Bereavement by suicide is a unique form of grief characterized by features such as stigma, shame, and rejection that may complicate the grieving process and place people at heightened risk for ...specific mental health disorders, suicide attempts, and dying by suicide. To better understand the unique support needs of the suicide-bereaved and how these can be met, this Australian study qualitatively explored the experiences of people bereaved by suicide. Fifteen individuals who had lost a spouse or partner or a family member to suicide formed three focus groups across different locations in Queensland, Australia. Analysis identified four dominant themes: changing support needs, difficulties navigating services, experiences of stigma and social isolation, and connecting with others. The results from this study provide a powerful insight into the experiences and specific needs of the suicide-bereaved and could inform further development of suicide bereavement support services.
Abstract Background Extensive research on impulsive suicide attempts, but lack of agreement on the use of this term indicates the need for a systematic literature review of the area. The aim of this ...review was to examine definitions and likely correlates of impulsive attempts. Methods A search of Medline, Psychinfo, Scopus, Proquest and Web of Knowledge databases was conducted. Additional articles were identified using the cross-referencing function of Google Scholar. Results 179 relevant papers were identified. Four different groups of research criteria used to assess suicide attempt impulsivity emerged: (a) time-related criteria, (b) absence of proximal planning/preparations, (c) presence of suicide plan in lifetime/previous year, and (d) other. Subsequent analysis used these criteria to compare results from different studies on 20 most researched hypotheses. Conclusions regarding the characteristics of impulsive attempts are more consistent than those on the risk factors specific to such attempts. No risk factors were identified that uniformly related to suicide attempt impulsivity across all criteria groups, but relationships emerged between separate criteria and specific characteristics of suicide attempters. Limitations Only published articles were included. Large inconsistencies in methods of the studies included in this review prevented comparison of effect sizes. Conclusions The vast disparities in findings on risk factors for impulsive suicide attempts among different criteria groups suggest the need to address the methodological issues in defining suicide attempt impulsivity before further research into correlates of such attempts can effectively progress. Specific recommendations are offered for necessary research.
Background: Deliberate self‐harm among young people is an important focus of policy and practice internationally. Nonetheless, there is little reliable comparative international information on its ...extent or characteristics. We have conducted a seven‐country comparative community study of deliberate self‐harm among young people.
Method: Over 30,000 mainly 15‐ and 16‐year‐olds completed anonymous questionnaires at school in Australia, Belgium, England, Hungary, Ireland, the Netherlands and Norway. Study criteria were developed to identify episodes of self‐harm; the prevalence of self‐harm acts and thoughts, methods used, repetition, reasons given, premeditation, setting for the act, associations with alcohol and drugs, hospitalisation, and whether other people knew, were examined.
Results: Self‐harm was more than twice as common among females as males and, in four of the seven countries, at least one in ten females had harmed herself in the previous year. Additional young people had thought of harming themselves without doing so. More males and females in all countries except Hungary cut themselves than used any other method, most acts took place at home, and alcohol and illegal drugs were not usually involved. The most common reasons given were ‘to get relief from a terrible state of mind’ followed by ‘to die’, although there were differences between those cutting themselves and those taking overdoses. About half the young people decided to harm themselves in the hour before doing so, and many did not attend hospital or tell anyone else. Just over half those who had harmed themselves during the previous year reported more than one episode over their lifetime.
Conclusions: Deliberate self‐harm is a widespread yet often hidden problem in adolescents, especially females, which shows both similarities and differences internationally.
Abstract Purpose The aim of the current analysis is to analyze suicide rates in adolescents aged 15–19 years in decades between 1990 and 2009 worldwide. Methods Suicide data were obtained from the ...World Health Organization Mortality Database and population data from the World Bank Data set. In total, 81 countries or territories, having data at least for 5 years in 1990–1999 and in 2000–2009, were included in the analysis. Additional analysis for regional trends with 57 countries was performed. Results Over the decades considered, analysis showed a declining trend in the overall suicide rate for males from 10.30 to 9.51 per 100,000 ( p = .076), and for females from 4.39 to 4.18 ( p = .472). The average suicide rate showed a significant decline for both genders in Europe, dropping from 13.13 to 10.93 ( p = .001) in males and from 3.88 to 3.34 in females ( p = .038). There was a significant increase in South American countries for males, from 7.36 to 11.47 ( p = .016), and a close to significant rise for females, from 5.59 to 7.98 ( p = .053). Although other world regions did not show significant trends, there were several significant changes at country level. Conclusions Reasons behind the decrease in Western countries could potentially be related to the overall improvements in global health; the possible contribution of suicide prevention activities remains unclear. Increases in several South American countries might be related to economic recession and its impact on adolescents from diverse cultural backgrounds, and partly also to improvements in mortality registration.
Addressing the lack of comparability of research results around the world, a systematic literature review of existing nomenclatures was conducted. After distinguishing the concepts of nomenclature ...and classification, 13 contributions to nomenclature of suicidal behavior are described and summarized using outcome and intent as guiding concepts for analysis. The issue of what is being defined in nomenclatures is fundamental and impacts the way intent and outcome are used. The existing confusion between classification and nomenclature stems from conflicting purposes of the nature of definition; that is, to communicate concepts versus to be descriptive of reality.
Background:
While numerous past reviews of psychological autopsy (PA) studies have examined the relationship between mental disorder and suicide, there has been little systematic investigation of ...suicide occurring in the absence of any identifiable psychiatric condition.
Aim:
This article reviews available literature on the topic by considering Axis I, sub-threshold, mild disorders and personality disorders.
Method:
We conducted a systematic review of PA studies from 2000 onwards. Studies included in the review had to clearly describe the proportion of suicide cases without a classifiable mental disorder or sub-threshold condition.
Results:
Up to 66.7% of suicide cases remained without diagnosis in those studies that only examined Axis I disorders (n = 14). Approximately 37.1% of suicide cases had no psychiatric condition in research papers that assessed personality and Axis I disorders (n = 9), and 37% of suicides had no Axis I, sub-threshold/mild conditions (n = 6). In general, areas in China and India had a higher proportion of suicides without a diagnosis than studies based in Europe, North America or Canada.
Conclusion:
Variation in the proportion of suicide cases without a psychiatric condition may reflect cultural specificities in the conceptualization and diagnosis of mental disorder, as well as methodological and design-related differences between studies.
Abstract Aim The present study aims to analyse predicting factors of suicide among older adults compared to sudden death controls and middle-aged suicides. Methods During the period 2006–2008, at two ...Australian sites, the psychological autopsy method was utilised to investigate suicides of individuals over the age of 35 by interviewing next-of-kin and healthcare professionals. A case–control study design was applied using sudden death cases as controls. Initial information was gathered from coroner's offices. Potential informants were approached and interviews were conducted using a semi-structured format. Results In total, 261 suicides (73 aged 60+) and 182 sudden deaths (79 aged 60+) were involved. Older adult suicides showed a significantly lower prevalence of psychiatric diagnoses (62%) when compared to middle-aged suicide cases (80%). In both age groups, subjects who died by suicide were significantly more likely to present a psychiatric diagnosis, compared to controls; however, diagnosis did not remain in the final prediction model for older adults. Hopelessness and past suicide attempts remained in the final model for both age groups. In addition, living alone was an important predictor of suicide in older adults. Conclusion Although mood disorders represent an important target for suicide prevention in old age, there should be increased attention for other risk factors including psychosocial, environmental, and general health aspects of late life.
The idea of a progression in suicide phenomena, from death wishes to suicide attempts and completed suicides, is quite old and widely present in literature. This model of interpreting suicidality has ...great relevance in preventative approaches, since it gives the opportunity of intercepting suicidal trajectories at several different stages. However, this may not be the case for many situations, and the hypothesis of a continuum can be true only in a limited number of cases, probably embedded with a specific psychopathological scenario (
e.g.
depression) and with a frequency that should not permit generalisations. This paper reviews the available evidence about the existence and validity of this construct, and discusses its practical implications.
Suicide in later life is a global public health problem. The aim of this review was to conduct a systematic analysis of studies with comparison groups that examined the associations between social ...factors and suicidal behavior (including ideation, non-fatal suicidal behavior, or deaths) among individuals aged 65 and older. Our search identified only 16 articles (across 14 independent samples) that met inclusion criteria. The limited number of studies points to the need for further research. Included studies were conducted in Canada (n = 2), Germany (n = 1), Hong Kong (n = 1), Japan (n = 1), Singapore (n = 1), Sweden (n = 2), Taiwan (n = 1), the U.K. (n = 2), and the U.S. (n = 3). The majority of the social factors examined in this review can be conceptualized as indices of positive social connectedness-the degree of positive involvement with family, friends, and social groups. Findings indicated that at least in industrialized countries, limited social connectedness is associated with suicidal ideation, non-fatal suicidal behavior, and suicide in later life. Primary prevention programs designed to enhance social connections as well as a sense of community could potentially decrease suicide risk, especially among men.
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