Objective:To identify the most frequent gender-specific suicide methods in Europe.Design:Proportions of seven predominant suicide methods utilised in 16 countries participating in the European ...Alliance Against Depression (EAAD) were reported in total and cross-nationally. Relative risk (RR) relating to suicide methods and gender was calculated. To group countries by pattern of suicide methods, hierarchical clustering was applied.Setting and participants:Data on suicide methods for 119 122 male and 41 338 female cases in 2000–4/5 from 16 EAAD countries, covering 52% of European population were obtained.Results:Hanging was the most prevalent suicide method among both males (54.3%) and females (35.6%). For males, hanging was followed by firearms (9.7%) and poisoning by drugs (8.6%); for females, by poisoning by drugs (24.7%) and jumping from a high place (14.5%). Only in Switzerland did hanging rank as second for males after firearms. Hanging ranked first among females in eight countries, poisoning by drugs in five and jumping from a high place in three. In all countries, males had a higher risk than females of using firearms and hanging and a lower risk of poisoning by drugs, drowning and jumping. Grouping showed that countries might be divided into five main groups among males; for females, grouping did not yield clear results.Conclusions:Research on suicide methods could lead to the development of gender-specific intervention strategies. Nevertheless, other approaches, such as better identification and treatment of mental disorders and the improvement of toxicological aid should be put in place.
Sexuality is a physiological component of adolescent development, though early initiation is associated with reproductive health risk. This study aimed at identifying correlates and predictors of ...sexual initiation in a large multinational cohort of European adolescents.
A questionnaire addressing socio-demographics, behaviours, mental health and sexual activity, was delivered to 11,110 adolescents recruited from 168 randomly selected schools in 10 European countries between 2009 and 2011. A follow-up questionnaire was delivered after 12 months. The longitudinal association of baseline risk behaviors, psychological attributes and contextual vulnerabilities, with sexual initiation during follow-up was evaluated through simple and multivariable age/sex stratified logistic regression. Multinomial logistic regression measured the association between predictors and sexual initiation with or without coexisting reproductive risk factors, such as multiple partners or infrequent condom use.
Baseline sexual experience was reported by 19.2% of 10,757 respondents (median age 15; IQR 14-15; females 59.6%). This was significantly more frequent among pupils older than 15 (41%) and males (20.8%). Of 7,111 pupils without previous experience who were available at follow-up (response rate 81.8%), 17% reported sexual initiation, without differences between females and males. Baseline smoking (age/sex adjusted odds ratio aOR 3.63), alcohol use (aOR 2.95), illegal drugs use (aOR 2.72), and poor sleep (aOR 1.71) predicted sexual initiation. Stratified analyses showed a particularly strong association in case of younger and female pupils, and, among girls, when initiation was reported together with multiple partners and/or infrequent condom use. Externalizing (i.e. conduct and hyperactivity) symptoms independently predicted sexual initiation. Internalizing difficulties (i.e. emotional and peer problems) were negatively associated with early and risky sexual initiation among boys. Significant predictors included also being bullied, fighting, truancy, and low parental involvement.
Adolescent sexual behaviours are related to non-sexual risk behaviours, psychological difficulties and contextual vulnerabilities. While gateway effects explain some associations, a comprehensive model is needed to understand adolescent sexual behaviours, their physical, mental, and social health outcomes, and their potential positive effects on wellbeing. Tailored interventions may need to consider younger girls as a particularly vulnerable group in view of a strong association between non-sexual and sexual behaviors.
Early onset and long-term smoking are associated with physical and psychological health problems. The aim of the presented analysis was to investigate risk and influencing factors for different ...smoking status in a big sample of European adolescents. In the context of the “saving and empowering young lives in Europe” (SEYLE) study we surveyed 12,328 adolescents at the age of 13–17 from 11 countries. The survey took place in a school-based context using a questionnaire. Overall 58% reported the onset of ever-smoking under the age of 14 and 30.9% smoke on a daily basis. Multinomial logistic regression model showed significant positive associations between adolescent smoking and internalizing problems (suicidal behavior, direct self-injurious behavior, anxiety), externalizing problems (conduct problems, hyperactivity, substance consumption) and family problems (parental substance consumption, broken home). Our data show that smoking among adolescents is still a major public health problem and adolescents who smoke are at higher risk for mental problems. Further, adolescent smoking is associated with broken home families and parental behaviors. Therefore, early preventive measures are necessary not only for adolescents, but also for their parents.
Background:
The present paper is based on a WHO Collaborative
Cross-National Study "Health Behavior in School-Aged Children
(HBSC)."
Aims:
It aimed at describing and analyzing
how the sexual ...behaviors of 13- to 15-year-old Estonian school children were
associated with self-reported depressive feelings and suicidality. Distinctive
behavioral traits in relation to age of first sexual intercourse were also
investigated.
Methods:
Self-reported questionnaires from school
children (
n
= 3,055) were analyzed.
Results:
In total, 15.2% of school children reported being nonvirgin. Among
13-year-olds, 2.9% of girls and 6.8% of boys were nonvirgins.
Approximately 25% of the 15-year-old girls and boys were nonvirgins. The
likelihood of depressive feelings and suicidal ideation increased significantly
in both genders with loss of virginity. Boys who had lost their virginity at 13
years or younger were 4.2 times more likely to have suicidal thoughts;
comparable girls were 7.8 times more likely to have suicidal thoughts. Compared
to virgins, youths who had lost their virginity reported poor self-assessed
health and more risk behaviors in themselves and their peers.
Conclusion:
Experiences of sexual intercourse increased the
odds ratios for depressive feelings and suicidality. The earlier sexual
intercourse was initiated, the greater were the odds of lower mental well-being.
Risk behaviors emerged as a complex phenomenon requiring complex
prevention.
A significant decline (34.5%) in the suicide rate occurred in 1984-1988 throughout the USSR. The decline was observed shortly after the introduction of strict restrictions on the sale of alcohol. We ...tested the hypothesis that the restrictive alcohol policy in the first years of perestroika (June 1985) caused the fall in suicide rates in the former USSR. Data on alcohol consumption, violent death caused by external injury and poisoning (n = 916,315), death due to accidental alcohol poisoning (n = 77,837), suicide (n = 192,305) and death undetermined whether accidentally or purposely (n = 54,253) were analyzed for all former Soviet republics for 1984, 1986, 1988 and 1990. Men were chosen for the analysis, since men are more prone to abuse alcohol than women. Regression analysis with alcohol consumption as the independent variable and suicide rates and violent death rates as dependent variables shows that suicide and alcohol consumption were positively correlated as were violet death and alcohol consumption. In the republics with high alcohol consumption (Slavic and Baltic), suicide rates were also high. In the Caucasian republics, low alcohol consumption was associated with low suicide rates. For most republics, alcohol seems to explain more than 50% of suicides. Alcohol also has considerable explanatory value for violent death. Thus, a restrictive alcohol policy might be a way to reduce suicide and violent death.
Suicide is one of the leading causes of death in adolescents and help-seeking behaviour for suicidal behaviour is low. School-based screenings can identify adolescents at risk for suicidal behaviour ...and might have the potential to facilitate service use and reduce suicidal behaviour. The aim of this study was to assess associations of a two-stage school-based screening with service use and suicidality in adolescents (aged 15 ± 0.9 years) from 11 European countries after one year. Students participating in the ‘Saving and Empowering Young Lives in Europe’ (SEYLE) study completed a self-report questionnaire including items on suicidal behaviour. Those screening positive for current suicidality (first screening stage) were invited to an interview with a mental health professional (second stage) who referred them for treatment, if necessary. At 12-month follow-up, students completed the same self-report questionnaire including questions on service use within the past year. Of the
N
= 12,395 SEYLE participants, 516 (4.2%) screened positive for current suicidality and were invited to the interview. Of these, 362 completed the 12-month follow-up with 136 (37.6%) self-selecting to attend the interview (screening completers). The majority of both screening completers (81.9%) and non-completers (91.6%) had not received professional treatment within one year, with completers being slightly more likely to receive it (
χ
2
(1)
= 8.948,
V
= 0.157, p ≤ 0.01). Screening completion was associated with higher service use (OR 2.695, se 1.017, p ≤ 0.01) and lower suicidality at follow-up (OR 0.505, se 0.114, p ≤ 0.01) after controlling for potential confounders. This school-based screening offered limited evidence for the improvement of service use for suicidality. Similar future programmes might improve interview attendance rate and address adolescents’ barriers to care.
The stability of the relationship between trends of violent deaths as a whole, suicides and death from undetermined causes was assessed by quantitative methods for the whole former USSR in the years ...1970–1990 and for each of the 15 republics in the former USSR for the years 1984–1990. Semi‐structured interviews during 1989–1996 were performed with 12 professionals involved in the diagnosis and coding of causes of death in the Baltic states and Russia. The quantitative analyses showed that mortality data were reliable for the Slavic (Russia, the Ukraine and Belarus) and Baltic (Estonia, Latvia and Lithuania) republics, and also for Kazakhstan, Kirgizia and Moldova. The Central Asian and Caucasian republics showed greater variation in trends and ratios, indicating a need for further investigations of the reliability of suicide statistics in these regions. It emerged from the interviews that no instructions to falsify data were given. The only instructions given were to treat the data on suicide and murder as ‘top secret’. None the less, certain classification errors might arise in the statistics. The diagnosis ‘undetermined cause of death’ was permissible only as a preliminary diagnosis for 14 days, and there was a risk of criticism for poor‐quality work if too many deaths were classified as being due to undetermined causes. Misclassifications could also occur in cases where there was a wish to conceal murder. Negative attitudes towards suicide, especially in Muslim regions, where suicide is taboo, might also have contributed to under‐reporting of suicide.
Objectives:
To compare frequencies of suicide attempt repetition in immigrants and local European populations, and the timing of repetition in these groups.
Method:
Data from 7 European countries, ...comprising 10 574 local and 3032 immigrant subjects, were taken from the World Health Organization European Multicentre Study on Suicidal Behaviour and the ensuing Monitoring Suicidal Behaviour in Europe (commonly referred to as MONSUE) project. The relation between immigrant status and repetition of suicide attempt within 12-months following first registered attempt was analyzed with binary logistic regression, controlling for sex, age, and method of attempt. Timing of repetition was controlled for sex, age, and the recommended type of aftercare.
Results:
Lower odds of repeating a suicide attempt were found in Eastern European (OR 0.50; 95% CI 0.41 to 0.61, P < 0.001) and non-European immigrants (OR 0.68; 95% CI 0.51 to 0.90, P < 0.05), compared with the locals. Similar patterns were identified in the sex-specific analysis. Eastern European immigrants tended to repeat their attempt much later than locals (OR 0.58; 95% CI 0.35 to 0.93, P < 0.05). In general, 32% of all repetition occurred within 30 days. Repetition tended to decrease with age and was more likely in females using harder methods in their index attempt (OR 1.29; 95% CI 1.08 to 1.54, P < 0.01). Large variations in the general repetition frequency were identified between the collecting centres, thus influencing the results.
Conclusions:
The lower repetition frequencies in non-Western immigrants, compared with locals, in Europe stands in contrast to their markedly higher tendency to attempt suicide in general, possibly pointing to situational stress factors related to their suicidal crisis that are less persistent over time. Our findings also raise the possibility that suicide attempters and repeaters constitute only partially overlapping populations.
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