Suchergebnisse

Abstract. Research on suicide by jumping is summarized. The incidence of suicide by this method varies but tends to be higher in cities, city states, or countries that have extensive high-rise housing. Most suicides by jumping occur from high-rise residential housing units. However, our knowledge about suicide by jumping tends to be limited to a small number of reports from sites, often bridges, which become well-known as places from which to take one's life. Media reports of newsworthy suicides from these sites appear to encourage imitative behavior. Prevention strategies have focused upon limiting suicides from iconic sites by surveillance, barriers, muted media reporting, and signage offering help and telephone hotlines. A small number of studies provides evidence that installing barriers at popular jumping sites reduces suicides from those sites. There are few reports of efforts to reduce suicides from high-rise residential buildings.

This article reviews the major life course factors and processes associated with the development of suicidal behaviors in young people. Key issues examined include (a) the spectrum of suicidal behaviors in young people; (b) changing risks of suicidal behavior during childhood, adolescence, and young adulthood; and (c) key risk and protective factors. It is concluded that suicidal tendencies are frequently the culmination of adverse life course sequences that involve multiple risk factors. Future research priorities include a focus on (a) greater understanding of the role of genetic and biologic factors in the development of suicidal behaviors, (b) exploration of factors that may protect young people against suicidal behaviors, and (c) evaluation of public health and clinical programs designed to minimize risk of suicidal behaviors in young people.

The article of record as published may be found at https://doi.org/10.7326/M19-1567

Abstract. Background: Suicidal behavior comprises a diverse set of behaviors with significant differences among several behavioral categories. One noteworthy category includes individuals who have made serious suicide attempts, epidemiologically very similar to those completing suicide. This behavioral category is important, since interviewing survivors of a potentially lethal incident of self-harm enables a detailed investigation of the psychological process leading to the suicidal act. Aim: To achieve a consensus definition and operational criteria of serious suicide attempts. Method: We reviewed studies that included the term serious suicide attempt or related terms (e.g., highly lethal), with a focus on the variety of operational criteria employed across studies. Results: More than 60 papers addressing various types of serious suicide attempt were explored. We found a large variety of operational definitions, reflecting the lack of consensus regarding terminology and criteria related to the term. Conclusion: We undertook the challenge of developing an integrative and comprehensive set of criteria of serious suicide attempt and suggest a definition comprising three key dimensions: medical lethality, potential lethality of the method used, and severity of the objective circumstances of the suicide intent. Clinicians and researchers are strongly encouraged to consider using the term serious suicide attempt with its attendant components.

This article describes trends in suicide attempt visits to emergency departments in the United States (US). Data were obtained from the National Hospital Ambulatory Medical Care Survey using mental-health-related ICD-9-CM, E and V codes, and mental-health reasons for visit. From 1992 to 2001, mental-health-related visits increased 27.5% from 17.1 to 23.6 per 1000 (p < .001). Emergency Department (ED) visits for suicide attempt and self injury increased by 47%, from 0.8 to 1.5 visits per 1000 US population (ptrend = .04). Suicide-attempt-related visits increased significantly among males over the decade and among females from 1992/1993 to 1998/1999. Suicide attempt visits increased in non-Hispanic whites, patients under 15 years or those between 50–69 years of age, and the privately insured. Hospitalization rates for suicide attempt-related ED visits declined from 49% to 32% between 1992 and 2001 (p = .04). Suicide attempt-related visits increased significantly in urban areas, but in rural areas suicide attempt visits stayed relatively constant, despite significant rural decreases in mental-health related visits overall. Ten-year regional increases in suicide attempt-related visits were significant for the West and Northeast only. US emergency departments have witnessed increasing rates of ED visits for suicide attempts during a decade of significant reciprocal decreases in postattempt hospitalization. Emergency departments are increasingly important sites for identifying, assessing and treating individuals with suicidal behavior.