dr. saman yousuf 15 june 2011. society community family individual
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SOCIO-DEMOGRAPHIC FACTORS
Male Being over 60 Separated, widowed or divorced Living alone Being unemployed or retired Indebted Occupation
SMOKING DRUG/ALCOHOL MISUSE HISTORY OF TRAUMA / ABUSE / BULLYING
PAST SUICIDE ATTEMPT / DELIBERATE SELF HARMAfter a suicide attempt that is seen in the Emergency
Room, about 1% per year take their own life, up to approximately 10% within 10 years
PSYCHIATRIC DISORDERSMost common psychiatric risk factor resulting in suicide
- Depression*- Major Depression- Bipolar Depression- Alcohol abuse and dependence- Drug abuse and dependence- Schizophrenia
*Especially when combined with alcohol and drug abuse
Other psychiatric risk factors account for significantly fewer suicides
- Post Traumatic Stress Disorder (PTSD)- Eating disorders
Prior suicide attempt 38.4 Eating disorders 23.1 Bipolar disorder 21.7 Major depression 20.4 Mixed drug abuse 19.2 Dysthymia 12.1 Obsessive-compulsive 11.5 Panic disorder 10.0 Schizophrenia 8.45 Personality disorders 7.08 Alcohol abuse 5.86 Cancer 1.80
General populationGeneral population 1.00 1.00
Adapted from A.P.A. Guidelines, part A, p. 16
MAJOR LIFE EVENTS
- Chronic physical pain - Major physical illness (especially if recent)
- Impending legal prosecution- Family/relationship breakdown- Impulsivity- Unwillingness to seek help- Difficulty accessing services
HOPELESSNESS
COGNITIVE THINKING DIMENSIONS
- Thought constriction- Polarized thinking
JOB OR FINANCIAL LOSS
EASY ACCESS TO LETHAL MEANS
RELATIONAL LOSS WITHIN COMMUNITY
LOCAL CLUSTERS OF SUICIDE / EXPOSURE TO
SUICIDE
CULTURAL AND RELIGIOUS BELIEFS THAT GLORIFY SUICIDE
- Seppuku/Hara-Kiri ("stomach-cutting") is a form of Japanese ritual suicide by disembowelment -- originally reserved only for samurai -- Part of the samurai “bushido” honor code, used voluntarily by samurai to die with honor rather than fall into the hands of their enemies, as a form of capital punishment for samurai who had committed serious offenses, or performed for other reasons that had brought shame to them.
The ceremonial disembowelment, which is usually part of a more elaborate ritual and performed in front of spectators, consists of plunging a short blade,
traditionally a “tanto”, into the abdomen and moving the blade from left to right in a slicing motion
- Sati/Devanagari is a religious funeral practice among some indian communities which the recently widowed lady voluntarily or by coercion immolates herself – rare and outlawed practice in India since 1829
Demographic male; widowed, divorced, single; increases with age; white
Psychosocial lack of social support; unemployment; drop in socio-economic status; access to means, media regulation on reporting suicides
Psychiatric psychiatric diagnosis; comorbidity
Physical Illness malignant neoplasms; HIV/AIDS; peptic ulcer disease; hemodialysis; systemic lupus erthematosis; pain syndromes; functional impairment; diseases of nervous system
Psychological Dimensions
hopelessness; psychic pain/anxiety; psychological turmoil; decreased self-esteem; fragile narcissism & perfectionism
Behavioral Dimensions
impulsivity; aggression; severe anxiety; panic attacks; agitation; intoxication; prior suicide attempt
Cognitive Dimensions thought constriction; polarized thinking (part of depression or otherwise)
Childhood Trauma sexual/physical abuse; neglect; parental loss
Genetic & Familial family history of suicide, mental illness, or abuse
Effective clinical care for mental, physical and substance disorders
Easy access to clinical interventions and support for help-seeking
Restricted access to highly lethal means of suicide
Strong connections to family and community support
Support through ongoing medical/mental health care relationships
Skills in problem solving, conflict resolution and handling disputes
Cultural/religious beliefs discouraging suicide & supporting self-preservation
- Christianity : Forbids the act “Thou shalt not kill”
- Islam : Forbids the act
Having children at home (other than those of postpartum depression)
Pregnancy / Life Satisfaction
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