The association between life events and suicide intent in self-poisoners with and without a history of deliberate self-harm: a preliminary study.

The associations between life events in the 12 months preceding an episode of self-poisoning resulting in hospital attendance (the index episode), and the suicide intent of this episode were compared in individuals for whom the index episode was their first, episode and in individuals in whom it was a recurrence of DSH. Results indicated a significant interaction between independent life events, repetition status, and gender in the prediction of suicide intent, the association between life events and intent being moderated by repetition status in women only. The results provide preliminary evidence to suggest the presence of a suicidal process in women, in which the impact of negative life events on suicide intent diminishes across episodes.

Problem-solving ability and repetition of deliberate self-harm: a multicentre study.

BACKGROUND: While recent studies have found problem-solving impairments in individuals who engage in deliberate self-harm (DSH), few studies have examined repeaters and non-repeaters separately. The aim of the present study was to investigate whether specific types of problem-solving are associated with repeated DSH. METHOD: As part of the WHO/EURO Multicentre Study on Suicidal Behaviour, 836 medically treated DSH patients (59% repeaters) from 12 European regions were interviewed using the European Parasuicide Study Interview Schedule (EPSIS II) approximately 1 year after their index episode. The Utrecht Coping List (UCL) assessed habitual responses to problems. RESULTS: Factor analysis identified five dimensions--Active Handling, Passive-Avoidance, Problem Sharing, Palliative Reactions and Negative Expression. Passive-Avoidance--characterized by a pre-occupation with problems, feeling unable to do anything, worrying about the past and taking a gloomy view of the situation, a greater likelihood of giving in so as to avoid difficult situations, the tendency to resign oneself to the situation, and to try to avoid problems--was the problem-solving dimension most strongly associated with repetition, although this association was attenuated by self-esteem. CONCLUSIONS: The outcomes of the study indicate that treatments for DSH patients with repeated episodes should include problem-solving interventions. The observed passivity and avoidance of problems (coupled with low self-esteem) associated with repetition suggests that intensive therapeutic input and follow-up are required for those with repeated DSH.

Loss of partner and suicide risks among oldest old: a population-based register study.

BACKGROUND: while mortality among the oldest old has improved over recent decades, these improvements are not reflected in the suicide mortality of this age group. We do not know the reasons why the suicide mortality is still very high among the oldest old. OBJECTIVE: the aim is to analyse the impact that loss of a partner has on the suicide risks of the oldest old (80+) compared to younger age groups. SUBJECTS: the entire Danish population aged 50 during 1994-1998 (n = 1,978,527). METHODS: we applied survival analysis to calculate the changes in relative risk of suicide after a loss by using individual-level data. RESULTS: the majority of older persons who commit suicide are widowed, although only a relatively small proportion of the oldest old who commit suicide have experienced a recent loss of partner (men: 18%, women: 6%). In absolute terms, the oldest old men experience the highest increase in suicide risk immediately after the loss (15-fold; 95% CI 10.2-23.6) compared to middle-aged men who are still married. Oldest old men seem to suffer more from the loss and need longer time to recover than women. CONCLUSIONS: although a small proportion of oldest old who commit suicide have experienced a recent bereavement, there is a significant increase in the suicide risk during the first year after a bereavement, especially for men. However, the increased risk of suicide in the oldest old men may only in part be explained by the loss of a partner.

Differences in suicide between the old and the oldest old.

OBJECTIVES: The purpose of our study is to examine suicide trends among the old (65-79 years) and oldest old (80+ years). METHODS: All persons aged 50 or older who committed suicide in Denmark during 1972-1998 are included in the analysis. Suicide trends are analyzed by sex, age, civil status, and methods. Age, period, and cohort effects are examined graphically. RESULTS: In all, 17,729 persons (10,479 men and 7,250 women) committed suicide. During the study period, the suicide trends among the middle-aged and the old adults decreased. The trend among the oldest old, by contrast, remained stable. Marriage ceases to have a preventive effect among the oldest old. The oldest old tend to use more determined suicide methods. DISCUSSION: Distinct differences in suicide mortality between the old and the oldest old were found. The suicide trend of the oldest old does not reflect the recent improvements found in their overall mortality. Interestingly, it seems that the preventive effect of marriage seems to be ceasing with increasing age.

Why people engage in parasuicide: a cross-cultural study of intentions.

Information obtained at interview from 1,646 parasuicide patients in 14 regions in 13 European countries participating in the WHO/EURO Multicentre Study on Suicidal Behaviour was used to study self-reported intentions involved in parasuicide. Comparisons were made across cultures, genders, and age groups. Although some statistically significant differences were found, the effect sizes were very small. The main finding from this study is thus that parasuicide patients in different countries tend to indicate that similar types of intentions are involved in their acts of parasuicide, and that the intentions do not vary greatly with gender or age. The hypothesis that rates of suicide and parasuicide vary between regions with the frequency with which suicidal intention is indicated by the patients was also tested, but was supported only for women and in relation to national suicide rates. The findings from this study are likely to be generalizable to other settings and have implications for clinical practice.

Suicidal behaviour in Europe : the situation in the 1990s / by Unni Bille-Brahe

This document summarizes the status of suicidal behaviour within the European Region of WHO. The definitions and meaning of suicidal behaviour in various cultural settings are discussed and the frequencies of suicide and attempted suicide are reported. Suicidal behaviour has constituted a problem of increasing concern in most European countries for many years. In recent years, the rates of suicide have been decreasing in most countries in western Europe, but marked increases have taken place in most countries in the eastern part of the European Region. There are no national statistics on attempted suicide, but studies indicate that there are at least 8-10 times as many suicide attempts as completed suicides. Finally, the work of WHO on preventing suicide together with that of the United Nations resulting in the document "Prevention of suicide. Guidelines for the formulation and implementation of national strategies" is discussed and various initiatives recommended