Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-27T08:48:18.720Z Has data issue: false hasContentIssue false

The Isle of Wight Suicide Study: a case study of suicide in a limited geographic area

Published online by Cambridge University Press:  05 June 2014

H. Shahpesandy*
Affiliation:
Tees, Esk and Wear Valleys NHS Foundation Trust, Middlesbrough, UK
M. Oakes
Affiliation:
Research Institute and Language Processing, University of Wolverhampton, Wolverhampton, UK
Ad van Heeswijck
Affiliation:
Acute and Recovery Community Mental Health Service, Chantry House, Newport, Isle of Wight, UK
*
*Address for correspondence: Dr H. Shahpesandy, MD, Ph.D., MSc, Consultant Psychiatrist Tees, Esk and Wear Valleys NHS Foundation Trust. (Email: homayun.shahpesandy@nhs.net; shahpesandy@hotmail.com)

Abstract

Background

Suicide is a major public health problem, with mental disorders being one of its major risk factors. The high incidence of suicide on the Isle of Wight has motivated this study, the first of its kind on suicide in this small geographic area.

Aim

The aim of the study was to identify socio-demographic and clinical risk factors for suicide in the population of service users and non-service users, and gender-related characteristics of suicidal behaviour in a limited geographic region.

Method

Data were collected on 68 cases of suicide (ICD-10×60-X84) from residents of the Isle of Wight District between January 2006 and December 2009. All data were statistically analysed using Pearson’s χ2 test and Yates’ correction for continuity.

Results

The mean annual suicide rates over the period were 5.65 per 100 000 for women and 19.28 for men. Significantly (p=0.0006), more men than women (male/female ratio 3:1) died as a result of suicide. Relatively (p=0.07) more women (56.2%) than men (32.7%), and significantly more (p=0.05) service users (45.3%) than non-service users (13.3%) were unemployed. Significantly, more (p=0.0006) service users (64%) than non-service users (20%) had a history of suicide attempts and relatively (p=0.06) more (50.9%) service users than non-service users (20%) had attended the accident and emergency department before their death; 69% had an adverse life event within a year before their suicide. Depression as the most common Axis-I illness was diagnosed in 36% of all; but significantly (p=0.008) more in women (66.6%) than men (17.3%). Relatively (p=0.07) more women (56.2%) than men (32.7%) have contacted services before their death. Suicide by hanging was the most common cause, accounting for the death of 71% of men and 50% of women.

Conclusions

The study found that 80% of all suicides occurred in people suffering from mental disorder. Men are at a significant risk of suicide. Depressive disorders in women and stress-related disorders in men were the most common mental disorders. Treating mental disorders and co-morbid conditions seems to be one of the key elements in suicide prevention strategies.

Type
Case Report
Copyright
© College of Psychiatrists of Ireland 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alvaro-Meca, A, Kneib, T, Gil-Prieto, R, Gil de Miguel, A (2013). Epidemiology of suicide in Spain, 1981–2008: a spatiotemporal analysis. Public Health 127, 380385.Google Scholar
Avoidable Deaths Report (2006). Avoidable deaths: five year report of the national confidential inquiry into suicide and homicide by people with mental illness. (http:/www.medicine.manchester.ac.uk/psychiatry/research/suicide/prevention/nci/inquiry_reports).Google Scholar
Beglund, M, Ojehagen, A (1998). The influence of alcohol drinking and alcohol-use disorders on psychiatric disorders and suicidal behaviour. Alcoholism: Clinical and Experimental Research 22, 333S345S.CrossRefGoogle Scholar
Bessant, M, King, EA, Peveler, R (2008). Characteristics of suicides in recent contact with NHS Direct. Psychiatric Bulletin 32, 9295.Google Scholar
Boardman, AP, Grimbaldeston, AH, Handley, C, Jones, PW, Willmott, S (1999). The North Staffordshire suicide study: a case-control study of suicide in one health district. Psychological Medicine 29, 2733.Google Scholar
Brooks, P, Watson, J (2006). A profile of suicide mortality in South East. (http://www.thehealthwell.info/node/29046).Google Scholar
Burgess, P, Pirkis, J, Morton, J, Croke, E (2000). Lessons from a comprehensive clinical audit of users of psychiatric services who committed suicide. Psychiatric Services 51, 15551560.CrossRefGoogle ScholarPubMed
Chang, SS, Gunnell, D, Sterne, JA, Lu, TH, Cheng, AT (2009). Was the economic crisis 1997–1998 responsible for rising suicide rates in East/South-East Asia? A time-trend analysis for Japan, Hong Kong, South Korea, Taiwan, Singapore and Thailand. Social Science and Medicine 68, 13221331.Google Scholar
Chew, K, McCleary, R (1995). The spring peak in suicides: a cross-national analysis. Social Science and Medicine 40, 223230.Google Scholar
Coryell, W, Young, EA (2005). Clinical predictors of suicide in primary major depressive disorder. Journal of Clinical Psychiatry 66, 412416.CrossRefGoogle ScholarPubMed
Crawford, MJ, Nur, U, McKenzie, K, Tyrer, P (2005). Suicidal ideation and suicide attempts among ethnic minority groups in England: results of a national household survey. Psychological Medicine 35, 369377.Google Scholar
Department of Health (DoH) (2002). National Suicide Prevention Strategy for England. Department of Health: London.Google Scholar
Department of Health (DoH) (2003). Compendium of Clinical and Health Indicators 2002. Department of Health: London.Google Scholar
Department of Health (DoH) (2012). Preventing Suicide in England: A Cross-Government Outcome Strategy to Save Lives. Department of Health: London.Google Scholar
Duleba, T, Gonda, X, Rihmer, Z, Dome, P (2012). Economic recession, unemployment and suicide. Neuropsychopharmacologia Hungarica 14, 4150.Google ScholarPubMed
Fergusson, DM, Beautrais, A, Harwood, LJ (2003). Vulnerability and resiliency to suicidal behaviours in young people. Psychological Medicine 33, 6173.Google Scholar
Foster, T, Gillespie, K, McClelland, R (1997). Mental disorders and suicide in Northern Ireland. British Journal of Psychiatry 170, 447452.CrossRefGoogle ScholarPubMed
Gairin, I, House, A, Owens, D (2003). Attendance at the accident and emergency department in the year before suicide: retrospective study. British Journal of Psychiatry 183, 2833.Google Scholar
Giotakos, O, Tsouvelas, G, Kontaxakis, V (2012). Suicide rates and mental health services in Greece. Psychiatrike 23, 2938.Google Scholar
Gunnell, D, Lewis, G (2005). Studying suicide from the life course perspective: implications for prevention. British Journal of Psychiatry 187, 206208.CrossRefGoogle ScholarPubMed
Gunnell, D, Lopatatzidis, A, Dorling, D, et al. (1999). Suicide and unemployment in young people. Analysis of trends in England and Wales, 1921–1995. British Journal of Psychiatry 175, 263270.Google Scholar
Hor, K, Taylor, M (2010). Suicide and schizophrenia: a systematic review of rates and risk factors. Journal of Psychopharmacology 24 (Suppl. 4): 8190.Google Scholar
Isometsä, ET, Lönnqvist, JK (1998). Suicide attempts preceding completed suicide. British Journal of Psychiatry 173, 531535.Google Scholar
Joe, S, Marcus, SC, Kaplan, MS (2007). Racial differences in the characteristics of firearm suicide decedents in the United States. American Journal of Orthopsychiatry 77, 124130.CrossRefGoogle ScholarPubMed
Johnson, H, Brock, A, Griffiths, C, et al. (2005). Mortality from suicide and drug-related poisoning by day of the week in England and Wales, 1993–2002. Health Statistics Quarterly 27, 1316.Google Scholar
King, EA (2001). The Wessex suicide audit 1988–1993: a study of 1457 suicides with and without a recent psychiatric contact. International Journal of Psychiatry in Clinical Practice 5, 111118.Google Scholar
King, EA, Baldwin, DS, Sinclair, JM, Baker, NG, Campbell, MJ, Thompson, C (2001a). The Wessex recent in-patient suicide study, 1. Case-control study of 234 recently discharged psychiatric patient suicides. British Journal of Psychiatry 178, 537542.Google Scholar
King, EA, Baldwin, DS, Sinclair, JM, Campbell, MJ (2001b).The Wessex recent in-patient suicide study, 2. Case-control study of 59 inpatient suicides. British Journal of Psychiatry 178, 531536.Google Scholar
Lönnqvist, JK (2000). Psychiatric aspects of suicidal behaviour: depression. In The International Handbook of Suicide and Attempted Suicide (ed. K. Hawton and K. Van Heeringen), pp. 107120. John Wiley: Chichester.Google Scholar
Maes, M, Cosyns, P, Meltzer, HY, et al. (1993). Seasonality in violent suicide but not in non-violent suicide or homicide. American Journal of Psychiatry 150, 13801385.Google Scholar
Mortensen, PB, Agerbo, E, Erikson, T, et al. (2000). Psychiatric illness and risk factors for suicide in Denmark. Lancet 355, 912.Google Scholar
NCISH (2006). Avoidable deaths: five year report of the national confidential inquiry into suicide and homicide by people with mental illness. (http:/www.medicine.manchester.ac.uk/psychiatry/research/suicide/prevention/nci/inquiry_reports).Google Scholar
Nordentoft, M (2007). Prevention of suicide and attempted suicide in Denmark. Epidemiological studies of suicide and intervention studies in selected risk groups. Danish Medical Bulletin 54, 306369.Google Scholar
Office for National Statistics (ONS) (2007). (http://www.statistics.gov.uk).Google Scholar
Office for National Statistics (ONS) (2011). (http://www.statistics.gov.uk).Google Scholar
Petridou, E, Papadopoulos, F, Frangakis, C, et al. (2002). A role of sunshine in the triggering of suicide. Epidemiology 13, 106109.Google Scholar
Preti, A (2000). Seasonal variation and meteotropism in suicide. Current Opinion in Psychiatry 13, 655660.Google Scholar
Preti, A, Miotto, P (1998). Seasonality in suicides: the influence of suicide method, gender and age on suicide distribution in Italy. Psychiatry Research 81, 219231.Google Scholar
Qin, P, Agerbo, E, Mortensen, PB (2003). Suicide risk in relation to socio-economic, demographic, psychiatric, and familial factors: a national register-based study of all suicides in Denmark, 1981–1997. American Journal of Psychiatry 160, 765772.Google Scholar
Rasanen, P, Hakko, H, Jokelainen, J, et al. (2002). Seasonal variation in specific methods of suicide: a national register study of 20 234 Finnish people. Journal of Affective Disorders 71, 5159.Google Scholar
Rihmer, Z, Gonda, X (2012). Prevention of depression-related suicides in primary care. Psychiatria Hungarica 27, 7281.Google ScholarPubMed
Rock, D, Greenberg, D, Hallmeyer, J (2003). Increasing seasonality of suicide in Australia 1970–1999. Psychiatry Research 120, 4351.Google Scholar
Rutz, W, von Knorring, L, Walinder, J (1989). Frequency of suicide on Gotland after systematic postgraduate education of general practitioners. Acta Psychiatrica Scandinavica 80, 151154.Google Scholar
Sareen, J, Houlahan, T, Cox, BJ, Asmundson, GJ (2005). Anxiety disorders associated with suicidal ideation and suicide attempts in the national co morbidity survey. Journal of Nervous and Mental Disease 193, 450454.Google Scholar
Schwartz-Lifshitz, M, Zalsman, G, Giner, L, Oquendo, MA (2012). Can we really prevent suicide? Current Psychiatry Reports 14, 624633.CrossRefGoogle ScholarPubMed
Simkin, S, Hawton, K, Yip, PS, et al. (2003). Seasonality in suicide: a study of farming suicides in England and Wales. Crisis 24, 9397.Google Scholar
Stenager, EN, Stenager, E (2000). Physical illness and suicidal behaviour. In International Handbook of Suicide and Attempted Suicide (ed. K. Hawton and K. van Heeringen), pp. 405420. Wiley: Chichester.Google Scholar
The National Confidential Inquiry into Suicide and Homicide by People with Mental Illness (NCISH). Annual report: England, Wales, Scotland, and Northern Ireland, July 2012, The University of Manchester.Google Scholar
Van Heeringen, K (2003). The neurobiology of suicide and suicidality. Canadian Journal of Psychiatry 48, 292300.CrossRefGoogle ScholarPubMed
Värnik, P (2012). Suicide in the world. International Journal of Environmental Research and Public Health 9, 760771.Google Scholar
Verzani, John (2005). Using R for Introductory Statistics. Chapman and Hall/CRC: Boca Raton, Florida.Google Scholar
Wasserman, D, Rihmer, Z, Rujescu, D, Sarchiapone, M, Sokolowski, M, Titelman, D, Zalsman, G, Zemishlany, Z, Carli, V (2012). The European Psychiatric Association (EPA) guidance on suicide treatment and prevention. Neuropsychopharmacol Hung 14, 113136.Google Scholar
World Health Organization (WHO) (1992). The ICD-10 Classification of Mental and Behavioural Disorders. Clinical Descriptions and Diagnostic Guidelines. World Health Organization: Geneva.Google Scholar
Yip, PSF, Callanan, C, Yuen, HP (2000). Urban/rural and gender differentials in suicide rates: East and West. Journal of Affective Disorders 57, 99106.Google Scholar
Yur’yev, A, Värnik, A, Värnik, P, Sisask, M, Leppik, L (2012). Employment status influences suicide mortality in Europe. International Journal of Social Psychiatry 58, 6268.Google Scholar