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Background: Psychoactive substances (PASs) are an important risk factor for suicide. This study investigated the sociodemographic characteristics, data related to the suicidal behavior, the methods employed, the circumstances of the events, and the use of PASs before dying in all suicides that occurred between 2005–2014 in the Brazilian Federal District, comparing cases with positive and negative detection for PASs in the post-mortem analysis to identify groups at greatest risk. Methods: A population-based, observational, cross-sectional study with an analytical aspect was conducted with suicides cases collected from local police, which toxicological examination was performed (headspace gas chromatographic-mass spectrometry-HS-GC/MS) for detection of ethanol and methanol in blood samples; immunoassay for other substances (cocaine, marijuana, benzodiazepine). Results: The results showed that the increase in the suicide rate was 10 × greater than the population growth, and 44% of the individuals used PASs before suicide. Individuals are more likely to die by suicide at home, be male, have tried before, and change their behavior days before death; they choose to hang as the method and are influenced by alcohol. Conclusion: Identifying what sociodemographic characteristics are associated with a fatal suicide attempt among individuals who use PASs and those who do not use and those who have/do not have mental disorders and what methods are employed could be employed as a path to better interventions. Thus, prevention actions could be planned and directed to individuals with greater risk. [ABSTRACT FROM AUTHOR]

Introduction: Suicide is considered as an intentional self-killing which happened because of complex factors, its rates are various from country to country. Typically, the suicide rate for men are more than women. Selecting an effective way for suicide could influence by complex elements including social, environmental, psychological and physical factors. Materials and Methods: Present cross-sectional study done at Hafte-Tir Medical Center from March 1995 to 2015 on 99 cases of attempted suicide by hanging. Among them, 85 (85.8%) were male and 14 (14.2%) were female. Variables such as age, gender, education, mortality rate, types of suspension, and previous history of suicide attempt were evaluated for these people. Results: Majority of suicides by hanging were done by men, which mainly occurs in the third or fourth decades of their lives. Complete suspension considered as a predictive operation of death. Among the studied variables, types of hanging represented a remarkable statistical difference for prognosis (p-value, 0.0001) and survival rate. Conclusions: Our results showed that the percentage of death, as a result of hanging, is higher among men rather than women which might be because of the highest number of men committed to suicide. However, we did not observe significant correlation between mortality of hanging and gender. [ABSTRACT FROM AUTHOR]

The aim of this study was to identify risk factors distinguishing inmates who attempt suicide from inmates who complete suicide. Compared with attempters, completers tended to be older, male, more educated, and married or separated/divorced; pretrial, committed for a violent crime, incarcerated in jail, housed in an inpatient mental health unit or protective custody setting, living in a single cell, not on suicide precautions, not previously under close observation; and more likely to act during overnight hours and die by hanging/self-strangulation. Targeted assessment of a broad range of risk factors is necessary to inform suicide prevention efforts in correctional facilities. [ABSTRACT FROM AUTHOR]

Kerala has one of the highest suicide rates in India. Prior studies conducted in Thiruvananthapuram in the south of Kerala and Kozhikkode which is a northern district have identified the demographic profile and the methods used for committing suicides. The present study, conducted in Ernakulam district which lies in central Kerala attempted to analyze the methods employed for committing suicide, as well as the age and sex profile of the suicides. The cases autopsied at a teaching hospital in central Kerala during an 18 month period were analyzed using descriptive statistics and ANOVA for this purpose. The study revealed that the female preference of self immolation (P 0.000) is statistically significant. Males on the other hand, showed a significant preference for poisoning (P 0.048). Senior citizens (aged above 60) had a less strong preference for hanging as a method of suicide (P 0.038), but they showed a statistically significant preference for self immolation (P 0.027). Those aged 30 or less showed statistically significant preference for drowning as a method for committing suicide (P 0.011). [ABSTRACT FROM AUTHOR]

Suicide, a pressing global health concern with far-reaching impacts on individuals and communities, necessitates a deeper understanding of its underlying mechanisms. Emerging evidence indicates that inflammation may hold a pivotal position in the pathophysiology of suicide but there is limited data available on genetic markers for inflammation in suicide, particularly in non-European ancestry populations. To address this gap, we first conducted a study of genetic variants in cytokine genes in population-based suicide deaths and postmortem controls in Delhi, India examining five single nucleotide polymorphisms (SNPs) in three proinflammatory cytokine genes (IL-1β: rs1143627 and rs16944, IL-6: rs1800795 and TNF-α: rs1800629 and rs1799724). The selection of these SNPs was based on their potential to impact the measures under investigation. A total of 490 unrelated individuals were included in our study, comprising 234 cases of suicidal death and 256 cases of non-suicidal death. The femoral blood sample was collected from each subject. Genotyping was conducted using the PCR-RFLP technique, which was validated through Sanger sequencing. Statistical group comparisons included examination of both genetic variation and covariates relevant to suicide risk (age, sex, marital status, SES). A quantitative analysis of psychological autopsy was also conducted. Population-based suicide deaths in Delhi, India were predominately deaths by hanging (92%) and poisoning (6%). Following psychological autopsies, the most common precipitating factor reported was intrapersonal issues (16 %), followed by mental illness (9%) and substance abuse (7%). Psychological autopsy analysis revealed underlying psychopathology in 23% of cases and 4% of controls. Several tested variants were significantly associated with increased suicide risk. Minor alleles of the SNPs rs1799724; rs1800795 and rs1143627 were found to be associated with suicide risk (95% CI; OR >2; p < 0.001). on the other hand, the major alleles of the SNPs rs16944 and rs1800629 were significantly associated with the suicide risk (95%CI; OR > 1.6; p < 0.001). Our findings align with previous research investigating the link between SNPs under study and depression or suicidal behavior. Providing new insights into the genetic factors that may contribute to suicidal tendencies in the Indian population in low- and middle-income countries (LMICs). Notably, the prevalence of prior psychiatric illness was relatively low in this population compared to Western populations, yet within the range (9 to 25%) commonly reported in Indian population studies. Furthermore, the data obtained from psychological autopsy findings shed light on an intriguing aspect, revealing an underdiagnosis of mental illness both in cases of suicide and among the general population. Addressing this underdiagnosis is crucial as it holds the potential to identify individuals at risk and provide them with the necessary support and interventions, ultimately preventing suicide and promoting overall mental well-being. Overall, our study lends support to the hypothesis that inflammation significantly correlates with suicidal behavior, while also revealing surprising generalizability in suicide patterns. Further analysis of this expanding cohort will contribute to validating these initial findings and enhancing our understanding of the topic. [ABSTRACT FROM AUTHOR]

Life events and circumstances leading to death change throughout the life course. In this study, 4 age groups within those who have died by suicide are compared in terms method of suicide, sex, occupation, mental disorders, prior suicide attempts, and life events prior to death. Analyses were based on a database of deaths by suicide and undetermined intent based on data in the Northern Ireland (NI) coronial files from 2005–2011 (N  = 1667). Research determined that hanging is very prominent as a method of death within the under-20 age group. Women who die by suicide are more likely to have a known mental disorder than men, and the proportions increase with age group. Relationship difficulties are associated with many of these deaths and particularly for males aged under 40 years. Physical health and life events were more relevant than mental illness per se, in males aged over 61 years. For a sizeable proportion of the cases included in the current database there was no information on the life events prior to death. Understanding the factors associated with suicide across age groups is essential to informing suicide prevention strategy and programs and the development of more nuanced and effective interventions. [ABSTRACT FROM PUBLISHER]

Death due to asphyxia is one of the most important causes of violent deaths. Domestic violence plays a great role in suicidal and homicidal violent asphyxia deaths. Various epidemiological and demographical parameters of our study are discussed in the present article. We found, death due to hanging constituted 321 (5.57%) of total deaths, which were subjected to medico-legal autopsy. Young adults of age group 21 to 30 years were accounted for maximum cases followed by 31-40 years group. In victims of hanging, 67% of total cases were of male while only 33% of cases were of female. Indoor places are the commonest places used by victims of hanging. Sari, dupatta and cotton rope are commonly used as a ligature material in hanging cases. Ceiling fan and ceiling hook are the ideal suspension point used by victims of hanging. Only in 0.93% of hanging cases, hyoid bone fracture is present. [ABSTRACT FROM AUTHOR]

Background Most attempted suicides have a low lethality, but hanging, drowning, and jumping from a great height have a high risk of completed suicide. The aim of this study was to assess the sociodemographic profiles of patients who attempted suicide using high lethality methods relative to all other methods of attempted suicide. Methods We retrospectively investigated all attempted suicides treated at a tertiary university hospital in Seoul between January 2008 and February 2012. The following variables were considered: the patients' attempted suicide methods, age, sex, history of attempted suicides, previous psychiatric history, occupation, and living conditions. The suicide methods were categorized into two groups: high lethality (e.g., hanging, falling, and drowning) and low lethality methods (e.g., self-poisoning and cutting). We investigated risk factors related to the choice of high lethality methods. Results A total of 560 patients were enrolled in this study. Deliberate self-poisoning was the most common method of attempted suicide (61.6%), followed by cutting (22.5%), hanging (10.4%), falling (4.1%), and drowning (1.4%). In logistic regression analyses, odds ratios for the choice of high lethality methods were 1.02 (95% CI =1.01 to 1.03, p < .01), 7.22 (95% CI =3.06 to 17.04, P < .01), and 0.59 (95% CI =0.35 to 0.99, p = .04) for age, previous attempted suicide with a high lethality method, and alcohol co-ingestion, respectively. Conclusions Our findings indicated that age and past attempted suicide using a high lethality method are associated with the use of high lethality methods for attempting suicide. [ABSTRACT FROM AUTHOR]

Abstract: Background: Hanging is a common method of suicide in many countries, and it has a higher success rate than other commonly employed modes of attempted suicide, such as self-poisoning. Study Objectives: The aim of this study was to determine the epidemiology and characteristics of near-hanging patients admitted to the main referral hospital in Arak, Iran. Methods: All patients with the diagnosis of hanging admitted between January 2000 and 2009 were included in the study. Data regarding demographics, radiographic studies, injuries, Glasgow Coma Scale score (GCS) on arrival, and outcomes, were examined. Results: During the 9-year study period, 43 cases of near hanging were identified. All patients were male, with a mean age of 24.2 years (range: 12–38 years). The median GCS at presentation was 6 (range: 3–12), and 83.8% of patients had a GCS of 8 or less. Cervical spine fracture of C2 was observed in two cases (4%). The imaging studies revealed that 62.7% of patients had an abnormal brain computed tomography scan, with brain edema being the most common finding (n=16, 37.2%), followed by subdural hematoma (n=10, 23.3%). Ophthalmologic examination demonstrated retinal bleeding in 24 patients (55.8%). There were four inpatient deaths among the study group, and 39 patients survived to discharge, yielding a mortality rate of 9.3%. Findings on presentation associated with subsequent mortality included a systolic blood pressure<90mm Hg, GCS<5, retinal bleeding, and pulmonary edema. Conclusion: Mortality among patients who present alive to the hospital after near hanging is low, including those with a low GCS on arrival. Ophthalmoscopic examination, as well as radiological examination of the brain and cervical spine, should be performed in cases of near hanging. [Copyright &y& Elsevier]

Suicide is an important public health hazard worldwide. A 4-year retrospective study from January 2000 to December 2003 was conducted to identify the favored methods in realized suicides among males and females in the west coastal region of India. During the study period, a total of 539 cases of suicidal deaths were autopsied. Males were predominantly affected (male: female—1.9:1). The age of the victims ranged from 13 to 90 years in males (mean = 40.1 years, median = 37.0 years) and 15 to 85 years in females (mean = 36.6 years, median = 32.0 years). Most favored method of suicide amongst males and females was hanging (36.9%, n = 199) followed by poisoning (34.7%, n = 187). Male dominance was apparent for each method of suicide except for self-immolation. Males were relatively more likely to use hanging and poisoning while females were more likely to prefer drowning and self-immolation as methods of suicide. Relatively younger females (mean = 33.0 years, median = 32.0 years) preferred hanging as a method of suicide when compared to males (mean = 42.4 years, median = 40.0 years). Among females, significantly younger females resorted to hanging when compared to older females who preferred drowning. On investigating the various theories proposed for choice of suicide methods in males and females in different regions we conclude that preference of method of suicide in men and women is complexly determined. In this region, availability, accessibility, popularity, and socioacceptability seem to be the major determinants in the choice of methods among males and females rather than violence associated and lethality of the method. Females were as likely to use lethal and violent methods as males in this region. [ABSTRACT FROM AUTHOR]

The typical circumstances of suicide occurrence in post-apartheid urban South Africa are described. Data comprise suicide cases from all geographical locations (urban municipalities) where an injury surveillance system has full coverage. Typical patterns were identified by means of a classification technique applied to eight variables descriptive of the events, their victims, and the suicide level of the cities. Six suicide mortality patterns were identified, most being race-specific and each associated with particular suicide methods. Preventive strategies should target local communities and specific population subgroups, and be appropriate and responsive to their sociocultural needs. [ABSTRACT FROM AUTHOR]

Background: In Lithuania, suicides are a grave public health problem, requiring more extensive investigation. The aim of the study was to assess the seasonal variations of suicides in Lithuania throughout the years 1993-2002, describing patterns by gender, age and method of suicide. Methods: The study material consisted of all registered suicides (n = 16,147) committed throughout 1993-2002 in Lithuania. Smoothed trends were inspected. The seasonal effect was explored using monthly ratio statistics and spectral analysis. Results: Suicides in Lithuania have a distinct annual rhythm with peaks in summer and troughs in December. The December frequencies fell by more than 23% in men and 30% in women, while June peak reached nearly 23% in men and July peak exceeded 29% in women, compare with the average levels, (p < 0.05). Hanging was the most common method of suicide both in men and women comprising up to 90% among all suicides in 1998-2002. Among different methods, only hanging suicides showed significant seasonal variations, especially in men. The seasonal amplitude has decreased over time. Conclusion: Substantial seasonal variations in suicides were associated with a high proportion of hanging. Extremely high suicide rates in Lithuania require further extensive studies and urgent preventive programs, taking into account the suggestions of this survey. [ABSTRACT FROM AUTHOR]

This paper reports 13 cases of near-hanging presenting to the Accident and Emergency (A+E) Department of a District General Hospital over a 52-month period. The purpose of the study was to analyse the epidemiology, methods, outcomes and complications of near-hanging. There were 13 cases in the study period, 12 of whom were male and 1 female. The mean age was 31 years. The most common method used was rope (five cases). The estimated mean duration of hanging was 5 min. Height of fall data was poorly recorded but only one fall was recorded as being more than 3 ft. Many had a very poor clinical picture on arrival of the ambulance crews: seven had a Glasgow Coma Score (GCS) of less than or equal to 8 on scene, of which five required intubation. Five patients required ventilation and a period of treatment on the Intensive Therapy Unit (ITU). There were no cervical spine (C-spine) injuries, nor neurological complications. There were two incidences of aspiration pneumonia. All of the patients made a full recovery. It is concluded that patients presenting with this injury go on to make a full recovery, despite an often dismal initial clinical picture. [Copyright &y& Elsevier]

The article presents a case report of Korsakoff's syndrome as a neuropsychiatric sequelae of attempted hanging. Strangulation has been cited as the cause of Korsakoff's syndrome in all surveys of the numerous causes of the disorder. The patient is a 39-year-old merchant seaman, who was found hanging in the ward lavatory of the ship. Oxygen and external cardiac massage were administered and the pulse and color were restored. He had no family history of psychiatric illness. The possibility of a hysterical pseudodementia was raised immediately after the attempt of suicide. The researchers concluded that intellectual defects in the Korsakoff's syndrome do not invalidate a diagnosis of the syndrome if other symptoms are present.

Hanging, one of the most common methods of suicide all over the world, is highly lethal and more than 70% of those who attempted suicide by using this method would die. In few cases, if the person is brought down within very short period of suspension and treated vigorously in hospital, there is always a hope for life. The present case report relates to a young adult who attempted to commit suicide by hanging and it is reported here because of rarity of such cases. [ABSTRACT FROM AUTHOR]

Introduction: Studies shows that about 16% of patients who attempted suicide are more likely to repeat the act within the first year; 23% within 4 years. Suicidal tendencies represent one of the main predictors of suicidal behaviors within one year. Objectives: The aim of the research was to evaluate how motivation and modality of a suicidal behavior changes over time. The purpose was to identify the risk factors, so that a correct prevention strategy could be put in action. Methods: The Department of Mental Health carried out an observational study involving 4 hospitals between 2016-2017. The study analyzed all the requests for counseling from patients who presented self harm and a suicidal thought. Results: The overall number of samples analyzed between 2016 and 2017 were 516 (n.273 in2016, n.243 in2017). Women presented a higher percentage of suicide attempts compared to male suicide attempts (51.6% vs 48.4%); The non-therapeutic drugs taking was the most frequent case (39.5%) in both sexes (61.3% vs 38.7%). In addition to this, death by hanging appears to be present in the male gender only. Patients who presented a suicidal behavior between 2016 and 2017, arrived in A&E with psychopathological problems which included mood swings (23.6%, F:54.1% M:45, 9%), whereas among the psychosocial problems were conflicts with the partner (56.8% vs 43.2%) and family problems (58.5% vs 41.5%). Conclusions: From the data found it emerges that a greater suicidal tendency occurs more in women than in men, who on the contrary, present more cruel, bloody actions. A careful analysis carried out over time could be the answer to manage all the red flags. [ABSTRACT FROM AUTHOR]

Hanging is one of the most common methods of suicide in India in which death of the individual occurs instantaneously. However, a few cases have been reported in literature in which death has occurred after a certain period or the patient has survived after prolonged resuscitative measures. Here a case of 18-year-old female is described who survived for seven days after hanging, remaining unconscious throughout in the hospital. She died due to cerebral damage caused by cerebral anoxia. [ABSTRACT FROM AUTHOR]

Introduction: Non-fatal suicide attempts are a risk factor for suicide, but less is known about its effect on the method of injury used in an eventual suicide death. This study examines the association between history of non-fatal suicide attempt and the risk of a poisoning suicide versus firearm or hanging suicide in Colorado.Methods: Nine years (2004-2012, N=7,020) of suicide deaths in Colorado were compiled through the National Violent Death Reporting System. With these data, a retrospective cohort study was conducted in 2015, examining the risk associated with a history of suicide attempt and an eventual suicide death by poisoning versus a firearm or hanging suicide death. Multivariable log-binomial regression modeling was used to analyze the possible confounders of age and county type and gender as an effect modifier.Results: Suicide decedents with evidence of prior suicide attempt were twice as likely to eventually die by suicide via self-poisoning rather than by firearm injury (relative risk=1.94, 95% CI=1.8, 2.1, p<0.001). A significant interaction (p<0.001) between prior attempt and gender was identified and the relationship between prior attempt and method (poisoning versus firearm) was stronger among male than female suicides (female attempt history, 1.16, 95% CI=1.07, 1.27, p<0.001; male attempt history, 1.91, 95% CI=1.69, 2.16, p<0.001).Conclusions: Individuals with a history of non-fatal suicide attempt are more likely to die by suicide via poisoning rather than firearm. Gender has a significant effect on this association. This information can be useful when discussing means restriction and suicide prevention efforts. [ABSTRACT FROM AUTHOR]

The article discusses the findings of a study on the incidence of suicidal acts with casualties reported in the Regional Institute of Medical Sciences (RIMS) hospital in Imphal, India. It was noted that the highest rate of suicidal method was poisoning, followed by hanging. It states the potential reasons why cases of attempted suicide are predominant in women including the use of less fatal approach to suicide and social bonds. The research revealed that summer had the greatest number of incidences of suicidal acts reported.

Introduction: In Portugal, drastic changes in suicide rates have been claimed in the last 10-year period. Portugal is frequently presented as an example of masked suicides within the registered undetermined deaths. References on suicide and undetermined death rates and trends in Portugal are outdated. Aim: To ascertain the actual numbers of suicide in Portugal providing the scientific community with an updated, methodologically correct, source of reference. Methods: Raw data of suicide deaths was obtained per year, by age, sex, geographic region and lethal causes, and specific rates per 100,000 habitants and age-adjusted rates were calculated. Results: From 1980 to 2009, rates of suicide mortality have remained stable, but this trend does not occur in all age groups, decreasing with respect to young people and increasing in higher age group. Mortality is much higher in males than in females, and in the south. Hanging is the main method. Mortality from suicide and undetermined causes correlate inversely and undetermined death and suicide rates ratio are close to 1:1. Conclusions: Suicide prevention should focus on males older than 55 years. A substantial proportion of deaths of undetermined causes seem to correspond to misclassified suicides. However, it is unlikely that not counting these masked suicides modifies the trends of suicide rates in the period under study. These are realistic trends for the Portuguese population. [ABSTRACT FROM AUTHOR]

Abstract: A case of a combined suicide by oxydemeton-methyl (Metasystox®) ingestion and hanging is reported. Dimethyl phosphate (DMP) proved to be a stable product of oxydemeton-methyl; for its determination a gas chromatographic/mass spectrometric procedure was performed. DMP levels were quantified in several liquids and tissue samples: measured concentrations were 103.31μg/ml DMP in gastric contents, 0.10μg/ml in blood, 1.40μg/g in liver, 2.87μg/ml in bile and 0.80μg/g in kidney. No DMP was found in either urine or cerebrum. On the basis of the distribution of the poison in the organism, and particularly due to the fact that no DMP could be detected in the urine and that also an amount of DMP was found in the gastric contents, it can be assumed that there was a close temporal connection between ingestion of poison and hanging. Therefore, it is a case of a primary combined suicide. [Copyright &y& Elsevier]

Presents news briefs related to medicine. Recommendation that insurance companies not be allowed to use genetic testing; Report that the average length of hospital stays decreased in the United States; How hanging is the most common suicide method among young men; Others.