Suchergebnisse

Background: Events of extraordinary violence attract media attention. Recently, much media reporting has moved to the Internet, giving readers the possibility to comment online. Aims: To analyze the content of public cognitions and the emotional tonality of attitudes expressed in spontaneous Internet comments on a familicide-suicide case reported in the Estonian media. Methods: A content analysis is based on the comments of 6,333 readers following media coverage. Descriptive statistics were used for quantitative data analysis. Results: Of all comments, 27.6% were without manifest content. Manifest content categories were "value judgments" (35.2%), "risk and protective factors" (27.2%), and "critics of media portrayal" (10.0%). As to emotional tonality, the comments were most often angry (34.5%), ironic (24.7%), or neutral (23.3%). "Critics of media portrayal" had the most clearly pronounced emotional tonality, the majority being angry or approving. Comments about "value judgments" were most frequently anguished. Conclusions: An analysis of Internet comments can provide valuable information about value judgments and attitudes in society. From an ethical and preventive perspective, similar homicide and suicide stories should not be open for unmoderated public discussion. Nevertheless, the study represents an original methodological approach for such research and also provides some guidance for public relations campaigns.

Background: Suicidal intent is an essential feature of suicidal behavior. Previous research has been controversial and the need for further evidence has been pointed out. Aims: The aim of the present study was to characterize the severity of attempted suicide by extracting components of suicidal intent and analyzing levels of suicidal intent by gender, age, and variables indicating the severity of attempted suicide. Methods: Data on suicide attempters (N = 469) were collected in Estonia using WHO SUPRE-MISS methodology. To measure suicidal intent, a revised version of the Pierce Suicidal Intent Scale (PSIS) was used. Results: The level of suicidal intent was not gender-dependent, but rose with age. Males and females were also similar in terms of discrete components. Classified in age groups, their unequivocally expressed "wish to die" was similar, but equivocal communication (components termed "arrangements" and "circumstances") increased with age. Middle-aged groups scored higher for the "alcohol/drugs" component. Psychiatric diagnosis, method of attempting suicide, and duration of hospitalization were linked to suicidal intent, but danger to life as assessed by interviewers was not. Conclusions: In suicide-risk assessment, results from a Suicidal Intent Scale contribute to clinical observation and add valuable information about a suicidal person's real intention.

Yur'yev A, Värnik A, Värnik P, Sisask M, Leppik L. Role of social welfare in European suicide preventionThe aims of this study were to assess the relationship between suicide mortality and social expenditure in 26 European countries, explore attitudes towards welfare systems and their relationship with suicide mortality, and compare attitudes towards welfare provision in Eastern and Western Europe. The World Health Organization suicide data and Organisation for Economic Co‐operation and Development social expenditure data for 1980–2005 were used. Data on attitudes towards welfare systems were taken from the European Social Survey. Differences between mean scores for attitudes in Western and Eastern European countries were calculated. Correlations between social expenditure and suicide trends were negative in most countries for both genders. Inverse correlations between attitudes towards welfare provision and suicide mortality rates were demonstrated for males only. Differences in attitudes were found between Eastern and Western European countries; for example, confidence in the welfare system was found to be stronger in Western Europe. Higher social expenditure and greater confidence in welfare provision appear to have suicide‐preventive effects.

Background: The present study attempted to assess the relationship between suicide mortality and employment status in Europe. Methods: Suicide trends were obtained from the World Health Organization, employment rates from the Conference Board Total Economy Database, and questions about citizens' attitudes towards employment from the European Social Survey. Correlations were analysed. Differences between mean scores for attitudes in Western and Eastern Europe were calculated. Results: Employment and suicide trends are negatively correlated in most countries. Suicide mortality is associated with unemployment risk and expectations of inadequate financial resources during unemployment, and negatively correlated with an assured high sdard of living for the unemployed. Suicide mortality and the degree of conviction that the government should ensure jobs for all are weakly correlated. Attitudes towards employment and unemployment in Eastern and Western Europe diverge. Conclusions: Changes in employment rates influence suicide mortality in many European countries. Factors that increase suicide mortality include lack of confidence in employment status and unemployed people's expectations of insufficient income and low living standards. Suicidal behaviour is more strongly related to attitudes linked with employment status among males than females. In Eastern Europe the status of being unemployed is feared more, and people rely more on the government.

"Contribute to suicide prevention by using appropriate research methods! This is a one-stop book for anyone who wants an overview of the research approaches and issues concerning suicide. Leading researchers provide a comprehensive toolbox of the current best practices in suicide research, showing you how to conduct high-quality research using quantitative, qualitative, and mixed-methods in suicide prevention from a public health perspective. Other aspects that are crucial to effective suicide research are also presented, including the proper use of epidemiological measures and study designs, definitional issues, historical background, and ethical aspects. The clearly written chapters include both theoretical and practical information along with specific examples from different areas of suicide research and prevention, and also explore essential topics such as psychological autopsies, health economics, and technological advances. This volume is ideal for researchers, students, and academics interested in suicide research, as well as policy makers, clinicians, and other practitioners."--

Background: The current study is aimed to assess the relationship between the 'economic/employment' and 'social/welfare' dimensions of social exclusion and suicide mortality in Europe. Methods: Suicide rates for 26 countries were obtained from the WHO. Data on social expenditure were obtained from the OECD database. Employment rates and GDP were obtained from the Total Economy Database. Questions about citizens' attitudes towards different aspects of social exclusion were taken from the European Social Survey. Structural equation modelling was applied to research the theoretical structure of the variables. Results: All variables are statistically significant in male and female models except of the relationships between 'economic/employment' and 'social/welfare' dimensions and female suicides; and the relationship between 'employment rates' and 'economic/employment' dimension. Suicide mortality rates among both males and females are influenced negatively by 'economic/employment' and 'social/welfare' dimensions. Among females, the influence of 'social/welfare' dimension is stronger compared to the 'economic/employment' dimension. The remaining influence of GDP is positive in both models. Conclusions: Both 'economic/employment' and 'social/welfare' dimensions of social exclusion significantly influence suicide mortality among males. The influence of 'economic/employment' and 'social/welfare' dimensions of social exclusion on female suicide mortality is controversial. Social exclusion might be considered as a risk factor for suicide mortality in Europe.

Depressive feelings and suicidal ideation in a non-clinical sample of adolescents in Estonia were analysed in the context of family structure, mutual relationships amongst family members and schoolchildren's preferences regarding intimate personal contacts with particular family members. Data from the WHO collaborative study 'Health Behaviour in School-aged Children 2005/2006' (HBSC) were used. A representative sample of schoolchildren aged 11, 13 and 15 years completed the semi-structured questionnaire. The analyses included only adolescents living in households with at least one birth parent. The subjects were 4,389 schoolchildren (2,178 boys and 2,211 girls), who were divided into three groups based on: (1) suicidal thoughts, with or without depressive feelings; (2) depressive feelings; and (3) neither suicidal thoughts nor depressive feelings. Multinomial logistic regression was used. The proportion of depressive feelings increased with age for both boys and girls. Girls expressed depressive feelings more frequently than boys from ages 13 and 15 years, and suicidal thoughts from age 15 years. Self-reported satisfaction with relationships in the family reduced the likelihood of depressive feelings and suicidal thoughts. Good communication with the parents reduced the likelihood of suicidal thoughts in all age groups. Adolescents who were satisfied with their family relationships suffered less frequently from depressive feelings and suicidal thoughts. The best environment for an adolescent was a family with both birth parents. Of the adolescents in 'non-intact' families, those with a step-parent in the family showed suicidal thoughts more frequently than those in single-parent families. Associations between family-related variables and suicidal thoughts were significant even after adjusting for family economic deprivation score.

Background: Suicide is a leading cause of death among youth. In the year 2002, Lithuania had the 2nd, Luxembourg the 5th, and Estonia the 9th highest suicide rates among 15- to 19-year-olds across 90 countries worldwide. Suicidal ideation is a significant precursor to suicide. Aims: To report on the prevalence of and associations between suicidal ideation, smoking, alcohol consumption, physical fighting, bullying, and communication with parents among 15-year-old schoolchildren. Methods: The survey analyzes data from the 2005/2006 HBSC study from Estonia, Lithuania, and Luxembourg (N = 4,954). The risk factors were calculated through multinomial logistic regression analyses. Results: The overall prevalence of suicidal ideation in the preceding year was 17%. Suicidal thoughts were associated with communication difficulties with parents (OR from 2.0 to 4.6) and other risk factors, especially multiple risks (OR for 4–5 concurrent risk factors from 4.5 to 13.6). Parent-child communication had a significant mediating effect by decreasing the odds for suicidality and multiple risks. Limitations: The prevalence estimates were obtained by self-reports. The causal relationships need further investigation. Conclusion: The risk factors studied, particularly multiple risks, were associated with higher odds for suicidal ideation. Good parent-child communication is a significant resource for decreasing suicidal ideation among adolescents.

Background: Community facilitators (CFs), such as pharmacists, policemen, teachers and clergy, may be an important community resource for patients with depression in addition to (mental) health professionals. However, they are ill prepared for such a role and little is known about their attitudes toward depression, which may affect practice. Aim: To investigate CFs' attitudes toward depression and compare them to those of (mental) health professionals and nurses. Method: Attitudes were assessed in participants ( n = 2,670) of training programmes about depression in nine countries of the European Alliance Against Depression (EAAD). The EAAD questionnaire included attitudes toward depression and its treatment, perceived causes, preferred treatment options, and knowledge of depression symptoms. Results: CFs and nurses had a more negative attitude toward patients with depression and toward antidepressants, and more limited knowledge of depression symptoms than (mental) health professionals. CFs more frequently supported non-standard treatment for depression. Nurse assistants clearly differed from registered nurses with their attitudes being among the least favourable and their knowledge the most limited of all groups. Conclusions: CFs and nurses had less favourable attitudes and more limited knowledge regarding depression when compared to mental health professionals and doctors. This may negatively affect professional collaboration, challenge optimal treatment and stigmatize patients. CFs' and nurses' knowledge and attitudes may be similar to those of the general population and be related to a lack of training in mental health issues.

The 'European Alliance Against Depression' community-based intervention approach simultaneously targets depression and suicidal behaviour by a multifaceted community based intervention and has been implemented in more than 115 regions worldwide. The two main aims of the European Union funded project "Optimizing Suicide Prevention Programmes and Their Implementation in Europe" were to optimise this approach and to evaluate its implementation and impact. This paper reports on the primary outcome of the intervention (the number of completed and attempted suicides combined as 'suicidal acts') and on results concerning process evaluation analysis. Interventions were implemented in four European cities in Germany, Hungary, Portugal and Ireland, with matched control sites. The intervention comprised activities with predefined minimal intensity at four levels: training of primary care providers, a public awareness campaign, training of community facilitators, support for patients and their relatives. Changes in frequency of suicidal acts with respect to a one-year baseline in the four intervention regions were compared to those in the four control regions (chi-square tests). The decrease in suicidal acts compared to baseline in the intervention regions (-58 cases, -3.26%) did not differ significantly (χ2 = 0.13; p = 0.72) from the decrease in the control regions (-18 cases, -1.40%). However, intervention effects differed between countries (χ2 = 8.59; p = 0.04), with significant effects on suicidal acts in Portugal (χ2 = 4.82; p = 0.03). The interviews and observations explored local circumstances in each site throughout the study. Hypothesised mechanisms of action for successful implementation were observed and drivers for 'added-value' were identified: local partnership working and 'in-kind' contributions; an approach which valued existing partnership strengths; and synergies operating across intervention levels. It can be assumed that significant events during the implementation phase had a certain impact on the observed outcomes. However, this impact was, of course, not proven. ; publishersversion ; published

There is expedient evidence showing that differences in adolescent alcohol consumption and other risk-behaviour depend on both family structure and family member drunkenness exposure. Data were obtained among adolescents (N = 12,115, mean age 14.9 ± 0.89) in Austria, Estonia, France, Germany, Hungary, Ireland, Israel, Italy, Romania, Slovenia and Spain within the European Union's 7th Framework Programme funded project, 'Saving and Empowering Young Lives in Europe (SEYLE)'. The current study reveals how adolescents' alcohol consumption patterns are related to their family structure and having seen their family member drunk. The results revealed statistically significant differences in adolescent alcohol consumption depending on whether the adolescent lives in a family with both birth parents, in a single-parent family or in a family with one birth parent and one step-parent. The study also revealed that the abstaining from alcohol percentage among adolescents was greater in families with both birth parents compared to other family types. The study also showed that the more often adolescents see their family member drunk the more they drink themselves. There is no difference in adolescent drinking patterns whether they see their family member drunk once a month or once a week. This study gives an insight on which subgroups of adolescents are at heightened risk of alcohol abuse and that decrease of family member drunkenness may have positive effects on the drinking habits of their children.

There is expedient evidence showing that differences in adolescent alcohol consumption and other risk-behaviour depend on both family structure and family member drunkenness exposure. Data were obtained among adolescents (N = 12,115, mean age 14.9 ± 0.89) in Austria, Estonia, France, Germany, Hungary, Ireland, Israel, Italy, Romania, Slovenia and Spain within the European Union's 7th Framework Programme funded project, 'Saving and Empowering Young Lives in Europe (SEYLE)'. The current study reveals how adolescents' alcohol consumption patterns are related to their family structure and having seen their family member drunk. The results revealed statistically significant differences in adolescent alcohol consumption depending on whether the adolescent lives in a family with both birth parents, in a single-parent family or in a family with one birth parent and one step-parent. The study also revealed that the abstaining from alcohol percentage among adolescents was greater in families with both birth parents compared to other family types. The study also showed that the more often adolescents see their family member drunk the more they drink themselves. There is no difference in adolescent drinking patterns whether they see their family member drunk once a month or once a week. This study gives an insight on which subgroups of adolescents are at heightened risk of alcohol abuse and that decrease of family member drunkenness may have positive effects on the drinking habits of their children.