[Seasonality of suicide in Poland. Analysis of the Main Statistical Office data for the years 1999-2003]. / Sezonowosc samobójstw w Polsce. Analiza danych Glównego Urzedu Statystycznego z lat 1999-2003".

AIM: The presented suicide seasonality analysis based on the Main Statistical Office general Polish population data is the first to deal with this problem in our country. An answer was sought to two research questions: whether the phenomenon of suicide seasonality occurs in Poland, and if so, whether there are any age- and gender-related differences in the seasonality pattern. Moreover, the obtained results were compared with seasonality patterns reported in other countries. METHOD: Statistical analyses were performed using the Demetra v.2.04. programme. The total of 29,232 cases of suicidal death registered in Poland in the years 1999-2003 were analysed. RESULTS: In the study, a stable seasonality of suicides was found in three groups: in the general Polish population, in the 40-44 age group irrespective of gender, and in males aged 40-44. A stable seasonality pattern was confirmed to exist in the period under study, with a peak in the spring-summer time and a clear decline in winter. No stable seasonality of suicide was found in women. CONCLUSIONS: The findings are concordant with a majority of these reported in studies of this type in other countries. The obtained results can be used in the future to assess changes in the suicide seasonality amplitude in Poland over time. Moreover, it seems worthwhile to corroborate the observation made by other authors that seasonality is modified mainly by violent suicides.

[Completed suicide in outline--on basis of Cracow's Institute of Forensic Medicine data in 1991-2000 years]. / Samobójstwo dokonane--zarys zjawiska na podstawie materialu krakowskiego zakladu medycyny sadowej z lat 1991-2000.

The study presents the results of research into completed suicide. The authors have analyzed cases of completed suicide committed in Cracow and it's environs in the years 1991-2000. The aim of the research is to describe some features of this phenomenon with it's transformations in the last periods. The presented material bases on archival data of postmortem examinations made in Cracow's Institute of Forensic Medicine. Analyses' were executed in reference of victims' sex, age and place of residence, number and frequency of suicides in Cracow population, methods, predictors and possible motives. The authors also present a sketch of the bibliography regarding the topic, and the comparison between the results of the present study and the results of earlier studies from Cracow environs of the phenomenon of suicide. 1933 cases of completed suicides were analysed, from what over a half concerned occupants of our city. The average coefficient for 100 000 occupants carried out 13.2. There were 1485 men and 448 women among victims, in age from 13 to 95 years. Male to female avarage ratio carried out 3.3:1 in the described period.. Average age carried out 45.5 years, for men 44.5, and for women 48.8 years. The superiority of men is strongly visible in groups of young persons and in "middle age". Results from archival data show that, hanging was the the most frequent way of suicide. In studied material there were more then 63% cases of suicidal hanging. Falls from height, poisonings and drownings were next in line. In very considerable number of cases (almost 60%) the presence of mental disorder in anamnesis was affirmed. This concerned particularly women where the most frequent were depression disorders. For men, first of all factors was dependence from acohol. Over one third of the victims were pensioners and unemployeds. The level of ethanol in blood in 718 cases was crossed 0.5 promille.

[Mental or physical disorders of people who committed suicide in penitentiary institutions in Poland in the years 1995-1997]. / Zaburzenia psychiczne i somatyczne osób, które dokonaly samobójstwa w zakladach penitencjarnych w Polsce w latach 1995-1997.

The study proves that mental disorders (mainly depression) rank among the main motives of suicidal behaviors, which are triggered by, for example, disadvantageous social factors. In the material under study, 27,7% of the inmates were treated at a mental ward and as many as 31,07% constituted the patients of Outpatient Mental Health Clinic. Hence, the high percentage--a total of 58,4% of mentally disturbed individuals--constituted the group at an increased risk of autoaggressive reactions. The percentage of individuals outside the psychiatric treatment amounted to 41,6%, this being the people who, in spite of deviations from the mental norm, failed to visit or did not deem it necessary to consult the mental health clinic. In the ICD-10 classification of mental disorders, the most numerous group among the inmates who committed 3a fatal suicidal attempt included individuals with behavior and personality disorders (F60-F69). These constituted 55.9% of the total number of suicides. The less numerous group (26.7%) consisted of the inmates with mental disorders and behavior deviations caused by psychoactive substances (F10-F19). The third group of suicides (13.9%) included individuals with organic mental disorders, including symptomatic syndromes (F00-F09). These three groups accounted for 96.1% of the total number of suicides.

[Assessment of socio-demographic factors in alcohol-addicted patients recurrently treated in a detoxification unit]. / Ocena czynników socjodemograficznych u osób uzaleznionych od alkoholu wielokrotnie leczonych w oddziale detoksykacji.

The aim of the presented study was the assessment some socio-demographic factors of alcohol dependent patients more times hospitalized in Department of Toxicology in Kraków in the years 1999-2004. The repeatedly hospitalization of 334 patients (298 men and 36 women), aged from 17 to 71 years (mean 45.1 years) due the alcohol problem on the basis of clinic documentation were established. The following socio-demographics traits were taken in analysis: age, sex, marital status, place of living, education, kind of jobs, employment and others sources of money. The patients were admitted from 2 or more 29 times during 6 years. Medical history of addiction of mentioned patients was from 1 to 40 years, mean 25 years. 43.7% persons live single and 53.6% was married. The most patients live in Kraków (80%) and others near the town. The education of them: 15.0% ended high school, 28.7% "medium", 30.5% "low professional" and elementary school--13.8% of them. This factor was similar like regional data. Amount mentioned persons 25.8% worked for salary, 11.7% had own business, and 25.4% was retired, and 29.0% was unemployed. This last factor was worse liked similar from mentioned region. The kind of jobs of persons on the aspect of "social safety" was described. Among the mentioned chronic alcohol addicted persons about 18.8% of them with machines in traffic was worked (bus drivers i.e.) and 7.5% described persons in special jobs was worked (policemen, physician i.e.). The authors were suggested that mentioned factors due health services cost in Poland and propose integration of treatment of alcohol-addicted patients.

[The assessment of suicidal risk in the concept of the presuicidal syndrome, and the possibilities it provides for suicide prevention and therapy--review]. / Ocena zagrozenia samobójstwem w koncepcji syndromu presuicydalnego jako perspektywy dla terapii i profilaktyki samobójstw.

OBJECTIVE: To present Erwin Ringel's theory of the presuicidal syndrome as an instrument for the assessment of suicidal risk. METHOD: The literature regarding the presuicidal syndrome was reviewed. RESULTS: As it is evident from the research and works by Ringel, and also from the works by other classics of suicidological literature, such as Farberow, Poldinger, Schneidmann, Beck, and B6hme, the discovery of the presuicidal syndrome has opened up new vistas for the therapy of suicidal tendencies. The knowledge of the nature of the presuicidal syndrome indicates that a specific "anti-suicide" therapy has to be applied. The principal aims of such a therapy include the removal of the patient's feeling of alienation by the creation of a good doctor-patient relationship, the creation of the conditions enabling the patient to vent his/her aggression verbally, the removal of the presuicidal narrowing of the patient's consciousness by the reinforcement of the effective, positive behaviour, and the stimulation of the patient's imagination towards the formulation of new aims in life. CONCLUSION: The concept of the presuicidal syndrome, although somewhat forgotten, still can enhance the understanding of the psychopathology of suicide, contribute to the effective identification of individuals endangered by the occurrence of suicidal tendencies, and contribute to the increase in the effectiveness of the therapy required. Finally, the present authors suggest that the presuicidal syndrome, as a special multifactor psychopathological phenomenon, should be recognized as a diagnostic unit, thus filling in the present gap in the classifications of mental illnesses.

[Committed suicide in the background of the history of previous suicide attempts--a 5-year prospective study of suicide attempts]. / Samobójstwa dokonane na tle historii wystqpujqcych uprzednio prób samobójczych--5-letnie badania prospektywne.

The aim of the study was to estimate the risk factors for eventual suicide in the case of individuals hospitalised for a suicide attempts (or attempted suicide). The group examined comprised 238 patients, who, in the years 2000-2001, were hospitalised in the Department of Clinical Toxicology CM UJ in Kraków for suicidal self-intoxication with medical drugs. The group consisted of 63 males and 175 females ranging in age from 17 to 79 years (the mean age was 36 years). The instruments applied in the examination included a structured interview and a set of psychological tests; complementary information was obtained from the patients' case histories. In the year 2005, on the basis of the data from the Institute of Forensic Medicine in Kraków, it was established that 10 of the patients under consideration--6 females, and 4 males--had eventually committed suicide within the period concerned. The retrospective analysis of the case of each of these 10 individuals revealed that the majority of them had been treated psychiatrically for depression or alcoholic addiction, had experienced parental or marital bereavement, or had experienced serious financial difficulties. The subjects' case histories informed also about the cases of suicidal death in the families of several subjects. As should be pointed out, the results of psychological tests obtained earlier by the 10 subjects concerned did not unequivocally indicated high endangerment by the risk of eventually committing suicide. Finally, it is necessary to observe that alcoholism and depression were the most frequently diagnosed mental disorders in the case of the male suicides. In the case of the female suicides, the results of the analysis reveal a variety of psychological, psychiatric and socio-demographic factors that, eventually, could lead to suicide.

The characteristics of suicide attempts based on the suicidal intent scale scores.

The aim of the work was to present the characteristics of suicide attempts, distinguished on the basis of the scores in the Suicidal Intent Scale questionnaire (SIS), created by Aaron Beck, professor of psychiatry from Philadelphia. The group examined comprised 238 patients (63 males and 175 females) hospitalised in the Department of Clinical Toxicology CMUJ in Kraków in the years 2000-2001, after a suicidal self-intoxication with xenobiotics. The examination was conducted by means of the Suicidal Intent Scale (SIS)--a psychological test created by Aaron Beck. In the case of about 65% of the patients examined, their suicide attempts most frequently were acts of impulsive behaviour, rarely planned for longer than three hours before the realization and usually made in another person's presence or in a situation in which another person's intervention was highly probable. Such attempts had the character of "a cry for help", and were aimed at effecting some change or at manipulating the environment. Nevertheless, the patients acted in a conviction that their act was a serious attempt at ending life, and, most frequently, they maintained such opinions during the examination. On the other hand, they rarely expressed further suicidal intents, and more frequently accepted the fact that their lives had been saved. By contrast, the remaining 35% of the patients examined had attempted suicide with the evident intention to kill themselves; they had taken full precautions against being discovered and had planned suicide carefully to eliminate the smallest possibility of intervention. In the majority of cases, they still maintained the wish to die after the attempt. As the results of the examination indicate, the Suicidal Intent Scale, and, especially, the Precautions subscale, point at the important aspect of suicidal intentions, which, being of vital importance for the diagnostic purposes and suicide prevention, requires further investigation.

Suicide and suicide attempts in adolescents and young adults in Kraków in the years 2002-2003.

The aim of the study was to present the increasingly alarming phenomenon of completed suicide in adolescents and young adults. The material analysed had been drawn from the records of post-mortem examinations conducted by the Institute of Forensic Medicine in Kraków. The analysis covered cases of completed suicide committed by 15-30 years old inhabitants of Kraków or its environs between the September 2002 and the September 2003. The group of subjects analysed comprised 47 individuals (9 females and 38 males); 57.4% of these had resided in a big city (Kraków), and the remaining 42.6%--in villages or little towns near Kraków. The data regarding cases of completed suicide were compared with the data regarding suicide attempts by self-intoxication in the period under consideration, extracted from the documentation of the Department of Clinical Toxicology in Kraków. The latter data encompassed 233 cases of suicide attempts by individuals ranging in age from 15 to 29 years, with females constituting 62.2% of these, and males--37.8%. 65% of the attempters had been residents of Kraków. The analysis of the data from the Institute of Forensic Medicine revealed that nearly half of the suicide victims concerned had been treated for mental disorders, mainly depression and addictive disorders. The occurrence of suicide attempts prior to the fatal act was established in the case of 17 subjects (18.5%). Over half of the subjects (48.9%) committed suicide by hanging themselves, 17%--by falling from a height, 8.6%--by drowning, and 19.1%--by self-intoxication with medicaments. 77.2% of the subjects committed suicide at home. In the case of 23 subjects (48.9%), the post-mortem examination revealed the presence of alcohol. The analysis of the cases of suicide attempts by self-intoxication revealed a significant percentage of depressive disorders (26%)--of high occurrence especially in the case of females, whereas alcohol addiction was the predominant diagnosis in the case of males. Furthermore, the majority of the attempters exhibited situational reactions or personality disorders. Suicide attempts constitute an essential part of the issue of suicide in adolescents and young adults and require further research. What attracts notice, is a high percentage of males among suicide victims, and a high percentage of suicide victims with earlier suicide attempts. The results of the study should be taken into consideration in suicide prevention in groups especially endangered by the risk of completed suicide, such as adolescents and young adults after suicide attempts.

[Suicidal behavior and suicide attempts in adolescents and young adults--epidemiology, risk factors, prevention and treatment]. / Zachowania i próby samobójcze mlodziezy i mlodych doroslych--epidemiologia, czynniki ryzyka, prewencja i leczenie.

According to WHO, every year, suicide is committed by at least 1 mln people in the world. In Europe, suicide is committed by about 43 thousand people a year, most frequently by middle-aged and elderly males, and attempted by 700 thousand people. In Poland, in 2002, 5100 people committed suicide. The number of suicide attempts is probably ten times higher. The aim of the study is to investigate the current state of knowledge concerning suicidal behaviour and attempted suicide in adolescents and young adults. The literature on the subject is analysed, and special attention is paid to the issue of suicide epidemiology, risk factors, prevention and treatment. Definitions of suicidal behaviour and presuicidal syndrome are debated. In the chapter concerning treatment, Bohme's model of crisis intervention in the case of suicidal patients is discussed, and detailed indications for treatment are presented. Suicide attempts are undertaken most frequently by young people, especially by teenage girls and young women. The ratio of suicide in this age group increased significantly in the last few years. Phenomena which are of special importance for the prevention of suicide among adolescents include suicidal thoughts, attempted suicide, and completed suicide. Multicentre study into suicidal behaviour conducted by WHO indicate that the highest average yearly European coefficients of suicide attempts have been detected in young females ranging in age from 15 to 24 years. Polish and foreign literature on the subject is dominated by publications regarding completed suicide. The issue of attempted suicide is treated rather marginally, which may be due to the scantiness of reliable data concerning large populations. The past few years, however, brought a significant advancement of the research into the epidemiology, etiology, and treatment of suicidal behaviour in adolescents. It is difficult to establish linear correspondence between risk factors and suicidal behaviour. The cause is usually a combination of constitutional factors including genetic ones, earlier personal experiences, and precipitating stressful events. Paradoxically, the risk of suicide among adolescents increases in highly developed countries, where the quality of life has undergone a significant improvement. In conclusion, the authors have stressed the importance of an interdisciplinary approach to work with individuals endangered by the risk of suicide. Attention has also been drawn to the importance of personal contact and the necessity to accompany the individual in suicidal crisis from the beginning to the end of the therapy.

[The frequency of suicide attempts depending on gender and the age structure]. / Czestosc prób samobójczych w zaleznosci od plci i struktury wiekowej.

Sex and the age structure have been for decades the crucial factors determining the dimensions of suicide. In the literature of the subject, it is possible to find different interpretations concerning the widely known facts of larger effectiveness of suicide among males. Females, on the other hand, exhibit suicidal behaviour and suicide attempts several times bigger than the number of completed suicides. In comparison with wide literature dealing with the problematic of completed suicide, the number of publications concerning suicide attempts is, both in foreign and in Polish literature rather scarce. That is why the present authors have undertaken the analysis of suicide attempts by subjects hospitalized in the Department of Clinical Toxicology Jagiellonian University College of Medicine in Krakow in the years 2000-2002. On the basis of the medical documentation, 2757 cases of attempted suicide through self-intoxication by subjects undergoing treatment in the toxicological department. In the period concerned, the number of hospitalizations after suicide attempts increased from 856 cases in the year 2000 to 971 cases in 2001, and subsequently slightly decreased to 930 cases in 2002. The highest indicator of suicide attempts through self-intoxication has been observed among adolescents and young adults. In the absolute values, within the span of the years in question, there is a substantial predominance of suicide attempts undertaken by adults ranging in age from 20 and 50. On the contrary, in the oldest age group (over 60), the number of suicide attempts through self-intoxication was in the years concerned the lowest. In contrast with completed suicide, where the proportion of males to females is 4:1, in the group examined, females constituted 50% of subjects after suicide attempts. The number of females after suicide attempts in the consecutive years analysed was higher among adolescents and young women under 30. Despite drawbacks in data gathering, there is convincing testimony indicating that suicide is the result of number of complex risk factors. Sex and the age structure belong to non-modifiable factors, and thus emphasis should be put on the importance of the gathering of relevant data and on further research into the factor of sex and age structure in suicide attempts and completed suicide.

[Fluctuations and seasonality in suicidal attempts]. / Fluktuacje i sezonowosc prób samobójczych.

The aim of the study was to analyze seasonality and temporal fluctuations in suicide attempts by persons living in Krakow and hospitalized in the Department of Clinical Toxicology CMUJ in the years 2000-2002. The research focussed on the frequency of suicide attempts in relation to the time of the day, day of the week, and month of the year. Temporal fluctuations in the frequency of suicide attempts have been assessed on the basis of the data from medical documentation concerning 2757 suicide attempts by individuals ranging in age from 14 to 90 years. The group consisted of 1607 females and 1150 males. According to the results of the research, seasonality and temporal fluctuations in the frequency of suicide attempts is different for males and females. In the case of the males examined, no dependence between the frequency of suicide attempts and a particular month or season has been observed. In the case of females, on the contrary, the data indicate the existence of a seasonal pattern with the peak in the spring (or early part of the summer), and in the autumn--in October and November. In males, the peak day for attempted suicide was Monday, whereas in females--Sunday and Monday. As regards the time of the day, both the results of the present research and data collected by WHO/EURO indicate that suicide attempts occurred most frequently in the evening, late in the evening or in the early part the night. In conclusion, it has been emphasized that the majority of suicide attempts, especially by females, occurs late in the evening or early in the night. This finding seems to be of particular importance for suicide prevention--it can contribute to the increase in the effectiveness of the organization of work in the Crisis Intervention Centres and make therapists and patients' families aware of the existence of periods of an increased suicide risk. The research has been conducted owing to the cooperation between the department of Clinical Toxicology, CMUJ and the Department of Adult Clinical Psychiatry, CMUJ in Kraków. The results obtained, together with the results of the research conducted by the centres participating in WHO/EURO are vital for suicide prevention and treatment.

[Risk factors for suicide attempts in elderly and old elderly patients]. / Czynniki ryzyka usilowania samobójstwa u osób starszych i w okresie póznej starosci.

The aim of the study was to assess the phenomenon of suicide attempt in the elderly inhabitants of Kraków. Special attention has been paid to the group of "seniors"--aged 75 years or over. The authors have analyzed all the 136 cases of suicide attempts by individuals aged over 60 years, selected from the cases of suicide attempts by self-intoxications by patients hospitalized in the Department of Clinical Toxicology, CMUJ in Kraków in the years 2000-2002. The group concerned included 45 males and 91 females. A large number of subjects (over a half of the total) ranged in age from 60 to 65 years. The group of seniors comprised 35 individuals (aged 75 years or over), including 7 males and 28 females. On the basis of the data from medical documentation, the subjects were analysed from the point of view of their health condition and in the psycho-social context. In the majority of cases the subjects are pensioners residing in Kraków, often living alone. In the case of 98% of the subjects, it was their first suicide attempt. Pharmaceuticals used for self-poisoning were most frequently psychotropic, or mixed-type drugs. The assessment of the severity of poisoning indicates that in about 20% patients poisoning was severe. 70% of the subjects suffered from depressive, reactive, or situational disorders, affective depression or organic brain disorders, often with dementive signs. A significant number of subjects suffered from hypertension, coronary artery disease, arteriosclerosis, or alimentary tract diseases. In the group of the seniors, the most conspicuous problems included serious somatic diseases (malignant diseases and chronic respiratory system diseases), depression, organic dementia, loneliness, and bad family situation. Taking into consideration the scantiness of research into attempted and completed suicide in the elderly and in the old elderly, the present authors stress the importance of the continuation of the research to prevent suicide in the aforesaid age group.

[Attempted suicide among teenagers and young adults]. / Samobójstwa usilowane u mlodziezy i mlodych doroslych.

The aim of the study was to present the phenomenon of suicide attempts by self-poisoning in a group of females and males ranging in age from 15 to 29 years, and treated in the Department of Clinical Toxicology Jagiellonian University College of Medicine in Kraków in the years 2000-2002. The group analyzed comprised of 1117 patients, 629 (69.1%) women and 425 (38.1%) men. In the female group, teenagers under 19 constituted 48.9%, whereas young females ranging in age from 20 to 29 years--51.1%. In the male patients group teenagers under 19 constituted 29.4%, the young men (20-29 years of age)--70.6%. The group was analyzed from the point of view of demographic, clinical and social factors such as gender, age, level of education, marital status and occupation (if applicable), the course of self-poisoning and kind of toxic substance involved. In the majority of cases, self-poisoning had been caused by taking one type of medicines, and less frequently by taking mixed-type medicines or by simultaneously taking medicines and ethanol. The most typical drugs used in the attempts included benzodiazepines, phenothiazines, nonsteroidal antiinflammatory and antiepileptic drugs. The assessment of the poisoning severity based on the PSS classification, indicates the predominance of the minor and moderate poisoning. Up to 50% of subjects suffered from mental disorders--most frequently from affective disorders, neurotic disorders, and personality disorders. As an essential part of the problem of suicidal behaviors in teenagers and young adults, suicide attempts among young population require an in-depth analysis. The scale of the problem indicates the necessity of initiating appropriate preventive actions and organizing appropriate psychological and psychiatric care.

[Somatic and psychiatric disorders in alcohol-addicted patients treated in a detoxification unit]. / Obraz zaburzen somatycznych i psychicznych u osób uzaleznionych od alkoholu leczonych w oddziale detoksykacji.

The aim of the presented study was the assessment of somatic and psychiatric disorders in alcohol addicted patients, treated in the Department of Clinical Toxicology detoxification unit in Kraków in 2002 year. The total number of 443 patients (377 men and 66 women) were considered for the research. More than 50% patients were hospitalized repeatedly (2 or more times) due to alcohol problems. Medical history as well as detail medical examination and diagnostic evaluation revealed the concomitance with alcohol disease different somatic illnesses and psychiatric disorders. In 194 patients (43.8%) the alcoholic liver damage was diagnosed, frequently (in 5.2% patients) with chronic pancreatitis. Only 22 patients (5%) were infected with hepatitis virus type B. Diabetes type 2 and different cardiovascular disorders were present in almost one third of patients. In the past 55 patients (12.4%) have had severe head trauma, and 51 (11.3%) were treated because multiorgan trauma. Psychiatric examination revealed in 102 patients (23%) affective disorders, and in 92 (20.7%) personality disturbances. The presented data should be a ground for discussion about treatment model alcohol dependency in Poland.

[Male and female suicides in the material of Department of Forensic Medicine in Krakow--comparative analysis]. / Samobójstwa kobiet i mezczyzn w materiale krakowskiego Zakladu Medycyny Sadowej--analiza porównawcza.

The study presents the results of research into completed suicide obtained by cooperation between the Department of Forensic Medicine and the University Psychiatry Department in Kraków. The aim of the research is to determine similarities and differences among the cases of completed suicide depending on the sex of the subjects. The authors analyzed cases of completed suicide committed in Kraków and its environs in the years 1991-2000. The groups of females and males have been compared from the point of view of medical-forensic and psychosocial aspects. The authors also present a sketch of the bibliography regarding the topic, and the comparison between the results of the present study and the results of earlier studies from Kraków environs on the phenomenon of suicide.

[Suicide attempts by self-poisoning among the elderly]. / Próby samobójcze przez samozatrucie u osób w podeszlym wieku.

The aim of the study was to present suicidological problems in the elderly. The investigation assessed patients treated for self-intoxication in the Department of Toxicology of Collegium Medicum, Jagiellonian University in Cracow. Medical documentation of the entire population of subjects aged over 65 and hospitalized in the years 1999-2001 was examined from the point of view of demographic and clinical factors. The examined population consisted of 68 subjects including 20 males and 48 females ranging in age from 65 to 90 years (mean age = 72.6). The majority of subjects were retired and, in many cases, lived alone. The majority of female subjects were widows living in Kraków or in small towns or villages around Kraków. A significant number of subjects had been undergoing psychiatric treatment or even repeated hospitalization prior to the suicide attempt. A significant percentage had suffered from severe somatic diseases. For 55 of the subjects (79.7%), it was the first suicide attempt, and for 14 subjects (20.3%)--a repeated one. The drugs most frequently used in the attempts were psychotropic, cardiological and mixed-type drugs. The assessment included the state of consciousness and the degree of intoxication on the subjects' admission to hospital. The mean duration of hospitalization was 13.7 days. The most frequently determined somatic diseases were hypertension (33.3%) and coronary artery decease (30.4%), atherosclerosis (15.9%) and diabetes (10.1%). In the process of a complex diagnostic and therapeutic procedure, the mental state of the patients was assessed. Depressive disorders (reactive) and endogenic depression (affective) were recognized in 51 subjects (73.9%). Organic brain disorders, often with dementive signs, were detected in 44 subjects. Schizophrenia was recognized in only a small percentage of subjects (5.8%). The description of the data indicate a close connection between depression and social factors in the case of the elderly. Therefore, an adequate treatment of depression should be give priority in programs for preventing suicide among the elderly.

[Completed suicide and depression in the elderly]. / Samobójstwa dokonane i depresja u osób w wieku podeszlym.

The aim of the study was to present problems of completed suicide and depression in the elderly. Postmortem examinations were conducted in the Institute of Forensic Medicine of the Jagiellonian University. The analysis included cases of completed suicide in adults, from which all the cases of individuals aged over 65 who in the years 1998, 1999, and 2000 committed suicide within the area of Kraków the City were selected for the present study. The examined group consisted of 92 individuals ranging in age from 65 to 89 years, including 34 females and 58 males. The mean age was 72.5 for the entire group. 44.5% of the subjects had resided in a big city (Kraków); the remainder of the group had resided in villages and towns around Kraków. 57.6% of the subjects committed suicide by hanging, 16.3%--by falling from a height, and 13%--by drowning. In the majority of cases (77.2%), the suicide was committed at home. In 17 cases (18.5%), the post mortem revealed the presence of alcohol. As regards somatic diseases in the examined population, the data from the anamnesis (often incomplete) indicate frequent occurrence of cardiovascular diseases. 43.5% of the subjects, who committed suicide, had been treated for mental disorders, mainly for depression, organic brain disorders, and alcohol addiction. 17 of the subjects (18.5%) had previously attempted to commit suicide. The above results indicate that a typical representative of the elderly committing suicide is a septuagenarian residing in the country or in a small town, and most typically committing suicide by hanging at home. The attention must be paid to the high number of mental disorders, especially depression, detected among both male and female subjects. The close relation between suicide and depression in the elderly is an important guideline on suicide prevention programs and therapy of psychogeriatric patients.

[The completed and attempted suicide in Krakow: similarities and differences]. / Samobójstwa dokonane i usilowane w Krakowie--podobienstwa i róznice.

The study presents the results of the interdisciplinary research conducted on the basis of cooperation between the Institute of Forensic Medicine, the Department of Clinical Toxicology, and the Clinic of Psychiatry in Kraków. The aim of the research was to determine similarities and differences between attempted and completed suicide from the point of view of socio-demographic and clinical traits. The authors analysed 220 cases of completed suicide committed in Kraków and its environs in the year 2000. The material presented in the study was based on the archive data from post mortem examinations conducted in the Institute of Forensic Medicine in Kraków. The sample consisted of 177 males and 43 females ranging in age from 13 to 89 years. The mean age was 43.6 years for the entire group, 42 years for males and 50 years for females. The majority of subjects were males, either unemployed, or pensioners. A similar tendency was observed in the group of female subjects. Mental disorders and alcoholic addiction in anamnesis were discovered in a significant number of cases, both in the group of males and in the group of females. Subjects, in whom serious somatic diseases had been detected, constituted a separate group of cases. According to the archive data, in the last century, suicide was most frequently committed by hanging. Similarly, in the sample examined, in 133 cases, suicide was committed by hanging. In 37% of cases, the level of alcohol in the suicides' blood was between 0.5 and 3 or more g/L. In 2000/2001, within the analogical period of 12 months, the group of 200 patients after a suicide attempt by drug intoxication was examined in the Department of Clinical of Toxicology Jagiellonian University College of Medicine. This group included 49 males and 150 females, ranging in age from 18 to 79 years (mean age 35). The examination was conducted by means of structured investigation and medical documentation. Contrary to completed suicide, in the group of suicide attempters, females outnumbered males. Young people under thirty, living in a large city, possessing elementary or secondary education, and either unemployed, or pensioners, constituted the majority of the examined group. A significant percentage of females was divorced and lived with their children only. The majority of the examined population of suicide attempters had used alcohol during the attempt, had suffered from depression, personality or behavioural disorders, had undergone psychiatric treatment, or had had cases of suicide among their friends or relatives.