Global Lifetime and 12-Month Prevalence of Suicidal Behavior, Deliberate Self-Harm and Non-Suicidal Self-Injury in Children and Adolescents between 1989 and 2018: A Meta-Analysis.

OBJECTIVE: This meta-analysis aimed to estimate the global lifetime and 12-month prevalence of suicidal behavior, deliberate self-harm and non-suicidal self-injury in children and adolescents. METHODS: A systematic search for relevant articles published between 1989 to 2018 was performed in multiple electronic databases. The aggregate 12-month and lifetime prevalence of suicidal behavior, deliberate self-harm, and non-suicidal self-injury were calculated based on the random-effects model. Subgroup analyses were performed to compare the prevalence according to school attendance and geographical regions. Results: A total of 686,672 children and adolescents were included. The aggregate lifetime and 12-month prevalence of suicide attempts was 6% (95% CI: 4.7-7.7%) and 4.5% (95% CI: 3.4-5.9%) respectively. The aggregate lifetime and 12-month prevalence of suicidal plan was 9.9% (95% CI: 5.5-17%) and 7.5% (95% CI: 4.5-12.1%) respectively. The aggregate lifetime and 12-month prevalence of suicidal ideation was 18% (95% CI: 14.2-22.7%) and 14.2% (95% CI: 11.6-17.3%) respectively. The aggregate lifetime and 12-month prevalence of non-suicidal self-injury was 22.1% (95% CI: 16.9-28.4%) and 19.5% (95% CI: 13.3-27.6%) respectively. The aggregate lifetime and 12-month prevalence of deliberate self-harm was 13.7% (95% CI: 11.0-17.0%) and 14.2% (95% CI: 10.1-19.5%) respectively. Subgroup analyses showed that full-time school attendance, non-Western countries, low and middle-income countries, and geographical locations might contribute to the higher aggregate prevalence of suicidal behaviors, deliberate self-harm, and non-suicidal self-injury. Conclusions: This meta-analysis found that non-suicidal self-injury, suicidal ideation, and deliberate self-harm were the three most common suicidal and self-harm behaviors in children and adolescents.

First World War and Mental Health: a retrospective comparative study of veterans admitted to a psychiatric hospital between 1915 and 1918.

AIM: The association between mental illness and war has been repeatedly investigated. Higher levels of depressive symptoms and an increased suicidal risk have been found in veterans. In this study we investigated the mental health conditions among Italian soldiers during the "Great War", who were hospitalized in a mental health hospital in Italy. METHODS: The study sample consists of 498 soldiers who were admitted during the World War I between 1915 and 1918, and 498 civilian patients admitted in two different periods (1898-1914, 1919- 1932). Psychiatric diagnoses have been recorded retrospectively by a detailed examination of clinical records. Socio-demographic informations, diagnosis at first admission, number of admissions, and deployment in war zones were collected. A logistic regression analysis was performed, the diagnosis of depression was considered as dependent variable while clinical and demographic variables as independent predictors. RESULTS: Soldiers deployed in war zones were more likely to have a diagnosis of depression compared to those not serving on the frontline. The logistic regression analysis showed that the diagnosis of depression is predicted by being a soldier and being deployed in a war area. DISCUSSION AND CONCLUSIONS: Our data confirm that soldiers engaged in war are at higher risk of developing depression compared to non-deployed soldiers.

Virginia Woolf, neuroprogression, and bipolar disorder

Family history and traumatic experiences are factors linked to bipolar disorder. It is known that the lifetime risk of bipolar disorder in relatives of a bipolar proband are 5-10% for first degree relatives and 40-70% for monozygotic co-twins. It is also known that patients with early childhood trauma present earlier onset of bipolar disorder, increased number of manic episodes, and more suicide attempts. We have recently reported that childhood trauma partly mediates the effect of family history on bipolar disorder diagnosis. In light of these findings from the scientific literature, we reviewed the work of British writer Virginia Woolf, who allegedly suffered from bipolar disorder. Her disorder was strongly related to her family background. Moreover, Virginia Woolf was sexually molested by her half siblings for nine years. Her bipolar disorder symptoms presented a pernicious course, associated with hospitalizations, suicidal behavioral, and functional impairment. The concept of neuroprogression has been used to explain the clinical deterioration that takes places in a subgroup of bipolar disorder patients. The examination of Virgina Woolf’s biography and art can provide clinicians with important insights about the course of bipolar disorder.

Virginia Woolf, neuroprogression, and bipolar disorder.

Family history and traumatic experiences are factors linked to bipolar disorder. It is known that the lifetime risk of bipolar disorder in relatives of a bipolar proband are 5-10% for first degree relatives and 40-70% for monozygotic co-twins. It is also known that patients with early childhood trauma present earlier onset of bipolar disorder, increased number of manic episodes, and more suicide attempts. We have recently reported that childhood trauma partly mediates the effect of family history on bipolar disorder diagnosis. In light of these findings from the scientific literature, we reviewed the work of British writer Virginia Woolf, who allegedly suffered from bipolar disorder. Her disorder was strongly related to her family background. Moreover, Virginia Woolf was sexually molested by her half siblings for nine years. Her bipolar disorder symptoms presented a pernicious course, associated with hospitalizations, suicidal behavioral, and functional impairment. The concept of neuroprogression has been used to explain the clinical deterioration that takes places in a subgroup of bipolar disorder patients. The examination of Virgina Woolf's biography and art can provide clinicians with important insights about the course of bipolar disorder.

[Suicidal ideation and completed suicide in The Decameron]. / Decameron'da intihar düsüncesi ve tamamlanmis intihar.

OBJECTIVE: To extend our understanding of suicidal ideation and completed suicide via examination of a medieval Italian text-in particular, examination of the role of social and environmental triggers in such events. Previous studies have successfully examined the texts of ancient Greco-Roman, Old Norse, and Finnish civilizations to better understand the circumstances associated with suicidal ideation and completed suicide. Those texts included depictions of suicide by people without any apparent mental disorder in response to painful social/environmental circumstances. MATERIALS AND METHODS: The Decameron, a collection of 100 short stories written by Giovanni Boccaccio in 1349-51, was examined in detail. The setting of The Decameron is during the Black Death and concerns a group of 10 people that leave plague-ridden Florence for a holiday in the countryside. On each of the 10 days of their trip, each individual tells a story, which in total form the 100 stories of Boccaccio's work. For the present study, all mentions of suicidal ideation and completed suicide were listed and arranged with appropriate headings. RESULTS: In total, 9 accounts of suicidal ideation and 4 accounts of completed suicide were identified, all of which were in response to social stressors, particularly romantic problems. CONCLUSION: Suicidal ideation and completed suicide in response to social stressors was a feature of The Decameron and it is feasible that this may have been a feature of medieval Italian culture. This would be in agreement with the findings of other studies that suggest that although commonly occurring in response to mental disorder, suicide can occur independently of such disorder as a result of a predicament in which an individual finds him/herself.

[Role of the ordinary surgeon Yvan beside Napoleon I on the night of April 12 to 13, 1814]. / Rôle du chirurgien ordinaire Yvan auprès de Napoléon ler dans la nuit du 12 au 13 avril 1814.

Alexandre-Urbain Yvan was born on April 28th, 1765 in Toulon, where he entered the military hospital as a student at 14. He got acquainted with Napoleon Bonaparte during the campaigns of Italy. On May 6th, 1800 the Secretary of the war appointed him to the care of the First Consul. He became a close friend of the Bonaparte family and obtained the post of ordinary surgeon of the Emperor. He was going to follow his illustrious patient as his shadow until April 1814. Several arguments evoke Napoleon Ist's suicide attempt, during the night from 12 to 13 April, in Fontainebleau, after the abdication. He absorbed a poison with opium but his menservants thwarted his plan, especially Caulaincourt. Baron Yvan was called at the bedside of the dying sovereign and managed to save him by making him vomit. For fear of being accused of murder, or for some other reason, the surgeon ran away without telling the Emperor. This episode ended definitively the relation between Napoleon and Yvan.

Four centuries of suicide in opera.

OBJECTIVE: To describe the depiction of completed suicide, non-fatal suicidal acts and suicidal thought in Western opera over the past four centuries. DESIGN AND SETTING: Examination of synopses all of the operas listed in a recent monograph covering a selection of operas written in the period 1607-2006. MAIN OUTCOME MEASURES: Frequency of completed suicides, non-fatal suicidal acts and suicidal thoughts over the entire 400-year period and in separate 100-year periods (1607-1706, 1707-1806, 1807-1906 and 1907-2006); circumstances of suicides; sex of the suicidal characters; and, for completed suicide, the method. RESULTS: There were 337 operas in total. In 112 (33%), there was completed suicide alone, non-fatal suicidal acts or suicidal thoughts alone, or both. There was at least one suicide in 74 operas (22%); female characters accounted for 56% of these. Non-fatal suicidal acts or suicidal thoughts were found in 48 operas (14%); male characters accounted for 57% of these. Suicide, non-fatal acts and suicidal thoughts always followed an undesirable event or situation. Cutting or stabbing was the most common method of suicide (26 cases). Other methods included poisoning (15 cases), drowning (10 cases), hanging (four cases), asphyxiation (four cases), "supernatural" methods (four cases), immolation (three cases), jumping from a height (two cases), shooting (one) and blunt trauma (one). Mass suicide occurred on two occasions. CONCLUSIONS: Over several centuries in opera, suicide has been frequently represented as an option when characters have been faced with a distressing event or situation. Historical fluctuations in the frequency of suicidal behaviour in opera may be explained by changes in attitudes towards suicide and its conceptualisation.

Suicidal behaviour in the ancient Greek and Roman world.

OBJECTIVE: We attempt to present and analyze suicidal behaviour in the ancient Greek and Roman world. METHODS: Drawing information from ancient Greek and Latin sources (History, Philosophy, Medicine, Literature, Visual Arts) we aim to point out psychological and social aspects of suicidal behaviour in antiquity. RESULTS: The shocking exposition of suicides reveals the zeitgeist of each era and illustrates the prevailing concepts. Social and legal reactions appear ambivalent, as they can oscillate from acceptance and interpretation of the act to punishment. In the history of these attitudes, we can observe continuities and breaches, reserving a special place in cases of mental disease. The delayed emergence of a generally accepted term for the voluntary exit from life (the term suicidium established during the 17th century), is connected to reactions triggered by the act of suicide than to the frequency and the extent of the phenomenon. CONCLUSIONS: The social environment of the person, who voluntary ends his life usually dictates the behaviour and historical evidence confirms the phenomenon.

Reinventing intention: 'self-harm' and the 'cry for help' in postwar Britain.

PURPOSE OF REVIEW: To sketch out how contemporary Anglophone literature on self-damaging behaviour negotiates serious conceptual difficulties around intention, and to demonstrate (in the British context) how the large-scale emergence of this type of behaviour is made possible by new forms of psychological provision at district general hospitals. RECENT FINDINGS: In the past decade, there has been increasing public awareness of 'self-harm'. Despite the view that 'self-harm' has always existed, the British roots of the current 'epidemic' can be traced to changes in the organization of mental healthcare in the postwar period. These changes make possible new understandings of the story behind physical injuries, and allow these readings to be aggregated and projected onto a national, epidemic scale. SUMMARY: The increasing provision of psychiatric expertise in general hospitals makes possible new interpretations of self-injury - as psychosocial communication, or affect self-regulation - and creates the phenomenon of 'self-harm' as we understand it today.

"Unborn selves"--literature as self-therapy in Virginia Woolf's work.

The connection between mental disorders and creativity in writers, poets, and other artists has been the subject of scientific interest for a long time. The aim of the present study is to examine the relationship between Virginia Woolf's bipolar disorder and her literary creativity. The authors summarize Virginia Woolf's life, family background, and the course of her illness and examine their influence on her work and creation. The authors try to present the complex process in the course of which the work of art is born with the help of the unconscious and conscious. In addition, the authors consider the effect of the development of her illness on her creativity and the way in which she integrated her experiences, anxieties, misconceptions, and hallucinations into art during decompensated depression. Based on these, the authors would like to give an insight into the writer's life and work, which can help us understand better Virginia Woolf's personality, both from artistic and psychiatric point of view.

Changes in associations between psychosocial factors and suicide attempts by adolescents in Greece from 1984 to 2007.

BACKGROUND: Suicide is the second commonest cause of death among adolescents and young adults aged 15-35 years in Europe. Suicide attempts are a strong risk indicator for suicide. This article examines psychosocial factors associated with self-reported suicide attempts in adolescents in Greece and whether the reported increase in suicide attempts from 1984 to 2007 was accompanied by changes in the pattern of related psychosocial factors. METHODS: Data were taken from nationwide probability sample surveys of Greek high school students aged 14-18 years in 1984 (n = 10,507) and 2007 (n = 9873). Logistic regression analysis was used to relate any self-reported suicide attempts to basic sociodemographic and psychosocial variables including family and psychological characteristics, and substance use. RESULTS: Female gender, smoking, illicit drug use, low socio-economic status, not living with both parents, dissatisfaction with relationship with parents, visits to a doctor for psychological problems, depression, anti-social behaviour and low self-esteem were risk factors for self-reported attempted suicide by adolescents in both surveys. Significant interaction terms showed that the effects of gender and illicit drug use were smaller in 2007 than in 1984. However, low self-esteem became significantly more important. CONCLUSIONS: Several common psychosocial factors seem to be steadily related to self-reported suicide attempts by Greek adolescents in 1984 and 2007. However, the increase in self-reported suicide attempts between 1984 and 2007 has been accompanied by changes in the relative importance of correlates.

Prosecuting attempted suicides in London: 1891-1913.

A study of 30 cases of attempted suicide tried at the Old Bailey criminal court in London (England) from 1891 to 1913 indicated that having made prior attempts was the only predictor of the severity of the sentence. 22 individuals were tried for murdering or attempting to murder their child and also attempting suicide. None of the murderers but half of the attempted murderers were found not guilty, or guilty then released. Mothers used drowning more than did fathers and were more likely to be found not guilty.

[Masked depression--history and present days]. / Depresja maskowana--historia i wspólczesnosc.

Masked depression is a special form of an atypical depression. In the 70's and 80's years it was often identified at patients who complained on somatic diseases, without any distinguishable organic disorder. Depression symptoms were of secondary importance, with lesser intensification, some of them didn't appear at all. The psychiatrists of the time created a lot of terms to describe them, i.e.: a depression equivalent, a vegetative equivalent, a depression without a depression, a hidden depression. Current classifications: ICD-10 (International Classification of Diseases, 10th Revision) and DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, published by the American Psychiatric Association) do not contain the term masked depression. It doesn't mean that have disappeared the problem of atypical depression syndrome with a picture significantly different from the commonly known. The american scientists claim that such group contains 6-7% of depression disorders. The lack of proper diagnosis and disease entity qualification leads to serious somatic and psychological consequences for patients. Improper diagnosis and treatment of a patient limits his or her social and professional life, forms suicide rate and makes high costs of diagnosis and treatment.