Some studies suggest seasonality of suicide attempts in females, but not males. Only few studies investigated whether gender differences in seasonality of suicide attempts reflect gender differences in the choice of method, with inconsistent results.

To analyze the association of gender with seasonality in suicide attempts by persons living in two Northern Bavarian regions (city of Nuremberg and region of Wuerzburg) between 2000 and 2004.

The sample consisted of 2269 suicide attempters (882 males and 1387 females). The overall seasonality was assessed using the chi2 test for multinomials. Moreover, the ratio of observed to expected number of suicide attempts (OER) with 95% confidence intervals within each season was calculated.

Overall distribution of suicide attempts differed significantly between seasons for women (chi2 = 9.19; df = 3; p = 0.03), but not for men. Female suicide attempts showed a trough in the spring (OER = 0.9; 95% C.I. = 0.8 – 1.0) which was restricted to female low-risk suicide attempts (OER = 0.87; 95% C.I. = 0.77 – 0.98). No seasonality was found for men. Seasonality of high-risk methods was more pronounced than that of low-risk methods; however, no significant gender differences were found.

The overall distribution of the sub-types of suicidal acts (parasuicidal gestures, suicidal pauses, suicide attempts in the strict sense) showed seasonality neither for males nor for females.

Whereas seasonality was absent in male suicide attempters, the frequency of low-risk suicide attempts in females was 13.1% lower than expected in the spring.

Suicide is a major public health problem in most of the countries because it has a high prevalence in young people. It has been studied that high levels of cortisol are associated with depression and increase of the suicidal risk.

To analyze the relationship between cortisol levels in a population of university students and the questionnaire results for the Beck Depression Inventory (BDI).

The sample was composed by 106 students of the Nursing School of Santiago de Compostela University. The 88.7% of the sample are women with a mean age of 21.50 + /−2.52, the 99% are unmarried. The protocol consisted in 3 sections: demographic variables, BDI questionnaire with spanish scale and determination of salivary cortisol levels. Statistical analysis was done with SPSS 15.

The are higher levels of salivary cortisol in students with a greater or equal score to 13 on the BDI with statistically significances differences (p = .000). Students with suicidal ideation (item 9 of the BDI) have highest rates of cortisol, with statistically significant differences (p = 0.001).

This study supports other researchs about the association between biological neuroendocrine markers and affective disorders. Explaining suicidal behavior could help us to prevent it by using early intervention strategies for vulnerable populations. They could also identify markers to establish the risk of suicide.

Suicide notes are considered very sensitive markers of suicide attempt severity providing a lot of information about the mental state of the victim. An interesting question is whether note writers differ from suicide victims who don’t leave suicide notes.

To present and discuss the differences between these two subgroups. We collected psychological autopsy data from one year's suicide deaths (November 2007 -October 2008), at the Athens’ Department of Forensic Medicine (covering 35% of the total Greek population).

Note writers represented 21.7% of our sample (30 out of 138), had no history of psychiatric disorders (p = 0.003) or recent (psychiatric) hospitalization (p = 0.026), were mostly men (p = 0.001), and died by hanging or shooting (p = 0.04). We believe that the powerful stigma associated with psychiatric disorders in our Country could provide a possible explanation for our results. A lot of people suffer in silence. For many of the deceased's relatives the suicide note provided, for the first time, an insight into their loved one's mental problems. It is also believed that psychiatric symptoms are indicating character weakness, incompatible with the sense of power that, particularly men, should display. Finally, it is well-known that men commit suicide more often than women, choosing more violent methods (hanging or shooting) compared to them.

More efforts against mental illness stigma and towards improving detection of psychiatric disorders are needed in our Country. Unfortunately, suicide notes seem to represent the first and only means of communication of mental suffering for a lot of people.

In Western Europe male die much more often by means of suicide than do females, although females attempt suicide more often. This pattern has been found in Belarus with some peculiarities.

Men and women under 18, who committed a suicide or made a suicide attempt.

To investigate peculiarities of suicides and parasuicides among men and women in Belarus in order to reveal target group for suicide prevention.

We used the Suicide database of the Ministry of Health for epidemiological analyze.

The study is still being carried out. The male to female suicide ratio is 5:1 in 2008 year. Prevalence of suicides hasn’t changed a lot in women during last 20 years. It rapidly grew among men in the beginning of 90ies with the peak in 2000 year. Then it started to decrease slowly with the rate of 48,5 in 2008 year. Prevalence of suicides is 2.5 time higher in countryside in comparing with cities. Men have higher suicide rate in age from 40 to 60 and after 70 years old, women -after 70 years old. Data on parasuicides have been collecting centrally since 2007. Prevalence of parasuicides was 80 per 100 000 of population and male: female ratio was 1:1 in 2009.

Men show a big influence of socio-economical state on suicidal behavior. Risk factors have different power in cities and in countryside. Main group for suicide prevention is 40–60 years old men in countryside with alcohol dependence.

There is a high frequency of attendance at emergency medical service for suicide attempts.

Determine the type of urgency for suicide attempt in our country.

The present study treats of suicide attempts (n = 248) attended by the Psychiatric Emergency Service of Hospital in our city between 2004–2008. The diagnoses were made by clinical interview following ICD-10 criteria.

248 suicide attempts (60% women), with age between 15 and 88 years.There are equal proportions of singles and married (a 38%). 53% live with couple with/without children, 30%live with parents and a 10%live alone. >55% of patients have a middle education and socioeconomic level. The average time from suicide attempt until the assessment in the emergency department is 2.71 ± 3.64 hours. The day of the week with more assistance for this reason is Monday. Also it's observed an increase in the months between May and October. The cases are uniformly distributed throughout the month, although there is a decrease in the number of cases in the initial and final days of the month. 60% of patients haven’t history of previous attempts and use an only method that is drug overdose. Personality disorders are the most frequent diagnose and 44% patients need an internment in a psychiatric ward.

Profile of the patient who makes a suicide attempt and that is evaluated in the Psychiatric Emergency Service of our Hospital: woman 36 years old, married/with couple and lives with him/her. She comes to emergency department in the first 4 hours after the drug overdose. She hasn’t history of previous attempts.She is diagnosed of emotionally unstable personality disorder.

Previous research has suggested that the consumption of different types of alcoholic beverage may have a differential effect on suicide rates. The aim of this study was to examine the relation between the consumption of different beverage types and suicide rates in Russia across the later-Soviet and post-Soviet periods.

Age-standardised sex- and age-specific suicide rates for the period 1980–2005 and data on beverage-specific alcohol sales were obtained Russian State Statistical Committee (Rosstat). Time-series analytical modelling techniques (ARIMA) were used to examine the relation between the sale of different alcoholic beverages and suicide rates.

Vodka consumption as measured by sales was significantly associated with both male and female suicide rates. The consumption of beer and wine were not associated with suicide rates. The estimates of the age specific models for men were positive (except for the 75+ age group) and ranging from 0.069 (60–74 age group) to 0.123 (30–44 age group). The estimates for women were positive for the 15–29 age group (0.08), 30–44 age group (0.096) and 45–59 age group (0.057).

These findings suggest that public health efforts should focus on both reducing overall consumption and changing beverage preference away from distilled spirits in order to reduce suicide rates in Russia.

In most countries suicide rates are generally higher in rural than in urban areas. In many countries there has been a disproportionate increase in rural suicide contributing to greater rural/urban gradient. A wide range of factors, including social isolation, material deprivation and unfavorable changes in the demographic structure, have been cited as possible reasons for comparatively higher suicide rates in rural community. Given that alcohol abuse is a major risk factor for autoagressive behavior, we assume that alcohol may be the reason behind rural/urban gradient in suicide.

The aim of this study was to examine the suicide and fatal alcohol poisoning rates (as a proxy for binge drinking) among rural and urban population of Belarus.

Using country age-adjusted, gender-specific mortality data between 1990 and 2005, we estimated rural/urban differentials in suicide and fatal alcohol poisoning rates over time. Results: Significant rural/urban gradient in suicide and fatal alcohol poisoning rates was found. The gradient increased consistently, suggesting widening rural/urban differentials across the period. The results of the correlation analysis indicate the presence of close association between the two variables for rural man and women.

The increase rural/urban gradient in suicide observed in this study might to some degree reflect differentials changes over time in the alcohol-related problems rate for rural and urban population.

The Chernobyl nuclear reactor accident that 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 suicide has increased dramatically among the exposed population.

This study was design to examine same of the socio-demographic characteristics which might explain this rise.

A psychological autopsy study of suicides occurring in the regions affected by Chernobyl nuclear disaster between 2003 and 2007 was conducted.

The suicide rate among the affected population is 3–4 times higher (95–130 per 100.000 of the population) than among general population (33 per 100.000 of the population). The risk factors for suicide among the affected population are the same as for general population. These include unemployment, low income, low education level, acute and chronic alcohol intoxication. Alcohol dependence was diagnosed in 70% of male suicides and 71.4% of female suicides. Alcohol dependence was diagnosed more frequently among men age 30–39 (81.1%) and 50–59 (80%). In the present study 72.3% of males and 62% of females were BAC-positive at the time of death. Positive BAC cases were found more frequently in men age 30–39 (86.5%); 50–59 (86.7%) and women age 30–39 (85.7%).

These results are consistent with previous studies suggesting that acute and chronic alcohol intoxication may function as proximal and distal risk factors of suicide.

Deficits in executive functions may play a leading role in late-life suicide behaviours.

To determine whether executive functions, and more specifically cognitive inhibition, could be associated with increased risk of suicidal behaviours among depressed elderly individuals.

We compared 10 depressed suicide attempters aged 65 and older with 10 depressed suicide non-attempters matched for age, gender and education. To assess cognitive inhibition, we used neutral material, in the form of the Modified Card Sorting Test (MCST), Go-No-Go task (GNG) and Stroop test (ST). The Brixton Spatial Anticipation test (BSA), the dual-task performance and verbal fluencies test were also used to assess flexibility, planning tasks and memory.

Suicidal (mean, 75.30 years; 70% female) and non-suicidal (mean, 72.90 years; 70% female) depressed groups were comparable in terms of burden of physical illness and severity of depression according to the Hamilton Depression Scale (mean score 27.90, p = 0.529). Suicide attempters showed greater impairments in cognitive inhibition as illustrated by significant between-group differences in the number of MCST errors (p = 0.023) and MCST preservative errors (p = 0.035), and by the trend of worse performance on GNG (p = 0.052). No significant differences were found in the scores on ST, BSA, dual-task performance and in semantic or phonemic verbal fluencies. Furthermore, suicide attempt was also associated with GNG score (adjusted Odds Ratio = 0.25 [95CI = 0.07–0.95], p = 0.041) after adjustment for age.

Our case-control study shows that poor cognitive inhibition is associated with suicidal behaviours in late-life depression.

The attachment says “sécure” facilitate better scores in these 3 markers.

1. 1) The regulations emotional Secure does not protect against strong suicidal ideation in patients suffering from major depressive disorder. Freud's theory of trauma in this direction by assuming a tolerable threshold above which any topic is disorganized. (p-value = 0,05)

2. 2) The strategies of emotional regulation parts protect against suicidal thoughts while concerned about emotional regulation strategies to expose depressed suicidal subjects. (p-value = 0,09)

3. 3) According to the literature, we find a better alliance with secure attachment. (except at the beginning of care) (p-value = 0,06 at period T3 and p-value = 0,08 at period T6)

The current study aims to test the hypothesis: Is suicide predictable? And try to classify the predictive factors in multiple suicide attempts.

A cross-sectional study was administered to 223 multiple attempters, women who came to a medical poison centre after a suicide attempt. The participants were young, poor, and single. A Regression Logistic Test was used to classify the predictive factors of suicide.

Women who had multiple suicide attempts exhibited a significant tendency to attempt suicide again. They had a history for more than two years of multiple suicide attempts, from three to as many as 18 times, plus mental illnesses such as depression and substance abuse. They also had a positive history of mental illnesses.

Results indicate that contributing factors for another suicide attempt include previous suicide attempts, mental illness (depression), or a positive history of mental illnesses in the family affecting them at a young age, and substance abuse.

Suicidal behavior represents a major public health issue. There has been a controversy concerning the possible increased risk of suicidal behaviour in some depressed patients treated with antidepressants and whether antidepressants affect the risk of suicidality among patients with major affective disorders is still matter of debate.

To investigate the real impact of SNRIs in treating patients with unipolar and bipolar disorder.

Recently we aimed to evaluate the efficacy of duloxetine versus venlafaxine in the acute treatment of unipolar and bipolar depression.

In a non randomized controlled trial, we recruited 62 participants as consecutive outpatients (41 men; 21 women) affected by unipolar and bipolar depression treated either with duloxetine and venlafaxine.

More patients treated with duloxetine had a positive response to treatment and remission both for depression (HAMD17 response: 90.3% vs 0.0%; p < .001; HAM-D17 remission: 48.4% vs 0.0%; p < .001), and anxiety (HAM-A response: 90.3% vs 6.5%; p < .001; HAM-A remission: 71.0% vs 6.5%; p < .001) than controls. Patients treated with duloxetine were also more likely to show a decrease in HAM-D17 suicidality (100% vs 45.2%; < .001) and an increase in the quality of life (SF-36 percentage of improvement: 6.35 [SD = 9.66 vs -2.58 [9.98]; p < .001) than controls.

Among SNRIs, based on our results, duloxetine is more effective in reducing anxiety and suicidal ideation. Both duloxetine and venlafaxine were safe and tolerated, and both may be successfully used in unipolar and bipolar depression.

Patients with white matter hyperintensities (WMHs) may be at higher risk for affective disorders and suicidal behaviour and affective temperaments may play a significant role in mood disorders.

Recently, we conducted a study in a sample of 247 patients with major affective disorders consecutively admitted as psychiatric inpatients.

We found that those with higher dysthymia and lower hyperthymia were more likely to have higher BHS scores, more WMHs, higher MINI suicidal risk, and more recent suicide attempts than patients with higher hyperthymia and lower dysthymia. Previously, we have reported that depressive, cyclothymic, irritable and anxious temperaments are risk factors whereas the hyperthymic temperament is a protective factor for suicidal behaviour, at least for suicide attempters. This is in line with recent genetic studies showing that the short allele of serotonin transporter gene promoter (5-HTTLPR) was significantly related to depressive, cyclothymic, irritable and anxious temperaments (but not to the hyperthymic temperament) and individuals with the short allele of the 5-HTTLPR and major affective disorders have more microstructural white matter abnormalities in specific brain regions.

In subjects with mood disorders, some temperament profiles in addition to WMHs presumably play a critical role in the emergence of hopelessness and suicidal behaviour. Differences among temperament profiles associated with WMHs may be used as biological markers for clinically grouping subjects at higher risk both for the emergence of mood disorders and suicidal behaviour (highly lethal suicide attempts) and this may have relevant implications for treatment.

1. 1. To examine all deaths in patients aged 16–65 years in Nottingham who were known to secondary psychiatric care services between 1998–2003.

2. 2. To compare the numbers of suicides with numbers in the general population.

3. 3. To identify the predictors of suicide.

Ethical approval was granted by the local research ethics committee. Patients who died between 1998 to 2003 were identified from our electronic database. AS reviewed case notes and filled out data on a template.

The Office for National Statistics (ONS) provided the causes of death and coroners’ verdicts, and the total numbers of suicides in the general population. All data was coded, entered onto a spreadsheet and analyzed using SPSS version 15.0.

Analysis was conducted using T-tests and chi-squared analyses to differentiate between groups. Logistic regression was performed to identify predictors of suicide.

Using a logistic regression model, the variables that predicted suicide were age (p < 0.001), diagnosis of affective disorder (p < 0.001), previous self-harm (p < 0.001) and being admitted to a psychiatric unit in the last year (p = 0.028). For each increasing year of age upto 65 years, the odds of dying by suicide decreased by 11%.

In total, 275 people aged 16–65 committed suicide in the study period. Of these, 71 were open to psychiatric services at the time of death.

The majority of patients committing suicide are not known to psychiatric services. There is a need for stronger links with primary care to improve identification of people at risk of suicide.

Assessment of suicidal risk is the most important and difficult goal in a psychiatric emergency. To prevent the suicide, it is essential to be effective and accurate with the prediction of individual cases and time-intervention.

To determine an assessment model which will reduce suicidal behavior. To identify risk and protective factorsGoal: Improve assessment, management and treatment of patients with suicidal thoughts and attempts in the psychiatric ward.

Prospective case-crossover study, 32 patients (19 men, 13 women), during 24 weeks. Psychiatric evaluation based on structural clinical interviews and questionnaires related to risk factors were conducted to patients with suicidal thoughts and attempts.

74% of cases with high Suicide risk were hospitalized; only 40% were medium risk. Frequent factors often identified were lack of hope, the presence of major mood disorders / schizophrenia, previous suicidal attempts, psychological distress and personality disorders. The risk for patients with strong or average desire for suicide attempt, if not subject to proper management is almost five times greater than other patients.

Compared to the general population, the risk of death from a person already having attempted suicide is seriously higher. Evaluation and selection of proper treatment and circumstances is the key for a significant reduction of suicidal thoughts within a short time.

Every year between 100’000 and 200’000 young people die by suicide and possibly 40 times as many attempt it [1]. Several studies analyze the seasonality of suicide in the general population, but few of them investigate it among young adults.

We look for a seasonal pattern in suicidal behaviors performed by young adults and evaluate the lethality of their behaviors.

We test the hypothesis that

1. (a) suicidal behaviors in young adults follow a seasonal pattern and

2. (b) acts performed by males have a different lethality that those carried out by females.

Analyses are based on data for 3614 cases of suicidal behaviours performed by individuals aged between 18 to 24 occurring between 2001 and 2008, provided by the Italian Institute for Statistical Analysis (ISTAT). Variables included in the analysis were gender, lethality of the act and season.

ANOVA shows a significant association between months and number of suicides with a significant difference between the first and the second semester. Peaks were found in January, March and May. Males have a significantly greater regularity of the peaks than females (Mann-Whitney U- Test p < 0,001). Females have a rapport between completed and attempted suicides of 0.14, while among males it is of 0.72.

Clinical implications of these findings should be considered with the aim of developing more effective preventative strategies targeted to this age group.

The accuracy of the Rorschach Test in identifying the pathway to suicide is still controversial, though it can help for a better understanding of the functioning of suicidal minds.

To investigate whether Rorschach indexes fit major suicidal models.

To evaluate whether Schneidman's psychache theory (1993), Baumeister's thought deconstruction model (1990) and Maltsberger's affect deluge model (2003) fit with Rorschach test indexes.

Three young women hospitalised for near-lethal suicide- attempts were analysed through the Rorschach test by trained researchers using the Exner Comprehensive System. The Concept of the Object Scale on the Rorschach (COR) and the Mutuality of Autonomy Scale (MOA) were used for a systematic assessment of object relations and as index of interpersonal relationship capacities respectively.

All the tests are scarce. All patients rejected Table 9.

Patient 1: L = 1.4, EB=3:0, X- index = 0.25, M- = 2, EA=3; X+% = 0.58; P=3; Zd = −1.5; Afr =0.2;Ego index = 0.5 sR=1 and S-CON = 9. COR: poor differentiation, articulation and integration and MOA level 2.

Patient 2 : L = 1.5; CDI +; EB = 2:0; Afr = 0.37. Ego index 0.3; EA = 2 ; S-CON = 8. COR = good differentiation and integration, though a poor articulation of the object, MOA level of 2.

Patient 3: L = 1.42; Ag=0, COP = 0; S-CON = 8; MOR = 2; Afr = 0.41, SumC’ = 1; CDI +; FM = 2, m = 1, M = 1. COR: scarce differentiation, severely impaired articulation and integration of the object, MOA = level 6.

Patient 1's Rorschach test suggests Baumeister's model; patient 2's test Maltsberger's model and patient 3's test Schneidman model.