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At least 19 recordsLinked to original sources
PubMed2004

Health care contacts before and after attempted suicide among adolescent and young adult versus older suicide attempters.

BACKGROUND: The pattern of all health care contacts among young people before and after attempted suicide is not well documented. Neither is it known if the health care contacts of young suicide attempters differ from those of older suicide attempters. This study investigated the age-related clinical characteristics of suicide attempters and the pattern of their contacts with health care before and after attempted suicide in different age groups, particularly adolescence and young adulthood. METHOD: All consecutive 1198 suicide attempters treated in hospital emergency rooms in Helsinki between January 1997 and January 1998 were identified and divided into three age groups (15-24 years, 25-39 years, 40 years and over). Data were gathered on all health care contacts 1 year before and after the index attempt. RESULTS: Although adolescent and young adult suicide attempters suffered from severe mental disorders, a remarkable proportion of them were left without psychiatric consultation and aftercare recommendation following the attempt. Two-thirds of 15-19-year-old male suicide attempters had no treatment contact during the month before the attempt, while a quarter of them were referred to psychiatric consultation and a half had no healthcare contact in the month following the attempt. CONCLUSIONS: These findings indicate considerable scope for improvement in the assessment of young suicide attempters and their referral to aftercare.

Adolescent↗
PubMed1978

Suicide, attempted suicide, and relapse rates in depression.

Suicide, attempted suicide, and relapse rates in 519 depressives were examined, comparing the effects of different treatments. After six months, suicide attempts were seen significantly less frequently in the ECT groups (0.8%) than in the antidepressant group (4.2%) or the "adequate" antidepressant subgroup (7.0%) Fewer suicide attempts occurred in the ECT group compared to the antidepressant group among both in those who had attempted suicide prior to admission (0% vs 10%) and in those who had not (1.1% vs 3.6%). A history of attempted suicide showed a greater risk of both suicide (2.9%) in the following year and subsequent suicide attempt (5.9%). A depressive diagnosis may be as good a predictor of suicidal behavior as a history of attempted suicide. Relapse rates did not differ between treatment groups.

Adjustment Disorders↗
PubMed2006

Antidepressants and the risk of suicide, attempted suicide, and overall mortality in a nationwide cohort.

BACKGROUND: It is unknown if antidepressant treatment is associated with either increased or decreased risk of suicide. OBJECTIVE: To estimate the risk of suicide, attempted suicide, and overall mortality during antidepressant treatments in a real-life setting with high statistical power. DESIGN AND SETTING: A cohort study in which all subjects without psychosis, hospitalized because of a suicide attempt from January 1, 1997, to December 31, 2003, in Finland, were followed up through a nationwide computerized database. PARTICIPANTS: A total of 15 390 patients with a mean follow-up of 3.4 years. MAIN OUTCOME MEASURES: The propensity score-adjusted relative risks (RRs) during monotherapy with the most frequently used antidepressants compared with no antidepressant treatment. RESULTS: In the entire cohort, fluoxetine use was associated with the lowest risk (RR, 0.52; 95% confidence interval [CI], 0.30-0.93), and venlafaxine hydrochloride use with the highest risk (RR, 1.61; 95% CI, 1.01-2.57), of suicide. A substantially lower mortality was observed during selective serotonin reuptake inhibitor use (RR, 0.59; 95% CI, 0.49-0.71; P<.001), and this was attributable to a decrease in cardiovascular- and cerebrovascular-related deaths (RR, 0.42; 95% CI, 0.24-0.71; P=.001). Among subjects who had ever used any antidepressant, the current use of medication was associated with a markedly increased risk of attempted suicide (39%, P<.001), but also with a markedly decreased risk of completed suicide (-32%, P=.002) and mortality (-49%, P<.001), when compared with no current use of medication. The results for subjects aged 10 to 19 years were basically the same as those in the total population, except for an increased risk of death with paroxetine hydrochloride use (RR, 5.44; 95% CI, 2.15-13.70; P<.001). CONCLUSIONS: Among suicidal subjects who had ever used antidepressants, the current use of any antidepressant was associated with a markedly increased risk of attempted suicide and, at the same time, with a markedly decreased risk of completed suicide and death. Lower mortality was attributable to a decrease in cardiovascular- and cerebrovascular-related deaths during selective serotonin reuptake inhibitor use.

Adolescent↗
PubMed2006

[Reduction in short-term repetition of attempted suicide associated with new organization of psychiatric management of suicide attempters. Two cohorts].

OBJECTIVES: To investigate the impact of the reorganization of psychiatric care in the Accident and Emergency (A&E) unit on repeated suicide attempts. METHOD: The study includes suicide attempters admitted to the Rennes University Hospital (Brittany, France) A&E unit in 1994 (n=1003) and 2000 (n=1018). We compared the clinical data (age, gender, marital status, suicide history, methods, and outcome at discharge from A&E) and psychiatric management of the two cohorts. The rate of repeated suicide attempts was measured according to the same criterion in 1994 and 2000 (re-admission to the A&E unit). RESULTS: Both populations of suicide attempters were very similar from both a clinical and demographic point of view. The repetition rate at 1 month was significantly higher (OR=4.16, p=0.0001) in 1994 than in 2000. The difference between the cohorts continued at three and six months, but became statistically insignificant at one year. CONCLUSION: By 2000, organization of psychiatric care in the A&E unit had been substantially strengthened. The presence of a complete psychiatric team (nurses, junior psychiatrist, and senior psychiatrist) in the A&E unit, 24 hours a day, seven days a week, was associated with a lower rate of repeated suicide attempts.

Adolescent↗
PubMed1989

Attempted suicide in those with personality disorders. A comparison of depressed and unsocialized suicide attempters.

From a sample of 499 patients admitted to hospitals for suicide attempts, a subsample of 182 suicide attempters who described histories of illicit activities or who were diagnosed with DSM-II anti-social, drug or alcohol personality disorders were compared with another sample of 109 suicide attempters diagnosed as having depressive disorders. The former group of unsocialized attempters obtained similar depression inventory scores as the diagnosed depressive attempters. However, the index attempts of the unsocialized group were made with less suicidal intent than those of the diagnosed depressive patients, and they made more prior suicide attempts than the diagnosed depressive patients.

Adult↗
PubMed1996

Attempted suicide in Europe: rates, trends and sociodemographic characteristics of suicide attempters during the period 1989-1992. Results of the WHO/EURO Multicentre Study on Parasuicide.

The World Health Organization/EURO Multicentre Project on Parasuicide is part of the action to implement target 12 of the WHO programme, "Health for All by the Year 2000', for the European region. Sixteen centres in 13 European countries are participating in the monitoring aspect of the project, in which trends in the epidemiology of suicide attempts are assessed. The highest average male age-standardized rate of suicide attempts was found for Helsinki, Finland (314/100,000), and the lowest rate (45/100,000) was for Guipuzcoa, Spain, representing a sevenfold difference. The highest average female age-standardized rate was found for Cergy-Pontoise, France (462/100,000), and the lowest (69/100,000) again for Guipuzcoa, Spain. With only one exception (Helsinki), the person-based suicide attempt rates were higher among women than among men. In the majority of centres, the highest person-based rates were found in the younger age groups. The rates among people aged 55 years or over were generally the lowest. For the majority of the centres, the rates for individuals aged 15 years or over decreased between 1989 and 1992. The methods used were primarily "soft' (poisoning) or cutting. More than 50% of the suicide attempters made more than one attempt, and nearly 20% of the second attempts were made within 12 months after the first attempt. Compared with the general population, suicide attempters more often belong to the social categories associated with social destabilization and poverty.

Adolescent↗
PubMed1998

Physiological reactions to a suicide film: suicide attempters, suicide ideators, and nonsuicidal patients.

A film about two teenagers who commit suicide was shown to three groups of psychiatric inpatients: 17 who had attempted suicide, 20 who had expressed suicidal thoughts, and 10 who were not suicidal. Anxiety before and after the film was evaluated with psychometric (anxiety rating scale) and physiological tools (heart and respiration rate, blood pressure, electromyogram). Values noted before and after screening, and the degree of change in these values, were compared. In addition, psychomotor agitation was rated at several points during the film. Most results were negative. The suicide attempters had significantly lower postscreening heart rates and a significantly lesser change in heart and respiration rates than the other two groups. The suicide attempters revealed an increase in psychomotor agitation until the discovery of the suicide and a decrease thereafter, whereas the agitation of the nonsuicidal patients continued to increase from the start to the end of the film. The study suggests that on some parameters, suicide attempters reveal less anxiety than nonsuicidal psychiatric patients following exposure to a simulated suicide. The reaction of suicide ideators falls somewhere between the two groups.

Adult↗
PubMed1999

Comparing suicide attempters, suicide ideators, and nonsuicidal homeless and runaway adolescents.

This study considers variables that best distinguish among attempters, ideators, and nonsuicidal youth in a sample of 527 homeless and runaway adolescents from four Midwestern states. Univariate results indicate that attempters are significantly more likely than ideators and nonsuicidal youth to have experienced physical or sexual abuse by an adult caretaker, to have experienced sexual victimization while on their own, and to have a friend who attempted suicide. Multivariate analyses reveal five variables that best distinguish among the three groups: self-esteem, depression, physical abuse, sexual abuse, and having a friend who attempted suicide. Further analysis suggests that the accumulation of these risk factors greatly increases the chance that these youth will engage in suicidal behavior.

Adolescent↗
PubMed1995

Project plan for studies on suicide, attempted suicide, and suicide prevention.

Completed and attempted suicide are major public health problems in most western countries. The importance of suicidal behavior as a health problem, particularly among adolescents and young adults, has been emphasized by the European Union, the WHO (Europe), as well as the Finnish authorities. Due to the exceptionally high suicide mortality, suicide prevention has been one of the main targets of Finnish health policy since the late 1980s. However, to develop feasible strategies for suicide prevention, better knowledge of the phenomenon of self-destruction is necessary. The Department of Mental Health of the National Public Health Institute has been actively involved in suicide research and the development of suicide strategies both in Finland and western Europe since 1986. The success is based on a long tradition of suicide research in Finland, the representative and reliable suicide data, a highly motivated research group, and also the necessary economic support by both the National Public Health Institute and the Finnish Academy. This article outlines our groups research plan for the next few years.

Adolescent↗
PubMed1980

Suicide, attempted suicide and antidepressant drugs.

The concepts of depression and hostility are reviewed. The relationship between the two has been clarified by the use of psychometric tests. Hostility levels are high in depressive illness, especially on the intropunitive scales. Both total hostility and the degree of intropunitiveness are reduced as the patient recovers from his illness. Suicidal acts are seen as aggression directed towards the self. In some patients a tendency to recurrent drug overdosage or other forms of self-punitive behaviour may be the result of pathological character traits caused in turn by abnormal development in infancy. Looking at the possibility of cutting down the incidence of suicidal behaviour we conclude that we must look at the influence of depression, total hostility and direction of hostility in precipitating self-damaging acts. It is possible that antidepressants vary in the extent to which they act on these various factors, as well as having different rates of action on the several components of the depressive syndrome. There are thus a priori grounds for predicting that the incidence of self-damaging behaviour will vary from drug to drug. We describe the results of a study of suicidal behaviour carried out in general practice. A differential association with the major antidepressant drug was observed. In particular low rates were seen with the imipramine group, and there was a tendency towards high rates with the dothiepin-doxepin group. We propose to investigate this relationship further.

Antidepressive Agents↗
PubMed1989

Alcoholism, alcohol and attempted suicide.

Attempted suicide patients referred to a general hospital over a 10 year period were studied with regard to alcoholism and drinking in association with suicide attempts. Alcoholism was diagnosed in 7.9% of patients (14.6% of males and 4.2% females), and this diagnosis became proportionately more common in both sexes during the study period. However, only male alcoholic attempters showed an increase in absolute numbers during the study period, the increase in the proportion of females diagnosed as alcoholic being due to a decline in attempts by non-alcoholics. Particularly high rates of alcoholism were found in the unemployed of both sexes and in housewives. Alcoholic attempters were at greatly increased risk of making repeat attempts. Alcohol consumption shortly before a suicide attempt and as part of the act was extremely common, especially among alcoholics. In addition to increasing the likelihood of an attempt, alcohol may add considerably to the danger of overdoses. Careful investigation of drinking patterns should be an integral part of the assessment of all attempted suicide patients, and there should be close liaison between general hospital services for such patients and local alcoholism treatment services.

Adolescent↗