SUICIDE

1- TRENDS AND GENES

2-SYMPTOM SYNDROME RISK AND TREATMENT
3-VARIOUS MODELS OF SUICIDE

DEPARTMENT OF PSYCHIATRY
RDGMC
TRENDS AND GENES
Dr. Samhita Bhushan
2nd Year Resident , Psychiatry

Moderator- Dr. Gautam Anand

 INTRODUCTION

Latin word - Sui means one self and Cide means a

killing.

WHO definition:

An act of deliberately killing oneself.

Risk factors - mental disorder (such as depression, personality
disorder, alcohol dependence, or schizophrenia), physical illnesses
such as neurological disorders, cancer, and HIV infection.
 Risk Factors
Family history of suicide
Family history of child maltreatment
Previous suicide attempt(s)
History of mental disorders, particularly clinical depression
History of alcohol and substance abuse
Feelings of hopelessness
Impulsive or aggressive tendencies
Cultural and religious beliefs (e.g., belief that suicide is noble resolution of a personal dilemma)
Local epidemics of suicide
Isolation, a feeling of being cut off from other people
Barriers to accessing mental health treatment
Loss (relational, social, work, or financial)
Physical illness
Easy access to lethal methods
Unwillingness to seek help because of the stigma attached to mental health and substance abuse
disorders or to suicidal thoughts

 Protective Factors
Effective clinical care for mental, physical, and substance
abuse disorders
Easy access to a variety of clinical interventions and support
for help seeking
Family and community support (connectedness)
Support from ongoing medical and mental health care
relationships
Skills in problem solving, conflict resolution, and nonviolent
ways of handling disputes
Cultural and religious beliefs that discourage suicide and
support instincts for self-preservation
 HISTORY

Romans and Greeks

Relaxed attitude towards the

concept of suicide.
Continued into the Christian
church until the Council of
Arles in 452 stated "if a slave
commits suicide no reproach
shall fall upon his master.
 HISTORY

Greek thinkers like Pythagoras was against the act.

Belief that there were only a finite number of

souls for use in the world, and that the sudden
and unexpected departure of one upset a
delicate balance.

Aristotle also condemned suicide, for more practical

reasons, in that it robbed the community of the
services of one of its members.
 IMPORTANT ERA

The years of great depression:1929-1939- Marked increase in rates

The Second World War :1939-1945 Marked decrease in rates

Another peak in 1990s in USA among adolescents.

A period of decline 2003-2004.

 SUICIDE PROCESS MODEL
Risk and Protective factors.

Situational factors.

Intent to commit suicide.

Suicide attempt.

Death or survival.

After-effects.
 RISK FACTORS

Proximal Vs Distal.

Suicide behavior measured under five domains:-

Intensity and intent.
Lethality.
Motivation.
Precipitant.
Availability of lethal agent.
 DETERMINANTS OF SUICIDE
Cultural Factors.

Familial and Environmental factors.

Religion - least in Muslims

Health Risk Behavior - Chronic Suicide

Mental disorders.

Medical conditions.
 SOCIOLOGICAL FACTORS

DURKHEIMS FOUR TYPES OF SUICIDES (1897)

DURKHEIMS
THEORY
 PSYCHOLOGICAL THEORIES

Freuds theory

Eros Vs Thantos

Karl Menninger

Suicidal triad
 OTHER PSYCHOLOGICAL THEORIES

Aaron Beck (1974,1976).

Arbitrary inference
Selective abstraction
Overgeneralization
Magnification and minimization.
Hopelessness is an indicator.

Recent theories.
Negative self image
Cognitive schemas
Psychological pain
NEUROBIOLOGICAL DETERMINANTS

Heritability.

Personality.

Reduced level of 5HT (serotonin).

Genes involved TPH 1, 5-HTTLPR.

 CYBER SUICIDE

Also called social suicide.

Term used to describe a suicide or suicide

attempt that has been influenced by websites
on the internet.

Cyber suicide is usually denoted by a public

showing of the suicide or suicide attempt when
the victim uses a Webcam to record the suicide
attempt or provides a detailed discussion of
their own suicide plans on public suicide-
oriented Web sites and forums.
 WERTHER EFFECT

The sorrow of young werther.

Marilyn Monroe.
 PARASUICIDE
Term used to describe patients who
injure themselves by self-mutilation but
do not wish to die

Usually they do not feel pain.

Do it due to anger and release tension.

Having personality disorders and usually

more introvert, neurotic and hostile.

Female : Male : : 3 : 1
 GROUP SUICIDES

The horror of Jonestown

(18 Nov 1978).

Heavens Gate Americas UFO

religion (23 March 1997).
TERRORIST SUICIDES
PHYSICIAN ASSISTED SUICIDE
 EPIDEMIOLOGY

According to a WHO report published in April 2016 :

More than 800,000 people die by suicide every year.

It is the second leading cause of death among 15-29 yrs old.
Most suicides in the world occur in the South-East Asia Region.
75% per cent of suicides occur in low- and middle-income
countries.
Ingestion of pesticides, hanging and fire arms are common
causes of suicide globally.
 EPIDEMIOLOGY
Males Vs Females 3 :1 (except China ,Japan , Sri lanka).

Elderly > young.

Marital status:
Unmarried.
Separated.
Divorced.
Widowed.
Profession.
Farmer
Doctors
Students
Sailors
Summers more incidences.
WORLD SUICIDE PREVENTION DAY

September 10th.

Prevention of suicide is everybodys business.

Collaboration of International Association for Suicide

Prevention and World Health Organization (WHO).
THANKS