bluuebunny/crossref_metadata_2025_split huggingface dataset:
Suicide attempts in Asia
Authors: Jiang Guo-Xin , Cheng Qi 
Published: January 2012

AbstractData on the prevalence of attempted suicide are sparse in Asian countries, particularly data gathered from large, general population- based surveys. Rates of attempted suicide reported results in various target groups and different areas, sometimes with large variations. For example, the prevalence of suicide attempts could be as low as 0.4 per cent of a sample aged over years in Hanoi, Vietnam; and 7.0 per cent among adolescent students aged 12–18 years in a rural prefecture of China. However, the age and gender distribution of suicide attempts are similar in Asia to Western countries, with the highest being among females and young people. Self-poisoning by ingestion of various medications or pesticides is a common method in Asian countries, predominantly in the rural areas. In general, fewer suicide attempters in Asia have had a diagnosis of psychiatric illness before the attempt compared to Western countries. Large representative, population-based investigations on suicide behaviour with a well-designed epidemiological method are urgently needed in Asia.
Suicide attempts in Europe
Authors: Rutz Ellenor Mittendorfer , Schmidtke Armin 
Published: January 2012

AbstractThe comparison of international statistics on suicide attempt across European countries is challenged by differences in definitions and the lack of compulsory registration of suicide attempts. The WHO/EURO multi-centre study on parasuicide has overcome these obstacles, and has provided comprehensive data on both the occurrence and background factors of suicide attempt in different European countries. This article summarizes findings from the WHO/EURO study as well as from various other clinical and community surveys carried out in the region. Peculiarities of the inter-European variation in patterns and trends of the phenomenon and various social and psychiatric determinants are described in detail. The WHO/EURO study is continued as the MONSUE (Monitoring suicidal behaviour in Europe) study, which will supply even more detailed data on specific risk groups. These can then be supported by tailor-made suicide prevention strategies.
Interaction of hereditary and environmental factors in the psychiatric disorders associated with suicidal behaviour
Authors: Roy Alec , Sarchiapone Marco 
Published: January 2012

Abstract
Data from clinical, twin and adoption studies suggest that genetic factors may play a role as a distal risk factor in suicidal behaviour. The serotonin transporter gene, as a model for studies examining interaction between genes and environment, is discussed. Studies that report interaction between the serotonin transporter and stressful life events, in relation to the development of depression in both adults and adolescents and in relationship to suicidal behaviour, are reviewed. Relevant interaction studies in primates are also discussed.
Suicide during transition in the former Soviet Republics
Authors: Värnik Airi , Mokhovikov Alexander 
Published: January 2012

AbstractSignificant social, political, and economic changes in the countries of the former Soviet Union present a good model for investigation of the impact of environment on suicide mortality during times of transition. During the period of perestroika (1985–1990), when promising social changes were rapid, a significant decrease of suicide mortality was observed for both genders in all fifteen republics of the USSR. One of the factors which contributed to the decrease was the strict anti-alcohol policy implemented in 1985 and suspended by 1989. However, times of spiritual liberation, the aspiration of democracy, social optimism and hopes for higher living standards could also have attributed to the causality of suicide decrease. In the years 1990–1994, after the disintegration of the Soviet Union, the suicide rates in post-Soviet countries increased, with the exception of prevailingly Muslim central Asiatic, and the Caucasus countries which have a traditionally low level of suicides. The transitional period called for high adaptation capacity and the necessity of developing suicide-prevention programmes to increase social support and re-education measures.
Suicide among migrants
Authors: Sharma Menakshi , Bhugra Dinesh 
Published: January 2012

AbstractMigration or mobility of individuals from one location to another is a frequent phenomenon and has been the case for millennia, although reasons for such movement of people have varied. Reasons for migration and the experiences an individual has when arriving at the new place are important, especially in terms of understanding the experiences and problems they may encounter. How well an individual adapts to the new country can be explained by factors of acculturation and how well this occurs may in turn affect the mental health of the person. Studies have shown that migration across the world is on the increase, as are the mental health problems amongst the migrant population; especially self-harm and suicide. Investigating the factors for this is important in order to develop strategies of prevention from a public health point of view. In this chapter we examine differences in the rates of suicide amongst the migrant groups across different countries and explore preventative methods from a public health perspective.
Suicide and attempted suicide among indigenous people
Authors: Wasserman Danuta , Durkee Tony , Hadlaczky Gergö 
Published: January 2012

AbstractThere are hundreds of indigenous groups and peoples around the world. Examples are the Australian Aborigines, the North American Indians (Native Americans) of the US and Canada, and the Maori of New Zealand. Such groups and peoples often have elevated suicide rates compared with the general population in their countries, and divergent epidemiological characteristics. Adoption of culture-specific prevention strategies in countries where indigenous peoples live is proposed and discussed.
Labour market, work environment and suicide
Authors: Mäkinen Ilkka Henrik 
Published: January 2012

AbstractWork is an important sphere of human life. Besides economic subsistence, it also furnishes workers with social status and influences their life conditions in a profound manner. Social class at large seems to be connected with suicidality, but studies on the effects of specific occupations have produced few lasting results, perhaps due to the different societies investigated. In addition, lack of adequate data and problems with the methods chosen cause problems in the estimates of suicide mortality by class or occupation. However, it seems that the most vulnerable position is that of those who do not work at all. There is abundant empirical evidence of a surplus risk for suicide among the unemployed, but the causal nature of this relationship still needs clarification. Globally, the labour markets differ greatly, and so does their connection with suicide. Labour-market oriented suicide prevention issues concern unemployment policies, reduction of work-related access to means of suicide, and the use of the workplace as a base for suicide prevention.
Measurement of suicidal behaviour with psychometric scales
Authors: Bech Per , Awata Suichi 
Published: January 2012

AbstractAmong the many psychometric scales for assessing suicidal risk and behaviour, only short scales with high clinical validity have been selected. According to clinical focus, the scales have been classified into those including ‘fixed’ items outside the suicidal process (predictive factors) and ‘flexible’ items measuring the severity of the current suicidal state.The SAD PERSONS scale supplemented by the NO HOPE scale are among the valid predictive scales, and the item of suicide severity in the Hamilton Depression Scale or the Paykel Suicidal Ladder are among the valid measurements of current suicidal severity.The subjective dimension of suicidal thoughts has been especially contrasted against the dimensions of positive psychological well-being as measured by WHO-5. Such short questionnaires have been found important in modern Internet communication, especially with young people. The individual, idiographic approach has also been discussed by selecting individual items from the Reasons for Living Inventory.
Instruments used in SUPRE-MISS
Authors: Fleischmann Alexandra , Bertolote José M , De Leo Diego , Wasserman Danuta 
Published: January 2012

AbstractThe WHO Multisite Intervention Study on Suicidal Behaviours (SUPRE-MISS) was launched on the five continents to increase knowledge about suicidal behaviours and effective interventions for suicide attempters in culturally diverse places around the globe, with the ultimate goal of reducing mortality and morbidity associated with suicidal behaviours.The three components of SUPRE-MISS are a community description to grasp basic sociocultural characteristics, a community survey to identify suicidal behaviours, and a randomized controlled trial to evaluate treatment strategies for suicide attempters treated in emergency care settings of the same catchment area. Three specific instruments were used for the three components of the study and commonly applied in all participating sites. These assessment instruments were designed for SUPRE-MISS in particular, partly based on existing instruments and measurements and compiling them. They succeeded in fulfilling the requirements of being applicable across different cultures, manageable in low- and middle-income countries, assessing suicidal behaviours, and comprising well-established and widely recognized predictors of suicidal behaviours.
Neuroimaging of suicidal behaviour
Authors: Oquendo Maria A , Gibbs Tresha , Parsey Ramin 
Published: January 2012

AbstractConsistent evidence implicates serotonin system dysfunction in the neurobiology of suicidal behaviour. Neuroimaging studies link brain structure and function in vivo and contribute to our understanding of neural pathways. Areas of the prefrontal cortex and limbic structures are targeted in neuroimaging studies of suicidal behaviour, which have focused on structural, haemodynamic, metabolic, and neuroreceptor changes in the brains of suicide attempters. Neuroimaging studies have revealed that signal hyperintensities, perfusion and metabolic abnormalities, processing of affect and serotonin receptor and transporter changes, may each play a role. Knowledge regarding the neurobiology of suicidal behaviour must rely on study designs utilizing robust methodologies, including improved patient and control group selection, improved neuroimaging techniques, and adequate statistical analysis to enhance the validity, consistency, and conclusiveness of the data. Ongoing development of new radioligands and imaging methodologies promise to enhance our ability to delineate the neurobiology of suicidal acts.
An economic perspective on suicide across the five continents
Authors: McDaid David , Kennelly Brendan 
Published: January 2012

AbstractIn considering suicide prevention measures it is important to consider potential economic risk factors, as well as the costs and consequences of suicide. We provide a brief overview of some areas where economics has played a role in the analysis of suicide and suicide prevention strategies. Evidence on the wide-ranging socioeconomic costs and consequences of suicide is provided, as well as a reflection on the development of economic theories on individual motivations for suicide. The evidence from econometric models at both cross-country and single country levels on the links between suicide and socio-economic risk factors such as poverty and unemployment are reviewed. Cost-effectiveness is increasingly used as part of decision-making processes in health and other sectors. In respect of suicide prevention, such evidence remains limited. The present review, nonetheless, suggests that suicide prevention measures may be highly cost-effective. Incorporating economic analyses into future effectiveness studies is likely to help strengthen the case for investment in suicide prevention. There is also scope to look at the economic implications of interventions already shown to be effective.
World Health Organization and European Union policy actions, responsibilities and solutions in preventing suicide
Authors: Wasserman Danuta , Mårtensson Elizabeth , Wasserman Camilla 
Published: January 2012

Abstract
Mental health policies in Europe have been driven, in recent years, by two key documents: The Mental Health Declaration (WHO 2005) and the European Commission Green Paper (2005). As such, these important papers have paved the way towards the development of a European Mental Health Pact (European Commission 2008) in which policy-makers and stakeholders are urged to act upon European, national and local policies and implement key measures to enable the prevention of suicide and depression, improvement of mental health in youth, older people and in working places.
Countertransference in the treatment of suicidal patients
Authors: Goldblatt Mark J , Maltsberger John T 
Published: January 2012

AbstractCountertransference is an inescapable component of all psychotherapy. Intense countertransference reactions often occur during the treatment of suicidal patients. Lack of awareness of countertransference reactions of malice and aversion may be suicide-inviting. On the other hand, awareness of these reactions may enhance the treatment by alerting therapists that the suicidal patient is fomenting issues he is unable or unwilling to articulate. Problems that arise in the course of psychotherapy of suicidal patients may be understood in relation to the therapist’s countertransference reactions. In this chapter, we review case examples of countertransference manifestations and their effects on the treatment of the suicidal patient.
Pharmacological and other biological treatments of suicidal individuals
Authors: Möller Hans-Jurgen 
Published: January 2012

AbstractDue to the role of depressive disorders, as the most frequent cause of suicidal behaviour, antidepressants have the most prominent place in psychopharmacological prevention of suicidal behaviour. Based on clinical experience, antidepressants reduce suicidality in association with the reduction of depressive symptoms, and it is assumed that suicidal behaviour is also reduced as a consequence. However, based on the results of empirical studies, the evidence is not as clear as clinicians like to believe, which might, in part, be due to methodological problems. Other pharmacological and biological treatment methods with lithium, neuroleptics, benzodiazepines, anti-epileptics and ECT are described as well.
Severe anxiety and agitation as treatment modifiable risk factors for suicide
Authors: Fawcett Jan 
Published: January 2012

AbstractThis chapter focuses on the presence of symptoms of severe anxiety and agitation in depressed patients, as an indicator of heightened suicide risk and a target for treatment to reduce suicide risk. Published evidence demonstrates that from 33–70 per cent of suicides occur in individuals in active treatment by mental health professionals. Clinicians who treat depressed patients who are at high chronic risk for suicide based on prior ideation or attempts, or patients with severe depressive illness who have not admitted suicidal ideation, or given history of prior attempts face a dilemma, since roughly half of patients who complete a suicide have not made previous attempts. Severe anxiety and agitation, often comorbid with depression, are modifiable suicide risk factors if recognized and treated.
Treatment of attempted suicide and suicidal patients in primary care
Authors: Rihmer Zoltán , Rutz Wolfgang 
Published: January 2012

AbstractAlthough suicidal behaviour is a rare event in society in general, it is very common among psychiatric patients who contact their general practioner (GP) before the suicide event. The most common current psychiatric diagnosis among suicide victims and attempters is major depressive episode (56–87 per cent). The current prevalence of major depressive episodes in GP practice is around 10 per cent, but at least half of these cases are not recognized and treated adequately by GPs. Successful acute and long-term treatment of depression significantly reduces the risk of suicidal behaviour. Given that more than half of all suicide victims contact their GPs within four weeks before their death, GPs play an important role in suicide prevention. Several large-scale community studies demonstrate that education of GPs on the diagnosis and appropriate pharmacotherapy of depression, particularly in combination with psychological interventions and public education, improve the identification and treatment of depression and reduces the frequency of suicidal behaviour in the areas served by trained GPs.
A specialized inpatient unit for suicidal patients
Authors: Träskman-Bendz Lil , Sunnqvist Charlotta 
Published: January 2012

AbstractIn 1986, the Suicide Research Unit (SRU) in Lund, Sweden was established. The unit included a psychiatric inpatient facility specializing in suicidal behaviour until it closed down in 2001. Structured management based on research, scientific evidence and confidence-building measures was offered. The SRU also had a consultation liaison with somatic clinics, an outpatient facility, as well as a unit for the aftermaths of suicide. At SRU, a structured psychiatric diagnostics as well as an organized nursing concept with different levels of supervision and treatment planning were in use. Care included contacts with families and significant others. SRU also collaborated with child and adolescent psychiatry staff. In order to prevent further suicidal acts, a confidence-inspiring relationship with the patients was created at SRU. Strong empathy for suicidal patients, non-judgemental attitudes as well as acceptance of the various feelings of the patients were cornerstones of the care. Warning signs of suicidal behaviour were discovered and discerned.
The role of schools, colleges and universities in suicide prevention
Authors: Gould Madelyn S , Klomek Anat Brunstein , Batejan Kristen 
Published: January 2012

AbstractThe present chapter reviews school-based suicide prevention strategies. School-based suicide prevention efforts have usually been designed separately for high school and college/university students, but the underlying strategies are similar, having two general goals: case finding with accompanying referral and treatment or risk factor reduction. Promising empirically based prevention strategies include screening for at-risk youth, gatekeeper training programmes, and skills training for students. Positive results from new ‘hybrid’ curriculum programmes may lead to overcoming the long-standing reluctance to implement curriculum-based strategies due to deleterious effects formerly reported for suicide ‘awareness’ curriculum programmes. Continuing evaluation studies of all the specific programmes reviewed in this chapter are needed, particularly as they are adapted to the cultural context in which a programme is to be implemented. A remaining challenge is to overcome the obstacles that have impeded the development and implementation of suicide prevention programmes in developing countries in Asia, Africa and South America. Today there is a marked disparity in the prevalence of school-based programmes between developing and developed countries.
Restriction of access to drugs and medications in suicide prevention
Authors: Leenaars Antoon , Lester David , Baquedano Gaspar , Cantor Chris , Connolly John F , Ovuga Emilio , Remigio Silvia Pelaez , Vijayakumar Lakshmi 
Published: January 2012

AbstractSuicide by prescription drugs and medications is a very common method of suicide in many countries. In 1972, Oliver and Hetzel first called attention to the adverse effects of easy availability of medications in Australia; they also reported that restriction of drugs and medications decreased the rate of suicides. Results for different countries support these observations; yet there is a lack of impact on clinical practice. Experiences from some countries are presented, which suggests, despite great variation around the world, that the way physicians and other mental health professionals act needs to be more congruent with existing evidence-based knowledge. Of course, even if medication is associated to risk, it can be asked if restriction makes a difference. The sparse research suggests that restriction of access to drugs and medications reduces the suicide rate. Governments and the WHO could be involved more; for example, to promote educational programmes, and to define standards and agreements among pharmaceutical companies, national health services, medical associations, and the population in general. Much more research and clinical action are needed.
Restrictions of access to pesticides in suicide prevention
Authors: Phillips Michael R , Gunnell David 
Published: January 2012

AbstractIntentional pesticide ingestion is one of the most common methods of suicide, accounting for up to one-third of all suicides worldwide. The importance of intentional ingestion of pesticides was initially recognized in Asia and the Western Pacific but it is becoming evident that it is also a significant problem in Africa and, to some extent, in Latin America. Pesticides are employed in about 300,000 suicides annually—primarily in the rural areas of low-and middle-income countries (LAMIC)—so limiting access to these lethal agents could, theoretically, substantially reduce the global burden of mortality due to suicide. Organophosphate pesticides are responsible for a large proportion of pesticide self-poisonings and the majority of deaths.
Prevention of metropolitan and railway suicide
Authors: Ladwig Karl-Heinz , Ruf Esther , Baumert Jens , Erazo Natalia 
Published: January 2012

AbstractRailway suicides account for a minority of &lt;10 per cent of all suicides, although they are considered a major public health issue because of their tremendous consequences on functioning of the transportation system and their deteriorating impact on the mental health of staff and bystanders. Railway suicide is a particularly violent method, and case fatality is 90 per cent of all attempts. However, case fatality in metro systems of &gt;60 per cent are rare. More men than women choose the track as a means of suicide with a trend towards a balanced distribution in metro systems. Victims are predominately young with a median age stratum in the range of 25–34 years. For men, a prevalence peak in April and a low in December has been observed. The weekly distribution shows a peak at the beginning of the week and a low on weekends. Railway suicide behaviour patterns include jumping, lying and wandering, some individuals present deviant behaviour prodromal to the attempt. Attractiveness of the method derives from high levels of opportunity and low levels of self-perceived costs.Prevention may rely on a package of different structural and communicative tools. Inhibiting access to the track, by providing barriers at places of advanced risk and surveillance systems, are among structural means. Inhibiting media coverage and education of gatekeepers to increase awareness and skilfulness in contact with potentially vulnerable subjects on station platforms are among communicative tools. Railway suicide prevention is a realistic option: however, enhancement of research in this field is urgently needed.