15 research outputs found
CHARACTERISTICS OF SUICIDE VICTIMS WHO HAD VERBALLY COMMUNICATED SUICIDAL FEELINGS TO THEIR FAMILY MEMBERS
Background: Verbal expression of suicidal feelings has rarely been investigated in the literature, particularly regarding
individuals who died by suicide.
Subjects and methods: We retrospectively collected data on the suicide cases of the period November 2007-October 2009 from
the Athens Greater Area and completed psychological autopsy questionnaires after phone interviews with their family members. The
specific question was: “Has your relative expressed to you his/her deep suffering or the intention to end his/her life at any time
during the six months prior to the suicide?”
Results: Data were collected for 248 individuals who died by suicide out of a total of 335. 121 of them (48.8%) had verbally
communicated their intention to die -or their profound suffering- to their family members. Suicide communicators were older
(p<0.001), less educated (p=0.04), more frequently divorced or separated and less often single (p<0.01) than non-communicators.
They had more often positive psychiatric history (p=0.004) and were less physically well (p=0.005), in comparison to noncommunicators.
Differences regarding sex, nationality, previous attempts, suicide note-leaving, completed suicide method and
hospitalization either for physical illness or psychiatric disorder the year prior to the suicide were not statistically significant among
the two groups. Considered that we interviewed only one relative for every case, the actual number of suicide communicators would
be probably higher; the suicidal feelings could have been disclosed to another relative instead.
Conclusions: This is the first time that a similar study was carried out in Greece. We found that approximately half of the
individuals who died by suicide in our sample had been (verbal) suicide communicators. The latter seem to present distinct
characteristics. These findings, coupled with the observation that the relatives are keen observers of the suicidal feelings of their
loved ones, could provide new insights to future suicide prevention efforts
Tackling Negative Symptoms of Schizophrenia with Memantine
We present a case of a 52-year-old male patient suffering from chronic schizophrenia stabilized on risperidone long-acting injection (37,5 mg/2 weeks) and biperiden 4 mg/day. Residual symptoms are affective flattening, alogia, avolition, and asociality. Memantine 10 mg/day was added. After 1.5 months, the patient spontaneously referred to “feel better being in company of my relatives.” The following scales have been completed: the Scale for the Assessment of Negative Symptoms (96), the Scale for the Assessment of Positive Symptoms (3), the Mini Mental Scale Examination (26), and the Calgary Depression for Schizophrenia Scale (2). Memantine was increased to 20 mg/day and biperiden was decreased to 2 mg/day. Two months later, apathy and asociality considerably improved and affective flattening, alogia, and attention slightly got better (SANS 76, SAPS 1, MMSE 26, and CDSS 1). After two more months, the improvement continued in the same domains (SANS: 70, SAPS: 1 MMSE: 27, and CDSS: 1). Positive symptoms remained in full remission. It has been hypothesized that one of the causes of schizophrenia is glutamate excitotoxicity. Memantine, a glutamate receptor antagonist, could possibly ameliorate schizophrenia symptoms, the negative ones among them, used as add-on therapy to atypical antipsychotics. Memantine could be of potential help in schizophrenia patients with severe residual negative symptoms
Psychological autopsy study of completed suicides
Introduction: Greece has one of the lowest suicide rates in the world (3,5 suicides/100.000 population). However, a 16.1% increase in the number of suicides has been noticed between 2007 & 2009. Aim: To present and discuss the characteristics of a 2-year (November 2007-October 2009) sample of suicide victims from the Athens greater area. We collected data from the Athens Department of Forensic Medicine, the largest of its kind in Greece, covering approximately 35% of our country’s population. Method: We collected data using the psychological autopsy method for the first time in our country. We completed a psychological autopsy questionnaire for every suicide case after phone interview with a victim’s relative. The questionnaire was focused on characteristics of the victim as well as of the act itself (socio-demographic parameters, history of prior physical and psychiatric illness(-es), family history of psychiatric disorder(s), prior suicide attempt(s), time of death etc.). Data were also collected from coroners’ reports for every case. Results: During the period under study, 335 persons were recorded as suicide victims (male/female ratio 3:1). The following findings are referred for the first time from a study on suicides in Greece: 15.8% of our sample were foreigners, 60.6% of the victims had history of psychiatric disorder(s) (mostly women), 57.2% suffered from depression, 58.4% were receiving no psychiatric medication, 48.0% suffered from physical illness(-es) and 22.6% had been hospitalized for physical illness in a general hospital the year prior to their death. As many as 76.0% had no history of prior suicide attempt(s). Most suicides occurred on Monday (17.3%) and the least on Saturday (9.6%). Self-shooting is the third most common suicide method among men (21.9%), but extremely rare among women (1.2%). Nearly half of the victims (48.8%) had verbally warned their relatives about their suicide intent; 26.6% left a suicide note. Economic difficulties were referred as the commonest stressful life event (31.1%) the year prior to the victims’ death (according to their relatives). We contacted relatives of 256 victims and interviewed the relatives of 248 of them (response rate: 96,9%). Given the fact that our study was largely based on the population of a big city its results aren’t necessarily representative of the whole of our country. Other limitations of our research include the unavailability of a standard model of conducting psychological autopsies and its retrospective nature (with the risk of information loss or bias due to memory decay, sense of guilt or shame of the informant). Conclusions: Our study helped in creating a database on numerous parameters (some searched for the first time in Greece), referring to the phenomenon of suicide: These constituted the focus of further discussion. The overwhelming acceptance of the psychological autopsy method by the victims’ relatives constitutes a wished for encouragement towards the direction of conducting similar studies in the near future.Εισαγωγή: Η Ελλάδα παρουσιάζει έναν από τους χαμηλότερους δείκτες αυτοκτονιών διεθνώς (3,5 αυτοκτονίες/100.000 άτομα). Σημειώνεται ωστόσο ότι μεταξύ 2007 και 2009 παρατηρήθηκε αύξηση κατά 16,1% των θανάτων από αυτοκτονία στη χώρα μας. Σκοπός: Η αποτύπωση και μελέτη των χαρακτηριστικών των περιστατικών που καταγράφηκαν ως αυτοκτονίες τη 2ετία Νοέμβριος 2007-Οκτώβριος 2009 στην Ιατροδικαστική Υπηρεσία Αθηνών, τη μεγαλύτερη της Ελλάδας (καλύπτει το 35% περίπου του πληθυσμού της χώρας). Υλικό και μέθοδος: Χρησιμοποιήθηκε, για πρώτη φορά στην Ελλάδα, η μέθοδος της ψυχολογικής αυτοψίας. Κατάλληλα διαμορφωμένο ερωτηματολόγιο συμπληρωνόταν έπειτα από τηλεφωνική επικοινωνία του ερευνητή με συγγενικό πρόσωπο του αυτόχειρα. Το ερωτηματολόγιο ήταν εστιασμένο στην καταγραφή πληθώρας παραμέτρων (ορισμένες διερευνήθηκαν για πρώτη φορά στη χώρα μας), σχετικών με τον αυτόχειρα και την πράξη του (κοινωνικό-δημογραφικές, ιατρικού-ψυχιατρικού ιστορικού, συνθηκών αυτοκτονίας κ.α.). Υλικό αντλήθηκε επίσης από τις ιατροδικαστικές εκθέσεις νεκροψίας-νεκροτομής. Αποτελέσματα: Το διάστημα της μελέτης καταγράφηκαν 335 άτομα ως θύματα αυτοκτονίας (αναλογία ανδρών-γυναικών 3:1). Δεδομένα τα οποία αποτυπώθηκαν για πρώτη φορά σε μελέτη αυτοκτονιών στην Ελλάδα είναι τα ακόλουθα: 15,8% των θυμάτων ήταν αλλοδαποί, 60,6% των αυτοχείρων είχαν θετικό ατομικό ψυχιατρικό ιστορικό (περισσότερο γυναίκες), 57,2% έπασχαν από κατάθλιψη, 58,4% δεν λάμβαναν καμία ψυχιατρική αγωγή την περίοδο του θανάτου τους, 48% παρουσίαζαν σωματική νοσηρότητα ενώ 22,6% είχαν νοσηλευτεί σε γενικό νοσοκομείο για την αντιμετώπιση σωματικού τους προβλήματος το έτος πριν την αυτοκτονία. Το 76% των θυμάτων δεν είχαν ιστορικό προηγούμενης απόπειρας. Ημέρα με τις περισσότερες αυτοκτονίες ήταν η Δευτέρα (17,3%), με τις λιγότερες το Σάββατο (9,6%). Ο αυτοπυροβολισμός ήταν η τρίτη σε συχνότητα μέθοδος αυτοκτονίας στους άνδρες (21,9%), ενώ είναι εξαιρετικά σπάνιος στις γυναίκες (1,2%). Περίπου τα μισά θύματα (48,8%) είχαν προειδοποιήσει λεκτικά τους οικείους τους για την αυτοκτονική τους πρόθεση, το 26,6% άφησε αποχαιρετιστήριο σημείωμα, ενώ οι οικονομικές δυσκολίες αναφέρθηκαν ως το συχνότερο ψυχοπιεστικό γεγονός (31.1%) στους μετέπειτα αυτόχειρες το έτος πριν το θάνατό τους (σύμφωνα τουλάχιστον με την αξιολόγηση των συγγενών τους). Τηλεφωνική επαφή κατέστη δυνατή με συγγενείς 256 θυμάτων, τηλεφωνική συνέντευξη με συγγενείς 248 εξ’ αυτών (96,9%). Περιορισμοί της μελέτης μας συνιστούν η αδυναμία γενίκευσης των αποτελεσμάτων στο σύνολο της χώρας (ως επί το πλείστον αφορούν τον πληθυσμό ενός μεγάλου αστικού κέντρου), καθώς και ορισμένες εγγενείς αδυναμίες της μεθόδου, όπως η ανυπαρξία «σταθερού» πρωτοκόλλου διεξαγωγής παρόμοιων μελετών και η αναδρομική της φύση με τον κίνδυνο απώλειας ή «αλλοίωσης» των πληροφοριών λόγω λήθης, αισθήματος ενοχής ή ντροπής του πληροφοριοδότη. Συμπεράσματα: Με τη μελέτη μας δημιουργήθηκε μια βάση δεδομένων σε πληθώρα παραμέτρων -ορισμένες διερευνήθηκαν λεπτομερώς για πρώτη φορά στην Ελλάδα- σχετικών με το φαινόμενο της αυτοκτονίας, τα οποία αποτέλεσαν βάση για συζήτηση και περαιτέρω προβληματισμό. Η εξαιρετική ανταπόκριση των συγγενών των θυμάτων στην εφαρμογή της μεθόδου της ψυχολογικής αυτοψίας συνιστά την καλύτερη ενθάρρυνση για την πραγματοποίηση ανάλογων ερευνών στο εγγύς μέλλον
CHARACTERISTICS OF SUICIDE VICTIMS WHO HAD VERBALLY COMMUNICATED SUICIDAL FEELINGS TO THEIR FAMILY MEMBERS
Background: Verbal expression of suicidal feelings has rarely been investigated in the literature, particularly regarding
individuals who died by suicide.
Subjects and methods: We retrospectively collected data on the suicide cases of the period November 2007-October 2009 from
the Athens Greater Area and completed psychological autopsy questionnaires after phone interviews with their family members. The
specific question was: “Has your relative expressed to you his/her deep suffering or the intention to end his/her life at any time
during the six months prior to the suicide?”
Results: Data were collected for 248 individuals who died by suicide out of a total of 335. 121 of them (48.8%) had verbally
communicated their intention to die -or their profound suffering- to their family members. Suicide communicators were older
(p<0.001), less educated (p=0.04), more frequently divorced or separated and less often single (p<0.01) than non-communicators.
They had more often positive psychiatric history (p=0.004) and were less physically well (p=0.005), in comparison to noncommunicators.
Differences regarding sex, nationality, previous attempts, suicide note-leaving, completed suicide method and
hospitalization either for physical illness or psychiatric disorder the year prior to the suicide were not statistically significant among
the two groups. Considered that we interviewed only one relative for every case, the actual number of suicide communicators would
be probably higher; the suicidal feelings could have been disclosed to another relative instead.
Conclusions: This is the first time that a similar study was carried out in Greece. We found that approximately half of the
individuals who died by suicide in our sample had been (verbal) suicide communicators. The latter seem to present distinct
characteristics. These findings, coupled with the observation that the relatives are keen observers of the suicidal feelings of their
loved ones, could provide new insights to future suicide prevention efforts
Psychiatric Medication Intake in Suicide Victims: Gender Disparities and Implications for Suicide Prevention
Frequency and gender differences of psychiatric medication intake in a
sample of suicide victims from the Athens Greater Area were investigated
with a particular focus on the implications for suicide prevention. Data
were collected from the toxicological analyses of the suicide cases of
the period November 2007-October 2009. Information was available for 262
individuals, 196 men (74.8%) and 66 women (25.2%); 109 of these
(41.6%) were receiving psychiatric medication(s). Women were
statistically more frequently under treatment: antidepressants (32.8%
vs. 11.3%, p < 0.001), antiepileptics (9.1% vs. 0.5%, p = 0.001),
antipsychotics (24.2% vs. 9.2%, p = 0.003), and benzodiazepines
(16.7% vs. 6.6%, p = 0.024). Campaigns aiming to bring men with
psychological difficulties in contact with mental health services and to
lessen the stigma of mental illness, together with better training of
nonpsychiatrists into “suspecting” “male” depression, could be
particularly helpful for decreasing male suicides. More thoughtful
choice of psychiatric medication could possibly already prevent a number
of female suicides
A 2-Year Psychological Autopsy Study of Completed Suicides in the Athens Greater Area, Greece
Objective To study the characteristics of a sample of suicide victims
from the Athens Greater Area using the psychological autopsy method for
the first time in Greece.
Methods We studied all recorded cases of completed suicide for the
2-year time period November 2007 October 2009 collecting data from the
victims’ forensic records as well as from the completion of a
psychological autopsy questionnaire.
Results 335 persons were recorded as suicide victims. We contacted
relatives of 256 victims interviewing those of 248 of them (96.9%). The
differences regarding sex, marital and employment status between our
sample and the general population were statistically significant
(p<0.001). The male/female ratio was 3:1. Comparatively more victims
were divorced, separated or single and a greater proportion were
pensioners or unemployed. 26.0% of the victims had history of prior
attempts (64.4% once, 20.3% twice and 15.3% more times). 42.6% were
taking psychiatric medication-significantly more women than men
according to blood tests; 14.2% had been hospitalized in a psychiatric
clinic the year prior to their death. 84.8% have deceased at the place
of suicide and 15.2% died in the hospital; 80.3% died indoors and
19.7% outdoors. Men died primarily by hanging or shooting by a firearm
while women preferred jumping from height instead (p<0.001). As many as
48.8% had expressed their intention to die to their relatives; 26.6%
left a suicide note.
Conclusion Our study has shown that the psychological autopsy method is
applicable and widely accepted yielding results comparable to the
international literature. Specific parameters associated with suicide
have been studied for the first time in Greece
Characteristics of immigrant suicide completers in a sample of suicide victims from Greece
Background: Immigrants have higher rates of suicidal behaviour in
comparison to the indigenous population.
Aims: To describe the characteristics of foreign nationality suicide
completers and search for differences between them and native Greeks.
This is the first study focused on immigrant suicide victims in Greece.
Methods: Data were collected for all recorded cases of completed suicide
for the two-year period November 2007 to October 2009 at the Athens
Department of Forensic Medicine, the largest, by far, of its kind in
Greece covering approximately 35% of the country’s population. The
material was collected using the method of psychological autopsy as well
as from the victims’ forensic records.
Results: Nearly 10% of Greece’s 11 million population are of foreign
nationality. Approximately half of them live in Athens and its suburbs,
an area where 35% of Greece’s population lives. In our sample, 15.8%
of the suicide victims were of foreign nationality (53 cases): 41 men
(77.4%) and 12 women (22.6%). Higher suicide rates were found for
citizens of Kuwaiti (9.1%), Somali (6.7%) and Afghan (0.9%)
nationality (immigrant communities with very few members); the lower
suicide rates were for individuals of Egyptian (0.01%), Ukrainian
(0.01%) and Albanian (0.006%) nationality (the Albanian immigrant
community is the largest in Greece). In comparison to their Greek
counterparts, immigrant victims were younger (mean age 38.7 vs 54.9
years, p < .001) more often unemployed (p = .007) and with a history of
alcohol abuse (p < .001). The main suicide method used by immigrants was
hanging (p <.001) while for Greeks it was jumping from a height.
Conclusions: Individuals who belong to small national communities seem
to have the highest risk of dying by suicide. Immigrant suicide victims
differ from the indigenous population in several parameters. Our data
could help define the most vulnerable of them and apply more effective
suicide prevention strategies
A comparative analysis of suicides in Greece's main port city area of Piraeus before (2006-2010) and during (2011-2015) the country's severe economic crisis
We investigated all cases of completed suicide in the city area of
Piraeus -the largest port in Greece-for the years 2006 up to 2015. We
searched, among others, parameters regarding the victims’ psychiatric
medication intake and drug and alcohol use that -to the best of our
knowledge-had never been investigated before by a study on suicides in
Greece within the crisis’ years. We documented variations before
(2006-2010) and during (20112015) crisis. Information was provided by
the victims’ forensic records at the Piraeus Department of Forensic
Medicine. During the period of the study 435 individuals died by
suicide. “Before” crisis: 227 cases, 77,1% males, mean age 48.6
years (SD: 19.8), 85% Greek. “During”: 208 cases, 79,8% males,
mean age 51.4 years (SD: 17.7), 83.2% Greek. Psychiatric medication
intake: “Before”-”During”: 16.3%-29.8% (p = 0.003), males:
16.1%-31.7%, females: 19.6%-27.5% (p = 0.003). Drug use: opioids
2.7%(5.5%), cannabis 1.4%(5.5%), cocaine 0(1.5%), alcohol
14.5%(13.4%). Significant seasonality was observed only for suicides
by jumping with a peak late in the month of July in the “Before”
group. There were no significant differences regarding suicide method,
place of suicide or place of death. The slight decrease in suicides
within the crisis’ years, together with the higher medication intake
observed within the same period, could imply that more individuals were
willing to accept their psychological difficulties and/or to commence
treatment. Probably the stigma of psychiatric illness is somewhat lower
after the beginning of the crisis and/or non-psychiatrists became more
aware of the psychological origins of some of their patients’ problems.
Our findings tentatively suggest that, as the crisis persists, adaptive
mechanisms have been set in motion
Switching Suicide Methods in Order to Achieve Lethality: A Study of Greek Suicide Victims
This article focused on the relation between the method of last
attempted suicide and the method used during the subsequent completed
suicide. Using the method of psychological autopsy, the authors studied
all suicide cases from the Athens Greater Area during a 2-year period.
Twenty-four percent of the victims had history of previous suicide
attempts. The majority of the suicide attempters switched to a different
method (p<0.001) for their final act. This difference is primarily due
to the individuals who had chosen self-poisoning or wrist cutting in
their last attempted suicide. Both of these groups switched to hanging
or jumping from a height for their final attempt. Individuals who
attempted suicide by hanging or jumping became completers using mainly
the same methods
Differences Between Suicide Victims Who Leave Notes and Those Who Do Not A 2-Year Study in Greece
Background: Whether differences exist between those who do leave a
suicide note and those who do not has not yet been comprehensively
answered. Leaving a suicide note is not a random phenomenon: A minority,
varying between 3-42%, of all suicide victims leave a note. Aims: To
compare the group of suicide victims who leave notes with the ones who
do not, using data from the Athens Department of Forensic Medicine, the
largest in Greece. Methods: We examined sex, age, nationality, religious
beliefs, marital and residential status, history of prior psychiatric
disorder and psychiatric attempt(s), suicide method, physical disease,
recent hospitalization, and existence of suicide notes. We completed
psychological autopsy questionnaires after phone interviews with
relatives of the suicide victims of a 2-year period (November
2007-October 2009). Results: Note writers, 26.1% of our sample,
differed in the following: they died by hanging or shooting (p = .007),
had no history of psychiatric illness (p < .001) or recent (i.e., within
12 months of the suicide) psychiatric hospitalization (p = .005).
Conclusions: Our study showed that there are indeed differences between
suicide victims who leave a note and those who do not. We also suggest
some explanations for these differences, which could represent a
valuable starting point for future research on this topic