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Suicide ideation: its relation to depression, suicide and suicide attempt.

A random sample of 3,935 adults from a general population were interviewed and asked to report how often they had thoughts of suicide as well as their opinion on the frequency of suicide ideation in others. Depression was found to be related to the respondent's reports of his/her own suicidal thoughts and to reports of frequent suicide ideation in others. A total of 5.4 percent of the respondents reported some degree of suicide ideation in the previous month and 9.1 percent reported that others think about suicide once a month or more. When the demographic characteristics of those who report suicide ideation in themselves or others were compared to those of suicide attempters and committers, some consistencies were found, suggesting that such questions may be useful in identifying those "at risk." Nevertheless, sufficient discrepancies were found which suggest that there may be a number of factors which increase or decrease the likelihood that someone with thoughts of suicide will attempt or commit suicide. Follow-up studies are necessary to uncover such factors and the degrees to which they influence the occurrence of suicide.

Adolescent

Suicidal wishes and depression in suicidal ideators: a comparison with attempted suicides.

A depression inventory was administered to a sample of psychiatric patients who had some suicidal ideation. A factor analysis of their responses to the inventory resulted in a factorial structure similar to that obtained for attempted suicides. The suicidal ideators were found to have higher depression scores on the inventory than the attempted suicides. It was suggested that this study supported the notion that individuals who show differing kinds of suicidal behavior nonetheless may show similar psychological phenomena.

Cognition

Risk of subsequent self-harm, suicide attempts and suicide following a first hospital-treated self-harm episode among young people: a population-based cohort study.

BACKGROUND: Self-harm in young people is associated with elevated risks for subsequent self-harm, suicide attempts and suicide, particularly during the first year. Yet the trajectory across sex, age and self-harm methods remains poorly understood. OBJECTIVE: To estimate risk for subsequent self-harm, suicide attempts and suicide following a first hospital-treated self-harm event in young people. METHODS: This study included 77 647 individuals (57.0% female) whose first hospital-treated (ie, within inpatient or outpatient specialised healthcare) self-harm episode occurred between ages 10-24 years during 1973-2019. We estimated cumulative incidence and incidence rate for subsequent self-harm, suicide attempts and suicide at 1 month, 3 months and 1 year following the initial episode. FINDINGS: Within 1 year, the cumulative incidence was 17.3% (95% CI 17.0 to17.5) for subsequent self-harm, 8.3% (8.1 to 8.5) for suicide attempt and 0.3% (0.2 to 0.3) for suicide. The highest risks occurred in the first month: 8.4% (8.2 to 8.6) for self-harm, 2.9% (2.8 to 3.0) for suicide attempt and 0.04% (0.03 to 0.05) for suicide. In the first month, the incidence rate of self-harm was 2.97 per 1000 person-days (2.90 to 3.05), falling to 0.55 (0.54 to 0.56) over the year. The suicide attempt rate declined from 0.98 (0.94 to 1.02) to 0.24 (0.24 to 0.25) and the suicide rate from 0.013 (0.009 to 0.019) to 0.007 (0.006 to 0.008). Males exhibited the highest suicide risk and females the highest attempts risk. First-month self-harm risk was greatest among males and children aged 10-12. CONCLUSIONS: The month following a self-harm episode is marked by an elevated risk of subsequent self-harm, suicide attempts and suicide, yet risk remains elevated over the full year. CLINICAL IMPLICATIONS: These findings underscore the need for both acute and sustained prevention efforts. Special attention should be given to males and children aged 10-12 presenting with self-harm of ambiguous intent, as their risk of repetition may otherwise go unrecognised.

Humans

[Suicide risk and care of suicide attempters].

Starting from the notion of suicidal risk and a critique of its usage, it is possible to distinguish groups whose suicidal risk is particularly high. The suicidal group-composed of persons who have already attempted to commit suicide once-is in this paper the subject of general considerations as well as personal research. The latter shows that it is still difficult to detect those persons who are about to commit suicide and that tell-tale signs-be they clinical or resulting from tests-are still not very reliable. The difficulties encountered by secondary prevention are made obvious by two pieces of research done on the taking in charge of suicide-prone persons in a university general hospital. the timely recognition of the pre-suicidal syndrome and of the self-denial syndrome is very important for suicide prevention. Self-depreciation, and consequently the narcissistic blow is, as are the aggression phenomena, one of the psychological cores which lead to an act of suicide. Medical attitudes concerning the suicidal person are analyzed, and the difficulty in the psychotherapeutic relationship is stressed. Pratical considerations on the psychotherapeutic approach to the suicidal person close up the article.

Adolescent

Suicide in Australia--a comparison with suicide in England and Wales.

This study reports changes of suicide rate in Australia and in England and Wales in the twenty years up to 1976. Rates in both places reached a peak in 1963, related to increases in poisoning as a means of suicide. Decreases since then can be attributed partly to reduced likelihood of death after inhalation of domestic gas or after ingestion of poisons. There has been an increase in suicide deaths among younger people, but a decrease among older age groups. The two countries have patterns of suicide which are similar in many respects, the most striking difference being the frequency with which firearms are used by male suicides in Australia. There is good reason to believe that variation in availability of a means of suicide is the factor which has most effect on rates of suicide, though cultural attitude towards each method also is an important determinant of how much it will be used for suicide.

Adolescent

Suicide among attempted suicides: a 10-year follow-up.

A 10-year follow-up is presented of 484 patients who made serious suicide attempts. Of this group 23% had died, 9% from natural causes, 3% from accidents or from uncertain causes, and 11% from suicide. Suicide frequenzy is highest in the period immediately after the suicide attempt. Especially interesting is the distribution according to sex. During the first 5 years there is a preponderance of male suicides (which is in agreement with the findings of other investigators), but after 10 years this difference in sex disappears. Suicides are found especially among men from 50 to 60 years of age, disabled pensioners, and persons who have attempted suicide several times, and to a lesser degree among persons living alone and criminals.

Adolescent

Integrative methylation and miRNA dysregulation in dlPFC reveal distinct molecular signatures of suicide and non-suicide subtypes in major depressive disorder.

AIM: Major depressive disorder (MDD) is a leading cause of disability and carries a high risk of suicide. MicroRNAs (miRNAs) are epigenetic regulators implicated in MDD and can be regulated by DNA methylation, potentially reshaping downstream gene networks. We investigated methylation-linked miRNA dysregulation and explored whether these changes are specifically associated with suicide among MDD patients. METHODS: Genome-wide DNA methylation profiling of the dorsolateral prefrontal cortex from 15 MDD patients who died by suicide (MDD+S), 17 MDD patients who died from causes other than suicide (MDD-S), and 16 controls (C) using the Illumina 850K MethylationEPIC array was integrated with small RNA sequencing-based miRNA quantification to identify miRNA-associated differentially methylated probes (DMPs), link methylation to miRNA expression, and infer downstream targets and pathways. RESULTS: Differential methylation analysis (P ≤ 0.05) revealed 139 miRNA-linked DMPs in C vs. MDD+/-S, 135 in C vs. MDD-S, 179 in C vs. MDD+S, and the highest in MDD+S vs. MDD-S (235). CpG-miRNA pairing (within 1500kb promoter) followed by Spearman correlation identified inverse associations between CpG β values and miRNA expression, with the most consistent signals in suicide-status-stratified subsets, including cg06341821-hsa-miR-574-3p and cg25451306-hsa-miR-2110 in MDD+S-related contrasts, and cg06179179-hsa-miR-595 in MDD-S-related contrasts. High-confidence target prediction and ClueGO enrichment indicated distinct biology: miR-595 target genes in MDD-S were enriched for interferon/innate immune signaling, whereas miR-2110 target genes in MDD+S were enriched for ligand-gated ion channel activity and synaptic/receptor signaling. CONCLUSION: This integrated approach identifies methylation-regulated miRNA pathways that may play key roles in the molecular pathogenesis of MDD and suicide.

Humans

[Cause and incidence of suicides and attempted suicides by patients over 65 years old in psychiatric hospitals (author's transl)].

Case reports of 184 suicides and attempted suicides in the six hospitals of the Landschaftsverband Rheinland from 1964-1974 were analyzed. 25 patients were over 65 years old. The combination of almost 30 variables revealed no significant constellation caused by old age. Furthermore no criterias could be found to assess increased suicidal tendency of hospitalized patients. Two conclusions are of importance. 1. The risk of suicides in hospitals does not increase by loosening of restrictions and open environment. 2. The concept of hospital suicide should include the time after being discharged and enlarge on other institutions which are involved in the psychiatric care system. A center of crisis intervention is disucssed which offers its services to different institutions for the purpose of suicide prophylaxis.

Age Factors

Suicide and attempted suicide in Greenland. A controlled study in Nuuk (Godthaab).

Suicidal behaviour in Eskimo populations has changed in pattern and quantity over the last decades. Rates have more than quadrupled and performers now are mainly young persons with obscure motivation. In a study from Greenland's major township all cases of attempted or completed suicide among Greenlanders are analysed for social, emotional, somatic, and environmental predisposing factors in comparison with a non-psychiatric, never-suicidal, matching group. Almost two per thousand of the adult population committed suicide yearly while attempts at suicide were five times as frequent. A quarrelsome, drinking, childhood home background was often found, at least as regards the attempters, who themselves frequently suffered from emotional conflicts with close contacts, alcohol affliction, criminality, and instability at work. Neither bereavement, cross-cultural exposure, broken homes, nor meteorological factors seemed to exert a significant influence. The results are discussed in relation to the social and cultural evolution of the Greenlandic society.

Adult

[The future of suicidal patients admitted to a general hospital. Comparative study of 2 methods of prevention recurrence and of suicides].

This is a comparative study of two groups of suicide attempters admitted in a general hospital, who were treated in different ways. The 143 attempters of the "systematically treated group (STG)" were proposed the classical therapeutic measures (supportive psychotherapy, psychiatric hospitalization, crisis interventions within couples or families, mixed interventions with the above treatments, psychoanalytically oriented psychotherapy, etc.), plus ambulatory controls (a few days after discharge from the general hospital, after one month, three months, six months, a year, and two years). The 145 attempters of the "reference group (RG)" were proposed the classical measures only. All the attempters of both groups had a follow-up after two years. The results suggest the controls to be probably responsible for the difference of relapses and committed suicides between the two groups. More indirectly, this study facilitated a further analysis of the relational problems between suicide attempters and staff, and among staff members themselves. The consequences were a modification of some attitudes of the staff toward the attempters and their significant others, and a new collaboration for an interdisciplinary clinical research.

Adolescent

[Suicide attempts in the Fribourg Canton. II. Suicide attempts in patients of the Marsens psychiatric hospital in the period from August 1st 1977 till July 31st 1978].

Subject of these two papers are the suicidal attempts in the Canton of Fribourg: - The first considers their admissions to the Cantonal Hospital at Fribourg. - The second, to the Psychiatric Clinic at Marsens This is a relatively restricted choice because may patients do not come to these hospitals. They are examined by a general practitioner or admitted to a private or a district hospital. The first paper analyzes the personaltiy types and emphasizes the rapidity of medical intervention and the cooperation between psychiatrists and other physicians and health personnel. The second paper is a statistical attempts, their numbers and their repetition, according also to the sex of the patients. Some considerations are made on preventive measures.

Adolescent