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Suicide: These are a few of the articles. Others are under depression or other pages. Body Dysmorphic Disorder High Rate of Suicidal Behavior: In a study of 200 adults with body dys-morphic disorder (BDD), patients had high rates of lifetime suicidal ideation (78.0%) and suicide attempts (27.5%). Body dysmorphic disorder was the primary reason for suicidal ideation in 70.5% of those with a history of ideation and nearly half of subjects with a past attempt. Suicidal subjects often did not reveal their BDD symptoms to their clinician. In univariate analyses, both suicidal ideation and suicide attempts were associated with lifetime functional impairment due to BDD (p < .001), current functional impairment (p < .001 to < .05), lifetime bipolar disorder (p < .05), any personality disorder (p < .05 to .001), and comorbid borderline personality disorder (p < .01 to < .001). A history of suicidal ideation (but not suicide attempts) was additionally associated with comorbid lifetime major depression (p = .001). A history of suicide attempts (but not suicidal ideation) was additionally associated with delusional appearance beliefs (p = .01) and lifetime posttraumatic stress disorder (PTSD), an eating disorder, or a substance use disorder (p < .001 to < .05). In logistic regression analyses, suicidal ideation was significantly predicted by comorbid major depression (p = .010) and greater lifetime impairment due to BDD (p = .003); suicide attempts were significantly predicted by PTSD (p = .011), a substance use disorder (p = .011), and greater lifetime impairment due to BDD (p = .005). Suicidal ideation and suicide attempts in body dysmorphic disorder. Phillips KA, et al. Butler Hospital, Providence, RI. . J Clin Psychiatry. 2005 Jun;66(6):717-2 Cognitive Therapy: Suicide Attempters Helped by Cognitive Therapy: In an 18-month random assignment study of 120 adults who recently attempted suicide, those assigned to 10 sessions of cognitive therapy had a 49% lower rate of reattempting suicide than those assigned to enhanced standard care. 13 participants (24.1%) in the cognitive therapy group and 23 participants (41.6%) in the usual care group made at least 1 subsequent suicide attempt (asymptotic z score, 1.97; P = .049)(hazard ratio, 0.51; 95% CI, 0.26-0.997). The severity of self-reported depression was significantly lower for the cognitive therapy group than for the usual care group at 6 months (P= .02), 12 months (P = .009), and 18 months (P = .046). Mondays the Worst: Suicides Peak: Office for National Statistics found 16% of male suicides and 17% of female suicides occured on Mondays, compared to 13% on the weekend days in a study of 34,935 suicides in the United Kingdom from 1993-2002. Researchers said the trend was not solely a result of returning to work as it was replicated for retired people. BBC News 8/26/05 Short Men: Suicide Higher: Previous studies have found associations between poor fetal and infant growth and the risk of suicide. In a record linkage study of the birth, conscription, mortality, family, and census register data of 1,299,177 Swedish men followed from age 18 to a maximum of age 49, there were 3,075 suicides over an average follow-up period of 15 years. There was a strong inverse association between height and suicide risk. In fully adjusted models, a 5-cm increase in height was associated with a 9% decrease in suicide risk. Strong inverse association between height and suicide in a large cohort of Swedish men: evidence of early life origins of suicidal behavior? Magnusson PK, et al. Am J Psychiatry 7/2005;162:1373-5. Depression: Suicide Attempts Often in First Major Depression: A study of 100 suicide attempters who were unsuccessful at killing themselves found that 88% had an axis I psychiatric diagnosis and 69% had diagnoses of Major Depressive Disorder. For 60% of the depressed, it was their first major depression. The study underlines the importance of early detection and treatment of psychiatric disorders for the prevention of suicidal behavior. Hungary. Prevalence and comorbidity of affective disorders in persons making suicide attempts in Hungary: importance of the first depressive episodes and of bipolar II diagnoses. Balazs J, Lecrubier Y, Csiszer N, Kosztak J, Bitter L. J Affect Disord. 2003 Sep;76(1-3):113-9. Ed: I may be wrong, but it appears to me that in most cities in the U.S., severely depressed and suicidal patients have a very hard time seeing a psychiatrist quickly on an out-patient basis. I have had many tell me, even ones with good insurance, that they were told they would have to wait for weeks to get an appointment. In my experience, this has little to do with a shortage of psychiatrists and a lot to do with the way psychiatrists and mental health centers run their practices. I have always been able to make openings for new patients even when I was once extremely busy, because I think there is an obligation to at least triage new patients so as to be available for the most in need. World Suicide Rates Highest in Russia, Lithuania, Latvia, Estonia; Lowest in Greece, Mexico, Thailand: Suicide rates were already high in eastern Europe in the early 1980s, but jumped 50% by the late 1990s. Suicide rates differ widely. Russia’s rate (34/100,000) is 12 times higher than Greece (2.8). The U.S. is about average at 10/100,000. In every country, successful suicide is at least twice as high for males as females. However, U.S. females have one of the lowest rates in the world, while U.S. males are in mid-range for males (3.7 for U.S. females vs. 16.4 for U.S. males or 340% higher). Female suicide rates have dropped 25% in the U.S. since 1980 while male rates have not decreased at all. Levi F, et al. Trends in mortality from suicide, 1965-99. Acta Psychiatr Scand 11/2003;108:341-9. Numerous governmental and non-governmental program have been funded to help females in the U.S. since 1980, while the same has not been true for males. Females now significantly outnumber males in college and even in small business ownership. Whether these have played any role in the sizable female mental health mortality improvement is unknown. Suicide is also lower in Israel, Italy, Chile, Argentina, Spain, and Great Britain. Risk Factors for Attempted Suicide in Young People: A prospective Danish study of children born in 1966 found that first-time suicide attempts were associated with parental psychiatric disorder, previous suicidal behavior, violence, physical child abuse, and neglect. Increased risk was found in teens and young adults with psychiatric disorders or physical handicaps, previously imprisoned, addicted to drugs, school dropouts, unemployed, and no vocational training. Being unemployed and having been in foster/residential care had the largest differential impacts. Christoffersen MN, Poulsen HD, Nielsen A. Attempted suicide among young people: risk factors in a prospective register based study of Danish children born in 1966. Acta Psychiatr Scand 11/2003;108:350-8 Anorexia Nervosa Has a Lower Suicide Risk: Study of death records of 5 million women found those with AN died of suicide only 1.4% of time vs. 4.1% for matched controls. Coren, U Brit Col, Am J Publ Health ’98:88:1206-7. This scientific study is in stark contrast to earlier, less well documented reports of very high suicide rates in anorexics. Such lurid reports have been used to keep many patients in the hospital for longer periods of time. Attempts by Gays Very High: High school study found suicide attempts by 28% bisexual or homosexual males, 20.5% bi/homo females, 14.5% hetero females, and 4% hetero males. Remafedi, U Minn, Am J Publ Health ’98;88:57-60 Up In English Young Males: Suicides in males 15-34 yo increased from 10/100,000 to 20/100,000 between 1973 and 1992 but no increase for females at 4.9 in 1970 and 4.4 in 1996. Males favor hanging and gas, females favor OD. Lancet 2/13/99 Up by 100-200% for Aussie teens: Young male suicide up 200% since 1960 and female up 100% since 1950. Lancet 8/22/98. (Ed: n-3 role? Drugs, alcohol, tobacco for sure, violent entertainment) Breast Implanted Women Triple Rate: In a study of 3,521 women in Sweden who had breast augmentation surgery for cosmetic reasons between 1965 and 1993, Koot and her colleagues found a higher-than-expected suicide rate after an average 11-year follow-up. Utrecht. BMJ 3/6/03. Children: Suicide Attempt Factors in Finland: In a Finnish study of 504 children and teens on psychiatric units, the factors independently associated with suicide attempts were: manifesting violent acts (OR 8.1), having depression diagnosis (OR 5.3), being affected by open adult sexual behavior (OR 4.9), involuntary treatment (OR 4.7), and being of the female sex (OR 3.7). Suicidal ideation and suicide attempts among child and adolescent psychiatric inpatients in Finland. Haavisto A, Sourander A, Ellila H, Valimaki M, Santalahti P, Helenius H. J Affect Disord. 2003 Sep;76(1-3):211-21 Marijuana, Excessive Alcohol & Firearm Accessibility Linked: Data from 1993 National Followback Mortality Survey in U.S. Risk factors for male and female suicide decedents ages 15-64 in the United States. Risk factors more common in year before suicide. Depression and treatment more common in women. Depression in older men. Results from the 1993 National Mortality Followback Survey. Kung HC, Pearson JL, Liu X. Soc Psychiatry Psychiatr Epidemiol. 2003 Aug;38(8):419-26 Spouse Psychiatric Admission, Death, and especially Suicide Increases Risk of Own Suicide: A Danish study found that if one's spouse was psychiatrically admitted within the previous two years, one's own risk of suicide increased by 409%. If the spouse died from any cause, the risk of suicide increased 665%. If the spouse committed suicide, the risk of one's own suicide was 2069% higher than normal. Univ Aarhus. Risk of suicide and spouse's psychiatric illness or suicide: nested case-control study. Esben Agerbo. BMJ 2003;327:1025-1026 (1 November) |