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Parasuicide

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Parasuicide (Greek "παρά", para-, "near" or "resembling", + suicide) refers to suicide attempts or gestures and self-harm where there is no result in death. It is a non-fatal act in which a person deliberately causes injury to himself or ingests any prescribed or generally recognised therapeutic dose in excess. The term was first coined in Edinburgh by Norman Krietman [1] It is considered to be a serious public health issue. Parasuicide is the strongest known indicator for a future successful suicide attempt.[2] Other researchers also include those who attempt suicide with the intent to kill themselves in the definition of parasuicide. Studies have found that about half of those who commit suicide have a history of parasuicide.[3] Parasuicide is most common in adolescents and young adults.[4]

Suicidal gestures

Examples of suicidal gestures include cutting, whereby the cut is not deep enough to cause significant blood loss, or taking a non-lethal overdose of medication. This differs from self-harm in that, in self-harm, the person's primary intention is to relieve unbearable emotions, sensations of unreality, or feelings of numbness by injuring their body. Suicidal gestures are typically done to alert others of the seriousness of the individual's clinical depression and suicidal ideation, and are usually treated as actual suicide attempts by hospital staff. Some suicidal gestures do lead to death, despite the individual not having the intention of dying. Studies show that 1% of patients who self-harm will commit suicide within two years of the first act.[5]

Epidemiology

Nearly half of all suicides are preceded by an attempt at suicide that does not end in death. Those with a history of such attempts are 23 times more likely to eventually end their own lives than those without.[6]

Those who attempt to harm themselves are, as a group, quite different from those who actually die from suicide; females attempt suicide much more frequently than males do, but males are four times more likely to die from suicide.[7] The incidence of parasuicide ranges from as low as 2.6 to as high as 1,100 per 100,000 people per year. The lifetime incidence of parasuicide has been estimated as low as 720 and as high as 5,930 per 100,000 people. Parasuicide is more likely to occur in younger people and females. Other risk factors include being single or being divorced, unemployment, recent change in living condition, mental illness, ill health and a past history of parasuicide. Substance abuse, especially alcohol, is highly associated with parasuicide.[2]

One study found that perfectionism could be a factor in parasuicide. A high level of perfectionism was found in patients that had been hospitalised for parasuicide and the study suggests that perfectionism is more likely to lead to feelings of failure, therefore making a suicide attempt or parasuicide more likely.[8]

See also

References

  1. ^ Krietman N., Parasuiced. Chichester: Wiley, 1977
  2. ^ a b Welch, SS (2001). "A review of the literature on the epidemiology of parasuicide in the general population". Psychiatr Serv. 52 (3): 368–75. PMID 11239107. {{cite journal}}: Unknown parameter |month= ignored (help)
  3. ^ Comtois, KA (2002). "A review of interventions to reduce the prevalence of parasuicide". Psychiatr Serv. 53 (9): 1138–44. PMID 12221313. {{cite journal}}: Unknown parameter |month= ignored (help)
  4. ^ Ung, EK (2003). "Youth suicide and parasuicide in Singapore". Ann Acad Med Singapore. 32 (1): 12–18. PMID 12625092. {{cite journal}}: Unknown parameter |month= ignored (help)
  5. ^ Semple, David. "Oxford handbook of Psychiatry" 2005.
  6. ^ Shaffer, DJ (1988). "The Epidemiology of Teen Suicide: An Examination of Risk Factors". Journal of Clinical Psychiatry. 49 (supp.): 36–41. PMID 3047106. {{cite journal}}: |access-date= requires |url= (help); Unknown parameter |month= ignored (help)
  7. ^ National Center for Health Statistics. Deaths: Injuries, 2002. Retrieved on 21 October 2007.
  8. ^ Attention: This template ({{cite pmid}}) is deprecated. To cite the publication identified by PMID 18664231, please use {{cite journal}} with |pmid=18664231 instead.