Psychological autopsy study of suicides by people aged under 35

1999 ◽  
Vol 175 (2) ◽  
pp. 168-174 ◽  
Author(s):  
Louis Appleby ◽  
Jayne Cooper ◽  
Tim Amos ◽  
Brian Faragher
Keyword(s):  
Young People ◽  
Suicide Rate ◽  
Social Withdrawal ◽  
Drug Misuse ◽  
Psychological Autopsy ◽  
Autopsy Study ◽  
Chronic Disorder ◽  
Self Harm ◽  
And Gender ◽  
The Uk

BackgroundIn the past two decades the suicide rate in young people has risen in the UK and other countries.AimsTo identify the characteristics of people aged under 35 who commit suicide.MethodPsychological autopsy study with case–control design. Cases were 84 suicides and probable suicides (open verdicts). Controls were 64 age- and gender-matched non-suicides obtained through the general practices of the matched cases. Main variables: social, including employment status, marital status and living circumstances; life events and interpersonal difficulties; clinical, including current psychiatric disorder, alcohol and drug misuse, previous self-harm and personality disorder.ResultsA large number of highly significant social, interpersonal and clinical differences between suicides and controls was found. Factor analysis identified two groups of variables within each of the social, interpersonal and clinical domains which were independently linked to suicide, corresponding to: acute, severe mental disorder and chronic disorder of behaviour; rootlessness and social withdrawal; chronic and recent interpersonal problems.ConclusionsA broad prevention strategy is needed to reverse the recent rise in the suicide rate in young people.

scholarly journals Children and young people who die by suicide: childhood-related antecedents, gender differences and service contact

BJPsych Open ◽  
2020 ◽  
Vol 6 (3) ◽  
Author(s):  
Cathryn Rodway ◽  
Su-Gwan Tham ◽  
Saied Ibrahim ◽  
Pauline Turnbull ◽  
Nav Kapur ◽  
...  
Keyword(s):  
Young People ◽  
Case Series ◽  
Third Sector ◽  
Drug Misuse ◽  
Mortality Data ◽  
Suicide Rates ◽  
National Mortality ◽  
Self Harm ◽  
The Uk ◽  
Witnessing Domestic Violence

Background Worldwide suicide is commonest in young people and in many countries, including the UK, suicide rates in young people are rising. Aims To investigate the stresses young people face before they take their lives, their contact with services that could be preventative and whether these differ in girls and boys. Method We identified a 3-year UK national consecutive case series of deaths by suicide in people aged 10–19, based on national mortality data. We extracted information on the antecedents of suicide from official investigations, primarily inquests. Results Between 2014 and 2016, there were 595 suicides by young people, almost 200 per year; 71% were male (n = 425). Suicide rates increased from the mid-teens, most deaths occurred in those aged 17–19 (443, 74%). We obtained data about the antecedents of suicide for 544 (91%). A number of previous and recent stresses were reported including witnessing domestic violence, bullying, self-harm, bereavement (including by suicide) and academic pressures. These experiences were generally more common in girls than boys, whereas drug misuse (odds ratio (OR) = 0.54, 95% CI 0.35–0.83, P = 0.006) and workplace problems (OR 0.52, 95% CI 0.28–0.96, P = 0.04) were less common in girls. A total of 329 (60%) had been in contact with specialist children's services, and this was more common in girls (OR 1.86, 95% CI 1.19–2.94, P = 0.007). Conclusions There are several antecedents to suicide in young people, particularly girls, which are important in a multiagency approach to prevention incorporating education, social care, health services and the third sector. Some of these may also have contributed to the recent rise.

scholarly journals Temporal trends in annual incidence rates for psychiatric disorders and self-harm among children and adolescents in the UK, 2003–2018

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lukasz Cybulski ◽  
Darren M. Ashcroft ◽  
Matthew J. Carr ◽  
Shruti Garg ◽  
Carolyn A. Chew-Graham ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Young People ◽  
Anxiety Disorders ◽  
Children And Adolescents ◽  
Autism Spectrum ◽  
Incidence Rates ◽  
Annual Incidence ◽  
Health Crisis ◽  
Self Harm ◽  
The Uk

Abstract Background There has been growing concern in the UK over recent years that a perceived mental health crisis is affecting children and adolescents, although published epidemiological evidence is limited. Methods Two population-based UK primary care cohorts were delineated in the Aurum and GOLD datasets of the Clinical Practice Research Datalink (CPRD). We included data from 9,133,246 individuals aged 1–20 who contributed 117,682,651 person-years of observation time. Sex- and age-stratified annual incidence rates were estimated for attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) (age groups: 1–5, 6–9, 10–12, 13–16, 17–19), depression, anxiety disorders (6–9, 10–12, 13–16, 17–19), eating disorders and self-harm (10–12, 13–16, 17–19) during 2003–2018. We fitted negative binomial regressions to estimate incidence rate ratios (IRRs) to examine change in incidence between the first (2003) and final year (2018) year of observation and to examine sex-specific incidence. Results The results indicated that the overall incidence has increased substantially in both boys and girls in between 2003 and 2018 for anxiety disorders (IRR 3.51 95% CI 3.18–3.89), depression (2.37; 2.03–2.77), ASD (2.36; 1.72–3.26), ADHD (2.3; 1.73–3.25), and self-harm (2.25; 1.82–2.79). The incidence for eating disorders also increased (IRR 1.3 95% CI 1.06–1.61), but less sharply. The incidence of anxiety disorders, depression, self-harm and eating disorders was in absolute terms higher in girls, whereas the opposite was true for the incidence of ADHD and ASD, which were higher among boys. The largest relative increases in incidence were observed for neurodevelopmental disorders, particularly among girls diagnosed with ADHD or ASD. However, in absolute terms, the incidence was much higher for depression and anxiety disorders. Conclusion The number of young people seeking help for psychological distress appears to have increased in recent years. Changes to diagnostic criteria, reduced stigma, and increased awareness may partly explain our results, but we cannot rule out true increases in incidence occurring in the population. Whatever the explanation, the marked rise in demand for healthcare services means that it may be more challenging for affected young people to promptly access the care and support that they need.

Thinking about ethnicity and gender diversity in children and young people

2018 ◽  
Vol 24 (2) ◽  
pp. 291-303 ◽  
Author(s):  
Nastasja M de Graaf ◽  
Ilham I Manjra ◽  
Anna Hames ◽  
Claudia Zitz
Keyword(s):  
Young People ◽  
Identity Development ◽  
Gender Identity ◽  
Gender Diversity ◽  
Age Groups ◽  
Chi Square ◽  
Children And Young People ◽  
And Gender ◽  
The Uk ◽  
Ethnicity Data

Background: Little is known about how social and cultural variants interact with gender identity development. This article aims to identify the ethnicities of children and young people referred to the United Kingdom’s national Gender Identity Development Service (GIDS), and compare the ethnicity data with the UK child population and referrals to Child and Adolescent Mental Health Services (CAMHS). Methods: GIDS referrals made between April 2012 and April 2015 for children and young people were retrieved. Ethnicity data were obtained by the ‘16 + 1’ ethnicity list. Chi-square and t-tests were performed on the demographics. Results: Less than 10% of the 995 referrals at GIDS were from Black and minority ethnic (BME) groups – an underrepresentation as compared with both the national population and CAMHS figures. No significant differences in ethnic representation were found between the demographic birth-assigned sexes, across age groups, or year of referral. Conclusions: Hypotheses proposed for this underrepresentation take into account both the potential barriers to accessing services and the possibility of cross-cultural variations in the conceptualisations of gender, gender roles and gender diversity. Ethnicity, culture and religion, and their overlapping relationship with gender need further exploration.

Openness to Experience and Completed Suicide Across the Second Half of Life

1995 ◽  
Vol 7 (2) ◽  
pp. 183-198 ◽  
Author(s):  
Paul R. Duberstein
Keyword(s):  
At Risk ◽  
Suicidal Behavior ◽  
Clinical Intervention ◽  
Openness To Experience ◽  
Behavioral Repertoire ◽  
Psychological Autopsy ◽  
Autopsy Study ◽  
Completed Suicide ◽  
And Gender

Personality data gathered in a psychological autopsy study indicate that completed suicides obtain higher neuroticism scores than age- and gender-matched controls. Older suicide victims obtained lower openness to experience (OTE) scores than both younger suicide victims and normal controls. Although the role of neuroticism and negative affect in psychopathology has been discussed extensively, OTE has been accurded relatively little attention in the psychiatric literature. The apparent role of OTE in completed suicide warrants its closer examination. In this article, I offer the testable hypotheses that persons low in OTE are at risk for taking their own lives because their affective dampening, cognitive certainty, diminished behavioral repertoire, and rigidly defined self-concept have decreased their capacity to adapt to the expectable age-associated changes in role, health, and function that accumulate over time. Concrete thinking and excessive focus on proximal, low-level goals place them at risk for descending into states of suicidal meaninglessness in times of stress or crisis. This state of awareness increases the desirability of suicide as an action oriented solution to the stressors of aging. Other lines of investigation are suggested. These include research on OTE in attempted suicide; OTE and the neurobiology of suicidal behavior; OTE and gender differences in suicidal behavior; and clinical intervention designed to increase the degree to which one is open to experience.

scholarly journals Child Health Clinical Outcome Review Programme: The Mental Healthcare of Young People and Young Adults

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Sophie Wood ◽  
Sarah Rees ◽  
Ting Wang ◽  
Amanda Marchant ◽  
Ashley Akbari ◽  
...  
Keyword(s):  
Mental Health ◽  
Young Adults ◽  
Young People ◽  
Transitional Care ◽  
Healthcare Utilisation ◽  
Mental Health Disorders ◽  
Children And Young People ◽  
Self Harm ◽  
Health Disorders ◽  
The Uk

IntroductionThe diagnosis, management and services available for mental disorders are of growing concern and controversy in the UK. Transitional care between child and adult services and the interface between primary and secondary/ specialist services is often disjointed and thresholds for referral to Child and Adolescent Mental Health Services are high. Objectives and ApproachRoutinely collected healthcare datasets and data linkage were used to identify patterns of healthcare utilisation by young people and young adults with mental health disorders across the four UK Nations. We explored the extent to which routinely collected datasets can contribute to an assessment of the health needs and the quality of care that children and young people with mental health disorders receive. Data was requested from the national data providers in each country. A series of descriptive analyses were performed and methods were developed for cross- national comparisons to be made (e.g. Four Nation Person Spell). ResultsIt is feasible to explore healthcare utilisation across the four countries of the UK using routine data. However the recording, availability and access varied considerably between countries, making meaningful comparisons challenging. Descriptive analyses showed strong deprivation gradients in the diagnoses and care provided for young people and young adults with mental health disorders. Depression and anxiety were the most commonly recorded mental health conditions in primary care. In secondary care drug/alcohol disorders and self-harm were the most commonly recorded. Re-admissions to emergency departments were higher for those admitted for self-harm or psychiatric conditions. Conclusion/ImplicationsRoutine data has the potential to make a difference to care. However collection and access needs to be standardised in order to improve efficiency and effectiveness in improving the care for children and young people with mental health disorders. MQ has funded an Adolescent Data Platform to facilitate this.

Reflections on ‘Thinking an Ethics of Gender Exploration: Against Delaying Transition for Transgender and Gender Variant Youth’

2019 ◽  
Vol 24 (2) ◽  
pp. 237-240
Author(s):  
Bernadette Wren
Keyword(s):  
Young People ◽  
Identity Development ◽  
Ethical Issues ◽  
Short Article ◽  
Medical Interventions ◽  
Gender Variant ◽  
Gender Diverse ◽  
Diverse Children ◽  
And Gender ◽  
The Uk

In this short article are offered some brief reflections on the commissioned response to my article on ethical issues arising in the provision of medical interventions for gender diverse children. Ashley argues for the importance of ‘an ethics of exploration’ which prioritises making opportunities for fluid, open-ended reflection by gender diverse children and young people, operating through and alongside, rather than prior to, social and medical transition. While noting significant areas of shared outlook between Ashley and myself, I correct some assumptions that Ashley may be making about the range of young people seen at the UK Gender Identity Development Service (GIDS) and the way we work clinically within a developmental framework. I highlight my reasons for thinking that there are particular concerns arising in the care of the very young. Finally, I reiterate my view that professionals cannot so easily abandon altogether an ‘ethic of prediction’ and surrender their responsibilities and accountabilities in this area of clinical practice.

scholarly journals Suicide in Hong Kong: a case-control psychological autopsy study

2006 ◽  
Vol 36 (6) ◽  
pp. 815-825 ◽  
Author(s):  
ERIC Y. H. CHEN ◽  
WINCY S. C. CHAN ◽  
PAUL W. C. WONG ◽  
SANDRA S. M. CHAN ◽  
CECILIA L. W. CHAN ◽  
...  
Keyword(s):  
Hong Kong ◽  
Suicide Rate ◽  
Case Control ◽  
Psychological Autopsy ◽  
Structured Interviews ◽  
Next Of Kin ◽  
Autopsy Study ◽  
Chinese Populations ◽  
Relative Contribution ◽  
Wide Range

Background. The relative contribution of psychosocial and clinical risk factors to suicide among Chinese populations is an important issue. In Hong Kong, this issue requires vigorous examination in light of a 50% increase in suicide rate between 1997 and 2003.Method. Using a case-control psychological autopsy method, 150 suicide deceased were compared with 150 living controls matched by age and gender. Semi-structured interviews were conducted with the next-of-kin of the subjects. Data were collected on a wide range of potential risk and protective factors, including demographic, life event, clinical and psychological variables. The relative contribution of these factors towards suicide was examined in a multiple logistic regression model.Results. Six factors were found to significantly and independently contribute to suicide: unemployment, indebtedness, being single, social support, psychiatric illness, and history of past attempts.Conclusions. Both psychosocial and clinical factors are important in suicides in Hong Kong. They seem to have mediated suicide risk independently. In addition, socio-economic adversities seem to have played a relatively important role in the increasing suicide rate in Hong Kong.

A cross-ethnic comparison on incidence of suicide

2010 ◽  
Vol 41 (6) ◽  
pp. 1213-1221 ◽  
Author(s):  
I. C. Liu ◽  
S. F. Liao ◽  
W. C. Lee ◽  
C. Y. Kao ◽  
R. Jenkins ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ethnic Groups ◽  
Suicide Rate ◽  
Help Seeking ◽  
Substance Dependence ◽  
Population Attributable Fraction ◽  
The Other ◽  
Psychological Autopsy ◽  
Autopsy Study ◽  
Suicide Rates

BackgroundSuicide rates vary widely across nations and ethnic groups. This study aims to explore potential factors contributing to inter-ethnic differences in suicide rates.MethodStudy subjects came from a case-control psychological autopsy study conducted in Taiwan, including 116 consecutive suicides from two aboriginal groups and Taiwanese Han; 113 of them each matched with two living controls. Gender-, age- and method-specific suicide rates, population attributable fraction (PAF) of suicide for five major risk factors, help-seeking before suicide and emergency medical aid after suicide were compared between the three ethnic groups.ResultsOne aboriginal group (the Atayal) had significantly higher adjusted rate ratios (RR) of suicide than the other aboriginal group (the Ami) [RR 0.20, 95% confidence intervals (CI) 0.12–0.34] and the Han (RR 0.26, 95% CI 0.16–0.40). Such differences can be explained by higher PAFs of suicide for three major risk factors (substance dependence, PAF 47.6%, 95% CI 25.5–64.2; emotionally unstable personality disorder, PAF 52.7%, 95% CI 32.8–69.0; family history of suicidal behaviour, PAF 43.5%, 95% CI 23.2–60.2) in this group than in the other two groups. This higher suicide rate was substantially reduced from 68.2/100 000 per year to 9.1/100 000 per year, comparable with the other two groups, after stepwise removal of the effects of these three risk factors. Suicide rates by self-poisoning were also significantly higher in this group than in the other two groups.ConclusionsHigher rates of specific risk factors and use of highly lethal pesticides for suicide contributed to the higher suicide rate in one ethnic group in Taiwan. These findings have implications for developing ethnicity-relevant suicide prevention strategies.

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