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Rocketing healthcare demands are not currently paralleled by available economic resources and the fight against inappropriateness has had only a modest impact. Distribution equilibrium is afforded by various concealed and [...]

The temporal variations (month of the year, day of the week, and time of day) in attempted suicide have been studied from data on 13,553 suicide attempts by persons aged 15 years and over from 13 centres participating in the WHO/EURO Multicentre Study on Parasuicide mainly in the three-year period 1990–1992. Seasonal and temporal fluctuation in suicide attempts were found throughout Europe. The seasonal pattern for attempted suicide was similar with that seen for suicide with a spring peak and a nadir in December, but only in females. In contrast with suicide, in which deaths are most common on Mondays, the peak days for attempted suicide was Sunday with fewest attempts occurring on Friday. Again this pattern was only statistically significant in females. The peak time of day for attempted suicide in both series was the late evening, whereas suicide is most frequent in the daytime. Our finding that half of the suicide attempts occur in the evening or early part of the night is particularly relevant to prevention, especially the availability of telephone help-lines and the accessibility of other sources of help for people in crisis.

In order to measure social support among suicide attempters, an instrument was especially designed to be included in the follow-up interview study being part of the WHO/Euro Multicentre Study on Parasuicide which is carried out in cooperation with EC Concerted Action on Attempted Suicide. In this paper, which is to be the first in a series, the theories behind the design and the methodology are discussed, and some general results presented. Judged by the level of the need for support, there are some differences between the 10 European areas under study, but judged by the individual's perception of to what degree his needs are met, somewhat to our surprise the majority of the suicide attempters in the various areas under study agree in feeling that their needs for support are met to a great extent.

In a double-blind, placebo-controlled, parallel-group, randomized clinical trial, we studied the efficacy of long-term (1-year) oral treatment with acetyl-L-carnitine in 130 patients with a clinical diagnosis of Alzheimer's disease. We employed 14 outcome measures to assess functional and cognitive impairment. After 1 year, both the treated and placebo groups worsened, but the treated group showed a slower rate of deterioration in 13 of the 14 outcome measures, reaching statistical significance for the Blessed Dementia Scale, logical intelligence, ideomotor and buccofacial apraxia, and selective attention. Adjusting for initial scores with analysis of covariance, the treated group showed better scores on all outcome measures, reaching statistical significance for the Blessed Dementia Scale, logical intelligence, verbal critical abilities, long-term verbal memory, and selective attention. The analysis for patients with good treatment compliance showed a greater drug benefit than for the overall sample. Reported adverse events were relatively mild, and there was no significant difference between the treated and placebo groups either in incidence or severity.

Study objectiveTo determine if there are associations between rates of suicide and attempted suicide in 15-24 year olds in different countries in Europe.DesignAttempted suicide rates were based on data collected in centres in Europe between 1989 and 1992 as part of the WHO/EURO Multicentre Study of Parasuicide. Comparison was made with both national suicide rates and local suicide rates for the areas in which the attempted suicide monitoring centres are based.Setting15 centres in 13 European countries.PatientsYoung people aged 15-24 years who had taken overdoses or deliberately injured themselves and been identified in health care facilities.Main resultsThere were positive correlations (Spearman rank order) between rates of attempted suicide and suicide rates in both sexes. The correlations only reached statistical significance for male subjects: regional suicide rates, r = 0.65, p < 0.02; national suicide rates, r = 0.55, p < 0.02.ConclusionsRates of attempted suicide and suicide in the young covary. The recent increase in attempted suicide rates in young male subjects in several European countries could herald a further increase in suicide rates.