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suicide as a cause of death, affects every health system, and is a particular problem in heavily urbanised states and low and middle income countries(which account for 75% of suicide deaths). The World Health Organisation records that 800000 commit suicide each year, representing 1.4% of annual global deaths, and that suicide was the second leading cause of death in 15-29year-olds across the world in 2012. In the United Kingdom, jumping from height accounts for 3%-5% of the 140000 suicide attempts annually is similar incidence to the rest of Europe. The Medline and EMBASE were interrogated for studies examining suicide caused by jumping from height. Manual screening of titles and abstracts was used to identify relevant works before data was extracted and systematically reviewed to identify the characteristics of a patient who jumps from height to commit suicide, delineate their patterns of injury and explore techniques that could be used to limit its occurrence. Emergency departments receiving patients who jump from a height need to have an understanding of the potential pathology that is likely to be encountered in order to deliver multidisciplinary, efficient and timely care in order that the impact of this devastating physical, psychological and social problem could modified to the benefit of the patients involved.

关键词： Polytrauma suicide Fracture

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Factors associated with hopelessness in epileptic patients

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World Journal of Psychiatry 2014年第4期4卷 141-149页

作者： Maurizio Pompili Gianluca Serafini Marco Innamorati Franco Montebovi Dorian A Lamis Mariantonietta Milelli Manuela Giuliani Matteo Caporro Paolo Tisei David Lester Mario Amore Paolo Girardi Carla Buttinelli Department of Neuro-sciences Mental Health and Sensory Organs Suicide Prevention Center Sant’Andrea Hospital Sapienza University of Rome 00189 Rome Italy Department of Neuroscience Rehabilitation Ophthalmology Genetics Maternal and Child Health Section of Psychiatry University of Genoa 16100 Genoa Italy Department of Psychiatry and Behavioral Sciences Emory University School of Medicine SC 29208 United States Department of Neurological Science Neurological Unit S. Andrea Hospital University La Sapienza 00189 Rome Italy The Richard Stockton College of New Jersey Galloway NJ 08205 United States

AIM: To investigate factors related to hopelessness in a sample of epileptic patients, including measures of depression and quality of life(QOL). METHODS: Sixty-nine participants were administered the following psychometric instruments: Beck Depression Inventory-Ⅱ, Beck Hopelessness Scale(BHS), and QOLin Epilepsy(QOLIE)-89. Patients were dichotomized into two categories: those affected by epilepsy with generalized tonic-clonic seizures vs those having epilepsy with partial seizures. RESULTS: The groups differed on the QOLIE Role Limitation/Emotional dimension. Patients with generalized seizures reported more limitations in common social/role activities related to emotional problems than patients with other types of epilepsy(89.57 ± 25.49 vs 72.86 ± 36.38; t 63 =-2.16; P suicide risk as evaluated by the BHS were older than those who had a lower suicidal risk. Future studies are required to further investigate the impact of hopelessness on the outcome of epileptic patients.

关键词： Epilepsy Hopelessness suicide risk Emotional problems Social/role activities

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Antecedents and sex/gender differences in youth suicidal behavior

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World Journal of Psychiatry 2014年第4期4卷 120-132页

作者： Anne E Rhodes Michael H Boyle Jeffrey A Bridge Mark Sinyor Paul S Links Lil Tonmyr Robin Skinner Jennifer M Bethell Corine Carlisle Sarah Goodday Travis Salway Hottes Amanda Newton Kathryn Bennett Purnima Sundar Amy H Cheung Peter Szatmari Institute for Clinical Evaluative Sciences Toronto M4N 3M5 Ontario Canada Department of Psychiatry University of Toronto Toronto M5T 1R8 Ontario Canada suicide Studies Unit St. Michael’s Hospital Toronto M5B 1W8 Ontario Canada Dalla Lana School of Public Health University of Toronto Toronto M5T 3M7 Ontario Canada Department of Psychiatry and Behavioural Neurosciences Mc Master University Hamilton L8N 3K7 Ontario Canada The Offord Centre for Child Studies Hamilton L8S 4K1 Ontario Canada The Research Institute at Nationwide Children’s Hospital Columbus OH 43205 United States The Ohio State University College of Medicine Columbus OH 43210 United States Sunnybrook Health Sciences Centre Toronto M4N 3M5 Ontario Canada Department of Psychiatry University of Western Ontario London N6A 5W9 Ontario Canada The Injury and Child Maltreatment Section Public Health Agency of Canada Ottawa K1A 0K9 Ontario Canada The Centre for Addiction and Mental Health Toronto M6J 1H4 Ontario Canada Department of Pediatrics University of Alberta Edmonton Alberta T6G 1C9 Canada The Department of Clinical Epidemiology and Biostatistics Mc Master University Hamilton L8S 4K1 Ontario Canada The Ontario Centre of Excellence for Child and Youth Mental Health Ottawa K1G 0Z1 Ontario Canada The Hospital for Sick Children Toronto M5G 1X8 Ontario Canada

suicide is the second leading cause of death in youth globally; however, there is uncertainty about how best to intervene. suicide rates are typically higher in males than females, while the converse is true for suicide attempts. We review this "gender paradox" in youth, and in particular, the age-dependency of these sex/gender differences and the developmental mechanisms that may explain them. Epidemiologic, genetic,neurodevelopmental and psychopathological research have identified suicidal behaviour risks arising from genetic vulnerabilities and sex/gender differences in early adverse environments, neurodevelopment, mental disorder and their complex interconnections. Further, evolving sex-/gender-defined social expectations and norms have been thought to influence suicide risk. In particular, how youth perceive and cope with threats and losses(including conforming to others' or one's own expectations of sex/gender identity) and adapt to pain(through substance use and helpseeking behaviours). Taken together, considering brain plasticity over the lifespan, these proposed antecedents to youth suicide highlight the importance of interventions that alter early environment(s)(e.g., childhood maltreatment) and/or one's ability to adapt to them. Further, such interventions may have more enduring protective effects, for the individual and for future generations, if implemented in youth.

关键词： suicide Attempted suicide Sex Gender Child Adolescent Review

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On the role of impulsivity and decision-making in suicidal behavior

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World Journal of Psychiatry 2015年第3期5卷 255-259页

作者： Yari Gvion Yossi Levi-Belz Gerg? Hadlaczky Alan Apter Department of Clinical Psychology Bar Ilan University Department of Clinical Psychology Tel-Aviv Jaffa Academic Center Interdisciplinary Center Department of Behavioral Sciences Ruppin Academic Center National Centre for suicide Research and Prevention of Mental Ill-Health (NASP) Karolinska Institutet Feinberg Child Study Center Schneider Children’s Medical Center of Israel

suicide risk constitutes a complex set of interacting demographic, clinical, psychobiological and environmental variables. Impulsivity is a long-known risk factor for suicide attempts. However, research based on clearer conceptual refinement in this area is imperative. One emerging field of study is that of decision-making. Impulsivity involves a failure of higher-order control, including decision-making. Using standardized operational definitions that take into consideration relevant aspects of impulsivity, including state- and trait-components and a deeper understanding of the process of decision-making in the suicidal mind, we may come a step closer to understanding suicidality and winning the fight in this scourge of human suffering.

关键词： suicide Suicidal behavior Decision-making Impulsivity

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