'Suicide rates in Crete, Greece during the economic crisis: the effect of age, gender, unemployment and mental health service provision'.

BACKGROUND: Recently, suicides in Greece have drawn national and international interest due to the current economic crisis. According to published reports, suicides in Greece have increased up to 40% and Crete has been highlighted as an area with the sharpest increase. AIM: To investigate the suicide mortality rates in Crete between 1999 and 2013 and their association with the economic crisis. METHODS: Data on suicides were selected from the Department of Forensic Medicine files of the University of Crete. RESULTS: Our analysis showed that (1) Crete, has the highest suicide mortality rate in Greece, however no significant increase was observed between 1999 and 2013, (2) there were opposing trends between men and women, with women showing a decrease whereas men showed an increase in that period, (3) there was a significant increase of suicides in middle-aged men (40-64 yrs) and elderly, although the highest unemployment rates were observed in young men and women, and (4) finally, there was a regional shift of suicides with a significant decrease in Western Crete and a significant increase in Eastern Crete. CONCLUSIONS: Although, Crete has the highest suicide mortality rates in Greece, we did not observe an overall increase during the last 15 years, including the period of economic crisis. Furthermore, there was an increase in middle-aged and elderly men, whereas young men and women showed oppositional trends during the years of austerity. This may be related to the culturally different expectations for the two genders, as well as that younger individuals may find refuge to either strong family ties or by immigrating abroad. Finally, the relative increase of suicides in Eastern Crete may be explained by factors, such as the lack of community mental health services in that area.

Suicidal self-stabbing: A report of 12 cases from Crete, Greece.

Sharp-force trauma is a popular cause of homicide and suicide in many countries. Characterisation of the injuries between the two is crucial for a differential diagnosis. The current paper reviews 12 self-inflicted sharp-force trauma deaths from the island of Crete in Greece. Forensic reports between 1999 and 2015 were collated, and we studied the number and location of injuries, the demographic characteristics of the deceased, the sharp object and the medical history of the deceased. One third of the cases where the forensic reports were available (3/10) involved multiple injuries, and one case involved a combination of stabbing and hanging. Most injuries involved a kitchen knife. Ninety-two per cent (11/12) of the victims involved male Greek nationals aged >50 years. The type and location of injuries were not found to be specific to suicide alone. Thus, death-scene investigation remains crucial to the differential diagnosis between suicide and homicide. This is the first report on self-inflicted sharp-force fatalities in Greece.

The impact of economic austerity and prosperity events on suicide in Greece: a 30-year interrupted time-series analysis.

OBJECTIVES: To complete a 30-year interrupted time-series analysis of the impact of austerity-related and prosperity-related events on the occurrence of suicide across Greece. SETTING: Greece from 1 January 1983 to 31 December 2012. PARTICIPANTS: A total of 11 505 suicides, 9079 by men and 2426 by women, occurring in Greece over the study period. PRIMARY AND SECONDARY OUTCOMES: National data from the Hellenic Statistical Authority assembled as 360 monthly counts of: all suicides, male suicides, female suicides and all suicides plus potentially misclassified suicides. RESULTS: In 30 years, the highest months of suicide in Greece occurred in 2012. The passage of new austerity measures in June 2011 marked the beginning of significant, abrupt and sustained increases in total suicides (+35.7%, p<0.001) and male suicides (+18.5%, p<0.01). Sensitivity analyses that figured in undercounting of suicides also found a significant, abrupt and sustained increase in June 2011 (+20.5%, p<0.001). Suicides by men in Greece also underwent a significant, abrupt and sustained increase in October 2008 when the Greek recession began (+13.1%, p<0.01), and an abrupt but temporary increase in April 2012 following a public suicide committed in response to austerity conditions (+29.7%, p<0.05). Suicides by women in Greece also underwent an abrupt and sustained increase in May 2011 following austerity-related events (+35.8%, p<0.05). One prosperity-related event, the January 2002 launch of the Euro in Greece, marked an abrupt but temporary decrease in male suicides (-27.1%, p<0.05). CONCLUSIONS: This is the first multidecade, national analysis of suicide in Greece using monthly data. Select austerity-related events in Greece corresponded to statistically significant increases for suicides overall, as well as for suicides among men and women. The consideration of future austerity measures should give greater weight to the unintended mental health consequences that may follow and the public messaging of these policies and related events.

Nitrogen-plastic bag suicide: a case report.

The use of pure nitrogen gas to commit suicide has recently become more popular, although suicides involving nitrogen oxide fumes have been occasionally reported in the past. The cause of death in such cases is attributed to asphyxia due to forced depletion of oxygen, a subcategory of a phenomenon dubbed environmental hypoxia. A case of a 26-year-old man who committed suicide by inhaling nitrogen through a plastic bag is reported. The exact method of suicide used here is one of the many described in detail on the Web.

Suicide by pesticide poisoning: findings from the island of Crete, Greece.

BACKGROUND: The role of pesticides in suicidal acts has not yet received adequate attention in Greece despite an evident rise of 39% in pesticide use over the period 1990-1992 to 2002-2004. AIMS: To investigate the epidemiology of pesticide suicide on the Greek island of Crete, a largely rural agricultural area, and by further exploring the victim profiles, as well as patterns and trends of pesticide ingestion, to suggest probable preventive measures. METHODS: Self-poisoning suicides between 1999 and 2007 were reviewed and information gathered was entered into a computerized database. RESULTS: The overall incidence of intentional pesticide poisoning was 1.7 per 100,000, representing the second most frequently used suicide method after hanging. The victim profile was composed of the following features: middle aged male, rural habitant, who carried out a suicidal act by consuming primarily methomyl or paraquat (WHO toxicity class Ib and class II, respectively). As to the place of death, the vast majority was found dead in the place of intoxication. CONCLUSIONS: Pesticide self-poisoning accounts for a quarter of the suicides in Crete. More detailed research is required to identify aspects of these deaths amenable to prevention, but measures such as bans on the most toxic pesticides and changes in storage practice would appear to be sensible initial approaches.

Suicide by firearms on the island of Crete: a 9-year record.

BACKGROUND: Whereas firearm suicide mortality has been a longstanding public concern worldwide, in Greece no systematic analysis has been reported so far despite the recent evidence of a rising rate of gun ownership. AIMS: To estimate the proportion of firearm suicides on the island of Crete, Southern Greece, well-known for its widespread gun ownership; to describe the victims' sociodemographic profile and firearm-related suicide variables; and to assess the severity of suicidal intention in the group. METHODS: Records of suicides between 1999 and 2007 were reviewed and information was extracted into a computerized database. A rating of the circumstances section of the Beck's Suicide Intent Scale (SIS) for each case was also performed. RESULTS: The firearm suicide rate was 1.3 per 100,000, with males constituting the vast majority. These men were more likely to be less than 55 years of age, to have lived in the western part of the island, to have some degree of planning prior to the suicidal act, and to have used a shotgun, but less likely to have left a note. CONCLUSIONS: As an important first step toward implementing preventive initiatives the authors stress the need for a thorough look at the sociocultural factors associated with firearms in the region.

An unusual suicide inside a grave with two gunshot wounds to the head--the psychological approach.

In this report, the authors present a case of suicide committed by a 66-year-old man, inside a grave at the local cemetery, with two gunshot wounds to the head. A multiple-paged, handwritten suicide note was found in an army type bag inside the victim's car, while a second one was found in his house. Medicolegal examination of the body revealed two typical contact gunshot entrance wounds and one exit wound to the head. Toxicological analysis of the femoral blood was negative for alcohol and drugs. The history, scene and autopsy findings, along with further police investigation, indicated an obvious case of suicide. The literature is reviewed and discussed. We report this case as the place of suicide is extremely uncommon and as there is no mention of a gunshot suicide inside a grave in the current literature.