Background: Suicide is the leading cause of death in Swiss prisons. The Federal Statistics Office provides numbers but no further details. Previous studies worldwide have focused on identifying suicide risk factors in prisoners, but very few have looked at the methods used in relation to prevention strategies. Aims: To obtain details of Swiss prison suicides, determine new findings in an international context, and establish prevention strategies based on the information acquired. Method: Retrospective data analysis of prison suicides extracted from the database of all suicides investigated by Swiss institutes of legal medicine between 2000 and 2010, using a standardized assessment sheet. Results: Out of 4,885 suicides investigated in the institutes of legal medicine in Switzerland, we identified 50 (1.02%) inmate suicides. Most were unmarried Swiss men, with a median age of 32 years. The two most common methods used were hanging and tricyclic antidepressant overdose. Two died due to self-immolation. Conclusion: Swiss prison suicides do not differ from those in other countries regarding sociodemographic details and the most common method of hanging. Anchoring devices, even low ones, should be avoided to prevent hanging and medication intake should be monitored. As prisoners use tricyclic antidepressants to die by suicide, we recommend the general monitoring of intake.
This study assesses the efficacy of the treatment approach implemented in the Bern Crisis Intervention Program, where particular emphasis is placed on the remediation of suicide ideation and suicidal behavior, and depression, fear, and phobia are generally considered to be contributing factors. Four questionnaires addressing psychopathology, emotional well-being, social anxiety, and personality were administered prior to and after the treatment of 51 patients over a period of 2 to 3 weeks. The reduction of symptoms contributing to suicidal ideation and behavior was interpreted as indirect evidence of an antisuicidal effect of the program. Significant improvements were found in the psychopathology ratings, with depression and anxiety showing the largest reductions. The impact on personality and social phobia, however, was only moderate, and on average patients still exhibited symptoms after attending the program. This residual symptomatology points to the necessity of introducing a two-step therapy approach of intensive intervention targeted at the precipitating causes of the crisis, augmented by long-term therapy to treat underlying problems.
Background: In the course of their lives individuals may encounter the phenomenon of suicide in various ways, for example, directly through suicidal behavior in the family or among peers; or indirectly through hearsay, the media, literature, etc. Aims: The study investigates such memory traces (engrams) in patients with and without a suicide attempt. Methods: Ten patients from a psychiatric crisis unit who had attempted suicide and ten patients without a history of suicidal behavior were interviewed with a narrative/semistructured interviewing technique. Interviews were video-recorded and fully transcribed. Stepwise reduction of the content was used to develop categories of recurrent memories and models of suicidal behavior. Results: Suicide attempters reported more memories of direct exposure to suicidal behavior (e.g., witnessing a suicidal act) than did patients who had no history of attempted suicide. They also reported more own suicidal crises, but associated them more often with interpersonal problems than with depression. They considered suicide more often as normal behavior than nonattempters. The total number of suicide-related memories and their origins was remarkably similar in both groups. Conclusions: The results suggest that direct exposure to suicidal behavior may leave engrams (memory traces) that increase an individual's susceptibility to suicidal behavior.
In: Schweizerische Ärztezeitung: SÄZ ; offizielles Organ der FMH und der FMH Services = Bulletin des médecins suisses : BMS = Bollettino dei medici svizzeri