Conceptualizations of suicide through time and socio-economic factors: a historical mini-review.

OBJECTIVES: Suicide is a complex phenomenon determined by the interplay of an articulated network of factors including socio-economic factors which have a decisive role. This paper investigates the development of the modern conceptualization of suicide in Europe, its sociological understandings and its intertwinement with economic cycles throughout time. METHODS: MEDLINE, SCHOLAR, EMBASE using the keywords 'socioeconomic factors AND suicide'; 'economic cycles AND suicide'; 'history AND suicide' without timeframe limitations. Moreover, journal-by-journal search in journals of related areas was performed. RESULTS: In total, 51 historical studies focusing on the subjects in European countries were included. Three main areas arose: (a) development of the conceptualization of suicide over time; (b) sociological understandings of suicide according to the structure of society and its economy of power; (c) economic theories explaining the intertwinement of economic cycles and suicides. CONCLUSIONS: Suicide is a deeply human phenomenon inescapably linked to and grounded in society and economic cycles. Understandings from the past show the importance of accurate analysis of socio-economic contexts that shape societies together with man's own sense of self in order to organize multi-layered tangible and intangible support strategies to better understand and prevent suicide in this day and age.

Predicament suicide: concept and evidence.

OBJECTIVE: The aim of this paper is to introduce the term 'predicament suicide' and add to the evidence that suicide may occur in the absence of Axis I diagnoses. METHOD: The term 'predicament suicide' was described as suicide which occurs when the individual without mental disorder is in unacceptable circumstances from which they cannot find an acceptable alternative means of escape. Accounts of suicide that satisfied these criteria, and could be illustrated by images, were sought. RESULTS: Four accounts were identified: Ajax, Brutus, Mayor Freyberg and Commander Donnicke. CONCLUSIONS: Predicament suicide appears to be a useful designation. This work added evidence indicating that suicide may occur in the absence of an Axis I mental disorder.

Suicide and Western culture.

OBJECTIVE: The aim of this paper is to examine the cultural roots and transmission of Western suicide and suicidal behaviour. METHOD: We explored a period of antiquity (mythical Greece-61 CE) and selected accounts of 10 prominent suicides. The precipitating circumstances were tabulated and an assessment made of the most likely attendant emotions. The same process was followed for a recent period (1994-2008), from which 10 suicides were identified. The precipitating circumstances and the attendant emotions were compared. These circumstances and emotions were then compared to statements commonly encountered in clinical practice from people demonstrating suicidal behaviour. Finally, we looked for evidence that these stories (and the response models) had entered Western culture. RESULTS: Precipitating circumstances, loss of a loved one, actual or imminent execution or imprisonment, other losses and public disgrace, and the negative emotions of shame, guilt, fear, anger, grief and sorrow were common to both historical periods. These circumstances and emotions are similar to those commonly expressed by people who have demonstrated suicidal behaviour. There was a clear record (literature, visual arts) of these stories forming part of our cultural heritage. CONCLUSION: Models of maladaptive responses to certain adverse circumstances are part of Western culture. Suicide as a response to certain circumstances and negative emotions can be traced back more than 2000 years. Cultural change will be necessary to minimize suicide.

[The death of Cleopatra]. / Mort de Cléopâtre.

The image of a queen bitten by a snake is controversial and the facts, such as the swiftness of her death and her servants, and scientific experiments are in favour of a deadly poisoning. The author reminds that in the ancient texts the snake had sacred virtues and it was a symbolic image to embellish the suicide of the one who was sentenced to death by the Romans. Octaves set up the myth of a fatal bite which became an iconographic image for the cinema.

Suicide: a Socratic revenge.

2400 years have passed since the occurrence in Athens, Greece of one of the famous suicides recorded in human history. This autobiographical essay provides a montage on the history of suicide, with snippets from the final hours of Socrates, as described by Plato. Suicide in contemporary Japanese culture is also explored briefly, with reference to the deaths of internationally acclaimed movie directors Akira Kurosawa and Juzo Itami. The author also questions why no researcher has yet been honoured for the past 99 years with a Medicine Nobel prize for his or her work on suicidology or thanatology.

Confucian ethic of death with dignity and its contemporary relevance.

This paper advances three claims. First, according to contemporary Western advocates of physician-assisted suicide and voluntary euthanasia, "death with dignity" is understood negatively as bringing about death to avoid or prevent indignity, that is, to avoid a degrading existence. Second, there is a similar morally affirmative view on death with dignity in ancient China, in classical Confucianism in particular. Third, there is a consonance as well as dissonance between these two ethics of death with dignity, such as that the Confucian perspective would regard the argument for physician-assisted suicide and voluntary euthanasia as less than compelling because of the latter's impoverished vision of human life.

[Not just for fire. The risk of production and misuse of phosphorus matches. Phosphorus necrosis, abortions and suicides during the latest half of the 1900-century]. / Inte bara eld. Vådan vid produktion och missbruk av fosfortänstickor. Fosfornekros, aborter och självmord under 1800-talets senare hälft.

The phosphorus match was a useful but poisonous match, used during the last half of the 1900-century. The medical consequences of the match production were far-reaching. The workers, usually women, could be affected by chronic phosphorus poisoning including necrosis in the mandible. The infected mandible had to be surgically removed if the patient should survive. In the last decades of the century the matches were used as a method for abortion and suicide. The misuse can be understood in the light of the widespread social structural changes at the time. With the right dosage, the heads of the matches could be used for abortion but many women died of acute phosphorus poisoning. An extensive debate was going on for decades in the parliament before the production of the phosphorus matches was forbidden in 1901.

Mind and mood in modern art, II: Depressive disorders, spirituality, and early deaths in the abstract expressionist artists of the New York School.

This article documents the high prevalence of mood disorders in a group of 15 of the mid-twentieth-century Abstract Expressionist artists of the New York School. These artists, using the technique of psychic automatism (based on free association) in order to reveal unconscious material, created a psychologically and spiritually significant art that addressed the mythic themes of creation, birth, life, and death. Over 50% of the 15 artists in this group had some form of psychopathology, predominantly mood disorders and preoccupation with death, often compounded by alcohol abuse. At least 40% sought treatment and 20% were hospitalized for psychiatric problems. Two committed suicide; two died in single-vehicle accidents while driving; and two others had fathers who killed themselves. Many of these artists died early deaths, and close to 50% of the group (seven of 15) were dead before the age of 60. The material presented in this article suggests the following formulation and hypothesis. Depression inevitably leads to a turning inward and to the painful reexamination of the purpose of living and the possibility of dying. Thus, by bringing the artist into direct and lonely confrontation with the ultimate existential question, whether to live or to die, depression may have put these artists in touch with the inexplicable mystery that lies at the heart of the "tragic and timeless" art that the Abstract Expressionists aspired to produce.

Icons of ancient suicide: self-killing in classical art.

Attitudes to suicide differ between societies, and also change with time. 104 items of ancient art that show suicide have been examined and catalogued. These icons, the most distinctive of which are discussed here, confirm the view suggested by literary sources that in the Graeco-Roman world self-killing was preferably seen as a deliberate, resolute, and heroic act.

Suicide and parasuicide in ancient personal testimonies.

Attitudes toward suicide have not always been the same as they are today, and understanding the ideas of other cultures and times could enable us to reexamine contemporary conceptions of self-killing. Greek and Roman personal testimonies were examined to investigate the thesis that ancients did not see suicide as caused by psychic or emotional forces. Indeed, though the documents of antiquity give us a closer look into personal motives, they demonstrate that even would-be self-killers themselves wished to regard suicide as a rational act of volition.

[Approach to the study of suicide in the essays of Enrico Morselli (1879) and in the successive hypotheses of Durkheim and Freud]. / Approccio allo studio del suicidio nel saggio di Enrico Morselli (1879) e nelle successive ipotesi di Durkheim e Freud.

Scientific investigations on suicide began at the beginning of the XIX century. The aim of such investigations was the evaluation of the epidemiological and statistical distribution of the phenomenon in order to set up preventive intervention, as well as the establishment of the psychological and psychopathological characteristics of the subjects choosing this solution to their life. E. Morselli's work on the matter (1879) can be considered the main Italian contribution to the discussion that was troubling and antagonizing the most competent authors in all the civil world from the half a century and it was regarded in due consideration by his contemporaries too. The second author taken into consideration is E. Durkheim, whose monograph issued twenty years later presents elements having such originality and accuracy that they represent even today a constant reference for the suicide studies. S. Freud, on his side, did never write any monograph on this matter, but fundamental observations on the self-suppression psychodynamic interpretation can be found in his works.

Social images of suicide.

Emile Durkheim's analysis of historical attitudes of societies toward suicide led him to claim that (1) the social disapproval of suicidal conduct increased constantly from ancient times to the present; (2) such increased disapproval was generated by the growing emphasis put on the dignity and sacredness of the individual; (3) the condemnation of suicidal conduct was therefore essentially moral, and it expressed the strong reaction of the collective conscience against offenses to the cult of the individual. In this study we show that Durkheim's interpretation of the historical evidence is erroneous: not increasing condemnation of suicide, but rather tolerance or mild aversion is the typical social response to suicide. Also, when confronted with the historical evidence, Durkheim's claim that increased disapproval of suicide accompanied increased consideration for the dignity of the individual is shown to be unfounded. Our argument develops in four steps. First, we survey the historical evidence on views of suicidal conduct from classical times to the nineteenth-century; second, we present the moral statistics literature on suicide which flourished during Durkheim's lifetime; third, we analyze Durkheim's own theory of anomic suicide. In the conclusion we propose an alternative interpretation of the historical evidence on attitudes on suicide, and a different framework in which to highlight their significance in contemporary society.

Suicides by opium and its derivatives, in England and Wales, 1850-1950.

In the mid-nineteenth century opium and its derivatives, such as laudanum and morphine, were the most common poisons in suicides in England and Wales. With legislative restrictions on these 'dangerous drugs' such a use declined. This study attempts to show this trend and indicates the large variety of these opium-related suicides.