| Flavio et al., 201326 |
To analyze rate of attempted suicides and their methods and to identify risk groups of attempted suicide. |
Women aged 37.4316.87 (p 0.001) Risk groups include single individuals, of foreign nationality, low education and low employment status |
Men were significantly more frequently affected by substance abuse disorder or psychosis, whereas in women adjustment disorders and personality disorders were diagnosed significantly more often. |
This study offers the first published representative data of an entire Swiss county. Established sociodemographic and clinical risk factors for suicide attempts were reproduced. The identification of risk factors contributes to the development of local targeted prevention strategies, for example education of risk groups and caregivers, and pharmacolegal consequences for package sizes. Gender- and age-specific prevention and aftercare programs are indicated. |
| Williams Jonshon et al., 201227 |
To document the characteristics of self-poisoning suicide attempters who were brought to the Emergency Room of the University Hospital of the West Indies (UHWI) and to outline the type of drug used in the attempt. |
Women (p < 0.001) Age 16 to 30 years (p < 0.001) Use of chemical agents greater among women (p < 0.019) |
Findings consistent with global trends of attempted suicides according to sex and age group. |
Substance ingested different from other data in the literature (women: chemicals; men: medication) |
| Rancic et al., 201228
|
To determine the frequency and distribution of suicide attempts relating to the manner of execution and (...) possible risk factors. |
Women: 405 (56.5%) Depression: 336 (48.4%) Mean age at attempt: 42.6 (SD = 16.78) Schizophrenia and delirious disorders: 150 (20.4%) Substance abuse: 85 (11.2%) |
Suicide attempts were two times more frequent among women than among men. Young people, both men and women. |
Patients hospitalized in general wards and not in psychiatric wards. No control group. |
| Lee et al., 201229 |
To describe risk factors of attempted suicide associated with intensity of self-inflicted injuries. |
Men: p = 0.001 (severe injury group) Age: 10 to 19 years; p = 0.001 (severe injury group) consumed no alcohol: p = 0.001 (severe injury group) |
Male sex, older age and not having consumed alcohol were predictors of severe suicide attempt. |
Data may be underestimated, as Koreans tend to mask their suicidal intent. |
| Turhan et al., 201230 |
To determine suicide rates, risk factors and reasons for suicide attempts. |
Young people (15-24 years): 87.1 (odds ratio) Women/men: 3.27 (odds ratio) Single women: 2.7 (odds ratio) Higher education level: 8.4 (odds ratio) |
Young people, women, single status and people with higher educational level and history of psychiatric disease in the family had a higher risk of attempts and recurrence. |
Study based on medical records. Higher educational level was a risk factor in this study. |
| Garcia-Rabago et al., 201031
|
To identify differences between patients with high-and low-lethality risk factors. |
Living alone: 6.7 (odds ratio) Prior alcohol poisoning: 3.8 (odds ratio) |
In the high-lethality group, chances of attempted suicide were 6.7 times greater among people that lived along and 3.8 times among people with a history of previous alcoholic poisoning. |
Lethality evaluated using instruments (Insa and Barrachina scale). |
| Yip et al., 201132 |
To compare the characteristics of patients hospitalized in Hong Kong and Oxford after repeated suicide attempt. |
Single (p = 0.04) Victim of violence in the last 5 years (p = 0.02) Hospitalization (p = 0.02) Adverse life problems (p = 0.01) Consequences of sexual abuse in childhood (p = 0.04) Consequences of physical abuse in childhood (p = 0.01) Repetitive self-mutilation (p = 0.00) |
Suicide intent: Hong Kong (48.9%) and Oxford (29%). Intent was higher among men in Oxford (35.71) than among women (25.7). Defaulted psychiatric treatment: 44. 6% in Hong Kong and 35.3% in Oxford. Alcohol abuse: Oxford 33.2%; and Hong Kong 14%. |
Study conducted in only one hospital. Short repetition follow-up (6 months). Large number of interviewees had a previous attempt. Authors believe more details are essential to evaluate actual risk factors and suggest that suicide intent scales should be different for different sexes. |
| Oh et al., 201122 |
To describe factors associated with repeated suicide attempts. |
Female sex (p = 0.002) Not having a family (p < 0.001) Attempt method: analgesics (p < 0.001) History of psychiatric treatment (p < 0.001) |
The most relevant factors were female sex, not having a family, having a history of psychiatric treatment and use of antidepressants. |
Data were collected from self-reports. Attempt repetitions may have been underreported due to collection at one site only. Study did not examine reasons for attempt, social class, marital status, use of substances, or other diseases. |
| Reazie et al., 201133 |
To compare the profile of suicide attempts by self-immolation and poisoning. |
Self-poisoning: women 53.3% (p < 0.001); younger (25 years) (p < 0.007); single 59.9%; higher educational level (p < 0.001) Positive suicidal intent behavior: 44.5% (p < 0.001) |
Risk factors were different in the two groups. |
Data from one hospital only and short study duration. No validated instruments for assessment. |
| Chowdhury, et al., 201034
|
To evaluate the characteristics of people that attempted suicide and survived and those that died, seen in a primary public healthcare service |
In both groups, risk factors were: Age: 24 years Women: 61.7% Illiterate: 39.5% Married: 71.9% Domestic conflicts and violence: 46.8% |
Both groups were classified as an important public health problem in the Sudarban area; correct pesticide management is essential as a preventive strategy. |
Cultural factors seem to have affected results, which differed from other data reported in the literature (marital status and low educational level). |
| Zyould et al., 201024
|
To determine risk factors and life stressors that predominate in cases of deliberate self-poisoning (DSP) with acetaminophen and identify gender differences in associated factors, as well as to determine the prevalence of psychiatric diagnoses and the patterns and types of psychotherapeutic interventions provided by psychiatrists. |
Risk factor for men: Chronic alcohol intake (p = 0.04) Higher reported dose ingested (p = 0.01) Higher latency time (p = 0.04) Length of hospital stay (p = 0.03) |
There were no significant differences between sexes. Men had greater toxicity because of greater chronic use of alcohol, greater doses and longer latency time. |
Specific findings for male sex, particularly associated with alcohol intake and DSP with acetaminophen. Psychiatric diagnoses made according to clinical examination and not by means of structured instruments. |
| Heyerdahl et al., 201035 |
To investigate differences in psychosocial factors and referrals to follow-up among self-poisoned patients according to intention. |
Age: 30 to 49 years; OR: 0.51 (95% CI 0.34-0.77) Immigrant from Asian countries, OR: 0.23 (95% CI 0.11 – 0.49) Living alone, OR: 2.21 (95% CI 1.12-4.37) Sick leave, OR: 0.30 (95% CI 0.15-0.61) |
Considerable similarities in social deprivation, drug use, previous attempts and previous or current psychiatric treatment between groups of attempted suicide and appealing attempts. The drug or alcohol misuse group had no referral after discharge and seemed to be excluded from follow-up, although their risk is well known. |
No validated instruments for assessment. Relevance of findings stress importance of physical examination. Drug and alcohol misusers (risk group) were not referred to treatment. |
| Ozdel et al., 200936
|
To examine the sociodemographic and clinical characteristics of a sample of 144 suicide attempters in an emergency clinic for suicide attempts. |
Female sex: 75% Low educational level (p = 0.05) Low religious orientation (p = 0.02) |
Suicide attempts were more frequent among internal immigrant women with a low educational level and low religious orientation; the main method was drug overdose, and the main cause, depression due to conflict within the family. |
Low educational level was a risk factor of attempted suicides. No control group. |
| Payne et al., 200937 |
To identify factors that influence hospital readmission due to self-poisoning. |
Risk factors for readmission: Previous psychiatric hospital admission (OR 2.85, p < 0.01) Personality disorder (OR 4.59, p < 0.01) Increased deprivation (quintile 3: OR 1.6, p < 0.01; quintile 5: OR 1.15, p < 0.01, compared with quintile 1) Taking medicines for chronic disease, drug dependency (OR 1.6 and 1.19, p 0.02) Medication dependency (OR 1.6 and 1.19, p 0.02) Use of antidepressants (compared with paracetamol) (OR 1.11, p = 0.01) Coingestion of three or more agents (OR 1.37, p < 0.01) |
Younger age, greater deprivation (quintile), ingestion of certain groups of drugs or multiple drug types and previous hospital admission were risk factors for readmission due to self-poisoning. |
The study did not provide an analysis of the effects of drug dependency on readmission rates, a factor that has been associated with recurrent self-harm. Study did not evaluate suicide intent. |
| Carter et al., 200738 |
To determine whether similar social and psychiatric factors are associated with suicide attempts in community and clinical settings, and whether magnitude of effect is greater in clinical populations. |
Male individuals in the community: Anxiety disorder (OR = 3.30) Substance use disorders (OR = 2.88) Current unemployment (OR = 1.98) Female individuals in the community: Affective disorder (OR = 1.52) Anxiety disorder (OR = 3.13) Substance use disorders (OR = 2.44) Personality disorder (OR = 2.41) Current unemployment (OR = 1.40) Male patients in clinical setting: Affective disorder (OR = 16.23) Anxiety disorder (OR = 3.82) Substance use disorders (OR = 3.01) Current unemployment (OR = 4.42) Female individuals in clinical setting: Affective disorder (OR = 7.48) Anxiety disorder (OR = 3.67) Substance use disorders (OR = 6.88) Personality disorder (OR = 1.92) Current unemployment (OR = 3.70) |
Magnitude of risk factors among clinical cases was equal to or greater than that among community cases. |
The study suggests that public health interventions should be aimed at modifiable psychosocial factors, such as education, income and psychiatric treatment. |
| Kapur et al., 20064 |
To determine the proportion of individuals that repeated suicide attempt within 12 months, to investigate timing of repetition and risk factors associated with repetition and their population impact. |
Age > 54 years (p < 0.01) Widowed (p < 0.01) Current psychiatric treatment (p < 0.01) Psychiatric treatment more than 12 months before (p < 0.01) Alcohol use (p < 0.01) Childhood abuse (p < 0.01) Problems in relationships with friends (p < 0.01) Response to mental problems (p < 0.01) Index episode (premeditation) (p < 0.01) Attempt method (presence and suicidal behavior) (drowning or asphyxiation) (p < 0.01) |
Risk factors for repetition of suicide attempt were psychiatric treatment, being unemployed or registered sick, self-injury, alcohol misuse and reporting suicidal plans or hallucinations at the time of index episode. The combined population attributable fraction (an indicator of the potential population impact) for these variables was 65%. |
Study was part of the Manchester and Saltford Self-Harm Project (MASSH) of the University of Manchester. Study did not evaluate suicidal intent; Not all cases of repetition were included (patients seen in other hospitals); “Suicidal behavior” equal to “self-harm”, both defined as an “act of intentional self-poisoning or injury irrespective of the apparent purpose of the act.” This definition is similar to the terms “attempted suicide” and “parasuicide” used in several countries. |
| Carter et al., 200639
|
To describe risk factors of referral to psychiatric hospitalization after hospitalization in general hospital due to self-poisoning in an Australian sample. |
Age 25-34 (1.61:1.22-2.14) and 35 years or older (1.94:1.44-2.59) Divorced or separated (0.60:0.46-78) High school education (1.31:0.74-2.32) Homelessness (3.29:1.82-5.03) Unemployment (1.39:1.04-1.86) Self-injury (1.35:1.11-1.65) Psychiatric hospitalization within 12 months (2.63:2.06-3.35) Previous psychiatric treatment (1.92:1.54-2.40) Low to moderate suicidal ideation (4.97:3.83-6.43) Suicidal planning (39.72: 29.05-54.33) Mood disorders (2.22:1.69-2.92) Adjustment disorder (0.83: 0.49-1.41) Other attention disorders (0.85: 0.67-1.01) Schizophrenia and other psychotic disorders (4.68:3.00-7.30) |
Psychiatric hospitalization referral after a suicide attempt is a complex decision that should take into consideration ideation, planning, psychiatric history and sociodemographic variables. |
Analysis in a single geographic area; No structured instruments to evaluate ideation, planning and mental disorder. |
| Alaghehbandan et al., 200540 |
To examine epidemiology and factors associated with suicide attempts requiring hospitalization in the province of Newfoundland and Labrador. |
Female sex when individuals in Labrador were compared with those in Newfoundland (p < 0.001) Younger age (15-24 years) when individuals in Labrador were compared with those in the island portion of the province (teen or young adult) (p < 0.001) Single status (p < 0.001) Less than 12 years of education (p < 0.001) Suicide attempt rates among single individuals in Labrador was higher than in Newfoundland (p – 0.001) Greater rates of mental disorder in Newfoundland (p < 0.001) Lower mean age at time of attempt in Labrador than in Newfoundland (p < 0.01) Women in Labrador were younger than in Newfoundland (p < 0.01) Both men and women were significantly younger in Labrador than in Newfoundland (p < 0.001) |
Differences between suicide attempt rates in Newfoundland and Labrador probably reflect social, economic and cultural factors that cannot be fully evaluated in studies using secondary data. |
Comparison between two samples (city and province). |
| Ichimura et al., 200541 |
To clarify characteristics of depression and measures to prevent suicide due to depression in comparison with other mental disorders. |
Mean age between groups: 49.2 vs. 33.2 (p < 0.001) Female sex between groups: (p < 0.001) Divorce between groups: (p < 0.01) Other attempt methods: (p < 0.01) Less severe physical injury between groups: (p < 0.01) Older patients: (p < 0.001) Odds: 0.953 (0.933-0.934); Married or cohabiting: (p < 0.004) Odds: 0.351 (0.173-0.714) Methods other than poisoning: (p < 0.007) Odds: 0.161(0.043-0.601) |
In this study, risk factors of patients with depression were different from those of patients that attempted suicide and similar to those of individuals that committed suicide. |
Data analyzed in a single hospital; No semi-structured interviews were used to diagnose suicide attempts; No firm criterion to define injury severity. |
| Fekete et al., 200542 |
To determine differences of suicidal behavior between sexes and investigate factors associated with suicide attempts. |
Female sex characterized by: Retired or economically inactive (OR = 2.38) Widowed (OR = 6.55) Divorced (OR = 1.64) Depression in personal history (OR = 1.27) |
There are significant differences in risk factors of suicide attempts between men and women. These factors should be taken into consideration in treatment and prevention. |
Data only from patients that received medication, and inclusion of patients with more than one attempt. |
| Douglas et al., 200443 |
To describe clinical and demographic characteristics of near-fatal suicide attempts (NFDSH); To determine whether age and sex profile of NFDSH cases is similar to that of cases of suicide; To describe clinical evaluation of NFDSH group; To collect data about individuals in the NFDSH group, including their views on prevention. |
Risk factors in both groups: Not married: Odds: 1.63 (1.04-2.54) Wanted to die: Odds: 2.11 (1.40-3.18) Previous psychiatric treatment: Odds: 11.70 (1.17-2.46) Previous self-harm: Odds: 1.82 (1.24-2.66) Feeling depressed: Odds: 2.24 (1.36-3.68) Eating disorders: Odds: 1.69 (1.16-2.47) |
NFDSH cases are important clinical phenomena associated with indicators of high risk of suicide. Their study may contribute to suicide prevention. |
Clinical conditions of patients prevented further questioning; NFDSH definition was based on initial evaluations; Other NFDSH definitions may be used. Suicidal intent was not evaluated. Cases of overdose, if excluded, might have changed results. |
| Carter et al., 200344
|
To explore the differences between a clinical sample of deliberate self-poisoning patients and a community sample that reported previous suicide attempts. To examine correlates of suicidal behavior in these groups compared with a community control group (CC) with no suicidal behavior. |
In the clinical group: Female sex (OR = 5.7; CI = 1.7-19.4) Anxiety (OR = 7.4; CI = 2.2-25.1) Affective disorder (OR = 23.0; CI = 6.9-76.5) Substance use disorders (OR = 19.2; CI = 5.6-65.4) Mental health related disability (OR = 0.5; CI = 0.3-0.7) In the community group: Anxiety (OR = 9.4; CI = 1.7-52.8) Substance use disorders (OR = 3.0; CI = 1.1-8.7) Mental health related disability (OR = 0.5; CI = 0.4-0.7) Affective disorder (OR = 4.0; CI = 0.9-17.1) |
Correlates of deliberate self-poisoning were usually more powerful in the clinical group, but had a similar pattern of psychiatric disorders and disability factors in both groups. |
This study stresses the importance of analysis of modifiable risk factors and interventions based on them According to authors, main limitation was the memory bias in the group that attempted suicide at any time in life. |
