Suicide prevention: a holistic approach

254 Pages·1998·2.44 MB·English

by  R. F. W. Diekstra

SUICIDE PREVENTION
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SUICIDE PREVENTION
A Holistic Approach
Edited by
D. DE LEO
Department of Psychogeriatrics, Institute of Neurology and Psychiatry, University of Padua,
Italy
A. SCHMIDTKE
Department of Clinical Psychology, Institute of Psychiatry, University of Würzburg, Germany
and
R. F. W. DIEKSTRA
Community Mental Health Center, Leiden and Municipal Health Authority, Rotterdam,
The Netherlands
Kluwer Academic Publishers
NEW YORK / BOSTON / DORDRECHT / LONDON / MOSCOW
eBookISBN: 0-306-47210-4
Print ISBN:0-792-34468-5
'2002 Kluwer Academic Publishers
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Table of Contents
Preface ix
1. Reflections on the State of Suicidology 1
R. F. W. Diekstra
2. Suicidal Ideation and Suicide Attempts: The Role of Comorbidity 15
with Depression, Anxiety Disorders, and Substance-use Disorder
T. Bronisch and H. U. Wittchen
3. Depression, Hopelessness and Suicide Intent in Attempted Sui- 27
cide: A Hospital-based Study of 201 Patients
A. T. Davison
4. Suicide Attempters who Attribute their Problems to Interpersonal 37
Difficulties
K. Michel and L. Valach
5. Suicide among Psychiatric Hospital Inpatients 45
A. Roy and R. Draper
6. Twin Research Perspective on Suicide and Suicidal Attempts 53
N. L. Segal and A. Roy
7. The WHO/EURO Multicentre Study on Parasuicide: State of the 63
Art and Future Directions
J. G. Sampaio-Faria
8. Suicide and Suicide Attempt Rates in Europe, 1989–1993: Rates, 67
Changes and Epidemiological Results of the WHO/EURO Multi-
centre Study on Parasuicide
A. Schmidtke, S. Fricke, B. Weinacker, U. Bille-Brahe, D. DeLeo,
A. Kerkhof, T. Bjerke, P. Crepet, C. Haring, K. Hawton,
J. Lönnqvist, K. Michel, A. Philippe, X. Pommereau, I. Quere-
jeta, E. Salander-Renberg, B. Temesváry, D. Wasserman and
J. G. Sampaio-Faria
vi Table of Contents
9. Relevance of Diagnostic Setting in Predicting the Outcome of 81
Suicide Attempters
P. Scocco and D. De Leo
10. Gender Differences in Adolescent Suicide 93
M. J. Marttunen, M. M. Henriksson, H. M. Aro, M. E. Heikkinen,
E. T. Isometsä and J. K. Lönnqvist
11. The Suicidal Process in Young Suicides 105
B. S. Runeson
12. Childhood Conceptions of Death and Suicide: Empirical
Investigations and Implications for Suicide Prevention 111
B. L. Mishara
13. What do we Know about Media Effects on Imitation of Suicidal 121
Behaviour: State of the Art
A. Schmidtke and S. Schaller
14. The Aftermath of Kurt Cobain’s Suicide 139
A. L. Berman, D. A. Jobes and P. O’Carroll
15. Media Reports on Suicide in Hungary, Austria, Germany and 145
Lithuania in 1981 and 1991. Reflection, Mediation and Changes
of Sociocultural Attitudes Towards Suicide in the Mass Media
S. Fekete, A. Schmidtke, E. Etzersdorfer and D. Gailiene
16. Shame and Guilt in Suicide and Survivors 157
N. L. Farberow
17. Shame – The Unbearable Legacy of Suicide 163
O. Grad and A. Zavasnik
18. The Erwin Ringel Memorial Lecture: On Suicide and Mental 167
Illness: How Right was Ringel?
J. Lönnqvist
19. A Critical Evaluation of Psychotherapy in the Treatment of Depres- 173
sion and in Suicide Prevention
D. Wasserman
20. Applications of Solution-Focused Brief Therapy in Suicide 185
Prevention
H. Fiske
21. Pharmacological Treatment of Suicidal Behavior 199
F. Schifano and D. de Leo
Table of Contents vii
22. Risk Factors for Non-Compliance with Outpatient Aftercare: 211
Implications for the Management of Attempted Suicide Patients
C. van Heeringen, C. Jannes, W. Buylaert and H. Henderick
23. Implementation of the Suicide Prevention Strategy in Finland: 219
First Follow-up
M. Upanne
24. Venlång: The Swedish National Programme for Suicide 225
Prevention
J. Beskow and D. Wasserman
25. England’s Policy on Severe Mental Illness 235
R. Jenkins
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Preface
Suicide prevention is still sadly neglected today by governments and public
health authorities, despite the fact that in several Western countries the phe-
nomenon has become the first cause of death among the younger age groups,
with a higher mortality rate than for road accidents. The World Bank and the
World Health Organization deem that suicide causes at least 800,000 deaths
per year throughout the globe and that the number of attempted suicides is
probably ten times higher. It follows that the people involved each year in
suicidal behaviour are several million in number, often leaving a long-term
legacy of emotional, social and economic distress.
These data, nonetheless, have not so far managed to provide backing for
preventive schemes of the same magnitude as the ones developed to tack-
le other public health problems of much lower epidemiological dimensions,
such as AIDS.
Some years ago, the European Office of the World Health Organization
set up a wide-scale multicentre study with a view to sensitizing national gov-
ernment authorities to the problem of suicide prevention, yet to date only a
very limited number of countries have actually promoted national programs.
Amongst these are Finland, Sweden, Norway and England. This apparently
contrasts with the multitude of existing national associations for suicide pre-
vention (although to be truthful, they are often composed of very few active
members) or supranational associations, such as the International Associa-
tion for Suicide Prevention (IASP), Befrienders International and the Inter-
national Academy for Suicide Research (IASR), the latter group addressing
in particular the promotion of high standard scientific study. “Man’s only true
philosophical problem”, to quote Camus, is, however, so complex to prevent
any attempt at comparison with other public-health issues, such as road acci-
dents. Consequently, strategies to counteract the spread of the phenomenon
must, by necessity, be highly integrated. In other words, suicide prevention
cannot be limited to psychosocial, or by contrast, to biological considerations
alone. Yet in spite of the many researchers in the field of suicidology, only a
handful of culturally equipped research teams adopt a truly multidisciplinary
orientation, with obvious repercussions on the development of the effective
prevention measures the international community still awaits.
In June 1995, under the auspices of the International Association for Sui-
cide Prevention, and sponsored by the World Health Organization and the
D. De Leo, A. Schmidtke and R.F.W. Diekstra (eds.), Suicide Prevention, ix–x.
© 1998 Kluwer Academic Publishers. Printed in the Netherlands.