The Hospital Management of Fatal Self-Poisoning in Industrialized Countries: An Opportunity for Suicide Prevention?

Science.gov (United States)

Kapur, Navneet; Turnbull, Pauline; Hawton, Keith; Simkin, Sue; Mackway-Jones, Kevin; Gunnell, David

2006-01-01

Suicide by self-poisoning is a prevalent cause of death worldwide. A substantial proportion of individuals who poison themselves come into contact with medical services before they die. Our focus in the current study was the medical management of drug self-poisoning in industrialized countries and its possible contribution to suicide prevention.…

Factors associated with the decline in suicide by pesticide poisoning in Taiwan: a time trend analysis, 1987-2010.

Science.gov (United States)

Chang, Shu-Sen; Lu, Tsung-Hsueh; Eddleston, Michael; Konradsen, Flemming; Sterne, Jonathan A C; Lin, Jin-Jia; Gunnell, David

2012-07-01

Pesticide self-poisoning accounts for one-third of suicides worldwide, but few studies have investigated the national epidemiology of pesticide suicide in countries where it is a commonly used method. We investigated trends in pesticide suicide, and factors associated with such trends, in Taiwan, a rapidly developing East Asian country. We conducted an ecological study using graphical approaches and Spearman's correlation coefficients to examine trends in pesticide suicide (1987-2010) in Taiwan in relation to pesticide sales, bans on selected pesticides, the proportion of the workforce involved in agriculture and unemployment. We compared pesticide products banned by the Taiwanese government with products that remained on the market and pesticides that accounted for the most poisoning deaths in Taiwan. Age-standardised rates of pesticide suicide showed a 67% reduction from 7.7 per 100,000 (42% of all suicides) in 1987 to 2.5 per 100,000 (12% of all suicides) in 2010, in contrast to a 69% increase in suicide rates by other methods. Pesticide poisoning was the most commonly used method of suicide in 1987 but had become the third most common method by 2010. The reduction was paralleled by a 66% fall in the workforce involved in agriculture but there was no strong evidence for its association with trends in pesticide sales, bans on selected pesticide products or unemployment. The bans mostly post-dated the decline in pesticide suicides; furthermore, they did not include products (e.g. paraquat) that accounted for most deaths and were mainly restricted to selected high-strength formulated products whilst their equivalent low-strength products were not banned. Access to pesticides, indicated by the size of agricultural workforce, appears to influence trends in pesticide suicide in Taiwan. Targeted bans on pesticides should focus on those products that account for most deaths.

Suicide attempts by deliberate self-poisoning in children and adolescents

Czech Academy of Sciences Publication Activity Database

Zakharov, S.; Navrátil, Tomáš; Pelclová, D.

2013-01-01

Roč. 210, č. 1 (2013), s. 302-307 ISSN 0165-1781 Institutional support: RVO:61388955 Keywords : Deliberate suicidal self-poisoning * Suicide attempts in children and adolescents * Czech Toxicological Information Centre Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 2.682, year: 2013

Time-trends in method-specific suicide rates compared with the availability of specific compounds

DEFF Research Database (Denmark)

Nordentoft, Merete; Qin, Ping; Helweg-Larsen, Karin

2006-01-01

Restriction of means for suicide is an important part of suicide preventive strategies in different countries. All suicides in Denmark between 1970 and 2000 were examined with regard to method used for suicide. Overall suicide mortality and method-specific suicide mortality was compared...... in the number of suicides by self-poisoning with these compounds. Restricted access occurred concomittantly with a 55% decrease in suicide rate....

Analysis of intentional drug poisonings using Ohio Poison Control Center Data, 2002-2014.

Science.gov (United States)

Pringle, Kelsey; Caupp, Sarah; Shi, Junxin; Wheeler, Krista K; Spiller, Henry A; Casavant, Marcel J; Xiang, Henry

2017-08-01

Pharmaceutical drug poisonings, especially those that are intentional, are a serious problem for adolescents and young adults. Poison control center data is a viable tool to track intentional drug poisonings in near real-time. To determine intentional drug poisoning rates among adolescents and young adults in Ohio using poison control center data. We analyzed data from 2002 to 2014 obtained by Ohio's three poison control centers. Inclusion variables were calls made to the centers that had appropriate subject age (10-29 years old), subject sex, involved substance (all drug classes), and medical outcome (no effect, minor effect, moderate effect, major effect, and death). Intentional drug poisoning reports were also separated into subgroups to compare suspected suicide reports to misuse and abuse reports. Finally, resident population estimates were used to generate 2014 intentional drug poisoning rates for each county in Ohio. The most common age group for intentional drug poisonings was 18-24. Females reported more suspected suicide drug poisonings while males reported more misuse/abuse drug poisonings. The most reported drug class across all ages was analgesics. Of the 88 counties in Ohio, Hamilton, Williams, Washington, and Guernsey counties had the highest rates of intentional drug poisonings. The high report rate of suspected suicides and analgesic class drugs demonstrates the need for preventative measures for adolescents and young adults in Ohio. Any interventions, along with legislative changes, will need to take place in our local communities.

Suicide attempts by deliberate self-poisoning in children and adolescents.

Science.gov (United States)

Zakharov, Sergey; Navratil, Tomas; Pelclova, Daniela

2013-11-30

The objective of the study was to examine the toxicological characteristics of suicide attempts by deliberate self-poisoning in children and adolescents. From the Toxicological Information Centre's database, the inquiries due to the suicide attempts in children (9-13 years old) and adolescents (14-18 years old) were evaluated. From 10,492 calls concerning suicide attempts, 2393 concerned children and adolescents. Most suicide attempts were attempted in spring (31.3%). Among the toxic agents, drugs were used in 97.8% cases. The most frequent ingestions appeared using drugs affecting the nervous system and anti-inflammatory non-steroids. The dose was evaluated as toxic in 73.4%, severely toxic in 3.0% and unknown in 11.2% cases. Only one in 10 children used a non-toxic dose. Girls, more frequently than boys (13.2% vs. 8.9%), used non-toxic doses. The symptoms of moderate and severe intoxications were present in 10.5% of the cases. Poison centre consultation was accessed within the first hour after the ingestion in one-fifth of the patients. In both age groups, the severity of the intoxication was greater among elder males who reached the medical facilities later than 4 h after the poisoning. The combinations of three or more drugs affecting central nervous system were present in the most severe cases. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Recent trends in elderly suicide rates in England and Wales.

Science.gov (United States)

Hoxey, K; Shah, A

2000-03-01

The proportion of elderly in the population is increasing due to increased life expectancy and falling birth rate, and suicide rates increase with age. This study examined the following in England and Wales: (i) recent trends in the elderly suicide rate; (ii) recent trends in method-specific elderly suicide rate; (iii) the relationship between elderly population size and elderly suicide rate in recent years; and (iv) the sex difference in overall and method-specific elderly suicide rate. Data on the various suicide variables were ascertained from the annually published mortality data for years 1985 to 1996. The main findings of this study were: (i) there is a trend towards decline in the overall pure and combined suicide rates for elderly men and women over the 12 year study period; (ii) the main contributors to this decline are suicides due to poisoning by solid and liquid substances (E950), hanging, strangulation and suffocation (E953), drowning (E954), firearms and explosives (E955), and jumping from high places (E957); (iii) the overall pure and combined suicide rates and that for most categories of suicide was higher in men compared to women; and (iv) suicide rates decreased with an increase in the elderly population size. Suicide rates can decline due to a number of reasons. The challenge now is to ensure further decline in suicide rates to meet the Our Healthier Nations target.

Autopsy rate in suicide is low among elderly in Denmark compared with Finland.

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Ylijoki-Sørensen, Seija; Boldsen, Jesper Lier; Boel, Lene Warner Thorup; Bøggild, Henrik; Lalu, Kaisa; Sajantila, Antti

2014-11-01

National differences in the legislation on cause and manner of death investigation are reflected in a high autopsy rate in suicides in Finland and a low corresponding rate in Denmark. The consequences for mortality statistics of these different investigation practices on deaths classified as suicides in Denmark and Finland, respectively, are not known in detail. The aim of this article was to analyse autopsy rates in deaths classified as suicides, and to identify any differences in investigation practices in deaths with a comparable cause of death, but classified as unnatural deaths other than suicide. Data from the mortality registries were summarised for the years 2000, 2005 and 2010. Autopsy rates (total, forensic and medical) were analysed with regard to deaths classified as suicide, and they were compared for three age groups (1-50 years, 51-70 years and ≥71 years) and for causes of death. Deaths classified as suicide were compared with other unnatural classifications, and comparable causes of death were coded into six subgroups: poisonings, suffocations/strangulations, firearm discharges, drowning/submersions, explosions/flames and other/unspecified causes. The total autopsy rate for suicides was 99.8% in Finland and 13.2% in Denmark. Almost all of these autopsies were conducted as forensic autopsies. In the age group ≥71 years, Danish suicides outnumbered Finnish suicides (410 versus 283). The total autopsy rate was lower in the more senior age group in Denmark (19.5%, 9.9%, 5.6%), whereas it was consistently high in Finland (99.8%, 99.9%, 99.6%). Among Danish deaths due to poisonings, the autopsy rate was 89.5% when these were classified as accidents, but only 20.7% for cases classified as suicides. The number of deaths in the two Danish subgroups was comparable (550 versus 553). In Denmark, the decision regarding the need, if any, for a forensic autopsy is made during the external forensic examination of the body. Our study showed that the limited use

Time-trends in method-specific suicide rates compared with the availability of specific compounds. The Danish experience

DEFF Research Database (Denmark)

Nordentoft, Merete; Qin, Ping; Helweg-Larsen, Karin

2006-01-01

Restriction of means for suicide is an important part of suicide preventive strategies in different countries. All suicides in Denmark between 1970 and 2000 were examined with regard to method used for suicide. Overall suicide mortality and method-specific suicide mortality was compared...... in the number of suicides by self-poisoning with these compounds. Restricted access occurred concomittantly with a 55% decrease in suicide rate...

Psychiatric comorbidity and its impact on mortality in patients who attempted suicide by paraquat poisoning during 2000-2010.

Directory of Open Access Journals (Sweden)

Chemin Lin

Full Text Available Paraquat poisoning is a lethal method of suicide used around the world. Although restricting its accessibility had been widely discussed, the underlying psychopathological mechanism of paraquat self-poisoning and its association with mortality have not yet been explicitly evaluated.We included all patients admitted to a tertiary general hospital in Taiwan between 2000 and 2010 following a suicide attempt by paraquat self-administration. Diagnoses were made upon psychiatric consultation based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV criteria. The risk of mortality was calculated by logistic regression with various psychiatric or medical covariates.The consultation-liaison psychiatry team assessed 157 patients who attempted suicide by paraquat poisoning. Mood disorders (54.0%, including dysthymic (26.7% and major depressive disorders (24.7%, were the most common psychiatric diagnoses among the self-poisoning patients. Among those who attempted suicide, 87 patients (58.0% died and dysthymic disorder (OR = 5.58, 95% CI: 1.13-27.69; p < 0.05 significantly increased the mortality risk after adjustment for relevant medical variables, including age, gender, severity index of paraquat poisoning (SIPP, and risk for respiratory failure.Awareness of comorbid psychiatric illnesses, especially dysthymic disorder, is vital in the prevention and treatment of suicide by paraquat poisoning.

Factors associated with the decline in suicide by pesticide poisoning in Taiwan

DEFF Research Database (Denmark)

Chang, Shu-Sen; Lu, Tsung-Hsueh; Eddleston, Michael

2012-01-01

of the workforce involved in agriculture and unemployment. We compared pesticide products banned by the Taiwanese government with products that remained on the market and pesticides that accounted for the most poisoning deaths in Taiwan. Results. Age-standardised rates of pesticide suicide showed a 67% reduction......, in Taiwan, a rapidly developing East Asian country. Methods. We conducted an ecological study using graphical approaches and Spearman's correlation coefficients to examine trends in pesticide suicide (1987-2010) in Taiwan in relation to pesticide sales, bans on selected pesticides, the proportion....... The reduction was paralleled by a 66% fall in the workforce involved in agriculture but there was no strong evidence for its association with trends in pesticide sales, bans on selected pesticide products or unemployment. The bans mostly post-dated the decline in pesticide suicides; furthermore, they did...

Relationship between Personality Profiles and Suicide Attempt via Medicine Poisoning among Hospitalized Patients: A Case-Control Study

OpenAIRE

Shafiee-Kandjani, Ali Reza; Amiri, Shahrokh; Arfaie, Asghar; Ahmadi, Azadeh; Farvareshi, Mahmoud

2014-01-01

Objectives. Inflexible personality traits play an important role in the development of maladaptive behaviors among patients who attempt suicide. This study was conducted to investigate the relationship between personality profiles and suicide attempt via medicine poisoning among the patients hospitalized in a public hospital. Materials and Methods. Fifty-nine patients who attempted suicide for the first time and hospitalized in the poisoning ward were selected as the experimental group. Sixty...

Trends in Suicide Methods and Rates among Older Adults in South Korea: A Comparison with Japan.

Science.gov (United States)

Park, Subin; Lee, Hochang Benjamin; Lee, Su Yeon; Lee, Go Eun; Ahn, Myung Hee; Yi, Ki Kyoung; Hong, Jin Pyo

2016-03-01

Lethality of the chosen method during a suicide attempt is a strong risk factor for completion of suicide. We examined whether annual changes in the pattern of suicide methods is related to annual changes in suicide rates among older adults in South Korea and Japan. We analyzed annual the World Health Organization data on rates and methods of suicide from 2000 to 2011 in South Korea and Japan. For Korean older adults, there was a significant positive correlation between suicide rate and the rate of hanging or the rate of jumping, and a significant negative correlation between suicide rate and the rate of poisoning. Among older adults in Japan, annual changes in the suicide rate and the pattern of suicide methods were less conspicuous, and no correlation was found between them. The results of the present study suggest that the increasing use of lethal suicide methods has contributed to the rise in suicide rates among older adults in South Korea. Targeted efforts to reduce the social acceptability and accessibility of lethal suicide methods might lead to lower suicide rate among older adults in South Korea.

Suicidal Death due to Organophosphorus Compound Poisoning ─ an Experience of 67 Cases

Directory of Open Access Journals (Sweden)

Nashid Tabassum Khan

2016-05-01

Full Text Available Background: Bangladesh is an agro-based country. Suicide by agrochemical compounds are increasing day by day in this country. Organophosphorus compounds (OPC are commonly used for suicide. Mostly these are used for suicidal purpose in rural areas in our country due to low cost, toxicity and availability. Objective: To find out the relationship of age and sex variation along with the causes that influenced different income group people to ingest OPC for committing suicide. Materials and Methods: This study was conducted in the Department of Forensic Medicine, Dhaka Medical College during January to December 2010. Data were collected at the time of autopsy and from postmortem examination report of viscera. Viscera were preserved and sent to the Chief Chemical Examiner’s Office, Dhaka for toxicological analysis. Results: In this study, middle aged subjects (20–30 years were found to commit suicide using OPC in comparison to other age groups. Among the cases male were 57% and female 43%. Poverty was found as the most common cause (20% of OPC poisoning. Conclusion: Poverty is the leading cause of death of OPC poisoning followed by failure in love and adultery. Business failure, unhappiness in conjugal life, demand for dowry and violence against women are other causes to commit suicide by OPC.

Gender differences in suicide methods.

Science.gov (United States)

Callanan, Valerie J; Davis, Mark S

2012-06-01

Gender differences in suicide completion rates have been attributed to the differences in lethality of suicide methods chosen by men and women, but few empirical studies have investigated factors other than demographic characteristics that might explain this differential. Data from the 621 suicides in Summit County, Ohio during 1997-2006 were disaggregated by gender to compare known correlates of suicide risk on three methods of suicide-firearm, hanging and drug poisoning. Compared to women, men who completed suicide with firearms were more likely to be married and committed the act at home. Unmarried men were likelier to hang themselves than married men, but unmarried women were less likely to hang themselves than married women. Men with a history of depression were more likely to suicide by hanging, but women with depression were half as likely to hang themselves compared to the women without a history of depression. Men with a history of substance abuse were more likely to suicide by poisoning than men without such history, but substance abuse history had no influence on women's use of poisoning to suicide. For both sexes, the odds of suicide by poisoning were significantly higher for those on psychiatric medications.

[The physician as Sherlock Holmes. Accident, murder by poisoning or suicide?].

Science.gov (United States)

Penning, R

2001-12-06

Any case of unclear or atypical clinical presentation must arouse a suspicion of poisoning. Although pathognomonic findings are rare, there may nevertheless be an accumulation of signs and symptoms. These include impairment of consciousness, vertigo, headache, circulatory disorders, cramps/convulsions, vomiting, diarrhea and abdominal pains. Forensic terminology differentiates between outside influence, self-poisoning and accidental poisoning. In the former case, substances are used that are deadly in small amounts, and are unremarkable in appearance, smell and taste. The poisons used by suicides are usually commonly used poisonous substances that are freely available to purchasers. For forensic purposes, it is essential that specimens of blood, urine or stomach contents be obtained for toxicological investigations. Inspection of the corpse must routinely include a search for unusual signs (e.g. traces of powder around the mouth, foam at the mouth and nose, desiccation, unusual postmortem lividity, hair loss, etc.).

Relationship between Personality Profiles and Suicide Attempt via Medicine Poisoning among Hospitalized Patients: A Case-Control Study.

Science.gov (United States)

Shafiee-Kandjani, Ali Reza; Amiri, Shahrokh; Arfaie, Asghar; Ahmadi, Azadeh; Farvareshi, Mahmoud

2014-01-01

Objectives. Inflexible personality traits play an important role in the development of maladaptive behaviors among patients who attempt suicide. This study was conducted to investigate the relationship between personality profiles and suicide attempt via medicine poisoning among the patients hospitalized in a public hospital. Materials and Methods. Fifty-nine patients who attempted suicide for the first time and hospitalized in the poisoning ward were selected as the experimental group. Sixty-three patients hospitalized in the other wards for a variety of reasons were selected as the adjusted control group. Millon Clinical Multiaxial Personality Inventory, 3rd version (MCMI-III) was used to assess the personality profiles. Results. The majority of the suicide attempters were low-level graduates (67.8% versus 47.1%, OR = 2.36). 79.7% of the suicide attempters were suffering from at least one maladaptive personality profile. The most common maladaptive personality profiles among the suicide attempters were depressive personality disorder (40.7%) and histrionic personality disorder (32.2%). Among the syndromes the most common ones were anxiety clinical syndrome (23.7%) and major depression (23.7%). Conclusion. Major depression clinical syndrome, histrionic personality disorder, anxiety clinical syndrome, and depressive personality disorder are among the predicators of first suicide attempts for the patients hospitalized in the public hospital due to the medicine poisoning.

Temperament and character personality profile and affective temperaments in self-poisoning nonlethal suicide attempters.

Science.gov (United States)

Ardani, Amir Rezaei; Naghibzadeh, Bahram; Farid Hosseini, Farhad; Asadpour, Zahra; Khabazianzadeh, Fatemeh

2015-09-30

Involvement of personality traits in susceptibility to suicidal behaviour has attracted considerable research interest over the past decades. This study was motivated by reports that emotionality may play a potentially confounding role in the association between the personality profile and suicidal behaviour. We assessed the association between personality traits, as measured using the Temperament and Character Inventory (TCI), and suicidal behaviour, while controlling for the effects of Affective Temperaments, measured using the Temperament Evaluation of the Memphis, Pisa, Paris and San Diego auto-questionnaire (TEMPS-A) in a sample of 140 consecutive self-poisoning nonlethal suicide (SNS) attempters admitted to the Emergency Toxicology Clinic, comparing them with a sample of 140 age and sex matched healthy controls. After controlling for Affective Temperaments, the temperament dimension of Novelty Seeking (NS) and the character dimensions of Self-directedness and Self-transcendence remained significantly associated with SNS attempts. NS, in particular, was most consistently and uniquely associated with suicidal behaviour. The present study conveys the difficulty in disentangling the personality profile of SNS attempters from their emotionality. We conclude that the risk associated with certain personality traits is often entirely mediated by Affective Temperaments and few dimensions independently contribute to the risk of self-poisoning nonlethal suicidal behaviour. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Poisons Implicated In Homicidal, Suicidal And Accidental Cases In North-West Pakistan.

Science.gov (United States)

Jan, Adil; Khan, Muhammad Jaffar; Humayun Khan, Muhammad Tariq; Masood Khan, Muhammad Tariq; Fatima, Sadia

2016-01-01

Pakistan has one of the highest prevalence of poisoning in the world. However, limited data exist on the frequency of poisons implicated in homicidal, suicidal, and accidental cases in North-West Pakistan (Khyber Pakhtunkhwa). This retrospective study of 353 cases and biological specimens of poisoning received at the department of Forensic medicine and toxicology, Khyber Medical College Peshawar from 13 districts of Khyber Pakhtunkhwa. Frequency of poisoning was assessed by testing each specimen for 17 different poisons. Of all the specimens, 250 (70.8%) specimens tested positive and the rest didn't show any indication of poisoning (n=103, 29.2%). The most frequent poisons detected were benzodiazepines (total n=75), organophosphates (total n=58), phencyclidine (total n=30) and morphine (total n=23). Gender had a significant association with benzodiazepines (p=0.011), tricyclic antidepressants (p=0.001), and organophosphates (ppoisoning in females while benzodiazepines were the most common cause of poisoning in males. Poisoning by benzodiazepines, organophosphates and phencyclidine are the most common causes of intoxication in population of Khyber Pakhtunkhwa. Source of poisoning varies with gender for organophosphates, benzodiazepines and tricyclic antidepressants.

Poisons Implicated in Homicidal, Suicidal and Accidental Cases in North-West Pakistan

International Nuclear Information System (INIS)

Jan, A.; Khan, M. T. H.; Khan, M. J.; Fatima, S.; Khan, T. M.

2016-01-01

Background: Pakistan has one of the highest prevalence of poisoning in the world. However, limited data exist on the frequency of poisons implicated in homicidal, suicidal, and accidental cases in North-West Pakistan (Khyber Pakhtunkhwa). Methods: This retrospective study of 353 cases and biological specimens of poisoning received at the department of Forensic medicine and toxicology, Khyber Medical College Peshawar from 13 districts of Khyber Pakhtunkhwa. Frequency of poisoning was assessed by testing each specimen for 17 different poisons. Results: Of all the specimens, 250 (70.8 percent) specimens tested positive and the rest did not show any indication of poisoning (n=103, 29.2 percent). The most frequent poisons detected were benzodiazepines (total n=75), organophosphates (total n=58), phencyclidine (total n=30) and morphine (total n=23). Gender had a significant association with benzodiazepines (p=0.011), tricyclic antidepressants (p=0.001), and organophosphates (p<0.001). Organophosphates were the most common cause of poisoning in females while benzodiazepines were the most common cause of poisoning in males. Conclusion: Poisoning by benzodiazepines, organophosphates and phencyclidine are the most common causes of intoxication in population of Khyber Pakhtunkhwa. Source of poisoning varies with gender for organophosphates, benzodiazepines and tricyclic antidepressants. (author)

Associations between changes in the pattern of suicide methods and rates in Korea, the US, and Finland

Science.gov (United States)

2014-01-01

Background The lethality of the suicide method employed is a strong risk factor for the completion of suicide. We examined whether annual changes in the pattern of suicide methods is related to annual changes in suicide rates in South Korea, the United States (US), and Finland. Methods We analyzed annual data from 2000–2011 for South Korea and Finland, and 2000–2010 for the US in order to examine trends in the rates and methods of suicide. Data on suicide methods were obtained from the World Health Organization (WHO) mortality database. Results Along with an annual rapid increase in suicide rates, the incidence of hanging increased steadily while suicide by self-poisoning steadily decreased in South Korea. In the US, along with an annual increase in suicide rates, the proportion of suicides committed by hanging increased while those committed with the use of firearms steadily decreased. In Finland, annual changes in the suicide rate and suicide method were not statistically significant during the study period. Conclusions Our present findings suggest that the increased use of specific lethal methods for suicide, namely hanging, is reflected in the increased suicide rates in the Korean and the US populations. The most effective approach for reducing overall suicide rates may be the implementation of population-based initiatives that reduce both the accessibility (e.g., access to firearms) and the social acceptability (e.g., effective and responsible regulations for reporting suicide) of lethal methods of suicide. PMID:24949083

Clinical features of emergency department patients with depression who had attempted to commit suicide by poisoning.

Science.gov (United States)

Wee, J H; Park, J H; Choi, S P; Woo, S H; Lee, W J; So, B H; Park, K N

2016-01-01

Many patients present to the emergency department (ED) complaining of intentional poisoning. Of those, some have major depressive disorder (MDD) in their medical history. The aim of this study was to investigate the prevalence of MDD patients who were treated for poisoning in the ED. A retrospective review was performed on 268 patients who were treated with poisoning between July 2007 and November 2011. Of these patients, we only included those who were over 18 years of age. Information regarding age, gender, cause, time of ingestion, type of drug, history of attempting suicide, and outcome, among other characteristics, was collected and compared to patients who did not have MDD. A total of 244 patients were included in this study. Of those, 52 patients (21.3%) had a history of MDD. Compared to non-MDD patients, a majority (34.6% vs. 19.8%) of those in the MDD group had a history of suicide attempts (P = 0.027), and 34 (65.4% in the MDD group vs. 34.4% in the non-MDD group) took more than two types of drugs (P suicidal behavior and to have ingested multiple types of drugs.

Restrictions in Availability of Drugs Used for Suicide

DEFF Research Database (Denmark)

Nordentoft, Merete

2007-01-01

Availability of drugs with high lethality has been hypothesized to increase the risk of self-poisoning suicides. A literature search concerning deliberate self-poisoning and the effect of restricting access to drugs was conducted, and the effect of restrictions in availability of barbiturates, tr...... in availability of drugs with high case fatality should be a part of suicide prevention strategies.......Availability of drugs with high lethality has been hypothesized to increase the risk of self-poisoning suicides. A literature search concerning deliberate self-poisoning and the effect of restricting access to drugs was conducted, and the effect of restrictions in availability of barbiturates......, tricyclic antidepressants, dextropropoxyphene, and weak analgesics was reviewed. The correlations between method-specific and overall suicide rates and sales figures for barbiturates, dextropropoxyphene, weak analgesics, and tricyclic antidepressants were reviewed. It is concluded that restriction...

The impact of pesticide suicide on the geographic distribution of suicide in Taiwan: a spatial analysis.

Science.gov (United States)

Chang, Shu-Sen; Lu, Tsung-Hsueh; Sterne, Jonathan Ac; Eddleston, Michael; Lin, Jin-Jia; Gunnell, David

2012-04-02

Pesticide self-poisoning is the most commonly used suicide method worldwide, but few studies have investigated the national epidemiology of pesticide suicide in countries where it is a major public health problem. This study aims to investigate geographic variations in pesticide suicide and their impact on the spatial distribution of suicide in Taiwan. Smoothed standardized mortality ratios for pesticide suicide (2002-2009) were mapped across Taiwan's 358 districts (median population aged 15 or above = 27 000), and their associations with the size of agricultural workforce were investigated using Bayesian hierarchical models. In 2002-2009 pesticide poisoning was the third most common suicide method in Taiwan, accounting for 13.6% (4913/36 110) of all suicides. Rates were higher in agricultural East and Central Taiwan and lower in major cities. Almost half (47%) of all pesticide suicides occurred in areas where only 13% of Taiwan's population lived. The geographic distribution of overall suicides was more similar to that of pesticide suicides than non-pesticide suicides. Rural-urban differences in suicide were mostly due to pesticide suicide. Areas where a higher proportion of people worked in agriculture showed higher pesticide suicide rates (adjusted rate ratio [ARR] per standard deviation increase in the proportion of agricultural workers = 1.58, 95% Credible Interval [CrI] 1.44-1.74) and overall suicide rates (ARR = 1.06, 95% CrI 1.03-1.10) but lower non-pesticide suicide rates (ARR = 0.91, 95% CrI 0.87-0.95). Easy access to pesticides appears to influence the geographic distribution of suicide in Taiwan, highlighting the potential benefits of targeted prevention strategies such as restricting access to highly toxic pesticides.

Suicide attempts and suicides in Bolivia from 2007 to 2012: pesticides are the preferred method - females try but males commit suicide!

Science.gov (United States)

Jørs, Erik; Christoffersen, Mette; Veirum, Nikoline Høgsgaard; Aquilar, Guido Condarco; Morant, Rafael Cervantes; Konradsen, Flemming

2014-01-01

Suicide attempts and suicides constitute a significant burden on communities and health systems, especially in low income countries. However, many low income countries lack epidemiological information on which to base future preventive strategies. This study reports on gender and age profiles as well as the likely background and means used for suicide attempts and suicides in Bolivia. This study presents 1124 cases from four different sources of information: (i) emergency ward data with suicide attempts by poisoning from the year 2007, (ii) psychiatric ward data including suicide attempts from July 2011 to July 2012, (iii) newspaper articles reporting attempted suicides and suicides from 2009 to 2011, and (iv) the National Statistics on Crime reporting suicides from the years 2010-2011. Data on age was stratified into three age groups: adolescents aged 10-19 years, young adults aged 20-29 years, and older adults aged above 29 years. Data from the hospital wards and Crime Statistics were pooled to compare characteristics of suicide attempts with suicides concerning age and gender. Data on age, gender, methods used, and reasons were analyzed using IBM SPSS version 21. Hospital data showed that more females (403/657, 61%) than males (254/657, 39%) attempted suicide, and females attempted suicide at a younger age than males (pcommitted suicide, and furthermore it was most prevalent among young adults aged 20-29 years of both genders, as observed from the Crime Statistics. The dominant method was pesticide poisoning varying from 400 out of 657 (70.5%) of the hospital poisoning cases to 65 out of 172 (37.8%) of the newspaper cases. Newspaper data showed a higher mortality rate (65/77, 85.1%) among those using violent methods such as hanging and jumping compared to non-violent methods (43/84, 50.9%) such as ingesting chemicals and drugs (psuicide seemed to be hidden due to cultural and religious reasons. More females attempted suicide, whereas more males realized suicide

Suicide attempts by chemicals poisoning in Colombia. 2007 - 2013

Directory of Open Access Journals (Sweden)

Viviana Calderón-Ramírez

2017-05-01

Full Text Available The objective was to set the epidemiological profile of suicide attempts by chemical substances in Colombia during the period 2007-2013. It was carried out a descriptive cross sectional study. Data were obtained from Public Health Surveillance system (SIVIGILA about poisoning chemicals 2007-2013. It was found that 55% of cases in 7 years of study corresponds to the female gender. 73% of cases occur from 10 to 29 years, with the highest concentration (31% in the group of 15 to 19. By ethnicity the Black, Afro Colombian Mulato and shows a high number of cases from 2007 to 2009 and indigenous show an upward trend from 2011 to 2013. Most people who attempt suicide are single (58% have a high school education (50% and live in municipal head. Approximately 0.05% of the women who tried to kill themselves, were in a state of pregnancy. In conclusion, a significant incidence of suicide attempts was found with chemicals, and for analysis must take into account the socio-cultural characteristics of the regions and population groups that make up the Colombian nation

Characteristics of methods of suicide attempts in Korea: Korea National Suicide Survey (KNSS).

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Kim, Bora; Ahn, Joon-Ho; Cha, Boseok; Chung, Young-Chul; Ha, Tae Hyon; Hong Jeong, Seong; Jung, Hee Yeon; Ju, Gawon; Kim, Eun-Young; Kim, Jae Min; Kim, Moon-Doo; Kim, Min-Hyuk; Kim, Soo In; Lee, Kyoung-Uk; Lee, Sang-Hyuk; Lee, Seung Jae; Lee, Yu Jin; Moon, Eunsoo; Ahn, Yong-Min

2015-12-01

Because the method used for a suicide attempt is an important determinant of outcome, these methods should be explored. The present study was a nationwide investigation of suicide attempts and the characteristics of suicidal behavior. To compare the suicide methods used in attempted suicides with those used in completed suicides and to examine the factors associated with each phenomenon. The present study reviewed the medical charts of subjects who had attempted suicide and subsequently visited the emergency rooms of 17 medical centers from May 1, 2013 to November 7, 2013. All subjects completed a full psychiatric interview conducted by trained psychiatric residents. Suicide-attempt methods were divided into the following six categories: drug poisoning, pesticide poisoning, gassing, cutting, hanging, and others. The associations among demographic variables, related psychiatric variables, and suicide-attempt methods were analyzed using a multinomial regression analysis. Of the 1359 suicide attempts or instrumental suicide-related behaviors with/without injuries and the 14,160 completed suicides, drug poisoning and cutting were the most common suicidal behaviors with/without injuries, but they were the least frequent method of completed suicides. In contrast, hanging and jumping from a height were less common among failed suicide attempts but resulted in a higher percentage of fatalities. Being male, age, and area of residence were associated with pesticide poisoning, whereas previous suicide attempts were associated with cutting, pesticide poisoning, and gassing. A previous suicide attempt is a risk factor for suicide; thus, assessing the characteristics of suicide attempts or instrumental suicide-related behaviors with/without injuries is necessary to prevent these attempts. The present findings showed that the methods of suicide used by individuals who only attempted suicide differed from those used by individuals who completed. Of the suicide methods, pesticide

The impact of pesticide suicide on the geographic distribution of suicide in Taiwan: a spatial analysis

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Chang Shu-Sen

2012-04-01

Full Text Available Abstract Background Pesticide self-poisoning is the most commonly used suicide method worldwide, but few studies have investigated the national epidemiology of pesticide suicide in countries where it is a major public health problem. This study aims to investigate geographic variations in pesticide suicide and their impact on the spatial distribution of suicide in Taiwan. Methods Smoothed standardized mortality ratios for pesticide suicide (2002-2009 were mapped across Taiwan's 358 districts (median population aged 15 or above = 27 000, and their associations with the size of agricultural workforce were investigated using Bayesian hierarchical models. Results In 2002-2009 pesticide poisoning was the third most common suicide method in Taiwan, accounting for 13.6% (4913/36 110 of all suicides. Rates were higher in agricultural East and Central Taiwan and lower in major cities. Almost half (47% of all pesticide suicides occurred in areas where only 13% of Taiwan's population lived. The geographic distribution of overall suicides was more similar to that of pesticide suicides than non-pesticide suicides. Rural-urban differences in suicide were mostly due to pesticide suicide. Areas where a higher proportion of people worked in agriculture showed higher pesticide suicide rates (adjusted rate ratio [ARR] per standard deviation increase in the proportion of agricultural workers = 1.58, 95% Credible Interval [CrI] 1.44-1.74 and overall suicide rates (ARR = 1.06, 95% CrI 1.03-1.10 but lower non-pesticide suicide rates (ARR = 0.91, 95% CrI 0.87-0.95. Conclusion Easy access to pesticides appears to influence the geographic distribution of suicide in Taiwan, highlighting the potential benefits of targeted prevention strategies such as restricting access to highly toxic pesticides.

Interrupted time-series analysis of regulations to reduce paracetamol (acetaminophen poisoning.

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Oliver W Morgan

2007-04-01

Full Text Available Paracetamol (acetaminophen poisoning is the leading cause of acute liver failure in Great Britain and the United States. Successful interventions to reduced harm from paracetamol poisoning are needed. To achieve this, the government of the United Kingdom introduced legislation in 1998 limiting the pack size of paracetamol sold in shops. Several studies have reported recent decreases in fatal poisonings involving paracetamol. We use interrupted time-series analysis to evaluate whether the recent fall in the number of paracetamol deaths is different to trends in fatal poisoning involving aspirin, paracetamol compounds, antidepressants, or nondrug poisoning suicide.We calculated directly age-standardised mortality rates for paracetamol poisoning in England and Wales from 1993 to 2004. We used an ordinary least-squares regression model divided into pre- and postintervention segments at 1999. The model included a term for autocorrelation within the time series. We tested for changes in the level and slope between the pre- and postintervention segments. To assess whether observed changes in the time series were unique to paracetamol, we compared against poisoning deaths involving compound paracetamol (not covered by the regulations, aspirin, antidepressants, and nonpoisoning suicide deaths. We did this comparison by calculating a ratio of each comparison series with paracetamol and applying a segmented regression model to the ratios. No change in the ratio level or slope indicated no difference compared to the control series. There were about 2,200 deaths involving paracetamol. The age-standardised mortality rate rose from 8.1 per million in 1993 to 8.8 per million in 1997, subsequently falling to about 5.3 per million in 2004. After the regulations were introduced, deaths dropped by 2.69 per million (p = 0.003. Trends in the age-standardised mortality rate for paracetamol compounds, aspirin, and antidepressants were broadly similar to paracetamol

ANALYSIS OF ORGANOPHOSPHORUS POISONING, AT TERTIARY CARE HOSPITAL: A REPORT

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Shakuntala

2015-01-01

Full Text Available BACKGROUND: Organophosphorus (OP compounds are the most common suicidal poison in developing countries and mortality continues to be high. The present study was aimed to know the pattern and outcome of the OP poisoning. METHODOLOGY: A record based retrospective study from January 2013 - December 2013 was Conducted in a tertiary care hospital and data regarding age, gender, domicile, type of poison, manner of poisoning, seasonal trends, marital status, motive behind poisoning , socio - economic status and outcome was collected in a pre - structured Performa. All data were documented, analyzed and interpreted as per the laid down protocol. RESULTS : out of total 1575 cases of OP compound poisoning, 71.73% (1130 were male, 28.27% (445 were female, 34.6% were in the age group 21 - 30 years, 70.95% were of low socio - economic status, Occupation wise agricultural workers were on top of the list (70.07%, The commonest (93.78% motive behind poisoning was suicidal in both males and females, Financial problem was one of the commonest (51.22% reasons of poisoning. The mortality rate in our study was 13.47%. CONCLUSION : Y oung and adult males of Low socio - economic class, rural, both literate and illiterate agriculturists commonly abuse this substance to commit suicide

Estimation of the rate and number of underreported deliberate self-poisoning attempts in western Iran in 2015

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Mehdi Moradinazar

2017-06-01

Full Text Available OBJECTIVES Rates of attempted deliberate self-poisoning (DSP are subject to undercounting, underreporting, and denial of the suicide attempt. In this study, we estimated the rate of underreported DSP, which is the most common method of attempted suicide in Iran. METHODS We estimated the rate and number of unaccounted individuals who attempted DSP in western Iran in 2015 using a truncated count model. In this method, the number of people who attempted DSP but were not referred to any health care centers, n0, was calculated through integrating hospital and forensic data. The crude and age-adjusted rates of attempted DSP were estimated directly using the average population size of the city of Kermanshah and the World Health Organization (WHO world standard population with and without accounting for underreporting. The Monte Carlo method was used to determine the confidence level. RESULTS The recorded number of people who attempted DSP was estimated by different methods to be in the range of 46.6 to 53.2% of the actual number of individuals who attempted DSP. The rate of underreported cases was higher among women than men and decreased as age increased. The rate of underreported cases decreased as the potency and intensity of toxic factors increased. The highest underreporting rates of 69.9, 51.2, and 21.5% were observed when oil and detergents (International Classification of Diseases, 10th revision [ICD-10] code: X66, medications (ICD-10 code: X60-X64, and agricultural toxins (ICD-10 codes: X68, X69 were used for poisoning, respectively. Crude rates, with and without accounting for underreporting, were estimated by the mixture method as 167.5 per 100,000 persons and 331.7 per 100,000 persons, respectively, which decreased to 129.8 per 100,000 persons and 253.1 per 100,000 persons after adjusting for age on the basis of the WHO world standard population. CONCLUSIONS Nearly half of individuals who attempted DSP were not referred to a hospital for

Rising longitudinal trajectories in suicide rates: The role of firearm suicide rates and firearm legislation.

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Anestis, Michael D; Selby, Edward A; Butterworth, Sarah E

2017-07-01

Firearms account for approximately half of all US suicide deaths each year despite being utilized in only a small minority of suicide attempts. We examined the extent to which overall suicide rates fluctuated relative to firearm and non-firearm suicide rates across a period of 16years (1999-2015). We further tested the notion of means substitution by examining the association between firearm suicide rates and non-firearm suicide rates. Lastly, we examined the extent to which the presence of specific laws related to handgun ownership previously shown cross-sectionally to be associated with lower suicide rates (universal background checks, mandatory waiting periods) were associated with an attenuated trajectory in suicide rates across the study period. As anticipated, whereas decreases in firearm suicide rates were associated with decreases in overall suicide rates (b=0.46, SE=0.07, psuicides were not associated with off-setting increases in suicides by other methods (b=-0.04, SE=0.05, p=0.36). Furthermore, the absence of universal background check (b=0.12, SE=0.05, p=0.028) and mandatory waiting period (b=0.16, SE=0.06, p=0.008) laws was associated with a more steeply rising trajectory of statewide suicide rates. These results mitigate concerns regarding means substitution and speak to the potential high yield impact of systematically implemented means safety prevention efforts focused on firearms. Copyright © 2017 Elsevier Inc. All rights reserved.

Time-trends in assisted and unassisted suicides completed with different methods: Swiss National Cohort.

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Steck, Nicole; Zwahlen, Marcel; Egger, Matthias

2015-01-01

The number of suicides assisted by right-to-die associations has increased in recent years in Switzerland. The aim of our study was to compare time trends in rates of assisted and unassisted suicide from 1991-2008. The Swiss National Cohort is a longitudinal study of mortality in the Swiss population; based on linkage of census data with mortality records up to 2008. The Federal Statistical Office coded suspected assisted suicides from 1998 onwards; and from 2003 onwards right-to-die associations reported the suicides they assisted. We used Poisson regression to analyse trends in rates of suicide per 100'000 person-years, by gender and age groups (15-34, 35-64, 65-94 years). A total of 7'940'297 individuals and 24'842 suicides were included. In women, rates changed little in the younger age groups but increased in 65-94-year-olds, due to an increase in suicide by poisoning (from 5.1 to 17.2 per 100'000; p suicides by poisoning was also observed in older men (from 8.6 to 18.2; psuicides by poisoning were assisted. In men, suicide rates declined in all age groups, driven by declines in suicide with firearms. Research is needed to gain a better understanding of the reasons for the tripling of assisted suicide rates in older women, and the doubling of rates in older men, of attitudes and vulnerabilities of those choosing assisted suicide, and of access to palliative care. Rates of assisted suicide should be monitored; including data on patient characteristics and underlying comorbidities.

[Suicide by poisoning in the Souss-Massa-Drâa region of Morocco].

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Mahir, Siham; Soulaymani, Abdelmajid; Hami, Hind; Mokhtari, Abdelrhani; Benali, Doha; Ouammi, Lahcen; Windy, Maria; Benchekh, Rachida Soulaymani

2013-01-01

Deliberate self-poisoning is a serious problem in Morocco, including in the Souss-Massa-Drâa region. However, our understanding of the problem of suicidal poisoning remains limited. This paper aims to describe the characteristics of patients, toxic substances and poisoning and to identify the risk factors influencing patient outcomes. A retrospective study was conducted of all cases of deliberate self-poisoning recorded between 1981 and 2007 by the Centre Anti-Poison et de Pharmacovigilance du Maroc. 1,130 cases of self-poisoning were identified. The mean age was 25 ± 10.1 years and the sex ratio was 0.4. Paraphenylenediamine was the most common cause of death (48 deaths), followed by hydrochloric acid (15 deaths). A close relationship was found between progression to healing and female adolescents and between progression to death and men in other age groups. The study also found that patients who used paraphenylenediamine were twelve times more likely to die (CI95%: 7.4%-19.2%) than those who used other substances. Patients with respiratory and cardiovascular conditions had a relative risk of 9.8 (CI95%: 6.3%-16%) and 3.6 (CI95%: 2.3%-5.7%). Of the 937 cases with known outcome, 89 died (9.5%).

Pesticide poisoning in Chitwan, Nepal: a descriptive epidemiological study

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Deepak Gyenwali

2017-07-01

Full Text Available Abstract Background Globally, there is a growing concern over pesticides use, which has been linked to self-harm and suicide. However, there is paucity of research on the epidemiology of pesticides poisoning in Nepal. This study is aimed at assessing epidemiological features of pesticides poisoning among hospital-admitted cases in selected hospitals of Chitwan District of Nepal. Methods A hospital-based quantitative study was carried out in four major hospitals of Chitwan District. Information on all pesticides poisoning cases between April 1 and December 31, 2015, was recorded by using a Pesticides Exposure Record (PER form. Results A total of 439 acute pesticides poisoning cases from 12 districts including Chitwan and adjoining districts attended the hospitals during the 9-month-long study period. A majority of the poisoned subjects deliberately used pesticides (89.5% for attempted suicide. The total incidence rate was 62.67/100000 population per year. Higher annual incidence rates were found among young adults (111.66/100000 population, women (77.53/100000 population and individuals from Dalit ethnic groups (98.22/100000 population. Pesticides responsible for poisoning were mostly insecticides (58.0% and rodenticides (20.8%. The most used chemicals were organophosphates (37.3% and pyrethroids (36.7%. Of the total cases, 98.6% were hospitalized, with intensive care required for 41.3%. The case fatality rate among admitted cases was 3.8%. Conclusions This study has indicated that young adults, females and socially disadvantaged ethnic groups are at a higher risk of pesticides poisoning. Pesticides are mostly misused intentionally as an easy means for committing suicide. It is recommended that the supply of pesticides be properly regulated to prevent easy accessibility and misuse. A population-based study is warranted to reveal the actual problem of pesticides exposure and intoxication in the community.

The pattern of acute poisoning in a teaching hospital, north-west Ethiopia.

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Abula, Teferra; Wondmikun, Yared

2006-04-01

Poisoning by means of hazardous chemicals through ignorance, mishap or intentionally is becoming a serious health problem worldwide. Epidemiological data on this important health issue are, however, scarce in Ethiopia. The purpose of this study is to assess the pattern of acute poisonings and determine the approaches employed for the management of poisoning. The medical records of patients with acute poisonings presented to the Gondar University hospital between July 2001 and June 2004 were reviewed retrospectively. One hundred and two patients presenting to the emergency department of the hospital were due to acute poisoning; accounting for about 0.45% of emergency room admissions. Organophosphates, rat poison and alcohol were the commonly encountered poisoning agents (in about 70% of cases) mainly in adults possibly with suicidal or para-suicidal intention. The approaches employed in the management of poisoning mainly involved gastrointestinal decontamination procedures. Specific antidotes were used in a substantial number of patients. The fatality rate was 2.4%. Poisoning with suicidal intention is becoming a serious health problem particularly in adults. Pesticides are commonly used toxicants. The approaches in the management of poisoning are justifiable in some cases. However, much is to be done to improve the recording of patient-related information and record-keeping processes. Further large scale studies are required to investigate national trends of poisoning and factors associated with poisoning.

Impacts of stress, self-efficacy, and optimism on suicide ideation among rehabilitation patients with acute pesticide poisoning.

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Feng, Jun; Li, Shusheng; Chen, Huawen

2015-01-01

The high incidence of pesticide ingestion as a means to commit suicide is a critical public health problem. An important predictor of suicidal behavior is suicide ideation, which is related to stress. However, studies on how to defend against stress-induced suicidal thoughts are limited. This study explores the impact of stress on suicidal ideation by investigating the mediating effect of self-efficacy and dispositional optimism. Direct and indirect (via self-efficacy and dispositional optimism) effects of stress on suicidal ideation were investigated among 296 patients with acute pesticide poisoning from four general hospitals. For this purpose, structural equation modeling (SEM) and bootstrap method were used. Results obtained using SEM and bootstrap method show that stress has a direct effect on suicide ideation. Furthermore, self-efficacy and dispositional optimism partially weakened the relationship between stress and suicidal ideation. The final model shows a significant relationship between stress and suicidal ideation through self-efficacy or dispositional optimism. The findings extended prior studies and provide enlightenment on how self-efficacy and optimism prevents stress-induced suicidal thoughts.

Characteristics of poisoning cases in Adiyaman city

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Öznur Uludağ

2015-09-01

Full Text Available Objective: Aim of this study was to retrospectively evaluate poisoning cases in an intensive care unit (ICU in order to determine the profile of poisoning cases, update epidemiological data in Adiyaman, and contribute to data about poisoning in our country. Methods: Between 01-01-2012 and 31-12-2013 174 patients (116 males, 58 females with a mean age of 23.7 years were treated. Demographic characteristics, reasons and ways of poisoning, types of toxic substances, length of their ICU stay and prognosis were evaluated. Results: 2733 patients admitted to the intensive care unit were 174 poisoning cases. Poisoning ways were suicide by drug overdose (n=162, 93.1%, and accidental poisoning (n=12,6.9%.119 patients (66.5% had single drug intake, thirty-three patients (18.4% with multiple drug intake, and 16 (8.9% were poisoned by organic phosphates. The most common drug used for suicide was antidepressants (n=87.5%. 32 patients (18.4% took analgesics and anti-inflammatory drugs. A total of 152 patients taking the drug, 22 patients were poisoned by other means. The median length of patient stay was 2 days (range 1-20 days. Ninety-nine patients (56.9% recovered and were discharged.72 patients (41.4% were admitted to inpatient after intensive care unit. Patients were followed up by asking poisoning suicidal psychiatric consultation.1 patient was followed up for 20 days in intensive care due to alcohol poisoning but was died.2 patients (1.1% were referred to a center forward. Conclusion: Majority of the patients were females, who took drugs with suicidal intention. Frequent use of antidepressants, which are not subject to control by authorities, to commit suicide was remarkable.

Drug suicide: a sex-equal cause of death in 16 European countries

LENUS (Irish Health Repository)

Varnik, Airi

2011-01-29

Abstract Background There is a lack of international research on suicide by drug overdose as a preventable suicide method. Sex- and age-specific rates of suicide by drug self-poisoning (ICD-10, X60-64) and the distribution of drug types used in 16 European countries were studied, and compared with other self-poisoning methods (X65-69) and intentional self-injury (X70-84). Methods Data for 2000-04\\/05 were collected from national statistical offices. Age-adjusted suicide rates, and age and sex distributions, were calculated. Results No pronounced sex differences in drug self-poisoning rates were found, either in the aggregate data (males 1.6 and females 1.5 per 100,000) or within individual countries. Among the 16 countries, the range (from some 0.3 in Portugal to 5.0 in Finland) was wide. \\'Other and unspecified drugs\\' (X64) were recorded most frequently, with a range of 0.2-1.9, and accounted for more than 70% of deaths by drug overdose in France, Luxembourg, Portugal and Spain. Psychotropic drugs (X61) ranked second. The X63 category (\\'other drugs acting on the autonomic nervous system\\') was least frequently used. Finland showed low X64 and high X61 figures, Scotland had high levels of X62 (\\'narcotics and hallucinogens, not elsewhere classified\\') for both sexes, while England exceeded other countries in category X60. Risk was highest among the middle-aged everywhere except in Switzerland, where the elderly were most at risk. Conclusions Suicide by drug overdose is preventable. Intentional self-poisoning with drugs kills as many males as females. The considerable differences in patterns of self-poisoning found in the various European countries are relevant to national efforts to improve diagnostics of suicide and appropriate specific prevention. The fact that vast majority of drug-overdose suicides came under the category X64 refers to the need of more detailed ICD coding system for overdose suicides is needed to permit better design of suicide

[Religion and suicide - part 2: confessions, religiousness, secularisation and national suicide rates].

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Ritter, Kristina; Zitterl, Werner; Stompe, Thomas

2011-01-01

National suicide rates differ remarkably. The influence of religion on the frequency of suicides was already stressed by Durkheim, however, character and dimension of this influence are still unclear. Our study claims to assess the association between (a) the distribution of believers of different religions, (b) the secularization, (c) the religiousness and the national suicide rates by gender. Data of the distribution of religious confessions and of the religiousness of the inhabitants of the single countries were correlated with the national suicide rates and illustrated by means of Scatter/Dot-Plots. Independent of gender, low suicide rates were found in Islamic countries. Buddhist countries showed high suicide rates in women, and countries with a high percentage of inhabitants without confession high suicide rates in men. Only catholic countries showed an association between secularisation and suicide rates. In countries with a high proportion of religious inhabitants we found low suicide rates. Although none of the World religions support the human right of suicide, the mosaic religions of resurrection refuse suicide more strictly than the Eastern religions of reincarnation. All in all our study supports the hypothesis that religiousness can be seen as a protective factor against suicide.

Presentations of patients of poisoning and predictors of poisoning-related fatality: Findings from a hospital-based prospective study

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Lin Hung-Jung

2008-01-01

Full Text Available Abstract Background Poisoning is a significant public health problem worldwide and is one of the most common reasons for visiting emergency departments (EDs, but factors that help to predict overall poisoning-related fatality have rarely been elucidated. Using 1512 subjects from a hospital-based study, we sought to describe the demographic and clinical characteristics of poisoning patients and to identify predictors for poisoning-related fatality. Methods Between January 2001 and December 2002 we prospectively recruited poisoning patients through the EDs of two medical centers in southwest Taiwan. Interviews were conducted with patients within 24 hours after admission to collect relevant information. We made comparisons between survival and fatality cases, and used logistic regressions to identify predictors of fatality. Results A total of 1512 poisoning cases were recorded at the EDs during the study period, corresponding to an average of 4.2 poisonings per 1000 ED visits. These cases involved 828 women and 684 men with a mean age of 38.8 years, although most patients were between 19 and 50 years old (66.8%, and 29.4% were 19 to 30 years. Drugs were the dominant poisoning agents involved (49.9%, followed by pesticides (14.5%. Of the 1512 patients, 63 fatalities (4.2% occurred. Paraquat exposure was associated with an extremely high fatality rate (72.1%. The significant predictors for fatality included age over 61 years, insufficient respiration, shock status, abnormal heart rate, abnormal body temperature, suicidal intent and paraquat exposure. Conclusion In addition to well-recognized risk factors for fatality in clinical settings, such as old age and abnormal vital signs, we found that suicidal intent and ingestion of paraquat were significant predictors of poisoning-related fatality. Identification of these predictors may help risk stratification and the development of preventive interventions.

Attempted suicides in India: a comprehensive look.

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Saddichha, Sahoo; Prasad, M N V; Saxena, Mukul Kumar

2010-01-01

Suicide continues to be one of the biggest killers in the world, with suicide rates varying between 8.1 and 58.3/100,000 population for different parts of India. Andhra Pradesh, the fourth largest state in India, is responsible for more than 11% of these. Unfortunately, most suicides are under-reported and there is scant data on attempted suicides. This study aimed to comprehensively study the characteristics of attempted suicides in Andhra Pradesh and using the primary data, make secondary projections for the forthcoming years. Using Patient Care Record (PCR) forms of all emergencies serviced by 108, the first comprehensive emergency service in India, an analysis of all cases was done to detect possible suicides during the period January-December 2007. A follow up 48 hours later was then done to confirm status and diagnosis. A total of 1007 cases were recorded as confirmed suicides. Hanging and insecticide poisoning (72%) were the most common methods used. Males preferred hanging and insecticide poisoning while females preferred self-immolation and hanging as common methods. Self-immolation and insecticide poisoning had the highest mortality (41.6%). Estimates of attempted suicides for the year 2008 revealed a mean of 3.2-3.8 per 1000 population for males, 3.3-3.7 per 1000 population for females and 6.4-7.6 per 1000 population combined. A serious epidemic of suicides seems to be in store in the coming years unless preventive steps in the form of policy changes are undertaken. Restricting access to poisonous substances or prescription drugs and taking into consideration the prevailing social, economic and cultural factors could help in reducing numbers. Starting tele-help services or offering brief interventions during hospital stays are other programs which may be considered.

Suicide in Sri Lanka 1975-2012

DEFF Research Database (Denmark)

Knipe, Duleeka W; Metcalfe, Chris; Fernando, Ravindra

2014-01-01

pesticides. We investigate these changes in suicide rates in relation to age, gender, method specific trends and birth-cohort and period effects, with the aim of informing preventative strategies. METHODS: Secular trends of suicide in relation to age, sex, method, birth-cohort and period effects were......BACKGROUND: Sri Lanka has experienced major changes in its suicide rates since the 1970s, and in 1995 it had one of the highest rates in the world. Subsequent reductions in Sri Lanka's suicide rates have been attributed to the introduction of restrictions on the availability of highly toxic...... investigated graphically using police data (1975-2012). Poisoning case-fatality was investigated using national hospital admission data (2004-2010). RESULTS: There were marked changes to the age-, gender- and method-specific incidence of suicide over the study period. Year on year declines in rates began in 17...

Hospitalizations for Suicide-Related Drug Poisonings and Co-Occurring Alcohol Overdoses in Adolescents (Ages 12-17) and Young Adults (Ages 18-24) in the United States, 1999-2008: Results from the Nationwide Inpatient Sample

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White, Aaron M.; MacInnes, Erin; Hingson, Ralph W.; Pan, I-Jen

2013-01-01

Drug poisoning is the leading method of suicide-related deaths among females and third among males in the United States. Alcohol can increase the severity of drug poisonings, yet the prevalence of alcohol overdoses in suicide-related drug poisonings (SRDP) remains unclear. Data from the Nationwide Inpatient Sample was examined to determine rates…

How Does Legalization of Physician-Assisted Suicide Affect Rates of Suicide?

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Jones, David Albert; Paton, David

2015-10-01

Several US states have legalized or decriminalized physician-assisted suicide (PAS) while others are considering permitting PAS. Although it has been suggested that legalization could lead to a reduction in total suicides and to a delay in those suicides that do occur, to date no research has tested whether these effects can be identified in practice. The aim of this study was to fill this gap by examining the association between the legalization of PAS and state-level suicide rates in the United States between 1990 and 2013. We used regression analysis to test the change in rates of nonassisted suicides and total suicides (including assisted suicides) before and after the legalization of PAS. Controlling for various socioeconomic factors, unobservable state and year effects, and state-specific linear trends, we found that legalizing PAS was associated with a 6.3% (95% confidence interval 2.70%-9.9%) increase in total suicides (including assisted suicides). This effect was larger in the individuals older than 65 years (14.5%, CI 6.4%-22.7%). Introduction of PAS was neither associated with a reduction in nonassisted suicide rates nor with an increase in the mean age of nonassisted suicide. Legalizing PAS has been associated with an increased rate of total suicides relative to other states and no decrease in nonassisted suicides. This suggests either that PAS does not inhibit (nor acts as an alternative to) nonassisted suicide, or that it acts in this way in some individuals but is associated with an increased inclination to suicide in other individuals.

Transdermal carbamate poisoning – a case of misuse

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Lalit Kumar Rajbanshi

2017-01-01

Full Text Available Acute pesticide poisoning is a common mode of intentional self harm. Oral ingestion is the usual mode of poisoning. However, inhalation, accidental or occupational transdermal exposure leading to acute or chronic poisoning can be the other route of poisoning. It has been seen that the purpose of poising is suicidal intensity in most of the cases. We report an unusual case where the victim had acute pesticide poisoning through transdermal route that was intended for non suicidal purpose. The patient was managed successfully with immediate decontamination and adequate antidote.

Acute Pesticide Poisoning in Children: Hospital Review in Selected Hospitals of Tanzania

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Elikana Lekei

2017-01-01

Full Text Available Background. Acute pesticide poisoning (APP is a serious problem worldwide. Because the burden of childhood APP is unknown in Tanzania, this study describes the distribution, circumstances, and patterns of APP involving children under 18 years in Tanzania. Methodology. A 12-month prospective study was conducted in 10 Tanzanian healthcare facilities in 2006 using a data collection tool for surveillance. Results. Of 53 childhood poisoning cases identified, 56.6% were female. The most common poisoning circumstances were accidents (49.1% and suicide (30.2%. The most vulnerable children were 16-17 years old (30.2%. Suicide was significantly more common in females (PRR females/males = 1.66; 95% CI = 1.03–2.68 and accidental cases were more common in children aged 10 years or younger. Suicide was concentrated in children over 10 years, comprising 53% of cases in this age group. Organophosphates (OPs, zinc phosphide, and endosulfan were common amongst reported poisoning agents. The annual APP incidence rate was 1.61/100,000. Conclusion. APP is common among children in this region of Tanzania. Prevention of suicide in older children should address mental health issues and control access to toxic pesticides. Prevention of accidents in younger children requires safer storage and hygiene measures. Diverse interventions are needed to reduce pesticide poisoning among children in Tanzania.

Proximal risk factors and suicide methods among suicide completers from national suicide mortality data 2004-2006 in Korea.

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Im, Jeong-Soo; Choi, Soon Ho; Hong, Duho; Seo, Hwa Jeong; Park, Subin; Hong, Jin Pyo

2011-01-01

This study was conducted to examine differences in proximal risk factors and suicide methods by sex and age in the national suicide mortality data in Korea. Data were collected from the National Police Agency and the National Statistical Office of Korea on suicide completers from 2004 to 2006. The 31,711 suicide case records were used to analyze suicide rates, methods, and proximal risk factors by sex and age. Suicide rate increased with age, especially in men. The most common proximal risk factor for suicide was medical illness in both sexes. The most common proximal risk factor for subjects younger than 30 years was found to be a conflict in relationships with family members, partner, or friends. Medical illness was found to increase in prevalence as a risk factor with age. Hanging/Suffocation was the most common suicide method used by both sexes. The use of drug/pesticide poisoning to suicide increased with age. A fall from height or hanging/suffocation was more popular in the younger age groups. Because proximal risk factors and suicide methods varied with sex and age, different suicide prevention measures are required after consideration of both of these parameters. Copyright © 2011 Elsevier Inc. All rights reserved.

A Rare but Potentially Fatal Poisoning; Aluminum Phosphide Poisoning

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Orkun Tolunay

2017-04-01

Full Text Available Phosphide, a very toxic gas, is used in our country as aluminium phosphide tablets impregnated in clay. It is widely used since it has a very high diffusion capacity, whereby it can eradicate all living creatures in any form of their life cycle and does not leave any remnants in agricultural products. Aluminum phosphide poisoning is among intoxications for which there are still no true antidotes. Mortality rate varies between 30% and 100%. This paper presents a case of aluminum phosphide poisoning caused by the uncompleted suicide attempt. A 14-year-old girl, who swallowed aluminum phosphate tablets, was brought to the emergency department with the complaints of nausea and vomiting. The patient was treated with gastric lavage and activated charcoal. Since the patient ingested a lethal amount of aluminum phosphide, she was referred to the pediatric intensive care unit. The patient was discharged in stable condition after supportive care and monitoring. Specific antidotes are life-saving in poisonings. However, this case was presented to show how general treatment principles and quick access to health services affect the result of treatment. Also, we aimed to highlight the uncontrolled selling of aluminum phosphate, which results in high mortality rates in case of poisoning.

Fatal poisonings in Oslo: a one-year observational study.

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Bjornaas, Mari A; Teige, Brita; Hovda, Knut E; Ekeberg, Oivind; Heyerdahl, Fridtjof; Jacobsen, Dag

2010-06-06

Acute poisonings are common and are treated at different levels of the health care system. Since most fatal poisonings occur outside hospital, these must be included when studying characteristics of such deaths. The pattern of toxic agents differs between fatal and non-fatal poisonings. By including all poisoning episodes, cause-fatality rates can be calculated. Fatal and non-fatal acute poisonings in subjects aged > or =16 years in Oslo (428 198 inhabitants) were included consecutively in an observational multi-centre study including the ambulance services, the Oslo Emergency Ward (outpatient clinic), and hospitals, as well as medico-legal autopsies from 1st April 2003 to 31st March 2004. Characteristics of fatal poisonings were examined, and a comparison of toxic agents was made between fatal and non-fatal acute poisoning. In Oslo, during the one-year period studied, 103 subjects aged > or =16 years died of acute poisoning. The annual mortality rate was 24 per 100 000. The male-female ratio was 2:1, and the mean age was 44 years (range 19-86 years). In 92 cases (89%), death occurred outside hospital. The main toxic agents were opiates or opioids (65% of cases), followed by ethanol (9%), tricyclic anti-depressants (TCAs) (4%), benzodiazepines (4%), and zopiclone (4%). Seventy-one (69%) were evaluated as accidental deaths and 32 (31%) as suicides. In 70% of all cases, and in 34% of suicides, the deceased was classified as drug or alcohol dependent. When compared with the 2981 non-fatal acute poisonings registered during the study period, the case fatality rate was 3% (95% C.I., 0.03-0.04). Methanol, TCAs, and antihistamines had the highest case fatality rates; 33% (95% C.I., 0.008-0.91), 14% (95% C.I., 0.04-0.33), and 10% (95% C.I., 0.02-0.27), respectively. Three per cent of all acute poisonings were fatal, and nine out of ten deaths by acute poisonings occurred outside hospital. Two-thirds were evaluated as accidental deaths. Although case fatality rates were

Association of suicide rates, gun ownership, conservatism and individual suicide risk.

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Kposowa, Augustine J

2013-09-01

The purpose of the study was to examine the association of suicide rates, firearm ownership, political conservatism, religious integration at the state level, and individual suicide risk. Social structural and social learning and social integration theories were theoretical frameworks employed. It was hypothesized that higher suicide rates, higher state firearm availability, and state conservatism elevate individual suicide risk. Data were pooled from the Multiple Cause of Death Files. Multilevel logistic regression models were fitted to all deaths occurring in 2000 through 2004 by suicide. The state suicide rate significantly elevated individual suicide risk (AOR = 1.042, CI = 1.037, 1.046). Firearm availability at the state level was associated with significantly higher odds of individual suicide (AOR = 1.004, CI = 1.003, 1.006). State political conservatism elevated the odds of individual suicides (AOR = 1.005, CI = 1.003, 1.007), while church membership at the state level reduced individual odds of suicide (AOR = 0.995, CI = 0.993, 0.996). The results held even after controlling for socioeconomic and demographic variables at the individual level. It was concluded that the observed association between individual suicide odds and national suicide rates, and firearm ownership cannot be discounted. Future research ought to focus on integrating individual level data and contextual variables when testing for the impact of firearm ownership. Support was found for social learning and social integration theories.

The impact of pesticide regulations on suicide in Sri Lanka

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Gunnell, D; Fernando, R; Hewagama, M

2007-01-01

BACKGROUND: Between 1950 and 1995 suicide rates in Sri Lanka increased 8-fold to a peak of 47 per 100,000 in 1995. By 2005, rates had halved. We investigated whether Sri Lanka's regulatory controls on the import and sale of pesticides that are particularly toxic to humans were responsible...... with these declines. CONCLUSION: These data indicate that in countries where pesticides are commonly used in acts of self-poisoning, import controls on the most toxic pesticides may have a favourable impact on suicide. In Asia, there are an estimated 300,000 deaths from pesticide self-poisoning annually. National...

Long-term trends of suicide by choice of method in Norway: a joinpoint regression analysis of data from 1969 to 2012.

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Puzo, Quirino; Qin, Ping; Mehlum, Lars

2016-03-11

Suicide mortality and the rates by specific methods in a population may change over time in response to concurrent changes in relevant factors in society. This study aimed to identify significant changing points in method-specific suicide mortality from 1969 to 2012 in Norway. Data on suicide mortality by specific methods and by sex and age were retrieved from the Norwegian Cause-of-Death Register. Long-term trends in age-standardized rates of suicide mortality were analyzed by using joinpoint regression analysis. The most frequently used suicide method in the total population was hanging, followed by poisoning and firearms. Men chose suicide by firearms more often than women, whereas poisoning and drowning were more frequently used by women. The joinpoint analysis revealed that the overall trend of suicide mortality significantly changed twice along the period of 1969 to 2012 for both sexes. The male age-standardized suicide rate increased by 3.1% per year until 1989, and decreased by 1.2% per year between 1994 and 2012. Among females the long-term suicide rate increased by 4.0% per year until 1988, decreased by 5.5% through 1995, and then stabilized. Both sexes experienced an upward trend for suicide by hanging during the 44-year observation period, with a particularly significant increase in 15-24 year old males. The most distinct change among men was seen for firearms after 1988 with a significant decrease through 2012 of around 5% per year. For women, significant reductions since 1985-88 were observed for suicide by drowning and poisoning. The present study demonstrates different time trends for different suicide methods with significant reductions in suicide by firearms, drowning and poisoning after the peak in the suicide rate in the late 1980s. Suicide by means of hanging continuously increased, but did not fully compensate for the reduced use of other methods. This lends some support for the effectiveness of method-specific suicide preventive measures

The global burden of fatal self-poisoning with pesticides 2006-15

DEFF Research Database (Denmark)

Mew, Emma J.; Padmanathan, Prianka; Konradsen, Flemming

2017-01-01

110,000 pesticide self-poisoning deaths each year from 2010 to 2014, comprising 13.7% of all global suicides. A sensitivity analysis accounting for under-reporting of suicides in India resulted in an increased estimate of 168,000 pesticide self-poisoning deaths annually, that is, 19.7% of global...... suicides. The proportion of suicides due to pesticide self-poisoning varies considerably between regions, from 0.9% in low- and middle-income countries in the European region to 48.3% in low- and middle-income countries in the Western Pacific region. Limitations: High quality method-specific suicide data...... were unavailable for a number of the most populous countries, particularly in the African and Eastern Mediterranean regions. It is likely we have underestimated incidence in these regions. Conclusion: There appears to have been a substantial decline in fatal pesticide self-poisoning in recent years...

Self-poisoning with baclofen in alcohol-dependent patients: national reports to French Poison Control Centers, 2008-2013.

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Pelissier, Fanny; de Haro, Luc; Cardona, Florence; Picot, Cyndie; Puskarczyk, Emmanuel; Sapori, Jean-Marc; Tournoud, Christine; Franchitto, Nicolas

2017-04-01

Alcohol use disorders are frequently associated with self-intoxication in attempted suicide. In France since 2008, the off-label use of baclofen for treatment of alcohol dependence has greatly increased, leading to temporary regulation of use of the drug. At the request of the national authorities, the French Poison Control Centers carried out a retrospective survey to give an overview of baclofen exposure in this population. A retrospective study was carried out from January 2008 to December 2013, focusing on baclofen exposures in alcohol-dependent patients managed by the nine national French Poison Control Centers. 294 observations of baclofen exposures in alcohol-dependent patients were identified in our database. Of these, 220 were suicide attempts by self-poisoning and 74 were unintentional. The mean age of patients was 41.7 years, with a sex-ratio of 1.6. Patients attempting suicide with baclofen were younger than those with unintentional exposures, and 43.6% of them were women (vs 22.9%, p < 0.01). The mean supposed ingested dose was higher (480.7 mg) in patients who attempted suicide (vs 192.5 mg, p < 0.0001). 21.8% of intentional exposures involved baclofen alone. Psychiatric comorbidity (50.4%) was more frequent in the group of self-poisoning (p < 0.001). 132 patients were coded as severely exposed (60.0%). Nine victims died, but the causal link between self-poisoning with baclofen and fatal outcome should be interpreted with particular caution. Baclofen self-poisoning by alcohol-dependent patients is a serious concern for the French health authorities. Our results are similar to those previously published, suggesting that most patients with baclofen overdose should be admitted to an intermediate or intensive care unit as the clinical course requires close monitoring. Because suicidal ideation and suicide attempts are more prevalent in people with substance use disorders than in the general population, and because of the lack of

High Rates of Suicide and Violence in the Lives of Girls and Young Women in Bangladesh: Issues for Feminist Intervention

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Christopher Adam Bagley

2017-11-01

Full Text Available Deaths by suicide in Bangladesh have an atypical sex ratio, with higher rates in females than in males—a characteristic shared with several countries in Southern Asia. Reasons for this are explored in this paper. An examination of the social structure of Bangladesh suggests that girls and women are subjected to higher rates of sexual and physical violence compared with males, especially in rural and urban slum areas. This violence is often linked to the enforced marriage of young girls to older men. A systematic review of 24 studies on suicide and suicidal behaviors in Bangladesh has shown that suicide death rates are exceptionally high in younger women, at a rate of about 20 per 100,000, more than twice the rate in males aged less than 49. In girls aged 15 to 17, the estimated suicide rate is 14 per 100,000, 50% higher than in males. Because of problems in obtaining systematic data on deaths by suicide, these rates are likely to be underestimates. Extreme poverty and lack of education have been recorded as factors in deaths by suicide, although there are methodological problems in reaching such conclusions. We speculate that some of the “suicides” (especially those using poison may in fact be cases of murder. A dowry system (not sanctioned by Islam is thought to be a major cause of family poverty, and violence experienced by young girls. In proposing solutions, we argue the case (as Muslims for the support of an Islamic feminism which urges better support for girls growing up in extreme poverty.

Suicide Methods in Asia: Implications in Suicide Prevention

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Paul S. F. Yip

2012-03-01

Full Text Available As the largest continent in the World, Asia accounts for about 60% of World suicides. Preventing suicide by restricting access to suicide methods is one of the few evidence-based suicide prevention strategies. However, there has been a lack of systematic exploration of suicide methods in Asian countries. To amend this shortage, the current review examines the leading suicide methods in different Asian countries, their trend, their age- and sex- specific characteristics, and their implications for suicide prevention. In total, 42 articles with leading suicide methods data in 17 Asian countries/regions were retrieved. The epidemiologic characteristics and recent trends of common suicide methods reflect specific socio-cultural, economic, and religious situations in the region. Common suicide methods shift with the introduction of technologies and constructions, and have specific age- or sex-characteristics that may render the restriction of suicide methods not equally effective for all sex and age sub-groups. Charcoal burning, pesticide poisoning, native plant poisoning, self-immolation, and jumping are all prominent examples. In the information society, suicide prevention that focuses on suicide methods must monitor and control the innovation and spread of knowledge and practices of suicide “technologies”. It may be more cost-effective to design safety into technologies as a way of suicide prevention while there is no rash of suicides yet by the new technologies. Further research on suicide methods is important for public health approaches to suicide prevention with sensitivity to socio-cultural, economic, and religious factors in different countries.

Suicide Methods in Asia: Implications in Suicide Prevention

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Wu, Kevin Chien-Chang; Chen, Ying-Yeh; Yip, Paul S. F.

2012-01-01

As the largest continent in the World, Asia accounts for about 60% of World suicides. Preventing suicide by restricting access to suicide methods is one of the few evidence-based suicide prevention strategies. However, there has been a lack of systematic exploration of suicide methods in Asian countries. To amend this shortage, the current review examines the leading suicide methods in different Asian countries, their trend, their age- and sex- specific characteristics, and their implications for suicide prevention. In total, 42 articles with leading suicide methods data in 17 Asian countries/regions were retrieved. The epidemiologic characteristics and recent trends of common suicide methods reflect specific socio-cultural, economic, and religious situations in the region. Common suicide methods shift with the introduction of technologies and constructions, and have specific age- or sex-characteristics that may render the restriction of suicide methods not equally effective for all sex and age sub-groups. Charcoal burning, pesticide poisoning, native plant poisoning, self-immolation, and jumping are all prominent examples. In the information society, suicide prevention that focuses on suicide methods must monitor and control the innovation and spread of knowledge and practices of suicide “technologies”. It may be more cost-effective to design safety into technologies as a way of suicide prevention while there is no rash of suicides yet by the new technologies. Further research on suicide methods is important for public health approaches to suicide prevention with sensitivity to socio-cultural, economic, and religious factors in different countries. PMID:22690187

Increased use of lethal methods and annual increase of suicide rates in Korean adolescents: comparison with adolescents in the United States.

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Park, Subin; Cho, Soo-Churl; Kim, Bung-Nyun; Kim, Jae-Won; Yoo, Hee Jeong; Hong, Jin Pyo

2014-03-01

The lethality of the suicide method is a strong risk factor for completed suicide. We examined whether the annual change in the pattern of suicide methods was related to the annual change in suicide rates among adolescents in South Korea and the United States. We analyzed annual data for the 2000-2009 period for South Korea and the 2000-2008 period for the United States to examine time trends in the suicide rates and suicide methods of adolescents aged 10-19 years in two countries. Data on suicide methods were obtained from the World Health Organization (WHO) mortality database. Suicide rates among adolescents in the United States have remained relatively steady since 2000, whereas the suicide among Korean adolescents has increased. Between 2000 and 2009, the most common suicide method among Korean adolescents was jumping for boys and girls, whereas it was hanging for girls and firearms for boys in the United States. Along with the annual increase in suicide rates in South Korea, the incidences of jumping among males and hanging (and recently jumping) among females have increased steadily, whereas suicide by self-poisoning steadily decreased. In the United States, between 2000 and 2008, the proportion of suicides committed by hanging increased, whereas those committed using firearms steadily decreased, particularly among adolescent females. These findings suggest that the increased use of lethal suicide methods is reflected in the increase in suicide rates in Korean adolescents. The most fruitful approach to addressing the rises in jumping suicides among Korean adolescents and hanging suicides among adolescents in the United States may be through population-based initiatives to reduce the physical availability (e.g., limiting access to or fencing off tall structures) and the social acceptability (e.g., effective and responsible regulations for reporting suicide) of these methods. © 2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association

Suicide rates: age-associated trends and their correlates

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Ajit Shah

2012-07-01

Full Text Available BACKGROUND: Suicide rates traditionally increased with ageing. There is a paucity of studies examining factors associated with age-associated trends in suicide rates. METHODS: The relationship between suicide rates and ageing was examined by ascertaining suicide rates in the seven age-bands 16-24 years to 75+ years from the World Health Organization for 97 countries. The relationship between socio-economic status, income inequality, healthcare expenditure, child mortality rates and life expectancy and countries with an increase, a decline and no change in suicide rates with ageing was examined using data from the United Nations. RESULTS: In males and females there was a decline in 5 and 10 countries, an increase in 33 and 37 countries and no change in 59 and 50 countries respectively in suicide rates with ageing. Age-associated trends in suicide rates were significantly associated with socio-economic status (males or income inequality (females, per capita expenditure in healthcare, the proportion of gross-national domestic product spent on healthcare, child mortality rates and life expectancy. CONCLUSIONS: The current study, of factors associated with age-associated trends in suicide rates, confirmed a previously developed five sequential stage model to explain the relationship between elderly suicide rates and socio-economic status and income inequality, quality and quantity of healthcare services, child mortality rates and life expectancy.

EPIDEMIOLOGY OF HUMAN RODENTICIDES POISONING IN BRAZIL

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Maíra Costa Ferreira

2013-09-01

Full Text Available This work aims to analyze the epidemiological profile of human poisoning by rodenticides in Brazil and Regions, in the period 2000 to 2008. This is a descriptive epidemiological study based on secondary data from the National System of Toxic- harmacological Information. Calculations were performed in the incidence rate and fatality rate. The North and Northeast regions had the highest mortality rates for the period. Children from 1 to 4 years had high incidence in all regions except in Northeast, where teenagers were most affected. The rodenticide poisoning was more incident in urban areas and among females, and had attempt suicide as predominant circumstance. Although most cases have evolved for healing, there was almost 40% unconfirmed healing in the South region and 57% of ignored evolution in Southeast. Deaths caused by ingestion of rodenticides were below 5%. The rodenticide poisoning has remained in Brazil with a major public health problem and, despite the differences in the country, the poisoning profile did not change significantly between different regions.

The Effects of Gun Ownership Rates and Gun Control Laws on Suicide Rates

OpenAIRE

Mark Gius

2011-01-01

The purpose of the present study is to determine the effects of gun control laws and gun ownership rates on state-level suicide rates. Using the most recent data on suicide rates, gun control measures, and gun ownership rates, the results of the present study suggest that states that require handgun permits have lower gun-related suicide rates, and states that have higher gun ownership rates have higher gun-related suicide rates. Regarding non-gun suicides, results suggest that stricter gun c...

Self-harm and self-poisoning in southern India

DEFF Research Database (Denmark)

Bose, Anuradha; Sandal Sejbaek, Camilla; Suganthy, Pearline

2009-01-01

over a period of 2 years. RESULTS AND CONCLUSION: The overall suicide rate was 71.4 per 100 000 population; the highest burden was among men. Most people died through hanging (81, 54%) and self-poisoning (46, 31%). Of the 46 who died from self-poisoning, 78.3% had taken pesticides and 19.7% had eaten...... poisonous plants. Eighty per cent of the self-poisoning cases obtained the poisonous substance in or in close proximity to the home, highlighting the importance of safe storage in the domestic environment. Of the 110 fatal and non-fatal self-poisoning cases, 87 (57.5%) were taken for treatment; 50 (57.......4%) went to government hospitals and 37 (42.5%) to private facilities. This indicates the importance of including the private sector in the efforts to improve case management. Furthermore, the fact that 31 (67%) of the self-poisoning patients, who eventually died, were alive after 4 h provides an incentive...

The global distribution of fatal pesticide self-poisoning: systematic review

DEFF Research Database (Denmark)

Gunnell, David; Eddleston, Michael; Phillips, Michael R

2007-01-01

BACKGROUND: Evidence is accumulating that pesticide self-poisoning is one of the most commonly used methods of suicide worldwide, but the magnitude of the problem and the global distribution of these deaths is unknown. METHODS: We have systematically reviewed the worldwide literature to estimate......-poisoning worldwide each year, accounting for 30% (range 27% to 37%) of suicides globally. Official data from India probably underestimate the incidence of suicides; applying evidence-based corrections to India's official data, our estimate for world suicides using pesticides increases to 371,594 (range 347......, not the quantity used, that influences the likelihood they will be used in acts of fatal self-harm. CONCLUSION: Pesticide self-poisoning accounts for about one-third of the world's suicides. Epidemiological and toxicological data suggest that many of these deaths might be prevented if (a) the use of pesticides...

Cases of Acute Poisoning in Southeast Anatolia of Turkey

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Cahfer Güloğlu

2004-01-01

Full Text Available This study was conducted to determine the biological effects of acute poisoning, nature ofagents involved and pattern of poisoning during 2000 in Diyarbakır City in Southeast AnatolianRegion of Turkey.Data from hospital records of all admissions to Emergency Department (ED of Dicle UniversityHospital following acute poisoning collected retrospectively were analysed for the period January toDecember in 2000. Present study included 44 (25.9% male (M and 126 (74.1% female (F, a total170 consecutive patients. A M/F ratio was found as 1.0/3.5 in the study.Mean age of cases was 23.3±6.3 years old; 63 (37.1% of them were under age of 20 years oldand 147 (86.5% of them were under age of 30 years old. Cases of intoxication have admitted insummer season (93 of 170 patients, especially in April, May and July (24, 26 and 30 patients,respectively. Sixty-two (36.5% cases due to accidental, 108 (63.5% cases due to suicidal goal. Thecases of suicidal purposeful intoxications were mostly determined in females (77 cases, 71.3%,p<0.05, and singles (74 cases, 68.5%, p<0.05. There were only two deaths (1.2% among the 170admissions of acute poisonings during hospitaliztion. One of the deaths was due to pesticides; otherone was due to abuse of medical drug. According to physical examination, tachycardia (59, 34.7%,vomit history (55, 32.4%, and unconsciousness (42, 24.7% were frequently observed; however,hypersecretion (15, 8.8%, bradycardia (5, 2.9%, convulsion (8, 4.7%, and hipertension (2, 1.2%,were seen rarely. Cases who poisoned with pesticide compared other cases have had significantlyhigher rate of convulsion (6, 10.2%, miosis (6, 10.2%, and hypersecretion (12, 20.3% (p=0.018,p<0.0001 and p<0.0001, respectively.In our region, pesticides intoxication especially affected to young unmarried females, and mostof them resulted from suicidal purpose. The annual rate of poisoning-related ED visits and mortalitywere within the reported ranges, psychoactive agents being

How Often Does Deliberate Self-Harm Occur Relative to Each Suicide? A Study of Variations by Gender and Age

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Hawton, Keith; Harriss, Louise

2008-01-01

Deliberate self-harm (DSH; i.e., nonfatal self-poisoning or self-injury) occurs much more frequently than suicide, yet there has been little detailed investigation of the comparative rates of DSH and suicide. We conducted a study of how rates of DSH relate to suicide rates across the life cycle by gender and by method of estimation of DSH rates,…

Suicide mortality rates in Louisiana, 1999-2010.

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Straif-Bourgeois, Susanne; Ratard, Raoult

2012-01-01

This report is a descriptive study on suicide deaths in Louisiana occurring in the years 1999 to 2010. Mortality data was collected from death certificates from this 12-year period to describe suicide mortality by year, race, sex, age group, and methods of suicide. Data were also compared to national data. Rates and methods used to commit suicide vary greatly according to sex, race, and age. The highest rates were observed in white males, followed by black males, white females, and black females. Older white males had the highest suicide rates. The influence of age was modulated by the sex and race categories. Firearm was the most common method used in all four categories. Other less common methods were hanging/strangulation/suffocation (HSS) and drugs/alcohol. Although no parish-level data were systematically analyzed, a comparison of suicide rates post-Katrina versus pre-Katrina was done for Orleans Parish, the rest of the Greater New Orleans area, and a comparison group. It appears that rates observed among whites, particularly males, were higher after Katrina. Data based on mortality do not give a comprehensive picture of the burden of suicide, and their interpretation should be done with caution.

Comparative epidemiology of suicide in South Korea and Japan: effects of age, gender and suicide methods.

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Kim, Seong Yi; Kim, Myoung-Hee; Kawachi, Ichiro; Cho, Youngtae

2011-01-01

Suicide is one of the leading causes of mortality in both South Korea and Japan. The study aims to compare the descriptive epidemiology of suicide over the last two decades (1985-2006) and to explore the conditions associated with the different distribution of suicides in both countries. Age-standardized suicide rates were obtained from the OECD Health Data 2009. Age-specific suicide rates for the age groups were calculated from the WHO Mortality Database. Suicide methods were identified based on ICD-10. Through 1980-2000, Japan showed consistently higher suicide rates compared to Korea. However, from the mid-1990s, Korea showed an acute increase of suicides and finally surpassed Japan; the age-standardized suicide rate of Korea increased from 10.2 (per 100,000) in 1985 to 21.5 in 2006, while it slightly increased from 18.4 to 19.1 in Japan. The highest age-specific suicide rate was observed among Japanese men aged 45-64 years and Korean men aged over 64 years. The increase of elderly suicides among Korean women was notable. The gender ratio increased in Japan and decreased in Korea, respectively. The preferred suicide methods were hanging and pesticide poisoning in Korea and hanging in Japan. Because of the limited number of observations, hypothesis testing of specific risk factors was not possible. Age and gender distribution of suicide rates differed considerably between the two countries. Welfare protection throughout the life course in both countries, and pesticide regulation in Korea would be helpful in reducing the burden of suicide mortality in both countries, even if the social values could not be changed in a short time.

Prevention of suicide and attempted suicide in Denmark. Epidemiological studies of suicide and intervention studies in selected risk groups

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Nordentoft, Merete

2007-01-01

at individuals who have already begun self-destructive behaviour. At the universal level, a review was carried out to highlight the association between availability of methods for suicide and suicide rate. There were mostly studies of firearms, and the conclusion of the review was that there was clear indication......, previous inpatient treatment, self-discharge before evaluation, sociopathy, unemployment, frequent change of address, hostility, and living alone. Several of the predictors are overlapping and most of them were already identified in early studies of factors predictive of repetition of suicide attempt...... or previous psychiatric treatment. In our follow-up study from Bispebjerg Hospital, we found that the risk of suicide during a ten-year follow-up period among patients admitted in 1980 after self-poisoning was 30 times greater than in the general population. We also found increased mortality by all other...

An Application of Durkheim's Theory of Suicide to Prison Suicide Rates in the United States

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Tartaro, Christine; Lester, David

2005-01-01

E. Durkheim (1897) suggested that the societal rate of suicide might be explained by societal factors, such as marriage, divorce, and birth rates. The current study examined male prison suicide rates and suicide rates for men in the total population in the United States and found that variables based on Durkheim's theory of suicide explained…

Amitraz, an underrecognized poison: A systematic review

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Sahajal Dhooria

2016-01-01

Results: The original search yielded 239 articles, of which 52 articles described human cases. After following the inclusion and exclusion criteria, 32 studies describing 310 cases (151 females, 175 children of human poisoning with amitraz were included in this systematic review. The most commonly reported clinical features of amitraz poisoning were altered sensorium, miosis, hyperglycaemia, bradycardia, vomiting, respiratory failure, hypotension and hypothermia. Amitraz poisoning carried a good prognosis with only six reported deaths (case fatality rate, 1.9%. Nearly 20 and 11.9 per cent of the patients required mechanical ventilation and inotropic support, respectively. The role of decontamination methods, namely, gastric lavage and activated charcoal was unclear. Interpretation & conclusions: Our review shows that amitraz is an important agent for accidental or suicidal poisoning in both adults and children. It has a good prognosis with supportive management.

The global distribution of fatal pesticide self-poisoning: Systematic review

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Eddleston Michael

2007-12-01

Full Text Available Abstract Background Evidence is accumulating that pesticide self-poisoning is one of the most commonly used methods of suicide worldwide, but the magnitude of the problem and the global distribution of these deaths is unknown. Methods We have systematically reviewed the worldwide literature to estimate the number of pesticide suicides in each of the World Health Organisation's six regions and the global burden of fatal self-poisoning with pesticides. We used the following data sources: Medline, EMBASE and psycINFO (1990–2007, papers cited in publications retrieved, the worldwide web (using Google and our personal collections of papers and books. Our aim was to identify papers enabling us to estimate the proportion of a country's suicides due to pesticide self-poisoning. Results We conservatively estimate that there are 258,234 (plausible range 233,997 to 325,907 deaths from pesticide self-poisoning worldwide each year, accounting for 30% (range 27% to 37% of suicides globally. Official data from India probably underestimate the incidence of suicides; applying evidence-based corrections to India's official data, our estimate for world suicides using pesticides increases to 371,594 (range 347,357 to 439,267. The proportion of all suicides using pesticides varies from 4% in the European Region to over 50% in the Western Pacific Region but this proportion is not concordant with the volume of pesticides sold in each region; it is the pattern of pesticide use and the toxicity of the products, not the quantity used, that influences the likelihood they will be used in acts of fatal self-harm. Conclusion Pesticide self-poisoning accounts for about one-third of the world's suicides. Epidemiological and toxicological data suggest that many of these deaths might be prevented if (a the use of pesticides most toxic to humans was restricted, (b pesticides could be safely stored in rural communities, and (c the accessibility and quality of care for poisoning

The Profile of Acute Poisonings in South East of Turkey

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Davut Akın

2007-01-01

Full Text Available The aim of this prospective study was to analyze the rate characteristics of acute poisonning adults admitted to Departments emergency and hospitalized in Department of internal medicineAll cases of acute poisoning admitted to Dicle University Hospital, between, 2005 and 2006, were included in study. Clinical, laboratory, and demographic characteristics, type of poison and patient’s outcomes were recorded.Eighty poisoning cases included in the study. The mean age was 23±8 years and the majority of the patients (75% were in 15-25 years of ages. 85% of acute poisonings were self-inflicted. Medical drugs overdose were the major cause (62.5% of intoxication followed by agricultural chemicals (35%. The most frequently involved medicinal drugs were psychiatric drugs (20% and paracetamol (17.5%. There was a high rate of suicides attemp in groups of young singles, females, crowded families, patients with low education status, and patient living in cities.

Potassium permanganate poisoning--a rare cause of fatal self poisoning.

OpenAIRE

Ong, K L; Tan, T H; Cheung, W L

1997-01-01

Attempted suicide by self poisoning is common because of the ready availability of drugs, whether prescribed or bought over the counter. In some cases, the ingestion of seemingly innocuous household products or chemicals can result in death. Potassium permanganate is an example. Poisoning with potassium permanganate can be fatal when a significant amount is ingested, as shown by a patient who suffered both the corrosive and systemic toxic effects of this chemical.

Features and Prognostic Factors for Elderly With Acute Poisoning in the Emergency Department

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Yu-Hui Hu

2010-02-01

Conclusion: Our results demonstrated that elderly patients with acute poisoning had a mortality rate of 9.6%. Suicide attempts resulted in more serious complications. The risk factors for mortality were herbicide intoxication, hypotension and respiratory failure.

Suicide epidemics: the impact of newly emerging methods on overall suicide rates - a time trends study

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Chang Shu-Sen

2011-05-01

Full Text Available Abstract Background The impact of newly emerging, popular suicide methods on overall rates of suicide has not previously been investigated systematically. Understanding these effects may have important implications for public health surveillance. We examine the emergence of three novel methods of suicide by gassing in the 20th and 21st centuries and determine the impact of emerging methods on overall suicide rates. Methods We studied the epidemic rises in domestic coal gas (1919-1935, England and Wales, motor vehicle exhaust gas (1975-1992, England and Wales and barbecue charcoal gas (1999-2006, Taiwan suicide using Poisson and joinpoint regression models. Joinpoint regression uses contiguous linear segments and join points (points at which trends change to describe trends in incidence. Results Epidemic increases in the use of new methods of suicide were generally associated with rises in overall suicide rates of between 23% and 71%. The recent epidemic of barbecue charcoal suicides in Taiwan was associated with the largest rise in overall rates (40-50% annual rise, whereas the smallest rise was seen for car exhaust gassing in England and Wales (7% annual rise. Joinpoint analyses were only feasible for car exhaust and charcoal burning suicides; these suggested an impact of the emergence of car exhaust suicides on overall suicide rates in both sexes in England and Wales. However there was no statistical evidence of a change in the already increasing overall suicide trends when charcoal burning suicides emerged in Taiwan, possibly due to the concurrent economic recession. Conclusions Rapid rises in the use of new sources of gas for suicide were generally associated with increases in overall suicide rates. Suicide prevention strategies should include strengthening local and national surveillance for early detection of novel suicide methods and implementation of effective media guidelines and other appropriate interventions to limit the spread of

A changing epidemiology of suicide? The influence of birth cohorts on suicide rates in the United States.

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Phillips, Julie A

2014-08-01

The increases in suicide among middle-aged baby boomers (born between 1946 and 1964) in the United States since 1999 suggest a changing epidemiology of suicide. Using data from 1935 to 2010, this paper conducts age-period-cohort analyses to determine the impact of cohorts in shaping temporal patterns of suicide in the United States. The analysis demonstrates that age, period and cohort effects are all important in determining suicide trends. Net of age and period effects, the cohort pattern of suicide rates is U-shaped, with cohorts born between 1915 and 1945 possessing among the very lowest suicide rates. Suicide rates begin to rise with boomers and subsequent cohorts exhibit increasingly higher rates of suicide. The general pattern exists for both men and women but is especially pronounced among males. The average suicide rate over the entire period for males is about 28 per 100,000, 95% CI [27.4, 28.7]. For males born in 1930-34, the suicide rate is estimated to be 17.4 per 100,000, 95% CI [15.9, 18.8]; for males born between 1955 and 1959, the rate is essentially the same as the average for the period while for males born between 1985 and 1989, the suicide rate is estimated to be 37.8 per 100,000, 95% CI [33.1, 43.4]. The results dispute popular claims that boomers exhibit an elevated suicide rate relative to other generations, but boomers do appear to have ushered in new cohort patterns of suicide rates over the life course. These patterns are interpreted within a Durkheimian framework that suggests weakened forms of social integration and regulation among postwar cohorts may be producing increased suicide rates. Copyright © 2014 Elsevier Ltd. All rights reserved.

Suicide Rates and State Laws Regulating Access and Exposure to Handguns.

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Anestis, Michael D; Anestis, Joye C

2015-10-01

Using previous research, we examined the impact of 4 handgun laws (waiting periods, universal background checks, gun locks, and open carrying regulations) on suicide rates. We used publicly available databases to collect information on statewide laws, suicide rates, and demographic characteristics for 2013. Each law was associated with significantly lower firearm suicide rates and the proportion of suicides resulting from firearms. In addition, each law, except for that which required a waiting period, was associated with a lower overall suicide rate. Follow-up analyses showed a significant indirect effect on overall suicide rates through the proportion of suicides by firearms, indicating that the reduced overall suicide rate was attributable to fewer suicide attempts, fewer handguns in the home, suicide attempts using less lethal means, or a combination of these factors. States that implemented any of these laws saw a decreased suicide rate in subsequent years, whereas the only state that repealed 1 of these laws saw an increased suicide rate. Our results were supportive of a potentially vital role in suicide prevention for state legislation that limits access and exposure to handguns.

The contribution of charcoal burning to the rise and decline of suicides in Hong Kong from 1997-2007.

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Law, C K; Yip, Paul S F; Caine, Eric D

2011-09-01

There has been scant research exploring the relationship between choice of method (means) of self-inflicted death, and broader social or contextual factors. The recent emergence and growth of suicide using carbon monoxide poisoning resulting from burning charcoal in an enclosed space (hereafter, "charcoal burning") was related to an increase in the overall suicide rate in Hong Kong. The growth of this method coincided with changing economic conditions. This paper expands upon previous work to explore possible relationships further. This study aims to discern the role of charcoal burning in overall suicide rate transition during times of both economic recession and expansion, as captured in the unemployment rate of Hong Kong, and to examine whether there was evidence of an effect from means-substitution. Age and gender specific suicide rates in Hong Kong by suicide methods from 1997 to 2007 were calculated. To model the transition of suicide rate by different methods, Poisson regression analyses were employed. Charcoal burning constituted 18.3% of all suicides, 88% of which involved individuals drawn from the middle years (25-59) of life. During both periods of rising and declining unemployment, charcoal burning played an important role in the changing suicide rates, and this effect was most prominent among for those in their middle years. Means-substitution was found among the married women during the period of rate advancement (1997-2003). Compared to others, working-age adults preferentially selected carbon monoxide poisoning from charcoal burning.

Benzodiazepine poisoning in elderly

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Perković-Vukčević Nataša; Vuković-Ercegović Gordana; Šegrt Zoran; Đorđević Snežana; Jović-Stošić Jasmina

2016-01-01

Background/Aim. Benzodiazepines are among the most frequently ingested drugs in self-poisonings. Elderly may be at greater risk compared with younger individuals due to impaired metabolism and increased sensitivity to benzodiazepines. The aim of this study was to assess toxicity of benzodiazepines in elderly attempted suicide. Methods. A retrospective study of consecutive presentations to hospital after self-poisoning with benzodiazepines was done. Collecte...

Causes of poisoning in patients evaluated in a hospital emergency department in Konya, Turkey

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Kara, H.; Bayir, A.; Degirmenci, S.; Akinci, M.; Ak, A.; Azap, M.

2014-01-01

Objectives: To evaluate demographic and clinical characteristics of patients with poisoning at a community hospital. Methods: The retrospective study comprised records of patients who were admitted to the emergency department of Konya Numune Hospital, Turkey, because of poisoning between January 1, 2009, and December 31, 2011. Data was evaluated for age, gender, educational status, occupation, arrival time, mechanism of intoxication , body temperature, pulse, respiratory rate, Glasgow Coma Scale score, treatment applied, duration of hospital stay, duration of follow-up, test results, final diagnosis, clinical disposition, and outcome. Agents causing the poisoning were also determined. Results: Records of 1036 patients were evaluated. Of them, 764(74%) were female and 272(26%) were male. The predominant age range was 15-24 years in 617(60%) patients. The median time from substance exposure to admission to the emergency department was 2 hours. The most common cause of poisoning was attempted suicide in 955 (92%) patients and drug intoxication was the agent involved in 932 (90%). In the 15-24 year age range, there were 469(76%) female patients. Of the total female population in the study, 716(94%) attempted suicide. The median hospital stay was 24 hours. There were 908(88%) patients who were advised to seek further evaluation at the psychiatry clinic, and 9 (0.9%) patients were admitted to the psychiatry inpatient units after medical treatment. In patients who were hospitalized and followed up, 1 (0.1%) died because of multiple drug poisoning. Conclusion: Most admissions to the emergency department for poisoning related to young women had used drugs during a suicide attempt. (author)

Relationship of suicide rates to economic variables in Europe

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Fountoulakis, Konstantinos N; Kawohl, Wolfram; Theodorakis, Pavlos N

2014-01-01

European countries and included the number of deaths by suicide in men and women, the unemployment rate, the gross domestic product (GDP) per capita, the annual economic growth rate and inflation. RESULTS: There was a strong correlation between suicide rates and all economic indices except GPD per capita...... in men but only a correlation with unemployment in women. However, the increase in suicide rates occurred several months before the economic crisis emerged. CONCLUSIONS: Overall, this study confirms a general relationship between the economic environment and suicide rates; however, it does not support...

Bans of WHO Class I Pesticides in Bangladesh—suicide prevention without hampering agricultural output

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Chowdhury, Fazle Rabbi; Dewan, Gourab; Verma, Vasundhara R; Knipe, Duleeka W; Isha, Ishrat Tahsin; Faiz, M Abul; Gunnell, David J; Eddleston, Michael

2018-01-01

Abstract Background Pesticide self-poisoning is a major problem in Bangladesh. Over the past 20-years, the Bangladesh government has introduced pesticide legislation and banned highly hazardous pesticides (HHPs) from agricultural use. We aimed to assess the impacts of pesticide bans on suicide and on agricultural production. Methods We obtained data on unnatural deaths from the Statistics Division of Bangladesh Police, and used negative binomial regression to quantify changes in pesticide suicides and unnatural deaths following removal of WHO Class I toxicity HHPs from agriculture in 2000. We assessed contemporaneous trends in other risk factors, pesticide usage and agricultural production in Bangladesh from 1996 to 2014. Results Mortality in hospital from pesticide poisoning fell after the 2000 ban: 15.1% vs 9.5%, relative reduction 37.1% [95% confidence interval (CI) 35.4 to 38.8%]. The pesticide poisoning suicide rate fell from 6.3/100 000 in 1996 to 2.2/100 000 in 2014, a 65.1% (52.0 to 76.7%) decline. There was a modest simultaneous increase in hanging suicides [20.0% (8.4 to 36.9%) increase] but the overall incidence of unnatural deaths fell from 14.0/100 000 to 10.5/100 000 [25.0% (18.1 to 33.0%) decline]. There were 35 071 (95% CI 25 959 to 45 666) fewer pesticide suicides in 2001 to 2014 compared with the number predicted based on trends between 1996 to 2000. This reduction in rate of pesticide suicides occurred despite increased pesticide use and no change in admissions for pesticide poisoning, with no apparent influence on agricultural output. Conclusions Strengthening pesticide regulation and banning WHO Class I toxicity HHPs in Bangladesh were associated with major reductions in deaths and hospital mortality, without any apparent effect on agricultural output. Our data indicate that removing HHPs from agriculture can rapidly reduce suicides without imposing substantial agricultural costs. PMID:29024951

Bans of WHO Class I Pesticides in Bangladesh-suicide prevention without hampering agricultural output.

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Chowdhury, Fazle Rabbi; Dewan, Gourab; Verma, Vasundhara R; Knipe, Duleeka W; Isha, Ishrat Tahsin; Faiz, M Abul; Gunnell, David J; Eddleston, Michael

2018-02-01

Pesticide self-poisoning is a major problem in Bangladesh. Over the past 20-years, the Bangladesh government has introduced pesticide legislation and banned highly hazardous pesticides (HHPs) from agricultural use. We aimed to assess the impacts of pesticide bans on suicide and on agricultural production. We obtained data on unnatural deaths from the Statistics Division of Bangladesh Police, and used negative binomial regression to quantify changes in pesticide suicides and unnatural deaths following removal of WHO Class I toxicity HHPs from agriculture in 2000. We assessed contemporaneous trends in other risk factors, pesticide usage and agricultural production in Bangladesh from 1996 to 2014. Mortality in hospital from pesticide poisoning fell after the 2000 ban: 15.1% vs 9.5%, relative reduction 37.1% [95% confidence interval (CI) 35.4 to 38.8%]. The pesticide poisoning suicide rate fell from 6.3/100 000 in 1996 to 2.2/100 000 in 2014, a 65.1% (52.0 to 76.7%) decline. There was a modest simultaneous increase in hanging suicides [20.0% (8.4 to 36.9%) increase] but the overall incidence of unnatural deaths fell from 14.0/100 000 to 10.5/100 000 [25.0% (18.1 to 33.0%) decline]. There were 35 071 (95% CI 25 959 to 45 666) fewer pesticide suicides in 2001 to 2014 compared with the number predicted based on trends between 1996 to 2000. This reduction in rate of pesticide suicides occurred despite increased pesticide use and no change in admissions for pesticide poisoning, with no apparent influence on agricultural output. Strengthening pesticide regulation and banning WHO Class I toxicity HHPs in Bangladesh were associated with major reductions in deaths and hospital mortality, without any apparent effect on agricultural output. Our data indicate that removing HHPs from agriculture can rapidly reduce suicides without imposing substantial agricultural costs. © The Author 2017. Published by Oxford University Press on behalf of the International

Influence of psychotherapist density and antidepressant sales on suicide rates.

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Kapusta, N D; Niederkrotenthaler, T; Etzersdorfer, E; Voracek, M; Dervic, K; Jandl-Jager, E; Sonneck, G

2009-03-01

Antidepressant sales and suicide rates have been shown to be correlated in industrialized countries. The aim was to study the possible effects of psychotherapy utilization on suicide rates. We assessed the impact of antidepressant sales and psychotherapist density on suicide rates between 1991 and 2005. To adjust for serial correlation in time series, three first-order autoregressive models adjusted for per capita alcohol consumption and unemployment rates were employed. Antidepressant sales and the density of psychotherapists in the population were negatively associated with suicide rates. This study provides evidence that decreasing suicide rates were associated with both increasing antidepressant sales and an increasing density of psychotherapists. The decrease of suicide rates could reflect a general improvement in mental health care rather than being caused by antidepressant sales or psychotherapist density alone.

[Epidemiological analysis of suicide in Brazil from 1980 to 2006].

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Lovisi, Giovanni Marcos; Santos, Simone Agadir; Legay, Letícia; Abelha, Lucia; Valencia, Elie

2009-10-01

The objective of this study was to carry out an epidemiological analysis of the suicide rates found in Brazilian regions and state capitals between 1980 and 2006. Data on mortality rates due to suicide were collected from the Departamento de Informática do Sistema Unico de Saúde (Information Technology Department of the Brazilian Public Health System--DATASUS). A total of 158,952 suicide cases were registered between 1980 and 2006, excluding those cases in which the individual was less than 10 years old (n = 68). In the period under study, the total suicide rate in Brazil increased from 4.4 to 5.7 deaths per 100,000 inhabitants (29.5%). Higher average rates were found in the South (9.3) and Central-West (6.1) regions. Men were more likely to commit suicide. The highest suicide rates were found in the 70-years or above age range while the highest increases were found in the 20 to 59 year age bracket. The most dominant social-demographic characteristics of the persons who committed suicide in the period under study were low educational level and singlehood. The most common methods of suicide were hanging, fire arms and poisoning. Although in Brazil the rate increased 29.5% in 26 years, the national rate is still considered to be low when compared to worldwide suicide rates (average of 4.9 per 100,000 inhabitants). Suicide rates in Brazilian regions vary broadly, ranging from 2.7 to 9.3.

Changes in Scottish suicide rates during the Second World War.

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Henderson, Rob; Stark, Cameron; Humphry, Roger W; Selvaraj, Sivasubramaniam

2006-06-23

It is believed that total reported suicide rates tend to decrease during wartime. However, analysis of suicide rates during recent conflicts suggests a more complex picture, with increases in some age groups and changes in method choice. As few age and gender specific analyses of more distant conflicts have been conducted, it is not clear if these findings reflect a change in the epidemiology of suicide in wartime. Therefore, we examined suicide rates in Scotland before, during and after the Second World War to see if similar features were present. Data on deaths in Scotland recorded as suicide during the period 1931-1952, and population estimates for each of these years, were obtained from the General Register Office for Scotland. Using computer spreadsheets, suicide rates by gender, age and method were calculated. Forward stepwise logistic regression was used to assess the effect of gender, war and year on suicide rates using SAS V8.2. The all-age suicide rate among both men and women declined during the period studied. However, when this long-term decline is taken into account, the likelihood of suicide during the Second World War was higher than during both the pre-War and post-War periods. Suicide rates among men aged 15-24 years rose during the Second World War, peaking at 148 per million (41 deaths) during 1942 before declining to 39 per million (10 deaths) by 1945, while the rate among men aged 25-34 years reached 199 per million (43 deaths) during 1943 before falling to 66 per million (23 deaths) by 1946. This was accompanied by an increase in male suicides attributable to firearms and explosives during the War years which decreased following its conclusion. All age male and female suicide rates decreased in Scotland during World War II. However, once the general background decrease in suicide rates over the whole period is accounted for, the likelihood of suicide among the entire Scottish population during the Second World War was elevated. The overall

A One-Year Study of Mortality Due to Drug and Chemical Poisoning in Sina Hospital of Hamadan

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S. Afzali

2003-10-01

Full Text Available Every year many people refer to emergency department due to poisoning and some of them be threated and some die because of the intensity of adverse effect. Most patients who refer to emergency department are those who commit intentionally for Suicide attempt and another group are those who are poisoned due to drug overdose. In this study we reviewed annual number of death due to drug and chemical poisonings that attend to Sina hospital, Hamadan in the year 2001. This retrospective study was gather based on poisoned file who refer to emergency department and died due to intensity of adverse effects of poisoning. The results show that out of 1079 patients ,47 cases have died because of intensity of adverse effects. Mortality rate in male was 74.5% and in female was 25.5%. 68.1% was seen in those patients who committed suicide and in the second degree was seen in drug abuser(21.3%. The greatest number of death (12 patients was seen between 10-20 year old and also above 50. Poisons mostly used organophosphates – opiates and herbicides successively , and other drugs and chemical came after them. The most common adverse effect leading to death was respiratory depression. In most cases toxicological examinations on dead body were negative, when the results of such examination were positive the majority of reports were about arsenic and methanol. The highest rate of death (55.3% occurred in those patients who referred to the hospital more than 6 hours after poisoning. The results showed that the rate of poisoning due to organophosphate insecticides and opiates are higher than other drugs in Hamadan.

Poison exposures in young Israeli military personnel: a National Poison Center Data analysis.

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Lavon, Ophir; Bentur, Yedidia

2017-06-01

To characterize poison exposures in young Israeli military personnel as reported to the national poison center. Retrospective poison center chart review over a 14-year period. Cases included were Israeli soldiers aged 18-21 years, the compulsory military service age required by the Israeli law. 1770 records of poison exposures in young military personnel were identified. Most exposed individuals involved males (n = 1268, 71.6%). Main routes of exposure were ingestion (n = 854, 48.3%), inhalation (n = 328, 18.6%) and ocular (n = 211, 11.9%). Accidents or misuse (n = 712, 40.2%) were the most frequently reported circumstances, followed by suicide attempts (370, 20.9%), and bites and stings (161, 9.1%). More than half of the cases involved chemicals (n = 939, 53.1%); hydrocarbons, gases and corrosives were the main causative agents. Pharmaceuticals (mainly analgesics) were involved in 519 (29.3%) cases, venomous animals (mainly scorpions, centipedes, and snakes) in 79 (4.5%). Clinical manifestations were reported in 666 (37.6%) cases, mostly gastrointestinal, neurologic, and respiratory. The vast majority of cases (1634, 92.3%) were asymptomatic or mildly affected; no fatalities were recorded. In 831 (46.9%) cases the clinical toxicologist recommended referral to an emergency department; ambulatory observation was recommended in 563 (31.8%) cases, and hospitalization in 86 (4.9%). Our data show that poison exposures among young soldiers involve mainly males, accidents, misuse and suicides, oral route and chemicals; most exposures were asymptomatic or with mild severity. Repeated evaluations of poison center data pertaining to military personnel is advised for identifying trends in poison exposure and characteristics in this particular population.

SUICIDAL ATTEMPTS AMONG YOUNG RURAL INHABITANTS

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Zdzisław Brzeski

2010-06-01

Full Text Available In recent years changes have been noted in the motivations for acute suicidal poisonings among young people from various environments, which are due to psychosocial changes both in the urban and rural environments. Suicidal attempts are accompanied – especially in the rural environment – by low social status, difficulties with adapting to a free market economy, emotional tension within the family, at school, in the environment of young people, addiction to alcohol, drug overuse, including psychotropes. Based on clinical material concerning rural inhabitants hospitalized due to suicidal poisonings, the authors performed the analysis of attitudes, motivations and causes of acute poisonings among the young rural population. Among rural adolescents who continued school or university education the dominant causes of undertaking a suicidal attempt were: adolescent period problems, conflicts within the family, conflicts with mates, and disappointment in love. Among young adults the motivations were as follows: difficulties with finding employment in the place of residence, conflicts within the family, overuse of stimulants, and sometimes states of depression during the period of aggravation of a disease.

Suicide menace in North-Eastern India: a hospital-based study on the clinical aspects of suicide attempters

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Robin Victor

2017-12-01

Full Text Available Context: Suicide is a rapidly evolving public health problem affecting people worldwide and is the second leading cause of death among 15-29 year olds globally in 2012. It is a multidimensional and multifactorial phenomenon in terms of the cause and the effect. Objectives: To find out sociodemographic profiles, modes of attempting suicide, and prevalence of depression among the subjects with suicide attempt, and to find any association between them. Methods: One hundred and eight cases of attempted suicide were selected consecutively who were attending the hospital irrespective of the department and were evaluated to find out various sociodemographic variables, methods of attempting suicide, and if they fulfilled ICD-10 criteria for depressive disorder. Results: Higher prevalence of suicide was seen in cases with age <35 years (77.6%, female gender (54.62%, from rural background (69.44%, living in nuclear family (64.81%, who were unmarried/single (60.18%, illiterate or having education up to class Xth (71.29%, occupationally dependent (68.51%, belonging to lower/lower middle socioeconomic class (51.85%. Organophosphorus poisoning (42.59% was the most common method of attempting suicide. 66.66% of cases suffered from depressive disorder at the time of attempting suicide. Poisoning was the more common method among cases with age less than 35 years (63.09% and while males opted for drug overdose (16.32% females used poisoning (64.40% as the most common method to attempt suicide. Conclusions: The data provides a range of information to identify vulnerable groups so that a multidimensional approach can be planned for formulation of suicide prevention strategies.

The epidemiology of suicide in Jamaica 2002-2010: rates and patterns.

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Abell, W D; James, K; Bridgelal-Nagassar, R; Holder-Nevins, D; Eldemire, H; Thompson, E; Sewell, C

2012-08-01

Suicide is increasingly recognized as a worldwide problem. There is a paucity of quality data pertaining to suicide in developing countries. Epidemiological analysis of suicide data elucidates prevailing patterns that facilitate risk factor identification and the development of germane programmatic responses. This paper analyses temporal variations in suicide rates for the years 2002-2010 in Jamaica and describes the sociodemographic profile of cases and method of suicide for the latter four years. Data pertaining to suicides were extracted from the police (The Jamaica Constabulary Force) records. These were summarized and analysed with respect to person, place and time. Population statistics for the computation of rates were obtained from publications of the Statistical Institute of Jamaica. Age-standardized rates were generated for comparison of trends over time. Poisson and binomial probabilities were used to determine statistically significant differences in rates. Suicide rates in Jamaica have remained relatively stable for the period reviewed with mean overall annual incidence of 2.1 per 100 000 population. Rates for males were significantly higher than those for females. The majority (90.4%) of suicide cases were males. A trend for higher rates of suicide was generally noted in the 25-34-year and the 75-year and over age groups. Hanging was the main method used to commit suicide (77.5%). Age-adjusted rates of suicide indicate no significant changes in Jamaica over the period 2002 to 2010. Continued surveillance of suicide as well as improved recording of the circumstances surrounding suicides are recommended to promote greater understanding of suicides and this will ultimately inform intervention strategies.

The Report of Suicide by Ingestion of Lidocaine Topical Spray

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Hossein Hassanian-Moghaddam

2014-09-01

Full Text Available Background: Lidocaine is a local anesthetic and antiarrhythmic agent. There are reports on accidental and intentional cases of poisoning following injection of lidocaine while rare are the fatal cases realized after oral ingestion of lidocaine. Suicidal poisoning with lidocaine pharmaceutical formulations is rare since no pharmaceutical dosage forms for oral use are available except gels and sprays used as local anesthetics in dentistry. Cases: Three cases of suicidal poisoning by ingestion of the content of lidocaine topical spray are reported in the present study. The cases developed episodes of seizure requiring diazepam and other therapeutic modalities upon admission. Eventually, one of the cases expired. Conclusion: To the best of our knowledge, this study is the first reported case of suicidal poisoning after ingestion of this formulation which highlights the fact that lidocaine topical spray formulation may be used for committing suicide. Ingestion of lidocaine present in topical spray can induce varying levels of toxicity that can even be fatal.

Suicide and self-inflicted injury hospitalizations in Canada (1979 to 2014/15

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R. Skinner

2016-11-01

Full Text Available Introduction: The purpose of this paper is to describe the trends and patterns of self-inflicted injuries, available from Canadian administrative data between 1979 and 2014/15, in order to inform and improve suicide prevention efforts. Methods: Suicide mortality and hospital separation data were retrieved from the Public Health Agency of Canada (PHAC holdings of Statistics Canada's Canadian Vital Statistics: Death Database (CVS:D (1979 to 2012; Canadian Socio-Economic Information Management System (CANSIM 2011, 2012; the Hospital Morbidity Database (HMDB (1994/95 to 2010/11; and the Discharge Abstract Database (2011/12 to 2014/15. Mortality and hospitalization counts and rates were reported by sex, 5-year age groups and method. Results: The Canadian suicide rate (males and fe­males combined, all ages, age-sex standardized rate has decreased from 14.4/100 000 (n = 3355 in 1979 to 10.4/100 000 (n = 3926 in 2012, with an annual percent change (APC of ­ 1.2% (95% CI: ­1.3 to ­1.0. However, this trend was not observed in both sexes: female suicide rates stabilized around 1990, while male rates continued declining over time—yet males still accounted for 75.7% of all suicides in 2012. Suffocation (hanging and strangulation was the primary method of suicide (46.9% among Canadians of all ages in 2012, followed by poisoning at 23.3%. In the 2014/15 fiscal year, there were 13 438 hospitalizations in Canada (excluding Quebec associated with self-in­flicted injuries—over 3 times the number of suicides. Over time females have displayed con­sistently higher rates of hospitalization for self-inflicted injury than males, with 63% of the total. Poisoning was reported as the most frequent means of self-inflicted harm in the fiscal year 2014/15, at 86% of all hospitalizations. Conclusion: Suicides and self-inflicted injuries continue to be a serious—but preventable—public health problem that requires ongoing surveillance.

The Impact of Celebrity Suicide on Subsequent Suicide Rates in the General Population of Korea from 1990 to 2010.

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Park, Juhyun; Choi, Nari; Kim, Seog Ju; Kim, Soohyun; An, Hyonggin; Lee, Heon-Jeong; Lee, Yu Jin

2016-04-01

The association between celebrity suicide and subsequent increase in suicide rates among the general population has been suggested. Previous studies primarily focused on celebrity suicides in the 2000s. To better understand the association, this study examined the impacts of celebrity suicides on subsequent suicide rates using the data of Korean celebrity suicides between 1990 and 2010. Nine celebrity suicides were selected by an investigation of media reports of suicide deaths published in three major newspapers in Korea between 1990 and 2010. Suicide mortality data were obtained from the National Statistical Office of Korea. Seasonal autoregressive integrated moving average models with intervention analysis were used to test the impacts of celebrity suicides, controlling for seasonality. Six of the 9 celebrity suicides had significant impacts on suicide rates both in the total population and in the same gender- or the same age-subgroups. The incident that occurred in the 1990s had no significant impact on the overall suicide rates, whereas the majority of the incidents in the 2000s had significant influences for 30 or 60 days following each incident. The influence of celebrity suicide was shown to reach its peak following the suicide death of a renowned actress in 2008. The findings may suggest a link between media coverage and the impact of celebrity suicide. Future studies should focus more on the underlying processes and confounding factors that may contribute to the impact of celebrity suicide on subsequent suicide rates.

Dietary tryptophan intake and suicide rate in industrialized nations.

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Voracek, Martin; Tran, Ulrich S

2007-03-01

The objective of this study was to assess the ecological association of dietary tryptophan intake and suicide rates across industrialized nations. Tryptophan, an essential amino acid, is the rate-limiting precursor of serotonin biosynthesis. The serotonergic system has been strongly implicated in the neurobiology of suicide. Contemporary male and female suicide rates for the general population (42 countries) and the elderly (38 countries) were correlated with national estimates of dietary tryptophan intake. Measures of tryptophan intake were significantly negatively associated to national suicide rates. Controlling for national affluence, total alcohol consumption and happiness levels slightly attenuated these associations, but left all of them negative. The effect is an ecological (group-level) finding. Estimated per capita tryptophan supply is only a proxy for actual consumption. Developed nations ranking high in dietary tryptophan intake rank low in suicide rates, independent of national wealth, alcohol intake and happiness.

Suicidality in the veterinary profession: interview study of veterinarians with a history of suicidal ideation or behavior.

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Platt, Belinda; Hawton, Keith; Simkin, Sue; Dean, Rachel; Mellanby, Richard J

2012-01-01

Suicide rates are elevated in the veterinary profession in several countries, yet little is known about possible contributory and preventive factors. To obtain information from veterinarians with a history of suicidal ideation or behavior about the factors associated with suicidality in their profession. We conducted a mixed-methods interview study with 21 UK veterinarians who had attempted suicide or reported recent suicidal ideation. Interview topics included work and nonwork contributory factors, coping mechanisms, and preventive factors. Self-poisoning was the most common method used or considered by participants. Common contributory factors were workplace relationships, career concerns, patient issues, number of hours and volume of work, and responsibility, although two-thirds of participants reported co-occurring difficult life events. Around half had received a psychiatric diagnosis following their suicidal behavior. Several possible preventive measures were suggested by participants. Several work- and non-work-related contributory factors to suicidality in the veterinary profession were identified. Future preventive measures may involve better promotion of support services, formal support for recent graduates, and improving employers' attitudes toward work-life balance.

Predictive Validity of the Columbia-Suicide Severity Rating Scale for Short-Term Suicidal Behavior

DEFF Research Database (Denmark)

Conway, Paul Maurice; Erlangsen, Annette; Teasdale, Thomas William

2017-01-01

adolescents (90.6% females) who participated at follow-up (85.9%) out of the 99 (49.7%) baseline respondents. All adolescents were recruited from a specialized suicide-prevention clinic in Denmark. Through multivariate logistic regression analyses, we examined whether baseline suicidal behavior predicted......Using the Columbia-Suicide Severity Rating Scale (C-SSRS), we examined the predictive and incremental predictive validity of past-month suicidal behavior and ideation for short-term suicidal behavior among adolescents at high risk of suicide. The study was conducted in 2014 on a sample of 85...... subsequent suicidal behavior (actual attempts and suicidal behavior of any type, including preparatory acts, aborted, interrupted and actual attempts; mean follow-up of 80.8 days, SD = 52.4). Furthermore, we examined whether suicidal ideation severity and intensity incrementally predicted suicidal behavior...

Economic conditions and suicide rates in New York City.

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Nandi, Arijit; Prescott, Marta R; Cerdá, Magdalena; Vlahov, David; Tardiff, Kenneth J; Galea, Sandro

2012-03-15

Extant analyses of the relation between economic conditions and population health were often based on annualized data and were susceptible to confounding by nonlinear time trends. In the present study, the authors used generalized additive models with nonparametric smoothing splines to examine the association between economic conditions, including levels of economic activity in New York State and the degree of volatility in the New York Stock Exchange, and monthly rates of death by suicide in New York City. The rate of suicide declined linearly from 8.1 per 100,000 people in 1990 to 4.8 per 100,000 people in 1999 and then remained stable from 1999 to 2006. In a generalized additive model in which the authors accounted for long-term and seasonal time trends, there was a negative association between monthly levels of economic activity and rates of suicide; the predicted rate of suicide was 0.12 per 100,000 persons lower when economic activity was at its peak compared with when it was at its nadir. The relation between economic activity and suicide differed by race/ethnicity and sex. Stock market volatility was not associated with suicide rates. Further work is needed to elucidate pathways that link economic conditions and suicide.

[Association between inequality and suicide rate in Colombia (1994-2013)].

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Campo-Arias, Adalberto; Herazo, Edwin

2015-01-01

Income inequality is directly related to the mental health of the population. However, the relationship between income inequality and suicide rates in Colombia has still not been explored. To estimate the relationship between inequality and suicide rates in Colombia from 1994 to 2013. An ecological study was conducted, in which the correlation was estimated (Spearman) between inequality (Gini coefficient) and suicide rate between 1994 and 2013, according to official information available from the National Administrative Department of Statistics (DANE), and the National Institute of Forensic Science and Forensic Medicine. A Gini coefficient between 0.53 and 0.60 (median, 0.65 [interquartile range, 0.54-0.57]) was observed, and suicide rates were between 3.84 and 5.26 (median, 4.20 [4.08-4.86]). The correlation between inequality and suicide rates was positive and statistically significant (r=.70; p<.001). There is a positive association between economic inequality and suicide rate in Colombia. It is important to achieve greater equity in the distribution of income to reduce suicide rate in the country. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Suicide among the youth in Malaysia: What do we know?

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Bahar, Norharlina; Ismail, Wan Salwina Wan; Hussain, Nurulwafa; Haniff, Jamaiyah; Bujang, Mohamad Adam; Hamid, Abdul Muneer; Yusuff, Yusni; Nordin, Norhayati; Ali, Nor Hayati

2015-06-01

This article aims to study the pattern of youth suicide cases in Malaysia, following which preventive actions can then be planned and practiced to reduce these suicide cases. This is a cross-sectional study looking at notifications of all suicides involving members of the youth population, as had been reported to National Suicide Registry Malaysia from January 1, 2009 to December 31, 2009. Information such as profile demographics and methods of suicide were utilized accordingly. There were 53 youths between the ages of 15 and 24 years reported to have undergone completed suicides. The suicide rate among youths was 1.03 per 100,000 populations in 2009, accounting for the male gender (66.0%), with Indians being the highest suicide completers (40.4% and 5.6 per 100,000 populations). The most common method of suicide was hanging (56.6%) followed by self-poisoning (15.1%). The suicide rate among Malaysian youth is relatively lower compared with other countries in the Asian region. Majority were male, of Indian descent, and were still in secondary school. Preventive actions need to be taken especially for specific groups such as the Indian youth. © 2014 Wiley Publishing Asia Pty Ltd.

Regional changes in charcoal-burning suicide rates in East/Southeast Asia from 1995 to 2011: a time trend analysis.

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Shu-Sen Chang

2014-04-01

Full Text Available Suicides by carbon monoxide poisoning resulting from burning barbecue charcoal reached epidemic levels in Hong Kong and Taiwan within 5 y of the first reported cases in the early 2000s. The objectives of this analysis were to investigate (i time trends and regional patterns of charcoal-burning suicide throughout East/Southeast Asia during the time period 1995-2011 and (ii whether any rises in use of this method were associated with increases in overall suicide rates. Sex- and age-specific trends over time were also examined to identify the demographic groups showing the greatest increases in charcoal-burning suicide rates across different countries.We used data on suicides by gases other than domestic gas for Hong Kong, Japan, the Republic of Korea, Taiwan, and Singapore in the years 1995/1996-2011. Similar data for Malaysia, the Philippines, and Thailand were also extracted but were incomplete. Graphical and joinpoint regression analyses were used to examine time trends in suicide, and negative binomial regression analysis to study sex- and age-specific patterns. In 1995/1996, charcoal-burning suicides accounted for <1% of all suicides in all study countries, except in Japan (5%, but they increased to account for 13%, 24%, 10%, 7%, and 5% of all suicides in Hong Kong, Taiwan, Japan, the Republic of Korea, and Singapore, respectively, in 2011. Rises were first seen in Hong Kong after 1998 (95% CI 1997-1999, followed by Singapore in 1999 (95% CI 1998-2001, Taiwan in 2000 (95% CI 1999-2001, Japan in 2002 (95% CI 1999-2003, and the Republic of Korea in 2007 (95% CI 2006-2008. No marked increases were seen in Malaysia, the Philippines, or Thailand. There was some evidence that charcoal-burning suicides were associated with an increase in overall suicide rates in Hong Kong, Taiwan, and Japan (for females, but not in Japan (for males, the Republic of Korea, and Singapore. Rates of change in charcoal-burning suicide rate did not differ by sex/age group

Regional changes in charcoal-burning suicide rates in East/Southeast Asia from 1995 to 2011: a time trend analysis.

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Chang, Shu-Sen; Chen, Ying-Yeh; Yip, Paul S F; Lee, Won Jin; Hagihara, Akihito; Gunnell, David

2014-04-01

Suicides by carbon monoxide poisoning resulting from burning barbecue charcoal reached epidemic levels in Hong Kong and Taiwan within 5 y of the first reported cases in the early 2000s. The objectives of this analysis were to investigate (i) time trends and regional patterns of charcoal-burning suicide throughout East/Southeast Asia during the time period 1995-2011 and (ii) whether any rises in use of this method were associated with increases in overall suicide rates. Sex- and age-specific trends over time were also examined to identify the demographic groups showing the greatest increases in charcoal-burning suicide rates across different countries. We used data on suicides by gases other than domestic gas for Hong Kong, Japan, the Republic of Korea, Taiwan, and Singapore in the years 1995/1996-2011. Similar data for Malaysia, the Philippines, and Thailand were also extracted but were incomplete. Graphical and joinpoint regression analyses were used to examine time trends in suicide, and negative binomial regression analysis to study sex- and age-specific patterns. In 1995/1996, charcoal-burning suicides accounted for <1% of all suicides in all study countries, except in Japan (5%), but they increased to account for 13%, 24%, 10%, 7%, and 5% of all suicides in Hong Kong, Taiwan, Japan, the Republic of Korea, and Singapore, respectively, in 2011. Rises were first seen in Hong Kong after 1998 (95% CI 1997-1999), followed by Singapore in 1999 (95% CI 1998-2001), Taiwan in 2000 (95% CI 1999-2001), Japan in 2002 (95% CI 1999-2003), and the Republic of Korea in 2007 (95% CI 2006-2008). No marked increases were seen in Malaysia, the Philippines, or Thailand. There was some evidence that charcoal-burning suicides were associated with an increase in overall suicide rates in Hong Kong, Taiwan, and Japan (for females), but not in Japan (for males), the Republic of Korea, and Singapore. Rates of change in charcoal-burning suicide rate did not differ by sex/age group in

Suicide attempts and suicides in Bolivia from 2007 to 2012

DEFF Research Database (Denmark)

Jørs, Erik; Christoffersen, Mette; Veirum, Nikoline Høgsgaard

2014-01-01

(65/77, 85.1%) among those using violent methods such as hanging and jumping compared to non-violent methods (43/84, 50.9%) such as ingesting chemicals and drugs (pdepression, and unwanted pregnancies. Many cases of suicide......BACKGROUND: Suicide attempts and suicides constitute a significant burden on communities and health systems, especially in low income countries. However, many low income countries lack epidemiological information on which to base future preventive strategies. This study reports on gender and age...... profiles as well as the likely background and means used for suicide attempts and suicides in Bolivia. METHOD: This study presents 1124 cases from four different sources of information: (i) emergency ward data with suicide attempts by poisoning from the year 2007, (ii) psychiatric ward data including...

Common causes of poisoning: etiology, diagnosis and treatment.

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Müller, Dieter; Desel, Herbert

2013-10-01

In 2011, German hospitals treated approximately 205 000 patients suffering from acute poisoning. Change is seen over time both in the types of poisoning that occur and in the indications for specific treatment. This article is based on a selective review of the literature, with special attention to the health reports of the German federal government, the annual reports of the GIZ-Nord Poisons Center (the poison information center for the four northwestern states of Germany, i.e. Bremen, Hamburg, Lower Saxony and Schleswig-Holstein), and the recommendations of international medical associations. From 1996 to 2011, the GIZ-Nord Poisons Center answered more than 450 000 inquiries, most of which involved exposures to medical drugs, chemicals, plants, foods, or cosmetics. Poisoning was clinically manifest in only a fraction of these cases. Ethanol intoxication is the commonest type of acute poisoning and suicide by medical drug overdose is the commonest type of suicide by poisoning. Death from acute poisoning is most commonly the result of either smoke inhalation or illegal drug use. Severe poisoning is only rarely due to the ingestion of chemicals (particularly detergents and cleaning products), cosmetics, or plant matter. Medical procedures that are intended to reduce the absorption of a poison or enhance its elimination are now only rarely indicated. Antidotes (e.g., atropine, 4-dimethylaminophenol, naloxone, toluidine blue) are available for only a few kinds of poisoning. Randomized clinical trials of treatment have been carried out for only a few substances. Most exposures to poisons can be treated with general emergency care and, if necessary, with symptomatic intensive-care measures. Poison information centers help ensure that cases of poisoning are dealt with efficiently. The data they collect are a useful aid to toxicological assessment and can serve as a point of departure for research projects.

Poisoning cases and their management in emergency centres of government hospitals in northwest Ethiopia

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Getnet Mequanint Adinew

2017-06-01

Discussion: Young females comprise a group at increased risk for suicidal poisonings. As a developing nation, pesticide and bleaching agents remain a significant cause of acute poisonings in Ethiopia. Intentional poisoning remains the most significant identified cause of poisoning overall.

Tolerance of suicide, religion and suicide rates : an ecological and individual study in 19 Western countries

NARCIS (Netherlands)

Neeleman, J; Halpern, D; Leon, D; Lewis, G

Background. Negative associations between religion and suicide, in individuals and countries, may be mediated by the degree to which suicide is tolerated. Methods. Linear regression was used to examine ecological associations between suicide tolerance, religion and suicide rates in 19 Western

Elderly suicide rates in the United Kingdom: trends from 1979 to 2002.

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Shah, Ajit

2007-01-01

The proportion of elderly in the population is increasing due to a falling birth rate and increased life expectancy, and suicide rates increase with age. Trends in elderly suicide rates over a 24-year period, 1979 to 2002, were examined. Differences in suicide rates between elderly men and women and between the age-bands 65 to 74 years and 75+ years were examined. Data was ascertained from the WHO website. Suicide rates for men and women for the age-bands 65 to 74 years and 75+ years declined over the 24-year study period. Suicide rates were higher in men than women for both the age bands. In men, suicide rates were higher in the 75+ age-band than in the 65 to 74 years age-band. Various national initiatives may have contributed to the decline in suicide rates. The challenge will be to sustain the decline, given that the population is ageing and suicide rates generally increase with age.

Suicide and accidental deaths in children and adolescents in England and Wales, 2001-2010.

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Windfuhr, Kirsten; While, David; Hunt, Isabelle M; Shaw, Jenny; Appleby, Louis; Kapur, Nav

2013-12-01

To investigate the impact of narrative verdicts on suicide statistics among 10-19-year-olds; to identify the number and rate of suicide and accidental deaths, particularly in 10-14-year-olds. National cohort study. England and Wales. Mid-year population estimates from the Office for National Statistics (ONS) were used to calculate rates per 100,000 population for suicide (undetermined and suicide verdicts) and accidental deaths (poisoning, hanging) for those aged 10-14 and 15-19. Trends in rates over time (2001-2010) were investigated using Poisson regression. Interaction tests were carried out to determine differences in trends between the two time periods (2001-2005 and 2006-2010). There were 1523 suicides (2.25/100,000). Suicide rates were highest in those aged 15-19 years (4.04/100,000) and in males (3.14/100,000). Between 2001 and 2010, rates significantly decreased among those aged 15-19 years (incidence rate-ratio (IRR): 0.95; 95% CI 0.93 to 0.97), with no change in rates of accidental deaths (IRR: 1.01, 95% CI 0.95 to 1.07). However, there was a significant interaction between the two time periods for accidental poisonings (2001-2005: IRR: 0.79 (95% CI 0.69 to 0.91); 2006-2010: IRR: 1.01 (95% CI 0.89 to 1.15), interaction p=0.012) and accidental hangings (2001-2005: IRR: 0.93 (95% CI 0.76 to 1.14); 2006-2010: IRR: 1.25 (95% CI 1.04 to 1.49), interaction=0.01) Undetermined deaths significantly decreased among females aged 15-19 yeras (IRR: 0.93; 95% CI 0.88 to 0.98). There were no significant trends among 10-14-year-olds. Rates of suicide are higher among older adolescents and males. There was a significant fall in suicide rates in males aged 15-19 years that was not accounted for by changes in rates of accidental death. The absence of a significant trend in suicide or accidental deaths in those aged 10-14 years may have been the result of small numbers. However, monitoring should continue to identify longitudinal trends in all young people.

Outcome of patients in acute poisoning with ethylene glycol - factors which may have influence on evolution

OpenAIRE

Tanasescu, A; Macovei, RA; Tudosie, MS

2014-01-01

Introduction. Intoxication with ethylene glycol occurs as a result of intentional ingestion in suicide attempts or accidentally. Clinical ethylene glycol poisoning is not specific and occurs in many poisoning cases therefore the diagnosis is difficult. Early diagnostic and establishment of therapy are very important for a favorable evolution. The mortality rate of ethylene glycol intoxication ranges between 1 and 22% depending on the amount of alcohol ingestion and the time period between alc...

Non-fatal self-poisoning across age groups, in Sri Lanka.

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Rajapakse, Thilini; Christensen, Helen; Cotton, Sue; Griffiths, Kathleen Margaret

2016-02-01

Attempted or non-fatal self-poisoning in common in Sri Lanka, but little is known about variation of psychiatric morbidity and suicidal intent across differing ages. The aim of this study was to investigate factors associated with non-fatal self-poisoning in Sri Lanka across three different age groups (namely 14-24 years, 25-34 years and ≥ 35 years). It was anticipated that the findings of the study would inform and guide development of preventive interventions for non-fatal self-poisoning in this country. 935 participants were interviewed within one week of admission to hospital for medical management of non-fatal self-poisoning, over a consecutive 14-month period. Socio-demographic factors, types of poison ingested, triggers and psychiatric morbidity was examined as a function of age. Results showed that a majority (83%) of participants were aged below 35 years. Younger participants aged aged 25-34 years, and ≥ 35 years), who were more likely to ingest pesticides. Recent interpersonal conflict was a proximal trigger seen in all age groups, but suicidal intent, depression and alcohol use disorders increased with age. The overall study findings indicate that most who carry out acts of non-fatal self-poisoning in Sri Lanka are young (aged age groups, but psychiatric morbidity and suicidal intent is higher in the older age groups, as is pesticide ingestion. Age specific interventions may be efficacious in the prevention of non-fatal self-poisoning in Sri Lanka. Copyright © 2016 Elsevier B.V. All rights reserved.

Neurological effects of glufosinate poisoning with a brief review.

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Watanabe, T; Sano, T

1998-01-01

Herbicides containing glufosinate ammonium are widely used in many countries including Japan. Many Japanese cases of accidental and suicidal poisoning by glufosinate have been reported since 1989. We report a case of a 64-year old man who ingested glufosinate in an attempted suicide. The patient suffered mental disturbances and hematological changes together with gastrointestinal effects shortly after ingesting the poison, and later developed generalized convulsions, impaired respiration and circulatory failure. During recovery he exhibited loss of short-term memory (retrograde and anterograde amnesia). Neurotoxicity is a characteristic of glufosinate poisoning, although the mechanism is not clear. From the analysis of clinical symptoms of previously published cases, glufosinate toxicity appears to arise both from the active ingredient and the surfactant in the formulation.

Epidemiology, neurobiology and pharmacological interventions related to suicide deaths and suicide attempts in bipolar disorder: Part I of a report of the International Society for Bipolar Disorders Task Force on Suicide in Bipolar Disorder

Science.gov (United States)

Schaffer, Ayal; Isometsä, Erkki T; Tondo, Leonardo; Moreno, Doris H; Sinyor, Mark; Kessing, Lars Vedel; Turecki, Gustavo; Weizman, Abraham; Azorin, Jean-Michel; Ha, Kyooseob; Reis, Catherine; Cassidy, Frederick; Goldstein, Tina; Rihmer, Zoltán; Beautrais, Annette; Chou, Yuan-Hwa; Diazgranados, Nancy; Levitt, Anthony J; Zarate, Carlos A; Yatham, Lakshmi

2016-01-01

Objectives Bipolar disorder is associated with elevated risk of suicide attempts and deaths. Key aims of the International Society for Bipolar Disorders Task Force on Suicide included examining the extant literature on epidemiology, neurobiology and pharmacotherapy related to suicide attempts and deaths in bipolar disorder. Methods Systematic review of studies from 1 January 1980 to 30 May 2014 examining suicide attempts or deaths in bipolar disorder, with a specific focus on the incidence and characterization of suicide attempts and deaths, genetic and non-genetic biological studies and pharmacotherapy studies specific to bipolar disorder. We conducted pooled, weighted analyses of suicide rates. Results The pooled suicide rate in bipolar disorder is 164 per 100,000 person-years (95% confidence interval = [5, 324]). Sex-specific data on suicide rates identified a 1.7:1 ratio in men compared to women. People with bipolar disorder account for 3.4–14% of all suicide deaths, with self-poisoning and hanging being the most common methods. Epidemiological studies report that 23–26% of people with bipolar disorder attempt suicide, with higher rates in clinical samples. There are numerous genetic associations with suicide attempts and deaths in bipolar disorder, but few replication studies. Data on treatment with lithium or anticonvulsants are strongly suggestive for prevention of suicide attempts and deaths, but additional data are required before relative anti-suicide effects can be confirmed. There were limited data on potential anti-suicide effects of treatment with antipsychotics or antidepressants. Conclusion This analysis identified a lower estimated suicide rate in bipolar disorder than what was previously published. Understanding the overall risk of suicide deaths and attempts, and the most common methods, are important building blocks to greater awareness and improved interventions for suicide prevention in bipolar disorder. Replication of genetic findings and

The effectiveness of suicide prevention programmes: urban and gender disparity in age-specific suicide rates in a Taiwanese population.

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Lung, F-W; Liao, S-C; Wu, C-Y; Lee, M-B

2017-06-01

The effectiveness of suicide prevention programmes is an important issue worldwide today. The impact of urbanization and gender is controversial in suicide rates. Hence, this study adjusted on potential risk factors and secular changes for suicide rates in gender and rural/urban areas. Observational study. A Suicide Prevention Center was established by the Executive Yuan in Taiwan in 2005 and tried to carry out suicidal intervention in the community in every city and town. There were two phases, including the first phase of the programme from 2005 to 2008, and the second phase of the programme from 2009 to 2013. The crude suicide rates data from the period of 1991-2013, which recruited nine urban and 14 rural areas in Taiwan, were extracted from the Taiwanese national mortality data file. The suicide rates in two areas of Taiwan (Taipei city and Yilan County) were further used to compare the differences between urban and rural areas. The results show that unemployment increased the suicide rate in men aged 45-64 years and in women older than 65 years of age in Taiwan. High divorce and unemployment rates resulted in increased suicide rates in men in the city, whereas emotional distress was the main cause of suicides in men in rural areas. The main method of suicide was jumping from a high building for both sexes in the city, whereas drowning was the most common method of suicide for men in rural areas. Following the intervention programme, suicide behaviour began to decrease in all urban and rural areas of Taiwan. This study showed the cumulative effect of the intervention programme in decreasing the suicide rate in Taiwan. Moreover, the gender-specific suicidal rate and disparity in suicidal methods in urban and rural areas should be considered in further preventive strategies in Taiwan. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Acute kidney injury from Paraquat poisoning: a case report. | Slater ...

African Journals Online (AJOL)

Acute kidney injury from Paraquat poisoning: a case report. H. E. Slater, O.C.A. Okoye, O. Okperi, N. Rajora. Abstract. Paraquat is a salt widely used as a herbicide. Although paraquat poisoning is rare in the general population, it may be considered as one of the most toxic poisons frequently used for suicide attempts, and is ...

Suicide rates in the national and expatriate population in Dubai, United Arab Emirates.

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Dervic, Kanita; Amiri, Leena; Niederkrotenthaler, Thomas; Yousef, Said; Salem, Mohamed O; Voracek, Martin; Sonneck, Gernot

2012-11-01

Reports on suicide from the Gulf region are scarce. Dubai is a city with a large expatriate population. However, total and gender-specific suicide rates for the national and expatriate populations are not known. To investigate total and gender-specific suicide rates in the national and expatriate population in Dubai and to elicit socio-demographic characteristics of suicide victims. Registered suicides in Dubai from 2003 to 2009, and aggregated socio-demographic data of suicide victims were analysed. Suicide rates per 100,000 population were calculated. Suicide rate among expatriates (6.3/100,000) was seven times higher than the rate among the nationals (0.9/100,000). In both groups, male suicide rate was more than three times higher than the female rate. Approximately three out of four expatriate suicides were committed by Indians. The majority of suicide victims were male, older than 30 years, expatriate, single and employed, with an education of secondary school level and below. Further research on risk factors for and protective factors against suicide, particularly among the expatriate population, is needed. Epidemiological monitoring of suicide trends at the national level and improvement of UAE suicide statistics would provide useful information for developing suicide prevention strategies.

Suicide by gassing in Hong Kong 2005-2013: Emerging trends and characteristics of suicide by helium inhalation.

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Chang, Shu-Sen; Cheng, Qijin; Lee, Esther S T; Yip, Paul S F

2016-03-01

Increased use of lethal suicide methods can have a profound impact on overall suicide incidence; the epidemic of suicide by barbecue charcoal gas poisoning in some East Asian countries is a recent example. There have been concerns about recent rises in suicide using gases in some Western countries. We investigated suicide by gassing in Hong Kong (2005-2013) using Coroner's files data. The characteristics were compared between suicide by helium inhalation, charcoal gas poisoning, and other methods. About one sixth (1407/8445, 16.7%) of all suicides used gases. Charcoal-burning suicides constituted the majority (97.5%) of them but showed a reduction over the 9-year period (-33%). Helium suicide was not recorded in 2005-2010 but increased from one in 2011 to three in 2012 and 11 in 2013, accounting for 1.2% of all suicides in 2013. Similar to the profile of charcoal-burning suicides, helium suicides were younger and more likely to have debt problem and less likely to receive psychiatric treatment than other suicides. Internet involvement related to the method was found in one third of cases of helium suicide. The small number of helium suicides (n=15) limits the power to examine their characteristics. Suicide by charcoal burning showed a downward trend whilst there was an alarming increase in helium suicide in Hong Kong. Public health measures to prevent an epidemic of helium suicide similar to that of charcoal-burning suicide may include close monitoring of trend, responsible media reporting, and restricting online information about and access to this method. Copyright © 2015 Elsevier B.V. All rights reserved.

AN ANALYTICAL STUDY OF DEATHS DUE TO POISONING IN VISAKHAPATNAM

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V. Chandrasekhar

2017-11-01

Full Text Available BACKGROUND The aim of this study was to determine and classify the various types of poisoning deaths as seen at Andhra Medical College Mortuary, Visakhapatnam city. MATERIALS AND METHODS This is a retrospective study of all the deaths due to poisoning seen in the Department of Forensic Medicine & Toxicology, Andhra Medical College, Visakhapatnam City over a 15 year period (January 2001‐December 2015 as recorded in the autopsy registers and postmortem reports of the department. RESULTS Poisoning is one of the commonest methods of committing suicide especially in developing countries like India. A total of 22475 autopsies were done during the period. Two thousand seventy four cases representing 9.23% of all bodies received by the mortuary were deaths due to poisoning. Organophosphate compounds were the most commonly 78.98% abused substance. The common motive of poisoning was suicidal 93.43%with male to female ratio 6.69:1.Peak incidence was observed in the age group 21-40 years. Type of poison consumed, socioeconomic status and place of household are also ascertained. CONCLUSION This study shows the pattern of poisoning deaths in Visakhapatnam and this preliminary data will provide a baseline for future research and help in formulating policies to prevent deaths due to poisoning.

Effect of the First World War on suicide rates in Ireland: an investigation of the 1864-1921 suicide trends.

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Osman, Mugtaba; Parnell, Andrew C

2015-10-01

Since the proposition of the social integration theory by Émile Durkheim, macro-sociological changes have been speculated to affect suicide rates. This study investigates the effect of the First World War on Irish suicide rates. We applied an interrupted time series design of 1864-1921 annual Irish suicide rates. The 1864-1913 suicide rates exhibited a slow-rising trend with a sharp decline from the year 1914 onwards. The odds for death by suicide for males during the 1914-1918 period was 0.811 (95% CI 0.768-0.963). Irish rates of suicide were significantly reduced during the First World War, most notably for males. None. © 2015 The Royal College of Psychiatrists. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.

Decomposing change in China's suicide rate, 1990-2010: ageing and urbanisation.

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Sha, Feng; Yip, Paul S F; Law, Yik Wa

2017-02-01

The study empirically quantifies the contributions of age composition and urbanisation to changes in the suicide rate in China over the periods 1990-2000 and 2000-2010. A decompositional method was used to quantify the absolute and relative contributions of the age structure; the age-specific proportion of the urban population and the suicide rate of each age-specific, gender-specific and urban/rural cohort to the overall suicide rates in the two 10-year intervals. In the period between 1990 and 2000, a significant decline in the suicide rate among younger age groups (especially young rural women) was identified as the main driving force of the downward trend in the overall suicide rate. In 2000-2010, the rate of decline in suicide was predominantly explained by the drop in the suicide rate among all age groups in rural areas, with the exception of those aged over 80. The positive impact of urbanisation on the decline of the suicide rate has gradually diminished relative to the earlier period. As the positive impact of urbanisation on suicide rates is diminishing, further urbanisation and rapid change in society may induce stress and adjustment problems that are not conducive to the promotion of well-being. Furthermore, as China is facing the prospects of slower economic growth and a rapidly ageing population, suicides among older adults may also be elevated, particularly among those in rural areas with insufficient healthcare and social support. In order to maintain the decreasing trend of suicide in China, it is important for the Chinese government to pay more attention to the mental well-being of the population and to mitigate the stress of urban life and to provide timely support to older adults especially in rural areas. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Suicide among urban South African adolescents.

Science.gov (United States)

Burrows, Stephanie; Laflamme, Lucie

2008-01-01

Knowledge of suicide epidemiology in low- and middle-income settings is important for both well-tailored policies and an increased global understanding of suicide macro-determinants. Adolescents are an important target group in that respect, and those from South Africa are a particular concern, given the additional challenges associated with dramatic political, economic, and health transition. This study presents a profile of adolescent suicide occurrence and sex, race, and city differences. Adolescents aged 10-19 years in post-apartheid urban South Africa. Sex-, race- and city-specific suicide rates were calculated for two age groups (10-14, 15-19 years). Using logistic regression, odds ratios were compiled, first adjusting for age, then additionally for sex, race, and city. Female subjects, those classified as 'coloured' (denoting mixed racial origin), and those living in Tshwane were used as reference groups. Proportions (with 95% confidence intervals) of leading suicide methods were compared. Suicide rates were considerably higher among older adolescents and varied by sex, race, and city. Males had more than twice the odds of committing suicide compared with females. In the fully adjusted model, differences between races were not significant, but city-level differences remained. The leading suicide method was hanging for males and both hanging and poisoning for females. In contemporary urban South Africa, male sex, and city of residence, but not race, were associated with the commission of adolescent suicide, which tends to occur by quite specific methods. The findings warrant research into the possible underlying contextual, demographic, and individual mechanisms.

Suicide rates and information seeking via search engines: A cross-national correlational approach.

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Arendt, Florian

2018-09-01

The volume of Google searches for suicide-related terms is positively associated with suicide rates, but previous studies used data from specific, restricted geographical contexts, thus, limiting the generalizability of this finding. We investigated the correlation between suicide-related search volume and suicide rates of 50 nations from five continents. We found a positive correlation between suicide rates and search volume, even after controlling for the level of industrialization. Results give credence to the global existence of a correlation. However, the reason why suicide-related search volume is higher in countries with higher suicide rates is still unclear and up to future research.

Epidemiology and risk factors of voluntary pesticide poisoning in Morocco (2008-2014).

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Nabih, Zineb; Amiar, Latifa; Abidli, Zakaria; Windy, Maria; Soulaymani, Abdelmajid; Mokhtari, Abdelrhani; Soulaymani-Bencheikh, Rachida

2017-01-01

To determine the epidemiological profile and risk factors of voluntary poisoning by pesticides. A retrospective analysis was conducted of all cases of voluntary poisoning by pesticides registered at the AntiPoison and Pharmacovigilance Center of Morocco between January 2008 and December 2014. During the study period, 2,690 cases of acute pesticide poisoning were registered. The region of Rabat-Salé-Zemmour-Zaer accounted for the largest proportion, with 598 cases. The average age of the patients was 24.63±10.29 years. The sex ratio (female-to-male) was 0.45. Adults and teenagers were most affected by this type of poisoning, with 1,667 cases (62.0%) and 806 cases (30.0%), respectively. Suicide attempts accounted for 98.4% of the cases (2,469 cases). Pesticide poisoning occurred more often in urban zones (64.8%). Insecticides were incriminated in 14.0% of cases, with a mortality rate of 4.2%. Among the 1,635 patients for whom the outcomes were known, 154 died, corresponding to a mortality rate of 5.7%. Voluntary intoxication by pesticides presents a real scourge that affects public health, and in this study, we developed an epidemiological profile of this phenomenon. Nevertheless, this study has limitations in that it did not evaluate the impact of the socioeconomic and psychological factors that are important contributors to this type of poisoning.

Cultural Aspects of Suicide

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Hari D. Maharajh

2005-01-01

Full Text Available Undefined cultural factors cannot be dismissed and significantly contribute to the worldwide incidence of death by suicide. Culture is an all embracing term and defines the relationship of an individual to his environment. This study seeks to investigate the effect of culture on suicide both regionally and internationally. Culture-bound syndrome with suicidal behaviours specific to a particular culture or geographical region are discussed. Opinions are divided as to the status of religious martyrs. The law itself is silent on many aspects of suicidal behaviour and despite decriminalization of suicide as self-murder, the latter remains on the statutes of many developing countries. The Caribbean region is of concern due to its steady rise in mean suicide rate, especially in Trinidad and Tobago where socio-cultural factors are instrumental in influencing suicidal behaviour. These include transgenerational cultural conflicts, psycho-social problems, media exposure, unemployment, social distress, religion and family structure. The methods used are attributed to accessibility and lethality. Ingestion of poisonous substances is most popular followed by hanging. The gender differences seen with regard to suicidality can also be attributed to gender related psychopathology and psychosocial differences in help-seeking behaviour. These are influenced by the cultural environment to which the individual is exposed. Culture provides coping strategies to individuals; as civilization advances many of these coping mechanisms are lost unclothing the genetic predisposition of vulnerable groups. In the management of suicidal behaviour, a system of therapeutic re-culturation is needed with an emphasis on relevant culture- based therapies.

Socio-Cultural Features and Sex Profile of the Individuals with Serious Suicide Attempts in Southeastern Turkey: A One-Year Survey

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Yasan, Aziz; Danis, Ramazan; Tamam, Lut; Ozmen, Sehmus; Ozkan, Mustafa

2008-01-01

Our objective was to elucidate potential causes of higher rates of suicide attempts in females compared to males in southeastern Turkey through a 1-year survey. Gender-related differences observed in 96 subjects who attempted suicide by poisoning for the first time were as follows: in comparison to male, females were predominantly within the age…

Suicide methods in children and adolescents.

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Kõlves, Kairi; de Leo, Diego

2017-02-01

There are notable differences in suicide methods between countries. The aim of this paper is to analyse and describe suicide methods in children and adolescents aged 10-19 years in different countries/territories worldwide. Suicide data by ICD-10 X codes were obtained from the WHO Mortality Database and population data from the World Bank. In total, 101 countries or territories, have data at least for 5 years in 2000-2009. Cluster analysis by suicide methods was performed for countries/territories with at least 10 suicide cases separately by gender (74 for males and 71 for females) in 2000-2009. The most frequent suicide method was hanging, followed by poisoning by pesticides for females and firearms for males. Cluster analyses of similarities in the country/territory level suicide method patterns by gender identified four clusters for both gender. Hanging and poisoning by pesticides defined the clusters of countries/territories by their suicide patterns in youth for both genders. In addition, a mixed method and a jumping from height cluster were identified for females and two mixed method clusters for males. A number of geographical similarities were observed. Overall, the patterns of suicide methods in children and adolescents reflect lethality, availability and acceptability of suicide means similarly to country specific patterns of all ages. Means restriction has very good potential in preventing youth suicides in different countries. It is also crucial to consider cognitive availability influenced by sensationalised media reporting and/or provision of technical details about specific methods.

Heart rate variability analysis in acute poisoning by cholinesterase inhibitors

OpenAIRE

JEONG, JINWOO; KIM, YONGIN

2017-01-01

Heart rate variability (HRV) has been associated with a variety of clinical situations. However, few studies have examined the association between HRV and acute poisoning. Organophosphate (OP) and carbamate inhibit esterase enzymes, particularly acetylcholinesterase, resulting in an accumulation of acetylcholine and thereby promoting excessive activation of corresponding receptors. Because diagnosis and treatment of OP and carbamate poisoning greatly depend on...

Suicide and general elections in Austria: do preceding regional suicide rate differentials foreshadow subsequent voting behavior swings?

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Voracek, Martin; Formann, Anton K; Fülöp, Gerhard; Sonneck, Gernot

2003-05-01

Suicide-epidemiological research on short-term effects of elections on national/regional suicide and parasuicide incidence has yielded contradictory evidence. Reversing the cause-effect relationship of this line of research we investigated whether preceding regional suicide rates are related to subsequent election results. For Austria's 121 districts, we regressed averaged standardized suicide rates for the preceding period (1988-1994) on political parties' subsequent electoral gains/losses (1999-to-1995) while controlling for a set of 12 domain-relevant psychosocial/economic indices. Stepwise weighted multiple regression led to a significant model. The 1999-to-1995 electoral gains/losses of two opposition parties, together with the population variation caused by migration balance and by births/deaths balance, accounted for a substantial part (30%) of the variability in preceding district-level suicide rates. Various other social indices failed to contribute further substantial increments to this model. This finding suggests that variations in preceding regional suicide incidence might be mirrored in subsequent changes in voting behavior. A speculative post hoc explanation for the finding is offered: on a community level, suicide's aftermath might produce socially and politically alienated survivors of suicide who co-shape swings towards opposition parties in subsequent general elections. The finding calls for more research on suicide's long-term aftermath. Within-country replicability and cross-national generalizability await further investigation. At present, the factor/mechanism accounting for this finding is neither well-established nor has been directly tested.

Suicide Following Deliberate Self-Harm.

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Olfson, Mark; Wall, Melanie; Wang, Shuai; Crystal, Stephen; Gerhard, Tobias; Blanco, Carlos

2017-08-01

The authors sought to identify risk factors for repeat self-harm and completed suicide over the following year among adults with deliberate self-harm. A national cohort of Medicaid-financed adults clinically diagnosed with deliberate self-harm (N=61,297) was followed for up to 1 year. Repeat self-harm per 1,000 person-years and suicide rates per 100,000 person-years (based on cause of death information from the National Death Index) were determined. Hazard ratios of repeat self-harm and suicide were estimated by Cox proportional hazard models. During the 12 months after nonfatal self-harm, the rate of repeat self-harm was 263.2 per 1,000 person-years and the rate of completed suicide was 439.1 per 100,000 person-years, or 37.2 times higher than in a matched general population cohort. The hazard of suicide was higher after initial self-harm events involving violent as compared with nonviolent methods (hazard ratio=7.5, 95% CI=5.5-10.1), especially firearms (hazard ratio=15.86, 95% CI=10.7-23.4; computed with poisoning as reference), and to a lesser extent after events of patients who had recently received outpatient mental health care (hazard ratio=1.6, 95% CI=1.2-2.0). Compared with self-harm patients using nonviolent methods, those who used violent methods were at significantly increased risk of suicide during the first 30 days after the initial event (hazard ratio=17.5, 95% CI=11.2-27.3), but not during the following 335 days. Adults treated for deliberate self-harm frequently repeat self-harm in the following year. Patients who use a violent method for their initial self-harm, especially firearms, have an exceptionally high risk of suicide, particularly right after the initial event, which highlights the importance of careful assessment and close follow-up of this group.

Teen Suicide and Changing Cause-of-Death Certification, 1953-1987.

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Males, Mike

1991-01-01

Examined whether tripling in teenage suicides since 1950s represents increase in suicides or in skill of medical examiners. Examined firearms and poisoning death from 1953-87. Concludes that increase in youth suicide is less dramatic than reported, and suicide increase indicated among youths and adults occurred from 1964-71 and has since…

The Study of Electrocardiographic Findings in Patients with Organophosphate Poisoning

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Morteza Rahbar Taromsari

2013-02-01

Full Text Available Background: Cardiac manifestations that occur in a majority of patients with organophosphate (OP poisoning may range from innocuous electrocardiographic manifestations, such as sinus tachycardia, to life-threatening complications, including cardiogenic pulmonary edema and myocardial necrosis. In this study, we evaluated the various electrocardiographic manifestations in patients with OP poisoning. Methods: This retrospective-descriptive study was performed by reviewing the medical records from all patients poisoned with organophosphate admitted to Razi Educational Hospital, Rasht, Iran, from April 2008 to March 2011. Patients with incomplete records were excluded from the study. Histories of all patients were collected and ECG analysis was conducted including the rate, rhythm, ST-T abnormalities, conduction defects, and measurement of PR and QT intervals by a cardiologist. Descriptive statistical analysis was conducted by SPSS software version18. Results: Of the total 100 patients (75 were male with OP poisoning that referred to the Emergency Ward of Razi Hospital, 63 patients presented ECG abnormalities. The mean age of the patients was 35.78 ± 12.91 years. The causes of poisoning were occupational in 71 patients, suicidal in 26 patients, and accidental in 3 patients. Sinus tachycardia (31% was the most common ECG abnormality, followed by non-specific ST-T changes (24%. Overall, mortality rate was 5% and all of the deceased patients presented changes in ECG. Conclusion: OP poisoning is associated with significant ECG abnormalities, especially tachycardia and non-specific ST-T changes.

Some critical methodological issues in secondary analysis of world health organization data on elderly suicide rates.

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Shah, Ajit

2009-07-01

Suicides may be misclassified as accidental deaths in countries with strict legal definitions of suicide, with cultural and religious factors leading to poor registration of suicide and stigma attached to suicide. The concordance between four different definitions of suicides was evaluated by examining the relationship between pure suicide and accidental death rates, gender differences, age-associated trends and potential distil risk and protective factors by conducting secondary analysis of the latest World Health Organisation data on elderly death rates. The four definitions of suicide were: (i) one-year pure suicides rates; one-year combined suicide rates (pure suicide rates combined with accidental death rates); (iii) five-year average pure suicide rates; and (iv) five-year average combined suicides rates (pure suicides rates combined with accidental death rates). The predicted negative correlation between pure suicide and accidental death rates was not observed. Gender differences were similar for all four definitions of suicide. There was a highly significant concordance for the findings of age-associated trends between one-year pure and combined suicide rates, one-year and five-year average pure suicide rates, and five-year average pure and combined suicide rates. There was poor concordance between pure and combined suicide rates for both one-year and five-year average data for the 14 potential distil risk and protective factors, but this concordance between one-year and five-year average pure suicide rates was highly significant. The use of one-year pure suicide rates in cross-national ecological studies examining gender differences, age-associated trends and potential distil risk and protective factors is likely to be practical, pragmatic and resource-efficient.

Effect of the First World War on suicide rates in Ireland: an investigation of the 1864–1921 suicide trends

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Parnell, Andrew C.

2015-01-01

Summary Since the proposition of the social integration theory by Émile Durkheim, macro-sociological changes have been speculated to affect suicide rates. This study investigates the effect of the First World War on Irish suicide rates. We applied an interrupted time series design of 1864–1921 annual Irish suicide rates. The 1864–1913 suicide rates exhibited a slow-rising trend with a sharp decline from the year 1914 onwards. The odds for death by suicide for males during the 1914–1918 period was 0.811 (95% CI 0.768–0.963). Irish rates of suicide were significantly reduced during the First World War, most notably for males. Declaration of interest None. Copyright and usage © 2015 The Royal College of Psychiatrists. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence. PMID:27703742

Family Conflict – The Major Underlying Influence in Suicide Attempts in Northern Bihar, India.

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Sangeeta Nair

2015-01-01

Full Text Available Suicide attempts in North India are generally underreported but have been considered to be rising. The number of admissions due to attempted suicide at Duncan Hospital, North Bihar, rose from 82 in 2007 to 419 in 2011.A structured interview and the WHO (World Health Organization Major (ICD-10 Depression Inventory were completed by 157 suicide-attempt survivors. Immediate relatives were also interviewed. Only 23% of patients came from India; 77% of patients came from Nepal. The highest incidence was in the age group 16-20 years. Females have higher rates in the 21-30 year age group (p=0.012, but after 30 years of age, the number of males becomes higher than the females (p=0.048; 81.5% of the respondents were below the age of 30 years.Pesticide poisoning was the major mode of attempted suicide (94.3%. Using the WHO Major (ICD-10 Depression Inventory, 28 of the participants suffered from depression (17.7%. Ninety people (56.9% admitted to previous thoughts of suicide, and nine (5.7% people had attempted suicide previously.Hindus made up 84.0% of the respondents. Almost 50% of respondents only carried out their religious rituals on an occasional basis or not at all. 70.2% had not completed education beyond primary school, and 49.7% earned less than Rs10,000 per month (US$200. Eighty percent of the participants stated conflicts with family members led to the attempted suicide. Relatives did not expect the attempted suicide in 97.4% of cases. Knowledge of the suicide of a neighbour, friends, or relative influenced 77.0% of the participants to attempt suicide.Efforts to prevent suicide attempts and deaths need to be multifaceted. Banning the most poisonous pesticides and improving poison storage in the community must be encouraged. Prevention, early intervention and treatment all are required in a suicide prevention plan. The lack of psychiatrists necessitates that other professionals and trained non-professionals be utilised in the mental health team

Low validity of Google Trends for behavioral forecasting of national suicide rates.

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Tran, Ulrich S; Andel, Rita; Niederkrotenthaler, Thomas; Till, Benedikt; Ajdacic-Gross, Vladeta; Voracek, Martin

2017-01-01

Recent research suggests that search volumes of the most popular search engine worldwide, Google, provided via Google Trends, could be associated with national suicide rates in the USA, UK, and some Asian countries. However, search volumes have mostly been studied in an ad hoc fashion, without controls for spurious associations. This study evaluated the validity and utility of Google Trends search volumes for behavioral forecasting of suicide rates in the USA, Germany, Austria, and Switzerland. Suicide-related search terms were systematically collected and respective Google Trends search volumes evaluated for availability. Time spans covered 2004 to 2010 (USA, Switzerland) and 2004 to 2012 (Germany, Austria). Temporal associations of search volumes and suicide rates were investigated with time-series analyses that rigorously controlled for spurious associations. The number and reliability of analyzable search volume data increased with country size. Search volumes showed various temporal associations with suicide rates. However, associations differed both across and within countries and mostly followed no discernable patterns. The total number of significant associations roughly matched the number of expected Type I errors. These results suggest that the validity of Google Trends search volumes for behavioral forecasting of national suicide rates is low. The utility and validity of search volumes for the forecasting of suicide rates depend on two key assumptions ("the population that conducts searches consists mostly of individuals with suicidal ideation", "suicide-related search behavior is strongly linked with suicidal behavior"). We discuss strands of evidence that these two assumptions are likely not met. Implications for future research with Google Trends in the context of suicide research are also discussed.

Regional analysis of big five personality factors and suicide rates in Russia.

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Voracek, Martin

2013-08-01

Extending cross-national and intranational studies on possible aggregate-level associations between personality dimensions and suicide prevalence, this study examined the associations of the Big Five personality factors and suicide rates across 32 regions of the Russian Federation. Failing to replicate one key finding of similar geographic studies, namely, a correspondence of higher suicide rates with lower Agreeableness and Conscientiousness (i.e., higher Psychoticism) scores, higher suicide rates corresponded to higher Agreeableness scores. This effect was obtained with one available data source (regional-level Big Five ratings based on the National Character Survey), but not with another (based on the NEO-PI-R measure). All in all, regional suicide rates across Russia were dissociated from regional variation in personality dimensions.

Vital Signs: Trends in State Suicide Rates - United States, 1999-2016 and Circumstances Contributing to Suicide - 27 States, 2015.

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Stone, Deborah M; Simon, Thomas R; Fowler, Katherine A; Kegler, Scott R; Yuan, Keming; Holland, Kristin M; Ivey-Stephenson, Asha Z; Crosby, Alex E

2018-06-08

Suicide rates in the United States have risen nearly 30% since 1999, and mental health conditions are one of several factors contributing to suicide. Examining state-level trends in suicide and the multiple circumstances contributing to it can inform comprehensive state suicide prevention planning. Trends in age-adjusted suicide rates among persons aged ≥10 years, by state and sex, across six consecutive 3-year periods (1999-2016), were assessed using data from the National Vital Statistics System for 50 states and the District of Columbia. Data from the National Violent Death Reporting System, covering 27 states in 2015, were used to examine contributing circumstances among decedents with and without known mental health conditions. During 1999-2016, suicide rates increased significantly in 44 states, with 25 states experiencing increases >30%. Rates increased significantly among males and females in 34 and 43 states, respectively. Fifty-four percent of decedents in 27 states in 2015 did not have a known mental health condition. Among decedents with available information, several circumstances were significantly more likely among those without known mental health conditions than among those with mental health conditions, including relationship problems/loss (45.1% versus 39.6%), life stressors (50.5% versus 47.2%), and recent/impending crises (32.9% versus 26.0%), but these circumstances were common across groups. Suicide rates increased significantly across most states during 1999-2016. Various circumstances contributed to suicides among persons with and without known mental health conditions. States can use a comprehensive evidence-based public health approach to prevent suicide risk before it occurs, identify and support persons at risk, prevent reattempts, and help friends and family members in the aftermath of a suicide.

Acute Poisoning in Elderly; a Five-Year Study (2008-2013 in Hamadan, Iran

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Saeed Afzali

2015-12-01

Conclusion: Deliberate self-harm and poisoning with opioids especially methadone showed a high prevalence in elderly poisoned patients in Hamadan, Iran.  It seems that drug trafficking control, addiction rehabilitation therapies and suicide prevention programs for elderly can be helpful in poisoning reduction in this age group in this part of the country.

[Pesticide poisoning in Moroccan children: epidemiological and prognostic aspects (1990-2008)].

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Achour, Sanae; Khattabi, Asmae; Rhalem, Naïma; Ouammi, Lahcen; Mokhtari, Abdelrhani; Soulaymani, Abdelmajid; Bencheikh, Rachida Soulaymani

2011-01-01

The purpose of this paper is to describe the epidemiological profile of acute pesticide poisoning in children (APP) treated by the Moroccan Poison Control Center (CAPM) and to analyze death cases in order to determine factors predictive of severity. the study is based on a retrospective study of all cases of APP collected by the CAPM over a period of eighteen years (January 1990 to December 2008). Univariate analysis was performed to identify risk factors. 2,672 cases of childhood poisoning by pesticide were collected. The mean age was 5.6 ± 4.57 years. The sex ratio was 1.12. The cause of poisoning was accidental in 87.1% of cases, followed by attempted suicide (12.1%). Organophosphates were the most frequent poison (50.7%), followed by alpha-chloralose (26.5%). The case fatality rate was 3.3%. Mortality was attributed to organophosphates in 30 cases, followed by inorganic derivatives (7 cases) and carbamates (6 cases). A univariate analysis comparing survivors and groups who died showed that rural origin (p = 0.04), voluntary circumstances (p = 0.001), and the type of chemical class of pesticide (p < 0.001) significantly influence fatal poisoning. Acute pesticide poisoning among children is a reality in Morocco. Preventive measures may be needed.

Completed suicides and self-harm in Malaysia: a systematic review.

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Armitage, Christopher J; Panagioti, Maria; Abdul Rahim, Wirda; Rowe, Richard; O'Connor, Rory C

2015-01-01

Most of the research into suicide and self-harm has been conducted in the United States and Europe, yet the volume of research does not reflect the distribution of suicide globally, with Asia accounting for up to 60% of all suicides. The present study systematically reviews the literature to assess the prevalence and correlates of suicidal acts in Malaysia in Southeast Asia. Five relevant databases were searched from inception up to February 2014, and a narrative synthesis of the results from the included studies was performed. Studies were eligible for inclusion if they were correlational survey research and archival/observational research describing self-harm and suicide. Outcomes included completed suicides and self-harm including suicide attempts and self-poisoning, suicide plans and suicidal ideation. In total, 39 studies met the inclusion criteria. The principal findings were that the prevalence of suicide in Malaysia is approximately 6-8 per 100,000 population per year and that there is an excess of suicide among men, people younger than 40 years and the Indian minority group. The past-month prevalence rates of suicidal ideation, plans and attempts are 1.7, 0.9% and 0.5%, respectively, whereas the past-year prevalence rates of suicidal ideation range between 6% and 8%. The present research marks a first step towards understanding the prevalence and correlates of suicide and self-harm in Malaysia. However, the heterogeneity of the included studies was high. Further research into the antecedents, consequences and interventions for suicide and self-harm in the Malaysian context is required. Copyright © 2015 Elsevier Inc. All rights reserved.

Suicide rate trends in the Slovak Republic in 1993-2015

DEFF Research Database (Denmark)

Brazinova, Alexandra; Moravansky, Norbert; Gulis, Gabriel

2017-01-01

BACKGROUND: Suicide is a significant public health issue worldwide, resulting in loss of lives, and burdening societies. AIMS: To describe and analyze the time trends of suicide rates (SRs) in the Slovak Republic in 1993-2015 for targeted suicide prevention strategies. METHODS: Data for this study...... were obtained from the mortality database of the Statistical Office of the Slovak Republic. Crude and standardized annual SRs were calculated. Trends and relative risks of suicide according to age and sex were analyzed by joinpoint regression and negative binomial regression. RESULTS: In total......, there were 14,575 suicides in the Slovak Republic in the period 1993-2015 (85.3% were men). The overall average age-standardized SR for the study period was 11.45 per 100,000 person years. The rate increases with age, the highest is in men aged 75+ (42.74 per 100,000 person years). Risk of suicide is six...

The influence of media reporting of the suicide of a celebrity on suicide rates: a population-based study.

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Cheng, Andrew T A; Hawton, Keith; Lee, Charles T C; Chen, Tony H H

2007-12-01

The impact of media reporting of suicides of entertainment celebrities may affect suicide rates due to an imitation effect. We investigated the impact on suicides of the media reporting of the suicide of a male television celebrity. All suicides during 2003-2005 in Taiwan (n = 10,945) were included in this study. A Poisson time series autoregression analysis was conducted to examine whether there was an increase in suicides during the 4-week period after extensive media reporting of the celebrity suicide. After controlling for seasonal variation, calendar year, temperature, humidity and unemployment rate, there was a marked increase in the number of suicides during the 4-week period after media reporting (relative risk = 1.17, 95% CI 1.04-1.31). The increase was in men (relative risk = 1.30, 95% CI 1.14-1.50) and for the individuals using the same highly lethal method (hanging) as the TV actor did (relative risk = 1.51, 95% CI 1.25-1.83). However, the age groups in which the increase occurred were younger than the age of the celebrity. The extensive media reporting of the celebrity suicide was followed by an increase in suicides with a strong implication of a modelling effect. The results provide further support for the need for more restrained reporting of suicides as part of suicide prevention strategies to decrease the imitation effect.

Epidemiologic study of Organophosphate and Organochlorate pesticides poisoning in hospitalized patients in khorramabad Shohada Ashayer hospital from Mars to August 2006

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ghafar ali Mahmoudi

2008-04-01

Full Text Available Abstract Background: poisoning is one of the most common medical emergencies. Every year many people refer to emergency wards due to poisoning and some of them are treated and some die because of severe complications. Most patients who refer to emergency wards are those who commit intentionally to suicide. This study is conducted to determine the prevalence of poisoning with pesticide (organophosphate and organochlorine in persons referred to Shohada Ashaier hospital of Khorramabad in the first six months in 2006. Metrials and methods: Required information of poisoned people with poisoning pesticide (organophosphate and organochlorine were collected using questionnaires which were distributed among the subjects. Results: In this study 153 patients including 118 patients who poisoned with organophophate and 35 patents with organochlorine were studied. Most of the patients (34.6% aged between 21-71 years including 57.5% female and 42.5% male and their education was about under secondary school, 91.5% of them attempted to suicided. The total mortality rate was 12 that 7 of them died by toxifications with organochlorine and 5 cases by organophosphate, which in turn was due to their respiratory complications like ARDS and aspiration pneumonia. Conclusion: findings indicate that due to high prevalence and mortality of poisoning with pesticides, this problem should be taken into consideration.

Epidemiology and risk factors of voluntary pesticide poisoning in Morocco (2008-2014)

Science.gov (United States)

2017-01-01

OBJECTIVES To determine the epidemiological profile and risk factors of voluntary poisoning by pesticides. METHODS A retrospective analysis was conducted of all cases of voluntary poisoning by pesticides registered at the AntiPoison and Pharmacovigilance Center of Morocco between January 2008 and December 2014. RESULTS During the study period, 2,690 cases of acute pesticide poisoning were registered. The region of Rabat-Salé-Zemmour-Zaer accounted for the largest proportion, with 598 cases. The average age of the patients was 24.63±10.29 years. The sex ratio (female-to-male) was 0.45. Adults and teenagers were most affected by this type of poisoning, with 1,667 cases (62.0%) and 806 cases (30.0%), respectively. Suicide attempts accounted for 98.4% of the cases (2,469 cases). Pesticide poisoning occurred more often in urban zones (64.8%). Insecticides were incriminated in 14.0% of cases, with a mortality rate of 4.2%. Among the 1,635 patients for whom the outcomes were known, 154 died, corresponding to a mortality rate of 5.7%. CONCLUSIONS Voluntary intoxication by pesticides presents a real scourge that affects public health, and in this study, we developed an epidemiological profile of this phenomenon. Nevertheless, this study has limitations in that it did not evaluate the impact of the socioeconomic and psychological factors that are important contributors to this type of poisoning. PMID:28882026

Epidemiology and risk factors of voluntary pesticide poisoning in Morocco (2008-2014

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Zineb Nabih

2017-09-01

Full Text Available OBJECTIVES To determine the epidemiological profile and risk factors of voluntary poisoning by pesticides. METHODS A retrospective analysis was conducted of all cases of voluntary poisoning by pesticides registered at the AntiPoison and Pharmacovigilance Center of Morocco between January 2008 and December 2014. RESULTS During the study period, 2,690 cases of acute pesticide poisoning were registered. The region of Rabat-Salé-Zemmour-Zaer accounted for the largest proportion, with 598 cases. The average age of the patients was 24.63±10.29 years. The sex ratio (female-to-male was 0.45. Adults and teenagers were most affected by this type of poisoning, with 1,667 cases (62.0% and 806 cases (30.0%, respectively. Suicide attempts accounted for 98.4% of the cases (2,469 cases. Pesticide poisoning occurred more often in urban zones (64.8%. Insecticides were incriminated in 14.0% of cases, with a mortality rate of 4.2%. Among the 1,635 patients for whom the outcomes were known, 154 died, corresponding to a mortality rate of 5.7%. CONCLUSIONS Voluntary intoxication by pesticides presents a real scourge that affects public health, and in this study, we developed an epidemiological profile of this phenomenon. Nevertheless, this study has limitations in that it did not evaluate the impact of the socioeconomic and psychological factors that are important contributors to this type of poisoning.

Fatal aluminium phosphide poisoning

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Meena Mahesh Chand

2015-06-01

Full Text Available Aluminium phosphide (AlP is a cheap solid fumigant and a highly toxic pesticide which is commonly used for grain preservation. AlP has currently aroused interest with a rising number of cases in the past four decades due to increased use for agricultural and non-agricultural purposes. Its easy availability in the markets has increased also its misuse for committing suicide. Phosphine inhibits cellular oxygen utilization and can induce lipid peroxidation. Poisoning with AlP has often occurred in attempts to commit suicide, and that more often in adults than in teenagers. This is a case of suicidal consumption of aluminium phosphide by a 32-year-old young medical anesthetist. Toxicological analyses detected aluminium phosphide. We believe that free access of celphos tablets in grain markets should be prohibited by law.

Associations Between the Macroeconomic Indicators and Suicide Rates in India: Two Ecological Studies.

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Rajkumar, Anto P; Senthilkumar, P; Gayathri, K; Shyamsundar, G; Jacob, K S

2015-01-01

While western studies have focused on the importance of psychiatric illnesses in the complex pathways leading to suicides, several Indian studies have highlighted the important contributions by economic, social, and cultural factors. Hence, we tested the hypothesis that annual national suicide rates and suicide rates of the different states in India were associated with macroeconomic indices. Data from the National crime records bureau, Ministry of finance, labour bureau, Government of India, population commission, and planning commission official portals, World Bank and the United Nations were accessed. We assessed the correlations of annual national and state-wise suicide rates with macroeconomic, health, and other indices using ecological study design for India, and for its different states and union territories. We documented statistically significant associations between the suicide rates and per capita gross domestic product, consumer price index, foreign exchange, trade balance, total health expenditure as well as literacy rates. As recent economic growth in India is associated with increasing suicide rates, macroeconomic policies emphasizing equitable distribution of resources may help curtailing the population suicide rates in India.

Relation Between Rates of Geriatric Suicide and Consumption of Alcohol Beverages in European Countries

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Leo Sher

2006-01-01

Full Text Available Among older adults, suicide is a significant and persistent health problem. The highest suicide rate is found among white men aged 65 years and older. The causes of elder suicide are multifaceted. Although no predominate factor precipitates or explains geriatric suicide, alcohol is strongly linked to suicide attempts and completions. This study examined the relationship between rates of suicide in 65- to 74-year-olds and per capita consumption of alcoholic beverages in European countries. Data on suicide rates in 65- to 74-year-olds and per capita consumption of alcoholic beverages were obtained from the World Health Organization databases. Correlations were computed to examine relationships between suicide rates in 65- to 74-year-old males and females and per capita consumption of beer, wine, and spirits in the general population in 34 European countries. There was a positive correlation between suicide rates in 65- to 74-year-old males and per capita consumption of spirits. No correlations between suicide rates in 65- to 74-year-old males and per capita consumption of beer or wine were found. We also found no correlations between rates of suicide in 65- to 74-year-old females and per capita consumption of beer, wine, or spirits. The results of this study are consistent with reports that consumption of spirits is associated with suicide events. It is to be hoped that this paper will stimulate further studies that are necessary to clarify the relation between suicide rates in different age groups and consumption of alcoholic beverages, and attract more attention to the problem of geriatric suicide.

Suicide and the 2008 economic recession: Who is most at risk? Trends in suicide rates in England and Wales 2001–2011

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Coope, Caroline; Gunnell, David; Hollingworth, William; Hawton, Keith; Kapur, Nav; Fearn, Vanessa; Wells, Claudia; Metcalfe, Chris

2014-01-01

The negative impacts of previous economic recessions on suicide rates have largely been attributed to rapid rises in unemployment in the context of inadequate social and work protection programmes. We have investigated trends in indicators of the 2008 economic recession and trends in suicide rates in England and Wales in men and women of working age (16–64 years old) for the period 2001–2011, before, during and after the economic recession, our aim was to identify demographic groups whose suicide rates were most affected. We found no clear evidence of an association between trends in female suicide rates and indicators of economic recession. Evidence of a halt in the previous downward trend in suicide rates occurred for men aged 16–34 years in 2006 (95% CI Quarter 3 (Q3) 2004, Q3 2007 for 16–24 year olds & Q1 2005, Q4 2006 for 25–34 year olds), whilst suicide rates in 35–44 year old men reversed from a downward to upward trend in early 2010 (95% CI Q4 2008, Q2 2011). For the younger men (16–34 years) this change preceded the sharp increases in redundancy and unemployment rates of early 2008 and lagged behind rising trends in house repossessions and bankruptcy that began around 2003. An exception were the 35–44 year old men for whom a change in suicide rate trends from downwards to upwards coincided with peaks in redundancies, unemployment and rises in long-term unemployment. Suicide rates across the decade rose monotonically in men aged 45–64 years. Male suicide in the most-to-medium deprived areas showed evidence of decreasing rates across the decade, whilst in the least-deprived areas suicide rates were fairly static but remained much lower than those in the most-deprived areas. There were small post-recession increases in the proportion of suicides in men in higher management/professional, small employer/self-employed occupations and fulltime education. A halt in the downward trend in suicide rates amongst men aged 16–34 years, may have begun

EPIDEMIOLOGY OF CARBON MONOXIDE POISONING IN LJUBLJANA FROM 1990 TO 1999

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Miran Brvar

2002-02-01

Full Text Available Background. Carbon monoxide (CO is the most common lethal poisoning. The incidence of sublethal CO poisoning in Slovenia is not known. The aim of the study was to investigate the epidemiology of sublethal acute CO poisoning in Ljubljana region (Slovenia.Methods. A retrospective study involved CO poisoned patients admited to Poison Control Centre and Centre of Intensive Care Medicine of the University Medical Centre Ljubljana, between January 1, 1990 and December 31, 1999.Results. There were annualy approximately 2.4 cases of sublethal CO poisonings per 100.000 population in Ljubljana region. Of these, 25% were suicide attempts and 75% were unintentional poisonings (28% happened in domestic environment as a result of heating, cooking or bathing, 22% were associated with fire, 11% happened in the working site, 10% happened in the workroom at home and only 3% occurred in the moving vehicle. Among the patients there were 72% male and 28% female. The domestic source of CO was a gas water heater or residential heating device in the 63% of the cases, a coal stove in the 32% and an oil heater in the 6%. In the 18% of the suicide attempts we found also acute drug or alcohol intoxication, and 18% of patients poisoned in the fire were intoxicated with alcohol. Collective poisoning happened in the 25% of cases affecting from 2 to 6 persons.Conclusions. The incidence of sublethal CO poisoning in Ljubljana region appers to be seven times lower than in other countries. The main reason is misdiagnosing of CO poisoning. In the future we should consider CO poisoning more often, particularly in all patients with flu-like symptoms, unexplained headache and worsening of pre-existing diseases. We should always exclude the collective poisoning and the presence of alcohol or other drugs.

Delayed encephalopathy after acute carbon monoxide poisoning

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Mehmet İbrahim Turan

2014-03-01

Full Text Available Carbon monoxide poisoning is a major cause of death following attempted suicide and accidental exposures. Although clinical presentation depends on the duration and the intensity of exposure, the assessment of the severity of intoxication is difficult. A small percentage of patients who show complete initial recovery may develop delayed neurological deficits. Delayed encephalopathy after acute carbon monoxide poisoning is a rare and poor prognosis neurologic disorders and there is no specific treatment. We present a case with early onset of delayed encephalopathy after acute carbon monoxide poisoning with typical cranial imaging findings in a child with atypical history and clinical presentation.

Age-Related Racial Disparity in Suicide Rates Among U.S. Youth

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... May 30, 2018 Age-Related Racial Disparity in Youth Suicide Rates May 21, 2018 News by Year 2018 ... May 30, 2018 Age-Related Racial Disparity in Youth Suicide Rates May 21, 2018 News by Year 2018 ...

Suicide and ethnicity in Malaysia.

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Murty, Om Prakash; Cheh, Lo Boon; Bakit, Pangie Anak; Hui, Foo Jhi; Ibrahim, Zarina Binti; Jusoh, Nazirah Binti

2008-03-01

This article highlights methods of ending life in different ethnic groups. This inference is drawn from analysis of data from suicidal cases from the University Malaya Medical Centre mortuary. This study also looked at sex, age, social, and employment factors. Kuala Lumpur has sizeable populations of Muslims, Chinese, Indians and Indonesian, etc. This study is based on 251 cases of suicide that were reported at the University Malaya Medical Centre from 2000 to 2004. Malaysia has a population of 22,662,365 people with 3 major ethnic groups: Malay (58%), Chinese (24%), and Indians (8%) with a minority of "others" (10%), which includes foreigners, Sabahan, and Sarawakian. This research found suicides of 164 male (65%) and 87 female (35%) victims. Their age ranged from 15 to 80 years. The age group from 21 to 30 had the highest total cases of suicide (83 of 251; 33.1%). Among ethnic groups highest rate of suicide was among Chinese with a total of 120 cases (120 of 251; 47.8%). As far as lone method of suicide is concerned, hangings accounted for the highest proportion of cases (108 of 251; 43%). Among ethnic groups, jumping from height was the commonest method used by Chinese (49 of 120; 41%), Malay (9 of 16; 56%), and others (15 of 28; 53.4%); whereas, hanging was the commonest method of committing suicide by Indians (49 of 87); Muslims showed the lowest cases of suicide (18 of 251; 7.2%). In poisoning group Indian was the highest ethnic group who used this method (20 of 37; 54.1%).

The relationship between elderly suicide rates and the internet: a cross-national study.

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Shah, Ajit

2010-05-01

Suicide rates generally increase with age. Internet websites and chat rooms have been reported both to promote suicides and to have a positive beneficial effect on suicidal individuals. The role of the internet in elderly suicides has not been studied. The relationship between elderly suicide rates and the prevalence of internet users was examined in a cross-national study using data from the World Health Organization and the United Nations website. The prevalence of internet users was significantly and positively correlated with suicide rates in both genders in the age bands 65-74 years and 75+ years. On multiple regression analysis the prevalence of internet users was independently associated with suicide rates in both genders in both age bands. Caution should be exercised in the attribution of a causal relationship and the direction of this relationship because of the cross-sectional and ecological study design whereby the findings are subject to ecological fallacy. However, the findings identify and support a need for further research.

Socio-economic factors and suicide rates in European Union countries.

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Ferretti, Fabio; Coluccia, Anna

2009-04-01

Are socio-economic factors valid determinants of suicide? The modern sociological theory of suicide is based on Durkheim's studies. In addition to these fundamental social determinants, modern theorists have put more attention on economic factors. The purpose of the research is to determine the relationship between suicide rates and socio-economic factors, such as demography, economic development, education, healthcare systems, living conditions and labour market. All data were collected from a Eurostat publication and they concern 25 European Union countries. In order to test this relationship, a discriminant analysis was performed using an ordinal dependent variable and a set of independent variables concerning socio-economic factors. A dataset of 37 independent variables was used. We estimated a model with five variables: annual growth rates for industry, people working in S&T (% of total employment), at-risk-of-poverty rate, all accidents (standardized rates), and healthcare expenditures (% of GDP). Highly significant values of Wilk's Lambda assess a good discriminating power of the model. The accuracy too is very high: all cases are correctly classified by the model. Countries with high suicide rate levels are marked by high levels of at-risk-of-poverty rates, high annual growth rates for industry and low healthcare expenditures.

Did the suicide barrier work after all? Revisiting the Bloor Viaduct natural experiment and its impact on suicide rates in Toronto.

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Sinyor, Mark; Schaffer, Ayal; Redelmeier, Donald A; Kiss, Alex; Nishikawa, Yasunori; Cheung, Amy H; Levitt, Anthony J; Pirkis, Jane

2017-06-19

This research aims to determine the long-term impact of the Bloor Street Viaduct suicide barrier on rates of suicide in Toronto and whether media reporting had any impact on suicide rates. Natural experiment. City of Toronto, Canada; records at the chief coroner's office of Ontario 1993-2003 (11 years before the barrier) and 2004-2014 (11 years after the barrier). 5403 people who died by suicide in the city of Toronto. Changes in yearly rates of suicide by jumping at Bloor Street Viaduct, other bridges including nearest comparison bridge and walking distance bridges, and buildings, and by other means. Suicide rates at the Bloor Street Viaduct declined from 9.0 deaths/year before the barrier to 0.1 deaths/year after the barrier (incidence rate ratio (IRR) 0.005, 95% CI 0.0005 to 0.19, p=0.002). Suicide deaths from bridges in Toronto also declined significantly (IRR 0.53, 95% CI 0.40 to 0.71, psuicide at the Bloor Street Viaduct were associated with an increase in suicide-by-jumping from bridges the following year. The current study demonstrates that, over the long term, suicide-by-jumping declined in Toronto after the barrier with no associated increase in suicide by other means. That is, the barrier appears to have had its intended impact at preventing suicide despite a short-term rise in deaths at other bridges that was at least partially influenced by a media effect. Research examining barriers at other locations should interpret short-term results with caution. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A replication of the relationship between elderly suicides rates and elderly dependency ratios: cross-national study

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Shah, Ajit

2010-01-01

Abstract: Background: A positive correlation between elderly dependency ratios and elderly suicide rates has been observed using one-year cross-sectional data on elderly suicide rates. Methods: A cross-national study designed to replicate this positive correlation between elderly dependency ratios and elderly suicide rates was undertaken by: (i) using one-year average of five years data on suicide rates; and (ii) using more recent data on both elderly suicide rates and elderly dependency ratios. Data on elderly suicide rates, and the total number of elderly and young people was ascertained from the World Health Organization website. Results: The main findings were of significant positive correlations between elderly dependency ratios and suicide rates in both sexes in both the elderly age-bands (65-74 years and 75+ years). Conclusions: The replication of the positive correlations between elderly dependency ratios and elderly suicide rates by using one-year average of five years data on suicide rates suggests that this relationship is robust and accurate. PMID:21483194

Solar radiation increases suicide rate after adjusting for other climate factors in South Korea.

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Jee, Hee-Jung; Cho, Chul-Hyun; Lee, Yu Jin; Choi, Nari; An, Hyonggin; Lee, Heon-Jeong

2017-03-01

Previous studies have indicated that suicide rates have significant seasonal variations. There is seasonal discordance between temperature and solar radiation due to the monsoon season in South Korea. We investigated the seasonality of suicide and assessed its association with climate variables in South Korea. Suicide rates were obtained from the National Statistical Office of South Korea, and climatic data were obtained from the Korea Meteorological Administration for the period of 1992-2010. We conducted analyses using a generalized additive model (GAM). First, we explored the seasonality of suicide and climate variables such as mean temperature, daily temperature range, solar radiation, and relative humidity. Next, we identified confounding climate variables associated with suicide rate. To estimate the adjusted effect of solar radiation on the suicide rate, we investigated the confounding variables using a multivariable GAM. Suicide rate showed seasonality with a pattern similar to that of solar radiation. We found that the suicide rate increased 1.008 times when solar radiation increased by 1 MJ/m 2 after adjusting for other confounding climate factors (P Solar radiation has a significant linear relationship with suicide after adjusting for region, other climate variables, and time trends. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Are elderly dependency ratios associated with general population suicide rates?

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Shah, Ajit

2011-05-01

The elderly population size is increasing worldwide due to falling birth rates and increasing life expectancy. It has been hypothesized that as the elderly dependency ratio (the ratio of those over the age of 65 years to those under 65) increases, there will be fewer younger people available to care for older people and this, in turn, will increase the burden on younger carers with increased levels of psychiatric morbidity leading to an increase in general population suicide rates. A cross-national study examining the relationship between elderly dependency ratios and general population suicide rates was conducted using data from the World Health Organization and the United Nations websites. The main findings were of a significant and independent positive correlation between elderly dependency ratios and general population suicide rates in both genders. The contribution of cross-national differences in psychiatric morbidity in younger carers on general population suicide rates requires further study. The prevalence of psychiatric morbidity in younger carers of older people should be examined by: (i) cross-national studies using standardized measures of psychiatric morbidity that are education-free, culture-fair and language-fair; and (ii) within-country longitudinal studies with changing elderly dependency ratios over time.

Study of trends of poisoning in the cases reported to government hospital, Yavatmal

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Yuganti Prabhakar Vaidya

2012-01-01

Full Text Available Context: India is a developing country in south Asia. Rural population of this country is mostly dependant on agriculture. Pesticides, mainly the organophosphorus compounds are the most frequently used substances in agriculture and thus are easily accessible. Animal bites such as snake bite, scorpion bites are also common, as people here are mainly involved in the field work. Aims: This includes, knowing the pattern of poisoning in India along with various parameters, such as mode of poisoning, type of poison, outcome of the poisoning, the most vulnerable age group involved in poisoning, so that the study will help in rapid clinical diagnosis and immediate treatment of the cases leading to decreased mortality and morbidity. Setting and design: Retrospective observational study. Materials and Methods: The study was conducted at Govt. Hospital, Yavatmal. Poisoning cases reported to casualty and post-mortem cases of poisoning brought to the hospital from 01/06/2003 to 30/05/2004 were included in the study. Result: Total 1003 patients studied; acute poisoning in the age group of 21-30 years was the most common with higher frequency in males. Most common mode was suicidal. Most common agent responsible for poisoning was organophosphorus compounds followed by snake bite. Overall mortality due to poisoning was 12%. It was highest in insecticidal poisoning. Conclusion: It was seen that adults between 21 and 30 years of age were more prone to suicidal poisoning with organophosphorous compounds followed by accidental poisoning due to snake bite. Steps are needed to be taken to educate the people, to improve their socioeconomic status and also to provide better treatment facilities at grass root level.

Improving suicide mortality statistics in Tarragona (Catalonia, Spain) between 2004-2012.

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Barbería, Eneko; Gispert, Rosa; Gallo, Belén; Ribas, Gloria; Puigdefàbregas, Anna; Freitas, Adriana; Segú, Elena; Torralba, Pilar; García-Sayago, Francisco; Estarellas, Aina

2016-07-20

Monitoring and preventing suicidal behaviour requires, among other data, knowing suicide deaths precisely. They often appear under-reported or misclassified in the official mortality statistics. The aim of this study is to analyse the under-reporting found in the suicide mortality statistics of Tarragona (a province of Catalonia, Spain). The analysis takes into account all suicide deaths that occurred in the Tarragona Area of the Catalan Institute of Legal Medicine and Forensic Sciences (TA-CILMFS) between 2004 and 2012. The sources of information were the death data files of the Catalan Mortality Register, as well as the Autopsies Files of the TA-CILMFS. Suicide rates and socio-demographic profiles were statistically compared between the suicide initially reported and the final one. The mean percentage of non-reported cases in the period was 16.2%, with a minimum percentage of 2.2% in 2005 and a maximum of 26.8% in 2009. The crude mortality rate by suicide rose from 6.6 to 7.9 per 100,000 inhabitants once forensic data were incorporated. Small differences were detected between the socio-demographic profile of the suicide initially reported and the final one. Supplementary information was obtained on the suicide method, which revealed a significant increase in poisoning and suicides involving trains. An exhaustive review of suicide deaths data from forensic sources has led to an improvement in the under-reported statistical information. It also improves the knowledge of the method of suicide and personal characteristics. Copyright © 2016 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

The influence of economic business cycles on United States suicide rates.

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Wasserman, I M

1984-01-01

A number of social science investigators have shown that a downturn in the economy leads to an increase in the suicide rate. However, the previous works on the subject are flawed by the fact that they employ years as their temporal unit of analysis. This time period is so large that it makes it difficult for investigators to precisely determine the length of the lag effect, while at the same time removing the autocorrelation effects. Also, although most works on suicide and the business cycle employ unemployment as a measure of a downturn in the business cycle, the average duration of unemployment represents a better measure for determining the social impact of an economic downturn. From 1947 to 1977 the average monthly duration of unemployment is statistically related to the suicide rate using multivariate time-series analysis. From 1910 to 1939 the Ayres business index, a surrogate measure for movement in the business cycle, is statistically related to the monthly suicide rate. An examination of the findings confirms that in most cases a downturn in the economy causes an increase in the suicide rate.

Suicide among children and adolescents in Canada: trends and sex differences, 1980-2008.

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Skinner, Robin; McFaull, Steven

2012-06-12

Suicide is the second leading cause of death for young Canadians (10-19 years of age)--a disturbing trend that has shown little improvement in recent years. Our objective was to examine suicide trends among Canadian children and adolescents. We conducted a retrospective analysis of standardized suicide rates using Statistics Canada mortality data for the period spanning from 1980 to 2008. We analyzed the data by sex and by suicide method over time for two age groups: 10-14 year olds (children) and 15-19 year olds (adolescents). We quantified annual trends by calculating the average annual percent change (AAPC). We found an average annual decrease of 1.0% (95% confidence interval [CI] -1.5 to -0.4) in the suicide rate for children and adolescents, but stratification by age and sex showed significant variation. We saw an increase in suicide by suffocation among female children (AAPC = 8.1%, 95% CI 6.0 to 10.4) and adolescents (AAPC = 8.0%, 95% CI 6.2 to 9.8). In addition, we noted a decrease in suicides involving poisoning and firearms during the study period. Our results show that suicide rates in Canada are increasing among female children and adolescents and decreasing among male children and adolescents. Limiting access to lethal means has some potential to mitigate risk. However, suffocation, which has become the predominant method for committing suicide for these age groups, is not amenable to this type of primary prevention.

Rhabdomyolysis as a manifestation of clomipramine poisoning

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Nathalie Oliveira de Santana

Full Text Available CONTEXT: Tricyclic antidepressive agents are widely used in suicide attempts and present a variety of deleterious effects. Rhabdomyolysis is a rare complication of such poisoning. CASE REPORT: A 55-year-old woman ingested 120 pills of 25 mg clomipramine in a suicide attempt two days before admission. After gastric lavage in another emergency department on the day of intake, 80 pills were removed. On admission to our department, she was disoriented, complaining of a dry mouth and tremors at the extremities. An electrocardiogram showed a sinus rhythm with narrow QRS complexes. Laboratory results showed high creatine phosphokinase (CK = 15,094 U/l on admission; normal range = 26 to 140 U/l, hypocalcemia, slightly increased serum transaminases and mild metabolic acidosis. The patient's medical history included depression with previous suicide attempts, obsessive-compulsive disorder, hypothyroidism and osteoporosis. She presented cardiac arrest with pulseless electric activity for seven minutes and afterwards, without sedation, showed continuous side-to-side eye movement. She developed refractory hypotension, with need for vasopressors. Ceftriaxone and clindamycin administration was started because of a hypothesis of bronchoaspiration. The patient remained unresponsive even without sedation, with continuous side-to-side eye movement and a decerebrate posture. She died two months later. Rhabdomyolysis is a very rare complication of poisoning due to tricyclic drugs. It had only previously been described after an overdose of cyclobenzaprine, which has a toxicity profile similar to tricyclic drugs. CONCLUSIONS: Although arrhythmia is the most important complication, rhabdomyolysis should be investigated in cases of clomipramine poisoning.

Suicide in India: a four year retrospective study.

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Mohanty, Sachidananda; Sahu, Geeta; Mohanty, Manoj Kumar; Patnaik, Manju

2007-05-01

Suicide is one of the ten leading causes of death in the world, accounting for more than a million deaths annually. The purpose of the study was to identify the risk groups. In the four-year period from January 2000 to December 2003, 588 suicide victims were autopsied. Information was obtained by interviewing the acquaintances of the victim, perusal of hospital records and the autopsy findings. All the cases were analyzed as to sex, age, and methods of suicide, seasonal variation, diurnal variation and other sociological aspects. The present study depicts a suicidal rate of 11.76 per 100,000 population. Males and females were almost equally the sufferers. The largest number of victims were found in the age group of 21-30 years. Hanging and poisoning constituted the two major modes of suicides (63%). Majority of the victims were mentally sound, married and were from rural background. Victims were mostly drawn from low socioeconomic status (48%). Less educated or illiterates were usually the victims. Suicidal note was detected in 5% of cases. Suicidal tendency and alcohol intake could not be encountered in most of the cases. Indoor incidence was almost double of the outdoor incidence, mostly seen in rainy season (43%) and occurred almost equally during day and night. Financial burden (37%) and marital disharmony (35%) were the principal reasons for the suicide.

Does adversity early in life affect general population suicide rates? a cross-national study

OpenAIRE

Ritesh Bhandarkar; Ajit Shah

2011-01-01

Abstract: Background: Adversity early in life has been suggested as a protective factor for elderly suicides. However, studies examining this relationship in general population suicide rates are scarce. Methods: The relationship between general population suicide rates and four proxy measures of adversity earlier in life was examined using data from the World Health Organization and the United Nations data banks. Results: General population suicide rates were negatively correlated with the pe...

Comparison of poisonings managed at military and Veterans Administration hospitals reported to Texas poison centers.

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Forrester, M B

2017-01-01

There is little information on poisonings managed at military and Veterans Administration (VA) hospitals. This investigation described and compared poisonings reported to Texas poison centers that were managed at military and VA hospitals. Retrospective analysis of poison centre data. Cases were poisonings among patients aged 18 years or more reported to Texas poison centers during 2000-2015 where management occurred at a military or VA hospital. The distribution of exposures for various demographic and clinical factors was determined for military and veterans hospitals and comparisons were made between the two groups. There were 4353 and 1676 poisonings managed at military and VA hospitals, resepctively. Males accounted for 50.5% of the military hospital patients and 84.9% of the VA hospital patients. The mean age for military hospital patients was 31 years and for VA hospital patients was 50 years. The proportion of poisonings managed at military hospitals and VA hospitals, respectively, were intentional (70.0% vs 64.1%), particularly suspected attempted suicide (57.3% vs 47.7%), and unintentional (25.0% vs 30.5%). More than one substance was reported in 37.7% of military and 33.2% of VA hospital poisonings. The most commonly reported substance categories for poisonings managed at military and VA hospitals, respectively, were analgesics (28.4% vs 19.7%), sedatives/hypnotics/antipsychotics (24.7% vs 23.4%), antidepressants (18.7% vs 19.7%) and alcohol (11.3% vs 10.6%). A number of differences were observed between poisonings managed at military and VA hospitals. These differing patterns of poisonings may need to be taken into account in the education, prevention and treatment of poisonings at these hospitals and among the populations they serve. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Availability of mental health service providers and suicide rates in Slovenia: a nationwide ecological study

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Korošec Jagodič, Helena; Rokavec, Tatjana; Agius, Mark; Pregelj, Peter

2013-01-01

Aim To investigate the influence of socioeconomic factors, mental health service availability, and prevalence of mental disorders on regional differences in the suicide rate in Slovenia. Methods The effects of different socioeconomic factors, mental health service availability, and mental disorders factors on suicide rates from 2000-2009 were analyzed using a general linear mixed model (GLMM). Pearson correlations were used to explore the direction and magnitude of associations. Results Among socioeconomic factors, unemployment rate ranked as the most powerful predictor of suicide and an increase of one unit in the unemployment rate increased regional suicide rate by 2.21 (β = 2.21, 95% confidence intervals [CI] = 1.87-2.54, P < 0.001). On the other hand, higher marriage/divorce ratio was negatively related to the suicide rate and an increase of one unit in marriage/divorce ratio reduced regional suicide rate by 1.16 (β = -1.16, 95% CI = -2.20 to -0.13, P < 0.031). The most influential mental health service availability parameter was higher psychiatrist availability (4 psychiatrists and more working at outpatient clinics per 100 000 inhabitants), which was negatively correlated with the suicide rate and reduced regional suicide rate by 2.95 (β = -2.95, 95% CI = -4.60 to -1.31, P = 0.002). Another negatively correlated factor was the antidepressant/anxiolytic ratio higher than 0.5, which reduced the regional suicide rate by 2.32 (β = -2.32, 95% CI = -3.75 to -0.89, P = 0.003). Among mental health disorders, only the prevalence of alcohol use disorders was significantly related to the regional suicide rates and an increase of one unit in the prevalence of alcohol use disorders per 1000 inhabitants increased the regional suicide rate by 0.02 (β = 0.02, 95% CI = 0.01- 0.03, P = 0.008). Conclusions Besides unemployment, which was a very strong predictor of suicide rates, unequal availability of mental

Pattern of pesticide storage before pesticide self-poisoning in rural Sri Lanka

DEFF Research Database (Denmark)

Mohamed, Fahim; Manuweera, Gamini; Gunnell, David

2009-01-01

BACKGROUND: Deliberate self-poisoning with agricultural pesticides is the commonest means of suicide in rural Asia. It is mostly impulsive and facilitated by easy access to pesticides. The aim of this large observational study was to investigate the immediate source of pesticides used for self......-harm to help inform suicide prevention strategies such as reducing domestic access to pesticides. METHODS: The study was conducted in a district hospital serving an agricultural region of Sri Lanka. Patients who had self-poisoned with pesticides and were admitted to the adult medical wards were interviewed...... the particular pesticide for self-harm were its easy accessibility (n = 311, 46%) or its popularity as a suicide agent in their village (n = 290, 43%). CONCLUSION: Three quarters of people who ingested pesticides in acts of self-harm used products that were available within the home or in close proximity...

Relationship of suicide rates to economic variables in Europe: 2000-2011

NARCIS (Netherlands)

Fountoulakis, K.N.; Kawohl, W.; Theodorakis, P.N.; Kerkhof, A.J.F.M.; Navickas, A.; Hoshl, C.; Lecic-Tosevski, D.; Sorel, E.; Rancans, E.; Palova, E.; Juckel, G.; Isacsson, G.; Korosec Jagodic, H.; Botezat-Antonescu, I.; Warmke, I.; Rybakowski, J.; Azorin, J.M.; Cookson, J.; Waddington, J.; Pregelj, P.; Demyttenaere, K.; Hranov, L.G.; Stevovic, L.I.; Pezawas, L.; Adida, M.; Figuera, M.L.; Pompili, M.; Jakovljevic, M.; Vichi, M.; Perugi, G.; Andreasen, O.; Vukovic, O.; Mavrogiorgou, P.; Vamik, P.; Bech, P.; Dome, P.; Winkler, P.; Salokangas, R.K.R.; From, T.; Danileviciute, V.; Gonda, X; Rihmer, Z.; Benhalima, J.F.; Grady, A.; Kloster Leadholm, A.K.; Soendergaard, S.; Nordt, C.; Lopez-Ibor, J.

2014-01-01

Background: It is unclear whether there is a direct link between economic crises and changes in suicide rates. Aims: The Lopez-Ibor Foundation launched an initiative to study the possible impact of the economic crisis on European suicide rates. Method: Data was gathered and analysed from 29 European

A Comparative Study of Suicide Rates among 10–19-Year-Olds in 29 OECD Countries

Science.gov (United States)

Roh, Beop-Rae; Jung, Eun Hee; Hong, Hyun Ju

2018-01-01

Objective This study had two main objectives: to compare current suicide rates in OECD countries among 10–19-year-olds and to identify patterns of suicide rates based on age, gender and time. Furthermore we investigated the main dimensions that contributed to the variation in child and adolescent suicide rates across countries. Methods We combined the WHO mortality data and the population data released by OECD to calculate the suicide rates in 29 OECD countries. A self-organizing map (SOM), k-means clustering analysis, and multi-dimensional scaling were used to classify countries based on similarities in suicide rate structure and to identify the important dimensions accounting for differences among groups. Results We identified significant differences in suicide rates depending on age, sex, country, and time period. Late adolescence and male gender were universal risk factors for suicide, and we observed a general trend of declining suicide rates in OECD countries. The SOM analysis yielded eight types of countries. Most countries showed gender gaps in suicide rates of similar magnitudes; however, there were outliers in which the gender gap was particularly large or small. Conclusion Significant variation exists with respect to suicide rates and their associated gender gaps in OECD countries. PMID:29486551

Suicide rates among Turkish and American youth: a cross-cultural comparison.

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Coskun, Murat; Zoroglu, Salih; Ghaziuddin, Neera

2012-01-01

This study compares youth (suicide rates in Turkey and the United States; a demographic and cross-cultural comparison and exploration of possible causative factors. Publicly available data were compared for children, adolescents, and young adults for years 1992-2004. The mean general population suicide rate in Turkey (per 100,000) was, male = 3.53 and female = 2.31 (for the US, males = 18.37, females = 4.31); for ages below 15 years the rate was, males = 0.28 and females = 0.39 (for the US, males = 1.09 and females = 0.38); while for aged 15-24 years the rate was, males = 4.58 and females = 5.22 (for the US, males = 18.84 and females = 3.36). The patterns for Turkey are: (a) Female youth had a higher suicide rate than male youth; this was the reverse of the U.S. pattern, (b) Youth suicide increased during the time period in Turkey, whereas it was relatively stable in the US, (c) However, suicide rates in Turkey were generally lower than the US, (d) Fifty percent of all female suicide victims in Turkey were under the age of 24 years (versus 11% in the US). Possible psychosocial causative factors may include (a) negative social status of females (forced marriage, young marriage age, low literacy, honor killings); (b) substantial rural to urban migration which disrupts ties and exposes migrants to a less traditional cultural system; (c) shortage of mental health services; (d) and possibly, reduced religious education enrollment may be an additional factor.

The Risk of Repetition of Attempted Suicide Among Iranian Women with Psychiatric Disorders as Quantified by the Suicide Behaviors Questionnaire

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Jalal Shakeri

2015-05-01

Full Text Available Objectives: The factors associated with repetition of attempted suicide are poorly categorized in the Iranian population. In this study, the prevalence of different psychiatric disorders among women who attempted suicide and the risk of repetition were assessed. Methods: Participants were women admitted to the Poisoning Emergency Hospital, Kermanshah University of Medical Sciences following failed suicide attempts. Psychiatric disorders were diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV symptom checklist. Risk of repetition was evaluated using the Suicide Behaviors Questionnaire-Revised (SBQ-R. Results: About 72% of individuals had a SBQ-R score >8 and were considered to be at high risk for repeated attempted suicide. Adjustment disorders were the most common psychiatric disorders (40.8%. However, the type of psychiatric disorder was not associated with the risk of repetition (p=0.320. Marital status, educational level, employment, substance use, history of suicide among family members, and motivation were not determinant factors for repetition of suicide attempt (p=0.220, 0.880, 0.220, 0.290, 0.350 and 0.270, respectively. Younger women were associated with violent methods of attempted suicide, such as self-cutting, whereas older individuals preferred consumption of poison (p<0.001. Drug overdose was more common among single and married women whereas widows or divorcees preferred self-burning (p=0.004. Conclusion: About 72% of patients with failed suicide attempts were at high risk for repeated attempts. Age, marital status, and type of psychiatric disorder were the only determinants of suicide method. Adjustment disorders were the most common psychiatric disorders among Iranian women. However, this did not predict the risk of further attempts.

[Epidemiological study of acute poisoning cases treated at a Galician hospital between 2005 and 2008].

Science.gov (United States)

de Miguel-Bouzas, José Carlos; Castro-Tubío, Eva; Bermejo-Barrera, Ana María; Fernández-Gómez, Purificación; Estévez-Núñez, Juan Carlos; Tabernero-Duque, María Jesús

2012-01-01

A descriptive retrospective study of acute intoxication cases registered at the Complexo Hospitalario de Pontevedra (CHOP) between January 2005 and December 2008 was performed to find out the number and types of poisoning cases treated, their distribution according to patient's sex and age, chronology, type of toxic agents involved, intentionality, history, symptoms, clinical development, treatment and toxicological analysis used for diagnosis. Data were recorded using Clinica and IANUS software and consulting all paper records of patients with symptoms of poisoning. Data from a total of 1893 patients with a mean age of 35.6 ± 17.6 years (66% men) were included. Highest rates of poisoning were recorded on Saturdays and Sundays during the summer months (June, July and August). Drugs of abuse were the most common toxic agents (70.4%), ethyl alcohol accounting for 61% of these cases, which often involved males and with people with high degrees of dependency. In second place was poisoning resulting from the abuse of medical drugs, more commonly associated with females, and involving benzodiazepines in 73.2% of cases. The majority of these intoxications were intentional, and suicide attempts accounted for 18.8%. The problems most commonly resulting from the poisoning were neurological, and mortality rate was just 0.2%.

A replication of the relationship between elderly suicides rates and elderly dependency ratios: a cross-national study.

Science.gov (United States)

Shah, Ajit

2010-01-01

A positive correlation between elderly dependency ratios and elderly suicide rates has been observed using one-year cross-sectional data on elderly suicide rates. A cross-national study designed to replicate this positive correlation between elderly dependency ratios and elderly suicide rates was undertaken by: (i) using one-year average of five years data on suicide rates; and (ii) using more recent data on both elderly suicide rates and elderly dependency ratios. Data on elderly suicide rates, and the total number of elderly and young people was ascertained from the World Health Organization website. The main findings were of significant positive correlations between elderly dependency ratios and suicide rates in both sexes in both the elderly age-bands (65-74 years and 75+ years). The replication of the positive correlations between elderly dependency ratios and elderly suicide rates by using one-year average of five years data on suicide rates suggests that this relationship is robust and accurate. ‎

Predictive Validity of the Columbia-Suicide Severity Rating Scale for Short-Term Suicidal Behavior: A Danish Study of Adolescents at a High Risk of Suicide.

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Conway, Paul Maurice; Erlangsen, Annette; Teasdale, Thomas William; Jakobsen, Ida Skytte; Larsen, Kim Juul

2017-07-03

Using the Columbia-Suicide Severity Rating Scale (C-SSRS), we examined the predictive and incremental predictive validity of past-month suicidal behavior and ideation for short-term suicidal behavior among adolescents at high risk of suicide. The study was conducted in 2014 on a sample of 85 adolescents (90.6% females) who participated at follow-up (85.9%) out of the 99 (49.7%) baseline respondents. All adolescents were recruited from a specialized suicide-prevention clinic in Denmark. Through multivariate logistic regression analyses, we examined whether baseline suicidal behavior predicted subsequent suicidal behavior (actual attempts and suicidal behavior of any type, including preparatory acts, aborted, interrupted and actual attempts; mean follow-up of 80.8 days, SD = 52.4). Furthermore, we examined whether suicidal ideation severity and intensity incrementally predicted suicidal behavior at follow-up over and above suicidal behavior at baseline. Actual suicide attempts at baseline strongly predicted suicide attempts at follow-up. Baseline suicidal ideation severity and intensity did not significantly predict future actual attempts over and above baseline attempts. The suicidal ideation intensity items deterrents and duration were significant predictors of subsequent actual attempts after adjustment for baseline suicide attempts and suicidal behavior of any type, respectively. Suicidal ideation severity and intensity, and the intensity items frequency, duration and deterrents, all significantly predicted any type of suicidal behavior at follow-up, also after adjusting for baseline suicidal behavior. The present study points to an incremental predictive validity of the C-SSRS suicidal ideation scales for short-term suicidal behavior of any type among high-risk adolescents.

Suicide deaths in rural Andhra Pradesh--a cause for global health action.

Science.gov (United States)

Joshi, Rohina; Guggilla, Rama; Praveen, Devarsetty; Maulik, Pallab K

2015-02-01

To determine the proportion of deaths attributable to suicides in rural Andhra Pradesh, India over a 4-year period using a verbal autopsy method. Deaths occurring in 45 villages (population 185,629) were documented over a 4-year period from 2003 to 2007 by non-physician healthcare workers trained in the use of a verbal autopsy tool. Causes of death were assigned by physicians trained in the International Classification of Diseases, version 10. All data were entered and processed electronically using a secure study website. Verbal autopsies were completed for 98.2% (5786) of the deaths (5895) recorded. The crude death rate was 8.0/1000. 4.8% (95% CI 4.3-5.4) of all deaths were suicides, giving a suicide rate of 37.5/100,000 population. Forty-three percent of suicides occurred in the age group 15-29 years, and 62% were in men. In the younger age groups (10-29 years), suicides by women (56%) were more common than by men (44%). Poisoning (40%) was the most common method of self-harm followed by hanging (12%). The suicide rate in this part of rural Andhra Pradesh is three times higher than the national average of 11.2/100,000, but is in line with that reported in the Million Death Study. There is an urgent need to develop strategies targeted at young individuals to prevent deaths by suicide in India. © 2014 John Wiley & Sons Ltd.

Autopsy rate in suicide is low among elderly in Denmark compared with Finland

DEFF Research Database (Denmark)

Ylijoki-Sørensen, Seija; Boldsen, Jesper Lier; Boel, Lene Warner Thorup

2014-01-01

National differences in the legislation on cause and manner of death investigation are reflected in a high autopsy rate in suicides in Finland and a low corresponding rate in Denmark. The consequences for mortality statistics of these different investigation practices on deaths classified...... as suicides in Denmark and Finland, respectively, are not known in detail. The aim of this article was to analyse autopsy rates in deaths classified as suicides, and to identify any differences in investigation practices in deaths with a comparable cause of death, but classified as unnatural deaths other than...... suicide. Data from the mortality registries were summarised for the years 2000, 2005 and 2010. Autopsy rates (total, forensic and medical) were analysed with regard to deaths classified as suicide, and they were compared for three age groups (1-50 years, 51-70 years and ≥71 years) and for causes of death...

Correlation between Cholinesterase and Paraoxonase 1 Activities: Case Series of Pesticide Poisoning Subjects

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S Austin Richard

2013-08-01

Full Text Available Introduction: Acute exposure to pesticide due to suicidal poisoning is the most extensive cause of pesticide exposure, compared with all other causes including agricultural or industrial exposure. Organophosphate (OP and carbamate group of pesticides can inhibit acetylcholinesterase; on the other hand, paraoxonase1 can detoxify organophosphate poisoning by hydrolyzing organophosphate metabolites. Methods: We have compared the serum paraoxonase1 status and cholinesterase activity of subjects who attempted to commit suicide by consuming OP pesticide. Cholinesterase and paraoxonase1 activity were measured spectrophotometrically using butyrylthiocholine and phenyl acetate as substrates, respectively. Results: A positive correlation was found between serum paraoxonase1 activity and cholinesterase activity among pesticide consumed subjects. Conclusion: Our results suggest that subjects with higher paraoxonase1 activity may have a better chance of detoxifying the lethal effect of acute organophosphate poisoning.

The effect of altitude and climate on the suicide rates in Turkey.

Science.gov (United States)

Asirdizer, Mahmut; Kartal, Erhan; Etli, Yasin; Tatlisumak, Ertugrul; Gumus, Orhan; Hekimoglu, Yavuz; Keskin, Sıddık

2018-02-01

Suicide is one of the most important public health problems. There was an association between suicide and several factors such as psychiatric diseases and psychological characteristics, somatic illness, cultural, socioeconomic, familial, occupational and individual risk factors. Also, high altitude and climatic factors including high temperature, cloudiness, more sunshine and low rainfalls were defined as some of these risk factors in the literature. In this study, we aimed to investigate correlation between suicide rates and altitudes of all cities in Turkey and between suicide rates and climatic factors including Rainfall Activity Index, Winter Mean Temperatures, Summer Mean Temperatures and Temperature Difference between January and July previously defined by several authors in the broad series in Turkey. In Turkey, 29865 suicidal deaths occurred in 10 years period between 2006 and 2015. Of them, 21020 (70.4%) were males and 8845 (29.6%) were females. In this study, we found that high altitude above 1500 m, winter median temperature lower than -10 °C and hard temperature changes above 25 °C between winter and summer of settlements were important factors that affected on female suicide rates appropriate to knowledge which defined in previous studies. In conclusion, we suggested that the associations among suicide rates with altitudes and climate should be studied in wider series obtained from different countries for reaching more reliable results. Copyright © 2018 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Suicide in Recent Onset Psychosis Revisited: Significant Reduction of Suicide Rate over the Last Two Decades - A Replication Study of a Dutch Incidence Cohort.

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Stynke Castelein

Full Text Available This study aims to compare the suicide risk over the past decade following recent onset psychosis to findings from the eighties and nineties in the same catchment area and to identify predictors of suicide in the context of the Psychosis Recent Onset Groningen-Survey (PROGR-S. A medical file search was carried out to determine the current status of all patients admitted between 2000 and 2009. The suicide rate was compared with a study executed in 1973-1988 in the same catchment area. Predictors of suicide were investigated using Cox regression. The status of 424 of the 614 patients was known in July 2014. Suicide occurred in 2.4% of patients with psychosis disorders (n = 10; mean follow-up 5.6 years; 6 out of 10 suicides took place within two years. Within two decades, the suicide rate dropped from 11% (follow-up 15 years, 8.5% after 5 years to 2.4%. The Standardized Mortality Rate (SMR of suicides compared with the general population was 41.6. A higher age was the only significant predictor for suicide. Neuroticism, living situation, disorganized and negative symptoms, and passive coping style all showed a trend for significance. A significant reduction in the suicide rate was found for people with psychosis over the past decades. Given the high SMR, suicide research should be given the highest priority. Identifying predictors may contribute to further reduction of suicide among patients with psychosis.

Impact of income inequality and other social determinants on suicide rate in Brazil.

Science.gov (United States)

Machado, Daiane Borges; Rasella, Davide; Dos Santos, Darci Neves

2015-01-01

To analyze whether income inequality and other social determinants are associated with suicide rate in Brazil. This study used panel data from all 5,507 Brazilian municipalities from 2000 to 2011. Suicide rates were calculated by sex and standardized by age for each municipality and year. The independent variables of the regression model included the Gini Index, per capita income, percentage of individuals with up to eight years of education, urbanization, average number of residents per household, percentage of divorced people, of Catholics, Pentecostals, and Evangelicals. A multivariable negative binomial regression for panel data with fixed-effects specification was performed. The Gini index was positively associated with suicide rates; the rate ratio (RR) was 1.055 (95% CI: 1.011-1.101). Of the other social determinants, income had a significant negative association with suicide rates (RR: 0.968, 95% CI: 0.948-0.988), whereas a low-level education had a positive association (RR: 1.015, 95% CI: 1.010-1.021). Income inequality represents a community-level risk factor for suicide rates in Brazil. The decrease in income inequality, increase in income per capita, and decrease in the percentage of individuals who did not complete basic studies may have counteracted the increase in suicides in the last decade. Other changes, such as the decrease in the mean residents per household, may have contributed to their increase. Therefore, the implementation of social policies that may improve the population's socioeconomic conditions and reduce income inequality in Brazil, and in other low and middle-income countries, can help to reduce suicide rates.

Regional suicide rates in the Netherlands : does religion still play a role?

NARCIS (Netherlands)

Neeleman, J

Background This study examined the nature of ecological associations between 'religiousness' and suicide rates (1985-1994) in the 11 provinces in the Netherlands. Methods Indices of religiousness, obtained from a nationwide survey were used as aggregate predictors of provincial suicide rates in

Does the environment affect suicide rates in Spain? A spatiotemporal analysis.

Science.gov (United States)

Santurtún, Maite; Santurtún, Ana; Zarrabeitia, María T

2017-06-05

Suicide is an important public health problem, it represents one of the major causes of unnatural death, and there are many factors that affect the risk of suicidal behaviour. The present study analyzes the temporal and spatial variations of mortality by suicide in Spain and its relationship with gross domestic product (GDP) per capita. A retrospective study was performed, in which deaths by suicide, sex and age group in 50 Spanish provinces between 2000 and 2012 were analyzed. The annual trend of suicide mortality was assessed using Kendall's tau-b correlation coefficient. Seasonality and monthly and weekly behaviour were evaluated by performing the ANOVA test and the Bonferroni adjustment. Finally, the relationship between GDP per capita and suicide was studied. Between 2000 and 2012, 42,905adult people died by suicide in Spain. The annual average incidence rate was 95 suicides per million population. The regions located in the south and in the northwest of the country registered the highest per capita mortality rates. There is a decreasing trend in mortality by suicide over the period studied (CC=-.744; P=.0004) in adults over the age of 64, and a seasonal behaviour was identified with summer maximum and autumn minimum values (f=.504; P<.0001). The regions with the highest GDP per capita showed the lowest mortality by suicide (r=-.645; P<.0001) and the relationship is stronger among older age groups. Mortality by suicide does not follow a homogenous geographical distribution in Spain. Mortality in men was higher than in women. Over the period of study, there has been a decrease in mortality by suicide in Spain in adults over the age of 64. The seasonal cycle of suicides and the inverse relationship with GDP per capita found in this study, provide information which may be used as a tool for developing prevention and intervention strategies. Copyright © 2017 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

Increased use of antidepressants and decreasing suicide rates: a population-based study using Danish register data

DEFF Research Database (Denmark)

Erlangsen, Annette; Canudas-Romo, V.; Conwell, Yeates

2008-01-01

OBJECTIVE: The objective of the present study was to examine if the change in the suicide rate is associated with individuals' use of antidepressants as has been suggested by ecological studies. DESIGN: Decomposition of suicide rates by antidepressant treatment group. SETTING: Population......-based record linkage. PARTICIPANTS: All individuals aged 50 years and older living in Denmark between 1 January 1996 and 31 December 2000 (N = 2,100,808). MAIN OUTCOME MEASURES: Suicide rates are calculated according to current antidepressant treatment status (no treatment, tricyclic antidepressants (TCA......), selective serotonin reuptake inhibitors (SSRI), other antidepressants). The change in the suicide rate during 1996-2000 was decomposed by treatment group. RESULTS: Only one in five older adults dying by suicide was in treatment at the time of death. Whereas the male suicide rate declined by 9.7 suicides per...

Impact of income inequality and other social determinants on suicide rate in Brazil.

Directory of Open Access Journals (Sweden)

Daiane Borges Machado

Full Text Available PURPOSE: To analyze whether income inequality and other social determinants are associated with suicide rate in Brazil. METHOD: This study used panel data from all 5,507 Brazilian municipalities from 2000 to 2011. Suicide rates were calculated by sex and standardized by age for each municipality and year. The independent variables of the regression model included the Gini Index, per capita income, percentage of individuals with up to eight years of education, urbanization, average number of residents per household, percentage of divorced people, of Catholics, Pentecostals, and Evangelicals. A multivariable negative binomial regression for panel data with fixed-effects specification was performed. RESULTS: The Gini index was positively associated with suicide rates; the rate ratio (RR was 1.055 (95% CI: 1.011-1.101. Of the other social determinants, income had a significant negative association with suicide rates (RR: 0.968, 95% CI: 0.948-0.988, whereas a low-level education had a positive association (RR: 1.015, 95% CI: 1.010-1.021. CONCLUSIONS: Income inequality represents a community-level risk factor for suicide rates in Brazil. The decrease in income inequality, increase in income per capita, and decrease in the percentage of individuals who did not complete basic studies may have counteracted the increase in suicides in the last decade. Other changes, such as the decrease in the mean residents per household, may have contributed to their increase. Therefore, the implementation of social policies that may improve the population's socioeconomic conditions and reduce income inequality in Brazil, and in other low and middle-income countries, can help to reduce suicide rates.

An ecological analysis of prison overcrowding and suicide rates in England and Wales, 2000-2014.

Science.gov (United States)

van Ginneken, Esther F J C; Sutherland, Alex; Molleman, Toon

Prisoners are at a greatly increased risk of suicides compared to the general population. Differences in suicide risk can be partly explained by individual risk factors, but the contribution of prison characteristics remains unclear. Overcrowded prisons have higher suicide rates, but this may be related to prison function, security level, population size and turnover. The aim of the current study was to investigate the contribution of each of these prison characteristics to suicide rates, using data from the Ministry of Justice for adult prisons in England and Wales from 2000 to 2014. Negative binomial regression analysis showed that larger population size, higher turnover, higher security and public management were associated with higher suicide rates. When controlling for these factors, overcrowding was not found to be related to suicide rates. Questions remain about the causal mechanisms underlying variation in prison suicides and the impact of the lived experience of overcrowding. Further research is needed to examine the relative contribution of prison and prisoner characteristics to suicides. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Burden of Suicide in Rural Bangladesh: Magnitude and Risk Factors.

Science.gov (United States)

Sharmin Salam, Shumona; Alonge, Olakunle; Islam, Md Irteja; Hoque, Dewan Md Emdadul; Wadhwaniya, Shirin; Ul Baset, Md Kamran; Mashreky, Saidur Rahman; El Arifeen, Shams

2017-09-09

The aim of the paper is to quantify the burden and risk factors of fatal and non-fatal suicidal behaviors in rural Bangladesh. A census was carried out in seven sub-districts encompassing 1.16 million people. Face-to-face interviews were conducted at the household level. Descriptive analyses were done to quantify the burden and Poisson regression was run to determine on risk factors. The estimated rates of fatal and non-fatal suicide were 3.29 and 9.86 per 100,000 person years (PY) observed, respectively. The risk of suicide was significantly higher by 6.31 times among 15-17 and 4.04 times among 18-24 olds compared to 25-64 years old. Married adolescents were 22 times more likely to commit suicide compared to never-married people. Compared to Chandpur/Comilla district, the risk of suicide was significantly higher in Narshingdi. Students had significantly lower risk of non-fatal suicidal behavior compared to skilled laborers. The risk of non-fatal suicidal behavior was lower in Sherpur compared to Chandpur/Comilla. Among adolescents, unskilled laborers were 16 times more likely to attempt suicide than students. The common methods for fatal and non-fatal suicidal behaviors were hanging and poisoning. Suicide is a major public health problem in Bangladesh that needs to be addressed with targeted interventions.

[The role of psychologist in clinic of acute poisonings].

Science.gov (United States)

Marczyńska-Wdówik, Agnieszka M

2009-01-01

This paper is a kind of observations' thesis on the role of psychological treatment of patients of the clinic of acute poisonings. Some proposals of affective treatment of potentially suicidal patients are also presented for doctors and other medical advisors.

Nonmarital Fertility and the Effects of Divorce Rates on Youth Suicide Rates

Science.gov (United States)

Messner, Steven F.; Bjarnason, Thoroddur; Raffalovich, Lawrence E.; Robinson, Bryan K.

2006-01-01

Using pooled, time-series data for a sample of 15 developed nations, we assess the effect of divorce rates on gender-specific suicide rates for youths aged 15-19 with models of relative cohort size, lagged nonmarital fertility, and an interaction term for divorce rates and nonmarital fertility. The results reveal that, for young men, relative…

National Suicide Rates a Century after Durkheim: Do We Know Enough to Estimate Error?

Science.gov (United States)

Claassen, Cynthia A.; Yip, Paul S.; Corcoran, Paul; Bossarte, Robert M.; Lawrence, Bruce A.; Currier, Glenn W.

2010-01-01

Durkheim's nineteenth-century analysis of national suicide rates dismissed prior concerns about mortality data fidelity. Over the intervening century, however, evidence documenting various types of error in suicide data has only mounted, and surprising levels of such error continue to be routinely uncovered. Yet the annual suicide rate remains the…

More than just numbers: Suicide rates and the economic cycle in Portugal (1910–2013

Directory of Open Access Journals (Sweden)

João Pereira dos Santos

2016-12-01

Full Text Available Suicides are a major concern for public health first and foremost because they are an avoidable cause of death. Moreover, they can be an indicator of self-reported emotional satisfaction and a good marker of overall well-being.In this study we examine how different economic and social aspects affected Portuguese suicide rates for more than one hundred years (1910–2013. We place this exercise in the specific historical context of the XX and early XXI century in Portugal, emphasizing the role of economic recessions and expansions. Controlling for aspects like wars, health care availability, political instability, and demographic changes, we find a strong association between a decline in the growth rate of real output and an increase in suicide rates for the whole population. In this regard, while male suicide rates are non-negligibly influenced by economic downturns, female suicide rates are in general more responsive to a more open political and economic environment. Our results are robust if we consider the mid-term cyclical relationship.Our findings advocate that, during recessions, public health responses should be seen as a crucial component of suicide prevention. Keywords: Suicide rates, Portugal, Mental health, Crisis, Austerity, Marriage

Suicide rates among working-age adults in South Korea before and after the 2008 economic crisis.

Science.gov (United States)

Chan, Chee Hon; Caine, Eric D; You, Sungeun; Fu, King Wa; Chang, Shu Sen; Yip, Paul Siu Fai

2014-03-01

Multiple studies have shown that macroeconomic factors are associated with changes in suicide rates. We investigated how changes in economic conditions associated with the recent economic crisis in South Korea influenced suicide rates among working-age adults. Time-series analyses were performed to examine the temporal associations of national unemployment rates and sex-employment-specific suicide rates in South Korea from 2003 to 2011, with particular attention to the increases of suicides that occurred during the recessionary period that began in 2008. We also compared the relative risk of suicide among different occupations. National unemployment rates were positively associated with suicide rates among employed and unemployed men and women, with a 2-month to 3 month lagged period. Significant increases of suicide rates among working-age adults during the recession were detected in most of the subgroups stratified by age, sex and employment status. Forty-three per cent of the increase of suicides was derived from the employed population. Compared with workers in elementary occupations, the relative risk of suicide for mangers increased by threefold during the recessionary period. Among those who were employed, half of the increases in suicides occurred among clerks and workers involved in sales and services. Changes in macroeconomic conditions are tied to population-level suicide risks for employed and unemployed persons. However, these associations vary depending on sex, employment status and occupational roles. In advance of future economic crises, it is important to develop prevention initiatives intended to reach the diverse populations potentially exposed to the adverse effects of sudden economic disruptions.

Suicide rates and risk factors among Korean cancer patients, 1993-2005.

Science.gov (United States)

Ahn, Eunmi; Shin, Dong Wook; Cho, Sung-Il; Park, Sohee; Won, Young-Joo; Yun, Young Ho

2010-08-01

As the number of cancer survivors increases, suicide risk approaches that of the general population. We therefore investigated suicide rates and risk factors among Korean cancer patients. We observed 816,295 cancer patients for 3,007,294 person-years from 1993 to 2005 through a nationwide cancer registry. We calculated their sex- and age-standardized mortality ratios (SMR) and studied suicide risk factors using rate ratios (RR) based on a log-linear Poisson regression model. Compared with the Korean general population, the suicide rate among cancer patients was high [SMR, 2.00; 95% confidence interval (95% CI), 1.91-2.08]. The rates were highest in the year following the cancer diagnosis (SMR, 3.45; 95% CI, 3.19-3.73) and were still elevated 5 years later (SMR, 1.23; 95% CI, 1.12-1.36). The clinical groups at highest risk were male pancreas cancer patients (SMR, 6.01; 95% CI, 4.33-8.33) and female lung cancer patients (SMR, 3.55; 95% CI, 2.55-4.94). The sociodemographic groups at highest risk were those who had no spouse versus those who were married (RR, 1.50; 95% CI, 1.35-1.68), those who were not employed versus those who were (RR, 1.39; 95% CI, 1.26-1.54), and those who did not have high school education versus those who had (RR, 1.52; 95% CI, 1.30-1.79). Korean cancer patients are at increased risk of suicide. Both clinical and sociodemographic factors play a role. There is a need for social support and suicide prevention strategies for cancer survivors in Korea. (c)2010 AACR.

More than just numbers: Suicide rates and the economic cycle in Portugal (1910-2013).

Science.gov (United States)

Dos Santos, João Pereira; Tavares, Mariana; Barros, Pedro Pita

2016-12-01

Suicides are a major concern for public health first and foremost because they are an avoidable cause of death. Moreover, they can be an indicator of self-reported emotional satisfaction and a good marker of overall well-being. In this study we examine how different economic and social aspects affected Portuguese suicide rates for more than one hundred years (1910-2013). We place this exercise in the specific historical context of the XX and early XXI century in Portugal, emphasizing the role of economic recessions and expansions. Controlling for aspects like wars, health care availability, political instability, and demographic changes, we find a strong association between a decline in the growth rate of real output and an increase in suicide rates for the whole population. In this regard, while male suicide rates are non-negligibly influenced by economic downturns, female suicide rates are in general more responsive to a more open political and economic environment. Our results are robust if we consider the mid-term cyclical relationship. Our findings advocate that, during recessions, public health responses should be seen as a crucial component of suicide prevention.

Does Unstable Employment Have an Association with Suicide Rates among the Young?

Science.gov (United States)

Kim, Chungah; Cho, Youngtae

2017-04-28

Although a growing body of literature has indicated that unemployment has a positive association with suicide, the dynamic aspects of unstable employment have not yet been considered in suicidology. This study explored the association between employment stability and completed suicide among people aged 25-34 years in 20 OECD (Organization for Economic Cooperation and Development) countries with time-series data (1994-2010). In order to consider the different aspects of unstable employment, we tested the impacts of employment protection legislation indicators as another proxy of job insecurity (employed, but unstable) apart from unemployment rates. Covariates, including economic growth rates, GDP per capita, fertility rates, and divorce rate, were controlled for. The analysis was designed to be gender- and age-specific, where observations with ages of 25-29 were separated from those with ages of 30-34. Random effect models were applied to examine changes over time in suicide rates, and other models were presented to check robustness. The results showed that it is a low level of employment protection, rather than unemployment itself, that was associated with increased suicide rates among all of the studied populations. The magnitude of the effect differed by gender.

acute poisoning in the community and its associated mortality

African Journals Online (AJOL)

SITWALA COMPUTERS

poisoning in the community, there are very few studies done on the subject in ... majority of cases were due to suicide attempt, and there were only 5 cases of ... 10% of the workload of emergency department and 20% of workload in the ...

Health information systems and pesticide poisoning at Pernambuco.

Science.gov (United States)

de Albuquerque, Pedro Costa Cavalcanti; Gurgel, Idê Gomes Dantas; Gurgel, Aline do Monte; Augusto, Lia Giraldo da Silva; de Siqueira, Marília Teixeira

2015-01-01

Understanding the epidemiologic profile of a particular disease is key to undertake health actions. To that end, information systems that present quality data help in the decision-making process and demonstrate the impact of the problems. To analyze the contribution of health information systems for the characterization of pesticide poisoning through SINAN, CEATOX and SIM in the State of Pernambuco. In this study, the completeness and consistency of the data were assessed, as well as the epidemiological profile of pesticide poisoning in Pernambuco in the period from 2008 to 2012, based on the following Health Information Systems: Center for Toxicological Assistance of Pernambuco (CEATOX), Notifiable Diseases Information System (SINAN) and Mortality Information System (SIM). The data revealed incompleteness and inconsistencies in information. Regarding the profile, females are more affected in the morbidity profile, and men have a higher mortality rate. Poisoning was more frequent in young adults with low educational level. With regard to the circumstances, most of the cases were suicide attempts, unique acute cases and not related to work. Despite suggesting underreporting, the data showed that persons engaged in agriculture are most commonly affected. The strengthening of these systems is necessary for the generation of consistent information that support health policies for the population groups involved.

Stigma, attitudes and help-seeking intentions for psychological problems in relation to regional suicide rates.

NARCIS (Netherlands)

Reynders, A.; Kerkhof, A.J.F.M.; Molenberghs, G.; Van Audenhove, C.

2016-01-01

In this ecological study, we investigated whether help-seeking related to stigma, intentions, and attitudes toward suicide are associated with the suicide rates of 20 regions within the Netherlands and Belgium. Significant associations were found between regional suicide rates and the intention to

Does adversity early in life affect general population suicide rates? A cross-national study.

Science.gov (United States)

Shah, Ajit; Bhandarkar, Ritesh

2011-01-01

Adversity early in life has been suggested as a protective factor for elderly suicides. However, studies examining this relationship in general population suicide rates are scarce. The relationship between general population suicide rates and four proxy measures of adversity earlier in life was examined using data from the World Health Organization and the United Nations data banks. General population suicide rates were negatively correlated with the percentage of children under the age of 5 years who were underweight, the percentage of children under the age of 5 years who were under height, the percentage of infants with low birth weight babies, and the percentage of the general population that was undernourished. The only independent predictor general population suicide rates in both sexes, on multiple regression analysis, was the Gini coefficient (a measure of income inequality). Income inequality may lead to low birth weight, undernourishment, underweight and under height because income inequality results in poor access to healthcare and nutrition. These adversities may increase child mortality rates and reduce life expectancy. Those surviving into adulthood in countries with greater adversity early in life may be at reduced risk of suicide because of selective survival of those at reduced risk of suicide due to constitutional or genetic factors and development of greater tolerance to hardship in adulthood. ‎

Does adversity early in life affect general population suicide rates? a cross-national study

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Ritesh Bhandarkar

2011-01-01

Full Text Available BACKGROUND: Adversity early in life has been suggested as a protective factor for elderly suicides. However, studies examining this relationship in general population suicide rates are scarce. METHODS: The relationship between general population suicide rates and four proxy measures of adversity earlier in life was examined using data from the World Health Organization and the United Nations data banks. RESULTS: General population suicide rates were negatively correlated with the percentage of children under the age of 5 years who were underweight, the percentage of children under the age of 5 years who were under height, the percentage of infants with low birth weight babies, and the percentage of the general population that was undernourished. The only independent predictor general population suicide rates in both sexes, on multiple regression analysis, was the Gini coefficient (a measure of income inequality. CONCLUSIONS: Income inequality may lead to low birth weight, undernourishment, underweight and under height because income inequality results in poor access to healthcare and nutrition. These adversities may increase child mortality rates and reduce life expectancy. Those surviving into adulthood in countries with greater adversity early in life may be at reduced risk of suicide because of selective survival of those at reduced risk of suicide due to constitutional or genetic factors and development of greater tolerance to hardship in adulthood.

Refractory Seizures in Tramadol Poisoning: A Case Report

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Mohammad Majidi

2014-09-01

Full Text Available Background: Tramadol, an analgesic drug abused by opioid addicts, is also abused accidentally or for suicidal purposes. Tramadol poisoning can induce CNS depression, seizures, coma, and ultimately death. Case: In this report, a 30-year-old male was admitted to the emergency department due to suicidal attempt with ingestion of 14000 mg (140 tablet 100 mg of tramadol. He had history of suicidal attempts in past years as well as depression in his past medical history, but he had not abused tramadol and other drugs in his history. There was no history of epilepsy or head trauma in. He presented with generalized seizures two hours post ingestion, and, then, he was referred to hospital four hours later. Generalized seizures were poorly controlled by multiple medications. Due to respiratory arrest, endotracheal tube was inserted and he was admitted to the ICU immediately. At admission, he experienced hypovolemic shock, hypoglycemia, coma, apnea, refractory seizures, muscle spasms, acute respiratory distress syndrome, coagolative disorder, rhabdomyolysis, and acute renal failure. Despite medical managements, he died 38 days after ingestion. Conclusion: In this report, despite using inhalational anesthetic drugs, seizures continued and were very poorly controlled. Cause of death in this patient can be seen as the side effects of tramadol poisoning.

Explaining Cross-State Differences in Elderly Suicide Rates and Identifying State-Level Public Policy Responses that Reduce Rates

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Giles-Sims, Jean; Lockhart, Charles

2006-01-01

Elderly Americans commit suicide at higher rates than other age groups. We contend that macro- and micro-social variables contribute distinct aspects to explanations of this tragic loss: the former focus on circumstances that affect overall rates, the latter reveal why certain individuals succumb to suicide. Our analysis focuses on the…

The Politics of Hope and Despair: The Effect of Presidential Election Outcomes on Suicide Rates*

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Classen, Timothy J.; Dunn, Richard A.

2010-01-01

Objectives This article examines the effect of election outcomes on suicide rates by combining the theory of social integration developed by Durkheim with the models of rational choice used in economics. Methods Theory predicts that states with a greater percentage of residents who supported the losing candidate would tend to exhibit a relative increase in suicide rates. However, being around others who also supported the losing candidate may indicate a greater degree of social integration at the local level, thereby lowering relative suicide rates. We therefore use fixed-effects regression of state suicide rates from 1981 to 2005 on state election outcomes during presidential elections to determine which effect is stronger. Results We find that the local effect of social integration is dominant. The suicide rate when a state supports the losing candidate will tend to be lower than if the state had supported the winning candidate—4.6 percent lower for males and 5.3 percent lower for females. Conclusion Social integration works at many levels; it not only affects suicide risk directly, but can mediate other shocks that influence suicide risk. PMID:20645463

Benzodiazepine poisoning in elderly.

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Vukcević, Natasa Perković; Ercegović, Gordana Vuković; Segrt, Zoran; Djordjević, Snezana; Stosić, Jasmina Jović

2016-03-01

Benzodiazepines are among the most frequently ingested drugs in self-poisonings. Elderly may be at greater risk compared with younger individuals due to impaired metabolism and increased sensitivity to benzodiazepines. The aim of this study was to assess toxicity of benzodiazepines in elderly attempted suicide. A retrospective study of consecutive presentations to hospital after self-poisoning with benzodiazepines was done. Collected data consisted of patient's characteristics (age, gender), benzodiazepine ingested with its blood concentrations at admission, clinical findings including vital signs and Glasgow coma score, routine blood chemistry, complications of poisoning, details of management, length of hospital stay and outcome. According the age, patients are classified as young (15-40-year old), middle aged (41-65-year old) and elderly (older than 65). During a 2-year observational period 387 patients were admitted because of pure benzodiazepine poisoning. The most frequently ingested drug was bromazepam, the second was diazepam. The incidence of coma was significantly higher, and the length of hospital stay significantly longer in elderly. Respiratory failure and aspiration pneumonia occurred more frequently in old age. Also, flumazenil was more frequently required in the group of elderly patients. Massive benzodiazepines overdose in elderly may be associated with a significant morbidity, including deep coma with aspiration pneumonia, respiratory failure, and even death. Flumazenil is indicated more often to reduce CNS depression and prevent complications of prolonged unconsciousness, but supportive treatment and proper airway management of comatose patients is the mainstay of the treatment of acute benzodiazepine poisoning.

Modeling of the temporal patterns of fluoxetine prescriptions and suicide rates in the United States.

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Michael S Milane

2006-06-01

Full Text Available To study the potential association of antidepressant use and suicide at a population level, we analyzed the associations between suicide rates and dispensing of the prototypic SSRI antidepressant fluoxetine in the United States during the period 1960-2002.Sources of data included Centers of Disease Control and US Census Bureau age-adjusted suicide rates since 1960 and numbers of fluoxetine sales in the US, since its introduction in 1988. We conducted statistical analysis of age-adjusted population data and prescription numbers. Suicide rates fluctuated between 12.2 and 13.7 per 100,000 for the entire population from the early 1960s until 1988. Since then, suicide rates have gradually declined, with the lowest value of 10.4 per 100,000 in 2000. This steady decline is significantly associated with increased numbers of fluoxetine prescriptions dispensed from 2,469,000 in 1988 to 33,320,000 in 2002 (r(s = -0.92; p < 0.001. Mathematical modeling of what suicide rates would have been during the 1988-2002 period based on pre-1988 data indicates that since the introduction of fluoxetine in 1988 through 2002 there has been a cumulative decrease in expected suicide mortality of 33,600 individuals (posterior median, 95% Bayesian credible interval 22,400-45,000.The introduction of SSRIs in 1988 has been temporally associated with a substantial reduction in the number of suicides. This effect may have been more apparent in the female population, whom we postulate might have particularly benefited from SSRI treatment. While these types of data cannot lead to conclusions on causality, we suggest here that in the context of untreated depression being the major cause of suicide, antidepressant treatment could have had a contributory role in the reduction of suicide rates in the period 1988-2002.

STUDY OF FACTORS AFFECTING SUICIDE ATTEMPTS IN PERSONS WITH SCHIZOPHRENIA

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Ottilingam Somasundaram Ravindran

2016-09-01

Full Text Available BACKGROUND Schizophrenia has been called a ‘Life-shortening disease’, because many sufferers die early than general population and suicide accounts for a significant proportion of those dying prematurely. Suicide attempts in schizophrenia has been an intriguing area of research work for mental health professionals. Indian research on suicide attempts in schizophrenia have been few. OBJECTIVES The objectives were to study the suicidal behaviour in schizophrenia, to compare and study the positive and negative symptoms, depressive symptoms, hopelessness and suicide intent in schizophrenic population with suicide attempt compared to nonattempters, along with socio-demographic parameters. METHODS A sample of 60 consecutive patients attending OPD of a Private tertiary care Hospital in Chennai were selected. Those who had a diagnosis of schizophrenia were screened for the presence of past suicide attempts. They were divided into two groups as suicide attempters and non-attempters, and analysed using the Positive and Negative Syndrome Scale (PANSS, Calgary Depression Scale for Schizophrenia (CDSS, Beck’s hopelessness scale (BHS, and Suicide intent scale (SIS. RESULTS Among the disorders schizophrenia is rated the second most common reason for suicide attempts (53.3%, especially when associated with positive symptoms, depressive features and significant hopelessness. Demographic parameters like age, sex, educational status, occupation, economic status, and marital status were not found to be significant factors linked to the suicide attempts, however family history of suicide had a significant association in schizophrenic suicide attempts. Suicidal intent severity was medium to high among most of the attempters; poisoning was the commonest method; and were found to be due to positive symptoms and depressive symptoms in the schizophrenic illness course.

Stigma, Attitudes, and Help-Seeking Intentions for Psychological Problems in Relation to Regional Suicide Rates.

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Reynders, Alexandre; Kerkhof, Ad J F M; Molenberghs, Geert; Van Audenhove, Chantal

2016-02-01

In this ecological study, we investigated whether help-seeking related to stigma, intentions, and attitudes toward suicide are associated with the suicide rates of 20 regions within the Netherlands and Belgium. Significant associations were found between regional suicide rates and the intention to seek informal help (β = -1.47, p = .001), self-stigma (β = 1.33, p = .038), and shame (β = .71, p = .030). The association between self-stigma and suicide rate was mediated by intentions to seek informal help. These results suggest that to promote suicide prevention at the level of the regional population, stigma, shame, and intentions to seek help should be targeted in the public domain. © 2015 The American Association of Suicidology.

Relationship of suicide rates with climate and economic variables in Europe during 2000-2012

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Fountoulakis, Konstantinos N; Chatzikosta, Isaia; Pastiadis, Konstantinos

2016-01-01

BACKGROUND: It is well known that suicidal rates vary considerably among European countries and the reasons for this are unknown, although several theories have been proposed. The effect of economic variables has been extensively studied but not that of climate. METHODS: Data from 29 European...... countries covering the years 2000-2012 and concerning male and female standardized suicidal rates (according to WHO), economic variables (according World Bank) and climate variables were gathered. The statistical analysis included cluster and principal component analysis and categorical regression. RESULTS......: The derived models explained 62.4 % of the variability of male suicidal rates. Economic variables alone explained 26.9 % and climate variables 37.6 %. For females, the respective figures were 41.7, 11.5 and 28.1 %. Male suicides correlated with high unemployment rate in the frame of high growth rate and high...

Outpatient treatment of acute poisonings in Oslo: poisoning pattern, factors associated with hospitalization, and mortality

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Lund Cathrine

2012-01-01

Full Text Available Abstract Background Most patients with acute poisoning are treated as outpatients worldwide. In Oslo, these patients are treated in a physician-led outpatient clinic with limited diagnostic and treatment resources, which reduces both the costs and emergency department overcrowding. We describe the poisoning patterns, treatment, mortality, factors associated with hospitalization and follow-up at this Emergency Medical Agency (EMA, "Oslo Legevakt", and we evaluate the safety of this current practice. Methods All acute poisonings in adults (> or = 16 years treated at the EMA during one year (April 2008 to April 2009 were included consecutively in an observational study design. The treating physicians completed a standardized form comprising information needed to address the study's aims. Multivariate logistic regression analysis was used to identify the factors associated with hospitalization. Results There were 2348 contacts for 1856 individuals; 1157 (62% were male, and the median age was 34 years. The most frequent main toxic agents were ethanol (43%, opioids (22% and CO or fire smoke (10%. The physicians classified 73% as accidental overdoses with substances of abuse taken for recreational purposes, 15% as other accidents (self-inflicted or other and 11% as suicide attempts. Most (91% patients were treated with observation only. The median observation time until discharge was 3.8 hours. No patient developed sequelae or died at the EMA. Seventeen per cent were hospitalized. Gamma-hydroxybutyric acid, respiratory depression, paracetamol, reduced consciousness and suicidal intention were factors associated with hospitalization. Forty-eight per cent were discharged without referral to follow-up. The one-month mortality was 0.6%. Of the nine deaths, five were by new accidental overdose with substances of abuse. Conclusions More than twice as many patients were treated at the EMA compared with all hospitals in Oslo. Despite more than a doubling of

Outpatient treatment of acute poisonings in Oslo: poisoning pattern, factors associated with hospitalization, and mortality.

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Lund, Cathrine; Vallersnes, Odd M; Jacobsen, Dag; Ekeberg, Oivind; Hovda, Knut E

2012-01-04

Most patients with acute poisoning are treated as outpatients worldwide. In Oslo, these patients are treated in a physician-led outpatient clinic with limited diagnostic and treatment resources, which reduces both the costs and emergency department overcrowding. We describe the poisoning patterns, treatment, mortality, factors associated with hospitalization and follow-up at this Emergency Medical Agency (EMA, "Oslo Legevakt"), and we evaluate the safety of this current practice. All acute poisonings in adults (> or = 16 years) treated at the EMA during one year (April 2008 to April 2009) were included consecutively in an observational study design. The treating physicians completed a standardized form comprising information needed to address the study's aims. Multivariate logistic regression analysis was used to identify the factors associated with hospitalization. There were 2348 contacts for 1856 individuals; 1157 (62%) were male, and the median age was 34 years. The most frequent main toxic agents were ethanol (43%), opioids (22%) and CO or fire smoke (10%). The physicians classified 73% as accidental overdoses with substances of abuse taken for recreational purposes, 15% as other accidents (self-inflicted or other) and 11% as suicide attempts. Most (91%) patients were treated with observation only. The median observation time until discharge was 3.8 hours. No patient developed sequelae or died at the EMA. Seventeen per cent were hospitalized. Gamma-hydroxybutyric acid, respiratory depression, paracetamol, reduced consciousness and suicidal intention were factors associated with hospitalization. Forty-eight per cent were discharged without referral to follow-up. The one-month mortality was 0.6%. Of the nine deaths, five were by new accidental overdose with substances of abuse. More than twice as many patients were treated at the EMA compared with all hospitals in Oslo. Despite more than a doubling of the annual number of poisoned patients treated at the EMA

The relationship between elderly suicide rates and different components of education: a cross-national study

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Ajit Shah

2012-07-01

Full Text Available BACKGROUND: Two recent studies reported a curvilinear (U-shaped between elderly suicide rates and educational attainment measured by the United Nation’s Education Index. A study examining the curvilinear (U-shaped relationship between elderly suicide rates and the individual components of the Education Index (adult literacy rate, percentage of children of relevant age group enrolled in primary schools and percentage of children of relevant age group enrolled for secondary schools and one other measure of educational attainment (youth literacy rate was undertaken to partial out the effects of the individual components of Education Index on elderly suicides. METHODS: A cross-national study examining the relationship between elderly suicide rates (Y-axis and different measures of educational attainment (X-axis was undertaken using data from the World Health Organization and the United Nations data banks using Curve estimation regression models. RESULTS: The relationship between elderly suicide rates with the adult literacy rate, the percentage of children of relevant age group enrolled for secondary schools and the youth literacy rate was curvilinear (U-shaped curve. This relationship was absent with the percentage of children of relevant age group enrolled in primary schools. CONCLUSIONS: Given the cross-sectional study design, a causal relationship between elderly suicide rates and measures of educational attainment, including the adult literacy rate, the percentage of children of relevant age group enrolled for secondary schools and the youth literacy rate, cannot be assumed. However, the findings suggest that future studies of elderly suicide rates and educational attainment should focus on the adult literacy rate, the percentage of children of relevant age group enrolled for secondary schools and the youth literacy rate as measures of educational attainment.

Male suicide rates in German prisons and the role of citizenship.

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Radeloff, Daniel; Lempp, Thomas; Kettner, Mattias; Rauf, Amna; Bennefeld-Kersten, Katharina; Freitag, Christine M

2017-01-01

Prisoners are at a particularly high risk of suicide. In contrast to other psychosocial risk factors it remains unclear to what degree the risk of suicide differs between prisoners with local citizenship and foreigners. In order to provide more detailed information for suicide prevention in prisons, this study aims to compare suicide rates (SR) between these populations in German criminal custody. Based on a German national database of completed suicide in custody, suicides by prisoners were analysed and compared with epidemiological data of the prison population and the general population, stratified for German and foreign citizenship. Data analysis was adjusted for differences in the age distribution of both populations by calculating standard mortality ratios (SMR) for suicide. SR were higher in prisoners with German citizenship than those with foreign citizenship (SR = 76.5 vs. SR = 42.8, Pcitizenship was comparable in juvenile and adult prisoners, indicating its relevance to both the juvenile and adult detention systems. Imprisonment is associated with a substantially increased risk of suicide in both German and non-German citizens, a finding which needs to be taken into consideration by the justice system. The lower suicide risk in non-German citizens is independent of whether or not they are in custody.

Male suicide rates in German prisons and the role of citizenship

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Lempp, Thomas; Kettner, Mattias; Rauf, Amna; Bennefeld-Kersten, Katharina; Freitag, Christine M.

2017-01-01

Purpose Prisoners are at a particularly high risk of suicide. In contrast to other psychosocial risk factors it remains unclear to what degree the risk of suicide differs between prisoners with local citizenship and foreigners. In order to provide more detailed information for suicide prevention in prisons, this study aims to compare suicide rates (SR) between these populations in German criminal custody. Methods Based on a German national database of completed suicide in custody, suicides by prisoners were analysed and compared with epidemiological data of the prison population and the general population, stratified for German and foreign citizenship. Data analysis was adjusted for differences in the age distribution of both populations by calculating standard mortality ratios (SMR) for suicide. Results SR were higher in prisoners with German citizenship than those with foreign citizenship (SR = 76.5 vs. SR = 42.8, Pcitizenship was comparable in juvenile and adult prisoners, indicating its relevance to both the juvenile and adult detention systems. Conclusion Imprisonment is associated with a substantially increased risk of suicide in both German and non-German citizens, a finding which needs to be taken into consideration by the justice system. The lower suicide risk in non-German citizens is independent of whether or not they are in custody. PMID:28591187

Surviving a massive sodium azide poisoning with toxic cardiomyopathy

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P. Overtchouk

2015-01-01

Full Text Available Sodium azide poisoning is rare (~50 case reports but can be quickly fatal. A systematic review reported the fatal dose in humans to be over 10 mg/kg1. A 69 year-old female was admitted to our hospital for voluntary sodium azide poisoning. She ingested a massive dose of a soup spoon (15 g of pure sodium azide powder with intention to commit suicide without any co-intoxication. Within minutes, she felt nauseous and had several vomiting. She was immediately brought to the hospital.

Suicide in older men: The health in men cohort study (HIMS).

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Almeida, Osvaldo P; McCaul, Kieran; Hankey, Graeme J; Yeap, Bu B; Golledge, Jonathan; Flicker, Leon

2016-12-01

Suicide rates are high in later life, particularly among older men. Mood disorders are known risk factors, but the risk of suicide associated with poor physical health remains unclear. We completed a cohort study of a community representative sample of 38,170 men aged 65-85 in 1996 who were followed for up to 16years. Data on suicide attempts and completion were obtained from the Western Australia Data Linkage System, as was information about medical and mental health diagnoses. 240 (0.6%) participants had a recorded history of past suicide attempt, most commonly by poisoning (85%). Sixty-nine men died by suicide during follow up (0.3% of all deaths), most often by hanging (50.7%). Age-adjusted competing risk regression showed that past suicide attempt was not a robust predictor of future suicide completion (sub-hazard ratio, SHR=1.58, 95% CI=0.39, 6.42), but bipolar (SHR=7.82, 95% CI=3.08, 19.90), depressive disorders (SHR=2.26, 95% CI=1.14, 4.51) and the number of health systems affected by disease (SHR for 3-4 health systems=6.02, 95% CI=2.69, 13.47; SHR for ≥5 health systems=11.18, 95% CI=4.89, 25.53) were. The population fraction of suicides attributable to having 5 or more health systems affected by disease was 79% (95% CI=57%, 90%), and for any mood disorder (bipolar or depression) it was 17% (95% CI=3%, 28%). Older Australian men with multiple health morbidities have the highest risk of death by suicide, even after taking into account the presence of mood disorders. Improving the overall health of the population may be the most effective way of decreasing the rates of suicide in later life. Copyright © 2016 Elsevier Inc. All rights reserved.

Suicide rates in children aged 10-14 years worldwide: changes in the past two decades.

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Kõlves, Kairi; De Leo, Diego

2014-10-01

Limited research is focused on suicides in children aged below 15 years. To analyse worldwide suicide rates in children aged 10-14 years in two decades: 1990-1999 and 2000-2009. Suicide data for 81 countries or territories were retrieved from the World Health Organization Mortality Database, and population data from the World Bank data-set. In the past two decades the suicide rate per 100 000 in boys aged 10-14 years in 81 countries has shown a minor decline (from 1.61 to 1.52) whereas in girls it has shown a slight increase (from 0.85 to 0.94). Although the average rate has not changed significantly, rates have decreased in Europe and increased in South America. The suicide rates remain critical for boys in some former USSR republics. The changes may be related to economic recession and its impact on children from diverse cultural backgrounds, but may also be due to improvements in mortality registration in South America. Royal College of Psychiatrists.

The impact of indiscriminate media coverage of a celebrity suicide on a society with a high suicide rate: epidemiological findings on copycat suicides from South Korea.

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Ju Ji, Nam; Young Lee, Weon; Seok Noh, Maeng; Yip, Paul S F

2014-03-01

This study examines the extent to which the indiscriminate media coverage of the famous young actress Lee Eun-ju's suicide in 2005 affected suicides overall and in specific subgroups (by age, gender, and suicide method) in a suicide-prone society, South Korea. South Korea's 2003-2005 suicide data (n=34,237) were obtained from death certificate records of the National Statistical Office (NSO). Data was analyzed with Poisson time series auto-regression models. After adjusting for confounding factors (such as seasonal variation, calendar year, temperature, humidity, and unemployment rate), there was a significant increase in suicide (RR=1.40, 95%, CI=1.30-1.51, no. of excess mortalities=331; 95% CI=267-391) during the 4 weeks after Lee's suicide. This increase was more prominent in subgroups with similar characteristics to the celebrity. In particular, the relative risk of suicide during this period was the largest (5.24; 95% CI=3.31-8.29) in young women who used the same suicide method as the celebrity. Moreover, the incidence of these copycat suicides during the same time significantly increased in both genders and in all age subgroups among those who committed suicide using the same method as the celebrity (hanging). It is difficult to prove conclusively that the real motivation of the suicides was Lee's death. The findings from this study imply that, if the media indiscreetly reports the suicide of a celebrity in a suicide-prone society, the copycat effect can be far-reaching and very strong, particularly for vulnerable people. © 2013 Published by Elsevier B.V.

Association between the Density of Physicians and Suicide Rates in Japan: Nationwide Ecological Study Using a Spatial Bayesian Model.

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Hideaki Kawaguchi

Full Text Available Regional disparity in suicide rates is a serious problem worldwide. One possible cause is unequal distribution of the health workforce, especially psychiatrists. Research about the association between regional physician numbers and suicide rates is therefore important but studies are rare. The objective of this study was to evaluate the association between physician numbers and suicide rates in Japan, by municipality.The study included all the municipalities in Japan (n = 1,896. We estimated smoothed standardized mortality ratios of suicide rates for each municipality and evaluated the association between health workforce and suicide rates using a hierarchical Bayesian model accounting for spatially correlated random effects, a conditional autoregressive model. We assumed a Poisson distribution for the observed number of suicides and set the expected number of suicides as the offset variable. The explanatory variables were numbers of physicians, a binary variable for the presence of psychiatrists, and social covariates.After adjustment for socioeconomic factors, suicide rates in municipalities that had at least one psychiatrist were lower than those in the other municipalities. There was, however, a positive and statistically significant association between the number of physicians and suicide rates.Suicide rates in municipalities that had at least one psychiatrist were lower than those in other municipalities, but the number of physicians was positively and significantly related with suicide rates. To improve the regional disparity in suicide rates, the government should encourage psychiatrists to participate in community-based suicide prevention programs and to settle in municipalities that currently have no psychiatrists. The government and other stakeholders should also construct better networks between psychiatrists and non-psychiatrists to support sharing of information for suicide prevention.

Association between the Density of Physicians and Suicide Rates in Japan: Nationwide Ecological Study Using a Spatial Bayesian Model.

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Kawaguchi, Hideaki; Koike, Soichi

2016-01-01

Regional disparity in suicide rates is a serious problem worldwide. One possible cause is unequal distribution of the health workforce, especially psychiatrists. Research about the association between regional physician numbers and suicide rates is therefore important but studies are rare. The objective of this study was to evaluate the association between physician numbers and suicide rates in Japan, by municipality. The study included all the municipalities in Japan (n = 1,896). We estimated smoothed standardized mortality ratios of suicide rates for each municipality and evaluated the association between health workforce and suicide rates using a hierarchical Bayesian model accounting for spatially correlated random effects, a conditional autoregressive model. We assumed a Poisson distribution for the observed number of suicides and set the expected number of suicides as the offset variable. The explanatory variables were numbers of physicians, a binary variable for the presence of psychiatrists, and social covariates. After adjustment for socioeconomic factors, suicide rates in municipalities that had at least one psychiatrist were lower than those in the other municipalities. There was, however, a positive and statistically significant association between the number of physicians and suicide rates. Suicide rates in municipalities that had at least one psychiatrist were lower than those in other municipalities, but the number of physicians was positively and significantly related with suicide rates. To improve the regional disparity in suicide rates, the government should encourage psychiatrists to participate in community-based suicide prevention programs and to settle in municipalities that currently have no psychiatrists. The government and other stakeholders should also construct better networks between psychiatrists and non-psychiatrists to support sharing of information for suicide prevention.

A one-year observational study of all hospitalized and fatal acute poisonings in Oslo: epidemiology, intention and follow-up.

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Lund, Cathrine; Teige, Brita; Drottning, Per; Stiksrud, Birgitte; Rui, Tor Olav; Lyngra, Marianne; Ekeberg, Oivind; Jacobsen, Dag; Hovda, Knut Erik

2012-10-09

Up to date information on poisoning trends is important. This study reports the epidemiology of all hospitalized acute poisonings in Oslo, including mortality, follow-up referrals, and whether the introduction of over-the-counter sales of paracetamol outside pharmacies had an impact on the frequency of poisonings. All acute poisonings of adults (≥16 years) treated at the five hospitals in Oslo from April 2008 to April 2009 were included consecutively in an observational cross-sectional multicentre study. A standardized form was completed by the treating physician, which covered the study aims. All deaths by poisoning in and outside hospitals were registered at the Institute of Forensic Medicine. There were 1065 hospital admissions of 912 individuals; 460 (50%) were male, and the median age was 36 years. The annual incidence was 2.0 per 1000. The most frequent toxic agents were ethanol (18%), benzodiazepines (15%), paracetamol (11%), and opioids (11%). Physicians classified 46% as possible or definite suicide attempts, 37% as accidental overdoses with substances of abuse (AOSA), and 16% as other accidents. Twenty-four per cent were discharged without any follow-up and the no follow-up odds were highest for AOSA. There were 117 deaths (eight in hospital), of which 75% were males, and the median age was 41 years. Thus, the annual mortality rate was 25 per 100 000 and the in-hospital mortality was 0.8%. Opioids were the most frequent cause of death. The incidence of hospitalized acute poisonings in Oslo was similar to that in 2003 and there was an equal sex distribution. Compared with a study performed in Oslo in 2003, there has been an increase in poisonings with a suicidal intention. The in-hospital mortality was low and nine out of ten deaths occurred outside hospitals. Opioids were the leading cause of death, so preventive measures should be encouraged among substance abusers. The number of poisonings caused by paracetamol remained unchanged after the

The sales of antidepressants and suicide rates in Norway and its counties 1980-2004.

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Bramness, Jørgen G; Walby, Fredrik A; Tverdal, Aage

2007-09-01

Suicide is a major public health problem and depression is among the most important risk factors for suicide. Treatment of depression might prevent suicide. To study this hypothesis further we conducted an ecological study. An ecological study using sales data for antidepressants and numbers of suicides in Norway and Norwegian counties 1980-2004 was performed. Data on alcohol consumption and unemployment rates were registered and taken into account. Data were analyzed using Cochrane-Orcutt time series for the country as a whole. The county specific data were analyzed with a random coefficient model with county as subject and intercept and time (slope) as random variables using an unstructured covariance matrix. Sales of non-tricyclic antidepressants (non-TCAs) and suicide were clearly negatively related, even when controlling for alcohol and unemployment (adjusted r(2): 0.57). There was an effect modification between time and level of sales of non-TCAs. Studying the relationship between the sales of non-TCAs and the suicide rate, we found that it was significant and stronger for the low sales figures, but non-existent for the high sales figures. Ecological studies cannot infer causality. The fall in suicide rates in Norway and its counties was related to the increased sales of non-TCAs. The effect was mostly a result of a sales increase in the lower sales segment, indicating that a change from the more toxic TCAs, or heightened awareness of depression and its treatment, could explain the relationship found between sales of newer antidepressants and a decrease in suicide rate.

Trends in Suicide Methods and Rates among Older Adults in South Korea: A Comparison with Japan

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Park, Subin; Lee, Hochang Benjamin; Lee, Su Yeon; Lee, Go Eun; Ahn, Myung Hee; Yi, Ki Kyoung; Hong, Jin Pyo

2016-01-01

Objective Lethality of the chosen method during a suicide attempt is a strong risk factor for completion of suicide. We examined whether annual changes in the pattern of suicide methods is related to annual changes in suicide rates among older adults in South Korea and Japan. Methods We analyzed annual the World Health Organization data on rates and methods of suicide from 2000 to 2011 in South Korea and Japan. Results For Korean older adults, there was a significant positive correlation betw...

Suicide in children and young adolescents: a 25-year database on suicides from Northern Finland.

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Lahti, Anniina; Harju, Aleksi; Hakko, Helinä; Riala, Kaisa; Räsänen, Pirkko

2014-11-01

Despite the large amount of research on adolescent suicidality, there are few detailed studies illustrating the characteristics of child and adolescent completed suicide. Our study presents the characteristics of child and adolescent suicides occurring over a period of 25 years within a large geographical area in Northern Finland, with a special focus on gender differences. The study sample included all 58 suicides among children and adolescents (suicide victims were male. Violent suicide methods predominated in both genders (males 98%, females 83%). While symptoms of mental illness were common, only a minority (15% of males and 17% of females) had a previous history of psychiatric hospitalization. 17% of females but none of the males had been hospitalized previously due to self-poisoning. A greater proportion of females than males had a history of self-cutting (33% vs. 7%) and previous suicide attempts (25% vs. 4%). 48% of males and 58% of females were under the influence of alcohol at the time of their suicide, and alcohol intoxication was related to suicides during the night. One fifth of the adolescents screened positive for substances other than alcohol. The results of this study indicate that there are similarities but also some differences in the characteristics of male and female suicides in adolescents. Copyright © 2014 Elsevier Ltd. All rights reserved.

The relationship between obesity and elderly suicide rates: a cross-national study

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Ajit Shah

2010-07-01

Full Text Available BACKGROUND: An inverse relationship between obesity and suicide has been observed in younger adults, but this has not been examined in the elderly. METHODS: A cross-national ecological study examined the independent relationship between the prevalence of obesity and elderly suicide rates, by controlling for potentially confounding variables, using data from the World Health Organization and the United Nations. RESULTS: Elderly suicide rates in females were independently associated with the prevalence of obesity. CONCLUSIONS: Caution should be exercised in attributing a causal relationship from this cross-sectional ecological study due to ecological fallacy and requires confirmation in individual-level case-control or cohort studies.

Benzodiazepine poisoning in elderly

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Perković-Vukčević Nataša

2016-01-01

Full Text Available Background/Aim. Benzodiazepines are among the most frequently ingested drugs in self-poisonings. Elderly may be at greater risk compared with younger individuals due to impaired metabolism and increased sensitivity to benzodiazepines. The aim of this study was to assess toxicity of benzodiazepines in elderly attempted suicide. Methods. A retrospective study of consecutive presentations to hospital after self-poisoning with benzodiazepines was done. Collected data consisted of patient's characteristics (age, gender, benzodiazepine ingested with its blood concentrations at admission, clinical findings including vital signs and Glasgow coma score, routine blood chemistry, complications of poisoning, details of management, length of hospital stay and outcome. According the age, patients are classified as young (15-40-year old, middle aged (41-65-year old and elderly (older than 65. Results. During a 2-year observational period 387 patients were admitted because of pure benzodiazepine poisoning. The most frequently ingested drug was bromazepam, the second was diazepam. The incidence of coma was significantly higher, and the length of hospital stay significantly longer in elderly. Respiratory failure and aspiration pneumonia occurred more frequently in old age. Also, flumazenil was more frequently required in the group of elderly patients. Conclusion. Massive benzodiazepines overdose in elderly may be associated with a significant morbidity, including deep coma with aspiration pneumonia, respiratory failure, and even death. Flumazenil is indicated more often to reduce CNS depression and prevent complications of prolonged unconsciousness, but supportive treatment and proper airway management of comatose patients is the mainstay of the treatment of acute benzodiazepine poisoning.

Treatment received, satisfaction with health care services, and psychiatric symptoms 3 months after hospitalization for self-poisoning

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Grimholt Tine K

2012-04-01

Full Text Available Abstract Background Patients who self-poison have high repetition and high mortality rates. Therefore, appropriate follow-up is important. The aims of the present work were to study treatment received, satisfaction with health care services, and psychiatric symptoms after hospitalization for self-poisoning. Methods A cohort of patients who self-poisoned (n = 867 over a period of 1 year received a questionnaire 3 months after discharge. The Beck Depression Inventory (BDI, Beck Hopelessness Scale (BHS, and Generalized Self-Efficacy Scale (GSE were used. The participation rate was 28% (n = 242; mean age, 41 years; 66% females. Results Although only 14% of patients were registered without follow-up referrals at discharge, 41% reported no such measures. Overall, satisfaction with treatment was fairly good, although 29% of patients waited more than 3 weeks for their first appointment. A total of 22% reported repeated self-poisoning and 17% cutting. The mean BDI and BHS scores were 23.3 and 10.1, respectively (both moderate to severe. The GSE score was 25.2. BDI score was 25.6 among patients with suicide attempts, 24.9 for appeals, and 20.1 for substance-use-related poisonings. Conclusions Despite plans for follow-up, many patients reported that they did not receive any. The reported frequency of psychiatric symptoms and self-harm behavior indicate that a more active follow-up is needed.

Suicidal insulin poisoning with nine day survival: recovery in bile at autopsy by radioimmunoassay

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Sturner, W.Q.; Putnam, R.S.

1972-01-01

The discovery of insulin fifty years ago enabled doctors to successfully treat an eleven year old boy dying from diabetes mellitus and thereby ushered in a new medical era. While millions of subsequent patients were thus able to lead productive lives, others turned this miraculous substance into self-destructive purposes, while a few attempted (and possibly succeeded in) carefully concealed homicidal undertakings. The first ''murder by insulin'' case, prosecuted with a conviction in Great Britain fifteen years ago, employed a laborious bioassay method to demonstrate the hormone at the site of injection. A recent series of insulin poisonings in California was dependent on pathological changes in the brain from anoxia (hypoglycemia) coupled with history and investigation rather than chemical measurements, although an immunoassay method was used for confirmation in the final case. Instances of suicidal attempts by self-administered insulin have been reported with analyses performed by radioimmunoassay, now employed in clinical laboratories to measure many hormonal and therapeutic substances. We have applied this principle from pathologic and toxicologic aspects in an effort to enhance the diagnostic capability of the forensic pathologist, who must examine and properly certify such deaths

Testing the hypothesis of the natural suicide rates: Further evidence from OECD data

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Andres, Antonio Rodriguez; Halicioglu, Ferda

2011-01-01

This paper provides further evidence on the hypothesis of the natural rate of suicide using the time series data for 15 OECD countries over the period 1970–2004. This hypothesis suggests that the suicide rate of a society could never be zero even if both the economic and the social conditions wer...

Hyperbaric Oxygen Therapy Is Associated With Lower Short- and Long-Term Mortality in Patients With Carbon Monoxide Poisoning.

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Huang, Chien-Cheng; Ho, Chung-Han; Chen, Yi-Chen; Lin, Hung-Jung; Hsu, Chien-Chin; Wang, Jhi-Joung; Su, Shih-Bin; Guo, How-Ran

2017-11-01

To date, there has been no consensus about the effect of hyperbaric oxygen therapy (HBOT) on the mortality of patients with carbon monoxide poisoning (COP). This retrospective nationwide population-based cohort study from Taiwan was conducted to clarify this issue. Using the Nationwide Poisoning Database, we identified 25,737 patients with COP diagnosed between 1999 and 2012, including 7,278 patients who received HBOT and 18,459 patients who did not. The mortality risks of the two cohorts were compared, including overall mortality, and stratified analyses by age, sex, underlying comorbidities, monthly income, suicide attempt, drug poisoning, acute respiratory failure, and follow-up until 2013 were conducted. We also tried to identify independent mortality predictors and evaluated their effects. Patients who received HBOT had a lower mortality rate compared with patients who did not (adjusted hazard ratio [AHR], 0.74; 95% CI, 0.67-0.81) after adjusting for age, sex, underlying comorbidities, monthly income, and concomitant conditions, especially in patients younger than 20 years (AHR, 0.45; 95% CI, 0.26-0.80) and those with acute respiratory failure (AHR, 0.43; 95% CI, 0.35-0.53). The lower mortality rate was noted for a period of 4 years after treatment of the COP. Patients who received two or more sessions of HBOT had a lower mortality rate than did those who received HBOT only once. Older age, male sex, low monthly income, diabetes, malignancy, stroke, alcoholism, mental disorders, suicide attempts, and acute respiratory failure were also independent mortality predictors. HBOT was associated with a lower mortality rate in patients with COP, especially in those who were younger than 20 years and those with acute respiratory failure. The results provide important references for decision-making in the treatment of COP. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

The Basic Act for Suicide Prevention: Effects on Longitudinal Trend in Deliberate Self-Harm with Reference to National Suicide Data for 1996–2014

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Miharu Nakanishi

2017-01-01

Full Text Available A suicide prevention strategy was launched in Japan in 2006 to address the high suicide rate, which had increased considerably since 1998. The national strategy from 2007 involved the enhancement of psychiatric treatment services at emergency medical facilities and supportive observation by individuals close to patients. The national suicide rate has decreased gradually since 2008; however, national information regarding the number of patients who had engaged in deliberate self-harm was absent. Therefore, the present study examined the longitudinal trend in hospital admissions due to deliberate self-harm in Japan. Data from the National Patient Survey between 1996 and 2014—a nationally representative cross-sectional survey of inpatient care every 3 years—were used. Data for 13,014 patients were included in the estimation of the number of hospital admissions due to deliberate self-harm. The results show that the estimated number of admissions due to deliberate self-harm increased from 2078 in September 1996 to 3189 in September 2008, when the national number of suicide cases peaked, and decreased to 1783 in 2014. Approximately half of the patients were admitted to hospital because of self-harm via means other than drug poisoning, which had a high mortality rate (5.6%. The proportion of patients receiving public assistance was higher in those who had engaged in deliberate self-harm (8.5% relative to that observed in the general population. Overall, the trend in deliberate self-harm was synchronous with the number of suicide cases over time. As economic poverty has been associated with suicidal ideation and behavior and some recipients of public assistance tend to abuse psychotropic medication, the public assistance program should provide mental health support for recipients of social benefit schemes.

Characteristics of suicidal attempts among farmers in rural South India

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Ravi S Kumar

2017-01-01

Full Text Available Background: Globally, farming as an industry is considered a high-risk occupation for suicides. Certain states in India like Karnataka have a suicide rate higher than the national average, and this is generally attributed to the farmers' suicide. Aims: The aim is to study the characteristics of suicidal attempts among the farmer community in South India, with special emphasis on gender differences, modes used, and the immediate precipitant causes. Materials and Methods: Retrospective, case register-based, explorative-descriptive study of 426 consecutive medicolegal case files of patients whose stated occupation was farming and who were admitted as cases of deliberate self-harm or suicide attempt to a rural tertiary care hospital in rural South India. Results: Out of the 426 farmers who attempted suicide, majority were male (355, 83.3%, in the age group of 21–40 years (318, 75%, married (358, 84%, and belonging to lower socioeconomic status (268, 62.9%. About 54% of them had attempted suicide by consuming pesticides (230. Surprisingly, 183 (43% and 86 (20.2% reported the immediate precipitant as being relationship issues and marital conflict, respectively, and only 100 (23.5% attributed it to financial reasons. Females were significantly associated with a past history of suicidal attempt while males tended to abuse alcohol before an attempt more frequently. Conclusions: Pesticide poisoning was the most common mode for attempting suicide among the farmers. Contrary to public perception and other studies, relationship, and marital issues, not financial reasons were found to be the most common immediate precipitant for the attempters in our study.

Identifying probable suicide clusters in wales using national mortality data.

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Phillip Jones

Full Text Available Up to 2% of suicides in young people may occur in clusters i.e., close together in time and space. In early 2008 unprecedented attention was given by national and international news media to a suspected suicide cluster among young people living in Bridgend, Wales. This paper investigates the strength of statistical evidence for this apparent cluster, its size, and temporal and geographical limits.The analysis is based on official mortality statistics for Wales for 2000-2009 provided by the UK's Office for National Statistics (ONS. Temporo-spatial analysis was performed using Space Time Permutation Scan Statistics with SaTScan v9.1 for suicide deaths aged 15 and over, with a sub-group analysis focussing on cases aged 15-34 years. These analyses were conducted for deaths coded by ONS as: (i suicide or of undetermined intent (probable suicides and (ii for a combination of suicide, undetermined, and accidental poisoning and hanging (possible suicides. The temporo-spatial analysis did not identify any clusters of suicide or undetermined intent deaths (probable suicides. However, analysis of all deaths by suicide, undetermined intent, accidental poisoning and accidental hanging (possible suicides identified a temporo-spatial cluster (p = 0.029 involving 10 deaths amongst 15-34 year olds centred on the County Borough of Bridgend for the period 27(th December 2007 to 19(th February 2008. Less than 1% of possible suicides in younger people in Wales in the ten year period were identified as being cluster-related.There was a possible suicide cluster in young people in Bridgend between December 2007 and February 2008. This cluster was smaller, shorter in duration, and predominantly later than the phenomenon that was reported in national and international print media. Further investigation of factors leading to the onset and termination of this series of deaths, in particular the role of the media, is required.

Self-Cutting: Patient Characteristics Compared with Self-Poisoners

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Hawton, Keith; Harriss, Louise; Simkin, Sue; Bale, Elizabeth; Bond, Alison

2004-01-01

A large (n = 14,892) consecutive sample of deliberate self-harm (attempted suicide) patients who presented to a general hospital in the United Kingdom during a 23-year study period was examined (over two consecutive time periods) in order to compare the characteristics of those who used self-cutting (n = 428) and those who self-poisoned (n =…

The relationship between sales of SSRI, TCA and suicide rates in the Nordic countries.

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Zahl, Per-Henrik; De Leo, Diego; Ekeberg, Øivind; Hjelmeland, Heidi; Dieserud, Gudrun

2010-08-06

In the period 1990-2006, strong and almost equivalent increases in sales figures of selective serotonin re-uptake inhibitors (SSRIs) were observed in all Nordic countries. The sales figures of tricyclic antidepressants (TCAs) dropped in Norway and Sweden in the nineties. After 2000, sales figures of TCAs have been almost constant in all Nordic countries. The potentially toxic effect of TCAs in overdose was an important reason for replacing TCAs with SSRIs when treating depression. We studied whether the rapid increase in sales of SSRIs and the corresponding decline in TCAs in the period 1990-98 were associated with a decline in suicide rates. Aggregated suicide rates for the period 1975-2006 in four Nordic countries (Denmark, Finland, Norway and Sweden) were obtained from the national causes-of-death registries. The sales figures of antidepressants were provided from the wholesale registers in each of the Nordic countries. Data were analysed using Fisher's exact test and Pearson's correlation coefficient. There was no statistical association (P = 1.0) between the increase of sales figures of SSRIs and the decline in suicide rates. There was no statistical association (P = 1.0) between the decrease in the sale figures of TCAs and change in suicide rates either. We found no evidence for the rapid increase in use of SSRIs and the corresponding decline in sales of TCAs being associated with a decline in the suicide rates in the Nordic countries in the period 1990-98. We did not find any inverse relationship between the increase in sales of SSRIs and declining suicide rates in four Nordic countries.

Associations between changes in the pattern of suicide methods and rates in Korea, the US, and Finland

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Park, Subin; Ahn, Myung Hee; Lee, Ahrong; Hong, Jin Pyo

2014-01-01

Background The lethality of the suicide method employed is a strong risk factor for the completion of suicide. We examined whether annual changes in the pattern of suicide methods is related to annual changes in suicide rates in South Korea, the United States (US), and Finland. Methods We analyzed annual data from 2000–2011 for South Korea and Finland, and 2000–2010 for the US in order to examine trends in the rates and methods of suicide. Data on suicide methods were obtained from the World ...

Suicide in inmates in Nazis and Soviet concentration camps: historical overview and critique

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Francisco eLopez-Munoz

2016-05-01

Full Text Available Living conditions in concentration camps were harsh and often inhumane, leading many prisoners to commit suicide. We have reviewed this topic in Nazi concentration camps (KL, Soviet special camps and gulags, providing some preliminary data of our research. Data show that the incidence of suicide in Nazi KL could be up to 30 times higher than the general population, and was also much higher than in Soviet special camps (maybe due to more favorable conditions for prisoners and the abolishment of death penalty, while available data on Soviet gulags are contradictory. However, data interpretation is very controversial, because, for example, the Nazi KL authorities used to cover up the murder victims as suicides. Most of suicides were committed in the first years of imprisonment and the method of suicide most commonly used was hanging, although other methods included cutting blood vessels, poisoning, contact with electrified wire, or starvation. It is possible to differentiate two behavior when committing suicide; impulsive behavior (contact with electrified barbed or premeditated suicide (hanging up or through poison. In Soviet special camps, possible motives for suicides could include feelings of guilt for crimes committed, fear of punishment and a misguided understanding of honor on the eve of criminal trials. Self-destructive behaviors such as self-mutilation in gulag camps or prisoners who let themselves die have been widely reported. Committing suicide in concentration camps was a common practice, although precise data may be impossible to obtain.

Inequalities in suicide mortality rates and the economic recession in the municipalities of Catalonia, Spain.

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Saurina, Carme; Marzo, Manel; Saez, Marc

2015-09-08

While previous research already exists on the impact of the current economic crisis and whether it leads to an increase in mortality by suicide, our objective in this paper is to determine if the increase in the suicide rate in Catalonia, Spain from 2010 onwards has been statistically significant and whether it is associated with rising unemployment. We used hierarchical mixed models, separately considering the crude death rate of suicides for municipalities with more than and less than 10,000 inhabitants as dependent variables both unstratified and stratified according to gender and/or age group. In municipalities with 10,000 or more inhabitants there was an increase in the relative risk of suicide from 2009 onwards. This increase was only statistically significant for working-aged women (16-64 years). In municipalities with less than 10,000 inhabitants the relative risk showed a decreasing trend even after 2009. In no case did we find the unemployment rate to be associated (statistically significant) with the suicide rate. The increase in the suicide rate from 2010 in Catalonia was not statistically significant as a whole, with the exception of working-aged women (16-64 years) living in municipalities with 10,000 or more inhabitants. We have not found this increase to be associated with rising unemployment in any of the cases. Future research into the effects of economic recessions on suicide mortality should take into account inequalities by age, sex and size of municipalities.

Decreased suicide rate after induced abortion, after the Current Care Guidelines in Finland 1987-2012.

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Gissler, Mika; Karalis, Elina; Ulander, Veli-Matti

2015-02-01

Women with a recent induced abortion have a 3-fold risk for suicide, compared to non-pregnant women. The increased risk was recognised in unofficial guidelines (1996) and Current Care Guidelines (2001) on abortion treatment, highlighting the importance of a check-up 2 - 3 weeks after the termination, to monitor for mental health disorders. We studied the suicide trends after induced abortion in 1987 - 2012 in Finland. We linked the Register on Induced Abortions (N = 284,751) and Cause-of-Death Register (N = 3798 suicides) to identify women who had committed suicide within 1 year after an induced abortion (N = 79). The abortion rates per 100,000 person-years were calculated for 1987 - 1996 (period with no guidelines), 1997 - 2001 (with unofficial guidelines) and 2002 - 2012 (with Current Care Guidelines). The suicide rate after induced abortion declined by 24%, from 32.4/100,000 in 1987 - 1996 to 24.3/100,000 in 1997 - 2001 and then 24.8/100,000 in 2002 - 2012. The age-adjusted suicide rate among women aged 15 - 49 decreased by 13%; from 11.4/100,000 to 10.4/100,000 and 9.9/100,000, respectively. After induced abortions, the suicide rate increased by 30% among teenagers (to 25/100,000), stagnated for women aged 20 - 24 (at 32/100,000), but decreased by 43% (to 21/100,000) for women aged 25 - 49. The excess risk for suicide after induced abortion decreased, but the change was not statistically significant. Women with a recent induced abortion still have a 2-fold suicide risk. A mandatory check-up may decrease this risk. The causes for the increased suicide risk, including mental health prior to pregnancy and the social circumstances, should be investigated further. © 2014 the Nordic Societies of Public Health.

Male suicide rates in German prisons and the role of citizenship.

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Daniel Radeloff

Full Text Available Prisoners are at a particularly high risk of suicide. In contrast to other psychosocial risk factors it remains unclear to what degree the risk of suicide differs between prisoners with local citizenship and foreigners. In order to provide more detailed information for suicide prevention in prisons, this study aims to compare suicide rates (SR between these populations in German criminal custody.Based on a German national database of completed suicide in custody, suicides by prisoners were analysed and compared with epidemiological data of the prison population and the general population, stratified for German and foreign citizenship. Data analysis was adjusted for differences in the age distribution of both populations by calculating standard mortality ratios (SMR for suicide.SR were higher in prisoners with German citizenship than those with foreign citizenship (SR = 76.5 vs. SR = 42.8, P<0.01. This association was not specific to the prison population, as the higher SR in citizens compared to non-citizens (SR = 19.3 vs. SR = 9.0, P<0.01 were also found in the general population. The association between prison suicide and citizenship was comparable in juvenile and adult prisoners, indicating its relevance to both the juvenile and adult detention systems.Imprisonment is associated with a substantially increased risk of suicide in both German and non-German citizens, a finding which needs to be taken into consideration by the justice system. The lower suicide risk in non-German citizens is independent of whether or not they are in custody.

Social psychological variables in populations contrasted by income and suicide rate: Durkheim revisited.

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Ferrada-Noli, M

1997-08-01

The ten richest and ten poorest municipalities of Sweden were investigated with respect to national statistics to assess the relationship between suicide incidence, discrete social psychological variables associated with welfare admittance among the elderly, and income of municipality. The relative frequency of suicide was 1.6 times greater for Swedes from the low-income municipalities than for those from the high-income ones. The group of municipalities with the highest suicide rate had a significantly higher proportion of older people in need of municipal social assistance at their homes and also a significantly higher proportion of elderly living in municipality-managed 'service-homes.' The findings replicate earlier investigations and suggest social psychological indicators denoting less favourable economic and social resources are also associated with both an increased suicide rate and a decreased county or municipal income. Some theoretical issues of the socioeconomic and of the external restraint hypotheses of the incidence of suicide, contradicted by the present findings as well as of Durkheim's hypothesis of social control are discussed. Further, we suggest the consideration of negative socioeconomic conditions as a risk factor amid psychiatric clinical assessments of risk for suicidal behaviour.

Suicide rates across income levels: Retrospective cohort data on 1 million participants collected between 2003 and 2013 in South Korea

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Lee, Sang-Uk; Oh, In-Hwan; Jeon, Hong Jin; Roh, Sungwon

2017-01-01

Background: The relation of income and socioeconomic status with suicide rates remains unclear. Most previous studies have focused on the relationship between suicide rates and macroeconomic factors (e.g., economic growth rate). Therefore, we aimed to identify the relationship between individuals' socioeconomic position and suicide risk. Methods: We analyzed suicide mortality rates across socioeconomic positions to identify potential trends using observational data on suicide mortality co...

Increased use of antidepressants and decreasing suicide rates: a population-based study using Danish register data

DEFF Research Database (Denmark)

Erlangsen, Annette; Canudas-Romo, V.; Conwell, Yeates

2008-01-01

-based record linkage. PARTICIPANTS: All individuals aged 50 years and older living in Denmark between 1 January 1996 and 31 December 2000 (N = 2,100,808). MAIN OUTCOME MEASURES: Suicide rates are calculated according to current antidepressant treatment status (no treatment, tricyclic antidepressants (TCA...... 100,000, recipients of antidepressants contributed to the decline by 0.9 suicides. Women redeeming antidepressant prescriptions accounted for 0.4 suicides of the observed reduction of 3.3 per 100,000. The average suicide rates for men receiving TCA and SSRI were 153.3 and 169.0 per 100,000 person......-years, respectively. Among older women, both TCA and SSRI users had an average suicide rate of 68.8 per 100,000 over the period examined. CONCLUSIONS: Just a small proportion of older adults dying by suicide were found to be in treatment with antidepressants at the time of death. Individuals in active treatment...

Rates and correlates of suicidal ideation among stroke survivors: a meta-analysis.

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Bartoli, Francesco; Pompili, Maurizio; Lillia, Nicoletta; Crocamo, Cristina; Salemi, Giuseppe; Clerici, Massimo; Carrà, Giuseppe

2017-06-01

A better understanding of the epidemiological impact of suicidal ideation after stroke is required to identify subjects needing personalised interventions. The aim of this meta-analysis was to estimate rates and correlates of suicidal ideation among stroke survivors. We searched via Ovid, Medline, Embase and PsycInfo from database inception until August 2016. Predefined outcomes were (1) rates of suicidal ideation based on random-effects pooled proportion and (2) relevant sociodemographic and clinical correlates, using random-effects odds ratio (OR) or standardised mean difference (SMD) for categorical and continuous variables, respectively. Fifteen studies and 13 independent samples, accounting for 10 400 subjects, were included in meta-analyses. The pooled proportion of suicidal ideation among stroke survivors was 11.8% (7.4% to 16.2%), with high heterogeneity across studies (I 2 =97.3%). Current (OR=11.50; psuicidal ideation. Moreover, suicidal ideation was less likely in stroke survivors who were married (OR=0.63; psuicidal ideation. Thus, there is enough evidence to support the use of routine screening and early interventions to prevent and treat suicidal ideation after stroke, especially among subjects carrying specific correlates. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Prevention of suicide and attempted suicide in Denmark. Epidemiological studies of suicide and intervention studies in selected risk groups.

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Nordentoft, Merete

2007-11-01

intent score, violent suicide attempt or suicide attempt with severe lethality, and ongoing or previous psychiatric treatment. In our follow-up study from Bispebjerg Hospital, we found that the risk of suicide during a ten-year follow-up period among patients admitted in 1980 after self-poisoning was 30 times greater than in the general population. We also found increased mortality by all other causes of death. Predictors of suicide were several previous suicide attempts, living alone and increasing age. There are not many randomised clinical trials of psychosocial interventions aiming to reduce risk of repetition among suicide attempters. A Cochrane review concluded that evidence was lacking to indicate the most effective forms of treatment for deliberate self-harm patients. A recent randomised controlled trial showed a positive influence of cognitive behavioural therapy on repetition rate. Our own quasi-experimental study of effectiveness of two weeks' inpatient treatment in a special unit of young persons who had severe suicidal thoughts or who had attempted suicide showed that risk of repetition was reduced in the intervention group, and that the intervention group obtained a significantly greater improvement in Beck's Depression Inventory, Hopelessness Scale, Rosenberg Self-Esteem Scale and CAGE-score. The study of emergency outreach indicates that there are many persons in the community that experience a suicidal crisis, and that this group is an important target group for psychiatric emergency outreach. In our study of registration and referral practice in Copenhagen Hospital Cooperation, we conclude that not all suicide attempts were registered as such in the National Patient Register - in fact, only 37 percent. It must be concluded that the quality of the Danish Patient Register must be improved with regard to registration of suicide attempt. We found that psychiatric evaluation was planned in relation to almost all suicide attempts, but that it must be

Cartap hydrochloride poisoning: A clinical experience

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Boorugu, Hari K.; Chrispal, Anugrah

2012-01-01

Cartap hydrochloride, a nereistoxin analog, is a commonly used low toxicity insecticide. We describe a patient who presented to the emergency department with alleged history of ingestion of Cartap hydrochloride as an act of deliberate self-harm. The patient was managed conservatively. To our knowledge this is the first case report of Cartap hydrochloride suicidal poisoning. Cartap toxicity has been considered to be minimal, but a number of animal models have shown significant neuromuscular to...

[The epidemiological surveillance of acute poisoning in 1997 (a study of 1140 cases from the area south of the Madrid Community)].

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Caballero Vallés, P J; Dorado Pombo, S; Brusínt Olivares, B; Jerez Basurco, B; Medina Sampedro, M

1999-07-01

Following a line of work we studied 1,140 acute poisoning (AP) attended at the Internal Medicine Emergency Department at 12 de Octubre Hospital, Madrid, in 1997. The incidence increased up to 157/100,000 inhabitants. Mean age was 36 years (SD: 15 y), median, 32 years. Self-inflicted AP: 1,052 cases (92%); the suicide attempt was the most common type (509, 48%). Among males, the alcoholic intoxication (332, 59%) predominated. Among accidental AP (88 cases), 90% occurred at home. Poisons: drugs. Drugs were used for 78% of suicide attempts. The relative incidence of benzodiazepines increased (47%) and that of antidepressive drugs decreased (11%). A remarkable increase in the "other drugs" group was noted, as well as the association of drugs and non-drugs (10%). Alcohol use increased significantly (249 cases more than in 1994), as well as drugs although to a lesser extent, breaking the trend observed in the last few years. Cocaine is now the most common (among women heroin is still the leading cause); 5 AP were caused by synthesis drugs (extasis, MDMA) and an increase was observed with "other drugs". suicide attempts: depression (30%) and previous attempts (19%); ethylism: alcoholism (40%); AP with other drugs: drug abuse (52%). Admitted to ICU: 1.4%. The mortality rate decreased to 0.08%.

The relationship between sales of SSRI, TCA and suicide rates in the Nordic countries

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Zahl Per-Henrik

2010-08-01

Full Text Available Abstract Background In the period 1990-2006, strong and almost equivalent increases in sales figures of selective serotonin re-uptake inhibitors (SSRIs were observed in all Nordic countries. The sales figures of tricyclic antidepressants (TCAs dropped in Norway and Sweden in the nineties. After 2000, sales figures of TCAs have been almost constant in all Nordic countries. The potentially toxic effect of TCAs in overdose was an important reason for replacing TCAs with SSRIs when treating depression. We studied whether the rapid increase in sales of SSRIs and the corresponding decline in TCAs in the period 1990-98 were associated with a decline in suicide rates. Methods Aggregated suicide rates for the period 1975-2006 in four Nordic countries (Denmark, Finland, Norway and Sweden were obtained from the national causes-of-death registries. The sales figures of antidepressants were provided from the wholesale registers in each of the Nordic countries. Data were analysed using Fisher's exact test and Pearson's correlation coefficient. Results There was no statistical association (P = 1.0 between the increase of sales figures of SSRIs and the decline in suicide rates. There was no statistical association (P = 1.0 between the decrease in the sale figures of TCAs and change in suicide rates either. Conclusions We found no evidence for the rapid increase in use of SSRIs and the corresponding decline in sales of TCAs being associated with a decline in the suicide rates in the Nordic countries in the period 1990-98. We did not find any inverse relationship between the increase in sales of SSRIs and declining suicide rates in four Nordic countries.

Suicidality-based prediction of suicide attempts in a community-dwelling elderly population: Results from the Osan Mental Health Survey.

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Oh, Dae Jong; Park, Jae Young; Oh, Miyoung; Kim, Kayoung; Hong, Jongwoo; Kim, Taehyun; Han, Ji Won; Kim, Tae Hui; Kim, Ki Woong

2015-09-15

Data on outcomes of suicidality in the community-dwelling elderly are scarce. We investigated the association of suicidality with the suicide attempts in a community-dwelling elderly cohort. In the Osan Mental Health Survey, 848 randomly sampled elderly Koreans participated in the baseline evaluation, 623 completed 2-year follow-up evaluation and 32 died during the follow-up period. The survey was conducted between February 2010 and January 2013. We evaluated suicidality using the Mini-International Neuropsychiatric Interview suicidality module that includes both suicidal ideation and attempts. The incidences of suicidality and suicide attempts were 70.7 and 13.1 per 1000 persons per year, respectively. Suicidality was associated with increased risk of suicide attempts (odds ratio (OR) = 3.84, 95% CI = 1.06-13.87). Two men with suicidality committed suicide by self-poisoning. Moderate to high intensity daily exercise decreased the risk of suicidality to become persistent or recurrent (OR = 0.32, 95% CI = 0.12-0.81). Low education level (OR = 2.41, 95% CI = 1.21-4.77) and depression (OR = 3.02, 95% CI = 1.65-5.53) were associated with risk of incident suicidality. Study sample was enrolled from a single city of Korea, and the size of the study sample was small. We may reduce suicide attempts by screening for suicidality and implementing exercise programs in community-dwelling elderly people. Copyright © 2015 Elsevier B.V. All rights reserved.

Changes in Female Sex Hormones in Patients with Intentional Drug and Chemical Poisoning

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Saeed Afzali

2016-07-01

Full Text Available Background: Hormonal changes as a factor influencing the emotional state of women have an important role in the incidence of suicide. The aim of this study is to investigate changes in FSH-LH, Estrogen, and Progesterone hormones in women attempting suicide by drugs and chemicals. Methods: In this cross-sectional study, women of reproductive diagnosed with drug and chemical poisoning who were hospitalized in Farshchian Hospital, Hamadan, Iran, were assessed regarding LH, FSH estrogen and progesterone hormones over a period of six months in 2011. Overall, 80 patients were studied with regard to the inclusion and exclusion criteria. Results: The highest rate of suicide was in the age range of 14-25 years (47 patients, 60.1%. A significant relationship was observed among the blood levels of hormones FSH, LH, progesterone, and estrogen. The association of hormone levels and LMP and attempted suicide was significant. The LH level was significantly lower in patients with substance abuse. The estrogen level was significantly lower in patients with the history of self-injury. Most patients (67.5% were in the follicular phase which was statistically significant. Conclusion: According to the obtained results, there was a significant relationship between the levels of different hormones. The significant relationship was positive in some cases but negative in other.

Emergency Department Visits Prior to Suicide and Homicide: Linking Statewide Surveillance Systems.

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Cerel, Julie; Singleton, Michael D; Brown, Margaret M; Brown, Sabrina V; Bush, Heather M; Brancado, Candice J

2016-01-01

Emergency departments (EDs) serve a wide range of patients who present at risk of impending suicide and homicide. Two statewide surveillance systems were probabilistically linked to understand who utilizes EDs and then dies violently within 6 weeks. Each identified case was matched with four randomly selected controls on sex, race, date of birth, resident zip code, and date of ED visit vs. date of death. Matched-pair odds ratios were estimated by conditional logistic regression to assess differences between cases and controls on reported diagnoses and expected payment sources. Of 1,599 suicides and 569 homicides in the 3-year study period, 10.7% of decedents who died by suicide (mean = 13.6 days) and 8.3% who died by homicide (mean = 16.3 days) were seen in a state ED within 6 weeks prior to death. ED attendees who died by suicide were more likely to have a diagnosis of injury/ poisoning diagnosis or mental disorder and more likely to have Medicare. Those who died by homicide were more likely to have a diagnosis of injury/poisoning and less likely to have commercial insurance. It is essential for research to further explore risk factors for imminent suicide and homicide in ED patients who present for psychiatric conditions and general injuries.

Epidemiological analysis of poisoning cases in Van, Turkey

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Aydin, I.; Karadas, S.; Gonullu, H.; Dulger, A. C.

2014-01-01

Objective: To investigate the etiological and demographical characteristics of acute adult poisoning cases in eastern Turkey. Methods: The retrospective study was conducted at the Emergency Department of Yuzuncu Yil University, School of Medicine, and comprised data related to the period between 2007 and 2009. The data obtained included age, gender, referrals, manner of poisoning, manner of application, the department which followed up on the patients, duration of hospital stay. All data was noted on proforma. SPSS 15 was used for statistical analysis. Results: Of the total cases visiting the Emergency Department, 1207 (1.1%) related to poisoning. Of them, 880 (72.9%) had attempted suicide; 858 (71.1%) were female; 349 (29%) were male. The average age of the females was 25.4+-8.5 years, and that of the males 28.3+-14.3 years. Single-medicine was noted in poisoning 544 (45.1%) patients. Other poisoning types were multidrugs 373 (30.9%); rat poisoning, insecticide and pesticides, 145 (12%); corrosives 38 (3.1%); and weed, mushroomang; food 47 (3.8%). Oral poisoning was noted in 1141 (94.5%) cases. A total of 1019 (84.4%) patients received treatment and were followed up in the Emergency Department. Six (0.6%) patients died. Conclusion: There is a need to generate more awareness about the hazards of domestic cleaning products and to keep it away at some distinct place to minimised chances of confusion. (author)

Suicide and Suicidal Behavior among Transgender Persons.

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Virupaksha, H G; Muralidhar, Daliboyina; Ramakrishna, Jayashree

2016-01-01

Suicide rate and suicidal tendencies among transgender persons are considerably high compared to general population. Hence, this review is an attempt to understand the issues around the suicide and suicidal behavior among transgender persons. The literature search conducted using three sources, i.e., electronic databases (PubMed, ProQuest, Google Scholar, PsycInfo), manual search (library catalog), and gray literature (consultation with experts). The suicide attempt rate among transgender persons ranges from 32% to 50% across the countries. Gender-based victimization, discrimination, bullying, violence, being rejected by the family, friends, and community; harassment by intimate partner, family members, police and public; discrimination and ill treatment at health-care system are the major risk factors that influence the suicidal behavior among transgender persons. In spite of facing a number of hardships in their day-to-day life, the transgender community holds a number of resiliency factors. Further, this community needs to be supported to strengthen their resiliency factors and draw culturally sensitive and transgender-inclusive suicide prevention strategies and increase protective factors to tackle this high rate of suicidality.

Prevalence of Suicide Ideation and Suicide Attempts among the Filipino Youth and Its Relationship with the Family Unit

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Mark Anthony Mujer Quintos

2017-05-01

Full Text Available The increasing threat of suicide amongst the youth serves as the motivation of this study. This study was done to add to the understanding of suicide in terms of ideation and actual attempts among the youth in the Philippines. In particular, this study attempted to accomplish the following objectives: (1 determine the prevalence of suicide ideation and suicide attempt among the Filipino youth, (2 determine the prevalent methods of suicide among the Filipino youth, (3 determine the prevalent reasons for suicide among the Filipino youth, and (4 determine if there is a significant correlation between the family and suicide ideation and suicide attempts among the Filipino youth. Results showed that roughly one in every ten Filipino youth aged 15 to 27 have thought of ending their life through suicide before, though only around one in every twenty pushes through with an actual attempt. When they do attempt to commit suicide, this is most frequently because of problems in the family and they utilize a violent method of suicide in the form of slashing of wrist(s or the non-violent method of ingesting poisonous substances. However, overall, the use of violent methods is more prevalent. When it comes to the factors correlated with suicide ideation and suicide attempts, this study found significant relationships between integration in the family and suicide. The study emphasizes the importance of a strong relationship between the youth and the other members of the family to curb the probability of suicide.

Increasing Suicide Rates Among Middle-age Persons and Interventions to Manage Patients with Psychiatric Complaints

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Bharath Chakravarthy

2014-02-01

Full Text Available The Centers for Disease Control and Prevention (CDC has published significant data and trends related to suicide rates in the United States (U.S.. Suicide is the 10th leading cause of death in U.S. adults, and rates are increasing across all geographic regions. There is a significant increase in the suicide rate among adults in the 35-64 age range. We present findings from the CDC’s Morbidity and Mortality Weekly Report (MMWR with commentary on current resources and barriers to psychiatric care. [West J Emerg Med. 2014;15(1:11–13.

Help-seeking, stigma and attitudes of people with and without a suicidal past. A comparison between a low and a high suicide rate country.

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Reynders, Alexandre; Kerkhof, Ad J F M; Molenberghs, Geert; Van Audenhove, Chantal

2015-06-01

A significant proportion of suicidal persons do not seek help for their psychological problems. Psychological help-seeking is assumed to be a protective factor for suicide. However, different studies showed that negative attitudes and stigma related to help-seeking are major barriers to psychological help-seeking. These attitudes and stigma are not merely individual characteristics but they are also developed by and within society. The aim of this study is twofold. First, we investigate if persons with a suicidal past differ from people without a suicidal past with respect to help-seeking intentions, attitudes toward help-seeking, stigma and attitudes toward suicide. The second aim is to investigate if these attitudinal factors differ between people living in two regions with similar socio-economic characteristics but deviating suicide rates. We defined high (Flemish Community of Belgium) and low (The Netherlands) suicide regions and drew a representative sample of the general Flemish and Dutch population between 18 and 65 years. Data were gathered by means of a postal questionnaire. Descriptive statistics are presented to compare people with and without suicidal past. Multiple logistic regressions were used to compare Flemish and Dutch participants with a suicidal past. Compared to people without a suicidal past, people with a suicidal past are less likely to seek professional and informal help, perceive more stigma, experience more self-stigma (only men) and shame (only women) when seeking help and have more accepting attitudes toward suicide. In comparison to their Dutch counterparts, Flemish people with a suicidal past have less often positive attitudes toward help-seeking, less intentions to seek professional and informal (only women) help and have less often received help for psychological problems (only men). The main limitations are: the relatively low response rate; suicidal ideation was measured by retrospective self-report; and the research sample

Firearms and suicide in the United States: is risk independent of underlying suicidal behavior?

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Miller, Matthew; Barber, Catherine; White, Richard A; Azrael, Deborah

2013-09-15

On an average day in the United States, more than 100 Americans die by suicide; half of these suicides involve the use of firearms. In this ecological study, we used linear regression techniques and recently available state-level measures of suicide attempt rates to assess whether, and if so, to what extent, the well-established relationship between household firearm ownership rates and suicide mortality persists after accounting for rates of underlying suicidal behavior. After controlling for state-level suicide attempt rates (2008-2009), higher rates of firearm ownership (assessed in 2004) were strongly associated with higher rates of overall suicide and firearm suicide, but not with nonfirearm suicide (2008-2009). Furthermore, suicide attempt rates were not significantly related to gun ownership levels. These findings suggest that firearm ownership rates, independent of underlying rates of suicidal behavior, largely determine variations in suicide mortality across the 50 states. Our results support the hypothesis that firearms in the home impose suicide risk above and beyond the baseline risk and help explain why, year after year, several thousand more Americans die by suicide in states with higher than average household firearm ownership compared with states with lower than average firearm ownership.

Prevalent Poisonings in Adolescents and Adults in Dubai: A Compendium from Rashid Hospital

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Fahad Akhtar Hameed

2014-09-01

Full Text Available Background: Profile of acute poisonings varies from country to country depending on the ease of availability of substances and socio-economic condition of people; however, very little information from the United Arab Emirates (UAE have been published, so far. This study was designed to find out the most common causes of overdose and poisoning in patients admitted to the emergency department of Rashid Hospital (RH, Dubai, UAE. Methods: In this retrospective cross sectional study, medical records of poisoned patients admitted to RH from 1st January 2012 to 31st December 2012 were reviewed. Demographic data, types of substances used, intention, length of hospital stay and outcomes were recorded in pre-designed checklists. Results: Overall, 163 patients were studied that among them gender distribution was relatively equal (male: female = 1.04: 1. Mean age of patients was 30.3 ± 11.5 and most patients were in the age group of 20 to 29 years age old (41.7%. Rgarding the type of poisons, the majority of patients were poisoned with pharmaceuticals (55.8% followed by chemical substances (23.3%. In pharmaceutical poisonings, most cases were due to multi-drug ingestion (22.6%, followed by ingestion of paracetamol (14.1% and benzodiazepines (4.3%. Considering the gender distribution, women were significantly more involved with pharmaceutical poisoning (P = 0.046, while venomous envenomation occurred only in men indicating a significant difference (P = 0.004. In chemical poisoning, most cases were due to ingestion of corrosive agents (19%. Suicidal poisoning was significantly more common in women (P < 0.001, while abuse was significantly more common in men (P < 0.001. Length of hospital stay averaged on 8.1 days. Only 3 patients died during the admission (mortality rate: 1.8%. Conclusion: Study on, training for and prevention of poisoning should receive more attention in the UAE. Over-the-counter drugs especially paracetamol should be prescribed in a more

Acute aluminium phosphide poisoning, what is new?

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Yatendra Singh

2014-01-01

Full Text Available Aluminium phosphide (AlP is a cheap solid fumigant and a highly toxic pesticide that is commonly used for grain preservation. AlP has currently generated interest with increasing number of cases in the past four decades because of its increased use for agricultural and nonagricultural purposes, and also its easy availability in the markets has led to its increased misuse to commit suicide. Ingestion is usually suicidal in intent, uncommonly accidental and rarely homicidal. The poison affects all systems, shock, cardiac arrhythmias with varied ECG changes and gastrointestinal features being the most prominent. Diagnosis is made on the basis of clinical suspicion, a positive silver nitrate paper test to phosphine, and gastric aspirate and viscera biochemistry. Treatment includes early gastric lavage with potassium permanganate or a combination of coconut oil and sodium bicarbonate, administration of charcoal and palliative care. Specific therapy includes intravenous magnesium sulphate and oral coconut oil. Unfortunately, the lack of a specific antidote Results in very high mortality and the key to treatment lies in rapid decontamination and institution of resuscitative measures. This article aims to identify the salient features and mechanism of AlP poisoning along with its management strategies and prognostic variables.

A gender-specific analysis of suicide methods in deliberate self-harm

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Kiran K Kumar

2017-01-01

Full Text Available Background: Deliberate self-harm (DSH is a major public health concern. Gender differences in suicide methods are a controversial realm with various regional and cultural variations. This study compared and assessed the methods used in DSH attempters as undertaken by men and women, and investigated the possible role of gender and other clinical variables in the selection of suicide method. Materials and Methods: Two hundred subjects fulfilling the inclusion and exclusion criteria were recruited in the study. The sociodemographic details were recorded in the semi-structured pro forma. Detailed assessment of psychiatric morbidity and DSH was done by clinical interview and validated by Mini International Neuropsychiatric Interview-Plus 5.0 and Beck Suicide Intent Scale. Data were analyzed using SAS version 9.2 and SPSS version 17.0. The sample was disaggregated by gender to compare the known correlates of suicide risk on the two most common methods of suicide – poison consumption and drug overdose using multivariate analyses. Results: The analysis revealed that majority of the attempters were in the age group of 11–40 years (91%. Females (63% outnumbered males (37%; poisoning was the most common type of method (50.5%, followed by drug overdose (35%. There were no statistical differences between the two genders with respect to other sociodemographic variables. Males from urban/semi-urban background (odds ratio [OR] = 4.059 and females living alone (OR = 5.723 had high odds ratio of attempting suicide by poison consumption. Females from urban/semi-urban background (P = 0.0514 and male subjects from nuclear families had an increased odds ratio (OR = 4.482 to attempt suicide by drug overdose. There were no statistical differences when the two genders were compared for other variables such as intentionality, lethality, impulsivity, and number of attempts. Conclusions: It appears that gender differences among DSH attempters appear less pronounced in

How often does deliberate self-harm occur relative to each suicide? A study of variations by gender and age.

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Hawton, Keith; Harriss, Louise

2008-12-01

Deliberate self-harm (DSH; i.e., nonfatal self-poisoning or self-injury) occurs much more frequently than suicide, yet there has been little detailed investigation of the comparative rates of DSH and suicide. We conducted a study of how rates of DSH relate to suicide rates across the life cycle by gender and by method of estimation of DSH rates, using 10 years of data from a local system for monitoring DSH presentations to a general hospital and national and local suicide statistics. The rate-ratio of DSH to suicide was 36 (95% CI 34.9-37.1) based on annual person-based rates of DSH episodes and was nearly five times higher in females (87.9; 95% CI 84.4-91.6) than in males (18.7; 95% CI 17.9-19.6). The ratio varied markedly across the life cycle, decreasing from more than 200 in teenagers to less than 10 in persons aged 60 years and over. The difference in the ratio between females and males also decreased over the life cycle. There were very similar findings when local suicide rates were used. These patterns were replicated when the data were analyzed, first, on the basis of all episodes of DSH during the study period, but with expectedly larger DSH:suicide ratios (e.g., overall 52.7; 95% CI 51.4-54.1), and second, on the basis of individual persons only engaging in DSH during the study period, but with smaller ratios (e.g., overall 26.2; 95% CI 25.4-27.2). The DSH:suicide rate ratios for those with high and low suicidal intent were similar within age groups except for those aged 60 years and over, in whom there was a greater proportion of high intent acts. These findings illustrate how the nature of self-harming behavior may vary in intention across the life cycle and between the genders, and provide a basis for further comparative work of this kind.

Management of acute organophosphorus pesticide poisoning.

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Eddleston, Michael; Buckley, Nick A; Eyer, Peter; Dawson, Andrew H

2008-02-16

Organophosphorus pesticide self-poisoning is an important clinical problem in rural regions of the developing world, and kills an estimated 200,000 people every year. Unintentional poisoning kills far fewer people but is a problem in places where highly toxic organophosphorus pesticides are available. Medical management is difficult, with case fatality generally more than 15%. We describe the limited evidence that can guide therapy and the factors that should be considered when designing further clinical studies. 50 years after first use, we still do not know how the core treatments--atropine, oximes, and diazepam--should best be given. Important constraints in the collection of useful data have included the late recognition of great variability in activity and action of the individual pesticides, and the care needed cholinesterase assays for results to be comparable between studies. However, consensus suggests that early resuscitation with atropine, oxygen, respiratory support, and fluids is needed to improve oxygen delivery to tissues. The role of oximes is not completely clear; they might benefit only patients poisoned by specific pesticides or patients with moderate poisoning. Small studies suggest benefit from new treatments such as magnesium sulphate, but much larger trials are needed. Gastric lavage could have a role but should only be undertaken once the patient is stable. Randomised controlled trials are underway in rural Asia to assess the effectiveness of these therapies. However, some organophosphorus pesticides might prove very difficult to treat with current therapies, such that bans on particular pesticides could be the only method to substantially reduce the case fatality after poisoning. Improved medical management of organophosphorus poisoning should result in a reduction in worldwide deaths from suicide.

Trends in fatalities due to poisoning at Umtata General Hospital, Mthatha (1993–2005

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Banwari L. Meel

2009-08-01

Full Text Available Poisoning is a common method of committing suicide in this region of South Africa. Females generally ingest poisons but it is increasingly becoming common in males too. This is a record review of autopsies carried out at the Umtata (Mthatha General Hospital mortuary, which forms part of the teaching hospital of the Walter Sisulu University Medical School. There were 10 230 unnatural deaths between 1993 and 2005. Of these deaths, 161 (1.6% were deaths due to poisoning. There was a marked increase in death by poisoning from 2.5% in 1993 to 13.7% in 2004. The highest percentage (17.4% of poison-related deaths was in 2001, and the lowest (2.5% was in 1993 and 1994. About two-thirds of victims (66% were males, and more than half of the victims (51.5% were in the 11 to 30 age group. There is an increasing trend in fatalities due to poisoning at Umtata General Hospital, Mthatha.

Decrease in Suicide Rates after a Change of Policy Reducing Access to Firearms in Adolescents: A Naturalistic Epidemiological Study

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Lubin, Gad; Werbeloff, Nomi; Halperin, Demian; Shmushkevitch, Mordechai; Weiser, Mark; Knobler, Haim Y.

2010-01-01

The use of firearms is a common means of suicide. We examined the effect of a policy change in the Israeli Defense Forces reducing adolescents' access to firearms on rates of suicide. Following the policy change, suicide rates decreased significantly by 40%. Most of this decrease was due to decrease in suicide using firearms over the weekend.…

Examining the Relationship Between Past Orientation and US Suicide Rates: An Analysis Using Big Data-Driven Google Search Queries.

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Lee, Donghyun; Lee, Hojun; Choi, Munkee

2016-02-11

Internet search query data reflect the attitudes of the users, using which we can measure the past orientation to commit suicide. Examinations of past orientation often highlight certain predispositions of attitude, many of which can be suicide risk factors. To investigate the relationship between past orientation and suicide rate by examining Google search queries. We measured the past orientation using Google search query data by comparing the search volumes of the past year and those of the future year, across the 50 US states and the District of Columbia during the period from 2004 to 2012. We constructed a panel dataset with independent variables as control variables; we then undertook an analysis using multiple ordinary least squares regression and methods that leverage the Akaike information criterion and the Bayesian information criterion. It was found that past orientation had a positive relationship with the suicide rate (P ≤ .001) and that it improves the goodness-of-fit of the model regarding the suicide rate. Unemployment rate (P ≤ .001 in Models 3 and 4), Gini coefficient (P ≤ .001), and population growth rate (P ≤ .001) had a positive relationship with the suicide rate, whereas the gross state product (P ≤ .001) showed a negative relationship with the suicide rate. We empirically identified the positive relationship between the suicide rate and past orientation, which was measured by big data-driven Google search query.

Acute mercury poisoning: a case report

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Aktas Can

2010-03-01

Full Text Available Abstract Background Mercury poisoning can occur as a result of occupational hazard or suicide attempt. This article presents a 36-year-old case admitted to emergency department (ED due to exposure to metallic mercury. Case Presentatıon A 36-year-old woman presented to the ED with a three-day history of abdominal pain, diarrhea and fever. One week ago her daughter had brought mercury in the liquid form from the school. She had put it on the heating stove. One day later, her 14-month old sister baby got fever and died before admission to the hospital. Her blood pressure was 134/87 mmHg; temperature, 40.2°C; heart rate 105 bpm and regular; respiration, 18 bpm; O2 saturation, 96%. Nothing was remarkable on examination and routine laboratory tests. As serine or urinary mercury levels could not be tested in the city, symptomatic chelation treatment with N-acetyl cysteine (NAC was instituted with regard to presumptive diagnosis and history. At the 7th day of admission she was discharged without any sequelae or complaint. At the discharge day blood was drawn and sent for mercury levels which turned out to be 30 μg/dL (normal range: 0 - 10 μg/dL. Conclusion Public education on poisoning and the potential hazards of mercury are of vital importance for community health.

Intoxicación aguda por plaguicidas Acute poisoning from pesticides

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Jaime Jesús Durán-Nah

2000-02-01

Full Text Available OBJETIVO: Describir la epidemiología de la intoxicación aguda por plaguicidas (IAP en el Hospital General O'Horán de Mérida, Yucatán, México. MATERIAL Y MÉTODOS: Se revisaron los expedientes de 33 pacientes ³ 13 años, tratados en una unidad de cuidados intensivos (UCI, entre 1994 y 1998. Se recopilaron variables demográficas y clínicas relevantes, y se aplicó estadística descriptiva. RESULTADOS: En la población estudiada predominó el sexo masculino (82% del medio rural (70%, y la edad media fue de 34 ± 15.8 años. El intento de suicidio fue causa frecuente de IAP (79%, y en 33% de los casos la intoxicación se produjo por la utilización de organofosforados. La mortalidad fue de 12%. CONCLUSIONES: La IAP fue baja entre los sujetos del medio rural, por lo que los resultados de este estudio parecen no reflejar la realidad del problema. Es importante añadir que los plaguicidas son utilizados con relativa frecuencia para el intento de suicidio.OBJECTIVE: To describe the epidemiologic pattern of acute pesticide poisoning (APP in a general hospital in Merida, Yucatan, Mexico. MATERIAL AND METHODS: From 1994 to 1998, 33 patients 13 years of age or older with diagnosis of APP were studied. Descriptive statistics were used to analyze information. RESULTS: Males were frequently affected (82%, specially those coming from rural areas (60%. The mean age of the group was 34 ± 15.8 years. In 79% of the cases, pesticides were used to commit suicide and 33% of poisoning cases were due to organophospate pesticides. The mortality rate was 12%. CONCLUSIONS: In this small sample, acute poisoning from pesticides in the agricultural setting may be underestimated, since it was less frequent than in the general population. APP was more commonly used by indigent people to commit suicide.

The Familial Factors and Demographic Characteristics of Children with Drug Poisoning

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Muzaffer Özenir

2013-12-01

Full Text Available Aim: The purpose of this study was to investigate the demographic characteristics, role of family factors, etiology and the factors affecting the prognosis in children who had been admitted to our hospital between 04 August 2007 and 24 January 2009 due to intoxication and, based on these data, to determine the preventive measures that can be taken. Methods: One hundred and one children (61 girls and 33 boys were included in the study. Patient age and sex, manner of poisoning, time between ingestion of poison and hospital admission, and attitudes and behaviors of families were recorded. Results: The poisoned patients represented 1.23%of all pediatric emergency admissions. The mean age of the patients was 6.75±5.30 years (range: 2-16. Self-poisoning was detected in 49 cases and 52 cases were accidental poisoning. It was seen that adolescent over 12 years of age were more prone to suicidal poisoning and children aged 2-6 years were more susceptible to accidental poisoning. Paracetamol (13.8% and amitriptyline (10.7% were the most common drugs. Conclusion: Although there are important improvements in the management of intoxication,family education and preventive measurements are of great importance. (The Medical Bulletin of Haseki 2013;51:157-61

A longitudinal comparison of age patterns and rates of suicide in Hong Kong, Taiwan and Japan and two Western countries.

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Snowdon, John; Chen, Ying-Yeh; Zhong, Baoliang; Yamauchi, Takashi

2018-01-01

Suicide data relating to 1979-2014 were obtained from three East Asian jurisdictions (Taiwan, Hong Kong, Japan) and two 'Western' countries (Australia, New Zealand). Rates and age patterns of suicide have changed markedly since 1979. Graphs of these patterns largely remained either upward-sloping, bimodal or flat (uniform) over the 36 years, male commonly differing from female, and East Asian patterns more like each other than those of the Western countries. Japan's male middle-aged suicide rate reached a peak in 1999-2003, which, like increased rates among working age males in Hong Kong and Taiwan, has been attributed largely to consequences of Asian financial crises. Male to female ratios of suicide rates have remained higher in the Western countries, but late life suicide rates have decreased to varying extents in all five jurisdictions. Identifying reasons for differences between jurisdictions in their suicide rates and patterns at particular times, and over time, is likely to point to factors (period, cohort, psychosocial or cultural) that protect against or foster suicidal ideation. This avenue of research may assist in identifying ways of preventing suicide. Copyright © 2017. Published by Elsevier B.V.

[A cross-sectional study on suicide attempts in urban middle school students in Chengdu].

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Zhang, Zhi-qun; Guo, Lan-ting

2003-03-01

To study the prevalence and associated factors of suicide attempt in middle school students. Five middle schools in Chengdu were randomly sampled in the study. A total of 1393 students between the ages of 11 and 18 finished a self-administered questionnaire, Beck Depression Inventory (BDI), Adolescent Self-Rating Life Events Check List (ASLEC) and Egma Minnen av Bardodosnauppforstran (EMBU). Everyone who had suicide attempts was interviewed. Data were analysed by SPSS 8.0 (statistical package for the social science) program on computer. Thirty-six (2.6%) of the 1 393 students has the history of attempted suicide and the ratio of boys and girls was 1:2. Among the suicide attempters, 33.3% had recurrent events. The most common reason of suicide attempts in middle school stage was family conflicts (34.4%) with most common event as taking overdose tranquilizers or poisoning (50.0%). Risk factors of suicide attempt seemed to include hallucination, cigarette smoking, being bullied by peers, wanting to change sex, parents' remarriage, being female, father's refusal, being neglected in childhood and experiencing more events in the previous year. Protecting factor was found to have been family warmness. Suicide attempts were not uncommonly seen in middle school students. Clinicians and teaching staff should identify the risk factors and carry out intervention as early as possible.

Gender differences in nonfatal suicidal behavior in Pakistan: significance of sociocultural factors.

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Khan, M M; Reza, H

1998-01-01

Suicidal behavior is an understudied subject in Pakistan. A variety of social, legal, and religious factors make reporting and data collection on suicide and nonfatal suicidal behavior difficult. To study the problem, a retrospective case-note analysis was carried out in which the sociodemographic and clinical characteristics of 262 female and 185 male suicidal individuals admitted to a university hospital in Karachi, Pakistan, are compared. Three quarters of the suicidal persons were under the age of 30 years. Compared to men, women were younger and more often married. Both women and men tended to use self-poisoning with benzodiazepines, but more women used organophosphate insecticides. In Pakistani society, legal, social, and economic discrimination predisposes women to psychological distress and subsequent suicidal behavior. The study highlights the need for culture-specific research on suicidal behavior in Pakistan.

Relationship between suicide rate and economic growth and stock market in the People’s Republic of China: 2004–2013

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Yin, Honglei; Xu, Lin; Shao, Yechang; Li, Liping; Wan, Chengsong

2016-01-01

Objectives The objective of this study was to estimate the features of suicide rate and its association with economic development and stock market during the past decade in the People’s Republic of China. Methods Official data were gathered and analyzed in the People’s Republic of China during the period 2004–2013. Nationwide suicide rate was stratified by four year age-groups, sex, urban/rural areas, and regions (East, Central, and West). Annual economic indexes including gross domestic product (GDP) per capita and rural and urban income per capita were all adjusted for inflation. Variation coefficient of market index (VCMI) was also included as an economic index to measure the fluctuation of the stock market. Negative binomial regression was performed to examine the time trend of region-level suicide rates and effects of sex, age, urban/rural area, region, and economic index on the suicide rates. Results Suicide rates of each age-group, sex, urban/rural area, and region were generally decreased from 2004 to 2013, while annual GDP per capita and rural and urban income per capita were generally increased by year. VCMI fluctuated largely, which peaked around 2009 and decreased after that time. Negative binomial regression showed that the decreased suicide rate in East and Central rural areas was the main cause of the decrease in suicide rate in the People’s Republic of China. Suicide rate in the People’s Republic of China for the study period increased with age and was higher in rural than in urban area, higher in males than in females, and the highest in the Central region. When GDP per capita increased by 2,787 RMB, the suicide rate decreased by 0.498 times. VCMI showed no significant relationship with suicide rate in the negative binomial regression. Conclusion Suicide rate decreased in 2004–2013; varied among different age-groups, sex, urban/rural areas, and regions; and was negatively associated with the economic growth in the People’s Republic of

Changes in suicide rates in disaster-stricken areas following the Great East Japan Earthquake and their effect on economic factors: an ecological study.

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Orui, Masatsugu; Harada, Shuichiro; Hayashi, Mizuho

2014-11-01

Devastating disasters may increase suicide rates due to mental distress. Previous domestic studies have reported decreased suicide rates among men following disasters. Few reports are available regarding factors associated with disasters, making it difficult to discuss how these events affect suicide rates. This study aimed to observe changes in suicide rates in disaster-stricken and neighboring areas following the Great East Japan Earthquake, and examine associations between suicide rates and economic factors. Monthly suicide rates were observed from March 2009 to February 2013, during which time the earthquake occurred on March, 2011. Data were included from disaster-stricken (Iwate, Miyagi, and Fukushima Prefectures) and neighboring (control: Aomori, Akita, and Yamagata Prefectures) areas. The association between changes in suicide rates and economic variables was evaluated based on the number of bankruptcy cases and ratio of effective job offers. In disaster-stricken areas, post-disaster male suicide rates decreased during the 24 months following the earthquake. This trend differed relative to control areas. Female suicide rates increased during the first seven months. Multiple regression analysis showed that bankruptcy cases (β = 0.386, p = 0.038) and ratio of effective job offers (β = -0.445, p = 0.018) were only significantly associated with male post-disaster suicide rates in control areas. Post-disaster suicide rates differed by gender following the earthquake. Our findings suggest that considering gender differences might be important for developing future post-disaster suicide prevention measures. This ecological study revealed that increasing effective job offers and decreasing bankruptcy cases can affect protectively male suicide rates in control areas.

Successful transplantation of donor organs from a hemlock poisoning victim.

Science.gov (United States)

Foster, Preston F; McFadden, Robert; Trevino, Raul; Galliardt, Scott; Kopczewski, Lea Ann; Gugliuzza, Kristene; Gonzalez, Zulma; Wright, Francis

2003-09-15

The poison hemlock plant (Conium maculatum) has been a known poison since early in human history, most notably as the agent used for the execution/suicide of Socrates in ancient Greece. No experience has been reported regarding the suitability of a hemlock victim's organs for transplantation. This report documents successful transplantation of the liver, kidney, and pancreas from a 14-year-old girl who died of anoxic encephalopathy from asphyxia after the accidental ingestion of fresh hemlock while on a nature hike. Predonation laboratory values were not remarkable, and liver and kidney biopsy results were normal. All organs in the three recipients had immediate function, and no recipient had any clinical evidence of transmitted toxin. All recipients are well, with functioning transplants at greater than 6 months after transplantation. Poison hemlock intoxication does not seem to be a contraindication to organ donation.

Pattern of Acute Poisoning Attending a Tertiary Care Hospital of Western Nepal

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Raju Prasad Shakya

2016-12-01

Full Text Available Introduction: Poisoning with various substances is a major public health problem and a reason for significant morbidity and mortality throughout the globe. It is one of the most common presentation in an emergency department. This study was conducted to determine the sociodemographic, poisoning types, and mode of poisoning in cases attending a tertiary hospital of Western Nepal. Methods: A retrospective observational study of two years was conducted from July 2014 to June 2016. Demography details, name of poisonous substance, and reasons for poisoning were reviewed and analyzed using descriptive statistics. Results: A total of 65 cases of poisoning were recorded. The occurrence was more common in female (n=44, 67.7% than in male (n=21, 32.3% with a F:M ratio of 2.1:1.  Poisoning  was most  common in the age group of 11-20 years (32.3%. Most of the cases were students (37% followed by farmers (26%. The most commonly abused poisoning substance were organophosphorous compounds, zinc-phosphate,  and  kerosene in adults, adolescents, and children respectively. Oral route was the most common (99% route of administration. Suicidal attempt, as a mode of poisoning, accounted for 70.8% of total poisoning cases. Conclusion: Female and young people are at greater risk of acute poisoning. Insecticide was the most common agent and self administer poisoning was the most common mode of poisoning. The occurrence of poisoning and its morbidity and mortality can be reduced by developing and implementation of effective prevention strategies like restricting easy poison sales, establishing drug and poison information centers,  and community awareness programs.

Suicidal behaviour

NARCIS (Netherlands)

Neeleman, J

2001-01-01

-Prevention of suicidal behaviour remains difficult, despite increasing knowledge of its determinants. Health service efforts hardly affect suicide rates. -Recent shifts in the epidemiology of suicidal behaviour are rising rates among the young and increasing use of violent methods. these can be

Stressors in attempted suicide by poisoning: a sex comparison Estressores na tentativa de suicídio por envenenamento: uma comparação entre os sexos

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Maria Cláudia da Cruz Pires

2012-01-01

Full Text Available OBJECTIVE: To identify stressors in attempted suicide by poisoning and to analyze differences between men and women. METHOD: This quantitative, comparative, cross-sectional study evaluated 110 patients aged between 14 and 78 years. The following instruments used were: standardized Mini International Neuropsychiatric Interview (MINI version 5.0.0 and an interview form specifically designed for the study. RESULTS: 70% of the suicide attempters were female; mean age was 28.1 years; 98.2% presented at least one psychiatric disorder. Among the stressors assessed, significant differences were observed between men and women for: not having a spouse, 72.7% among men and 54.5% among women; attempted suicide planning, 66.7% among men and 46.8% among women; being under the influence of alcohol during the attempted suicide, 51.5% among men and 26.0% among women; harmful use of alcohol, 42.4% in men and 22.1% in women; sexual abuse, 22.1% in women and 6.1% in men. CONCLUSIONS: Women presented a three times higher number of attempted suicides by poisoning. The identification of stressors with significant differences between sexes in the high-risk population here described can help define and organize strategies aimed at suicide prevention. Similar studies should be conducted in the general population.OBJETIVOS: Identificar estressores na tentativa de suicídio por envenenamento e analisar diferenças entre homens e mulheres. MÉTODO: Estudo quantitativo, transversal e comparativo que avaliou 110 pacientes, com idades entre 14 e 78 anos. Os instrumentos de avaliação utilizados foram: entrevista padronizada Mini International Neuropsychiatric Interview (MINI, versão 5.0.0, e formulário de entrevista desenvolvido especificamente para o estudo. RESULTADOS: 70% dos pacientes eram mulheres; a idade média foi de 28,1 anos; 98,2% apresentavam pelo menos um transtorno psiquiátrico. Dentre os estressores avaliados, foram observadas diferenças significativas

Comparison of elderly suicide rates among migrants in England and Wales with their country of origin.

Science.gov (United States)

Shah, Ajit; Lindesay, James; Dennis, Mick

2009-03-01

The black and minority ethnic (BME) elderly population size in England and Wales has progressively increased over the last three decades. Only two studies, both well over a decade old, have compared suicide rates in BME groups in England and Wales with those in their country of origin. A study comparing suicide rates among elderly migrants in England and Wales and in their country of origin using the latest available mortality data from the Office of National Statistics and the World Health Organization was conducted. There were wide variations in standardised mortality ratios for elderly suicides among migrants from different countries compared with those born in England and Wales and in their country of origin. There was convergence towards elderly suicide rates for England and Wales in some migrant groups in males in the age-bands 65-74 years and 75 + years, and in females in the age-band 75 + years. However, males aged 75 + years from most migrant groups had higher rates than those born in England and Wales. A more detailed analysis of suicide of older people from migrant groups is required to determine vulnerability and protective influences.

A case of organophosphate poisoning presenting with seizure and unavailable history of parenteral suicide attempt

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Pandit Vinay

2011-01-01

Full Text Available Organophosphate (OP poisoning is common in India. Only few case reports of parenteral OP poisoning have been described. We report a case of self-injected methyl parathion poisoning, presenting after four days with seizure, altered sensorium, and respiratory distress which posed a diagnostic and therapeutic dilemma. Despite nonavailability of history of OP poisoning, he was treated based on suspicion and showed a good clinical response to treatment trial with atropine and pralidoxime, and had a successful recovery. Atypical presentations may be encountered following parenteral administration of OP poison, and even a slight suspicion of this warrants proper investigations and treatment for a favorable outcome. Persistently low plasma cholinesterase level is a useful marker for making the diagnosis.

Methadone Related Poisoning on the Rise in Tehran, Iran

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Kambiz Soltaninejad

2014-09-01

Full Text Available Background: In Iran, methadone has been used for methadone maintenance treatment (MMT as well as analgesic treatment in pain clinics. Recently, there are some reports regarding accidental and intentional methadone poisonings and deaths. The aim of this study was to evaluate the trend of methadone poisonings and deaths during a 10-year period in Tehran, Iran. Methods: This was a retrospective cross-sectional study over 2000 to 2010. Patients with a documented methadone poisoning who were admitted in Loghman Hakim Hospital Poison Center in Tehran, Iran were identified and included in the study. The data including patients’ age, gender, ingested dose, co-ingestants, intention of ingestion and outcome were extracted from the patients’ medical records. Results: During the study period, 1426 cases of methadone poisoning were recorded, of which, 1041 cases (73% were men. Thirty-six cases (2.5% died. Mean age of the patients was 29.9 ± 17 years. In 476 cases, the intention of poisoning could not be determined, and in the remaining, the intention was misuse (n = 273, 28.7%, suicide (n = 254, 26.7%, accidental (n = 245, 25.8% and abuse (n = 178, 18.8%. Mean of the ingested dose of methadone was 120.6 ± 306.8 mg. The incidence of acute methadone poisoning per one million population of Tehran was 0.43 in 2000 that rose to 37.62 in 2010. Conclusion: The results indicate that methadone poisoning and deaths have increased in Tehran. MMT clinics should be strictly run according to the national guideline to prevent methadone poisoning. With regard to high frequency of poly-drug use in methadone poisoning, it seems important to warn health care providers against prescription of other drugs with methadone. 

A population-based analysis of increasing rates of suicide mortality in Japan and South Korea, 1985-2010.

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Jeon, Sun Y; Reither, Eric N; Masters, Ryan K

2016-04-23

In the past two decades, rates of suicide mortality have declined among most OECD member states. Two notable exceptions are Japan and South Korea, where suicide mortality has increased by 20 % and 280 %, respectively. Population and suicide mortality data were collected through national statistics organizations in Japan and South Korea for the period 1985 to 2010. Age, period of observation, and birth cohort membership were divided into five-year increments. We fitted a series of intrinsic estimator age-period-cohort models to estimate the effects of age-related processes, secular changes, and birth cohort dynamics on the rising rates of suicide mortality in the two neighboring countries. In Japan, elevated suicide rates are primarily driven by period effects, initiated during the Asian financial crisis of the late 1990s. In South Korea, multiple factors appear to be responsible for the stark increase in suicide mortality, including recent secular changes, elevated suicide risks at older ages in the context of an aging society, and strong cohort effects for those born between the Great Depression and the aftermath of the Korean War. In spite of cultural, demographic and geographic similarities in Japan and South Korea, the underlying causes of increased suicide mortality differ across these societies-suggesting that public health responses should be tailored to fit each country's unique situation.

Medical illness, medication use and suicide in seniors: a population-based case-control study.

Science.gov (United States)

Voaklander, D C; Rowe, B H; Dryden, D M; Pahal, J; Saar, P; Kelly, K D

2008-02-01

Suicide among seniors is a significant health problem in north America, particularly for men in whom the rates rise steadily after 50 years of age. The goal of this study was to examine elder suicides identified from a large population-based database using case-control methods to determine disease and medication factors related to suicide. A population-based 1 : 5 case-control study was conducted comparing seniors aged 66 years and older who had died by suicide with age and sex-matched controls. Case data were obtained through British Columbia (BC) Vital Statistics, whereas controls were randomly selected from the BC Health Insurance Registry. Cases and controls were linked to the provincial PharmaCare database to determine medication use and the provincial Physician Claims and Inpatient Hospitalization databases to determine co-morbidity. Between 1993 and 2002 a total of 602 seniors died by suicide in BC giving an annual rate of 13.2 per 100,000. Firearms were the most common mechanism (28%), followed by hanging/suffocation (25%), self-poisoning (21%), and jumping from height (7%). In the adjusted logistic model, variables related to suicide included: lower socioeconomic status, depression/psychosis, neurosis, stroke, cancer, liver disease, parasuicide, benzodiazepine use, narcotic pain killer use and diuretic use. There was an elevated risk for those prescribed inappropriate benzodiazepines and for those using strong narcotic pain killers. This study is consistent with previous studies that have identified a relationship between medical or psychiatric co-morbidity and suicide in seniors. In addition, new and potentially useful information confirms that certain types and dosages of benzodiazepines are harmful to seniors and their use should be avoided.

High Altitude Remains Associated with Elevated Suicide Rates after Adjusting for Socioeconomic Status: A Study from South Korea

OpenAIRE

Kim, Jaelim; Choi, Nari; Lee, Yu-Jin; An, Hyonggin; Kim, Namkug; Yoon, Ho-Kyoung; Lee, Heon-Jeong

2014-01-01

There have been several studies supporting a possible relationship between high suicide rate and high altitude. However socioeconomic status may confound this association because low socioeconomic status, which is known to be related to a high suicide rate, is also associated with living at high altitude. This study aims to explore whether the relationship between high altitude and high suicide rate remains after adjusting for socioeconomic status in South Korea. We collected demographic data...

Suicide rates in five-year age-bands after the age of 60 years: the international landscape.

Science.gov (United States)

Shah, Ajit; Bhat, Ravi; Zarate-Escudero, Sofia; DeLeo, Diego; Erlangsen, Annette

2016-01-01

There is paucity of studies examining suicide rates in narrow five-year age-bands after the age of 60 years. This study examined suicide rates in eight five-year age-bands between the age of 60 and 99 years because this will allow more precise comparison between the young old (60-79 years) and the oldest old (80+ years) age groups. Data on the number of suicides (International Classification of Diseases - ICD-10 codes, X60-84) in each of the eight five-year age-bands between the age-bands 60-64 years and 95-99 years in both gender for as many years as possible from 2000 were ascertained from three sources: colleagues with access to national data, national statisics office websites and email contact with the national statistics offices. The population size for the corresponding years and age-bands was estimated for each country using data provided by the United Nations website. In men, suicide rates continued to increase for each of the seven five-year age-bands from 60-64 years to 90-94 years age-band, and then declined slightly for the 95-99 year age-band. In women, suicide rates continued to increase for each of the six five-year age-bands from 60-64 years to 85-89 years age-bands, and then declined slightly for the 90-94 years and 95-99 years age-bands. The overall global suicide rates for each of the eight five-year age-bands are sufficiently large for them to constitute a public health concern. This is especially important given the ongoing rise in the elderly population size and the paucity of data on risk and protective factors for suicide in the five-year age-bands after the age of 60 years.

Impact of macro-level socio-economic factors on rising suicide rates in South Korea: panel-data analysis in East Asia.

Science.gov (United States)

Hong, Jihyung; Knapp, Martin

2014-12-01

The rapid increase in suicide rates in South Korea, particularly in the aftermath of the Asian economic crisis in the late 1990s, compares with the declining suicide rates observed in most other OECD countries over the same period. This study aimed to examine an array of macro-level societal factors that might have contributed to the rising suicide trend in South Korea. We first investigated whether this trend was unique to South Korea, or ubiquitous across five Asian countries/areas that are geographically and culturally similar (South Korea, Hong Kong, Japan, Singapore, and Taiwan), using WHO mortality data and national statistics (1980-2009). Age-standardised suicide rates (per 100,000 population) were calculated for each gender and age group (15-24, 25-44, 45-64, and 65+) for each country. Both panel data and country-specific time-series analyses were employed to investigate the impact of economic change and social integration/regulation on suicide. Despite similarities in geography and culture, the rising trend of suicide rates was unique to South Korea. This atypical trend was most apparent for people aged 65 and over, which was in sharp contrast to the decreasing suicide trends observed in the other four Asian countries. The results of the panel data analyses generally pointed to a negative relationship between economic growth and suicide rates, particularly for working-aged people. The results of the time-series analyses further suggested that low levels of social integration, as indicated by rising divorce rates, may also have a role in rising suicide rates in South Korea, particularly for older people. Furthermore, the association between suicide rates and economic adversity (unemployment and economic downturn) was most salient among middle-aged men in South Korea. Compared to four other East Asian countries/areas (Hong Kong, Japan, Singapore, and Taiwan), South Korea has uniquely experienced a rising trend of suicide rates over the past three decades

Impulsive but fatal self-poisoning with pesticides among South Asians in Nickerie, Suriname

NARCIS (Netherlands)

Spijker, v.B.A.J.; Graafsma, T.; Dullaart, H.I.A.; Kerkhof, A.J.F.M.

2009-01-01

Background: Intentional self-poisoning with pesticides is a serious problem in many developing countries. It is a commonly used method among South Asians all over the world. Aims: To describe the circumstances and characteristics of suicides in Nickerie, Suriname, in order to gain insight into why

Psychometric validation of the Columbia-Suicide Severity rating scale in Spanish-speaking adolescents.

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Serrani Azcurra, Daniel

2017-12-30

Adolescent suicide is a major public health issue, and early and accurate detection is of great concern. There are many reliable instruments for this purpose, such as the Columbia-Suicide severity rating scale (C-SSRS), but no validation exists for Spanish speaking Latin American adolescents. To assess psychometric properties and cut-off scores of the C-SSRS in Spanish speaking adolescents. Exploratory assessment with principal component analysis (PCA) and Varimax rotation, and confirmatory analysis (CFA) were performed on two groups with 782 and 834 participants respectively (N=1616). Mean age was 24.8 years. A Receiver operator analysis was applied to distinguish between control and suicide-risk subgroups adolescents. Promax rotation yielded two 10-items factors, for suicide ideation and behavior respectively. C-SSRS was positively correlated with other suicide risk scales, such as Beck Depression Inventory-II, Suicidal Behaviors Questionnaire-Revised, or PHQ-9. Confirmatory factor analysis yielded a two-factor solution as the best goodness of fit model. C-SSRS showed adequate ability to detect suicide risk group with positive predictive value of 68.3%. ROC analyses showed cutoff scores of ≥ 6 and ≥ 4 for suicide ideation and behavior scales respectively. This research offers data supporting psychometric validity and reliability of C-SSRS in nonclinical Spanish-speaking students. Added benefits are flexible scoring and management easiness. This questionnaire yields data on distinct aspects of suicidality, being more parsimonious than separate administration of a bunch of questionnaires.

[Cerebellar Infarction After Carbon Monoxide Poisoning and Hyperbaric Oxygen Therapy].

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Wick, Matthias; Schneiker, André; Bele, Sylvia; Pawlik, Michael; Meyringer, Helmut; Graf, Bernhard; Wendl, Christina; Kieninger, Martin

2017-06-01

We report on a patient who developed a space-occupying cerebellar infarction with occlusive hydrocephalus after a poisoning with carbon monoxide with the intention to commit suicide. A neurosurgical and intensive care therapy were needed. The patient's survival without severe neurological deficits could be secured due to the early detection of the intracerebral lesions. Georg Thieme Verlag KG Stuttgart · New York.

Suicidal thoughts and behaviors among women firefighters: An examination of associated features and comparison of pre-career and career prevalence rates.

Science.gov (United States)

Stanley, Ian H; Hom, Melanie A; Spencer-Thomas, Sally; Joiner, Thomas E

2017-10-15

Women protective service workers die by suicide at a higher rate than women workers in other occupational groups. However, no study has examined rates and correlates of suicidal thoughts and behaviors among women firefighters, despite the potential for these data to inform suicide screening, prevention, and intervention initiatives. The purpose of this study is to describe and compare pre-career and career rates of suicidal thoughts and behaviors and identify their sociodemographic and occupational correlates among women firefighters. Data were obtained from 313 current U.S. women firefighters who completed a web-based survey (mean age = 37.30y, SD = 9.70y, 92.7% White). Pre-career rates of suicide ideation, plans, attempts, and non-suicidal self-injury (NSSI) were found to be 28.4%, 10.2%, 5.8%, and 11.2%, respectively. Career rates of suicide ideation, plans, attempts, and NSSI were found to be 37.7%, 10.9%, 3.5%, and 9.3%, respectively. Pre-career rates of suicide ideation (OR = 4.760, 95% CI = 2.820-8.034, p harassment) are needed. Copyright © 2017 Elsevier B.V. All rights reserved.

On-Year Study on Pattern of Acute Pharmaceutical and Chemical Poisoning Cases Admitted to a Tertiary Care Hospital in Thrissur, India

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Padmakumar Krishnankutty Nair

2015-06-01

Full Text Available Background: Identification of regional pattern of poisoning is essential for health care authorities for proper planning on prevention programs and optimized management of antidote stockpiles. This study was designed to evaluate one-year epidemiologic pattern of acute poisoning cases treated at a tertiary care hospital in Thrissur, India. Methods: In this retrospective cross sectional study, medical records of patients with the diagnosis of acute pharmaceutical and chemical poisoning admitted to Jubilee Mission Hospital (JMH, during 1st October 2012 to 30th September 2013 were reviewed. Results: During the study period, 168 poisoned patients (59.5% women were treated at emergency department of JMH. Married patients outnumbered unmarried ones (55.4% vs. 44.6%. The highest number of patients aged 21 to 30 years (31.5% followed by patients with 11-20 years of age (17.3%. Most of the poisonings occurred following suicidal ideation (72.6%. Familial disharmony (14.3% was the most common reason behind suicidal ingestions, followed by mental disorders (11.3%. Drug poisoning made up the largest proportion of poisoning-related admissions (43.5% followed by pesticide poisoning (37.5%. Among poisoning with pharmaceutical agents, most cases were due to paracetamol (13.7% followed by anti-psychotics and sedatives (5.4%. In pesticide poisonings, the most common classes ingested by the patients were rodenticides and organophosphates. The most common household items ingested by the patients were petroleum products. The average length of hospital stay was 5.5 days. Seven patients (4.2% died, of which 4 were due to organophosphates followed by 2 due to carbamates and one due to rodenticide ingestion. Conclusion: Pharmaceutical and pesticide products were identified as the main cause of poisoning. This finding warrants educational programs for adequate safety measures on storage and use of these substances.

[When a Suicide Attempt is Kid's Stuff].

Science.gov (United States)

Vásquez-Rojas, Rafael; Quijano-Serrano, Margarita

2013-01-01

Attempted suicide in children and adolescents is a disturbing and painful issue for patients, their families and physicians. Current medical literature provides little information about minors who attempt suicide, possibly because there is under-reporting of this condition as a diagnosis, or maybe because it is sometimes considered as a way for the child to draw attention. To present the experience of the Department of Psychiatry (Universidad Nacional de Colombia) at the Hospital Infantil de La Misericordia, from 2003 to 2013. An observational retrospective study was conducted by reviewing 213 cases of children and adolescents treated for attempted suicide at the Hospital Infantil de La Misericordia from January 1, 2003 to October 31, 2013, and who received hospital or outpatient care in Child Psychiatry. A review was performed of the diagnosis, the number of suicide attempts, the peak months of consultation for this reason, and the methods selected, as well as a detailed description of the group of patients under 12 years old, and those managed with outpatient follow-up. The average patient is a female teenager who becomes intoxicated with drugs. Most often, patients do not return to outpatient follow-up. Those with follow-up have multiple psychopathologies and a high level of suffering. The most common methods, other than poisoning by drugs, are hanging and jumping from heights. Patients under 12 years old generally have their first attempt by drug poisoning. There is a predominance of anxiety disorder and depression, with a strong association with cognitive dysfunction, as a vulnerability factor. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Cyanide poisoning: report of a case studied by CT and MR

International Nuclear Information System (INIS)

Garcia, S.; Barrena, R.; Guelbenzu, S.; Garcia, A.I.

1997-01-01

Attempted suicide by cyanide poisoning causes rapid death by inhibition of cell-mediated oxidation. There are few cases of survival and most reports on the victims involve postmortem pathological studies. We present the case of a long-term survivor who developed parkinson, focusing especially on the contribution of neuroimaging to the diagnosis and follow-up. (Author) 15 refs

Profile of acute carbon monoxide poisoning in the west province of Iran

International Nuclear Information System (INIS)

Yari, M.; Ahmadi, H.

2012-01-01

Objective: To document the epidemiology and risk factors of acute carbon monoxide (CO) poisoning in the west of Iran and specify potentially presentable characteristics. Study Design: Observational study. Place and Duration of Study: Imam Khomeini Hospital of Kermanshah, Iran, from July 2006 to March 2008. Methodology: This study was conducted using the records of 143 cases of CO poisoning referred to the only centre for the reference of poisoning cases. Intent, age groups, source of poisoning and clinical presentation were noted and described as frequency. Results: One-hundred forty two cases (99.3%), were accidental and only one case (0.7%) was suicidal. Mortality was (21.7%, n=31). The highest mortality was found in the age groups of 20-30 years and below 10 years. The greatest frequency happened in autumn and winter. The clinical symptoms and manifestations of CO poisoning included headache (35.3%), nausea (25.4%), vomiting (21%), dyspnea (10.3%), and decrease in level of consciousness (8%). Gas water heaters (35%), room heaters (32%), stoves (24%) and other items (9%) were the principal sources of the individuals' exposure to CO. Conclusion: CO poisoning is a serious public health problem in west of Iran (Kermanshah). The number of CO poisoning cases was highest in the colder seasons of the year, whereas the majority of the poisoning cases could be prevented. (author)

Religion and assisted and non-assisted suicide in Switzerland: National Cohort Study.

Science.gov (United States)

Spoerri, Adrian; Zwahlen, Marcel; Bopp, Matthias; Gutzwiller, Felix; Egger, Matthias

2010-12-01

In the 19th century, eminent French sociologist Emile Durkheim found suicide rates to be higher in the Protestant compared with the Catholic cantons of Switzerland. We examined religious affiliation and suicide in modern Switzerland, where assisted suicide is legal. The 2000 census records of 1,722,456 (46.0%) Catholics, 1,565,452 (41.8%) Protestants and 454,397 (12.2%) individuals with no affiliation were linked to mortality records up to December 2005. The association between religious affiliation and suicide, with the Protestant faith serving as the reference category, was examined in Cox regression models. Hazard ratios (HRs) with 95% confidence intervals (CIs) were adjusted for age, marital status, education, type of household, language and degree of urbanization. Suicide rates per 100,000 inhabitants were 19.7 in Catholics (1664 suicides), 28.5 in Protestants (2158 suicides) and 39.0 in those with no affiliation (882 suicides). Associations with religion were modified by age and gender (P < 0.0001). Compared with Protestant men aged 35-64 years, HRs (95% CI) for all suicides were 0.80 (0.73-0.88) in Catholic men and 1.09 (0.98-1.22) in men with no affiliation; and 0.60 (0.53-0.67) and 1.96 (1.69-2.27), respectively, in men aged 65-94 years. Corresponding HRs in women aged 35-64 years were 0.90 (0.80-1.03) and 1.46 (1.25-1.72); and 0.67 (0.59-0.77) and 2.63 (2.22-3.12) in women aged 65-94 years. The association was strongest for suicides by poisoning in the 65-94-year-old age group, the majority of which was assisted: HRs were 0.45 (0.35-0.59) for Catholic men and 3.01 (2.37-3.82) for men with no affiliation; 0.44 (0.36-0.55) for Catholic women and 3.14 (2.51-3.94) for women with no affiliation. In Switzerland, the protective effect of a religious affiliation appears to be stronger in Catholics than in Protestants, stronger in older than in younger people, stronger in women than in men, and particularly strong for assisted suicides.

Treatment of self-poisoning at a tertiary level hospital in Bangladesh

DEFF Research Database (Denmark)

Verma, Vasundhara; Paul, Sujat; Ghose, Aniruddha

2017-01-01

OBJECTIVES: Approximately 10,000 people die from suicide annually in Bangladesh, many from pesticide poisoning. We aimed to estimate financial costs to patients and health services of treating patients with self-poisoning. METHODS: Data on direct costs to families, sources of funds for treatment...... and family wealth were collected prospectively over a one-month period in 2016 at the tertiary Chittagong Medical College Hospital, Bangladesh. Aggregate operational costs to the government were calculated using annual budget, bed occupancy and length-of-stay data. RESULTS: Agrochemicals were the most common...... as organophosphorus poisoning in 17(.) 0% of agrochemical cases resulted in increased cost to patients. Only 51(.) 9% of patients had indicators of wealth; 78(.) 1% borrowed money to cover costs. Conservatively estimated median healthcare costs (US$ 21(.) 30 per patient) were markedly lower than costs to patients...

Risk factors associated with purchasing pesticide from shops for self-poisoning

DEFF Research Database (Denmark)

Weerasinghe, Manjula; Konradsen, Flemming; Eddleston, Michael

2015-01-01

of individuals who purchase pesticides directly from shops and how they differ from individuals who access pesticides from other sources such as home, home garden or farmland. This information will help inform possible vendor/shop-based intervention strategies aimed at reducing access to pesticides used for self-harm......INTRODUCTION: Pesticide self-poisoning is one of the most frequently used methods of suicide worldwide, killing over 300,000 people annually. Around 15-20% of pesticide self-poisonings occur soon after the person has bought the pesticide from a shop. We aim to determine the characteristics....... METHODS AND ANALYSIS: This study will investigate risk factors associated with purchasing pesticides for acts of self-poisoning from pesticide shops, including cases identified over a 9-month period using a population-based case-control group approach. Four interviewer-administered data collection tools...

Time trend by region of suicides and suicidal thoughts among Greenland Inuit

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Peter Bjerregaard

2015-02-01

Full Text Available Background: Suicides remain a major public health problem in Greenland. Their increase coincides with the modernization since 1950. Serious suicidal thoughts are reported by a significant proportion of participants in countrywide surveys. Objective: To analyze the time trend by region of suicides and suicidal thoughts among the Inuit in Greenland. Design: Data included the Greenland registry of causes of death for 1970–2011 and 2 cross-sectional health surveys carried out in 1993–1994 and 2005–2010 with 1,580 and 3,102 Inuit participants, respectively. Results: Suicide rates were higher among men than women while the prevalence of suicidal thoughts was higher among women. Suicide rates for men and women together increased from 1960 to 1980 and have remained around 100 per 100,000 person-years since then. The regional pattern of time trend for suicide rates varied with an early peak in the capital, a continued increase to very high rates in remote East and North Greenland and a slow increase in villages relative to towns on the West Coast. Suicidal thoughts followed the regional pattern for completed suicides. Especially for women there was a noticeable increasing trend in the villages. The relative risk for suicide was highest among those who reported suicidal thoughts, but most suicides happened outside this high-risk group. Conclusion: Suicide rates and the prevalence of suicidal thoughts remain high in Greenland but different regional trends point towards an increased marginalization between towns on the central West Coast, villages and East and North Greenland. Different temporal patterns call for different regional strategies of prevention.

Gender differences of suicides in children and adolescents: Analysis of 167 suicides in a Mexican population from 2003 to 2013.

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Aguilar-Velázquez, Daniela Georgina; González-Castro, Thelma Beatriz; Tovilla-Zárate, Carlos Alfonso; Juárez-Rojop, Isela E; López-Narváez, Maria Lilia; Frésan, Ana; Hernández-Díaz, Yazmin; Guzmán-Priego, Crystell Guadalupe

2017-12-01

Suicide is the second cause of death in youth population. The aim of the present study was to analyze demographic characteristics and suicide methods used, as well as to identify gender differences among Mexican children and adolescents (aged 10-17 years) that committed suicide. Between January 2003 and December 2013, 167 suicides of children and adolescents between 10 and 17 years of age were documented by the Secretary of Health of the state of Tabasco, Mexico. All sociodemographic characteristics were compared according to gender. Our sample included 67.7% males and 32.3% females (male to female 2.1:1). The predominant marital status was single (89.6%) and hanging (93.7%) was the principal method of suicide used. Both female and male adolescents were predominantly students (50%); however, female adolescents were more frequently married (17%) and were housewives (26.4%). Our results identified that hanging is the principal suicide method used by children and adolescents in Mexican population; we also detected main gender differences in terms of poisoning/drug toxicity as the method used, occupation and marital status. These results should be taken into consideration when designing suicide prevention programs due to the differences found by gender. Copyright © 2017 Elsevier B.V. All rights reserved.

Suicide among Arab-Americans.

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Abdulrahman M El-Sayed

2011-02-01

Full Text Available Arab-American (AA populations in the US are exposed to discrimination and acculturative stress-two factors that have been associated with higher suicide risk. However, prior work suggests that socially oriented norms and behaviors, which characterize recent immigrant ethnic groups, may be protective against suicide risk. Here we explored suicide rates and their determinants among AAs in Michigan, the state with the largest proportion of AAs in the US.ICD-9/10 underlying cause of death codes were used to identify suicide deaths from among all deaths in Michigan between 1990 and 2007. Data from the 2000 U.S. Census were collected for population denominators. Age-adjusted suicide rates among AAs and non-ethnic whites were calculated by gender using the direct method of standardization. We also stratified by residence inside or outside of Wayne County (WC, the county with the largest AA population in the state. Suicide rates were 25.10 per 100,000 per year among men and 6.40 per 100,000 per year among women in Michigan from 1990 to 2007. AA men had a 51% lower suicide rate and AA women had a 33% lower rate than non-ethnic white men and women, respectively. The suicide rate among AA men in WC was 29% lower than in all other counties, while the rate among AA women in WC was 20% lower than in all other counties. Among non-ethnic whites, the suicide rate in WC was higher compared to all other counties among both men (12% and women (16%.Suicide rates were higher among non-ethnic white men and women compared to AA men and women in both contexts. Arab ethnicity may protect against suicide in both sexes, but more so among men. Additionally, ethnic density may protect against suicide among Arab-Americans.

Suicide among Arab-Americans.

Science.gov (United States)

El-Sayed, Abdulrahman M; Tracy, Melissa; Scarborough, Peter; Galea, Sandro

2011-02-17

Arab-American (AA) populations in the US are exposed to discrimination and acculturative stress-two factors that have been associated with higher suicide risk. However, prior work suggests that socially oriented norms and behaviors, which characterize recent immigrant ethnic groups, may be protective against suicide risk. Here we explored suicide rates and their determinants among AAs in Michigan, the state with the largest proportion of AAs in the US. ICD-9/10 underlying cause of death codes were used to identify suicide deaths from among all deaths in Michigan between 1990 and 2007. Data from the 2000 U.S. Census were collected for population denominators. Age-adjusted suicide rates among AAs and non-ethnic whites were calculated by gender using the direct method of standardization. We also stratified by residence inside or outside of Wayne County (WC), the county with the largest AA population in the state. Suicide rates were 25.10 per 100,000 per year among men and 6.40 per 100,000 per year among women in Michigan from 1990 to 2007. AA men had a 51% lower suicide rate and AA women had a 33% lower rate than non-ethnic white men and women, respectively. The suicide rate among AA men in WC was 29% lower than in all other counties, while the rate among AA women in WC was 20% lower than in all other counties. Among non-ethnic whites, the suicide rate in WC was higher compared to all other counties among both men (12%) and women (16%). Suicide rates were higher among non-ethnic white men and women compared to AA men and women in both contexts. Arab ethnicity may protect against suicide in both sexes, but more so among men. Additionally, ethnic density may protect against suicide among Arab-Americans.