Along with inflicting superficial wounds, substances ingestion - usually drugs - is the most common way of committing the autolitic acts. The databases regarding psychological and pharmacological treatment are insufficient and they are not corroborated.

The objective of the research was to establish the socio-demographic characteristics of this category which is vulnerable to self-injury and to determine the differences between the patients who use substances abuse and those who use mechanical means.

The study was done on a number of 175 inmates (all males), who committed non-lethal autolitic acts between the 1st of January 2009 and the 31st of December 2009. The group was divided in two - one group of persons who committed the self-injury through chemical methods N = 48 and another one using mechanical means, N = 127. The data has been processed using SPSS 17.0 software, through cross-sectional and descriptive analysis, average comparison test and non-parametric ones.

The average age of those with substance abuse was 3 years lower. They have committed the self-injury especially on Saturdays, the other ones mostly on Wednesdays and Mondays and, although they have all accepted the therapeutic intervention, a larger number of patients were hospitalized. The ones using mechanical means had more frequent recurrences.

There are significant differences between the patients with substances abuse and those who used mechanical means. It seems that the motivation for the act in itself is different and the psychological counseling that followed was done more systematically for those with substances abuse.

Depressive and suicidal symptoms are common in adolescence, yet often underestimated. The Youth Risk Behavior Surveillance (2009) found that 6.3% of High School students in the United States had attempted suicide and that 13.8% had seriously considered attempting suicide, during the previous year.

Investigating the prevalence of depression and suicidal behaviours in the Italian sample of the SEYE study.

SEYLE (Saving and Empowering Young Lives in Europe) is a randomized controlled trial evaluating school-based health promotion interventions for suicide prevention. The study comprises 12, 395 adolescents from 11 European countries.

Italian sample consists of 1195 students (mean age 15.3 ± 0.6; 68% females) from the Molise region. A self-report questionnaire including a number of well-established instruments was administered. For the current analysis, based on baseline data, we focus on the Beck Depression Inventory-II and the Paykel Suicide Scale.

Mean BDI-II score was 8 ± 6.48. Total BDI-II scores were significantly higher in females than males (8.83 ± 6.72 vs 6.22 ± 5.55; p < 0.0001), even after controlling for age. 210 adolescents (17.8%) scored higher than 13, indicating some degree of clinical depression. Mean PSS score was 1.14 ± 2.38. Females also scored higher than males on the PSS (1.28 ± 2.45 vs 0.83 ± 2.20; p = 0.002), even after controlling for age.

Our results show a high prevalence of depressive symptoms and suicidal thoughts among Italian adolescents, especially among females. Knowing that more than 90% of adolescents who commit suicide suffer from an associated psychiatric disorder, an early detection and appropriate care becomes of particular importance.

Several studies show that the season of birth of suicide victims does not follow a random distribution.

To examine season of birth, of a sample of suicide victims from Greece. We collected data from the Athens Department of Forensic Medicine, the largest in Greece, referring to the suicide victims of a 2-year period (November 2007-October 2009).

Date of birth was available for 296 out of a total of 335 suicide victims; 30% were born in winter, 30.5% in spring, 19.3% in summer & 20.3% in autumn. Relatively more were born in January (15.2%) & May (12.2%), fewer in June (4.1%) & November (5.1%). Our findings are in accordance with most of the relevant literature: It has been also shown that a seasonal distribution is associated with the high sensitivity of the CNS to environmental exposure in utero, infections, hormonal changes, maternal diet, photoperiod, temperature & weather conditions. Winter-borns more frequently present modifications in the behavioral expression of dopaminergic genetic polymorphisms that could predispose to impulsive & risky, as well as sensation seeking behaviors, later in life. Furthermore, low serotonin turnover at birth has been observed in those born between February & April; it is well-known that similar findings have been documented in adult suicidal behavior too.

Risk of completed suicide seems to be higher for those born during winter & spring. More research is needed in order to clarify if season-month of birth should be included in the future assessment of suicide risk.

Stressful events the year prior to the suicide could play an important role in a person's decision to end his/her life.

To present the most common stressful life events in a sample of suicide victims from Greece. We studied a 2-year (November 2007-October 2009) sample (n=335) in the area of coverage of the Athens Department of Forensic Medicine, the largest in our country. Data were provided from the completion of a psychological autopsy questionnaire following interview with a relative of the deceased. Relatives were asked to mention a single event that, according to them, provoked considerable stress to the victim the year before suicide.

Data were available in 119 cases; most commonly referred events were: Economic difficulties (37 cases: 31.1%), health problems of the victim (32 cases: 27.0%), separation or divorce (16 cases: 13.4%), health problems of victims’ relatives (13 cases: 11.0%), grief (12 cases: 10.1), legal matters to settle (3 cases: 2.5%), work promotion (2 cases: 1.7%), retirement (2 cases: 1.7%), issue of honor (1 case: 0.8%), and imminent expulsion (a case of an immigrant: 0.8%). Stressful life events could increase the risk of suicide mainly by causing or deteriorating psychiatric disorders; in some cases though, the risk is unrelated to mental disorders.

There is a remarkable correlation between economic difficulties and suicide: Given the fact that when our research took place the economic crisis in Greece had not yet started, its influence on the phenomenon of suicide is expected to be significant.

Suicide notes are the only personal interpretation evidence of his action causes among all possible information sources about suicide.

To improve quality of suicide prevention by the mean of suicide notes analysis.

Objects of the study: 77 suicide notes of Belarusian citizens who had committed suicide and corresponding prosecutor's reports.

Evaluation of the formal visual characteristics of notes and demographic data, content analysis (note addressee, stated reason, manifested affect, dominant theme and direction of the charges).

The mean age of the sample was 43.8 years, 87% were male. 75% of the notes had specific addressee, 32.2% of them were directed to a spouse. In 55.8% of notes the main theme was “apology”, in 50.7% it was 'inability to stand the pain/illness “, but the main emotion displayed by half of cases was “guilt”. The vast majority of notes with the theme “charge” belonged to men (92.6%), 60% of these charges were directed to their wives. Women most frequently reported such reasons as “avoiding” (80%) and “self-punishment '(40%), men - a “protest/revenge” and “coercion”- in 32.8% and 23.9% respectively. Notes of women were characterized by higher volume, accuracy, consistency, and literacy. For persons aged 26–35 years the main causes of suicide were “protest/revenge” and “coercion”, and for those at the age of 66–75 years - “avoidance” and “rational denial'.

Age and gender tendencies of suicide causes should be considered in planning the suicide prevention strategies in different age groups.

Belarus has one of the worlds’ highest suicide rates (48.5/100000 men, 9.1/100000 women, 2008). The country's first suicide prevention project is carried out from 2009 to 2013 in two regions of the Minsk County (pop. 75,773) targeting on improving primary care physician's skills in diagnosing of depression and suicide risk assessment.

The aim of this paper was to investigate physician's attitudes changes towards work with suicidal patients through a training seminar and whether potential changes vary with the earlier experience of a patient's suicide.

90 physicians (60% of physician's stuff, 64.4% women) answered the questionnaire (40 items) before and after the 2 day courses (2009/2011) held by qualified psychiatrists. Chi-square test has been applied to investigate significance of pre/post differences.

Significant improvements regarding expectations, knowledge and collaboration for suicidal patients were noted after the training. Physicians more often perceived clarity in the organization of responsibilities for suicidal patients after the seminar than before (86% vs. 32%, p < 0.001). No improvements in the perceived possibility of preventing suicide were noted, still the vast majority (72%) considered suicide to be preventable before the seminar. There were no influence of patient's suicide experience (47% of the participants) on change in attitudes towards work with suicidal patients.

Job clarity and perceived knowledge were significantly improved through a 2-day educational training. No changes regarding the perceived possibility to prevent suicide were noted. Increased efforts to work with these issues are planned for the next round of training seminars.

To study the rate of suicidality in Thai population.

Methodology: Nationally representative faceto-face household survey based on a stratified clustered sampling of people aging 15 to 59 (n = 17,140). The data were conducted between June and August 2008 using Mini International Neuropsychiatric Interview (M.I.N.I.) and general information questionnaire by trained psychiatric professionals. The data analysis was determined by means adjusted weight of rate generalized to Thai population and analyzed with descriptive statistical methods by attaining percentage of mean, proportions, standard errors, population estimation and probability inference from the data.

The overall national rate of suicidality accounted for 7.3%, the severity risk of suicide was found mild 6.0%, moderate 0.6% and severe 0.7%. The highest risk of suicide was found in the north (8.8%, severe degree 1.3%) females (8.6%), age of 35 to 44 (8.1%), being buddhists (7.4%), separated, divorced or widowed (11.8%), being unemployed (13.8%), mood disorders with psychotic features (87.9%), current manic episode (64.3%).

For effective surveillance and prevention of suicide in Thailand's general population, the focus should be on the population of Northern provinces, females, those in productive age, being unemployed and those concurrently having major depressive disorder and psychotic disorders.

Schizophrenia is a serious and common disease, one of the most disabling mental disorders in developed countries (Azevedo et al., 2010) and it is associated with high suicide attempt rates. A significant percentage of premature deaths is due to suicide and up to 50% of the patients attempt suicide during their lifetime, specially during the earlier course of the disease (Meltzer, 2003).

In this study, the authors aimed to identify clinical factors (focusing on emotional reactivity and negative symptoms) and social-demographic variables associated to suicidal behaviour in Schizophrenia, in a large sample of Portuguese patients.

508 patients with a diagnosis of Schizophrenia were selected according ICD-10 diagnostic criteria definitions, using the OPCRIT polydiagnostic system (McGuffin et al., 1991). Clinical and social-demographic variables were extracted from DIGS (Azevedo et al., 1993; Nurnberger et al., 1994).

Suicidal Behaviour was assessed with the “Suicidal Behaviour Section” from DIGS.

Suicidal behaviour occurred in 21.8% of the patients, with voluntary drug overdosing being the most used method. Although men showed to use more violent methods, the behaviour was more frequent in female patients. There was no association with the severity of delusions or hallucinations.

The absence of formal thought changes, emotional withdrawal and affective blunting (meaning greater emotional reactivity) showed to be risk factors for the occurrence of suicidal behaviour.

This work may have relevant clinical implications due to its potential to guide the clinician in identifying a suicidal profile among his/her patients with Schizophrenia and delineating early intervention strategies.

To find out difference of methods and circumstances of parasuicides, anamnesis of suicidal behavior in men and women.

Object of study: suicide attempters over 15 years old admitted to the psychiatric hospital within one month after parasuicide (N=264; 114 men, 149 women).

EPSIS 5.1 based questionnaires; the Motive for Parasuicide Questionnaire.

Cutting was the most frequent mean of suicide attempt (48%), poisoning with psychiatric drugs was the second (19.5%), hanging - the third (11%). Men more often used cutting and hanging, women - poisoning with psychiatric drugs (ρ< 0,05). Portion of 56% were alcohol intoxicated at the time of the act (more often - men). Conflict with partner turned to be the most common trigger for men and women. Women more often expressed their motive as “wish to escape” and “wish to attract attention”. Women had more suicide attempts previously (26,8% versus 11,3%). They also expressed their suicidal ideation in direct utterance more often (11,3% men, 26,9% women).

Men used more violent methods of parasuicides. Women more often used psychotropic drugs, what can be connected with their more intensive contacts with mental health services. For women parasuicide was more common behavior and was more often used as a way of communication. Prevalence of parasuicide methods in Belarus differs from other countries likely due to the discrepancy of patients who are admitted to psychiatric hospitals after suicide attempts.

Police officers are important gatekeepers in suicide prevention, but at the same time, cases of suicidal behaviour and suicides are, among other deaths, one of the most stressful parts of their job. Police trustees are a special group of police officers who offer support to their colleagues in ambiguous or stressful cases.

The objective of this study was to educate and train the police trustees on suicide prevention and help them dealing with the suicide related situations. Besides, we aimed to evaluate the effects of the intervention.

13 police trustees (Mage = 39,23 years; SDage = 16,23) participated in our 1-day workshop. We used a pre-post evaluation design with both quantitative and qualitative questions. We used Perceived Stress Scale PSS (Cohen et al., 1983), and additional questions on self-perceived competence and anxiety regarding suicide related situations as evaluation tools.

Preliminary results show that according to the questionnaire's norms, four participants reported slightly higher level of perceived stress prior to our training. Further on, most common answers on self-perceived competence questions were either moderately or quite competent in suicide related situations, but participants also feel moderately to severely anxious in these situations. Our workshop met the expectations of a vast majority (86%) of attendees.

In our opinion, preliminary results show a great need for further cooperation with the police in suicide prevention initiatives. Follow up evaluation will serve as an indicator of the workshop's efficacy and will serve as guideline for its improvement.

Chernobyl nuclear reactor accident tat occurred on 26 April 1986 was the greatest technological disaster in history. There is evidence that the accident has had a significant long-term impact on psychological well-being of the affected population. In particular, the rate of suicidal behavior has increased dramatically among the exposed population. At the same time, little epidemiological information about parasuicidal individuals is available.

This study was design to extend our understanding of suicidal behavior by examining same of the socio-demographic and mental health characteristics of suicide attempters in the region affected by Chernobyl nuclear disaster.

From January 2009 to June 2010, we interviewed 443 suicide attempters (244 man and 199 women) received treatment at Gomel regional psychiatric hospital (Belarus).

The most important risk factors identified were younger age (18–29), being single or divorced (70.5% of males and 62.8% of females), being unemployed (59.1% of males and 68.7% of females), having mental disorders (71.7% of males and 87.9% of females), having previous suicide attempts (17.6% of males and 22.6% of females). The most frequent diagnoses were neurotic disorders and adjustment disorders for women and personality disorders for men. In this study, 57.8% of men and 34.2% of women had consumed alcohol before their parasuicide. Alcohol dependence was diagnosed in 48% of male parasuicides and 24.1% of female parasuicide.

These findings are consistent with previous research indicating a causal role for mental health problems and alcohol abuse in suicidal behavior.

Suicide is one of the main causes of premature mortality in Belarus, brining considerable losses of human lives. There is strong evidence of a crucial role of alcohol in explanation of high suicide rate and its profound fluctuations over the past decades in this country. The aim of this study was to examine the relation between the overall alcohol consumption and suicide mortality rates in Belarus.

Trends in alcohol consumption per capita and age-standardized male and female suicide rates from 1980 to 2005 were analyzed employing ARIMA time series analysis.

Alcohol consumption is significantly associated with both male and female suicide rates. The results suggest that 1 litre increase in overall alcohol consumption would result in a 7.4% increase in the male suicide rates and 3.2% increase in female suicide rates. The estimated effects of alcohol consumption on the age-specific suicide rates for men ranging from 0.024 (15–29 age group) to 0.082 (30–44 and 45–59 age groups). The estimated effects of alcohol consumption on age specific rates for women were positive for age groups 15–29 (0.017), 30–44 (0.047), 45–59 (0.039) and 60–74 (0.017). The estimated alcohol attributable fraction (AAF) for men ranging from 28% (15–29 age group) to 67% (30–44/45–59 age groups) and for women raging from 21% (15–29 age group) to 47% (30–34 age group).

The outcome of this study provides indirect support for the hypothesis that alcohol played a crucial role in the fluctuation in suicide mortality rate in Belarus during recent decades.

For the last few years Psychiatry has been challenged with the difficult task of meeting the unstoppable social demand, and to try to find medical answers to the suffering that daily living generates. Disconnected from their past and with an uncertain future, patients often they demand instant happiness, forgetting that the job of giving sense to one's own life is the intimate task of each human being, whether they suffer from a mental illness or not.

Analyze the frequency and severity of suicide attempts treated in an Acute Mental Health Unit (MHU).

Systematic review of cases who attended the casualty department in 2010 after a suicide attempt and finally those who that got admitted in the Acute Mental Health Unit (MHU).

From a total of 61 men and 100 women, most attempted suicides by women were in the context of a relationship breakdown and a “manipulative” goal. Those admitted to the MHU resulted in 28% men and 15% women.

All suicide attempts are serious since they are motivated by a suffering that the person can’t bear. Even the so called “manipulative”, the patient's life might have been at risk.

Whether we have to admit the patient for a serious vital risk or we plan an out-patient treatment, we are obliged to meet the implicit demand, often desperate, without being overwhelmed by our anguish towards death, thus beginning to articulate mature and honest ways out of situations that once were seen as impossible to solve.

About 150,000 people each year present themselves to NHS after an episode of self harm. This project has tried to provide an easy, step by step guideline to help the assessor to make safe and rational management plans for self harming patients in an acute setting.

A flowchart was designed on the basis of current literature, guidelines and consulting with few experienced psychiatry consultants. Then its validity and reliability was tested in three small pilot studies. Anonymous cases studies were used for these pilot studies.

The flowchart divides patients to five groups between “No risk” and “Definite risk to self/others” on the basis of assessor's observations and reports by patient, carer and other medical professionals.

In next step, answering to three basic questions: “Is there any history of previous serious self harm with similar presentation?”, “Is there a supportive adult at home?” and finally “Is there any severe mental illness in the patient?” would lead the assessor to one of these management plans: “Admit”, “Home with crisis team support”, “Home and CMHT referral” and finally “Home with GP follow up”.

The preliminary results suggest some potentials for clinical use of this guideline by GPs, psychiatry liaison services and junior doctors. However this guideline is not and shall not be used as a replacement of doctor's clinical judgment and seeking proper advice. Further clinical studies on real cases are required to confirm validity of above findings.

Suicidal ideation and behavior are present among Kosovar youth. The suicide rate is lower compared to the suicide rate in other countries, however the data indicate it is an increasing inclination. This study tends to asses the interaction between anxiety, depression and hopelessness with suicidal and behavior among the young people.

The sample consisted of data collected from 25September-30 November 2008 2001 to 2005. 2393 participants were high school students (grades 11–13) from 25 municipalities of Kosovo. Participants completed the Questionnaire on Suicide ideation and behavior (Q-SIB), Hamilton Anxiety Depressive scale (HADS), Brief Hopelessness Scale (BHS), and demographic survey. Data collected are analyzed with statistic program SPSS 12, and statistic parameters are used .

The analysis revealed that the anxiety, depression and hopelessness are related with suicide ideation and behavior (arithmetic mean M, standard deviation SD), p < .001, Also T-test was used.

These findings contribute to a theoretical framework, which has implications for educational and clinical intervention. The present findings will help guide further preventative research on examining sub-clinical anxiety and depression, also hopelessness.

Exposure to traumatic events may precipitate suicidal ideation and previous research has shown that specific PTSD symptoms, particularly hyperarousal and intrusive thoughts, correlate with suicidal ideation.

To test if gender-specific configurations of PTSD symptoms are predictive of suicidal ideation.

To provide practitioners with gender-specific and refined PTSD symptom indicators that may precipitate suicidal behaviour.

A male group (N = 161) and a female group (N = 56) of South African police officers were assessed by means of the Posttraumatic Diagnostic Scale and a short version of the Adult Suicide Ideation Questionnaire. Linear and hierarchical regressions were used to determine which PTSD symptom criteria best predicted suicide ideation.

Hyperarousal was the primary predictor of suicide ideation with males (R2 [adjusted] = 0.249), with avoidance added only marginally (2.5%) to the model. For females intrusive thoughts was the primary predictor of suicide ideation (R2 [adjusted] = 0.381), with general problems adding 7.4% to the variance declared in the model. In both cases the contributions of the remaining two symptom types were negligible.

In this study hyperarousal (for males) and intrusive thoughts (for females) significantly correlated with suicide ideation and it is suggested that practitioners be alert to gender-specific symptom groupings as possible indicators of suicidal ideation. This has implications for suicide risk assessment and prevention measures.

In the Netherlands, there is an increased incidence of non-affective psychotic disorders (NAPD) among first- and second-generation migrants from Turkey, Morocco, Surinam and the Netherlands Antilles.

The purpose of this population-based study was to compare the risk of suicide in Dutch natives and immigrants with or without NAPD. We examined the influence of NAPD, ethnicity and history of migration (first or second generation).

Cases of NAPD (n = 12,580) from three Dutch psychiatric registers were linked to the cause of death register of Statistics Netherlands and compared to matched controls (n = 124,547) from the population register, who had no such diagnosis. Hazard ratios (HRs) of suicide were estimated and adjusted for age and gender by Cox regression analysis.

The presence of NAPD was strongly associated with suicide risk in each ethnic group.

However, for most ethnic minority groups the HRs were somewhat lower than among Dutch natives, for whom the HR was 30.4 (95%; 22.8–40.7). A closer examination revealed that suicide risk was influenced by history of migration. While the risk for immigrants of the first generation, diagnosed with NAPD, was significantly lower than that for native Dutch patients (HR = 0.44; 95% CI: 0.27–0.72), the risk for those of the second generation was similar to that for the Dutch (HR = 0.81; 95% CI: 0.48–1.38). The same pattern was found among first- and second-generation immigrants not diagnosed with NAPD.

Immigrants of the first generation appear to be protected against suicide, whereas this protection is waning among those of the second generation.