scholarly journals Psychosocial aspects of deliberate physical suicide attempts by children and adolescents

Author(s):  
Odeta Kinciniene ◽  
Rokas Sambaras ◽  
Auge Lesinskaite ◽  
Virginija Zilinskaite ◽  
Sigita Lesinskiene

Abstract Background and objectives: Suicide is a topical issue in Lithuania and all around the world. It is the second most common cause of death among young people. There is a lack of research studies on the psychosocial aspects of adolescent suicide in Lithuania. This study aimed to evaluate demographics, life circumstances, and health conditions as factors related to suicide attempt in adolescents. Materials and Methods: A retrospective study was performed at the Children’s Hospital (Vilnius University Santara Clinics). Medical documentation of adolescents treated in this hospital after suicide attempts from January 2011 to April 2018 were analyzed. Results: There were 117 cases of hospitalization due to suicide attempts during this period, and 102 cases were included in the study. There were 83.8% female and 16.2% male patients with an average age of 15.02 ± 1.9 years (p = 0.405); 40.6% of patients lived in divorced families, 17.7% lived in orphanages, 4.2% lived in foster care, 36.4% suffered from parental alcoholism, and 17.2% experienced suicide in their close surroundings. They had comorbidities (girls 72.5%, boys 68.8%), mostly depression (31.3%), were suffering from bullying (54.1%) or violence (26.0%), and 85.4% showed signs of other types of self-harm (girls more often (p < 0.001)). Most of them chose to cut for suicide attempts (86.0% girls, 56.2% boys). In 52.8% of cases, the attempt was spontaneous and 34% relapsed. Thirty-four events occurred in March (18.9%) (p = 0.688). Conclusions: Our study revealed the possible circumstances related to adolescent suicide attempt. Female gender was more common overall and males were more likely to carry out more potentially lethal methods. Other common associated factors were a lack of prosperity in family life, experience of bullying, violence, comorbidities, and the early spring period. Signs of any self-harm could be an indicator of later suicide attempt.

2021 ◽  
Author(s):  
Odeta Kinciniene ◽  
Rokas Sambaras ◽  
Auge Lesinskaite ◽  
Virginija Zilinskaite ◽  
Sigita Lesinskiene

Abstract Background and objectives: Suicide is a topical issue in Lithuania and all around the world. It is the second most common cause of death among young people. There is a lack of research studies on the psychosocial aspects of adolescent suicide in Lithuania. This study aimed to evaluate demographics, life circumstances, and health conditions as factors related to suicide attempt in adolescents. Materials and Methods: A retrospective study was performed at the Children’s Hospital (Vilnius University Santara Clinics). Medical documentation of adolescents treated in this hospital after suicide attempts from January 2011 to April 2018 were analyzed. Results: There were 117 cases of hospitalization due to suicide attempts during this period, and 102 cases were included in the study. There were 83.8% female and 16.2% male patients with an average age of 15.02 ± 1.9 years (p = 0.405); 40.6% of patients lived in divorced families, 17.7% lived in orphanages, 4.2% lived in foster care, 36.4% suffered from parental alcoholism, and 17.2% experienced suicide in their close surroundings. They had comorbidities (girls 72.5%, boys 68.8%), mostly depression (31.3%), were suffering from bullying (54.1%) or violence (26.0%), and 85.4% showed signs of other types of self-harm (girls more often (p < 0.001)). Most of them chose to cut for suicide attempts (86.0% girls, 56.2% boys). In 52.8% of cases, the attempt was spontaneous and 34% relapsed. Thirty-four events occurred in March (18.9%) (p = 0.688).Conclusions: Our study revealed the possible circumstances related to adolescent suicide attempt. Female gender was more common overall and males were more likely to carry out more potentially lethal methods. Other common associated factors were a lack of prosperity in family life, experience of bullying, violence, comorbidities, and the early spring period. Signs of any self-harm could be an indicator of later suicide attempt.


Author(s):  
Odeta Kinciniene ◽  
Rokas Sambaras ◽  
Auge Lesinskaite ◽  
Virginija Zilinskaite ◽  
Sigita Lesinskiene

Background and objectives: Suicide is a topical issue in Lithuania and all around the world. It is the second most common cause of death among young people. There is a lack of research studies on the psychosocial aspects of adolescent suicide in Lithuania. This study aimed to evaluate demographics, life circumstances, and health conditions as factors related to suicide attempt in adolescents. Materials and Methods: A retrospective study was performed at the Children&rsquo;s Hospital (Vilnius University Santara Clinics). Medical documentation of adolescents treated in this hospital after suicide attempts from January 2011 to April 2018 were analyzed. Results: There were 117 cases of hospitalization due to suicide attempts during this period, and 102 cases were included in the study. There were 83.8% female and 16.2% male patients with an average age of 15.02 &plusmn; 1.9 years (p = 0.405); 40.6% of patients lived in divorced families, 17.7% lived in orphanages, 4.2% lived in foster care, 36.4% suffered from parental alcoholism, and 17.2% experienced suicide in their close surroundings. They had comorbidities (girls 72.5%, boys 68.8%), mostly depression (31.3%), were suffering from bullying (54.1%) or violence (26.0%), and 85.4% showed signs of other types of self-harm (girls more often (p &lt; 0.001)). Most of them chose to cut for suicide attempts (86.0% girls, 56.2% boys). In 52.8% of cases, the attempt was spontaneous and 34% relapsed. Thirty-four events occurred in March (18.9%) (p = 0.688). Conclusions: Our study revealed the possible circumstances related to adolescent suicide attempt. Female gender was more common overall and males were more likely to carry out more potentially lethal methods. Other common associated factors were a lack of prosperity in family life, experience of bullying, violence, comorbidities, and the early spring period. Signs of any self-harm could be an indicator of later suicide attempt.


Crisis ◽  
2014 ◽  
Vol 35 (1) ◽  
pp. 60-66 ◽  
Author(s):  
Amanda Venta ◽  
Carla Sharp

Background: Identifying risk factors for suicide-related thoughts and behaviors (SRTB) is essential among adolescents in whom SRTB remain a leading cause of death. Although many risk factors have already been identified, influential theories now suggest that the domain of interpersonal relationships may play a critical role in the emergence of SRTB. Because attachment has long been seen as the foundation of interpersonal functioning, we suggest that attachment insecurity warrants attention as a risk factor for SRTB. Aims: This study sought to explore relations between attachment organization and suicidal ideation, suicide attempts, and self-harm in an inpatient adolescent sample, controlling for demographic and psychopathological covariates. Method: We recruited 194 adolescents from an inpatient unit and assigned them to one of four attachment groups (secure, preoccupied, dismissing, or disorganized attachment). Interview and self-report measures were used to create four variables reflecting the presence or absence of suicidal ideation in the last year, single lifetime suicide attempt, multiple lifetime suicide attempts, and lifetime self-harm. Results: Chi-square and regression analyses did not reveal significant relations between attachment organization and SRTB, although findings did confirm previously established relations between psychopathology and SRTB, such that internalizing disorder was associated with increased self-harm, suicide ideation, and suicide attempt and externalizing disorder was associated with increased self-harm. Conclusion: The severity of this sample and methodological differences from previous studies may explain the nonsignificant findings. Nonsignificant findings may indicate that the relation between attachment organization and SRTB is moderated by other factors that should be explored in future research.


2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Silje Støle Brokke ◽  
Thomas Bjerregaard Bertelsen ◽  
Nils Inge Landrø ◽  
Vegard Øksendal Haaland

Abstract Background Suicide attempt is the most predictive risk factor of suicide. Trauma – especially sexual abuse – is a risk factor for suicide attempt and suicide. A common reaction to sexual abuse is dissociation. Higher levels of dissociation are linked to self-harm, suicide ideation, and suicide attempt, but the role of dissociation in suicidal behavior is unclear. Methods In this naturalistic study, ninety-seven acute psychiatric patients with suicidal ideation, of whom 32 had experienced sexual abuse, were included. Suicidal behaviour was assessed with The Columbia suicide history form (CSHF). The Brief trauma questionnaire (BTQ) was used to identify sexual abuse. Dissociative symptoms were assessed with Dissociative experiences scale (DES). Results Patients who had experienced sexual abuse reported higher levels of dissociation and were younger at onset of suicidal thoughts, more likely to self-harm, and more likely to have attempted suicide; and they had made more suicide attempts. Mediation analysis found dissociative experiences to significantly mediate a substantive proportion of the relationship between sexual abuse and number of suicide attempts (indirect effects = 0.17, 95% CI = 0.05, 0.28, proportion mediated = 68%). Dissociative experiences significantly mediated the role of sexual abuse as a predictor of being in the patient group with more than four suicide attempts (indirect effects = 0.11, 95% CI = 0.02, 0.19, proportion mediated = 34%). Conclusion The results illustrate the importance of assessment and treatment of sexual abuse and trauma-related symptoms such as dissociation in suicide prevention. Dissociation can be a contributing factor to why some people act on their suicidal thoughts.


2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e45-e45 ◽  
Author(s):  
Rachel Mitchell ◽  
Cornelius Ani ◽  
James Irvine ◽  
Claude Cyr ◽  
Ari Joffe ◽  
...  

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&gt;F; p&lt;.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&lt;.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&lt;.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.


Author(s):  
Lauren M. O'Reilly ◽  
Erik Pettersson ◽  
Kelly Donahue ◽  
Patrick D. Quinn ◽  
E. David Klonsky ◽  
...  

2020 ◽  
Author(s):  
Anna Hansen ◽  
Dessi Slavova ◽  
Gena Cooper ◽  
Jaryd Zummer ◽  
Julia F Costich

Abstract Background Non-suicidal self-injury and suicide attempts are increasing problems among American adolescents. This study proposed a definition for identifying intentional self-harm injuries (ISHIs) in emergency department (ED) records coded with International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes and sought to estimate: (1) the definition’s positive predictive value (PPV) in a pediatric population treated in one Kentucky ED, and (2) the proportion of Intentional self-harm injuries (ISHIs) with intent to die (i.e., suicide attempt) that cannot be captured by ICD-10-CM codes and can only be identified by a medical record abstraction. Methods The study definition captured initial encounters for ISHIs based on first valid external cause-of-injury self-harm codes in the ICD-10-CM range X71-X83, T14.91, T36-T65, or T71. Medical records for a random sample of 207 ED discharge records were reviewed following a specified protocol. The PPV for the study definition was reported with its 95% confidence interval (95%CI). Results The estimated PPV for the study definition’s ability to capture true ISHIs was 88.9%, 95%CI (83.8%, 92.8%). The estimated percentage of ISHIs with intent to die was 45.9%, 95%CI (47.1%, 61.0%). The ICD-10-CM code “suicide attempt” (T14.91) captured only 7 cases, but coding guidelines allow assignment of this code only when the mechanism of the suicide attempt is unknown. Conclusions This study demonstrated a critical shortcoming in U.S. morbidity surveillance. The ICD-10-CM coding system and coding guidelines do not allow accurate identification of ISHIs with intent to die; modifications are needed to address this issue.


Crisis ◽  
2018 ◽  
Vol 39 (5) ◽  
pp. 335-343
Author(s):  
Tatiana Tairi ◽  
Petar Milojev ◽  
Nikos Zilikis

Abstract. Background: Suicide attempts are a significant public health problem among youth, resulting in a major social and economic burden for communities and a devastating impact on families. Aims: To determine whether we can identify distinct clinical profiles using latent class analysis in a clinical sample of Greek adolescents who were admitted to hospital following a suicide attempt. Method: Data on 11 clinical parameters from 182 adolescents were analyzed, with a two-class solution selected as the best fitting among the one- through three-class solutions that were examined. Results: We observed two distinct classes, specifically in the probability of mood disorders, substance use disorders, abandonment/neglect, and displaying traits of personality disorders. While most of the adolescents who attempted suicide showed a low probability of these parameters (71.7%), about a third of the sample (28.3%) showed a much more severe clinical profile. Analyses of pertinent contextual and risk factors indicated that those with a more severe clinical profile tend to come from overall more dysfunctional family systems, have more problems in school, and have made a previous attempt. Conclusion: We conclude that the adolescent suicide attempt population is a heterogeneous group in need of focused differentiated care specifically targeted to particular subgroups.


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