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Aims and method To ascertain differences in patterns of suicide in young men over three decades (1960s, 1990s and 2000s) and discuss implications for suicide prevention. Data on suicides and open verdicts in men aged 15-34 were obtained from coroner's records in Newcastle upon Tyne and analysed using SPSS software. Results An increase in suicide rates from the first to the second decade was followed by a fall in the third decade. This was associated with an increasing proportion of single men, those living alone, unemployment, consumption of alcohol, use of hanging, previous suicide attempt and history of treatment for mental illness. Clinical implications This study highlights the need for more interventions and focus to be given to young males in the suicide prevention area and is of high importance in the field of public health. Areas that could be tackled include reducing access to means of suicide, reducing alcohol use, support for relationship difficulties, engagement with mental health services and management of chronic illness.
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We evaluated police contact with individuals prior to suicide, using a systematic study of suicides within County Durham and Darlington over a 3-year period and analysis of police computer records covering the same area. A total of 205 cases of suicide were identified. A fifth of these (n=41) had a documented contact with police within 3 months prior to the suicide, there was an equal mixture of victims and alleged perpetrators of crime, and a significant number of those with police contact had also seen a health professional recently. As many people see a police officer in the 3 months prior to their suicide as see a mental health professional within 12 months prior to suicide. Our findings have implications for suicide prevention.
Assuntos
Serviços de Saúde Mental/estatística & dados numéricos , Polícia/estatística & dados numéricos , Suicídio/estatística & dados numéricos , Adolescente , Adulto , Crime/estatística & dados numéricos , Emergências/epidemiologia , Inglaterra , Medicina de Família e Comunidade/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricosRESUMO
BACKGROUND: Prostatodynia is a common and often disabling condition that affects males and has the characteristics of a somatoform pain disorder. It presents with urogenital pain and urinary symptoms. Failure of conventional treatment and a successful uncontrolled pilot study with fluvoxamine in this condition prompted this study. METHOD: In a randomized double-blind trial, 42 patients with prostatodynia were assigned to receive either fluvoxamine (N = 21) or placebo (N = 21) for up to 8 weeks. Doses were adjusted according to therapeutic need. The median dose of fluvoxamine was 150 mg (range, 50-300 mg). Self-rated pain scores, urinary flow rates, and depression and anxiety scores were measured at baseline and several times throughout the study period. RESULTS: The groups were similar at baseline, and the results were examined by intent-to-treat analysis either using the last observation carried forward or, in the case of dichotomous measures, counting treatment dropouts as treatment failures. Fluvoxamine was significantly more likely to reduce pain intensity (p = .01) and normalize urinary flow rates (p = .03) with a clinically significant number needed to treat value of 1.5 (confidence interval = 1.12 to 5.50). This therapeutic effect could not be attributed to change in mood, as the 2 groups did not differ with respect to affective ratings at the end of the study. The fluvoxamine-treated group had significantly lower (p = .02) final scores on the General Health Questionnaire, indicating an overall benefit from pain relief. CONCLUSION: Fluvoxamine is a viable treatment for prostatodynia. Dose-ranging studies and longer trials are needed to evaluate this agent further.