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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

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

Ulcer, attempted suicide and suicide.

Attempted suicide and suicide have been investigated among 2,619 patients suffering from duodenal ulcer, gastric ulcer and ulcer dyspepsia without ulcer demonstrable by x-ray. There was no difference in the percentage of attempted suicides and suicides among the three ulcer groups or between the sexes. Within well-defined periods, there was a statistically significant greater excess of attempted suicides among patients operated on than among unoperated patients. The distribution according to psychiatric diagnosis was very similar to the one observed among persons in general in Copenhagen attempting suicide. The number of patients committing suicide exceeded the expected number significantly, for men as well as for women, but there was no difference between patients operated on and unoperated patients. The psychiatric diagnoses of those committing suicide were predominantly neuroses and psychopathy.

Denmark

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

[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

Multiple suicide attempts and informal labeling: an exploratory study.

Attempted suicide is considered to be a form of deviant behavior. Multiple suicide attempts are evaluated within the labeling perspective. Specifically, it is determined if labeling theory can explain acts of repeated suicide attempts as a form of deviance. Two hypotheses are created to test the influence of informal labeling on multiple suicide attempts. Family and friends constitute the categories most important in informal labeling. Labeling by them is measured through a series of behavioral scales. It is hypothesized that the greater the labeling by each of these categories, the greater the likelihood of recurrence of attempted suicide. It is also predicted that the greater the "self concept as suicidal," the greater the likelihood of recurrence. Labeling by family and friends was found to be significantly related to repeat. Conclusions about the relationship between "suicidal self-concept" and repeat were not drawn.

Adult

The serious suicide attempt. Five-year follow-up study of 886 patients.

A five-year follow-up study was undertaken of a previously reported 1968 cohort of 886 people who had attempted suicide. The working hypothesis that those who had seriously attempted suicide (21%) would have a higher suicide rate on long-term follow-up was confirmed. During the five-year follow-up period, a total of 34 suicides were found, which represented 3.84% of the total number at risk. Of those who had seriously attempted suicide, 12 (6.45%) of 186 succeeded later; of the other (nonserious or less serious) attempters, 22 (3.1%) of 700 succeeded. The serious-attempter suicide rate was 2.1 times that of the others, and this difference was statistically significant (P less than .05). In addition, patients who made attempts that were judged serious on medical but not on psychiatric grounds were found to have a suicide rate significantly higher (P less than .05) than patients who had made suicide attempts that were not a serious medical threat.

Adult

Report on a three-year follow-up of 100 cases of suicidal attempts in Shiraz, Iran.

One hundred cases of attempted suicide were followed up after three years. Only 50 records were recovered and of these 26 subjects were personally contacted. There had been only one subsequent suicide and three suicide attempts after three years. The possible relationship between psychiatric intervention and the low incidence of subsequent suicide attempts was discussed. The psychological adaptation after a suicidal attempt was also discussed.

Adaptation, Psychological

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

Visual-motor problems of adolescents who attempt suicide.

Using the Canter Background Interference Procedure with the Bender-Gestalt Test, a group of 18 adolescent suicide attempters earned test scores indicating they had significantly more problems with visual-motor coordination than did a control group of 21 adolescents. There were also a greater number of school failures and behavior problems among these suicide attempters. The findings suggest that learning disabilities may be an unrecognized factor which increases the risk of suicide attempts by adolescents.

Achievement