On suicide statistics.

The classical methodological problem of suicidology is reliability of official statistics. In this article, some recent contributions to the debate, particularly concerning the increased problem of suicide among Inuit, are reviewed. Secondly the suicide statistics of Greenland are analyzed, with the conclusion that the official statistics, as published by the Danish Board of Health, are generally reliable concerning Greenland.

Availability of psychotropic drugs and suicidal self-poisoning mortality in Belgium from 1971-1984.

Trends in completed suicide by solid or liquid substances in Belgium were investigated for the period 1971-1984 in relation with data about sales of psychotropic drugs. Mortality rose sharply between 1973 and 1980 (from 21.1 per million population of 15 years and older to 52.2 in males and from 26.7 to 61.7 in females) and decreased slightly thereafter. No apparent coincidence with the availability of psychotropic drugs was found, and the increasing risk of suicidal persons dying at home suggested an increase in the severity of the attempts until 1980. However, incidence changes could also have affected these trends. The evolution in accidental and in suicidal hospital rates suggested that emergency care had improved. Although barbiturate sales decreased continuously (from 46.7 packages per year per 100 population in 1974 to 28.5 in 1984), these drugs still account for a high proportion of fatal self-poisonings (23%) in Belgium. Possible shortcomings that could affect the validity of our findings are discussed.

Gun ownership and suicide in the United States.

The circulation of firearm magazines was used as an index of gun ownership in the states of the USA. States with a higher per capita circulation of firearm magazines had higher suicide rates by gun and higher overall suicide rates. Homicide rates were unrelated to this measure of gun availability. Implications for the prevention of suicide are discussed.

El consumo de alcohol y su relación con la conducta suicida / Alcohol consumption and its relation with suicide behavior

Se describe la relación que hay entre la ingestión de alcohol y el suicidio. Varias investigaciones coinciden en que el suicidio es una de las causas de muerte más comunes entre los alcohólicos, después de los transtornos psicoafectivos. Asimismo, se reporta que la depresión y la desesperanza son factores determinantes en la conducta suicida de las personas con problemas de alcoholismo. se analizan los mecanismos de autodestrucción, sobre todo en lo referente al manejo de la agresión interna y externa, que pueden estar influidos por el consumo de bebidas alcohólicas, y que culminan en conductas suicidas. Se plantea la relación que existe entre los transtornos psicóticos y el riesgo de suicidio, sobre todo en las etapas avanzadas edel padecimiento en las que aparece pérdida de la introspección como consecuencia de un gran deterioro intelectual y del menoscabo de la memoria. Inicialmente puede presentarse una marcada depresión con ideas suicidas. Finalmente, se describe el papel que desempeño la ingestión de alcohol en 80 suicidios consumados, de los cuales el 55% (44 personas) bebían alcohol. De este porcentaje, el 43% resultó ser de alcohólicos, de acuerdo con la escala de preocupación por el consumo de alcohol, de Jackson. Asimismo, es de tomarse en consideración el índice de problemas relacionados con la ingestión de bebidas alcohólicas en los suicidas que estaban preocupados por su consumo de alcohol, debido a que de los 19 alcohólicos, 17 tenían diversos tipos de problemas, sobre todo de índole familiar, laboral y de salud

Deaths from accidents, poisoning and violence--differences between the various population groups in the RSA.

The pattern of deaths from accidents, poisoning and violence of the four population groups in the RSA for 1980 was examined in terms of the number of male and female deaths, separately and together, of certain WHO International Classification of Diseases (ICD) groupings of deaths from those causes. The main findings were: (i) that motor vehicle accidents (MVAs) accounted for 3.6% of all deaths in whites, 3.7% in coloureds, 3.1% in Asians and 2.2% in blacks, male deaths being 4 times as frequent as female and more than 70% of those deaths occurring in people under 40 years; 6% of MVAs in whites, 38% in coloureds, 17% in Asians and 34% in blacks involved pedestrians; (ii) that the next most common cause of death under these ICD headings was suicide in whites (1.6% of total) and homicide in coloureds (4.8% of total) and blacks (3.9% of total); and (iii) that under the ICD grouping 'other accidents', 45% of those deaths in whites, 58% in coloureds, 79% in Asians and 36% in blacks were due to drowning, with over 80% of deaths from drowning in people under 40 years.

Cause- and age-specific mortality rates from accidents, poisoning and violence.

Cause- and age-specific mortality rates (MRs) were calculated for 1980 for all four population groups in the RSA for certain accidents, poisonings and violence as they are grouped in the WHO International Classification of Diseases (ICD). Cause-specific MRs of coloureds, Asians and blacks were age-adjusted to the age-distribution of whites in 1980 in order to judge the relative importance of the various causes of death. This showed that in whites and Asians motor vehicle accidents (MVAs) head the rank order of MRs; furthermore the first three MRs in the rank order, namely for MVAs, suicide and violence, are common in these two populations. A similar situation exists among coloureds and blacks in that the MRs for homicide rank first and the first four causes of death in the rank order of MRs--homicide, MVAs, violence and other accidents--are common to those two population groups. The fact that deaths from MVAs and violence rank so high in the MRs for all four population groups lends support to the contention that the RSA is a 'violent society'.

A 25-year prospective mortality study in the spinal cord injured patient: comparison with the long-term living paraplegic.

Herein we combine 2 studies: a 25-year prospective followup on 270 spinal cord injury patients and a more than 20-year (average 24.2 years) evaluation of 175 paraplegics. The mortality rate was 49 per cent after 25 years, with renal disease as the major cause of death (43 per cent). Vascular deaths were just as prevalent during the last 5 years of spinal cord life. There are probably several reasons why some patients have long-term survival (more than 20 years), including patient motivation (better followup), less vascular problems, less chronic decubitus and a higher percentage of lower motor neuron lesions. Patients with lower motor neuron lesions had the best bladder status associated with less upper tract deterioration.