Smoking and suicidal behavior are two major public health problems associated in epidemiological and clinical studies. Smoking has been associated with suicidal ideation, suicide attempts, and suicide, independently of mental disorders. Yet, the mechanism that links smoking and suicidal behavior is unknown. We investigated the relationship between the level of tobacco dependence and the severity of suicidal outcomes among suicide attempters.

We examined a sample of 542 adult suicide attempters to compare the characteristics of the attempts depending on the level of tobacco dependence. All participants had made a suicide attempt in the previous two years (criterion for suicidal behavior disorder). Level of tobacco dependence was assessed with the Fagerstrom test. Diagnoses were ascertained with the Mini International Neuropsychiatric Interview and suicidal behaviors were assessed, among others, with the Risk Rescue Rating Scale and the Suicidal Intent Scale. Impulsivity was measured with the Barratt Impulsiveness Scale.

Independently of potential confounders, heavy smokers (Fagerstrom≥7) made more attempts and reached higher medical lethality than non-smokers (OR=2.42; 95%CI= 1.43-4.11, p=0.001, and OR=1.88; 95%CI=1.09-3.24; p=0.03, respectively). Light smokers (Fagerstrom<7) were not associated with features of severity in their suicide attempts. The combination of high impulsiveness and severe tobacco dependence showed an additive effect on the number of suicide attempts (OR=3.55; 95%CI= 1.75-7.21).

A high level of tobacco dependence could indicate a specific vulnerability leading to more severe suicide attempts, which was only partially explained by impulsivity traits.

Survivors of suicide are generally supported by many kind of interventions focused on containing the pain and the grief of the loss at the most. The holding capacity of these approaches is essential but the experience taught us that survivors need more than just support. In many cases there is the possibility to work on the resources they have to go beyond and to resolve the dynamics that the loss had let emerge.

Aim of this paper is to present an experience of group psychotherapy with survivors of suicide.

The group was made of 6 survivors, weekly sessions, 12 in total, 1h 30m each, 2 psychotherapists with more than 5 years of clinical experience focused on suicide. The approach to the group was to understand and to resolve the dysfunctional dynamics that each of them had with the suicide and/or with the people around (family, parents, friends and so on) before and after his or her death.

The emerging and the comprehension of the dysfunctional dynamics helped the survivors to manage in a better way anguish and pain, resolving the grief and mostly to find the possibility of beginning again a life even with such a dramatic loss always present.

The approaches to help the survivors of suicide are not only supportive. The elaboration of the dynamics that the loss had enhanced can require a targeted psychotherapy as our model of group psychotherapy showed.

Suicide is one of leading cause of preventable deaths. Recent data suggest South India as one of the regions with highest suicide rates in World. In 2012, 1,35,445 people committed suicide in India according to the statistics released by the National Crime Records Bureau

Suicide note is one of the most important sources to understand suicide, which may be beneficial in suicide prevention. Studies on suicidal notes from this part of world are sparse

The aim was to study the themes in suicide notes that might be useful in prevention strategies

A descriptive study of all Suicide notes of those individuals who committed suicide between 2010 – 2013 available with Police Department,Mysore District was obtained and analysed.

A total of 22 suicide note were available. A majority of suicide note were in age group of 16-40 years (86%) and most were males (59%). All suicide notes were handwritten, majority (16) in regional language Kannada. Length of notes varied from just few words to few pages. Contents of suicide notes included apology, shame, guilt in 80%, love for those left behind (55%),instruction regarding practical affairs (23%). Most have blamed none for the act (50%). 23% committed suicide to prove their innocence. 32% mentioned a last wish.

Majority of suicidal note contained ‘guilt’ which is strong indicator of possible depression in deceased. Creating awareness about suicide among public ensuring access to professionals trained in suicide prevention is need of the hour in this part of world.

Suicide remains the leading cause of premature death in patients with psychotic disorders. The lifetime suicide risk for schizophrenia is approximately 10%.

This study aims to compare the suicide risk over the past decade following recent onset psychosis to findings from the eighties and nineties in the same catchment area and to identify predictors of suicide in the context of the Psychosis Recent Onset Groningen – Survey (PROGR-S).

A medical file search was carried out to determine the current status of all patients admitted between 2000 and 2009. The suicide rate was compared with a study executed in 1973-1988 in the same catchment area. Predictors of suicide were investigated using Cox regression.

The status of 424 of the 614 patients was known in July 2014. Suicide occurred in 2.4% of the patients with psychotic disorders (n=10; mean follow-up 5.6 years); 6 out of 10 suicides took place within two years. Within two decades, the suicide rate dropped from 11% (follow-up 15 years, 8.5% after 5 years) to 2.4%. The Standardized Mortality Rate (SMR) of suicides compared with the general population was 41.6. A higher age was the only significant predictor for suicide. Neuroticism, living situation, disorganized and negative symptoms, and passive coping style showed a trend for significance. A significant reduction in the suicide rate was found for people with psychosis over the past decades.

A considerable drop in suicide rate was found. Given the high SMR, suicide research should have the highest priority.

CYP2D6 and CYP2C19 are involved in the metabolism of widely used antidepressants and other drugs with psychotropic activity. They also participate in the metabolism of endogenous substrates, and are expressed in the brain.

This study examined, for the first time, whether a high CYP2D6-CYP2C19 metabolic capacity combination increases the likelihood of suicidal intent severity in a large study cohort.

Survivors of a suicide attempt (n=587; 86.8% women) were genotyped for CYP2C19 (*2, *17) and CYP2D6 (*3, *4, *4xN, *5, *6, *10, wtxN) genetic variation and evaluated with the Beck Suicide Intent Scale (SIS).

Patients with a high CYP2D6-CYP2C19 metabolic capacity showed an increased risk for a severe suicide attempt (P<0.01) as measured by the SIS-objective circumstance subscale (odds ratio (OR)=1.37; 95% confidence interval (CI)=1.05-1.78; P=0.02). Importantly, the risk was greater in those without a family history of suicide (OR=1.82; CI=1.19-2.77; P=0.002).

Further research is warranted to evaluate whether the observed relationship is mediated by the role of CYP2D6 and CYP2C19 involvement in the endogenous physiology or drug metabolism or both.

This work was supported in part by Union Europea Fondo Social Europea (FEDER/FSE), Instituto de Salud Carlos III-FIS (PI10/02758) and Gobierno de Extremadura Consejería de Economía, Competitividad e Innovación (IB13186 and PD10199). CHU Montpellier (PHRC UF 7653), Agence Nationale de la Recherche (ANR NEURO 2007 'GENESIS').

Those suicide attempters that choose violent methods dramatically diminish the possibility of survival. Completed suicide using violent means, which appears common among first-time suicide attempters, was recently found to be more likely among T allele carriers in the three most common ABCB1SNPs, encoding for P-gp.

This study examined, for the first time, whether the ABCB1(C1236T, G2677T/A, C3435T) SNPs were associated with the use of violent means among survivors of a suicide attempt.

Suicide attempters (n=578, 87.4% women; of whom 16.6% committed a violent intent) were genotyped for ABCB1C1236T, G2677T/A, C3435T. The relations of the three genotypes and of the TTT haplotype with the use of a violent suicide method were evaluated separately. The impact of confounds on these variables was controlled.

A higher frequency (p=0.02) of suicide attempters using violent methods was found among those carrying the ABCB1haplotype (1236TT-2677TT-3435TT). Since gender and number of previous suicide attempts were identified as confounds, the relation was tested in the subset of women who were first-time attempters or second- and more-time attempters. The ABCB1 haplotype increased the risk more than three times in those women attempting a violent suicide for the first time (OR=3.6; CI95%:1.08-12.09; p=0.04).

The ABCB1haplotype (1236TT-2677TT-3435TT) was related to the use of a violent suicide attempt method. Genotyping for these three ABCB1SNPs may be helpful to detect people at risk of first suicide intents using violent methods.

FEDER/FSE-GOBEX Consejería Economía, Competitividad e Innovación IB13186 and PD10199.

The suicidal behaviours constitute a significant problem in terms of public health, thus a major goal of the WHO is to reduce these behaviours.

In the '80s suicide rates and suicide attempts in the Trieste were the highest in Italy, comparable with those of Central Europe. Since the '90s a project was launched to prevent suicidal behaviour and suicide rates and non-lethal self-harm gestures have plummeted.

We study the sociodemographic variables of this phenomenon.

The aim of our study is to monitor the performance of non-lethal self-harm over time and identify evidences to implement prevention strategies

We conducted retrospective study in the period 01.01.2000- 31.12.2007.

We analyzed the records of hospital emergency rooms in Trieste, screened according to the keywords that indicate the diagnosis of access “self-harm” and “voluntary intoxication”.

Socio-demographic variables were stratified by age and gender.

Outcome variables were evaluated. Data were compared with those of a study conducted from 1993 to 1990.

The study showed a mean of 85/100,000 inhabitants. The methods most frequently used were drug intoxication and cutting. There was a reduction in hospitalisations rates and an increased number of appointments in the Mental Health Department by the subjects with a suicide attempt history.

The rates of non-lethal self-harm in the period considered decreased compared to the '80s, while the average age of those who commit the act increased. These data can be used to enhance the primary and secondary prevention strategies.

The rate of non fatal self-injurious behaviour in young people has increase in recent years. Non fatal self-injurious behaviour such as cutting oneself and abuse of substance is often performed without suicidal intent to cope with emotional distress although it is well known to have a close association with future suicidal behaviour.

Evaluating people under 29's suicidal behaviours' rates.

Monitoring developments in not lethal self injurious behaviour in the population of adolescents and young adults in Trieste to identify strategies that will guide the prevention of suicidal behaviour in this age group.

Retrospective study based on verbal access to emergency, extracts under the headings “self-harm” and “poisoning” during period 2000-2007. We considered as variables the calculation of rates for the age groups 15-19 and 20-29 years, mode of self-injurious act coded according to the parameters of the ICD-10.

The average rate for the age group 15-19 years was found to be 0.5 cases per 100,000 inhabitants, while for ages 20-29 was found to be 1.3 cases per 100,000 inhabitants. There wasn't a significant difference between the two genders.

The methods most frequently adopted were found to be voluntary intoxication and cutting.

To counter the fragility and risk of self-harm and suicide in adolescents and young adults, our Local Health Company launched in 2014 a dedicated website. The site provides information on the types of conditions that may affect the target population and the self-destructive behaviors.

A review of the literature shows that the self-injurious behaviours are more common among females, and suicides among male subjects. A significant difference between the two genders is also reflected in the choice of means used to commit the act of self-injuring, considering the male gender predilection for more violent means.

Some recent studies indicate trends that deviate from the above data in the literature or indicate a tendency to an attenuation of these differences.

Reasons for engaging in self-harm behaviours include to regulate emotion and to elicit attention. Correlates of these practices include a history of sexual abuse, depression, anxiety, alexithymia, hostility, smoking, dissociation, suicidal ideation, and suicidal behaviors.

Aims:

the aim of this study is to evaluate the gender difference in self-injurious behaviour.

Our retrospective study was conducted making a comparison between a period of time before and after the start of an articulated program of prevention of suicidal behaviors in Trieste, from 1983 to 2007.

In the '80, the self-injurious behavior were more common among males; after 2000 years this difference has continuously attenuated. This trend is in contrast with findings in the international literature.

Even the repeated acts of self-harm were more common among males.

Regarding the data on suicides, they were more frequent in male subjects, and this fact has remained stable over time, in accordance with international data.

More studies are necessary to evaluate gender difference in self-injurious behaviour.

Childhood abuse is inherited in families and mainly associated with poor physical and mental health. Its association with mental health problems in adulthood is not well-studied in Jordanian women.

This study aimed at examining the relationship between history of childhood abuse and experiences of mental health problems in Jordanian women.

to assess the prevalence of childhood abuse in Jordanian women and to examine differences in mental health problems based on type of childhood abuse.

Data about childhood abuse and mental health problems were assessed in 409 women visiting healthcare centers. Statistical analysis included descriptive statistics for prevalence rates and one-way between-groups multivariate analysis of variance (MANOVA) for relationship between mental health and abuse experiences.

Emotional abuse and physical abuse were the most frequently reported during childhood (47.1% and 46.5%, respectively). Statistically significant differences in mental health between women who experienced emotional abuse and childhood neglect and their counterparts were found (Wilks' Lambda for emotional abuse = 0.914, p < .0001; Wilks' Lambda for childhood neglect = 0.83, p < .0001). Mental health problems did not differ significantly between physically and sexually abused women compared to their counterparts.

Mental health consequences of childhood abuse last to adulthood. Emotional abuse and neglect can be more harmful and more damaging to women’s mental well-being than physical and sexual abuse. Mental health consequences of childhood abuse may alter women's commitments and obligations to others. Therefore, professional health efforts focusing on mental health should be established in healthcare centers.

Experiences of abuse during childhood and/or adulthood has an impact on women's mental health as well as generating frequent hospital admission. Experiences of abuse are common among female patients in general psychiatric care.

The aim of the study is to elucidate how nine women with experiences of physical, emotional and/or sexual abuse experienced the care provided at a general psychiatric clinic after disclosure of abuse.

Qualitative design with an inductive approach. Interviews with nine women who were recipients of general psychiatric care in an urban area in Sweden. The women had disclosed experiences of abuse to a member of staff. Qualitative inductive content analysis was used.

The nine women reported being subjected to abuse during childhood and adulthood, only one of them reported only being abused as an adult. The overall theme emerging from the narratives, 'Dependency as a reality containing a duality of suffering and trust' describe the general psychiatric care as caring and noncaring. In a caring environment was the women acknowledged, listened to and treated with sensitivity. Experiences of noncaring were when the abuse was disregarded, the women were not believed in, offended or self-blamed for the abuse. A noncaring environment focused primarily on the diagnosis and the experienced abuse was seen as secondary.

Women who have experienced abuse experience the care provided as caring as well as noncaring. General psychiatric could be supportive as well as belittling depending on staff at the clinic.

The most obvious that could be conceived is that after an intersubjective crisis situation such as a genocide, the victims fall under a heinous dynamics and a desire of revenge against their torturers. It is thus potentially paradoxical in such a context to imaginate a harmonious link, of deep attachment between the survivor and his attacker or his relative. However, the factual reality in the aftermath of the 1994 Rwandan genocide drama presents a different picture. Improbable families recomposed with the adoption of abandoned genocidaries (in flight) children by survivors.

To consider a healthy bond where the hatred in the trauma of the otherness seems as evidence becomes the most enigmatic paradoxes, that which comes the concepts of “hainamoration” in the trauma clinic.

The major question here is the one of the direction of this adoption for the survivors.

In other words, what whould be the real dimension of the relationship that is built between these abandoned children and the surviving victims of the destructive act of their parents ?

To understand the psychic mechanisms induced by the constraint of the Co-existance of two enemies after an intersubjective drama such as a genocid.

Consider a theoretical reflection in the service of trauma clinical and identify the paterns of the traumatic remission in such a context.

This study is based on our clinical experience in Rwanda after the 1994 genocid. The target populations here is the survivors of this genocid.

It is primarily based on psychopathology and psychoanalytic repositories from and maintains clinical observation.

'hainamoration” as mutation and/or transformation of the primary hatred into 'love” allows the victim to better reflect and decide the fate of his trauma. From this, we reach to the second conclusion that, with the constant desire for revenge and hatred that drives the survivor, “only love allows the enjoyment to condescend of desire” (of this revenge).

Reproductive events have a complex impact on women's lives. The possible effects of endogenous and exogenous gonadal hormones on women's psychological status are matters of debate.

This research aims at examining mood and sleep symptoms of women in different reproductive stages and in association to contraceptive use.

Data were collected at the Centralized Family Planning of the City of Helsinki (March 2012-February 2013) through a questionnaire regarding participants' reproductive features, psychiatric history and current psychological status at baseline and after 3 months.

A total of 208 women (18-50 years) accepted to participate: 52 (25.0%) starting contraception, 68 (32.7%) stopping or changing to a different method, 62 (29.8%) continuing with their current method, and 26 (12.5%) breastfeeding women. The response rate at follow-up was 73%. Psychiatric symptoms during the previous month were commonly reported both at baseline and follow-up (sleep symptoms: 86.1% and 80.3%, respectively; anxiety and depressive symptoms: 61.8% and 55.6%; death and suicide thoughts: 10.1% and 5.3%), with no differences between the contraceptive groups. At follow-up, women who continued with their contraception had higher risks of early awakening and tiredness (OR=3.312 and OR=2.942; p<0.05), and breastfeeding women of tiredness (OR=5.716, p<0.05), in comparison with women who stopped/changed their contraception. The type of contraceptive method did not influence the results. The contraceptive group was not significantly associated with the other, more severe psychiatric symptoms.

Sleep, anxiety and depressive symptoms are common among women; the use of contraception seems to only marginally associate with these symptoms.

Marital abuse is a serious social problem that has damaging impact on women's wellbeing. Therefore, prevention and intervention efforts require determining the risk factors involved.

Study the prevalence and risk factors of marital violence against women.

A descriptive cross-sectional and analytical study carried on 50 married women without psychiatric history.

Data collection was conducted via a questionnaire exploring socio-demographics characteristics and the marital relationship.

- The Conflict Tactics Scales (CTS): to assess verbal domestic violence (six items) and physical domestic violence (nine items).

- Maternity social support scale (MSSS): to evaluate the social and family support.

- Marital satisfaction scale of Azrin: assessing the satisfaction experienced of the wife at the partner's behavior.

The average age was 41 ± 11.5 years.

Education level did not exceed the primary level in 64% cases. The socioeconomic level was judged to be average in 72% of cases.

The prevalence of marital violence in its verbal and physical forms was 72%. More than one third of women (44%) reported that they were victims of physical violence.

Low socioeconomic level (p=0,003), low partner’s educational level (p=0,049), parental history of childhood abuse (0,002), poor marital satisfaction (0,001) and poor social and family support (0,01) were significantly associated with physical violence.

Marital abuse in its various forms remains a worldwide phenomenon. Several risk factors inherent to the woman, the husband and their marital relationship seem to be associated with marital violence in its physical form.

There is little information on cervical screening attendance in the psychiatric population. 78.3% of the general population have been screened once in five years. Evidence suggests that women with mental illness are less likely to engage in recommended health screening programmes. Reasons for non-attendance include shame and embarrassment, lack of knowledge, fear of a positive result, beliefs that the procedure may cause cancer and a high rate of sexual abuse, rendering the procedure too traumatic.

Cervical screening in the UK- recommended every 3 years for women aged 25-49 and every 5 years for women aged 50-64. Expected standard 100%

Cross-sectional survey of psychiatric inpatient sample, including ages 25-64, inpatient sample size 28. Questioned individuals about awareness of cervical screening programme, last/next screening date and cross-correlated with primary care records

25 (90%) were aware of cervical screening programme. 20 (70%) claimed correspondence from their doctor and had accepted the screening. Further analysis of primary care records indicated only 8(36%) had actually had the screening, with 20 (64%) being non responders.

Women with mental illness are 50% less likely to attend a cervical screening programme, compared to general population. Level of education appears to be an important indicator of uptake, regardless of severity and duration of illness.

Further exploration of identifying barriers to accepting such important screening tests needs to be conducted in the psychiatric population and raising awareness of such screening should not only be the domain of primary care, but also mental health services.

the influence of hormones in various psychological aspects of attention deficits are being studied increasingly more often and their significance has been acknowledge. However, hormonal fluctuations and the influence of estrogen on the brain has not been considered or treated. Recent studies show the influence of estrogen in the functioning and the functional consequences, observing an improvement in functioning, particularly in attention, of women during phases with high levels of estrogen. This can influence the treatment of Deficit Attention/Hyperactivity (ADHD) in females.

a systematic review was performed, searching for studies on the following databases: MEDLINE (PubMed), The Cochrane Library and EMBASE. The search was made using the Medical Subject Headings (MeSH) terms 'Sex/gender”, 'Response treatment” and 'ADHD/Attention-Deficit/Hyperactivity Disorder. Limiters were applied and Boolean logic used to expand and restrict searches. A total of 208 articles were identified, and 6 were included.

three main findings were identified: treatment with stimulant drugs is effective independent of gender; women had more complex presentation of ADHD, with more comorbidities such as depression and anxiety and women had one statistically significant gender-by-treatment response, but only on emotional dysregulation.

it is as yet uncertain as to the role of gender in the treatment of ADHD. While some evidence is more persuasive than others, results still can not be used safely by the medical community. Therefore further more study needs to be carried out to clarify the answer to this question.

Clinical and cost data will inform approaches to routine prenatal mental health screening.