1. 1. To assess how nurses evaluate their abilities to communicate to individuals who attempted suicide.

2. 2. To ascertain the attitude of nurses to the importance of the influence of communication with patients to their social rehabilitation.

3. 3. To determine, what kind of help nurses would appreciate to improve communication with patients with attempted suicide.

Original survey questionnaire, data analysis. Sample was selected by means of nonprobability - simple sampling method.

Study included a total number of 64 nurses working at the Hospital of Kaunas University of Medicine. Most of nurses evaluate their communication with suicidal individuals as positive: 80 percent believe they listen closely to their patients, 69 percent believe they pay enough attention, 69 percent talk to patients about their problems. 66 percent of nurses report the lack of information about psychological characteristics of suicidal patients, and 48 percent refer to the lack of experience in communication with such patients as the greatest problems in communication with individuals with attempted suicide. Also 52 percent emphasize lack of time and 34 percent mention reluctance of doctors to cooperate. 66 percent of nurses would like to undergo training containing these topics during lectures and seminars.

1. 1. Majority of nurses precisely determine suicide itself, however, causes of suicide are not so obvious.

2. 2. It is necessary to keep ongoing training of nursing staff on the topics of suicide prevention, treatment and rehabilitation.

The literature on suicidal behaviour among immigrants is scarce and little has been written from a comparative perspective.

The aim was to investigate whether suicide attempts are more common among immigrants than among their hosts, to map the differences between different immigrant groupings, and to analyse whether suicidal behaviours among immigrants and the populations of their countries of origin are related.

Data on suicide attempts (27,000 person-cases) originated from the WHO/EURO Multicentre Study on Suicidal Behaviour. Suicide attempt rates were calculated for each group. The immigrant groups were compared at each Center and across Centers. The completed-suicide rates of the home countries were compared to attempted-suicide rates in the immigrant groups using rank correlations.

Twenty-seven of the 56 immigrant groups showed significantly higher suicide attempt rates than their hosts. Also, they tended to have similar rates across different Centers. There was a significant correlation between the country-of-origin suicide rate and the immigrant-group suicide attempt rate among those born there. However, Chileans, Iranians, Moroccans and Turks displayed high suicide-attempt rates as immigrants despite low suicide rates in the home countries.

The similarity of the groups’ rates across Centers, and that of the suicidal behaviour in the countries of origin and among immigrants suggests strong continuity, which may be interpreted in cultural or genetic terms. The generally higher rates among immigrants in each Center and across Centers point to the influence of acculturative factors. Additional investigation into the specific characteristics of immigrant suicide attempters is needed.

interconsultation mode of observation from the emergency service is a subtype of demand related in large part with suicide attempts. the initial priority is to ensure the absence of organic complications resulting from suicide attempts, so it is usual in the course of 24 hours is appropriate to the request for psychiatric assessment

description of demographic and clinical profile associated with suicide attempts treated in the emergency department

are selected interconsultations motivated suicide attempts over 4 consecutive months in the emergency department of a tertiary hospital. the results were analyzed using SPSS 14

is selected from all those applications that relate to suicide attempts, resulting in a sample of 48 patients. the percentage of sex femininity is 73% and the average age is 38 years. respect to outstanding personal psychiatric history of affective disorders with 74%, substance abuse accounts for 37% and 10% psychotic history. 52% had made previous suicide attempts of low lethality and in 6% serious previous attempts. regarding the method used highlights with a 57% intake of drugs and second toxic and ingestion of alcohol and drugs.

evidenced a higher prevalence in female suicide attempts and low lethality, both of previous attempts like those presented today. only 10% of cases, held an admission to a psychiatric inpatient unit. the relationship with affective disorders, as well as with substance abuse is widely recognized in the literature

Around thirty of cases of public self-immolation occurred in Czechoslovakia, Poland and Lithuania between 1968 and 1972 in the background of protest movement against the Soviet ledinvasion. Rather than an act of a political protest, in a moment of absurdity of the existence, or a rational solution aimed to finish a desperate life situation, could a self-immolation also testify a suicidal behaviour and a failure of adaptation mechanisms of the victims concomitant a mental disorder?

We have selected and studied four most mediated cases of this period. Press articles available in English, French and Czech, biographical writings and czech archived data concerning Palach J. R. Kalanta, J. Zajic and R. Siwiec allowed us to retrospectively analyse the circumstances of the acting out, their apparent or hidden motivations and identify their suicidal risk factors.

All the four victims were men, young single students, aged between 18 and 21 years, excepted from R. Siwiec, aged 60 years. None had a psychiatric history or abuse of alcohol. All four, in the opposition of the communist system, were surrounded by a supporting family background. The public character of their act highlights the opposition against a totalitarian system and is questionning the possible intentionality of their behavior or the identification process of the young adults in post-adolescence.

Immolation by fire of Soviet opponents in Central Europe should be revised in the light of the likely depression and narcissistic vulnerabilities of these subjects.

Due to the inresed rate of depression and suicide the problem of correlation between suicidal behavior and symptoms of agitated depression became extremly important. In outpatient settings health professionals tend to underestimate clinical features indicated the increased suicide risk in patients with agitated depression. Inaccurate diagnosis and treatment plan frequently are suggested. Furthermore, agitated depression may occur in healthy person without previous psychiatric history, who has never applied to psychiatrist.In our study we aimed to verify the clinical features of agitated depression, which intensify suicidal trends leading to completed suicide.

From 477 patients with agitated depression we selected 126, who presented high risk of suicide and studded them by using Mood Anxiety Inventory (Greenberger D, Padesky CA (1995). Mind Over Mood. New York: Guildford Press).

On the bases of the structural-dynamic analyses we determine seven clinical variations of agitated-depression with prominent affective, cognitive, psychomotor, somato-algetic and behavioral symptoms.

The most dangerous types with regards of suicidal behavior appeared to be senesthopathic and algetic types and agitated depression with depersonalization and derealization.

Suicide remains the most severe emergency in every psychiatric disorder.

After evaluating the frequency of suicide among patients followed from 1-1-2004 to 31-12-2005 by the Mental Health Service of Modena Centro, we statistically analyzed socio-demographic and clinical data of suicide patients (n=25).

Among psychiatric population followed by our psychiatric service in the observation period, suicide occurred in the 0.15% of all patients (25/16392) and represented the third cause of death, after cardiovascular disorders and neoplasia. The median age of suicide patients was 42 years for male and 50 years for women, with a ratio male/female of 1.8:1. “Depressive Disorders” followed by “Schizophrenia and other Psychotic Disorders” represented the prevalent psychiatric diagnosis with a statistically significant correlation to suicide death cause (p< 0.005; Chi square test). The suicide patients had being treated for more than one year by psychiatric service (685 days, median) and 10 % of them was hospitalized in a psychiatric ward during the observation period. Suicide occurred after 73 days (median) from last psychiatric discharge and 12 days (median) from last psychiatric consultation.

Our data confirmed the literature: suicide is more frequent in young male affected by Depressive Disorders or Schizophrenia and other Psychotic Disorders1. We have to conclude pessimistically about our preventive capacity since suicide occurred in patients already hospitalized and treated for a long period and after a short period from the last psychiatric intervention.

The aim of this study was to investigate the relationship between suicidal behavior and hypothalamic-pituitary thyroid (HPT) axis activity in depressed patients.

The serum levels of thyrotropin (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) were evaluated before and after 8 AM and 11 PM TRH challenges, on the same day, in 95 medicationfree DSM-IV euthyroid major depressed inpatients and 44 healthy hospitalized controls

Compared to controls:

1. 1) patients with a positive suicide history (PSH; n=53) showed lower basal FT4 (at 8AM: p< 0.005; at 11PM: p< 0.03), but normal FT3 levels, while patients with a negative suicide history (NSH; n=42) showed normal FT4 and FT3 levels;

2. 2) TSH responses to TRH (delta TSH) were blunted in NSHs (at 8 AM: p< 0.03; at 11PM: p< 0.00001), but not in PSHs.

Compared to NSHs, basal FT4 levels were reduced in PSHs (at 8AM: p< 0.002; at 11PM: p< 0.006). HPT parameters were not significantly different between recent suicide attempters (RSA; n=32) and past suicide attempters (PSA; n=21). However, compared to controls, RSAs showed lower 11PM-deltaTSH (p< 0.04) and lower basal FT4 values (at 8AM: p< 0.002; at 11PM: p< 0.008).

Our results indicate that various degrees of HPT axis dysregulation are associated with the history of suicide. In NSHs, one may hypothesize that hypersecretion of hypothalamic TRH (as reflected by decreased TRH receptor responsiveness) represents a compensatory mechanism to maintain normal thyroid hormone secretion. In PSHs this mechanism is ineffective.

Russia has one of the highest suicidal ratings in the world. Mental patients form the absolute majority both in suicidal attempts and consummated suicides.

448 cases of mental patients with suicidal attempts in the period 1991-2001, who received medical care in St. Petersburg district outpatient clinic were studied.

The amount of suicidal patients among all mental outpatients was 4.9%. Male/female ratio was 1 : 1,6. Suicidal patients were diagnosed as schizophrenia (F2 -55.6%) and delusional disorders (F22 - 4.5%), affective disorders (F3 - 16.5%), organic disorders (F07.8 - 18.8%), personality disorders (F60 - 4.5%). Mean age for males was significantly lower (31.4) compared to females (36.6). The tendency of decrease in suicide mean age (4.1 year) was obtained during the period of 1990-2001. The preponderate mode of suicide in females was self-poisoning (82,7%); in males preponderate modes were self-injuring (50,6%) and self-poisoning (45,9%). The duration of mental disorder in our study was higher (mean 10.3 years), compared to previous data. Maximum of suicidal attempts (20%) was registered in 1997-96. Less number of registered suicidal attempts after 1997 may be explained by the loss of officially registered mental patients including firstly registered in the outpatient service. The role of risk factors such as mental disorder heredity, suicidal attempts in relatives, loneliness, and alcohol abuse was elucidated.

Antisuicidal programs in outpatient care should include introduction of suicide risk ratings together with mental patient compliance improvement.

Suicide is one of the most frequent causes of death. In 1993, Bleuler emphasized its importance in his “Suicidal behavior is the most serious symptom of schizophrenia”. Since then, various studies have confirmed importance of suicide in schizophrenia, and today it's clear that his research and knowledge is one of the great challenges of psychiatry.

1. - Establish clinical-socio-demographic profile and risk factors for psychotic people with autolytic behaviors.

2. - Determine frequency of suicides in psychotic disorders in our area of care.

Retrospective study(3 years evolution) that includes psychotic patients(diagnosed according DSM IV-TR) admitted to the HCU of Valladolid. With data provided by hospital medical records, analyzed socio-demographic variables and clinics. Study consists of two groups:group of cases(those patients who have suicidal behavior) and control group (those that haven't autolytic gesture during the study period). Statistical evaluation was performed with SPSS.

1. - The sample includes 191 patients:41(21%) have attempted suicide.

2. - Of them:73% are males;88% singles;51% have basic studies;61% we re unemployed;37% were 31-40 aged;54% started disease 21-30 aged and 63.5% are schizophrenic.

3. - Considering statistical study we find that suicidal patient profile is male(p = 0.039),diagnosed with schizophrenia(p = 0.033),with previous suicide attempts(p = 0.009)and lack of social support(p = 0.007).

:

1. - 21% of hospitalized psychotic patients have presented some autolytic attempt.

2. - Profile of suicidal psychotic patient is a male, single, 21-40 aged, primary education, unemployed, with a primary diagnosis of schizophrenia, particularly paranoid, with ten years evolution,without acceptable social support, number of revenues higher than non-suicidal psychotic and a personal history of previous autolytic attempts.

Low serum cholesterol has been linked to suicide and violent behaviour. The same kind of associations has been reported regarding low levels of 5-hydroxyindolacetic acid (5-HIAA) in the cerebrospinal fluid (CSF) and suicidal behaviour. The hypothesis of the link between serum cholesterol and suicide incorporate serotonin. It proposes that low cholesterol is related to reduced serotonergic neurotransmission, which in turn, is linked to violent and suicidal behaviour. A correlation between CSF 5-HIAA and serum cholesterol has been shown in animal-studies, but has not been found in humans.

To study the interrelationship between serum cholesterol and CSF 5-HIAA in suicide attempters. Since both cholesterol and CSF 5-HIAA are associated with suicide and violent suicide-attempts, we also investigated the correlation with suicide, violent suicide attempt method, suicide intent, hopelessness and depression severity.

Serum total cholesterol and CSF 5-HIAA was measured in 42 medication free suicide attempters. Patients were assessed with Becks‘s Hopelessness scale (BHS), Suicide Intent Scale (SIS) and Montgomery-Åsberg depression rating scale (MADRS) and followed-up for causes of death.

Serum total cholesterol and CSF 5-HIAA showed a significant positive correlation adjusted for age, body mass index and substance abuse diagnosis. Cholesterol and CSF 5-HIAA levels did not differ between violent and non-violent suicide attempters or between suicide completers and survivors.

These findings indicate that the serotonergic system may be connected to serum cholesterol in patients with a recent suicide attempt.

Paracetamol is one of the most frequently used drugs in intentional overdoses. Countries that limit the quantity of paracetamol available in a single purchase generally report lower rates of paracetamol related morbidity and mortality.

To determine the socio-demographic characteristics of those who intentionally overdosed on paracetamol and associated psychiatric illness (identifying high-risk groups).

To improve mental health care delivery and propose a restriction of pack sizes of paracetamol in a single purchase.

This study was a retrospective, descriptive analysis study. Cases of parasuicide in the year 2008 were identified through our database and their case notes studied by completing questionnaires pertaining to details of the act.

Of the 437 cases of parasuicide, 195 cases overdosed on paracetamol (44.6%). Indians made up 41.0% of cases, followed by Malays (31.8%) and Chinese (20.5%). Of the Malays, 63.3% overdosed on paracetamol, compared with other means of parasuicide. 72.8% of those who overdosed with paracetamol were female, 54.4% were single and 69.7% purchased paracetamol over the counter. With increasing age, the incidence of paracetamol overdose declines, being highest (55.2%) in the age group 16-25. Of those who overdosed on paracetamol, 46.2% had a diagnosis of adjustment disorder, 26.2% of acute stress reaction and 21.0% of depression. 42.1% of them had a history of paracetamol overdose.

Paracetamol continues to be commonly used in parasuicides. Legislation restricting pack sizes of paracetamol in a single purchase is the most pragmatic means of reducing paracetamol related parasuicides and suicides.

Suicide is a serious phenomenon associated with psychiatric disorders.

In the present study, we investigated factors that can predict follow-up at the psychiatric clinic after medical care at the emergency room (ER).

Medical records of the 145 patients treated at the ER following suicide attempt from Jan 1, 2009 to July 31, 2009 were reviewed. Age, sex, past psychiatric history, impulsiveness and medical severity of suicide attempt, risk-rescue rating scores, reasons for suicide attempt and methods of suicide were examined. Psychiatric diagnoses were made by psychiatrists at the initial interview with patients at ER.

The mean age of the patients was 42.9 ± 15.7 years, and 68.3 % were women and 31.7% were men. Among the suicide methods, psychotropics were the most common (69%), and ingestion of pesticides was the second (19.3%). Interpersonal problems were the most common precipitating event (57.9%), and depression was the most common (89%). About a half had previous psychiatric disorders and about one third had previous suicide attempt. Fifteen patients (10.3%) attempted planned suicide and 124 patients (85.5%) attempted impulsively. Mean risk and rescue rating scores was 8.6 ±1.6 and 12.3 ± 2.2. About one third had a follow-up psychiatric visit. The most important predictor of psychiatric follow-up was risk rating scores.

This study suggests that women with interpersonal problems and depression should be carefully monitored to reduce suicide attempt. Patients commit less risky suicide attempts tend to more loss to psychiatric follow-up, thus, need more attention to prevent suicide re-attempts.

To examine associations between current diagnostic profile, suicidal intent, functional impairment and history of deliberate self harm (DSH) and life events among patients admitted to a general hospital after an act of attempted suicide.

Participants (n = 86) were patients consecutively admitted to a general hospital emergency care unit over the inclusion period of 26 months after an act of attempted suicide. They were interviewed within 2 days using the EPSIS protocol, the MINI and SCID-II interviews and a range of scales measuring life events (Brugha's scale), depression (MADRS), alcohol abuse (AUDIT), substance abuse (DAST), suicidal intent (SIS) and functioning levels (GAF). Simple regression analyses (linear and logistic) and t-tests were used in data analyses.

Men [4.9(2.6)] reported significantly more life events than women [3.6(2.0)], t(47.7) = 2.2, p < .05. Functional impairment was inversely associated with the number of life events among men, explaining more than 25% of the variance, F = 10.2(1, 28), p < .01. Number of life events was not associated with any diagnostic group, mean scores of depression severity, alcohol abuse, substance abuse, suicidal intent or with a history of an act of DSH.

Not only did men report more life events, their functioning was also affected by number of life events, indicating vulnerability to psychosocial aspects beyond psychological or psychiatric aspects in men admitted to a general hospital after attempted suicide.

Depression is among the most prevalent psychiatric conditions in general population. Previous reports established a link between suicidal attempts and major depressive disorder (MDD). There is a large number of risk factors which can participate in suicidal behavior. Many studies showed the role of personality dimensions such as borderline personality dimensions risk factors of suicidal behavior. The aim of this study was to assess dimensions of personality in inpatients who were hospitalized after suicidal attempt.

The sample consisted of sixty inpatients with MDD diagnosed with ICD X. There were thirty patients with suicidal attempt and thirty with no history of suicidal attempts. The assessment of personality dimensions was carried out by the Millon Clinical Multiaxial Inventory III (MCMI III).

Our findings have shown that borderline and masochistic dimensions were more frequently present in the group of patients with suicidal attempts. Compulsive dimensions were more present in the group of patients with no history of suicidal attempt.

Borderline personality dimensions with underlying impulsivity and low level of self-confidence might be potential risk factor for suicidal behavior, while the patients with a rigid system of organization and conscientiousness are less prone to suicidal behavior. Assessing personality dimensions is recommended in the process of psychodiagnostics and might be useful in preventive interventions.