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Purpose: Our objective was to explore the utility of age at first suicide attempt in identifying subgroups of suicide attempters., Methods: In a retrospective study design, we collected information from the clinical charts of 895 patients assessed over a seven-year period. Admixture analysis was used to determine the best fitting theoretical model for distribution of age at first attempt that divided the sample. Subsequently, multivariate analysis was performed to identify variables that distinguished the subgroups identified., Results: The theoretical solution that best explained the observed distribution of age at first suicide attempt was a mixture of two Gaussian distributions with a cut-off of 31 years for the two subgroups. In logistic regression analysis, male gender (Odds ratios [OR] 3.047, 95% Confidence Interval (CI) 1.818-5.106), fewer years of formal schooling (OR 3.384, 95% CI 1.701-6.734) and being married (OR 23.36, 95% CI 10.753-50.000), were more commonly associated with the late onset subgroup (age at first attempt >31 years). Further, the late onset subgroup had poorer global functioning (OR 0.980, 95% CI 0.962 to 0.998)., Conclusion: Age at onset of first suicide attempt is a useful candidate marker to delineate an early and late onset subgroup among suicide attempters. These results are likely to inform customization of suicide prevention strategies., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Objectives: To identify the prevalence and correlates of bipolar I patients with a lifetime history of suicide attempt., Materials and Methods: Bipolar I disorder was diagnosed in 150 patients as per DSM-IV-TR criteria. Their lifetime suicide risk was assessed using the Columbia Suicide Severity Rating Scale. NIMH retrospective Life Chart Methodology was used to chart the illness course. Medication Adherence Rating Scale (MARS) and Pittsburgh Sleep Quality Index (PSQI) were used to assess the recent adherence and subjective sleep quality, respectively. The suicide attempters were compared with non-attempters on individual variables., Results: Around 23% had a positive lifetime history of suicide attempt. They were predominantly female, had an index (first ever) episode of depression, spent more proportion of time being ill, especially in depressive or mixed episode phase. Comorbid substance use disorder along with suicidal attempts was seen only in males. Suicide attempters displayed poor medication adherence attitudes for medications taken during the past week and reported impaired sleep quality for the previous month., Conclusions: A positive history of lifetime suicide attempt was significantly associated with a worse course of bipolar I disorder. Effective treatment of depressive episodes, addressing non-adherence, substance use and sleep problems can reduce the suicide risk in such patients. Retrospective design of the study and recall bias are some of the limitations.

Background: Gender appears to be a factor closely related to key suicide-related constructs., Aims: The study aims to assess gender differences in personality factors among suicide attempters and to examine the role of gender in mediating the relationship between suicide attempts and selected personality attributes in the same group., Methods: A chart review of 156 consecutive suicide attempters was carried out. All participants were administered the Beck Suicide Intent Scale (BSIS), Barratt Impulsivity Scale-11 (BIS-11), Buss-Perry Aggression Questionnaire (BPAQ) and Past Feelings and Acts of Violence (PFAV) Scale., Results: The suicidal intent and impulsiveness did not differ significantly between men and women, although men had significantly greater PFAV scores (t = 3.361, p = 0.001). BPAQ showed a significant difference between the genders (F = 3.621, p = 0.008; Wilk's Λ = 0.950, partial η(2) = 0.100), mainly for physical aggression (F = 11.006; p = 0.001; partial η(2) = 0.076) and anger (F = 4.298; p = 0.040; partial η(2) = 0.031)., Conclusion: Certain differences seem to be present between Indian male and female suicide attempters with regard to baseline personality attributes and their role in predicting suicide intent. The import of personality traits as potential targets for suicide prevention is worth exploring further., (Copyright © 2015 John Wiley & Sons, Ltd.)

Background: There is need for a common and uniform nomenclature for suicide and related behaviors. Many nomenclatures exist to address the same., Aims: Study proposes to assess the inter-rater reliability of Silverman et al. nomenclature on suicide and suicidal behaviors., Method: The present study was conducted at the crisis intervention clinic of a tertiary care centre. Case records of patients referred to the centre were evaluated by two trained psychiatrists and were rated according to the Silverman's nomenclature in the domains of suicide related ideation, suicide related communication and suicide related behavior. Inter-rater reliability was measured using kappa coefficient. The relationship of suicide intent item of a structured scale with suicide related ideation, communication and behavior were explored., Results: Inter-rater reliability of the two evaluators using the Silverman's nomenclature on 198 case records was in the moderate range for suicidal related ideation and behavior domains (kappa of 0.476 and 0.502 respectively), but low for communication domain (kappa value of 0.016). The stated intent item of the Pierce Suicide Intent Scale correlated highly with suicide related ideation and behavior as assessed using the Silverman et al. nomenclature (Kendall tau = 0.723 and 0.747 respectively)., Conclusions: Based upon the same case record material, evaluators rate suicide related ideations and behaviors with moderate degree of concordance. However, the concordance is poor for suicide related communication.

Background: Intent in attempted suicide is considered an indicator of subsequent suicide. Few studies in developing countries have examined correlates of suicidal intent among young adults., Aims: This study aimed to assess the intent score among a sample of young suicide attempters from South India and to identify the factors associated with suicide intent among them., Method: The clinical charts of 64 consecutive subjects aged 15-24 years attending emergency services for attempted suicide were reviewed. All participants completed a semistructured proforma, the Presumptive Stressful Life Events Scale, the Beck Hopelessness Scale, the Pierce Suicide Intent Scale, and the Global Assessment of Functioning Scale. Psychiatric diagnoses were made according to the ICD-10 clinical descriptions and diagnostic guidelines., Results: The intent scores were in the moderate-to-high range for most subjects. Suicide intent score significantly varied depending on the presence or absence of psychiatric morbidity. In bivariate analysis, psychiatric morbidity and hopelessness correlated positively with suicide intent, and in linear regression, hopelessness emerged as a predictor of suicide intent., Conclusion: A high intent of suicide in young is associated with psychiatric morbidity and presence of hopelessness. Hopelessness may be a key predictor of suicidal intent. Assessment of suicidal intent and hopelessness among young attempters is important and may help identify high-risk individuals who need intensive interventions.