Biomedical subjects

I O'Donnell

Publications and source records attributed to I O'Donnell.

10 recordsLinked to original sources

PubMed1996

Explaining suicide: the views of survivors of serious suicide attempts.

BACKGROUND: There is a dearth of information on the motivational aspects of serious suicide attempts, in particular those which involve violent methods. Clarification of the reasons which lie behind such acts may suggest appropriate preventive strategies. METHOD: Interviews were carried out with 20 individuals who had attempted suicide by jumping in front of a railway train. Demographic and psychiatric data were collected for each case and the Suicidal Intent Scale was administered. RESULTS: In most cases the act had been impulsive and was characterised by an extremely high level of suicidal intent. The majority were receiving psychiatric treatment at the time of their suicide attempt. In some cases, survival and the aftermath of the attempt appeared to have a beneficial effect on mental state. CONCLUSIONS: While high levels of psychiatric morbidity and high suicidal intent were common, impulsivity and improved mental state indicate that there are similarities between high and low suicide intent survivors.

Adult↗

PubMed1995

The limitations of official suicide statistics.

BACKGROUND: This study explored some of the problems associated with current procedures for the ascertainment of suicide. METHOD: A sample of 242 deaths which were known to have been self-inflicted was followed up through the coroners' courts where causes of death were legally established. RESULTS: Verdicts other than suicide were returned on half of the men, and on one-quarter of the women. CONCLUSIONS: For suicide statistics to become valid indicators of suicide rates it might be more appropriate to apply the civil, rather than the criminal, standard of proof during inquest proceedings.

Adult↗

PubMed1994

The epidemiology of suicide on the London Underground.

A database containing details of every incident of suicidal behaviour on the London Underground railway system between 1940 and 1990 was assembled from the records of London Underground Ltd and the British Transport Police. The total number of cases was 3240. The mean annual number of suicidal acts on the London Underground system increased from 36.1 (1940-1949) to 94.1 (1980-1989). There were significantly fewer incidents on Sundays than on the other days of the week and the daily rate was highest in the spring. 64% of incidents involved males and the peak age group for both sexes was 25-34 yr. Suicide verdicts were returned for a greater proportion of women than men. Overall case fatality was 55%. However, case fatality rates differed between stations, environmental factors appearing to influence survival. Possible strategies to prevent railway suicides and reduce the lethality of this method are discussed.

Adolescent↗

PubMed1994

A follow-up study of attempted railway suicides.

This paper reports the subsequent mortality of 94 persons who attempted suicide by jumping in front of London Underground trains between 1977 and 1979. The follow-up period was 10 yr. Despite the apparent seriousness of the method, completion of suicide was not found to be higher than in previous studies of attempted suicide by other methods. By the end of the follow-up period 18 persons had died, nine of natural causes. Coroners' inquests were held for the unnatural deaths. Seven verdicts of suicide and two of accidental death were recorded. Of the nine unnatural deaths four were from multiple injuries, three from drowning, one from asphyxia and one from acute narcotic poisoning. All four multiple injury deaths were women, three of these were from repeated incidents involving London Underground trains. The time interval between the index attempt and eventual death for the suicide/accident group ranged from 1 day to 43 months. For ethical reasons it was not possible to follow-up attempted suicides who were presumed to have remained alive.

Adolescent↗

PubMed1993

Suicide and HIV disease.

It has been suggested that HIV infection is associated with an increased risk of suicidal behaviour. This paper reviews the literature on suicide in patients with HIV disease and discusses methodological problems encountered in studying the incidence of suicide in this population. A snowballing method was used to identify cases of suicide in patients who were receiving treatment for HIV disease in a central London health district. The possible under detection of suicides among AIDS patients is considered. The six case reports are described to illustrate the clinical and psychosocial characteristics of suicides, and they are discussed in relation to other findings on suicide in patients with HIV disease and other physical illnesses.

Acquired Immunodeficiency Syndrome↗

PubMed1993

Suicide notes.

Detailed case reports of incidents of suicide and attempted suicide on the London Underground railway system between 1985 and 1989 were examined for the presence of suicide notes. The incidence of note-leaving was 15%. Notes provided little insight into the causes of suicide as subjectively perceived, or strategies for suicide prevention.

Accidents, Traffic↗

PubMed1992

Railway suicide: the psychological effects on drivers.

People have jumped (or fallen) in front of trains on the London Underground system in increasing numbers throughout the twentieth century. During the past decade there have been about 100 such incidents each year, of which around 90 would involve the train driver witnessing his train strike the person on the track. Most are suicides or attempts at suicide. They represent major unexpected and violent events in the lives of the train drivers and it might be expected that some of them would respond by developing a post-traumatic stress reaction of the type identified by Horowitz (1976) or other adverse psychological reactions or both. The research reported in this paper was designed to characterize the range of responses of drivers to the experiences of killing or injuring members of the public during the course of their daily work. It was found that 16.3% of the drivers involved in incidents did develop post-traumatic stress disorder and that other diagnoses, e.g. depression and phobic states, were present in 39.5% of drivers when interviewed one month after the incident.

Adult↗

PubMed1992

Suicidal acts on metro systems: an international perspective.

Suicide is a problem experienced by railway networks worldwide. The epidemiology of this method of suicide has not been described in any detail. To investigate the characteristic features of railway suicide, data were gathered from 23 metro systems around the world. The similarities in the nature of this problem across systems were striking. Universally the victims were young (aged less than 40 years); most incidents involved men; case fatality was generally less than 60%; there was no consistent seasonal variation in incidence; the peak time of day for incidents was 1000-1200; proximity to psychiatric institutions was possibly a risk factor. This method of suicide may be prevented by environmental modification of the railway system. Strategies for reducing the opportunities for suicide on railways are discussed.

Adolescent↗

PubMed1991

Suicide on the London Underground System.

Over the past 50 years there has been an increase in the numbers of people jumping/falling in front of trains on the London Underground system. Case-fatality rates have fallen from 70% in the 1950s to 55% today. The proportion certified as suicide has fallen while the proportions certified as accidents or open verdicts have risen. There is unusual clustering of events at some stations which are adjacent to psychiatric units. The hypothesis that ease of access to London Underground stations may sometimes be a determinant of suicide is investigated.

Humans↗

PubMedDate not supplied

Improving procedures for recording suicide statistics.

OBJECTIVE: To explore the changing relationship between rates of suicide and undetermined death in Britain and Ireland. DESIGN: Longitudinal analysis of the official statistics relating to unnatural deaths in England and Wales and the Republic of Ireland between 1976 and 1992. MAIN OUTCOME MEASURES: Male and female rates of suicide and undetermined deaths for Ireland and England and Wales, age adjusted to the standard world population. Ratio of undetermined deaths to suicide. RESULTS: The official Irish male suicide rate is now much higher than that of England and Wales while the female rates are broadly similar. The rate of undetermined deaths has risen amongst English males and remained stable for females but has significantly fallen off among both Irish males and females. The proportion of deaths classified as 'undetermined' is now very much less in Ireland than in England and Wales. DISCUSSION: National plans for suicide prevention in either country cannot be properly audited unless improved procedures are put in place to increase the validity and reliability of the official suicide figures. Each country could beneficially learn from the other in this regard.

Adolescent↗