Observación de un espectro de manifestaciones clínicas ante la exposición a información relacionada con eventos suicidas / Observation of a Spectrum of Clinical Manifestations when Exposed to Information Related to Suicidal Events

Resumen Hace muchos años se describió el ahora conocido efecto copycat. Se entiende como la reproducción del acto autolesivo, por parte de personas susceptibles, posterior a la exposición a la información en los medios de comunicación relacionada con un suicidio concretado (en noticias, redes sociales, etc.). A partir de la observación en la atención psicológica y psiquiátrica de los pacientes, nuestro grupo ha detectado que esta replicación en realidad forma parte de un espectro mucho más amplio, y que, consecuentemente, otras manifestaciones suelen pasar inadvertidas. Si se trazara un continuum de esas expresiones, en el extremo más severo, se encontraría el suicidio consumado luego de la exposición a dicho material, que es el componente más reconocido hasta la fecha (efecto copycat); no obstante, en otras zonas del espectro, también es posible que las personas experimenten distorsiones cognitivas, componentes obsesivos e intrusivos, ideación pasiva y activa de muerte e intentos no consumados de suicidios. El presente documento se propuso como objetivo describir este fenómeno y, a la vez, ejemplificarlo mediante la exposición de un caso. Resulta probable que el correcto reconocimiento y abordaje fenomenológico sean pasos básicos para establecer los tratamientos y las estrategias preventivas, que garanticen la seguridad de estas personas

Abstract: Long ago, the scientific literature informed about the now well-known copycat effect, understood as a reproduction of the self-injurious act by susceptible individuals after being exposed to suicide-related information in the media (news, social networks, etc.). From observations in psychological and psychiatric care of patients, our group has detected that these manifestations are actually part of a much broader clinical spectrum, where other manifestations can also be found. It would seem plausible that if a spectrum is defined, the most severe end would be consummated suicide, which is the well-recognized component to date (copycat effect); but it is also possible that there is a series of more diverse expressions in other patients after having been exposed to this information, which could include cognitive distortions, obsessive and intrusive phenomena, passive and active ideation of death and unsuccessful suicide attempts. Our purpose with this paper is to explain our observations and present a clinical vignette as an example. We believe that correct recognition and approach to these phenomena is fundamental to establish treatments and preventive strategies that guarantee the safety of this population.

Aircraft-Assisted Pilot Suicides in the General Aviation Increased for One-Year Period after 11 September 2001 Attack in the United States.

Pilot aircraft-assisted suicides (AAS) are rare, and there is limited understanding of copycat phenomenon among aviators. The aim of this study was to evaluate the possible effect the 11 September 2001, terrorist attacks had on pilot AASs in the U.S. Fatal aviation accidents in the National Transportation Safety Board (NTSB) database were searched using the following search words: "suicide", "murder-suicide" and "homicide-suicide". The timeline between 11 September 1996, and 11 September 2004, was analyzed. Only those accidents in which NTSB judged that the cause of the accident was suicide were included in the final analysis. The relative risk (RR) of the pilot AASs in all fatal accidents in the U.S. was calculated in order to compare the one, two, and three-year periods after the September 11 terrorist attacks with five years preceding the event. The RR of a fatal general aviation aircraft accident being due to pilot suicide was 3.68-fold (95% confidence interval 1.04⁻12.98) during the first year after 11 September 2001, but there was not a statistically significant increase in the later years. This study showed an association, albeit not determinate causal effect, of a very specific series of simultaneous terrorist murder-suicides with subsequent pilot AASs.

Cobertura periodística sobre el suicidio: ¿habría riesgo de causar efectos negativos en personas susceptibles? / Journalistic Coverage of Suicide: Could there be a risk of causing a negative impact on susceptible persons? / Cobertura jornalística sobre o suicídio: haveria o risco de causar efeitos negativos em pessoas suscetíveis?

Resumen El artículo buscó comprobar que un uso inadecuado de la información en medios de comunicación puede incrementar riesgos en personas susceptibles a enfermedades mentales. Para ello, se estudió el efecto de noticias colombianas, tanto nacionales como regionales, que se relacionaban con la palabra suicidio en el 2014. Posteriormente, se analizaron las noticias, aplicando una encuesta con ocho preguntas por parte de dos integrantes del grupo, entrenados previamente para la realización de la investigación, a fin de ir más a fondo y ver el efecto de los medios de comunicación y su estigmatización. Hoy en día, los adolescentes se ven más expuestos a situaciones que pueden afectar su estado de ánimo por un uso inadecuado de medios de comunicación, teniendo en cuenta que el peor desenlace sería llevar a una conducta suicida.

Abstract The article attempts to verify that inappropriate use of information provided by the media can increase risks for persons who are susceptible to mental illness. The impact of Colombian news in 2014 (national and regional) related to the word suicide was studied to that end. The news was analyzed subsequently through a survey with eight questions applied by two members of the group who had been trained to conduct the study. The idea was to delve deeper and to see the effect of the media and its stigmatization. Nowadays, adolescents are more exposed to situations in which their mood can be affected by improper use of the media, bearing in mind that the worst outcome would be that it leads to suicidal behavior.

Resumo Este artigo procurou comprovar que um uso inadequado da informação em meios de comunicação pode gerar riscos em pessoas suscetíveis a doença mental. Para isso, estudou-se o efeito de notícias colombianas, tanto nacionais como regionais, que se relacionavam com a palavra suicídio, em 2014. Em seguida, analisaram-se as notícias aplicando uma pesquisa com oito perguntas por parte de dois integrantes do grupo, treinados para a realização da pesquisa, a fim de ir mais a fundo e ver o efeito dos meios de comunicação e sua estigmatização. Atualmente, os adolescentes se veem mais expostos a situações que podem afetar seu humor por um uso inadequado de meios de comunicação, considerando que o pior desfecho seria levar a um comportamento suicida.

Media roles in suicide prevention: a systematic review.

The aim of the current systematic review was to monitor and provide an overview of the research performed about the roles of media in suicide prevention in order to find out possible effects media reporting on suicidal behaviours might have on actual suicidality (completed suicides, attempted suicides, suicidal ideation). The systematic review was performed following the principles of the PRISMA statement and includes 56 articles. Most of the studies support the idea that media reporting and suicidality are associated. However, there is a risk of reporting bias. More research is available about how irresponsible media reports can provoke suicidal behaviours (the 'Werther effect') and less about protective effect media can have (the 'Papageno effect'). Strong modelling effect of media coverage on suicide is based on age and gender. Media reports are not representative of official suicide data and tend to exaggerate sensational suicides, for example dramatic and highly lethal suicide methods, which are rare in real life. Future studies have to encounter the challenges the global medium Internet will offer in terms of research methods, as it is difficult to define the circulation of news in the Internet either spatially or in time. However, online media can provide valuable innovative qualitative research material.