Suchergebnisse

Different medical, social, and environmental regional characteristics were investigated as possible predictors of suicide rates in 60 self-governing communes in Slovenia. The distribution pattern of regional suicide rates for Slovenia shows some similarity to that of the rest of Europe, especially in terms of the substantial variation of suicide density within the country. On the basis of the multivariate analysis, prevalence of alcohol psychosis, percentage of Catholics, and low duration of sunshine appeared to be the most important predictors of regional suicide rates in Slovenia. The rate of murders was proven to be a highly useful clue of suicide potential among younger groups, whereas income per capita of population was associated with suicide risk in old age. The principal component analysis provided three suicide risk patterns: a socio-economic risk pattern (Catholic religion in poor community), a behavioral one (antisocial features, including heavy drinking), and a depression-related risk pattern with a climatic component (lack of sunshine). Different approaches are necessary for the different risk patterns listed above. Psychiatry, especially clinical psychiatry, can only deal with components of two of the patterns, namely, depression and antisocial behavior.

Summary: Objective: To determine the association between asthma and suicidal ideation among youth in the community. Method: Data were drawn from the MECA (n = 1285), a community-based study of youth aged 9-17 in the United States. Multiple logistic regression analyses were used to determine the association between asthma and suicidal ideation, adjusting for differences in sociodemographic characteristics and mental disorders. Results: Asthma was associated with a significantly increased likelihood of suicidal ideation (OR = 3.25 '1.04, 10.1'), compared to youth without asthma. Conclusions: These data suggest that youth who are hospitalized for asthma may have higher than expected levels of suicidal ideation, compared with youth without asthma in the community. This association appears to persist after controlling for the effects of comorbid mental disorders. These findings are consistent with previous clinical reports of an association between physical illness and suicidal ideation, as well as with links between asthma and suicidal ideation among adults. More in-depth evaluation of the mental health of youth hospitalized for asthma may be indicated if these results are replicated.

Summary: There is good evidence from recent studies that depression is familial, and that a substantial proportion of the variation in liability is explained by genes. Suicidal behavior, including completed suicide, also seems to cluster in families. First-degree relatives of individuals who have committed suicide (included dizygotic twins) have more than twice the risk of the general population. For identical co-twins of suicides, the relative risk increases to about 11. Applying a simple structural equation model to the published data suggests a heritability for completed suicide of about 43% (95% confidence intervals 25-60). It is not known at present whether the genes predisposing to suicide are identical with those predisposing to affective disorder, but since only about half of those committing suicide have a diagnosis of depression, it seems probable that the overlap is incomplete. The mode of inheritance of suicidal behavior is almost certain to be complex, involving many genes. There have already been some initial studies of allelic association with polymorphisms in candidate genes such as those involved in serotonergic transmission. Further progress is likely to come from candidate gene and linkage disequilibrium studies that are capable of detecting multiple genes of small effect.

Background: Previous studies have reported that many suicide victims have had contact with their physicians a week or month prior to their suicide. Aims: To assess the date of the last appointment (and complaint) of suicide victims in the Škofja Loka region within Slovenia. Method: We included all suicide victims in the region in the period 1993—2003. Each of the cases was assigned the closest control in terms of age and gender. Medical death certificates served as a source of demographic data information and information about suicide method. From personal medical records we obtained the date of the last appointment (and the complaint) with the primary care physician. The same was done for the control group. The groups were compared for their last appointment with their physician (date and complaint). Results: Thirty out of 77 suicide victims visited their physician in the last month before suicide (14/77 in the last week); only 16/77 controls did so before the index day (3/77 in the last week). In 30% of suicide victims, the reason for the last visit was mental health problems (only 3% in the control group). Conclusion: The results emphasize the important role of primary care physicians in suicide prevention.

Summary: The number of adolescents who attempt or complete suicide is increasing. Risk factors range from mental disorders, to problems at school, family problems, or difficulties in establishing relationships. A further important, and too often underestimated, risk factor for adolescent suicide is the presence of suicidal behavior in the adolescent's family. We investigated 184 high school adolescents in a region in Slovenia with a high suicide rate (30/100,000/year). They were questioned by means of an anonymous questionnaire about the presence of suicidal behavior in their relatives and about the presence of suicidal thoughts, plans, and acts in themselves. The results revealed that 13% of the adolescents studied had a relative who had attempted suicide and a further 9% of the adolescents had lost a relative due to suicide. About half of all females and almost a third of males had had suicidal thoughts (differences between sexes were statistically significant: χ2= 6.13; p < .01). Attempted suicide among relatives was positively correlated with the presence of suicidal plans among adolescents (Φ = 0.15; p < .05). This correlation proved to be even stronger and statistically more significant in men when we split the sample by gender. All variables (suicidal thoughts, suicidal plans, and suicide attempts) in the adolescent males positively correlated with attempted suicide among their relatives (Φ = 0.28, p < .01; Φ = 0.26, p < .05; Φ = 0.34, p < .01; respectively). Our results speak in favor of a higher risk of suicidal behavior among adolescents with suicidal behavior in their families.

Background: Different types of marital status are associated with different levels of suicidal risk. Aims: To study marital status change and the effect of its recency in relation to suicidal behavior. Methods: Suicide victims (1614) in Slovenia and matched controls (4617) were compared for incidence and recency of marital status change during the last 5 years of their lives. Results: A higher percentage of suicide victims (10.7%) had a marital status change in the last 5 years compared with the controls (5.6%). All types of marital status changes (becoming widowed, getting divorced, getting married) proved to be risk factors for suicidal behavior. Almost half of all marital status changes in suicide victims occurred in the year prior to suicide, whereas marital status changes in the control group were equally distributed over the last 5 years. For recently married and divorced people, the increase in suicide risk depended on age: The risk was higher in older people. Conclusions: Marital status change represents a risk factor for suicidal behavior. The first year after the change is critical for elevated suicidal risk, in particular for older people.