ABSTRACT
Objectives:
Suicides are the second most common cause of death between the ages of 15-29. Suicide rates vary according to the sociodemographic, clinical, and psychological factors. Since it is an important mental health problem in our country, it is planned to investigate suicide attempts and relevant factors in Batman province retrospectively.
Materials and Methods:
As part of this study, forensic files of suicide attempt between the years of 2013 and 2018 were reached, and clinical interviews were conducted with 88 cases who attempted suicide. Sociodemographic information, risk factors and features related to suicide attempt were obtained. The information obtained was evaluated according to gender and suicide risk level.
Results:
The average age of suicide is 17.3±2.3 years. 73.9% of the cases were female and 26.1% were male. The most frequently used method in both sexes and at all suicide risk levels was determined as high dose drug intake. The history of get involved in crime and physical causes were found to be significantly higher in males. When the suicide was evaluated according to the risk level, pre-suicidal depressive mood, alcohol substance use, and physical and psychological causes were significantly lower in the mild risk group.
Conclusion:
In our study, the fact that suicide attempts are seen more frequently in girls and that most of the patients under the age of 18 do not attend school and those who are over the age of 18 do not work to a large extent give an important idea in terms of risk factors related to suicide attempt. Alcohol use, presence of perceived support, physical diseases are important factors for more serious attempts.
References
1
World Health Organization. Suicide. 2019. [https://www.who.int/news-room/fact-sheets/detail/suicide, cited: 01.04.2020]
2
Türkiye İstatistik Kurumu. İntihar İstatistikleri, 2015. [www.tuik.gov.tr. 2016;21516. cited: 01.04.2020]
3
Turecki G, Brent DA. Suicide and suicidal behaviour. Lancet. 2016;387:1227-1239.
4
Parellada M, Saiz P, Moreno D, Vidal J, Llorente C, Alvarez M, García-Portilla P, Ruiz-Sancho A, Arango C, Bobes J. Is attempted suicide different in adolescent and adults? Psychiatry Res. 2008;157:131-137.
5
Goldston DB, Daniel SS, Erkanli A, Reboussin BA, Mayfield A, Frazier PH, Treadway SL. Psychiatric diagnoses as contemporaneous risk factors for suicide attempts among adolescents and young adults: developmental changes. J Consult Clin Psychol. 2009;77:281-290.
6
Arria AM, O’Grady KE, Caldeira KM, Vincent KB, Wilcox HC, Wish ED. Suicide Ideation Among College Students: A Multivariate Analysis. Arch Suicide Res. 2009;13:230-246.
7
Birmaher B, Brent D; AACAP Work Group on Quality Issues; Bernet W, Bukstein O, Walter H, Benson RS, Chrisman A, Farchione T, Greenhill L, Hamilton J, Keable H, Kinlan J, Schoettle U, Stock S, Ptakowski KK, Medicus J. Practice parameter for the assessment and treatment of children and adolescents with depressive disorders. J Am Acad Child Adolesc Psychiatry. 2007;46:1503-1526.
8
Carballo JJ, Llorente C, Kehrmann L, Flamarique I, Zuddas A, Purper-Ouakil D, Hoekstra PJ, Coghill D, Schulze UME, Dittmann RW, Buitelaar JK, Castro-Fornieles J, Lievesley K, Santosh P, Arango C; STOP Consortium. Psychosocial risk factors for suicidality in children and adolescents. Eur Child Adolesc Psychiatry. 2020;29:759-776.
9
Ercan S, Aksoy ŞM, Yalçın A, Şimşek AÇ, Acar SR, Erçin Şahin T. Socio-Demographical and Clinical Characteristic of Suicide Cases That Admitted to Emergency Services in Ankara. JCBPR. 2016;5:5-12.
10
Tel H, Uzun S. Social support and coping with stress in patients who were accepted to the emergency room with the suicide. Anadolu Psikiyatr Derg. 2003;4:151-158.
11
Aktepe E, Kandil S, Göker Z, Sarp K, Topbaş M, Özkorumak E. Sociodemographic features of child and adolescents admitted to Karadeniz Technical University Medical Faculty child outpatient clinic with suicide attempt. TAF Prev Med Bull. 2006;5:444-454.
12
Devrimci-Ozguven H, Sayıl I. Suicide attempts in Turkey: results of the WHO—EURO multicentre study on suicidal behaviour. Can J Psychiatry. 2003;48:324-329.
13
Chu C, Klein KM, Buchman-Schmitt JM, Hom MA, Hagan CR, Joiner TE. Routinized Assessment of Suicide Risk in Clinical Practice: An Empirically Informed Update. J Clin Psychol. 2015;71:1186-1200.
14
Wunderlich U, Bronisch T, Wittchen HU, Carter R. Gender differences in adolescents and young adults with suicidal behaviour. Acta Psychiatr Scand. 2001;104:332-339.
15
Eaton DK, Kann L, Kinchen S, Shanklin S, Flint KH, Hawkins J, Harris WA, Lowry R, McManus T, Chyen D, Whittle L, Lim C, Wechsler H; Centers for Disease Control and Prevention (CDC). Youth risk behavior surveillance - United States, 2011. MMWR Surveill Summ. 2012;61:1-162.
16
Akin E, Berkem M. İntihar Girişiminde Bulunan Ergenlerde Psikiyatrik Tanıların, Demografik ve Klinik Özelliklerin Değerlendirilmesi. 2012;17:228-232.
17
Oquendo MA, Bongiovi-Garcia ME, Galfalvy H, Goldberg PH, Grunebaum MF, Burke AK, Mann JJ. Sex differences in clinical predictors of suicidal acts after major depression: a prospective study. Am J Psychiatry. 2007;164:134-141.
18
Arsenault-Lapierre G, Kim C, Turecki G. Psychiatric diagnoses in 3275 suicides: a meta-analysis. BMC Psychiatry. 2004;4:37.
19
Hawton K, van Heeringen K. Suicide. Lancet. 2009;373:1372-1381.
20
Schrijvers DL, Bollen J, Sabbe BGC. The gender paradox in suicidal behavior and its impact on the suicidal process. J Affect Disord. 2012;138:19-26.
21
Rossow I, Ystgaard M, Hawton K, Madge N, van Heeringen K, de Wilde EJ, DeLeo D, Fekete S, Morey C. Cross-national comparisons of the association between alcohol consumption and deliberate self-harm in adolescents. Suicide Life Threat Behav. 2007;37:605-615.
22
Brent DA, Emslie GJ, Clarke GN, Asarnow J, Spirito A, Ritz L, Vitiello B, Iyengar S, Birmaher B, Ryan ND, Zelazny J, Onorato M, Kennard B, Mayes TL, Debar LL, McCracken JT, Strober M, Suddath R, Leonard H, Porta G, Keller MB. Predictors of spontaneous and systematically assessed suicidal adverse events in the treatment of SSRI-resistant depression in adolescents (TORDIA) study. Am J Psychiatry. 2009;166:418-426.
23
King RA, Schwab-Stone M, Flisher AJ, Greenwald S, Kramer RA, Goodman SH, Lahey BB, Shaffer D, Gould MS. Psychosocial and risk behavior correlates of youth suicide attempts and suicidal ideation. J Am Acad Child Adolesc Psychiatry. 2001;40:837-846.
24
Çiçek İE. Death Anxiety and Suicidal Ideation in Patients with Alcohol Use Disorder. Bağımlılık Dergisi. 2021;22:413-420.
25
Grøholt B, Ekeberg Ø, Wichstrom L, Haldorsen T. Youth suicide in Norway, 1990–1992: A comparison between children and adolescents completing suicide and age‐and gender‐matched controls. Suicide Life Threatening Behav. 1997;27:250-263.
26
Hawton K, Fagg J, McKeown SP. Alcoholism, alcohol and attempted suicide. Alcohol Alcohol. 1989;24:3-9.
27
Ramstedt M. Alcohol and suicide in 14 European countries. Addiction. 2001;96:59-75.
28
Pirkola SP, Marttunen MJ, Henriksson MM, IsometsÄ ET, Heikkinen ME, Lönnqvist JK. Alcohol-related problems among adolescent suicides in Finland. Alcohol Alcohol. 1999;34:320-329.
29
Bruffaerts R, Demyttenaere K, Borges G, Haro JM, Chiu WT, Hwang I, Karam EG, Kessler RC, Sampson N, Alonso J, Andrade LH, Angermeyer M, Benjet C, Bromet E, de Girolamo G, de Graaf R, Florescu S, Gureje O, Horiguchi I, Hu C, Kovess V, Levinson D, Posada-Villa J, Sagar R, Scott K, Tsang A, Vassilev SM, Williams DR, Nock MK. Childhood adversities as risk factors for onset and persistence of suicidal behaviour. Br J Psychiatry. 2010;197:20-27.
30
Bearman PS, Moody J. Suicide and friendships among American adolescents. Am J Public Health. 2004;94:89-95.
31
Brent DA, Bridge J, Johnson BA, Connolly J. Suicidal behavior runs in families. A controlled family study of adolescent suicide victims. Arch Gen Psychiatry. 1996;53:1145-1152.
32
Christiansen E, Goldney RD, Beautrai AL, Agerbo E. Youth suicide attempts and the dose–response relationship to parental risk factors: a population-based study. Psychol Med. 2011;41:313-319.
33
Pelkonen M, Marttunen M. Child and adolescent suicide: epidemiology, risk factors, and approaches to prevention. Paediatr Drugs. 2003;5:243-265.
34
Hedeland RL, Teilmann G, Jørgensen MH, Thiesen LR, Andersen J; Study-Associated Pediatric Departments. Risk factors and characteristics of suicide attempts among 381 suicidal adolescents. Acta Paediatr. 2016;105:1231-1238.
35
Velting DM, Gould MS. Suicide contagion. In: Maris RW, Silverman MM, Canetto SS, eds. Review of suicidology. New York: Guilford Press; 1997:96-137.
36
Abrutyn S, Mueller AS. Are suicidal behaviors contagious in adolescence? Using longitudinal data to examine suicide suggestion. Am Sociol Rev. 2014;79:211-227.
37
Baller RD, Richardson KK. The “dark side” of the strength of weak ties: The diffusion of suicidal thoughts. J Health Soc Behav. 2009;50:261-276.
38
Miklin S, Mueller AS, Abrutyn S, Ordonez K. What does it mean to be exposed to suicide?: Suicide exposure, suicide risk, and the importance of meaning-making. Soc Sci Med. 2019;233:21-27.
39
Spann M, Molock SD, Barksdale C, Matlin S, Puri R. Suicide and African American teenagers: Risk factors and coping mechanisms. Suicide life-threatening Behav. 2006;36:553-568.
40
Vitiello B, Brent DA, Greenhill LL, Emslie G, Wells K, Walkup JT, Stanley B, Bukstein O, Kennard BD, Compton S, Coffey B, Cwik MF, Posner K, Wagner A, March JS, Riddle M, Goldstein T, Curry J, Capasso L, Mayes T, Shen S, Gugga SS, Turner JB, Barnett S, Zelazny J. Depressive symptoms and clinical status during the Treatment of Adolescent Suicide Attempters (TASA) Study. J Am Acad Child Adolesc Psychiatry. 2009;48:997-1004.
41
Vitiello B, Silva SG, Rohde P, Kratochvil CJ, Kennard BD, Reinecke MA, Mayes TL, Posner K, May DE, March JS. Suicidal events in the Treatment for Adolescents With Depression Study (TADS). J Clin Psychiatry. 2009;70:741-747.
42
Asarnow JR, Baraff LJ, Berk M, Grob C, Devich-Navarro M, Suddath R, Piacentini J, Tang L. Pediatric emergency department suicidal patients: two-site evaluation of suicide ideators, single attempters, and repeat attempters. J Am Acad Child Adolesc Psychiatry. 2008;47:958-966.
43
Zubrick SR, Hafekost J, Johnson SE, Sawyer MG, Patton G, Lawrence D. The continuity and duration of depression and its relationship to non-suicidal self-harm and suicidal ideation and behavior in adolescents 12–17. J Affect Disord. 2017;220:49-56.
44
Cheung YTD, Wong PWC, Lee AM, Lam TH, Fan YSS, Yip PSF. Non-suicidal self-injury and suicidal behavior: prevalence, co-occurrence, and correlates of suicide among adolescents in Hong Kong. Soc Psychiatry Psychiatr Epidemiol. 2013;48:1133-1144.
45
Cloutier P, Martin J, Kennedy A, Nixon MK, Muehlenkamp JJ. Characteristics and co-occurrence of adolescent non-suicidal self-injury and suicidal behaviours in pediatric emergency crisis services. J Youth Adolesc. 2010;39:259-269.
46
Nock MK, Joiner TEJ, Gordon KH, Lloyd-Richardson E, Prinstein MJ. Non-suicidal self-injury among adolescents: diagnostic correlates and relation to suicide attempts. Psychiatry Res. 2006;144:65-72.
47
Andover MS, Gibb BE. Non-suicidal self-injury, attempted suicide, and suicidal intent among psychiatric inpatients. Psychiatry Res. 2010;178:101-105.
48
Gorlyn M. Impulsivity in the prediction of suicidal behavior in adolescent populations. Int J Adolesc Med Health. 2005;17:205-209.
49
Horesh N. Self-report vs. computerized measures of impulsivity as a correlate of suicidal behavior. Crisis. 2001;22:27-31.
50
De Leo D, Cerin E, Spathonis K, Burgis S. Lifetime risk of suicide ideation and attempts in an Australian community: Prevalence, suicidal process, and help-seeking behaviour. J Affect Disord. 2005;86:215-224.
51
Husky MM, McGuire L, Flynn L, Chrostowski C, Olfson M. Correlates of help-seeking behavior among at-risk adolescents. Child Psychiatry Hum Dev. 2009;40:15-24.
52
Bruffaerts R, Demyttenaere K, Hwang I, Chiu WT, Sampson N, Kessler RC, Alonso J, Borges G, de Girolamo G, de Graaf R, Florescu S, Gureje O, Hu C, Karam EG, Kawakami N, Kostyuchenko S, Kovess-Masfety V, Lee S, Levinson D, Matschinger H, Posada-Villa J, Sagar R, Scott KM, Stein DJ, Tomov T, Viana MC, Nock MK. Treatment of suicidal people around the world. Br J Psychiatry. 2011;199:64-70.
53
Miller AB, Esposito-Smythers C, Leichtweis RN. Role of social support in adolescent suicidal ideation and suicide attempts. J Adolesc Heal. 2015;56:286-292.
54
Durkheim E. Suicide, a study in sociology (1951 Edition, Spaulding JA, Simpson G, Trans.). London: Routledge. 1897.
55
Joiner TE. Why people die by suicide: Harvard University press. Cambridge, MA. 2005;10.
56
Sharaf AY, Thompson EA, Walsh E. Protective effects of self-esteem and family support on suicide risk behaviors among at-risk adolescent. J Child Adolesc Psychiatr Nurs. 2009;22:160-168.
57
Bonanno RA, Hymel S. Beyond hurt feelings: Investigating why some victims of bullying are at greater risk for suicidal ideation. Merrill-Palmer Quarterly. 2010;420-440.
58
Winfree Jr LT, Jiang S. Youthful suicide and social support: Exploring the social dynamics of suicide-related behavior and attitudes within a national sample of US adolescents. Youth Violence Juv Justice. 2010;8:19-37.
59
Czyz EK, Liu Z, King CA. Social connectedness and one-year trajectories among suicidal adolescents following psychiatric hospitalization. J Clin Child Adolesc Psychol. 2012;41:214-226.
60
O’Connor RC. Towards an integrated motivational–volitional model of suicidal behaviour. Int Handb suicide Prev Res Policy Pract. 2011;1:181-198.
61
Dean-Boucher A, Robillard CL, Turner BJ. Chronic medical conditions and suicidal behaviors in a nationally representative sample of American adolescents. Soc Psychiatry Psychiatr Epidemiol. 2020;55:329-337.
62
Sayar K, Acar B. Psikofarmakolojik ajanlarla yapılan intihar girişimlerinde risk etkenleri. Bulletin of Clinical Psychopharmacology. 1999;9:208-212.
63
Ünlü G, Aksoy Z, Ersan EE. Evaluation of child and adolescents with attempted suicide. Pamukkale Medical Journal. 2014;7:176-183.
64
Spicer RS, Miller TR. Suicide acts in 8 states: incidence and case fatality rates by demographics and method. Am J Public Health. 2000;90:1885-1891.
65
Kim B, Ahn JH, Cha B, Chung YC, Ha TH, Hong Jeong S, Jung HY, Ju G, Kim EY, Kim JM, Kim MD, Kim MH, Kim SI, Lee KU, Lee SH, Lee SJ, Lee YJ, Moon E, Ahn YM. Characteristics of methods of suicide attempts in Korea: Korea National Suicide Survey (KNSS). J Affect Disord. 2015;188:218-225.