Suchergebnisse

Abstract. Restriction of access to means for suicidal behavior, especially dangerous methods, is a key element in most national suicide prevention strategies. In this paper the rationale for this is discussed, including the fact that suicidal impulses are often brief, that availability of a method may influence both the occurrence and outcome of a suicidal act, and that if a favored means becomes less available it does not always result in substitution by another method. Examples of evidence for the effectiveness of restricting availability of suicidal methods on subsequent suicidal behavior are presented, plus the supporting findings from studies of long-term survivors of serious suicide attempts in which only a minority have gone on to die in subsequent suicide attempts. Finally, factors likely to determine the effectiveness of modifying access to means for suicide are considered, together with the main elements that need to be addressed in evaluation.

Several countries in the Western hemisphere have experienced a marked increase in suicide rates in young males in recent years. This article considers this phenomenon largely from the perspective of the United Kingdom, where rates of suicide in 15-24-year-old males nearly doubled in just over a decade. The possible reasons for this are considered, particularly in the context of relative stability of suicide rates in young females.

Abstract. Background: Overall gender ratios are often quoted in studies of deliberate self-harm (DSH) patients, almost always with higher rates in females than males. Reporting a ratio across all ages may conceal important variations in the gender ratio across the life cycle. Method: Analysis was done of the gender ratio by age groups in rates of DSH in a consecutive sample of DSH patients presenting to a general hospital over a 10-year period. The patients were identified through a well-established monitoring system. Results: The study sample included 2,189 female and 1,439 male patients. While the overall gender rate ratio was 1.5 females to each male, the ratio varied considerably by age group: 8:1 in 10-14-year-olds, 3.1:1 in 15-19-year-olds, 1.6:1 in 20-24-year-olds, approximately 1.3:1 in 25-49-year-olds, and 0.8:1 in people aged 50 years and over. Conclusion: Statements about overall gender ratios for DSH conceal important changes in the ratio across the life cycle. These changes probably reflect differences in development and problems faced in adolescence, changes in motivation for DSH with age, and the closer resemblance of DSH to suicide in older age groups.

Summary: Suicide rates in prisons in England and Wales are high, including those in juvenile detention centers. Previous deliberate self-harm (DSH) is the strongest predictor of suicide in the general population. There is limited information on how many juvenile offenders (15 to 18 year-olds) have a history of DSH at the time of entering custody, or on factors associated with previous DSH. We aimed to determine the prevalence of previous DSH and suicidal ideation in a population of juvenile offenders in custody and to identify factors associated with DSH and suicidal ideation. Seven out of 45 subjects (15.6%) reported an act of DSH in the past. Twelve (26.6%) reported past suicidal ideation. Peer relationship difficulties and sexual abuse were significantly associated with DSH (p < 0.05). Other factors showed a trend toward being more common among those with DSH, but the premature ending of the project by the juvenile detention center prevented full investigation of the extent of DSH and associated factors. Nevertheless, the results indicated a much higher rate of DSH in this population than in young males in the community. A larger joint project with juvenile detention centers is required to confirm the extent of previous DSH at the time young offenders are admitted, and the associated risk factors, in order to assist prevention and intervention strategies.

Self-harm in adolescents is an increasingly recognized problem, and there is growing awareness of the important role schools and health services can play in detecting and supporting those at risk. By Their Own Young Hand explores the findings of the first large-scale survey of deliberate self-harm and suicidal thinking in adolescents in the UK, and draws out the implications for prevention strategies and mental health promotion. . Six thousand young people were asked about their experiences

Background: As in several other countries, inquiries after a suspected suicide in England and Wales now routinely seek to include both medico-legal and family perspectives on the character and motivations of the person who died. Little research attention, however, has been paid to the reactions of the bereaved to the coroner's verdict. Aims: To explore people's accounts of their acceptance or resistance to the verdict and the resources they draw upon in explaining their perspectives, especially when these contraindicate the coroner's verdict. Methods: Indepth interviews with 40 people who had been bereaved by suicide, followed by qualitative analysis, combining thematic analysis with constant comparison. Results: Bereaved relatives who saw the suicide verdict as a correct reflection of events drew on the conventional constructions of suicide used by coroners, and (thus) the media. Relatives who resisted a suicide verdict referred to their privileged knowledge and beliefs about the person who had died, producing claims about their character, relationships, and motivations which often contradicted the conventional cues, such as a diagnosis of mental illness, previous attempts at suicide, method used, and suicide notes. For some relatives an open verdict was acceptable, even desirable, while for others it left too much uncertainty. Conclusions: The findings have implications for coroner's practice, understanding varied responses of people bereaved by suicide, and for future research.

The aims of this study were to identify in what ways adolescents who cut themselves differ from those who take overdoses, and to investigate the role of contagion in these behaviours. Data from an anonymous self-report questionnaire survey of 6,020 adolescents in 41 schools were analysed. Comparison of 220 adolescents who reported self-cutting in the previous year with 86 who had taken overdoses in the previous year as the sole method of deliberate self-harm (DSH) showed that far more of those who cut themselves had friends who had also engaged in DSH in the same period (OR 2.84, 95% CI 1.5–5.3, P < 0.001), and fewer had sought help from friends before cutting (OR 0.5, 95% CI 0.3–0.9, P < 0.02). Self-cutting usually involved less premeditation. Analyses at both the individual and school level showed that the association between engaging in DSH and exposure to DSH amongst peers was largely confined to girls who cut themselves. There are important differences between adolescents who cut themselves and those who take overdoses. Contagion may be an important factor in DSH by adolescents, especially in girls who cut themselves. These findings are relevant to the design of prevention and treatment programmes.