Gender differences in methods of suicide attempts and prevalence of previous suicide attempts

Comparison between aborted/interrupted and actual suicide attempt: An observational study on clinical and sociodemographic characteristics

BACKGROUND

Little is known about the differences between actual suicide attempts and aborted/interrupted attempts, but evidence suggests some clinical distinctions. The present study aimed to provide information on the rates of aborted/interrupted and actual suicide attempts, and analyze associated sociodemographic and clinical characteristics, relying on a sample of patients admitted to emergency departments in four different regions of Switzerland (Geneva, Neuchâtel, Valais, Vaud).

METHODS

We compared groups (aborted/interrupted vs actual attempts) using independent t-tests and Pearson's Chi-Square tests. Odds ratios (OR) were calculated using univariable logistic regression. A multivariable logistic regression was run including variables associated with the outcome.

RESULTS

Among 687 individuals, 230 (33.5 %) presented an aborted/interrupted and 457 (66.5 %) an actual attempt. Those from the Valais region presented a doubled significant risk for an actual attempt. Those aged 24-44 were more at risk of presenting an aborted/interrupted attempt compared to those aged 45-65 (OR: 0.34; 95 % CI: 0.17-0.70). Compared to those admitted for an intoxication, those using other methods such as cutting object (OR: 0.19: 95 % CI: 0.10-0.38), jumping (OR: 0,05; 95 % CI: 0.02-0.12), strangulation (OR: 0.02; 95 % CI: 0.01-0.07), vehicular impact (OR: 0.08; 95 % CI: 0.02-0.40) and other methods (OR: 0.16; 95 % CI: 0.07-0.39) were significantly more likely to present an aborted/interrupted suicide attempt.

LIMITATIONS

The study has a cross-sectional design, and longitudinal studies are warranted to further understand the direction of the associations.

CONCLUSIONS

Despite these differences, the groups overlapped among several characteristics. Thus, clinical risk staging based on the nature of the attempt might not be recommended, in line with current recommendation for self-harm.

Youth Suicide Deaths: Investigation of Clinical Predictors in a Statewide Sample

Death by suicide is a significant cause of mortality among youth. However, there is limited information on the demographic and clinical factors associated with youth suicide deaths. The objective of this study was to link large statewide databases to describe demographic, clinical, and cause of death characteristics among youth who died by suicide. We examined 1,218 decedents under age 26 who died by suicie between 2000 and 2014. Eighteen died before age 12, 53 died between ages 12 and 14, 292 died between ages 15 and 18, and 855 died between ages 19 and 25. Most were male (83%), and firearm was most common cause of death; 28% previously attempted suicide, 31% had a mental health diagnosis, and 17% were prescribed psychotropic medication. Younger children died by hanging/smothering (89% of all 7- to 11-year olds), and overdose/poisoning increased progressively with age. Adolescents had a higher proportion of females than young adults (23% vs. 14%, p = .002). Combining data from the medical examiner and large hospital systems allows examination of youth suicide from a developmental perspective. Differences between age groups included gender, method, diagnosed mental illness, and diagnosis of attention deficit hyperactivity disorder. These data point to missed opportunities for effective interventions for specific developmental stages.

Self-poisoning in the acute care medicine 2005-2012

OBJECTIVE

To describe the trend of acute self-poisoning in the emergency and intensive care.

METHODS

Electronic charts of adults who presented to the emergency department of the University Hospital Leipzig with self-poisoning following a suicide attempt (suicide group), intoxication (intoxication group), drug overdose for relief of pain or discomfort (drug overdose group) between 2005 and 2012 were analyzed.

RESULTS

3533 adults (62.6% males) were identified, with the yearly admissions increasing from 305 in 2005 to 624 in 2012. The admission rate in relation to the total emergency department admissions also increased, from 1.2% in 2005 to 1.9% in 2012. 31.7% of the patients were younger than 25 years. The reasons for self-poisoning were suicide attempt (18.1%), intoxication (76.8%) and drug overdose (2.9%). The reason could not be clearly classified in 80 patients. Psychotropic drugs were used in 71.6% of suicide attempts, while alcohol was the sole cause of intoxication in 80.1% of cases in the intoxication group. Self-poisoning using at least two substances was observed in 52.0% of the suicide attempts, 10.3% of those with intoxication and 29.7% of those with drug overdose. While alcohol remains the most common cause of intoxication, there was a drastic increase in the consumption of cannabinoids, Crystal Meth and gamma-hydroxybutyrate in the years 2011 and 2012. ICU admission was necessary in 16.6% of the cases. There were 22 deaths (0.6% of the study population), of whom 15 were in the suicide group (2.3%), four (0.15%) in the intoxication group, and three in the not clearly classified group (3.8%).

CONCLUSION

Acute self-poisoning is an increasing medical issue. Psychotropic drugs remain the most common means of suicide attempt. Although alcohol intoxication is very frequent, intake of illicit drugs as the cause of emergency admission is increasing.

The prevalence and psychosocial correlates of suicide attempts among inpatient adolescent offspring of Croatian PTSD male war veterans

Despite evidence that children of male war veterans with combat-related posttraumatic stress disorder (PTSD) are at particularly high risk for behavior problems, very little is currently known about suicidal behaviors in this population of youth. This study aimed to examine the prevalence and psychosocial correlates of suicide attempts among psychiatrically hospitalized adolescent offspring of Croatian male PTSD veterans. Participants were psychiatric inpatients, ages 12-18 years. Self-report questionnaires assessed demographics, suicide attempts, psychopathology, parenting style, and family functioning. The prevalence of suicide attempts was 61.5% (65.2% for girls and 58.0% for boys). Internalizing symptoms, family dysfunction, lower levels of maternal and paternal care, and paternal overcontrol were significantly associated with suicide attempts. Our findings suggest that suicide attempts are common among inpatient adolescent offspring of male PTSD veterans and that interventions targeting both adolescent psychopathology and family relationships are needed for adolescents who have attempted suicide.