findings suggest that social support may be important for suicide prevention. Avoiding social isolation may decrease the incidence of suicide in men and women, and esteem support can provide additional benefit for women.     

Social fragmentation,severe mental illness and suicide

Abstract.Background: Geographic patterns of suicide are associated with area levels of social fragmentation. It is unknown whether this reflects higher levels of severe mental illness in socially fragmented areas.Method: Data on psychiatric inpatient admissions and suicides amongst people aged 15–64 living in the City of Bristol [1991–1992] were postcode matched to the citys 34 electoral wards. Ecological associations of psychiatric admission (used as a proxy measure of prevalence of severe mental illness) and suicide rates with levels of social fragmentation were investigated using negative binomial regression models.Results: Psychiatric hospital admission rates were higher in areas with high levels of socioeconomic deprivation than in areas with high levels of social fragmentation. In contrast, associations with suicide were stronger in relation to social fragmentation than socioeconomic deprivation. Association of suicide with social fragmentation was only moderately attenuated in models controlling for psychiatric admission rate and socio-economic deprivation, RR 1.23 (95 % C. I. 1.09–1.38) per quartile increase in social fragmentation, compared to 1.29 (95% C. I. 1.16–1.44) before adjustment.Conclusion: The association between social fragmentation and suicide is not explained by socioeconomic deprivation or the prevalence of severe mental illness within socially fragmented areas as measured by psychiatric admission rate.     

Social support concepts and measures

Distinctions among concepts and approaches to assessing social support are made, and published generic and specialized measures of social support are reviewed. Depending on study aims, investigators may be interested in assessing perceived or received support from the perspective of the provider, the recipient, or both. Whereas some measures inquire about the availability or mobilization of several kinds of supportive resources, others seek supplemental information about the membership and structural properties of the social network as well. Observational and self-reported measures of support are presented, along with brief and extensive measures. A final set of three support measures is highlighted, including their psychometric properties.     

Social environment factors associated with suicide attempt among low-income African Americans: The protective role of family relationships and social support

Abstract Background Suicide and suicide attempts are important public health concerns, and recent decades have witnessed a rising rate of suicide among African Americans. A history of prior attempts is a leading risk factor for completed suicide. Further research is needed into the social environment risk factors for suicide attempt among African Americans. This study focused on two important dimensions of the social environment, family relationships and social support, as well as an important person-level risk factor—depressive symptoms. Method Data were obtained from a case-control study of 200 African American men and women aged 18–64 years, who sought services at a large, urban, public hospital. Odds ratios adjusted for significant sociodemographic differences between groups (aORs) were calculated for environment risk factors for suicide attempt among the cases and controls. The role of depressive symptoms was also studied. Results Lower levels of family adaptability and family cohesion increased the relative rate of suicide attempt in the sample. The aOR associated with the lowest quartile of family adaptability was 3.90, and the aORs associated with the first and second quartiles of family cohesion were 8.91 and 5.51, respectively. Lower levels of social embeddedness and social support increased the relative rate of suicide attempt in our sample. The aOR associated with the first and second quartiles of social embeddedness were 5.67 and 4.93, respectively, and the aOR associated with the lowest quartile of social support was 6.29. A mediating role of depression was discovered when depressive symptoms were entered into the logistic regression models. Conclusions Our findings indicate that social environment factors including deficits in family functioning and social support are associated strongly with suicide attempts among low-income African American men and women seeking treatment in a large, urban hospital. Thus, better family functioning and social supports can be considered protective factors in this population. The presence of depressive symptoms, a well-known risk factor for suicide attempts and suicide, appears to mediate the association between social environment factors and suicide attempt.     

Social,toxicological and meteorological data on suicide attempts

Summary A sample of 151 patients, admitted to an Intensive Care Unit after attempted suicide by poisoning was analysed with regard to age, drugs consumed, possible causal factors and influence of weather. The German Weather Service provided the meteorological data. Mean age of the patients was 37.6 years. The patients had taken barbiturates, aggressive chemicals, tranquillizers or a combination of drugs (47%). Alcohol had been taken in addition to the drugs in 24%, which might indicate a trigger function. The main provoking causes for the suicide attempts were conflicts in partnerships and occupational problems. Some 15% of the patients had previously diagnosed psychiatric disorders. There was a significant positive correlation between the time of attempted suicide and the weather parameters stable upslide, labile upslide, fog, thunderstorm, warm air, upslide and weather drier than on the 2 preceding days. Significantly fewer attempts than expected occurred with low pressure and trough situation, labile ground layer-upslide above, subsidence or downslide motion. Apart from individual provoking factors, such as the reaction to conflicts and the spectrum of reactions, exogenous factors like weather must be considered as important for the timing of suicide attempts. These results may be of relevance for suicide prevention.     

Social attempted suicide: young women in two contrasting areas.

The study compares attempted suicide data among young women of two ethnic groups resident in native West Indian and immigrant Birmingham environments. Although African rates were higher than East Indian ones, the three-fold increase in the immigrant population was unrelated to ethnic origin. This was also true regarding clinical data, patients using psychotropic tablets and giving similar reasons for attempting suicide. Formal psychiatric diagnoses were, however, less frequently made in Birmingham where patients preferred analgesic tablets to the domestic agents used instead by the West Indian population. The aetiological significant of sociocultural factors is discussed.     

Social phobia is associated with suicide attempt history in bipolar inpatients

OBJECTIVES: In an attempt to reduce the phenotypical heterogeneity in an ongoing genetic study of suicidal behavior, we investigated the impact of comorbid anxiety disorders on suicidal behavior in bipolar disorder (BD) patients. METHODS: Anxiety disorders were compared in 406 BD I and BD II patients with or without lifetime history of suicide attempt. RESULTS: Among anxiety disorders, only social phobia (SP) was significantly associated with history of suicide attempt in BD [p<0.001, odds ratio 4.26 (2.284-7.946)]. Moreover, onset of SP was found to precede onset of BD. CONCLUSIONS: This result suggests that SP is an important risk factor for suicidal behavior in BD. Further studies are required to determine whether comorbid SP may help to identify a more homogeneous BD sub-group, especially when studies of suicidal behavior are conducted. A second question is whether SP identifies a sub-group of subjects with BD who have a more severe illness course and whether treatment of SP with selective serotonin reuptake inhibitor (SSRI) antidepressants is associated with improvement or worsening of the course of BD.