The International Handbook of Suicide and Attempted Suicide

Description

Recent research in the area of suicidology has provided significant new insights in the epidemiological,psychopathological,and biological characteristics of suicidal behaviour. The International Handbook of Suicide and Attempted Suicide is the first book to bring together this expertise and translate it into practical guidelines for those responsible for policy issues and for those involved in the treatment and prevention of suicidal behaviour.

Leading international authorities provide a truly comprehensive and research-based reference to understanding, treating, and preventing suicidal behaviour. They explore concepts and theories which best guide work within this field and detail key research which has supported conceptual developments, preventive interventions and clinical treatment.

"No self-respecting worker in deliberate self-harm and suicide prevention, either clinical or research, can afford to be without access to this comprehensive handbook - possession and regular use, may well become a marker of serious involvement in the subject! ...This is the most comprehensive, up-to-date, informative and well-written source of information on sucide and suicidal behaviour...an invaluable work of reference which will be essential for clinicians and researchers for many years to come."
—Andrew Sims, Emeritus Professor of Psychiatry, St James's University Hospital, Leeds, UK - British Journal of Psychiatry

Cover 2
Title Page 6
Copyright Page 7
Contents 8
About the Editors 12
List of Contributors 14
Preface 20
Introduction 22
- REFERENCES 26
Part I Understanding Suicidal Behaviour 28
- Chapter 1 Suicide in the Western World 30
  - INTRODUCTION 30
  - HISTORY AND CULTURE 31
  - INTERNATIONAL COMPARISONS 31
    - Western Europe (Austria, Belgium, France, Germany, West Germany, The Netherlands and Switzerland) 33

Cover 2
Title Page 6
Copyright Page 7
Contents 8
About the Editors 12
List of Contributors 14
Preface 20
Introduction 22
- REFERENCES 26
Part I Understanding Suicidal Behaviour 28
- Chapter 1 Suicide in the Western World 30
  - INTRODUCTION 30
  - HISTORY AND CULTURE 31
  - INTERNATIONAL COMPARISONS 31
    - Western Europe (Austria, Belgium, France, Germany, West Germany, The Netherlands and Switzerland) 33
    - Southern Europe (Greece, Italy, Portugal and Spain) 33
    - Scandinavia (Denmark, Finland, Norway and Sweden) 34
    - UK and Ireland 35
    - New World (Australia, Canada, New Zealand and USA) 36
  - GENDER 37
  - AGE 39
  - MARITAL AND PARENTAL STATUS 42
  - METHODS 43
  - SEASONS AND WEATHER 45
  - REFERENCES 46
  - CONCLUSIONS 46
- Chapter 2 Suicide in Asia and the Far East 50
  - BASIC PATTERNS AND TRENDS 51
    - Cross-national Variations 51
    - Relationships of Sex and Age to Suicide 53
  - INTRODUCTION 51
  - BIOLOGICAL FACTORS 58
  - PSYCHIATRIC FACTORS 58
  - SOCIAL FACTORS 59
    - Islamic Religion and Suicide 59
    - Sri Lanka as an Area with the Highest Suicide Rate in Asia 60
    - Political Environment and Reversion Anxiety 60
    - Female Social Status in China 62
    - Migration and Suicide 62
    - Social Integration and Suicide 63
  - METHODS OF SUICIDE 63
  - CULTURE-RELATED TYPES OF SUICIDE 64
  - IMITATIVE SUICIDE 65
  - PROBLEMS IN THE ASCERTAINMENT OF SUICIDE 66
  - CONCLUSIONS 67
  - REFERENCES 67
- Chapter 3 Attempted Suicide: Patterns and Trends 70
  - INTRODUCTION 71
  - DESCRIPTION AND DEFINITION 71
  - EPIDEMIOLOGY 72
  - THE WHO/EURO MULTICENTRE STUDY ON PARASUICIDE 73
    - Differences between Catchment Areas and Countries 74
    - Trends 76
    - Sex and Age 76
    - Other Sociodemographic Characteristics 77
    - Method 78
  - REPETITION 78
  - SELF-REPORTED ATTEMPTED SUICIDE 79
  - TEMPORAL FACTORS 80
  - MODELLING 80
  - CULTURAL VARIATION 81
  - CONCLUSIONS 81
  - REFERENCES 82
- Chapter 4 Biological Aspects of Suicidal Behaviour 86
  - DISTINGUISHING THE BIOLOGY OF MOOD AND OTHER PSYCHIATRIC DISORDERS FROM BIOLOGICAL CORRELATES OF SUICIDAL BEHAVIOUR 87
  - INTRODUCTION 87
  - THE SEROTONIN SYSTEM AND METHODS OF STUDY 88
  - CSF 5-HIAA 89
    - Neuroendocrine Studies of the Serotonergic System 90
    - Platelet 5-HT2 Receptor Binding 90
    - Molecular Genetic Studies 90
  - THE HPA AXIS 91
  - CHOLESTEROL 91
  - AUTOPSY STUDIES OF SUICIDE 92
  - OTHER NEUROTRANSMITTERS 93
  - REFERENCES 94
  - CONCLUSION 94
- Chapter 5 The Psychology of Suicidal Behaviour 100
  - PSYCHOANALYTICAL PERSPECTIVES ON SUICIDE 101
  - INTRODUCTION 101
  - PERSONALITY VARIABLES 102
    - Impulsivity 102
    - Dichotomous Thinking 103
    - Cognitive Rigidity 104
    - Problem-solving 105
    - Autobiographical Memory 106
    - Hopelessness 107
    - Processes Underlying Hopelessness: the Role of Future Thinking 108
  - SUICIDAL BEHAVIOUR AS A CRY OF PAIN 109
  - CONCLUDING REMARKS 111
  - REFERENCES 112
- Chapter 6 Ethology and Suicidal Behaviour 116
  - INTRODUCTION 116
  - THEORETICAL HYPOTHESES 117
  - RECENT NEUROBIOLOGICAL PERSPECTIVES 120
  - ANIMAL STUDIES 121
  - NATURALISTIC LONGITUDINAL COHORT STUDIES 124
  - CONCLUSION 125
  - REFERENCES 125
- Chapter 7 Psychiatric Aspects of Suicidal Behaviour: Depression 128
  - INTRODUCTION 129
  - THE RISK OF SUICIDE IN DEPRESSION 129
  - DEPRESSION AMONG SUICIDES: PSYCHOLOGICAL AUTOPSY STUDIES 131
  - SUICIDAL BEHAVIOUR IN BIPOLAR DISORDER 136
  - ATTEMPTED SUICIDE AND DEPRESSIVE DISORDER 137
  - CONCLUSION 138
  - REFERENCES 138
- Chapter 8 Psychiatric Aspects of Suicidal Behaviour: Schizophrenia 142
  - INTRODUCTION 142
  - RISK FACTORS FOR SUICIDE IN SCHIZOPHRENIA 143
  - SUICIDE IN SCHIZOPHRENIA: RECENT STUDIES 145
    - Finnish National Suicide Prevention Project 146
    - Chesnut Lodge Follow-up Study 146
    - Denmark Nested Case-control Study 146
    - Belgian Suicide in Schizophrenia Project 147
  - RISK FACTORS AND HYPOTHESES ON SUICIDE IN SCHIZOPHRENIA 147
  - IMPLICATIONS FOR TREATMENT 150
  - CONCLUSION 151
  - REFERENCES 151
- Chapter 9 Psychiatric Asects of Suicidal Behaviour: Substance Abuse 156
  - THE LIFETIME RISK OF SUICIDE IN ALCOHOLICS 157
    - The Sex Factor 159
  - THE FACTS 157
  - PREDICTORS OF SUICIDE IN SUBSTANCE ABUSERS 159
  - ATTEMPTED SUICIDE 162
  - PREVENTING SUICIDE 164
  - REFERENCES 165
  - CONCLUSIONS 165
- Chapter 10 Psychiatric Aspects of Suicidal Behaviour: Personality Disorders 168
  - INTRODUCTlON 169
  - DESIGNS OF STUDIES EXAMINING SUICIDAL BEHAVIOUR AND PERSONALITY DISORDERS 170
  - METHODOLOGICAL ISSUES 177
    - Variability in Procedures for Identifying Personality Disorders: the Unequal Status of Axis II Disorders 177
  - PREVALENCE OF PERSONALITY DISORDERS AMONG INDIVIDUALS WHO COMMIT SUICIDE 179
  - INCIDENCE OF SUICIDE AMONG INDIVIDUALS MEETING CRITERIA FOR AN AXIS II DIAGNOSIS 184
  - CO-VARIATION OF PERSONALITY DISORDERS AND ATTEMPTED SUICIDE 188
  - RISK FACTORS FOR SUICIDE AMONG INDIVIDUALS MEETING CRITERIA FOR PERSONALITY DISORDERS 189
  - CONCLUSIONS 190
  - ACKNOWLEDGEMENT 194
  - REFERENCES 195
- Chapter 11 Psychiatric Aspects of Suicidal Behaviour: Anxiety Disorders 200
  - PATHOLOGICAL ANXIETY 200
  - MORTALITY STUDIES IN CLINICAL PATIENTS WITH NEUROSIS 201
  - MORTALITY IN COMMUNITY SAMPLES WITH NEUROSIS OR ANXIETY 203
  - SUICIDAL BEHAVIOUR AND DSM-Ill NOSOLOGY IN THE COMMUNITY 204
  - SUICIDAL BEHAVIOUR AND DSM-Ill NOSOLOCY IN CLINICAL PATIENTS 206
  - PANIC DISORDER 207
  - CONCLUSIONS 208
  - REFERENCES 209
- Chapter 12 Sociology and Suicidal Behaviour 214
  - INTRODUCTION 214
  - THE CLASSICAL SOCIOLOGICAL APPROACH 215
  - SOCIAL INTEGRATION 217
  - SUICIDE AS A CULTURAL PHENOMENON 219
  - MEANINGS OF AND ATTITUDES TOWARDS SUICIDE IN A HISTORICAL PERSPECTIVE 220
  - SUICIDAL TRANSMISSION AND THE IMPORTANCE OF NORMS, VALUES AND ATTITUDES 222
  - THE SOCIAL ORDER AND SOCIO-ECONOMIC CHANGES 224
  - CONCLUSIONS 226
  - REFERENCES 227
- Chapter 13 The Genetics of Suicidal Behaviour 230
  - CLINICAL STUDIES 231
    - Type of Suicide Attempt 231
    - The Amish Study 232
    - Confounding Factors 232
  - INTRODUCTION 231
  - TWIN STUDIES 232
    - Mode of Inheritance 233
  - ADOPTION STUDIES 234
  - MOLECULAR GENETIC STUDIES 234
    - TPH in Surviving Co-twins of MZ Suicide Victims 237
    - TPH Studies in Bipolar and Depressed Patients 237
    - Serotonin Transporter Studies 238
    - TPH Studies in Personality-disordered Patients 238
    - Dopamine Receptors 239
    - Monoamine Oxidase Studies 239
    - Serotonin Receptors 239
  - CONCLUSIONS 239
  - REFERENCES 240
- Chapter 14 Pathways to Suicide: an Integrative Approach 244
  - THE INTERACTION BETWEEN THE INDIVIDUAL AND THE ENVIRONMENT 245
  - INTRODUCTION 245
  - AT THE CROSSROADS OF PSYCHOLOGY AND BIOLOGY: THE BRAIN’S PREFRONTAL CORTEX AND ITS MEMORY FUNCTIONS 247
  - THE SPECIFICITY OF FINDINGS 249
  - THE CONTINUUM OF SUICIDAL BEHAVIOUR AND ASSOCIATED PSYCHOPATHOLOGICAL PHENOMENA 250
  - UNDERSTANDING SUICIDAL BEHAVIOUR 252
  - CONCLUSIONS 253
  - REFERENCES 254
- Part II Suicide and Attempted Suicide in Specific Populations and Circumstances 256
  - Chapter 15 Suicidal Behaviour in Children: an Emphasis on Developmental Influences 258
    - INTRODUCTION 258
    - DEVELOPMENTAL EPIDEMIOLOGY OF YOUTH SUICIDAL BEHAVIOUR 259
    - FAMILY CORRELATES OF SUICIDAL BEHAVIOUR IN CHILDREN AND YOUNG ADOLESCENTS 261
    - COGNITIVE AND SOCIAL ADJUSTMENT PROFILES OF SUICIDAL BEHAVIOUR 263
    - PSYCHIATRIC SYMPTOMS AND SUICIDAL BEHAVIOUR IN CHILDREN AND YOUNG ADOLESCENTS 263
    - BIOLOGICAL CORRELATES OF SUICIDAL BEHAVIOUR IN CHILDREN AND YOUNG ADOLESCENTS 264
    - ASSESSMENT OF SUICIDAL BEHAVIOUR IN CHILDREN AND YOUNG ADOLESCENTS 265
    - TREATMENT OF SUICIDAL CHILDREN 267
    - CONCLUSIONS 267
    - REFERENCES 268
  - Chapter 16 Adolescent Suicidal Behaviour: a General Population Perspective 270
    - INTRODUCTION 270
    - EPIDEMIOLOGICAL ISSUES 271
    - CONTINUITY OF SUICIDAL PHENOMENA IN THE GENERAL POPULATION 273
    - CORRELATES OF ADOLESCENT SUICIDAL BEHAVIOUR IN GENERAL POPULATION SAMPLES 274
      - Environmental Factors: External Influences 274
      - Environmental Factors: Exposure to Adverse Life Events 275
      - Psychological Factors 275
    - PREVENTION 276
    - REFERENCES 277
    - CONCLUSIONS 277
  - Chapter 17 Adolescent Suicidal Behaviour: Psychiatric Populations 282
    - OVERVIEW OF SUICIDAL BEHAVIOUR IN PSYCHIATRIC POPULATIONS 283
    - INTRODUCTION 283
    - DEPRESSION 284
    - SCHIZOPHRENIA 286
    - SUBSTANCE ABUSE 287
    - CONDUCT DISORDERS 288
    - EATING DISORDERS 289
    - BORDERLINE PERSONALITY DISORDER 291
    - REFERENCES 292
    - CONCLUSIONS 292
  - Chapter 18 Suicidal Behaviour among the Elderly 296
    - INTRODUCTION 296
    - COMMUNITY STUDIES OF SUICIDAL IDEATION IN OLDER PEOPLE 297
    - INDIRECT SELF-DESTRUCTIVE BEHAVIOUR 298
    - DELIBERATE SELF-HARM IN OLDER PEOPLE 299
      - Demographic Risk Factors 299
      - Methods of Deliberate Self-harm 299
      - Risk Factors for Deliberate Self-harm 300
      - Outcome 301
    - SUICIDE IN OLDER PEOPLE 301
      - Epidemiology 302
      - Risk Factors for Suicide in Older People 305
      - Characteristics of the Suicidal Act in Older People 305
      - Rational Suicide, Physician-assisted Suicide and Euthanasia in Older People 308
    - CONCLUSIONS 308
    - REFERENCES 309
  - Chapter 19 Sexuality, Reproductive Cycle and Suicidal Behaviour 314
    - INTRODUCTION 314
    - SEXUAL ORIENTATION AND SUICIDAL BEHAVIOUR 315
      - Methodological, Social and Other Issues in Research 315
      - Suicide and Sexual Orientation 316
      - Deliberate Self-harm and Sexual Orientation 317
    - PREGNANCY AND SUICIDAL BEHAVIOUR 319
      - Suicide and Pregnancy 319
      - Suicide during Pregnancy 319
      - Suicide Following Childbirth 320
      - Suicide and Failure to Complete Pregnancy 320
      - Deliberate Self-harm and Pregnancy 321
    - PARAPHILIAS AND SUICIDAL BEHAVIOUR 323
    - CONCLUSIONS 324
      - Sexual Orientation and Suicidal Behaviour 324
      - Pregnancy and Suicidal Behaviour 325
      - Paraphilias and Suicidal Behaviour 326
    - REFERENCES 326
  - Chapter 20 Suicidal Behaviour and the Labour Market 330
    - BACKGROUND 331
    - METHODOLOGICAL ISSUES 333
      - literature Search Strategy 333
      - Identification of Relevant literature 334
      - Categorization of Studies by Research Design 335
    - LABOUR MARKET CONDITIONS AND SUICIDAL BEHAVIOUR: EMPIRICAL EVIDENCE FROM THE LITERATURE 337
      - The Relationship between Unemployment and Suicidal Behaviour 337
      - The Relationship between Female labour Force Participation (FLFP) and Suicidal Behaviour 377
      - The Relationship between Occupational Status, Occupation and Suicidal Behaviour 383
    - SUMMARY OF MAIN FINDINGS 394
      - Unemployment and Suicidal Behaviour 394
      - Occupational Status, Occupation and Suicidal Behaviour 397
      - Female Labour Force Participation and Suicidal Behaviour 397
    - IMPLICATIONS FOR PREVENTION 398
    - CONCLUSIONS 399
    - REFERENCES 400
  - Chapter 21 Repetition of Suicidal Behaviour 406
    - INTRODUCTION: THE SPECTRUM OF REPETITIVE DELIBERATE SELF-HARM AND ITS RELATIONSHIP TO SUICIDE 407
    - THE IMPORTANCE OF REPEATED SUICIDE ATTEMPTS IN MORTALITY FROM SUICIDE 408
    - REPETITION PREVALENCE AT INDEX CONTACT 409
    - PREDICTION OF NON-FATAL REPETITION 412
    - PREDICTION OF FATAL REPETITION 414
    - CAUSES OF REPETITION 416
    - CONCLUSIONS 419
    - REFERENCES 419
  - Chapter 22 Physical Illness and Suicidal Behaviour 426
    - INTRODUCTION 427
      - Psychosocial Consequences of Somatic Disorders 427
    - STUDY METHODS 428
    - SUICIDE IN PHYSICAL ILLNESS 429
      - Cancer 429
      - Neurological Disorders 430
      - Other Somatic Disorders 433
    - ATTEMPTED SUICIDE AND PHYSICAL ILLNESS 436
    - PAIN AND SUICIDE 437
    - REFERENCES 438
    - CONCLUSION 438
  - Chapter 23 Ethical and legal Issues 442
    - INTRODUCTION 443
    - SUICIDE AND ATTEMPTED SUICIDE 444
    - EUTHANASIA AND ASSISTED SUICIDE 445
    - STANDARDS OF REASONABLE AND PRUDENT CARE 449
    - RESPONSIBILITY OF CARE 450
    - FAILURE IN CARE 451
    - LIABILITY AND MALPRACTICE 453
    - CONCLUSION 454
    - REFERENCES 455
  - Chapter 24 Suicide and Violence 458
    - INTRODUCTION 458

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