Gender Differences in Deliberate Self-Poisoning in Hungary
Analyzing the Effect of Precipitating Factors and Their Relation to Depression
Abstract
Background: The suicide rate in Hungary is one of the highest in the European Union, with a male–female ratio of 3.55:1. Suicide rates correlate positively with suicide attempts, for which depression is the most frequent underlying disorder. Aims: The aim of this qualitative study was to examine gender differences in suicide attempts, with a focus on the effect of precipitating factors on depression. Method: Semistructured interviews were conducted among 150 suicide attempters. Data on circumstances, reason, and method of attempt were recorded. Patients completed the Shortened Beck Depression Inventory, the Beck Hopelessness Scale, the Sense of Coherence Scale, and the Social Support Questionnaire. Results: Interpersonal conflict was found to be the most frequent precipitating factor. There were significant gender differences in depressive symptoms among patients with interpersonal conflicts. We found differences in depressive symptoms according to presence or absence of interpersonal conflicts among men, but not among women. Male suicide attempters who indicated interpersonal conflicts had lower levels of depression. Conclusion: Depressive symptoms are frequent among suicide attempters. However, a subgroup of male attempters reporting interpersonal conflicts are characterized by a lower level of depression. This subgroup of attempters would probably not be detected with depression screening programs and may have an unmet need for other forms of screening and prevention.
References
2009). Risk factors for suicide in Hungary: A case-control study. BMC Psychiatry, 9, 45–54.
(2007). Psychosocial stressors may be strongly associated with suicide attempts. Stress and Health, 23(3), 191–198.
(2000). Prevalence of subthreshold forms of psychiatric disorders in persons making suicide attempts in Hungary. European Psychiatry, 15, 354–361.
(2003). Prevalence and comorbidity of affective disorders in persons making suicide attempts in Hungary: Importance of the first depressive episodes and of bipolar II diagnoses. Journal of Affective Disorders, 76, 113–119.
(1996). Prevalence and comorbidity of mental disorders in persons making serious suicide attempts: A case-control study. American Journal of Psychiatry, 153, 1009–1014.
(1974). The measurement of pessimism: The hopelessness scale. Journal Consult Clinical Psychology, 42(6), 861–865.
(2006). Life events, social support and sense of coherence among frequent attenders in primary health care. Public Health, 120(3), 229–236.
(1997). A repetition–prediction study of European parasuicide populations: A summary of the first report from Part II of the WHO/EURO Multicentre Study on Parasuicide in co-operation with the EC Concerted Action on Attempted Suicide. Acta Psychiatrica Scandinavica, 95(2), 81–86.
(1997). Az öngyilkosság [Suicide]. Budapest, Hungary: Animula.
(1987). Stress moderating effects: Social support in the context of gender and locus of control. Personality and Social Psychology Bulletin, 13(2), 5–17.
(1995). Mental illness and suicide. Archives of General Psychiatry, 52, 594–603.
(1989). Suicide and the attempted suicide: An international perspective. Acta Psychiatrica Scandinavica, 80(S 354), 1–24.
(1994). Problem-solving appraisal, hopelessness, and suicide ideation: Evidence for a medicational model. Journal of Counseling Psychology, 41, 91–98.
(1998). Age and gender differences in social-problem solving ability. Personality and Individual Differences, 25, 241–252.
(2005). Gender differences in suicide attempters in Hungary: Retrospective epidemiological study. Croatian Medical Journal, 46(2), 288–293.
(1991). The prediction of suicide. Archives of General Psychiatry, 48, 418–423.
(2007). Manic-depressive illness: Bipolar disorders and recurrent depression. New York, NY: Oxford University Press.
(1999). Suicide risk assessment: A review of risk factors for suicide in 100 patients who made severe suicide attempts: Evaluation of suicide risk in a time of managed care. Psychosomatics, 40(1), 18–27.
(2000). Sex and suicide. Gender differences in suicidal behaviour. The British Journal of Psychiatry, 177(6), 484–485.
(1998). Relation between attempted suicide and suicide rates among young people in Europe. Journal of Epidemiology and Community Health, 52(3), 191–194.
(2009). Suicide. Review. Lancet, 373, 1372–1381.
(2006). The Alliance Against Depression: Two year evaluation of a community-based intervention to reduce suicidality. Psychological Medicine, 36(9), 1225–1234.
(2009). Optimizing suicide prevention programs and their implementation in Europe (OSPI Europe): An evidence-based multi-level approach. BMC Public Health, 9(1), 428.
(2002). Why people engage in parasuicide: A cross-cultural study of intentions. Suicide and Life-Threatening Behavior, 32(4), 380–393.
(2010). Hungarian Statistical Yearbook. Budapest, Hungary: Hungarian Central Statistical Office.
(1995). Recent life events and completed suicide in bipolar affective disorder. A comparison with major depressive suicides. Journal of Affective Disorders, 33, 99–106.
(1981). Sex differences in psychiatric help-seeking: Evidence from four large-scale surveys. Journal of Health and Social Behavior, 22(1), 49–64.
(2007). The Central-Eastern European health paradox: Why are men more vulnerable in a changing society? In , From slavery to citizenship (pp. 242–248). London, UK: John Wiley and Sons.
(1995). Socioeconomic factors, severity of depressive symptomatology and sickness absence rate in the Hungarian population. Journal of Psychosomatic Reasarch, 39(8), 1019–1029.
(2001). The influence of societal structure on depressive symptomatology and morbidity in the Hungarian population. In , The practice of social influence in multiple cultures (pp. 207–221). Mahwah, NJ: Lawrence Erlbaum.
(1997). Az öngyilkossági magatartás pszicholszociális háttértényezői a magyar lakosság körében [Psychosocial background factors of suicidal behavior in the Hungarian population]. Végeken, 8(4), 4–14.
(2006). Gender differences in medically serious suicide attempts: A study from south India. Psychiatry Research, 144(1), 79–86.
(2009). Major psychiatric disorders in suicide and suicide attempters. In , Oxford textbook of suicidology and suicide prevention. A Global perspective (pp. 275–286). London, UK: Oxford University Press.
(1975). Deliberate self harm: Clinical and socioeconomic characteristics of 368 patients. British Journal of Psychiatry, 127(12), 564–574.
(1989). SPSS advanced statistics user guide. Chicago, IL: SPSS Inc.
(2001). Az öngyilkossági kísérletek diagnosztikus és prevenciós háttere [Diagnostic and preventional background of suicide attemtps] (Doctoral dissertation). Retrieved from aok.pte.hu/docs/phd/file/dolgozatok/2002/Osvath_Peter_PhD_dolgozat.pdf
(2004). Life events and psychopathology in a group of suicide attempters. Psychopathology, 37, 36–40.
(2003). Predisposing factors in suicide attempts: Life stressors. In , Evaluating and treating adolescent suicide attempters (pp. 42–49). San Diego, CA: Academic Press.
(2001). A Beck-féle Reménytelenség skála pszichomteriai vizsgálata [Psychometric analysis of Beck’s hopelessness scale]. Psychiatria Hungarica, 16(6), 632–643.
(2002). The Brief Stress and Coping Inventory: A useful stress management instrument. International Journal of Stress Management, 9(2), 61–70.
(2001). Social problem solving, mood and suicidality among inpatient adolescents. Cognitive Therapy and Research, 25(6), 743–746.
(2009). Affective temperaments, as measured by TEMPS-A, among nonviolent suicide attempters. Journal of Affective Disorders, 116, 18–22.
(2007). Suicide risk in mood disorders. Current Opinion in Psychiatry, 20, 17–22.
(2012). Öngyilkosság és öngyilkossági kísérlet. Öngyilkossági rizikó- és protektív faktorok [Suicide and suicide attempt. Risk and protective factors]. In , Öngyilkosság orvosi szemmel (pp. 91–112). Budapest, Hungary: Medicina.
(1995). Depression and suicide on Gotland: An intensive study of all suicides before and after a depression-training programme for general practitioners. Journal of Affective Disorders, 35(4), 147–152.
(2003). A HUNGAROSTUDY 2002 országos reprezentatív felmérés általános módszertana és a felhasznált tesztbattéria pszichometriai jellemzői [General methodology and the psychometric features of the test battery in the Hungarostudy 2002 national representative survey]. Psychiatria Hungarica, 18(2), 83–94.
(1996). Lessons from the Gotland study on depression, suicide and education: Effects, shortcomings and challenges. International Journals of Methods of Psychiatric Research, 6, 9–14.
(2007). Motives and psychosocial stressors in parasuicides: Comparison of self-poisoners and self-cutters. Malaysian Journal of Psychiatry, 16(24), 36–40.
(2007). A suicide prevention program in a region with a very high suicide rate. Archives of General Psychiatry, 64(8), 914–920.
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