scholarly journals Mortality and suicide after self-harm: community cohort study in Taiwan

2011 ◽  
Vol 198 (1) ◽  
pp. 31-36 ◽  
Author(s):  
Vincent C. H. Chen ◽  
Happy K. L. Tan ◽  
Chung-Ying Chen ◽  
Tony H. H. Chen ◽  
Long-Ren Liao ◽  
...  
Keyword(s):  
Suicide Mortality ◽  
First Year ◽  
National Mortality ◽  
Prevention Programmes ◽  
History Of ◽  
Self Harm ◽  
Independent Risk Factors ◽  
Sample Support ◽  
And Gender ◽  
Major Target

BackgroundLittle is known about outcomes after self-harm in East Asia.AimsTo investigate mortality after self-harm in a Taiwanese population.MethodBetween 2000 and 2003, 1083 individuals who self-harmed were identified through a population self-harm register in Nantou County, Taiwan, and followed until 2007 for date and cause of death on a national mortality database.ResultsIn total, 145 individuals died, 48 through suicide. The risks of all-cause and suicide mortality in the first year were 4.7% and 2.1% respectively, representing 8- and 131-fold age- and gender-standardised increases. Male gender and older age were independent risk factors for both suicide and non-suicide mortality. Use of more lethal methods in the index episode was associated with higher mortality but this was accounted for by gender.ConclusionsResults in this sample support the recommendation that people with a history of recent self-harm should be a major target for suicide prevention programmes.

scholarly journals Suicide and non-suicide mortality after self-harm in Taipei City, Taiwan

2012 ◽  
Vol 200 (5) ◽  
pp. 405-411 ◽  
Author(s):  
Chian-Jue Kuo ◽  
David Gunnell ◽  
Chiao-Chicy Chen ◽  
Paul S. F. Yip ◽  
Ying-Yeh Chen
Keyword(s):  
Suicide Mortality ◽  
First Year ◽  
Western Countries ◽  
Taipei City ◽  
Physical Disorders ◽  
Prevention Programmes ◽  
Self Harm ◽  
Standardised Mortality Ratios

BackgroundMost previous studies of long-term mortality risk following self-harm have been conducted in Western countries with few studies from Asia.AimsTo investigate suicide and non-suicide mortality after non-fatal self-harm in Taipei City, Taiwan.MethodProspective cohort study (median follow-up 3.3 years) of 7601 individuals presenting to hospital with self-harm (January 2004 to December 2006). Standardised mortality ratios (SMRs) for suicide and non-suicide mortality were calculated.ResultsSuicide risk in the year following self-harm was over 100 times higher than in the general population (SMR = 119.6, 95% CI 99.6–142.5). Males and middle-aged and older adults had the highest subsequent risk of suicide. Compared with people who took an overdose, individuals who used hanging or charcoal burning in their index episode had the highest risk of suicide. For non-suicide mortality the SMRs were 6.7 (95% CI 5.7–7.8) in the first year and 4.4 (95% CI 3.9–4.9) during the whole follow-up period.ConclusionsPatterns of increased all-cause and suicide mortality following an episode of self-harm are similar in Taipei City to those seen in Western countries. Designing better aftercare following non-fatal self-harm, particularly for those with underlying physical disorders or who have used lethal self-harm methods, should be a priority for suicide prevention programmes in Asia.

scholarly journals Self-harm in first-episode psychosis

2009 ◽  
Vol 33 (3) ◽  
pp. 104-107 ◽  
Author(s):  
Kamlesh Patel ◽  
Rachel Upthegrove
Keyword(s):  
Local Area ◽  
First Episode Psychosis ◽  
Psychiatric Services ◽  
First Episode ◽  
Psychotic Illness ◽  
Completed Suicide ◽  
Episode Psychosis ◽  
History Of ◽  
Self Harm ◽  
And Gender

Aims and MethodSuicide in schizophrenia remains frequent. One of the best predictors of suicide, previous self-harm, is increasing in young people. the aim of this case-note review was to investigate the frequency of a history of self-harm for individuals presenting to psychiatric services with a first episode of psychosis in our local area and study their demographic characteristics.ResultsA history of self-harm was found in 32% of the cohort. the predominant method of self-harm was self-laceration. In univariate analyses, age and gender were significant predictors of self-harming behaviour.Clinical ImplicationsThe rate of self-harm among those with first-episode psychosis is high. Efforts to reduce the rate of completed suicide in psychotic illness need to focus on this risk, which often predates contact with psychiatric services. This emphasises again the need for early detection and intervention in psychotic illness.

Suicide in prisons and remand centres

2021 ◽  
pp. 227-232
Author(s):  
Marco Sarchiapone ◽  
Miriam Iosue
Keyword(s):  
General Population ◽  
Suicide Risk ◽  
Suicide Attempts ◽  
Individual Vulnerability ◽  
High Prevalence ◽  
Common Causes ◽  
Prevention Programmes ◽  
History Of ◽  
Self Harm ◽  
High Level

Suicide is one of the most common causes of death in custodial settings worldwide, accounting for around 10% of prisoners’ deaths. Suicide attempts and suicidal ideation are also more common among prisoners compared to the general population. The high prevalence of suicidal behaviours among prisoners is likely the result of a complex interaction between individual vulnerability and the high level of stress and deprivation caused by the condition of confinement. Among prisoners and inmates, the prevalence of well-established suicide risk factors, such as a history of self-harm, psychopathological conditions, aggressive personality traits, and childhood trauma, is higher than in the general population. Moreover, the loss of freedom and autonomy, social isolation, lack of purposeful activity, and victimization are prison-specific stressors that showed to increase the suicide risk among inmates. Given this complexity, comprehensive multifactored prevention programmes involving the administrative, custodial, and clinical staff are the most effective in preventing suicide.

scholarly journals 109 Near-fatal suicide attempts among Canadian Youth: A CPSP Study

2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e45-e45 ◽  
Author(s):  
Rachel Mitchell ◽  
Cornelius Ani ◽  
James Irvine ◽  
Claude Cyr ◽  
Ari Joffe ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Suicide Attempt ◽  
Mental Health Care ◽  
Family Conflict ◽  
Suicide Attempts ◽  
Suicide Mortality ◽  
Prevention Interventions ◽  
History Of ◽  
Self Harm

Abstract Background Suicide is the second leading cause of death among Canadian adolescents. Youth who make near fatal suicide attempts, such as those requiring intensive care unit (ICU) level care, are the closest proxy to those that die by suicide; however, there is limited data on this group. Objectives To evaluate the minimum incidence rate and patterns of presentation of youth (under 18 years of age) admitted to the ICU for medically serious self-inflicted injury. Design/Methods From January 2017 to December 2018, over 2,700 paediatricians/subspecialist members of the Canadian Paediatric Surveillance Program were electronically surveyed on a monthly basis regarding cases of medically serious self-harm. Participants completed a detailed questionnaire about the reported case and descriptive statistics were used for analyses. Results Ninety-four cases (71 female; mean age 15.2 years) of confirmed (n=87) and suspected/probable (n=7) medically serious self-harm were reported. The majority (87%) of cases were reported from 4 out of 13 provinces and territories in Canada (Alberta, British Columbia, Ontario, Quebec). There were 11 deaths by suicide (M>F; p<.05). Medication ingestion was the most common method of self-harm among females (76% F vs. 52% M; p=.03) compared with hanging among males (14% F vs. 39% M; p=.009). More females than males had a prior suicide attempt (62% F vs. 32% M; p=.07) and a history of non-suicidal self-injury (NSSI) (65% F vs. 14% M; p<.05), although only history of NSSI reached significance. More females than males had a past psychiatric diagnosis (77% F vs. 55% M; p=.05), and past use of mental health services (69% F vs. 30% M; p<.001), although only service use reached significance. Half of the youth left evidence of intent (54%) and 33% of parents of included youth were aware that their child was considering suicide. Family conflict was the most common precipitating factor for suicide attempt in both females and males (46%). Conclusion These Canadian findings are consistent with international epidemiologic data that observe a gender paradox of higher rates of suicide attempts in females and greater mental health care engagement but increased suicide mortality in males with decreased involvement with mental health care. This study suggests that family conflict is a potential target for suicide prevention interventions among youth. Future research focusing on gender-specificity in risk factor identification and effectiveness of primary prevention interventions among youth is warranted.

scholarly journals Characteristics of Individuals with Self-Harm: A Retrospective Descriptive Study from Karachi, Pakistan

2021 ◽  
Author(s):  
Ambreen Tharani ◽  
Salima Farooq ◽  
Maryam Ali ◽  
Uroosa Talib ◽  
Murad Moosa Khan
Keyword(s):  
Psychiatric Illness ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Descriptive Study ◽  
Global Public Health ◽  
Over The Counter ◽  
Prevention Programmes ◽  
History Of ◽  
Self Harm ◽  
Global Public Health Problem

Abstract Background: Self-Harm (SH) is a major global public health problem which is under-researched in Pakistan. A prior act of self-harm is one of the strongest predictors of future suicide.Method: This retrospective descriptive study describes the characteristics of SH cases (n=350) that presented to a tertiary care teaching hospital in Karachi, Pakistan, from January 2013 to December 2017. Details related to demography, history, associated factors, access to methods used, and intent to die were collected on a structured proforma and analysed using STATA version 14. Results: It was found that self-harm acts were twice as more common in females than in males. More than half of the reported cases were in the age group 20-39 years. Drug overdose and use of insecticides were the two most common methods used in both genders. Depression was identified in nearly half of the reported SH cases. Intention to die was found to be 3 times greater among patients with psychiatric illness as compared to those with no history of psychiatric illness. Conclusion: This study suggests that limiting access to lethal means, regulating over-the-counter sale of medications, and safe storage of pesticides can possibly serve as effective measures to minimize self-harm incidences. Moreover, integration of suicide assessment and prevention programmes for the general population is also suggested.

scholarly journals Comparison of empathy with patients between first-year and last-year medical students of Tehran University of Medical Sciences

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Reyhane Hizomi Arani ◽  
Zohrehsadat Naji ◽  
Ali Moradi ◽  
Seyed Vahid Shariat ◽  
Sara Mirzamohamadi ◽  
...  
Keyword(s):  
Medical Students ◽  
First Year ◽  
Medical Sciences ◽  
Chi Square ◽  
Developmental Factors ◽  
Student Version ◽  
Chi Square Test ◽  
History Of ◽  
And Gender ◽  
Academic Year

Abstract Purpose This study was conducted to assess the developmental factors of empathy among medical students of Tehran University of Medical Sciences (TUMS). Methods To assess the empathy levels, 42 first-year and an equal number of last-year medical students were randomly selected. They answered a questionnaire including the medical student version of the Jefferson Scale, demographic, and some related variables. Statistical analyses were performed using the Chi-square test, T-test, univariate, and multivariate regressions. Result The study population consisted of 51 (60.7 %) men and 33 (39.3 %) women with a mean (SD) age of 22.24 (4.10) years. The Jefferson score was 110.19 ± 13.61 and 103.52 ± 20.00 in first- and last-year medical students, respectively. Moreover, medical students who completely passed at least one of the considered empathy courses of the TUMS curriculum had higher empathy scores compared to their counterparts (109.83 ± 15.54 vs. 103.68 ± 19.02). There was no significant association between empathy and gender, self-experience of illness, marital status, family history of chronic disease, and parents’ education (all P-values > 0.05). After adjusting for the effects of confounders, the empathy scores were significantly associated with the academic year level (p = 0.04), level of interest in medicine (p = 0.001), and passing the empathy courses (p = 0.04). Conclusions The data provided from a top Iranian medical school indicated that the academic year level, level of interest in medicine, and passing the empathy courses were significantly associated with the empathy level. Further studies are recommended.

scholarly journals Adverse Childhood Experiences and Risk of Subsequently Engaging in Self-Harm and Violence towards Other People—“Dual Harm”

2020 ◽  
Vol 17 (24) ◽  
pp. 9409
Author(s):  
Matthew J. Carr ◽  
Sarah Steeg ◽  
Pearl L. H. Mok ◽  
Carsten Bøcker Pedersen ◽  
Sussie Antonsen ◽  
...  
Keyword(s):  
Growing Up ◽  
Case Control Studies ◽  
Childhood Experiences ◽  
Adverse Childhood ◽  
Parental Unemployment ◽  
History Of ◽  
Self Harm ◽  
And Gender ◽  
Rate Ratios ◽  
Nested Case Control

The etiology of “dual harm” (the co-occurrence of self-harm and externalized violence in the same individual) is under-researched. Risk factors have mostly been investigated for each behavior separately. We aimed to examine adversities experienced between birth and age 15 years among adolescents and young adults with histories of self-harm and violent criminality, with a specific focus on dual harm. Three nested case-control studies were delineated using national interlinked Danish registers; 58,409 cases in total aged 15–35 were identified: 28,956 with a history of violent criminality (but not self-harm), 25,826 with a history of self-harm (but not violent criminality), and 3987 with dual-harm history. Each case was matched by date of birth and gender to 20 controls who had not engaged in either behavior. We estimated exposure prevalence for cases versus controls for each of the three behavior groups, and incidence rate ratios (IRRs). Experiencing five or more childhood adversities was more prevalent among individuals with dual-harm history (19.3%; 95% CI 18.0, 20.8%) versus self-harm (10.9%; 10.5, 11.3%) and violence (11.4%; 11.0%, 11.8%) histories. The highest IRRs for dual harm were linked with parental unemployment (5.15; 95% CI 4.71, 5.64), parental hospitalization following self-harm (4.91; 4.40, 5.48) or assault (5.90; 5.07, 6.86), and parental violent criminality (6.11; 5.57, 6.70). Growing up in environments that are characterized by poverty, violence, and substance misuse, and experiencing multiple adversities in childhood, appear to be especially strongly linked with elevated dual-harm risk. These novel findings indicate potential etiologic pathways to dual harm.

scholarly journals Suicide Trends over Time by Occupation in Korea and Their Relationship to Economic Downturns

2019 ◽  
Vol 16 (11) ◽  
pp. 2007 ◽  
Author(s):  
Jin-Ha Yoon ◽  
Sun Jae Jung ◽  
Jaesung Choi ◽  
Mo-Yeol Kang
Keyword(s):  
Age Groups ◽  
Suicide Mortality ◽  
Standardized Mortality Ratio ◽  
Service Trade ◽  
Occupational Groups ◽  
Economic Downturns ◽  
Suicidal Death ◽  
Mortality Ratio ◽  
Self Harm ◽  
And Gender

We analyzed suicide mortality by occupation using administrative data from 1993 to 2016. Methods: National death records from 1993 to 2016 of the Korea National Statistical Office (KNSO) were used. Suicidal death was taken from Korean Classification of Disease codes as intentional self-harm (X60–X84) and sequelae of intentional self-harm (Y870). Occupational groups were categorized into “Manager,” “Officer,” ”Service-Trade,” “Agricultural-Fishery-Forestry” (AFF), “Skilled Manual,” and “Unskilled Manual.” Direct standardized mortality (DSM) and standardized mortality ratio (SMR) with 95% confidence interval (95% CI) were calculated. Overall, suicide rates increased during economic downturns, especially among lower socio-economic occupation classes. Both DSM and SMR were highest in AFF, followed by Unskilled Manual, Service-Trade, Officer, Skilled Manual, and Manager categories among men, whereas women showed the highest DSM and SMR in AFF, followed by Service-Trade, Officer, Unskilled Manual, Manager, and Skilled Manual categories. The age-stratified analysis showed that age groups with increasing trends in suicide differed according to occupation and gender. In certain occupational groups, the time-point prevalence fluctuated with socio-economic background in suicidal mortality and differed by age and gender.

Suicide in recently released prisoners: a case-control study

2009 ◽  
Vol 40 (5) ◽  
pp. 827-835 ◽  
Author(s):  
D. Pratt ◽  
L. Appleby ◽  
M. Piper ◽  
R. Webb ◽  
J. Shaw
Keyword(s):  
Risk Factors ◽  
Community Mental Health Services ◽  
England And Wales ◽  
White Ethnicity ◽  
History Of ◽  
Self Harm ◽  
Independent Risk Factors ◽  
Risk Factors For Suicide ◽  
Release From Prison

BackgroundRecently released prisoners are at markedly higher risk of suicide than the general population. The aim of this study was to identify key risk factors for suicide by offenders released from prisons in England and Wales.MethodAll suicides committed by offenders within 12 months of their release from prison in England and Wales, between 2000 and 2002, were identified. One control matched on gender and date of release from prison was recruited for each case. Univariate and multivariate logistic regression modelling identified key independent risk factors for suicide.ResultsOf 256 920 released prisoners, 384 suicides occurred within a year of release. Factors significantly associated with post-release suicide were increasing age over 25 years, released from a local prison, a history of alcohol misuse or self-harm, a psychiatric diagnosis, and requiring Community Mental Health Services (CMHS) follow-up after release from prison. Non-white ethnicity and a history of previous imprisonment were protective factors.ConclusionsThere is a need to improve the continuity of care for people who are released from prison and for community health, offender and social care agencies to coordinate care for these vulnerable individuals.

scholarly journals Adverse Childhood Experiences and Risk of Subsequently Engaging in Self-Harm and Violence Towards Other People – ‘Dual Harm’

2020 ◽  
Author(s):  
Matthew J. Carr ◽  
Sarah Steeg ◽  
Pearl L. H. Mok ◽  
Carsten Bøcker Pedersen ◽  
Sussie Antonsen ◽  
...  
Keyword(s):  
Growing Up ◽  
Case Control Studies ◽  
Childhood Experiences ◽  
Adverse Childhood ◽  
Parental Unemployment ◽  
History Of ◽  
Self Harm ◽  
And Gender ◽  
Rate Ratios ◽  
Nested Case Control

The etiology of ‘dual harm’ (the co-occurrence of self-harm and externalized violence in the same individual) is under-researched. Risk factors have mostly been investigated for each behavior separately. We aimed to examine adversities experienced between birth and age 15 years among adolescents and young adults with histories of self-harm and violent criminality, with a specific focus on dual harm. Three nested case-control studies were delineated using national interlinked Danish registers; 58,409 cases in total aged 15-35 were identified: 28,956 with a history of violent criminality (but not self-harm), 25,826 with a history of self-harm (but not violent criminality), and 3987 with dual harm history. Each case was matched by date of birth and gender to 20 controls who had not engaged in either behavior. We estimated exposure prevalence for cases vs. controls for each of the three behavior groups, and incidence rate ratios (IRRs). Experiencing 5 or more childhood adversities was more prevalent among individuals with dual harm history (19.3%; 95% CI 18.0, 20.8%) versus self-harm (10.9%; 10.5, 11.3%) and violence (11.4%; 11.0%, 11.8%) histories. The highest IRRs for dual harm were linked with parental unemployment (5.15; 95% CI 4.71, 5.64), parental hospitalization following self-harm (4.91; 4.40, 5.48) or assault (5.90; 5.07, 6.86), and parental violent criminality (6.11; 5.57, 6.70). Growing up in environments that are characterized by poverty, violence and substance misuse, and experiencing multiple adversities in childhood, appear to be especially strongly linked with elevated dual harm risk. These novel findings indicate potential etiologic pathways to dual harm.

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