bluuebunny/crossref_metadata_2025 huggingface dataset:
Tick-borne rickettsial diseases
Authors: Angelakis Emmanouil , Raoult Didier
Published: January 2012

Bacteria of the genus Rickettsia belong to the family Rickettsiaceae in the order Rickettsiales and have for long been described simply as short, Gram-negative, strict intracellular rods that retain basic fuchsin when stained by the method of Gimenez (Raoult and Roux 1997). These bacteria are associated with ticks, lice, fleas or mites. To date the Rickettsia genus contains 24 recognized species classified into three groups based on their antigenic, morphological, and ecologic patterns: 1) the typhus group, 2) the spotted fever group and 3) Rickettsia bellii (Fournier and Raoult 2007). Most spotted fever group (SFG) rickettsiae are closely associated with ticks belonging to the family Ixodidae (also called “hard” ticks) (Parola et al. 2005). Ticks can act as vectors, reservoirs, and/or amplifiers of SFG rickettsiae and require optimal environmental conditions which determine the geographic distribution of the vectors and consequently the risk areas for rickettsioses. Many Rickettsia species are strictly associated with one genus of ticks and the transmittion to people is made through the tick bite, which generally implies that the Rickettsia can localize to their salivary glands. Therefore, since larvae, nymphs, and adults may all be infective for susceptible vertebrate hosts, the ticks must be regarded as the main reservoir host of rickettsiae. Humans are not considered as good reservoirs for Rickettsiae, as they are seldom infested with ticks for long periods and rickettsiaemia has normally short duration, especially with antibiotic intervention.
Other bacterial diseasesCat-scratch disease
Authors: Drancourt Michel
Published: January 2012

Cat-scratch disease (CSD) is a worldwide zoonoses caused by infection with the bacterium, Bartonella henselae. The formal description of the disease by Debré in 1950 (Debré et al. 1950) corresponds to the most frequently diagnosed form of the disease. Cats are the main reservoir for B. henselae and transmission is via Ctniocephalides felis. Humans usually become infected after being scratched or bitten by a cat and is most frequently seen in children and young adults.

CSD is a self-limiting illness which often begins with a small papule developing at the site of cat scratch or bite within 3-14 days of the infection. Nearby lymph nodes, usually neck, axillary or groin, become swollen and can persist for several months. It may take up to 7 weeks for the enlarged lymph nodes to appear and individuals may not recall any cat scratch or bite. In healthy cases antibiotics are not indicated.

About 5-10% of patients may develop other forms of CSD including eye infection characterised by conjunctivitis and swollen lymph nodes, rash, liver and spleen enlargement, and more rarely encephalitis. Immunosuppresed patients may develop more severe disease, such as bacillary angiomatosis.

General advice for preventing CSD includes avoiding rough play with cats, particularly kittens. Cat scratches and bites should be washed immediately with water and soap and cats should not be allowed to lick open wounds.
Herpes B virus (Cercopithecine Herpes 1)
Authors: Brown David W. G.
Published: January 2012

Herpes B virus or Cercopithecine herpes 1 as it is formally classified causes a persistent infection of monkeys of the Macaca genus. In monkey colonies and social groups, it is transmitted by close contact and sexually. Human infection is rare with less than 50 human cases described it has been seen in monkey handlers exposed to infected monkeys following bites, scratches and abraded skin. Infection has also been recognized in two cases following exposure through laboratory work. Following an incubation period of 9-59 days typically an ascending encephalomyelitis develops which is fatal in 80% of cases. Prevention and control of the risk of B virus is based on avoiding direct contact with infected animals by screening, following handling guidelines for monkeys used in biomedical research and rigorous laboratory safety precautions. Treatment with acyclovir has been successful and halved mortality in recent cases. It is also recommended for prophylaxis in potential exposures.
Prion-protein-related diseases of animals and man
Authors: Hope James , Dagleish Mark P.
Published: January 2012

Scrapie, bovine spongiform encephalopathy (BSE), Creutzfeldt–Jakob disease (CJD), and related diseases of mink (transmissible mink encephalopathy), mule deer and elk (chronic wasting disease) are the founder members of a group of diseases called the transmissible degenerative (or spongiform) encephalopathies (TSE). These diseases can be transmitted by prions from affected to healthy animals by inoculation or by feeding diseased tissues. Prions are cellular proteins that can transfer metabolic and pathological phenotypes vertically from parent to progeny or horizontally between cells and animals. TSEs are characterised by the accumulation of the prion form of the mammalian prion protein (PrPC) in the central nervous system or peripheral tissues of animals and humans. Mutations of the human PrP gene are linked to rare, familial forms of disease and prion-protein gene polymorphisms in humans and other species are linked to survival time and disease characteristics in affected individuals. Iatrogenic transmission of CJD in man has occurred, and a variant form of CJD (vCJD) is due to cross-species transmission of BSE from cattle to humans. Atypical forms of scrapie and BSE have been identified during large-scale monitoring for TSEs worldwide. This chapter outlines our current understanding of scrapie, BSE, CJD and other TSEs and highlights recent progress in defining the role in disease of the prion protein, PrP.
Rabies and rabies-related lyssaviruses
Authors: Banyard Ashley C. , Fooks Anthony R.
Published: January 2012

Rabies virus is epidemic in most parts of the world. It can replicate in all warm-blooded animals in which it causes a devastating neurological illness, which almost invariably results in death. Rabies is a disease of animals and human infection is a ‘spillover’ event occurring most commonly following a bite from an infected dog. Infection is seen in different patterns; rabies with little or no wildlife involvement, sometimes known as urban or street rabies, or in the wildlife population with spillover into domesticated animals (sylvatic).

Eleven distinct species of lyssavirus are now recognized: species 1 is the most common strain found predominately in terrestrial animals. Species 2-7 are found in bat species with the exception of Mokola virus (species 4). Despite the availability of effective vaccines significant mortality still occurs, mostly in the tropics. The majority of rabies free countries are islands which are able to remain rabies free by import controls. Effective animal vaccines are available and dog rabies is well controlled in most parts of the developed world with dog vaccination. However, it remains an intractable problem in many countries in Asia and Africa due to lack of infrastructure, cost of vaccines and difficulty to control dog population. In recent years progress in controlling wildlife rabies has been achieved in west Europe using vaccine in bait, which offers promise for other regions with complex epidemiology.
Rift Valley fever
Authors: Swanepoel R. , Paweska J. T.
Published: January 2012

Rift Valley fever (RVF) is an acute disease of domestic ruminants in mainland Africa and Madagascar, caused by a mosquito borne virus and characterized by necrotic hepatitis and a haemorrhagic state. Large outbreaks of the disease in sheep, cattle and goats occur at irregular intervals of several years when exceptionally heavy rains favour the breeding of the mosquito vectors, and are distinguished by heavy mortality among newborn animals and abortion in pregnant animals. Humans become infected from contact with tissues of infected animals or from mosquito bite, and usually develop mild to moderately severe febrile illness, but severe complications, which occur in a small proportion of patients, include ocular sequelae, encephalitis and fatal haemorrhagic disease. Despite the occurrence of low case fatality rates, substantial numbers of humans may succumb to the disease during large outbreaks. Modified live and inactivated vaccines are available for use in livestock, and an inactivated vaccine was used on a limited scale in humans with occupational exposure to infection. The literature on the disease has been the subject of several extensive reviews from which the information presented here is drawn, except where indicated otherwise (Henning 1956; Weiss 1957; Easterday 1965; Peters and Meegan 1981; Shimshony and Barzilai 1983; Meegan and Bailey 1989; Swanepoel and Coetzer 2004; Flick and Bouloy 2005). In September 2000, the disease appeared in south-west Saudi Arabia and adjacent Yemen, and the outbreak lasted until early 2001 (Al Hazmi et al. 2003; Madani et al. 2003; Abdo-Salem et al. 2006). The virus was probably introduced with infected livestock from the Horn of Africa, and it remains to be determined whether it has become endemic on the Arabian Peninsula.
Hepatitis E virus
Authors: Meng X. J.
Published: January 2012

Hepatitis E virus (HEV) is a small, non-enveloped, single-strand, positive-sense RNA virus of approximately 7.2 kb in size. HEV is classified in the family Hepeviridae consisting of four recognized major genotypes that infect humans and other animals. Genotypes 1 and 2 HEV are restricted to humans and often associated with large outbreaks and epidemics in developing countries with poor sanitation conditions, whereas genotypes 3 and 4 HEV infect humans, pigs and other animal species and are responsible for sporadic cases of hepatitis E in both developing and industrialized countries. The avian HEV associated with Hepatitis-Splenomegaly syndrome in chickens is genetically and antigenically related to mammalian HEV, and likely represents a new genus in the family. There exist three open reading frames in HEV genome: ORF1 encodes non-structural proteins, ORF2 encodes the capsid protein, and the ORF3 encodes a small phosphoprotein. ORF2 and ORF3 are translated from a single bicistronic mRNA, and overlap each other but neither overlaps ORF1. Due to the lack of an efficient cell culture system and a practical animal model for HEV, the mechanisms of HEV replication and pathogenesis are poorly understood. The recent identification and characterization of animal strains of HEV from pigs and chickens and the demonstrated ability of cross-species infection by these animal strains raise potential public health concerns for zoonotic HEV transmission. It has been shown that the genotypes 3 and 4 HEV strains from pigs can infect humans, and vice versa. Accumulating evidence indicated that hepatitis E is a zoonotic disease, and swine and perhaps other animal species are reservoirs for HEV. A vaccine against HEV is not yet available.
Giardia infections
Authors: Thompson R. C. Andrew
Published: January 2012

Giardia is a ubiquitous intestinal protozoan parasite of vertebrates and the most common intestinal pathogen of humans and domestic animals with a worldwide distribution including both temperate and tropical regions.

Giardia was first observed in 1681 by Antony van Leeuwenhoek in his own faeces (Dobell 1920), and the organism has intrigued biologists and clinicians ever since. However, the first detailed description of the parasite was not given until two centuries later by Lambl (1859). Koch’s postulation was proven by Rendtorff in 1954 when he successfully transmitted symptomatic Giardia infection to human volunteers following orally administered cysts. The first symptoms of clinical giardiasis were reported in the early 1920s, although the significance of Giardia as a cause of diarrhoeal disease was controversial for many years (see Farthing 1994; Cox 1998), and it is only recently that the significance of Giardia as a cause of chronic disease in children and its association with failure to thrive, wasting and malabsorption syndromes has been fully realised (reviewed in Farthing 1994; Hall 1994; Gracey 1994; Rabbani and Islam 1994; Hesham et al. 2005; Savioli et al. 2006; Thompson 2008).

The question of Giardia ’s role as a source of zoonotically transmitted disease again has been controversial. The World Health Organization (WHO) recommended that Giardia should be considered as a zoonotic agent in 1979 (Anon. 1979). Since that time, increasing circumstantial epidemiological evidence from waterborne outbreaks, the results of some cross-infection experiments and molecular characterization studies of Giardia isolates from humans and other animals has led most authorities to conclude that Giardia should be considered a zoonotic parasite (Acha and Szyfres 2003; Savioli et al. 2006; and reviewed in Thompson 2004). However, as discussed below, the frequency of zoonotic transmission is uncertain.
Cryptosporidiosis
Authors: Jex Aaron R. , Chalmers Rachel M. , Smith Huw V. , Widmer Giovanni , McDonald Vincent , Gasser Robin B.
Published: January 2012

Cryptosporidium species represent a genus of parasitic protozoa (Apicomplexa) that are transmitted via the faecal-oral route and commonly infect the epithelial tissues of the gastric or intestinal (or sometimes the respiratory) tract of many vertebrates, including humans. Infection occurs following the ingestion of viable and resistant oocysts, through direct host-to-host contact or in contaminated food, drinking or recreational water. Infection can be transmitted via anthroponotic (human-to-human, human-to-animal) or zoonotic (animal-to-human or animal-to-animal) pathways, depending upon the species of Cryptosporidium. Although infection can be asymptomatic, common symptoms of disease (cryptosporidiosis) include diarrhoea, colic (abdominal pain), nausea or vomiting, dehydration and/or fever. In humans, cryptosporidial infection in immunocompetent patients is usually short-lived (days to weeks) and eliminated following the stimulation of an effective immune response. However, infection in immunodeficient individuals (e.g., those with HIV/AIDS) can be chronic and fatal (in the absence of immunotherapy), as there are few effective anti-cryptosporidial drugs and no vaccines available. The present chapter provides an account of the history, taxonomy and biology, genomics and genetics of Cryptosporidium, the epidemiology, pathogenesis, treatment and control of cryptosporidiosis and the advances in tools for the identification and characterisation of Cryptosporidium species and the diagnosis of cryptosporidiosis.
Other adult and larval cestodes
Authors: Lloyd Sheelagh
Published: January 2012

Adult Diphyllobothrium latum is acquired by consumption of raw fish by persons living around lakes/reservoirs/rivers. Hymenolepis nana can have a direct life cycle so eggs produced by adults in man are important in transfer between humans. The contribution of rodents and the indirect life cycle through arthropods need re-evaluation. Other minor adult cestode infections are described.

Man can be an intermediate host for tissue metacestodes. Taenia multiceps and related species are that acquired from canids and produce a coenurus. Spirometra spp. pleurocercoids are acquired from copepod or reptile/amphibian/mammalian intermediate hosts. Other metacestode infections are very rare.
Strongyloidosis
Authors: Nolan T. J. , Nutman T. B. , Schad G. A.
Published: January 2012

Strongyloidosis is an intestinal parasitism caused by the threadworm, Strongyloides stercoralis. The parasite, occurring in dogs, primates and man, is found throughout the moist tropics, as well as in temperate areas where poor sanitation or other factors facilitate the occurrence of faecally transmitted organisms. In some parts of the world, notably Africa and New Guinea, human infections caused by S. fülleborni have been reported. In Africa, the latter is primarily a parasite of primates, but in New Guinea, no animal host is known. S. stercoralis is unique among zoonotic nematodes, in that larvae passing in the faeces can give rise to a free-living generation of worms which, in turn, give rise to infective larvae. This life history alternative (i.e. heterogonic development) acts as an amplification mechanism, increasing the population of infective larvae in the external environment. The infective larvae are active skin penetrators; infection per os , while possible, is probably of limited importance. Because the parasitic female’s eggs hatch internally, a potential for autoinfection exists when precociously developing larvae attain infectivity while still in the host. This is another virtually unique feature of S. stercoralis infections in both its human and animal hosts. Autoinfection can occasionally escape control by the host, with massive re-penetration and larval migration. This can cause pulmonary or cerebro-spinal strongyloidosis as well as fulminant intestinal parasitism. Control of canine strongyloidosis has been achieved in kennels by strategic use of anthelmintics. Given the lack of epidemiological information community-based programs to control human strongyloidosis have not been attempted. The growing importance of human strongyloidosis depends upon the unique ability of S. stercoralis to replicate within its host and to behave as a potentially fatal opportunistic pathogen in immunocompromised hosts, particularly in those receiving corticosteroids.
Flea infestations
Authors: Mehlhorn Heinz
Published: January 2012

Fleas are wingless bloodsucking insects infesting a large variety of hosts. They can cause dermatological problems and act as zoonotic vectors transmitting very important agents of diseases in humans and in animals living close to humans. Among the agents of diseases occur: viruses, plaque bacteria or even worms etc. Thus flea control is an important target nowadays in order to protect human and animal health all over the world.
Hindu religion and suicide in India
Authors: Vijayakumar Lakshmi
Published: January 2012

Hinduism is one of the oldest religions in the world. It is estimated that there are approximately 965 million Hindus in the world, of which, 909 million are in India.

As early as 3000 BC, suicides were generally condemned, but religious suicides were condoned. The practice of sati (self-immolation) and jauhar (mass suicide) was also prevalent among the Hindus. Suicide by self-immolation often occurs in Hindus, particularly among young women: the dowry system and arranged marriages are prevalent amongst Hindus and sometimes lead to suicides. Suicidal behaviour was higher among Hindus than that of the native population in the countries to which Hindus had migrated.

A case control study in India found that strong faith in Hinduism is a significant protective factor against suicide: odds ratio (OR) 6.83, confidence interval (CI) 2.88–19.69. Belief in karma and reincarnation probably make a Hindu more concerned that they should have a dignified death: in Hinduism it is ultimately the individual’s decision as to how they live and die.
Christianity and suicide
Authors: Retterstøl Nils , Ekeberg Øivind
Published: January 2012

First, the views on suicide as found in the Old and New Testament are presented. In the early Christian period, suicide does not seem to be prohibited. St Augustine (350–430 AD), however, considered it a sin, violating the fifth commandment, ‘Thou shall not kill’. Later, synods of the Church gave strong regulation as to how the suicide should be buried. The same negative attitudes were expressed throughout most of the Middle Ages across Europe.

The European Enlightenment movement brought about moderated views on suicide, challenging former Christian condemnations. From about 1800, psychiatry was established, stating that most people who committed suicide were mentally ill.

Contemporary official Christian attitudes are presented with special reference to the Roman, Greek and Russian Orthodox Church, as well as the Protestant Church. The viewpoints on euthanasia are presented briefly. Finally, we discuss how Christian traditions influence suicide prevention today.
Suicide attempts in North America
Authors: Silverman Morton M
Published: January 2012

North America comprises Canada, the United States of America (USA), Mexico, and the Caribbean Island nations. North America covers 9,355,000 square miles (24,230,000 square kilometres). The two largest countries, Canada and the United States of America, have populations of approximately 33.4 million and 301.1 million respectively, and are home to multiple ethnic and racial groups, including Native Americans and immigrants from many other continents. The suicide rate in Canada has tended to be higher than that of the USA during the last two decades. There is virtually no reliable data on suicide and suicide attempt rates in North American countries other than Canada and the USA.

Suicide was the third leading cause of death for the age group 15–19 years in the USA during 2000. In Canada, suicide was the second leading cause of death for the age group 15–24 years, and the leading cause of death for men aged 25–29 and 40–44, together with women aged 30–34, and it is estimated that there are at least 100 attempts for every completed suicide. Furthermore, there are substantial variations across gender, age, and ethnic groups.

Suicide attempts in North America are a growing concern. Suicide attempts are known to be a primary risk factor for future suicidal behaviours, and those who have previously attempted suicide are at an increased risk of death by suicide. Brickman and Mintz (2003) claim that suicide attempt rates have more than doubled from 600 to 1600/100,000 from 1992–1999, with indications of continuously increasing. Therefore, more epidemiological research needs to be done in order to understand this problem.

This chapter examines published surveillance records and hospital records on the prevalence, trends, social and demographic factors of suicide attempts in North America.
Extended suicide
Authors: Lester David
Published: January 2012

Analyses of suicide committed by couples’ suicide pacts and mercy killings and by groups of people in mass suicides are presented. Those involved appear to differ demographically and psychologically from suicides acting alone. In addition, examples of murderers who commit suicide after killing are presented, including mass murderers who have a high suicide rate and serial killers who have a much lower suicide rate than mass murderers. This chapter will examine these phenomena.
Suicide during war and genocide
Authors: Lester David
Published: January 2012

Research indicates that suicide rates decline during wartime. The most likely explanation for this decline is the greater social cohesion of societies during wartime, but changes in the economy, such as reduced rates of unemployment, may also play a role. The impact of civil wars on suicide rates is unclear since the data in the different reports are inconsistent. Prisoners of war who are treated harshly have higher suicide rates after release. The suicide rate of Jews was high during all phases of the Holocaust in the 1930s and 1940s.
Prevention of suicidal behaviour in females
Authors: Canetto Silvia Sara
Published: January 2012

Females have higher rates of suicidal ideation and behaviour, and lower rates of suicide mortality than males. This is a dominant, but not a universal pattern, both across and within countries. One of few national exceptions is China, a country where both non-fatal and fatal suicidal behaviours are most common in women. There is also cultural heterogeneity in meanings of, and attitudes about female suicidal behaviour. In some cultures, suicide is viewed more negatively in women, while in other cultures in men. This cultural diversity in gender patterns and meanings of suicidal behaviour challenges essentialist perspectives on female suicidal behaviour, and calls for culture and gender-grounded theory, research and prevention. The perception, dominant in industrialized countries, that suicide is a male behaviour is a challenge, but can also be an opportunity in prevention in that it may discourage female suicide. Evidence indicates that critical to the prevention of female suicidal behaviour is attention to social, economic and political factors, including structures of social inequality.
Suicide in prisons and remand centres
Authors: Kerkhof Ad , Blaauw Eric
Published: January 2012

Early identification of prisoners with suicide risk, and the prevention of suicide, are of great importance given the high suicide rates in correctional facilities. General suicide screening instruments are not very useful in prisons and remand centres. A new screening instrument has been developed and tested consisting of eight questions. The cut-off score, retrospectively, allowed the identification of 82 per cent of all Dutch prisoner suicides. By screening new inmates, this set of questions classified 18 per cent of all prisoners in a high-risk group. All of these inmates require immediate and further assessment by a medical or mental health care officer. However, even without screening, these prisoners will visit medical or mental health services sometime later during their incarceration, because of their level of psychopathology. Regular follow-up interviews are necessary to assess the suicide risk. Suicidal prisoners, most of whom have severe psychiatric disorders, should receive standard treatment in the same way as ordinary people would receive treatment beyond prison walls.
The clinical interview as a method in suicide risk assessment
Authors: Schechter Mark , Maltsberger John T
Published: January 2012

In this chapter we describe the role of the clinical interview in the assessment of suicide risk. In the course of the interview the clinician must endeavour to understand the patient’s crisis from both the ‘objective/descriptive’ and the ‘experiential’ perspectives, each of which we describe in detail. A focus on both of these perspectives is critical in the clinician’s coming to the best possible understanding of the patient. In addition to the role of the clinical interview in assessing risk, this critical clinical interaction is also the beginning of the treatment relationship and crisis intervention; thus it has a role in reducing risk as well. Finally, we comment briefly on the clinician’s conscious as well as unconscious responses to the patient, or ‘countertransference’, that can arise in the interview of potentially suicidal patients and influence the clinical assessment.
Biological predictors of suicidal behaviour in mood disorders
Authors: Mann J John , Currier Dianne
Published: January 2012

Predicting suicide is difficult due to the low base rate, even in high-risk groups, and the multi-causal nature of suicidal behaviour. Retrospective and cross-sectional studies have identified a number of biologic abnormalities associated with suicide and suicide attempt. Prospective studies provide estimates of the predictive utility of biologic measures. Here, we review prospective studies of suicidal behaviour and serotonergic, noradrenergic, dopaminergic systems and the hypothalamic–pituitary– adrenocortical (HPA) axis function in mood disorders. The most promising biologic predictors are low CSF (cerebrospinal fluid) 5-hydroxyindoleacetic acid (5-HIAA) and HPA axis dysfunction as demonstrated by dexamethasone non-suppression that are each associated with about 4.5-fold greater risk of suicide.
The role of the state and legislation in suicide prevention
Authors: Anderson Martin , Jenkins Rachel
Published: January 2012

This chapter explores the way in which current states intervene in suicide prevention. The broader context for the development of national policy will be discussed including guidance from the WHO and the United Nations. At the centre of this is the recognition of suicide as a global phenomenon and the need to ensure that countries do all they can to reduce suicide rates and help those bereaved by suicide. We examine how nations have been asked to consider suicide prevention in national public health policy and look at the common areas for state intervention. The chapter draws upon information from the five continents perspective and emphasizes the similarities, differences and areas in which state work is needed.
Strategies in suicide prevention
Authors: Durkee Tony
Published: January 2012

Strategies in suicide prevention have developed throughout the years, and progressed into conceptual models that are defined by a set of restrictive definitions. In this chapter, classifications of two suicide preventive strategic models, namely the Primary/ Secondary/Tertiary (PST) and Universal/Selective/Indicated (USI) are described, as well as a pragmatic suggestion for health care and public health-oriented strategies in suicide prevention. Health care-oriented strategies use the individual-centred approach with the focus on the treatment of patients. Public health strategies in prevention of suicide are directed toward groups and whole populations.
The psychological and behavioural treatment of suicidal behaviour
Authors: Rudd M David , Williams Ben , Trotter David RM
Published: January 2012

This chapter provides a review of all currently available clinical trials targeting suicidal behaviour. In contrast to some previous available reviews, the focus of the current chapter is on identifying common elements of treatments that work. More specifically, we attempted to answer the question, what do treatments that work have in common? A number of psychological treatments have emerged as effective or potentially effective at reducing suicidal behaviour (i.e. suicide attempts). There now appear to be a number of identifiable core elements for treatments that have proven effective at reducing suicide attempts, all with direct and meaningful implications for day to day clinical practice. We also point out limitations in current science, including problematic follow-up periods and questions about the high-risk nature of some study samples.
Family psychoeducation with suicide attempters
Authors: Dunne Edward J
Published: January 2012

Inappropriate or inadequate treatment in emergency treatment settings frequently leads to failures to adhere to after-care prescriptions and an increase in subsequent suicidality. Working collaboratively with the patient and the family can increase compliance and reduce risk. An intervention based on the family psychoeducation model developed to treat serious mental illnesses is described. A rationale for using this model is presented, which stems from the high rate of mental illness diagnoses in psychological autopsies of completed suicides. Sequential tasks for the clinician are presented. ‘Joining’ as a collaborative technique with both the patient and the family is described. Specific guidelines for the family to reduce potential for further harm are suggested.
The role of paintings in suicide treatment and prevention
Authors: Bronisch Thomas , von Spreti Flora
Published: January 2012

The theme ‘suicide’ in paintings mirror social, cultural, religious and philosophical stances to suicide. However, behind these more public aspects of the artist’s work there is often a personal meaning for the artist as well. The motives and interests of the artists go beyond the theme of suicide. An important factor in suicidal behaviour is a depressive mood or a depressive disorder. However, the depressive mood as well as the underlying manic-depressive illness of some artists may also be seen as an important prerequisite for their creativity. Despite the importance of suicidality in art and that art therapy is well-established for treating patients in psychiatry and psychotherapy, only a small body of empirical literature about the role of art therapy in depressed and suicidal patients exists today. In paintings and sculptures of art therapy, done by patients primarily reflect the inner experiences of their illness and biography. Art therapy can help the patient to alleviate self-destructive ways of acting.
Crisis hotlines
Authors: Gould Madelyn S , Kalafat John
Published: January 2012

This chapter reviews the evidence of the effectiveness of telephone crisis services (‘hotlines’) as a suicide prevention strategy. Hotlines are a ubiquitous source of help internationally, but the evidence for their effectiveness is equivocal. Recent research provides support for crisis hotlines’ role in reducing callers’ crisis and suicidal states, bearing in mind the lack of control conditions. However, studies have also raised concerns about the extent and quality of suicide risk assessments and crisis interventions by hotline staff. A particular challenge is making hotline services attractive to youth. These concerns have prompted current efforts to enhance risk assessments, training and outreach strategies in telephone crisis centres.

Crisis hotlines are ubiquitous sources of help worldwide. A rationale for the role of crisis hotlines in suicide prevention is that suicidal behaviour is often associated with a crisis (Mishara and Daigle 2000). The psychological autopsy research generally supports the association of stressful life events, such as interpersonal losses and legal or disciplinary problems, with suicide (Runeson 1990; Brent et al. 1993; Gould et al. 1996). Furthermore, suicide is usually contemplated with psychological ambivalence—surviving suicide attempters often report that the wish to die coexisted with wishes to be rescued and saved (Shaffer et al. 1988). This can result in a ‘cry for help’, which can be addressed by those with special training (Litman et al. 1965). Lastly, crisis services may provide relief to an individual who is in the ‘final common pathway to suicide’ (Shaffer et al. 1988) by providing the opportunity for immediate support at these critical times. The goal of crisis hotlines is to prevent deleterious outcomes for callers by reducing their current crisis and/or suicidal states and identifying alternate coping approaches, including referrals to formal and/or informal community resources. Crisis hotlines have the practical advantage of providing temporally, financially, and geographically accessible services.
Education and awareness programmes for adults
Authors: Hegerl Ulrich , Dietrich Sandra , Pfeiffer-Gerschel Tim , Wittenburg Lisa , Althaus David
Published: January 2012

Awareness campaigns and multilevel intervention programmes from different countries and continents, their effects on suicidality, as well as limitations of these programmes, are presented and discussed.

Experiences from multilevel interventions, such as the Nuremberg Alliance Against Depression in Germany, show that awareness campaigns develop the strongest effect when combined with other measures to create a synergistic effect. Awareness campaigns draw the attention and interest of primary care providers to activities focusing on depression and suicidality, and make it easier for them to consult with patients with psychiatric diagnoses and motivate them concerning treatment, not least because awareness campaigns can contribute to improving community mental health knowledge. Finally, for those affected by depression or other mental disorders, public campaigns reduce the perceived stigma, thus, lessening the isolation which contributes to despair and suicide risk.
Suicide awareness and mental health among youth in the community
Authors: Hoven Christina W , Tyano Sam , Mandell Donald J
Published: January 2012

In this chapter, we propose a strategy for increasing the likelihood of identifying youth who are experiencing serious emotional difficulties, which would place them at risk for suicide. Admittedly, current knowledge of the multiple causes of youth suicide remains incomplete, and the scant, currently available mental health resources to address this problem are generally woefully inadequate to meet the need. The situation is even worse in under-resourced environments throughout the world, where there is an acute lack of all mental health services for youth. New efforts are called for. Raising awareness of children’s mental health among important youth stakeholders, parents, teachers, and youth themselves, and increasing help and treatment-seeking behaviours, holds out the potential to help reduce unnecessary deaths by suicide in youth.
Protecting bridges and high buildings in suicide prevention
Authors: Beautrais Annette , Gibb Sheree
Published: January 2012

Suicide by jumping is a relatively uncommon method of suicide in most countries. However, in some places where there is accessible high-rise housing, jumping accounts for a significant proportion of suicides. While, internationally, most suicides by jumping occur from residential housing units, preventive efforts have tended to focus on a relatively small number of sites (often bridges) which have acquired notoriety as sites for suicide. A small number of studies suggest that the installation of safety barriers at these sites is an effective approach to reducing suicides by jumping. The extent to which lessons and principles from these examples may be applied to other jumping sites has yet to be fully explored.
Prevention of suicide by jumping
Authors: Chen Ying-Yeh , Yip Paul
Published: January 2012

Nearly 80 per cent of the population of Hong Kong and Singapore live in high-rise buildings. High-rise buildings provide an opportunity for committing suicide by jumping, and elevated rates of suicide by this method are observed in the above-mentioned cities. An analysis of the suicides in Singapore, Hong Kong and Taipei can increase understanding and improve possibilities for prevention.
Gun availability and control in suicide prevention
Authors: Leenaars Antoon
Published: January 2012

Although countries differ in the most frequent methods of suicide, firearms are a preferred method in some countries. It is a method with high case fatality. Individual (case–control) studies and population studies show that restriction of firearms reduces suicide. This is especially evident in the young. Further, population studies show that gun control, such as strict licensing and restricted availability of firearms, is effective. Individual and population studies also found that one must especially control the availability of firearms to people with mental disorders. Canada’s Criminal Law Amendment Act of 1977 (Bill C-51) illustrates the effect of legislating means restriction when one controls for confounding social and economic factors. The young show the most significant decrease in suicide rates, not substituting guns with other methods of suicide. Studies on firearms and suicide across the globe support the studies from Canada. Yet, there are researchers who espouse the opposite and the debate has been polemic. More research is needed to strengthen the conclusion on the positive effects of gun control laws worldwide.
Restriction of alcohol consumption in suicide prevention
Authors: Hadlaczky Gergö
Published: January 2012

Alcohol consumption is related to suicide rates on an aggregate level. Given that a causal relationship is also supported by both natural experiments and studies on an individual level, restricting access to alcohol can arguably prevent suicides. Sensitivity of suicide rates to changes in alcohol consumption varies from one region to another, depending on cultural drinking habits. Identifying the key characteristics of cultures where changes in alcohol consumption most affect suicide rates may help in deciding where alcohol restriction policies may be effective in reducing suicide.
How to help survivors of suicide loss
Authors: Baro Franz , Ngoubene-Atioky Arlette J , Toye Jan , Gucht Marc Vande
Published: January 2012

Survivors, i.e. relatives and friends of persons who have died by suicide, experience a plethora of emotional and societal difficulties. Due to the complicated nature of grieving in the aftermath of a suicide, emotional and social support to survivors can only ameliorate the life functioning of this population. The present chapter outlines therapeutic resources that will be beneficial to this unique group. Therapeutic groups, and many other group-related activities, have been established to assist survivors of suicide. Descriptive information with regards to these groups and how to create them is provided. The chapter ends with recommendations on additional resources and services for survivors of suicide.
The link between physical disabilities and suicidality in children and adolescents
Authors: Zalsman Gil , Shoval Gal
Published: January 2012

The existence of physical disorders and disabilities has been associated with suicidal behaviour among adults. Though relatively less often studied in children and adolescents, a growing body of evidence supports a similar link in this population as well. This chapter describes recent studies on suicidality among young patients with diabetes mellitus, bronchial asthma, human immunodeficiency virus (HIV), epilepsy, multiple sclerosis, traumatic brain injuries and physical injuries. Suggested models addressing biological, psychological and social aspects relevant to the possible pathophysiological mechanisms linking physical disorders and disabilities to suicidal behaviour in the paediatric age group are also discussed.
Effective treatments for suicidal youth
Authors: Brent David
Published: January 2012

There are few empirically tested treatments for suicidal adolescents. In this chapter, the relationship between adolescent depression and suicidal behaviour is reviewed, as well as the risk factors for suicidal behaviour in depressed adolescents. The impact of psychosocial and pharmacotherapeutic interventions on depression and on suicidal outcomes is reviewed, including recent reports that SSRIs may be associated with an increase in spontaneously reported suicidal adverse events. We then review the few empirically tested psychosocial interventions for the treatment of suicide-attempting adolescents, including treatments that target family interactions, cognitions, social and emotion regulation skills, and the social ecology (either social network or school) of the suicidal adolescent. Studies have also examined the impact of different aspects of clinical management, such as the development of a safety plan, providing open access to an inpatient unit, and augmenting usual care with occasional postcards from clinical staff. The possible impact of lithium, divalproex, neuroleptics, and SSRIs in the reduction of impulsive aggression and suicidal risk is also discussed. Recommendations for further research are advanced.
The World Psychiatric Association Section of Suicidology
Authors: Sarchiapone Marco , Soubrier Jean-Pierre , Wasserman Danuta
Published: January 2012

The World Psychiatric Association (WPA) Section on Suicidology was established on the eve of the third millennium, and has a quite recent history compared to other Sections. The path of suicidology is transdisciplinary, rather than having a definite location: its study was, at first, the object of philosophy, then of literature, theology, social sciences, only in the last two centuries has it acquired a medical character, specifically in psychiatry. Also in the psychiatric area, suicidology settled in a ‘trans’ fashion, namely acquiring a ‘trans-nosographical’ characterization, cutting across several psychiatric diagnoses. Possibly for this reason, a Section on suicidology within the World Psychiatric Association was necessary, serving as a vessel for a fluid entity as the study of suicidal behaviours.
The International Academy of Suicide Research
Authors: Mann J John
Published: January 2012

The International Academy of Suicide Research (IASR) was established in Bologna on 29 September 1990, at Padua University (De Leo and Schmidtke 2001). In his inauguration speech, the late Professor Nils Retterstol from Oslo, Norway, welcomed this association of the world’s leading researchers in suicidology and suicide prevention as an essential step forward in the field (IASR 2004a). The overall aim of the Academy is to reduce the mortality and morbidity of suicide-related incidents by promoting the highest standard of suicide research and fostering communication and collaboration among scholars in the field of suicidology. Traditionally, suicide research has focused on the psychological and behavioural characteristics of suicide attempters. However, promising evidence of the biology of suicide has emerged and, accordingly, the IASR now aims to promote more research in this specific area of suicidology. Another of IASR’s objectives is to promote research on evaluation of preventive interventions and of suicide-prevention programmes under way in various countries. Examining the effects of various prevention programmes in different countries and cultures makes it possible to identify which components of an intervention are effective, and thus draw up better strategies for future suicide-preventive programmes (Mann et al. 2005).
The American Foundation for Suicide Prevention
Authors: Haas Ann P , Gebbia Robert , Clayton Paula J
Published: January 2012

In 1987, leading experts on suicide joined with families who had lost a loved one to suicide to form the American Foundation for Suicide Prevention (AFSP).

Following the approach that had proven to be effective in advancing the treatment and prevention of heart disease, cancer and diabetes, AFSP began with the goals of furthering the research necessary to understand and prevent suicide, and educating mental health professionals and the public about effective treatment and suicide-prevention strategies. From its inception, the work of the Foundation aimed to lower suicide rates, increase the public and private resources available for suicide prevention, and develop and support programmes to assist survivors of suicide loss. Over time, AFSP’s focus broadened to include representatives from the civic and business communities, as well as people suffering from depression and other mood disorders that convey suicide risk.

More than 20 years later, AFSP remains the leading national non-profit organization in the US, exclusively dedicated to understanding and preventing suicide through research and education, and to reaching out to people with mood disorders and those impacted by suicide. From a single national office in New York City, the Foundation has expanded to include twenty-eight Chapters throughout the United States that bring AFSP programmes to states and communities and play an important role in focusing public attention on suicide.
Suicide prevention in Japan
Authors: Kawanishi Chiaki , Kaneko Yoshihiro
Published: January 2012

Suicide has been an emerging problem for many years in Japan, especially amongst males of working age, young people and the elderly. A dramatic jump in the year-over-year number of suicides occurred in 1998 (32,863 victims compared to 24,391 in 1997). Since 1998, suicide numbers have exceeded 30,000 every year for ten consecutive years (MHLW 2008). According to the latest suicide rates, 37.7 per 100,000 males and 14.7 per 100,000 females completed suicide in Japan in 2007 (National Police Agency 2008). Seventy per cent of the victims are men and approximately a third are aged 60 years or over. Trigger factors for suicide are health and financial problems. The number of people who attempted or committed suicide in Japan due to work-related stress has doubled since 2003– 2004. Due to cultural factors, Japanese men are not supposed to show weakness. The economic conditions of the elderly are worsening as the government restructures its budget and reduces the social security and pension budgets. There are not enough experts and psychiatrists available for consultations with people suicidal crisis.
Suicide prevention in Australia
Authors: De Leo Diego , Krysinska Karolina
Published: January 2012

Australia is among countries with a medium rate of suicide: 10.3 per 100,000, with the male:female suicide ratio of approximately 4 to 1, and suicide rates 16.4 per 100,000 and 4.3 per 100,000, respectively (ABS 2007). Young males in the age group of 25–34 are at the highest risk 25.1 per 100,000 (ABS 2007). Similarly to other countries with an Anglo-Saxon sociocultural background (De Leo 1999), the rates for males decrease with advancing age only to rise again among elderly males over the age of 75, to 21.6 per 100,000 (ABS 2007).