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Why do some people kill themselves?

Original post made by Sharon on May 6, 2009


A very thorough report from The New Scientist casts light on this tragic syndrome and reports the latest research.Web Link

"Suicide has always been a conundrum for psychologists and other researchers interested in human behaviour.
Self-preservation is one of the strongest human instincts, so the drive to commit suicide must be even more powerful. But what causes it?------

Someone who develops anorexia is 50 to 60 times more likely to kill themselves than people in the general population.
No other group has a suicide rate anywhere near as high (Archives of General Psychiatry, vol 60, p 179).---

Some progress has been made by crunching large amounts of data on suicide, says Harvard University psychologist Matthew Nock, who studies suicide and self-harm.
Researchers have learned, for example, that suicide rates are rising and now account for 1.5 per cent of all deaths worldwide.
Suicide is the second leading cause of death among people aged 15 to 24, after vehicle accidents.
Women are more likely than men to attempt suicide, while men are much more likely to succeed."Web Link

Comments (15)

Posted by Walter_E_Wallis, a resident of Midtown
on May 6, 2009 at 2:22 pm

Walter_E_Wallis is a registered user.

Why do people accept the deaths that a people catcher could prevent? Why do people get hyper at the thought that seepage from nuclear wastes will, 10,000 years from now raise the radiation level of the Colorado River by one PPM yet let this slaughter continue with nothing but pieties?


Posted by Sharon, a resident of Midtown
on May 6, 2009 at 5:00 pm



The value of the New Scientist review of the research on suicide for me is that it identifies sub groups at risk for suicide.

If we can identify people at risk by objective criteria then we can provide targeted prevention and intervention.

On group clearly at risk is Anorectics, the research is eye opening and compelling

Quote

"It has long been known that anorexia has the highest death rate of any mental illness: one out of every five people with anorexia eventually die of causes related to the disease.
What has only now been recognised, however, is that a huge number of those deaths are from suicide rather than starvation.
Someone who develops anorexia is 50 to 60 times more likely to kill themselves than people in the general population.
No other group has a suicide rate anywhere near as high (Archives of General Psychiatry, vol 60, p 179").Web Link


That statistic is a clear call to action, Anorexia is more common among the socio-economic groups we have in Palo Alto.
It is a call for action to help these young women who are at very high risk of suicide.


Posted by OhlonePar, a resident of Duveneck/St. Francis
on May 6, 2009 at 7:13 pm

Sharon,

I found the article interesting, but knowing that anorexics have a high suicide risk doesn't help in most situations. Depressives are at a higher risk--but given how many depressives there are--well, I don't know that targeting, per se, means much.

Anorexia Nervosa has a high mortality rate--I don't think it's a condition that people ignore, per se.


Posted by Sharon, a resident of Midtown
on May 6, 2009 at 8:02 pm




OP, seems we agree on the safety issue
The fact that girls who have been diagnosed with Anorexia are 50 to 60 times more likely to commit suicide is shocking, I did not know that until I read the research.
My concern is that prevention and interventions efforts must be focused on kids at risk for suicide.
I agree that depression is also an issue, evidence based psychiatric and drug treatments are valid, my concern is that less qualified MFCCs and non MDs may be missing the critical issues in these cases,
The evidenced diagnoses and treatment for the best interest of the child and the parents


Posted by OhlonePar, a resident of Duveneck/St. Francis
on May 6, 2009 at 9:02 pm

Sharon,

I'm not sure what the 50 to 60 times means, but certainly the rate is high for anorexia as it is for borderline personality disorder (around 20 percent) and, of course, clinical depression.

In general, some groups are more inclined to suicide than others. Greenland's rate is the highest in the world. Men have a higher rate than women and so on.

Our train tracks seem to be a local version of the Golden Gate Bridge. I just keep thinking of a New Yorker article where a guy who jumped off the bridge realized after he jumped that all the problems that had convinced him to jump could be solved and were transitory--except for his having jumped off the bridge . . . fortunately, he survived.


Posted by Mary S, a resident of Stanford
on May 7, 2009 at 3:43 pm



I feel that Philippe Reys quote in the papers today was very poor jugement.

It is clear from the New Scientist article that there is very good research on who commits suicide and the identification of a risk groups.
There are some very well qualified Psychiatrists at Stanford who address the issue in a rational and level headed way. I wish they would comment based upon their clical and research experience.


Posted by OhlonePar, a resident of Duveneck/St. Francis
on May 7, 2009 at 3:51 pm

Mary,

Emile Durkheim wrote the seminal work on this--Suicide--about 100 years ago now. It's still worth looking at. I think Andrew Solomon's The Noonday Demon gives a good idea of the extent of depression (including suicide) at this point for lay people.

It's worth keeping in mind that most people in a risk group do not kill themselves. And while elderly white men are at a higher risk of suicide than teens, teen suicide may be the greater concern.


Posted by Mary S, a resident of Stanford
on May 7, 2009 at 4:00 pm



While the literary approach to suicide has a place.

As a mother I am interested in the medical approach to understandingand treating suicidal young adults.
The linked article from NS was very helpful, in contrast to Reys trivail and misleading comments in the Daily Post today.
I am sure many local parents would like to hear from a qualified Psychiatrist from Stanford Medical School or the Dept of Psychiatry @ Stanford, on this matter.

It is a serious issues and deservers serious, qualified information


Posted by OhlonePar, a resident of Duveneck/St. Francis
on May 7, 2009 at 4:53 pm

Mary,

I'm not suggesting either book as a literary approach. The Durkheim is sociology--and was the first statistical look at who commits suicide and why. The NS study was building upon the parameters established long ago by Durkheim. The Solomon is really a comprehensive look at the subject--including medication and statistics.

While medical treatment of depression is common now, it's controversial. There's some indication that pharmaceuticals can make suicidal patients feel just energetic enough to go through with a suicide attempt.

For many people, depression is a chronic, but intermittant condition. There isn't a simple cure in that sense. There are treatments, both pharmaceutical and "talk".



Posted by Sharon, a resident of Midtown
on May 7, 2009 at 5:45 pm



I found the research showing the huge high suicide rate among Anorectics, 57 times greater than expected, in fact

"BOSTON, Mass. - In a study of suicidal behavior of 246 women with eating disorders over a span of 8.6 years, Debra L. Franko, an associate professor of counseling psychology at Northeastern University's Bouvé College of Health Sciences, and her colleagues at Massachusetts General Hospital (MGH), found that women with anorexia nervosa are 57 times more likely to commit suicide than the expected rate for other women in the same age and racial groups."Web Link


The reason such studies are important is that they are evidence based and lead directly to focused interventions to help individual groups at risk.

The problem with many psychotherapy claims and theory is that the vast majority of it is not evidence based.

Some of it is downright misleading and dangerous.

Here in Palo Alto, for example, at the MRI, researchers claimed that schizophrenia was caused by "double bind" communications by parents and bad mothering.
This theory did untold harm to patients and parents alike for decades.
It has become clear that the vast majority of serious mental health problems are best treated with psychiatric medication backed up by well designed social support.
The diagnosis, evaluation and treatment plans are best made by someone with an MD after their name.

We need a serious discussion of suicide by physicians trained in neuropharmacology Web Link
And a discussion of evidence based cognitive/behavioral interventions that work.

I too read the article in today's paper quoting Adolescent Counseling Services Director Philippe Rey and I think they are very ill advised, thoughtless and irresponsible.


Posted by Sharon, a resident of Midtown
on May 7, 2009 at 9:07 pm



Does anyone know the statistics on suicide rates in similar socio-economic communities to Palo Alto,are we out of the norm?

Again this is in the interest of a rational view, if we do not have a crisis we need to calm down.
This is not to diminish the tragic loss of the families involved, but the statements by some local therapists may be inflammatory and that is not in our kids best interests.
Anyone have the data, I am sure Stanford Med or Harvard Med does.


Posted by OhlonePar, a resident of Duveneck/St. Francis
on May 8, 2009 at 2:24 am

Sharon,

I don't think there's really an acceptable level of teen suicide in Palo Alto. It certainly happens enough here that it's been an ongoing issue. And the particulars of this case--this was not someone earlier pegged as a troubled teen worries a lot of people.

After a 15-year-drop, the national suicide rate's been up the last few years. You probably saw that.

Treatment of depression usually has both talk and pharmaceutical aspects. Psychologiests handle the talk part and psychiatrists dole out the drugs. Because of the monitoring required, psychologists due the bulk of the monitoring with psychiatrists seeing the patiant once or month or so.

Some conditions--such as borderline personality disorder--don't respond all that much to drugs. Bipolar illness, on the other hand, pretty much requires it. It's not a one-size-fits-all issue.


Posted by Sharon, a resident of Midtown
on May 8, 2009 at 8:46 am


Suicide rates among teenagers is declining, the new classes of anti-depressant medications seems to be of help.

"Suicide rates in those aged 10-19 in the UK declined by 28% in the seven year period from 1997-2003, shows a study published today in The Journal of Child Psychology and Psychiatry.
The study, carried out by researchers at the University of Manchester, showed that the decline was particularly marked in young males, where rates declined by 35%."Web Link


Posted by OhlonePar, a resident of Duveneck/St. Francis
on May 8, 2009 at 12:46 pm

Sharon,

Your information's a little out of date. There was a significant drop in the 1990s through 2003. In 2004, however, there was a sharp spike upwards (8 percent increase) and early numbers look like the number's been staying up.

Web Link

Web Link

Some think it might be a drop in the use of anti-depressants. Other factors may come into play as well--there's a higher-than-usual rate among the military.

Biggest jump is among young teen girls--may go with those eating disorders . . .

The average teen suicide rate is less than one per 100,000. So, yes, our rate is well over the norm.


Posted by Sharon, a resident of Midtown
on May 8, 2009 at 2:01 pm


Lucile Packard Children's Hospital Health Library has a very informative web page on Teen Suicide here Web Link


It is worth reading in full and has links to other resources.

"As many as 12 to 25 percent of older children and adolescents experience some form of thoughts about suicide (suicidal ideation) at one time or another. When feelings or thoughts become more persistent, are accompanied by changes in behavior or specific plans for suicide, the risk of a suicide attempt increases.
What is known about teen suicide?
Suicide is the third leading cause of death in 15 to 24 year olds. According to the National Institute of Mental Health (NIMH), reliable scientific research has found the following:

* There are as many as eight to 25 attempted suicides to one completed suicide - with the ratio even higher in youth.

* The strongest risk factors for attempted suicide in youth are depression, substance abuse, and aggressive or disruptive behaviors.

The Centers for Disease Control and Prevention (CDC) reports the following:

* Males are four times more likely to die from suicide than females.
* Females are more likely to attempt suicide than males.
* Firearms are used in over half of youth suicides.

What are the risk factors for suicide?
Suicide risk factors vary with age, gender, and cultural and social influences and may change over time. Risk factors for suicide frequently occur in combination with each other. The following are some suicide risk factors that may be present:Web Link


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