Suicide

This text focuses on the situation of suicide in Brazil, defines and quantifies information, and presents a description of the main risk factors, as well as a reflection on the phenomenon and the possibilities for prevention. Fatal suicide is a serious public health problem. In 2012, 172 member states of the World Health Organization registered 804,000 self-inflicted deaths, representing an annual rate of 11.4/100,000, of which 15/100,000 men and 8.0/100,000 women. Consummate suicide rates are unevenly distributed globally, within countries, according to sex and according to age groups. The mortality rate is highest in Asia (17.7/100 thousand inhabitants), followed in Europe (12/100 thousand inhabitants). The Americas have a mortality rate of 7.3/100 thousand inhabitants (WHO, 2014). In Brazil, with an unevenly distributions between the regions, gender and ages, the total rate is 4.5/100,000. In the country and everywhere, risk factors are classified as medical, psychiatric and psychological, micro social, social and environmental. The history of the occurrence of suicides shows that it is possible to prevent them and to reduce the incidence rates. This requires investment in local diagnostics and multidisciplinary action. Given the delicacy of the problem and the taboos that surround it, the protection network for people at risk for suicide needs to be constantly in the process of training and taking action. As national and international surveys show, at least two-thirds of the individuals who tried or committed suicide had somehow communicated to friends, family, acquaintances or health professionals their intention to kill themselves.

In this paper, we sought to examine the levels of suicidal risk and anxiety, as well as the coping strategies used in a sample of 154 Spanish university students, most of them first-year students, during the situation of confinement and the pandemic. After approval by the Ethics Committee, instruments for the evaluation of these constructs were administered. An ex post facto design was used. A high level of suicide risk was not found in the sample. Statistically significant differences were found in the levels of suicidal risk and anxiety according to gender, with higher scores in both variables for women. Likewise, the coping strategies of self-criticism and social withdrawal show direct associations with the levels of suicidal risk. We conclude by pointing out the relevance of the data obtained for a more effective design of psychoeducational interventions to face these public health problems with the training of effective coping strategies.

There are various kinds of discrimination is prevailing in Indian Society. India is practising discrimination against the lower caste for many centuries. But in contemporary Indian Society, caste-based discrimination is becoming a matter of grave concern for committing suicide. Caste-based discrimination is surviving in Indian society. In many cases of caste discrimination, Dalits were persecuted by the upper caste of Indian society for demanding education, employment, and equal social status. Every year several Dalits were committing suicide due to atrocities and discrimination. The present study will understand the nature of suicide among Dalits due to social discrimination and explores the factors affecting Dalit suicide. The data on suicide have been collected from 2011 to 2021 through various newspapers, magazines, journals and articles.

Traumatic brain injury (TBI) is associated with varied neuropsychiatric sequelae, including elevated risk for later suicidal behaviors (SBs). This chapter provides a qualitative narrative review of hypothesized biological and neurocognitive mechanisms linking TBI to subsequent SBs. The following selective review specifically highlights: (1) Structural and functional alterations to neural circuitry secondary to common head injuries (e.g., concussions or mild TBI) as well as severe or repetitive TBI (e.g., chronic traumatic encephalopathy); (2) Overlap between post-TBI neuropsychological deficits and proposed bio-behavioral indicators of suicide risk; and (3) Potential neurocognitive mediators of the relationship between TBI and SBs, with a particular focus on executive functions involved in self-regulation (i.e., cognitive and affective inhibitory control) and their neural substrates, e.g., corticolimbic, frontostriatal, and frontoparietal circuitry. The chapter concludes with theoretical and practical implications of this shared pathophysiology, based on the reviewed empirical literature.

There are three feelings that prompt a person to take their life: hopelessness, helplessness and worthlessness. Studies have found that the risk of suicide increases with decreasing happiness. In the recent past, people have been left clueless when celebrities and successful people ended their lives despite appearing overtly happy. What prompted them to do so? Modern society today highlights the importance of success over failure. Although we are motivated to be successful in life, it should not become our main gauge of happiness. In the same way we should not let success be our main goal in life and get discouraged by failure. Happiness has been viewed in two ways: as concerning the well-being of a person, and as the opposite of depression. Each one of us has different ways of measuring happiness. The quality of one’s happiness depends on one’s priorities in life. Happiness is not merely something that can be quantified with how much success and failure one has because such metric is very much subjective. How do we prevent a young life from extinguishing? How do we identify suicidal behavior among successful people and help those around? The present chapter covers the possible reasons why successful people commit suicide. Role of media in preventing suicide and measures for preventing suicide by successful people has been discussed.

This chapter focuses on the assessment of the severity of anxiety as a risk factor for suicide. Previous studies have neglected to examine the severity of anxiety and its association with suicide. Subsequent studies reviewed in this chapter, support the association of severe anxiety/agitation with suicide. This suggests that the assessment of the severity of anxiety and its reduction through treatment may offer a clinical path towards the reduction of acute suicide risk.

The causes of suicide are complex and multifactorial, and it is clear that no simple explanations are to be found. In this chapter, a comprehensive stress-vulnerability (diathesis) model, which is used as a general framework for explaining why certain individuals engage in suicidal behaviours whereas others do not, is presented. The role of acute stressors (“state”), such as on-going psychiatric illnesses or recent traumatic life experiences and of a diathesis (“trait”) developed over a lifetime, by the influence of genetic risks and environmental experiences from childhood and adolescence to adulthood, is described. The role of biology in the suicidal diathesis, as it can be understood today, and the view of the suicidal crisis as a stress-reaction, is introduced. Different lines of research which point towards the feasibility of this perspective are presented, showing future promise for reducing and treating suicidal behaviors.

Numerous abnormalities have been found in the serotonergic system in suicide attempters and completers. There is considerable evidence that the serotonergic system is partly under genetic control and that as yet unknown genetic factors mediate the risk for suicidal behavior independently of the genetic factors responsible for the heritability of major psychiatric conditions associated with suicide. An argument is made that there is a relationship of genetic variants to intermediate phenotypes, such as impulsivity, psychomotor change, pathological aggression and biological abnormalities including specific gene products. A variety of biological indices have been generated by new approaches using postmortem tissue and in vivo imaging that will provide a rich substrate for further genetic studies.

Psychopharmacological treatment of suicidal patients is in particular important in those patients who suffer from an underlying psychiatric disorder, such as unipolar and bipolar depression, schizophrenia, and anxiety disorders. In the case of abnormal reactions to common psychosocial stresses, hypnotics or benzodiazepines might be helpful. Also, personality disorders might be an indication for psychopharmacological treatment. The psychopharmacological treatment should be offered in the frame of the complex psychosocial treatment programme.