Archives of Suicide Research

Adolescent suicide attempters are often noncompliant with outpatient psychotherapy and drop out of treatment much more quickly than non-suicidaladolescents. In this study, 23 adolescents received medical treatment and astandard psychiatric evaluation in an Emergency Department following asuicide attempt. In addition, all subjects and their parents received apsychotherapy compliance enhancement intervention which included a verbalagreement between the adolescent and parent/guardian to attend at least fourpsychotherapy sessions. After discharge from the hospital, each subjectreceived three phone interviews over an 8 week period using a problemsolving approach around two key areas: suicidal ideation and psychotherapycompliance. Compared to a three month follow-up of 78 subjects (which didnot include an experimental intervention), conducted at the same hospital,the experimental intervention resulted in fewer outpatient psychotherapy ’noshows‘ (9% vs. 18%) and a trend toward greater number ofsessions attended (5.5 vs. 3.9). There were no re-attempts in theexperimental group as compared to 9% in the comparison group. Resultsare promising and a randomized intervention trial appears indicated.

Very few studies have attempted to define the underlying link between a history of sexual abuse and subsequent deliberate self-harm (DSH). Correlations and logistic regression modelling were used to examine the relationship between the frequency of DSH, the severity of sexual, physical, and psychological abuse, and various outcome measures in a sample of 257 females consecutively admitted to a general hospital in England after taking an overdose. The severity of all three types of abuse related strongly to the frequency of DSH, but not to measures of past or current psychopathology. Both abuse and psychopathology made independent contributions to self-poisoning, but only abuse contributed to other deliberate self-injury. These findings provide further evidence that abuse may be etiologically related to DSH. If confirmed, some patients may require treatment of the underlying abuse or its consequences in order to reduce the risk of further DSH.

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.