Imitative suicide on the Viennese subway

The number of subway suicides in Vienna increased dramatically between 1984 and mid-1987. In the second-half of 1987 there was a decrease of 75% which has been sustained for 5 yr. This reduction in subway suicides began when a working group of the Austrian Association for Suicide Prevention developed media guidelines and initiated discussions with the media which culminated with an agreement to abstain from reporting on cases of suicide. The characteristics of suicide and attempted suicide on the Viennese subway are discussed and appropriate guidelines for media coverage of suicidal acts are presented.     

Site of entrance wound and direction of bullet path in firearm fatalities as indicators of homicide versus suicide

In a retrospective study, 288 firearm deaths were analysed to identify factors indicating homicide. The cases were classified as suicides (213), homicides (54), accidents (14) and undetermined cases (7). A number of factors, related to the circumstances and the autopsy findings, were studied. Whereas 41% of the homicide victims were females, women only constituted 1.4% of the suicide victims. The mean age was 37 and 50 years among homicide and suicide victims, respectively. Most suicides were committed at or in the vicinity of the residence, whereas a majority of the homicides occurred elsewhere. The majority of the suicide victims had either left a suicide note or had medical records of previous psychiatric illness. In all groups, shotguns were the most frequent weapon used. Fifty-seven percent of the homicide victims, but only three percent of the suicide victims had sustained more than one gunshot wound. One-third of the homicide victims were shot at close range. Alcohol was present in one-third of both homicide and suicide victims. Whereas 38% of the homicidal gunshot wounds had their entrances at anatomical regions typical of suicide, the direction of the bullet path often differed from the directions recorded in suicides. Hence, in this material, an entrance wound in the right temple indicated suicide, but in combination with a direction back-to-front, the wound was more likely to be homicidal. This study suggests that an estimation of the direction of the internal bullet path should be conducted in firearm fatalities, and that this factor may assist in the determination of the manner of death.     

Extrapolation from attempted suicides to completed suicides.

Used D. Lester's (see record 1971-10261-001) methodology for analyzing data from suicide attempters to make extrapolations to completed suicides. A sample of 246 suicide attempters was divided into 3 groups on the basis of their intent to die. When 56 possible correlates of suicidal intent were examined, a number of significant monotonic differences between the groups were found, from which predictions concerning completed suicides were made. Many of the particular findings supported previous observations on suicide, but some deviations from expectations were noted. Results demonstrate that it is possible to make inferences about completed suicides from studies of attempted suicides. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Big Ten Student Suicide Study: a 10-year study of suicides on midwestern university campuses

The Big Ten Student Suicide Study was undertaken from 1980-1990 to determine the suicide rates on Big Ten University campuses. The study design attempted to address many of the statistical and epidemiological flaws identified in previous studies of campus student suicides. The 10-year study collected demographic and correlational data on 261 suicides of registered students at 12 midwestern campuses. The largest number of suicides for both males and females were in the 20-24-year-old age group (46%), and amongst graduate students (32%). The overall student suicide rate of 7.5/100,000 is one half of the computed national suicide rate (15.0/100,000) for a matched sample by age, gender, and race. Despite the overall lower suicide rate, the analyses revealed that students 25 and over have a significantly higher risk than younger students. Although women have rates roughly half those of men throughout their undergraduate years, graduate women have rates not significantly different from their male counterparts (graduate women 9.1/100,000 and graduate men 11.6/100,000).     

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.     

Suicide in patients with Parkinson''s disease. An epidemiological study

The purpose of this study was to estimate the risk of suicide for patients with Parkinson's disease (PD) in Denmark compared with that in the background population. The study involved 458 patients with a PD diagnosis, 226 men and 232 women. The follow-up period to either death or end of follow-up on December 31, 1990 was 0 to 17 years, mean 5.7 years. Deaths in the follow-up period amounted to 254, 135 men and 119 women. Two women committed suicide. The number of expected suicides was 1.06 for men and 0.55 for women, a total of 1.62. Neither for men nor for women was the difference between expected and observed suicides statistically significant.     

Aspects of suicide and parsuicide

Five aspects of suicidal behaviour in Edinburgh from 1968 to 1974 were examined. The data referred to 478 suicidal deaths and to parasuicide (attempted suicide) admissions to the Regional Poisoning Treatment Centre (R.P.T.C.). Firstly: 28% of suicides were found to have had a parasuicide admission and there was some evidence of a slight excess of deaths in the years immediately following parasuicide. Secondly: among suicides preceded by parasuicide, those with a recent episode (within 2 years of death) were found to be essentially similar to those with a longer interval. Thirdly: a history of previous parasuicide at any time was found to be important in delineating two groups of suicide. Suicides with prior parasuicide died more often from poisoning with drugs and were more likely to have a history of psychiatric treatment; suicides without prior parasuicide died more often from poisoning with domestic gas or violent means, were older, of higher social class and less often married. Fourthly: parasuicides who killed themselves within 2 years of admission to the R.P.T.C. were compared with a group of (broadly nonsuicidal) parasuicides. And lastly: a scale predictive of repetition of parasuicidal behaviour was used in an attempt to distinguish parasuicides who killed themselves from those who did not. The scale did not discriminate between the two groups.     

Cosmetic breast surgery

In a comprehensive national survey among adolescents aged 14-22 years, a total of 579 (7.6% of the net sample) stated that they had at same time taken an overdose of pills or had tried to harm themselves, in some other way. The proportion of the attempted suicides who had received help or treatment in hospital or from a medical practitioner afterwards was 6%. The proportion was higher among those who had made repeated attempts of suicide and among frequent users of drugs. A total of 16% reported having received help or treatment from a psychologist or psychiatrist, and showed a higher depression score than other attempted suicides. Thirty-two percent reported receiving help from family or friends after-wards, mostly from friends. Two thirds of the boys reported not having received any help or treatment after the suicide attempt.     

Suicide among gifted women: A prospective study.

The longitudinal data from the Terman Genetic Studies of Genius (L. M. Terman, 1925; Terman and M. Oden, 1947, 1959) were used to predict suicide in 40 women: 8 suicides, 15 Ss who were matched with the suicides on age of death, and 17 Ss who were still living in 1964. The Terman studies covered 60 yrs and followed 1,528 gifted individuals (IQs over 135) from childhood into the retirement years. Seven variables from the Ss' files were assessed as possible predictors of suicide: S's physical health, early loss of the father, stress in the family of origin, problems with alcohol, and 3 indices of mental health ("signatures" [e.g., suicide attempts, alcohol abuse, depression]; self-reports of temperament; and a cumulative mental health rating developed by Terman). A discriminant function analysis was able to differentiate the women who committed suicide from the 2 control groups. A 7-variable function predicted 100% of the suicides. A 4-variable function predicted 75% of the suicides. It is concluded that suicide risk factors can be identified in women and that certain signatures of suicide are as useful in predicting female suicide as male suicide. (49 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Calculation of some costs of suicide prevention using certain predictors of suicidal behavior.

On the premise that successful suicide prevention demands the detection of potential suicides and the application of effective prevention procedures, a method is presented for calculating the cost per unit of prevented suicide. Analysis is made in terms of the detection errors inherent in several indicators of potential suicides. These errors are of 2 kinds: failing to identify actual suicides, and treating nonsuicides like potential suicides. The 2nd kind of error inflates the costs, and decreases the likelihood, of successful suicide prevention as the suicide rate of the target population declines. The 1st kind of error raises the cost of continuing suicide occurrence. The 3rd type of cost examined is the loss of suicides by failure of the prevention method. The cost situation might improve by (1) reducing detection errors of both kinds, (2) improving the effectiveness of prevention methods, and (3) concentrating prevention efforts on groups which have high suicide rates. The computation procedures presented permit the rigorous assessment of the efficiency of any alleged predictor of suicide. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The lateral and transverse forces with indirect headgear and its modifications

Suicide is currently recognized as one of the leading causes of death of adolescents and young adults worldwide. A representative sample of all high-school students in Addis Abeba in 1989/90 academic calendar was surveyed to estimate life-time prevalence and risk factors of suicide attempts. 14.3% of the adolescents reported having attempted suicide. 17.5% usually felt hopeless. Suicide attempts were strongly and linearly associated with hopelessness, grade, and heavy alcohol intake. No significant associations were observed between attempts and age, sex, family history of suicide or parental educational level. It is concluded that a substantial proportion of adolescents attempt suicide and also exhibit the risk factors.     

Employment status influences the weekly patterns of suicide among alcohol misusers

As part of the National Suicide Prevention Project in Finland, a nationwide psychological autopsy study, all suicide victims (n = 1397) over a 12-month period were investigated concerning factors associated with any variation in suicide frequency between weekdays and weekends. In particular, employment status was expected to have influenced the weekly pattern of alcohol misuse, and thereby to have caused clustering of suicides at weekends among the employed. Among suicide victims who had misused alcohol, those in employment were significantly more likely to have committed suicide during the weekend that those without work (52% vs. 34%, p < 0.001). In logistic regression analysis, employment was the only independent variable significantly associated with suicide at the weekend. According to forensic chemical analysis, those classified as misusers had frequently used alcohol at the time of suicide, regardless of the weekday, and slightly more often if employed. The clustering of suicides at weekends among employed alcohol misusers is probably explained by a weekly pattern in the use of alcohol, which suggests that besides the established risk factors for suicide among alcohol misusers, the act of using alcohol per se also contributes to the suicidal act.     

A historical survey of police suicide in Queensland, Australia, 1843-1992

Police suicide research has yielded inconsistent results. An opportunity presented to survey Queensland police suicides in a historical context and add to the existing literature; the study describes changes in police suicide over time, the associated characteristics, and opportunities for intervention. Suicides were examined from the origins of police in Queensland in 1843 up to 1992. Suicide rates were higher earlier, around 60 per 100,000, declining to around 20 per 100,000 recently. The recent rate is lower than most other police studies but the same as the general community (employed). Most suicides were associated with psychological and physical ill health, alcohol abuse, and domestic problems, in keeping with general community surveys. However, occupational problems were more evident than is generally the case. The proximity in time of disciplinary events and suicides was striking. Future studies should explore the interactions between these factors.     

Trends in suicide in England and Wales, 1982-96

This article, the first of two, updates previous analyses of suicides published in Population Trends. Suicide trends in England and Wales are analysed by age and sex. Analyses by method and occupation suggest a link between suicide rates and easy access to effective means of committing suicide. The steadily growing number of cars with catalytic converters may go some way to explain the decreasing suicide rates from 'other gas poisoning' for both men and women since the early 1990s. Indeed, it may also explain to some extent the decline in overall suicide rates for men since this time.     

Suicide by young men in Lothian 1993 and 1994

OBJECTIVES: To examine the circumstances surrounding the suicides during 1993 and 1994 of young men aged 20-29 from the Lothian region. METHODS AND MATERIALS: The list of suicides for Lothian residents in this group was obtained from the General Registry Office and information relating to these people abstracted from records held in General Practice and at the Forensic Medicine Unit at the University of Edinburgh. RESULTS: Thirty-nine men met the selection criteria which gave a suicide rate of 28.7/100,000. Twenty-five had zero blood alcohol recorded post mortem and ten had blood alcohol concentrations above the legal driving limit of 80 mg/100 ml. Ten (26%) had seen their General Practitioner (GP) in the week and 13 (33%) in the month before suicide. Previous suicide attempts (seven within a year of death) were recorded in 19 men. Ten men left suicide notes. CONCLUSION: Using an overall rate to describe suicide hides the complexity of the issues involved: the inclusion or not of undetermined deaths in numerical targets also causes confusion. Targets should be interpreted carefully and suicide rates should not be considered as a proxy for the mental health status of a population. Prevention cannot be the domain of only the GP. Assessment of suicide risk should be integrated as part of improved mental health training for all health service staff.     

Attempted suicide among Inuit youth: psychosocial correlates and implications for prevention

OBJECTIVE: To identify potential risk and protective factors associated with attempted suicide among Inuit youth, a population known to have a high rate of both attempted and completed suicide in recent years. METHOD: A secondary analysis of data on 203 Inuit youth (aged 15 to 24 years) from a random community survey conducted by Santé Québec in 1992. Factors previously identified in the literature and in clinical consultation and ethnographic research were tested with bivariate statistics and logistic regression models for each gender. RESULTS: At the bivariate level, positive correlates included substance use (solvents, cannabis, cocaine), recent alcohol abuse, evidence of a psychiatric problem, and a greater number of life events in the last year. Regular church attendance was negatively associated with attempted suicide. Multivariate analysis indicated that a psychiatric problem, recent alcohol abuse, and cocaine or crack use were the strongest correlates of attempted suicide for females, while solvent use and number of recent life events were the strongest correlates for males. CONCLUSIONS: Suicide prevention programs can be targeted at youth who are using substances, particularly solvents, cocaine, and alcohol, have psychiatric illness, and have experienced recent negative life events. Involvement in church or other community activities may reduce the risk for suicide. Consideration of gender differences may allow more precise identification of those at risk for attempted suicide.     

Suicides after pregnancy in Finland, 1987-94: register linkage study

OBJECTIVE: To determine rates of suicide associated with pregnancy by the type of pregnancy. DESIGN: Register linkage study. Information on suicides in women of reproductive age was linked with the Finnish birth, abortion, and hospital discharge registers to find out how many women who committed suicide had had a completed pregnancy during her last year of life. SETTING: Nationwide data from Finland. SUBJECTS: Women who committed suicide in 1987-94. RESULTS: There were 73 suicides associated with pregnancy, representing 5.4% of all suicides in women in this age group. The mean annual suicide rate was 11.3 per 100,000. The suicide rate associated with birth was significantly lower (5.9) and the rates associated with miscarriage (18.1) and induced abortion (34.7) were significantly higher than in the population. The risk associated with birth was higher among teenagers and that associated with abortion was increased in all age groups. Women who had committed a suicide tended to come from lower social classes and were more likely to be unmarried than other women who had had a completed pregnancy. CONCLUSIONS: The increased risk of suicide after an induced abortion indicates either common risk factors for both or harmful effects of induced abortion on mental health.     

Multiple chemical sensitivity: a new type of toxicity?]

OBJECTIVE: To compare characteristics and risk factors of suicide in early adolescence (younger than age 15 years) and in late adolescence. The authors examined whether differences in risk factors or resilience might explain the different suicide rates in the two age groups. METHOD: Information about all registered suicides of young people in Norway from 1990 through 1992 was gathered from several professional informants. Children younger than 15 years old who committed suicide (n = 14) were compared with late-adolescent suicides (15 through 19 years) (n = 115) and with controls (n = 889). RESULTS: Younger compared with older adolescent suicides more often hanged themselves (93% versus 35%). Suicidal ideation (7% versus 39%) and precipitating events were described less frequently (29% versus 49%). Older adolescents more often had psychiatric disorders (77% versus 43%). Compared with controls, the risk factors for suicide were affective disorders (young adolescents: odds ratio [OR] = 23.8, 95% confidence interval [CI] = 2.3 to 1,183; older adolescents: OR = 19.6, CI = 10.6 to 38.8); disruptive disorders (young adolescents: OR = 3.4, CI = 0.0 to 340; older adolescents: OR = 6.1, CI = 3.0 to 12.7); and not living with two biological parents (young adolescents: OR = 3.1, CI = 0.6 to 14.7; older adolescents: OR = 2.5, CI = 1.6 to 3.8). CONCLUSION: Children and young adolescents completing suicide were less exposed to known risk factors than older adolescents. The increased suicide risk was similar for both groups when they were compared with community controls. The low suicide incidence in childhood may be related to fewer risk factors, rather than to resilience to risk factors.