Depression occurs quite often at the old age. In the group of geriatric patients the suicidal thoughts occur very often.In our study we had 14 gerontopsychiatric patients placed in retirement home and treated for depression and 14 patients who do not live int the retirement home-they lived at home.In both groups of patients we have examined the age, gender, social conditions,degree of education and occurence of chronic diseases (somatic).The questioner was used to evaluate the depression , geriatric depression scale (GDS)and BECK ś self evaluation scale for depression.All of the patients from the retirement home had good social conditions and they had mostly elementary education.In the group of patients they lived at home , the social status was assessed as excellent and the level of education was higher- college and high school diploma.In spite of our expectations, the suicidal thoughts occured with the same frequency in both group of patients.Among major risk of depression and suicidal thoughts are emotional problems at the older age and anxiety associated with the partner´s death, illness, loss of the job and the changes of the home, for example  placement in the retirement home.We have also environmetal stressors as risk factors of depression and suicidal thoughts in the older age.

The KCAP (“Klinical” Center for Acute Psychiatry) is the only acute closed psychiatric hospital in The Hague and consists of 52 beds. With around 1300 admissions each year it is now the largest acute closed ward in the Netherlands.  The Netherlands do not have formal guide-lines for estimating suicide risk and for treating patients with suicidal behaviour or ideation.
Patients with a supposed high risk for suicide, whom are recognised by a mental health worker are commonly admitted to a closed ward. Suicidal behaviour is difficult to predict, but there is a need to identify the factors that are associated with suicide among in-patients (Powell et al. 2000). Many studies have investigated risk factors of in-patient suicide. These studies are still complicated because of the rarely occurrence of in-patient suicides (Neuner et al., 2008). However it is imperative to guarantee safety for patients as well as for the staff. Therefore  a method was developed to estimate risk and setting for suicidal inpatients at the KCAP. About 30% of patients who are admitted at the KCAP are suicidal (Bohnen, 2008). Every patient receives a ‘danger code’ at admission as part of  a new developed safetyplan as described before by de Winter (2008).
In this poster presentation we will describe in detail our safety plan and we will show an evaluation of  the experiences with this method over a period of six months. We will also present clinical and demographic characteristics of these suicidal patients regarding  to this safety plan.

Introducción: A enfermagem é a arte da proteção da vida.Seus programas de desenvolvimento devem ser habilitados a uma busca, um diagnóstico para localizar e prevenir futuros casos de suicidio. Objetivos:Prevenção de casos de suicidio ,devido a investigação de pontos de diagnósticos ,ou seja, investigação de caracteristicas principais de pessoas que cometem suicidio.Ajuda pelo programa saúde da familia , do governo brasileiro. Diseño: Resultados: Formar uma cartilha para uso diário do enfermeiro , com pontos a serem examinados nas visitas domiciliares, afim de prevenir casos de suicidio. Conclusiones:Com este trabalho podemos informar o quanto é importante o trabalho da enfermagem , ajudando a psicologia e prevenindo futuros casos de suicidio

Introducción: Desde muitos séculos atrás , a igreja interfere não somente na nossa maneira de pensar , mas também na nossa forma de agir.Alguns pecados são indiscutiveis, como o suicidio.Com esse trabalho ,mostrar-se-ia como de fato a igreja consegue interferir positivamente ou negativamente na questão : pecado versus suicidio
Objetivos: Analizar pontos negativos e positivos sobre a igreja e a questão do suicidio como pecado
Diseño:
Resultados:
Conclusiones:Com esse trabalho mostraremos como a igreja pode ajudar ou atrapalhar na questão suicidio e vida

Introducción: Consideramos o suicídio uma das causas de morte mais complexa e atribuímos importância ao estudo de seus aspectos delineadores, pois compreender a morte pode ser uma forma de dar sentido a vida. O artigo em questão é resulado parcial de um projeto que visou estudar e pesquisar esta questão de saúde coletiva pouco discutida, mas que vêm alcançando índices de mortalidade importantes no quadro da Saúde Pública no Brasil e no mundo. O enfoque desta pesquisa baseou-se no pressuposto de que o desejo suicida suscita mudanças nas atividades cotidianas dos tentadores de suicídio e que estas transformações podem ser observadas e analisadas para sinalizar a progressividade da idéia auto-destrutiva. Objetivo: A identificação da variação das atividades do cotidiano do suicida pode ser incluída como um dos instrumentos preventivos ao ato, assim permitindo que profissionais de saúde e pessoas próximas ao indivíduo ofereçam antecipadamente a assistência necessária mediante as “situações de risco”. Assim sendo, este estudo visou a compreensão de alguns aspectos inerentes às tentativas de suicídio, explicitados no período que antecede o ato e contribuiu assim para a prevenção e atenção à população com risco de suicídio. Essa pesquisa não visou descobrir as origens/causas do suicídio, mas sim a compreender o suicídio como o ato final de um processo desencadeado, que se fortalece diariamente, mediante a pequenos pensamentos e atitudes discretas. Diseño: Na metodologia deste trabalho tivemos como base a procura dos tentadores de suicídio do município de Santos, num ano fechado e, com entrevistas com os mesmos, analisamos suas possíveis alterações de cotidiano no mês anterior ao ato suicida.
Resultados: Em análise as alterações de cotidiano do suicida um mês antes do ato e a procura de indicadores de alteração do comportamento e outros, que possam sinalizar o ato. Assim, levantamos a possibilidade de criar um instrumento de detecção de risco suicida para profissionais da saúde e ser utilizados como forma de estratégia de prevenção ao suicídio em unidades de saúde coletiva. Conclusiones: Ainda não concluído.

Introducción: La fagofobia, considerada como un fobia específica o dentro del espectro de la ansiedad social suele  acompañarse de conducta suicida a lo largo de su evolución, ensombreciendo su curso
Objetivos:Estudiar la presencia de ideación e intento de suicidio en pacientes cuyo diagnóstico fue Fagofobia como fobia específica , atendidos ambulatoriamente en el Instituto Nacional de Salud Mental durante la última década. Diseño:Estudio longitudinal descriptivo efectuado en pacientes ambulatorios cuyo diagnóstico fue Fagofobia, como fobia específica, segun los criterios del DSM IV, y la aplicación de Instrumentos como Escala de Liebowitz, Sheehan, y Test de Hamilton y Beck para la depresión, intento e ideación suicidas por un equipo multidisciplinario.
Resultados:Se contó con una muestra de 10 pacientes : 2 varones, 8 damas, diagnosticados con Fagofobia, 9 de lo cuales (90 %) presentó ideación suicida y 3 de ellos (33 %) registró intento de suicidio que motivó la atención en el servicio de urgencias. Asi mismo se observó co-morbilidad con Trastorno depresivo mayor en 8 casos ( (80 %), y en 5 pacientes (50 %) se registró criterios de Traatorno de Ansiedad Social co-mórbida. Conclusiones: En este estudio se pudo apreciar que la Fagofobia, puede acompañarse de ideas e intento suicida, asi como Trastorno Depresivo Mayor y Trastorno de Ansiedad Social , que no hace mas que cronificar y complicar el curso y pronóstico de la ya penosa fobia.

Introducción:Las relaciones materno-filiales pueden verse seriamente afectadas por en involucramiento sentimental de las madres con las parejas de las hijas , precipitando desenlaces tales como conductas suicidas Objetivos: Dar a conocer las circunstancias de las complicaciones de las relaciones sentimentales de las madres con los esposos o enamorados de sus propias hijas y  las consecuencias que de éstas se derivan, incluyendo conductas suicidas, en un período de 6 años. Diseño: Descripción de 3 casos de madres que se ligaron afectivamente con las parejas sentimentales de sus propias hijas, motivando episodios depresivos e intentos suicidas, siendo evaluadas por un equipo multidisciplinario con criterios DSM-IV e instrumentos como la Escala de Hamilton.Resultados:Tres casos de madres cuyas edades fluctuaban entre 50 y 60 años de edad establecieron relaciones sentimentales paralelas con las parejas de sus propias hijas , que tenían entre 19 y 28 años de edad, con el desencadenamiento posterior de episodios depresivos agudos e intento suicida en los 6 casos en diferentes momentos, que requirieron atención en el servicio de urgencias de la Institución, y que motivó  la desintegración del matrimonio de las madres, asi como el debilitamiento del matrimonio o unión convivencial de las hijas. Conclusiones: Se concluye que las relaciones extra-maritales de las madres con sus yernos o parejas de sus propios hijas condujo a la aparición de episodios depresivos e intento suicida tanto en las madres como en aquellas, con el consecuente debilitamiento del matrimonio en ambos niveles  y las secuelas familiares y sociales consecuentes.

Objective. Many suicidal people do not seek help in mental health care. This may be out of shame, due to fear of stigma, or not having faith in mental health care. There are indications that the internet is an easily accessible source for suicidal people to seek help. It is therefore important that the information on the internet is useful and of good quality. There are many Dutch suicide-related websites, but an inventory from 2002 showed that their quality is not always sufficient. Since the internet is a rapidly changing medium, the aim of this study is to update the inventory for 2007 and to rate the quality of the suicide prevention websites. Method. Google was used to search for suicide-related websites, using four Dutch search terms: ‘zelfmoord’ (‘suicide’), zelfdoding’ (‘suicide’),’ suïcide’ (‘suicide’), and ‘ik wil dood’ (‘I want to die’). These search terms were chosen to approach the search method of a suicidal person. Only Dutch websites were included. Of the search results, the first 50 were selected and listed. The listed websites were viewed and divided in nine categories: suicide prevention, articles, pro-suicide, culture, interactive communication, blogs, news & media, religious, and other. Subsequently, the quality of the websites in the suicide prevention category was rated by means of 17 quality requirements. Results. In total, 153 different websites were categorised. The largest category was news & media (N=47). Fifteen percent of the retrieved websites fitted into the category suicide prevention (N=23). Of these prevention websites, six met enough quality requirements to be satisfactory. Important information, such as warning signs, was often missing and interactive possibilities were limited. No pro-suicide websites were retrieved. Conclusion. Given that the quality of only 25% of the retrieved suicide prevention websites was satisfactory, there is room for improvement.

Aim: To compare the psychosocial profile and suicidal behavior of 110 pregnant teenagers (PT) with 110 non-pregnant teenagers (NPT). Method: Subjects were matched by age and residential district. A structured interview and psychometric scales were used. Uni-and multivariate logistic regression were performed. Results:   Prevalence in the PT and the NPT groups were: attempted suicide (20.0% vs 6.3%); depression (26.3% vs 13.6%); anxiety (43.6% vs 28.0%). Univariate analysis revealed the following significant associations with pregnancy: relocation in the previous 3 years (odds ratio (OR) = 6); years of schooling < 7  (OR = 3.4); dropping out of school (OR = 5.2); death of a parent during childhood (OR = 2.9); use of alcohol/drugs in the family (OR = 2.5); previous attempted suicide (OR = 3.6); suicide by a relative (OR = 2.1); threats of physical/sexual abuse (OR = 3.5); depression (OR = 2.2); low level of social support (OR = 4.2), psychosocial difficulties (OR = 4.4); prior use of marijuana (OR = 4.8); weekly intake of alcohol over the previous 12 months (OR = 4.2). Multivariate analysis identified the following associations: relocation (OR = 6.4); prior use of tobacco (OR = 2.9); dropping out of school (OR = 2.3); suicide by a social acquaintance (OR = 2.5). Conclusion: The PT case group exhibited a psychosocial profile whose characteristics clearly differentiate this group from the NPT control group. Preventive mental health care is needed to help pregnant teenagers because their behavioral pattern exposes them to high risk for suicide.

Introduction: Youth in risk of suicide rarely call upon the ordinary medical system for help. To capture youth at risk, early intervention must reach areas outside public health services. “Gatekeeper” training among high school staff is an important contribution. Method: A questionnaire targeting knowledge and skills in suicide prevention was distributed to public health nurses, school counsellors and teacher/advisors in 30 high schools in eastern Norway (50,5 % women and 41,1 men). Findings: Generally, participants who scored high on knowledge also scored high on skills. They also reported to prioritise suicide prevention work more. Public health nurses and school counsellors scored significantly higher than teachers/ advisors concerning knowledge about suicide rates, alarm signals, suicide risk and health services available. Public health nurses reported the best suicide prevention skills and teachers/ advisors the poorest. Conclusion: Findings give insight in the different group’s basic knowledge- and skill level in suicide prevention and the relation between knowledge and skills. This gives the opportunity for tailored training of the three groups in high schools in order for them to manage a “gatekeeper” role. 

In Sweden today, there are no evidence based guidelines concerning help and support to relatives of suicide victims, since existing studies are small and based on qualitative research. We have developed a method that combines qualitative and quantitative research, making it possible to perform population based studies of those bereaved by suicide. Objective To create a questionnaire that captures individual experiences quantitatively. Methods We developed a questionnaire by using the method ”Clinical epidemiology- Steinecks hierarchical step model for integration of qualitative and quantitative information”. Each experience of loss is unique. Narrative interviews with suicide bereaved parents (n=17) were conducted to deepen the researchers’ knowledge about bereavement.-Qualitative content analysis was used to create themes that were transformed into questions and a questionnaire draft. - Since researchers and bereaved use different terminology, the questionnaire was tested and validated together with suicide bereaved parents (n=20). - A pre-study including suicide bereaved parents (n=36) was undertaken to test logistics, response rate and the respondents´ experience of answering the questionnaire. Results - 29 of 36 answered the questionnaire - Almost all of the participants answered each of the 220 questions (mean 97 % of the questions) - 28 of 29 found the study valuable - 3 of 29 stated being negatively affected by the participation · 15 of 29 stated being positively affected by the participation· 28 of 29 would recommend another suicide bereaved parent to participate · 28 of 29 stated that they did not regretted regret their participation  Conclusion A questionnaire based on individual experience is suitable for collecting data from the study-population consisting of parents who have lost a son or daughter to suicide.  By using un-selected nationwide population registers and an established epidemiological method we should be able to show possible relationships between causes and outcomes of professional interventions.

Introducción:  Na literatura, os processos migratórios têm sido associados  a intenso stress psicológico, maiores riscos de perturbação psiquiátrica e mesmo a maior risco de suicídio. A partir da década de oitenta do século XX, com a integração na União Europeia a sociedade portuguesa sofreu intensas transformações em termos sociodemográficos devido a alterações radicais dos fluxos migratórios – de país de emigrantes, Portugal tornou-se também num país de imigrantes. A geografia da imigração para Portugal sofreu transformações muito profundas, tanto no que se refere às áreas de recrutamento, como no padrão geográfico de fixação dos imigrantes em Portugal, com um afluxo crescente e exponencial de imigrantes oriundos da Europa de Leste. Trata-se de uma população predominantemente masculina, jovem, em idade activa, altamente qualificada, em que predomina o estado civil de casado. Em termos de nacionalidade, predominam os imigrantes oriundos da Ucrânia, Rússia, Moldávia. Objetivos:  Este estudo, do tipo descritivo-correlacional, teve como objectivo principal avaliar   o status de saúde mental em 556 imigrantes russófonos residentes em Portugal e identificar incidência de morbilidade psiquiátrica e ideação suicida. Resultados: Analisou-se a relação entre o apoio social , as variáveis sociodemográficas, o status de saúde mental ,   a vulnerabilidade ao stress e a ideação suicida utilizando, como instrumentos de medida, o SSQ6, o GHQ-28, o 23QVS e um questionário sociodemográfico.54.9% dos inquiridos apresentavam vulnerabilidade ao stress (23QVS)10,4% reportavam morbilidade psiquiátrica e  6,2% ideação suicida (GHQ-28). Verificou-se que a população inquirida reportava baixos índices de apoio social . O apoio social (número de apoiantes e  satisfação com o apoio) estava positivamente correlacionado com melhores índices de saúde mental e negativamente correlacionado com vulnerabilidade ao stress e incidência de morbilidade psiquiátrica. Conclusiones: A ideação suicida está relacionada com  elevada vulnerabilidade ao stress, baixo apoio social e dificuldades de integração social.

Introducción: Se realiza un estudio epidemiológico descriptivo del total de pacientes atendidos en el CENSAM, cuyo motivo de ingreso o atención fue el de intentos de suicidios, haciéndose especial énfasis en el método de ingestión de psicofármacos. Teniendo en cuenta que el método más utilizado fue el antes expuesto se realiza una comparación con otros métodos utilizados, se valoran las variables epidemiológicas, frecuencia, incidencia, Se sugieren medidas preventivas de esta conducta Objetivos: Metodo:Resultados: Conclusiones:

El centro de salud mental, creado desde hace mas de 40 años para realizar actividades curativas en relacion con la salud mental, pero fundamentalmente preventivas, ha desarrollado la linea de investigacion de suicidio por la importancia que para el pais y para el mundo requiere el estudio de este flagelo. en este trabajo se exponen las extrategias de prevención que hemos aplicado y estamos validando con estudios nacionales en diferentes poblaciones de riesgo, asi como el trabajo con los pacientes que han intentado el suicidio, como con las familias de los mismos y de los que lo han consumado.

Introducción: Se realiza un estudio epidemiológico descriptivo directo para evaluar el riesgo suicida en los trabajadores de los servicios en 4 empresas de la provincia de Holguín. Para este estudio se escogió una muestra al azar de 10 trabajadores por centro laboral, sin previo conocimiento de sus antecedentes patológicos personales.A los mismos se les aplicó el cuestionario de indicadores de riesgo (CIR), cuyos parámetros nos llevan a valorar si existe o no, riesgo de cometer suicidio.Los resultados se exponen mediante tablas y gráficos, se emiten conclusiones y recomendaciones.Queremos con el mismo, contribuir al conocimiento del fenómeno en nuestro medio y la importancia del enfoque preventivo para promover estilos de vida más sanos en nuestra población.

Suicide is the most common cause of death among young people in Sweden, and affected siblings often develop long-term morbidity which can probably be prevented by adequate professional interventions.  Despite this, there are no evidence-based clinical guidelines for the professional care-giving to those bereaved by suicide. OBJECTIVE: a) To learn if and to what extent the loss of a sibling during adolescence and early adulthood (12 – 20 years) due to suicide affects long-term psychological and physical health and academic achievements in middle adulthood (25 – 35 years), and b) to define a clinical practice that reduces the risk for long term morbidity in this population. METHOD: We use the "Clinical epidemiology- Steinecks hierarchical step model for integration of qualitative and quantitative information” 1- In-depth interviews are being conducted with suicide bereaved siblings. Emerging themes will be operationalized into questions by qualitative content analysis and an extensive questionnaire will be developed, validated and tested in a pilot study. 2- The questionnaire will be sent to 1000 siblings of children, adolescents and young adults who died by suicide in Sweden between 2000 - 2006 defined through population registers. A matched comparison group of non-bereaved will be used. Collected data will be analyzed qualitatively and quantitatively. The outcome measures are prevalence of anxiety, depression, self-rated mental and physical well-being as well as academic difficulties and achievements. RESULTS:  Hypotheses derived from the siblings narratives Long-term anxiety and depression in this group is reduced by: - Emotional preparedness of the suicide at the time of death - Adequate information regarding cause of death and possible reasons for suicide  - An immediate and personal notification of the death - Being able to view the body in dignified circumstances before funeral.

The impact of deliberate self-harm on Maori: A study of responses, needs, and outcomes for the family
Deliberate Self-Harm (DSH) is one of the most significant social problems facing young Maori, the indigenous people of New Zealand. Suicide by Maori was traditionally very rare but has increased dramatically over the last half century, most markedly amongst young people. Little is known about the reactions to a young person’s DSH or the needs of the family members following DSH, especially with Maori. International research suggests that both the impact of DSH and consequent needs may be considerable, and that the response of family is an important factor in DSH prevention. This includes their attitudes to, and engagement with treatment. In the case of Maori, engagement with mental health services following a young person’s DSH is particularly low compared with other cultural groups. Development of a fuller understanding of the reactions and needs of Maori parents following DSH, and the factors that influence these, will further advance our understanding of how best to engage and help families. In particular, the findings of this study were expected to have clear implications for improving services for young Maori and their families in New Zealand child and adolescent mental health services (CAMHS). Maori parents presenting to a CAMHS following DSH by their child were interviewed about the impact of the DSH, perceived motives for DSH, and their needs. Secondary data from CAMHS files about the young person was also collated. The interviews were conducted upon initial assessment at the CAMHS and again approximately three months later. Interviews were taped and transcribed, then analyzed using thematic analysis. Themes identified from interviews are described and recommendations for changes to provision of services at the CAMHS are presented.

Background:         Restricting access to means of suicide has been shown to be a highly effective suicide prevention strategy.  Goal 4 of the New Zealand Prevention Strategy 2006 – 2016, Reduce Access to the Means of Suicide, seeks to develop policies, strategies and regulations to reduce access to, and lethality of, the means of suicide.  Commissioned by the Ministry of Health, this study is an analysis of the locations and methods of suicide using the NZ Mortality Database and the Coronial Inquiry Reports. The purpose of the analysis is to: gain greater understanding of emerging methods of suicide and determine the frequency of less common methods identify any trends in the locations of suicides and favoured suicide sites  The analysis will inform future policy and programme strategies to reduce access to means of suicide and also establish a “baseline” monitoring system to identify trends in the use of means and locations of suicide against which emergent trends can be considered.  Methodology:       Quantitative analysis of the NZ Mortality Database and a qualitative review of 1006 Coronial Report files for all deaths by suicide in 2005 & 2006  Findings:   This presentation will present on several key themes arising from the analysis: Suicide is mostly a localised event occurring mostly in the deceased’s home.  Proximity, impulsivity and opportunity are key factors influencing location There are few ‘iconic’ public sites for suicide. Methods utilised are influenced mostly about what is accessible for the deceased and common household items are often used Suicide is often a private act with no one else being present when the suicide occurs  There are no emerging new trends in either locations or methods of suicide.

Introduction
The immune system has gained substantial attention in psychiatric research, and several lines of evidence have confirmed the role of proinflammatory cytokines and chemokines in the pathophysiology of major depressive disorder (MDD). Most of these studies have investigated immunological markers in the blood of non-suicidal depressed patients. Concentrations of cytokines and chemokines in cerebrospinal fluid (CSF) and their association with aspects of suicidality have previously not been investigated.
Methods
Sixty-three suicide attempters and 47 healthy controls were included in this study. The following substances were quantified in CSF using multiplex sandwich ELISAs: Interleukin-1β, interleukin-6 (IL-6), interleukin-8, tumor necrosis factor-α, eotaxin, eotaxin-3, interferon-gamma-inducible protein-10, macrophage-derived chemokine, macrophage inflammatory protein-1α, matrix metalloprotease 1, matrix metalloprotease 3, matrix metalloprotease 9, monocyte chemotactic protein-1, monocyte chemotactic protein-4, and TARC. We thereafter included all the variables measured in CSF in a factor analysis with varimax rotation.  Patients were classified according to diagnosis and violent or non-violent suicide attempt. We evaluated suicidal ideation and depressive symptoms using the Suicide Assessment Scale and the Montgomery – Åsberg Depression Rating Scale (MADRS).
Results
IL-6 in CSF was significantly higher in suicide attempters than in healthy controls (student’s t-test, p<0.001), and the highest levels were seen in violent suicide attempters (n=16) and patients diagnosed with MDD (n=19). Furthermore, there was a significant positive correlation between MADRS scores and CSF IL-6 levels in all patients (pearson’s r=0.31; p=0.016). Factor analysis identified several relevant factors.
Discussion 
This is the first study to demonstrate increased cytokine levels in the CSF of suicide attempters. We hypothesize that IL-6 is involved in the pathogenesis of suicidal behavior and MDD, perhaps due to increased cytokine production in the central nervous system.

Introduction: Community based studies highlighted that the majority of youths who have made suicidal behaviors have psychiatric disorders (Fergusson et al., 2000; Lewinshon et al., 1996) and are also at greater risk for recurrent suicidal behavior (Gould et al., 1998). Until now, few studies analyzed the difference between children and adolescents regarding the comorbidity of psychiatric disorders with suicidal ideation. The aim of this presentation is to determine the strength of association between the most frequent psychiatric disorders in youths and suicidal ideation according to age groups (6-11;12-15).
Method: This study was conducted using two data-banks from previous studies on the psychometric properties of the Dominic Interactive for children (n=453) and adolescents (n=465). This instrument is a pictorial computerized assessing DSM-IV-TR mental disorders. Interactions effects will be tested by logistical regression analyse.
Results: Preliminary descriptive results suggest that 17% of children and adolescents (N=918) have answered yes to the question “Do you often think about death or about killing yourself?”. In addition 13.7% of youths present at least one internalizing disorder and 8.4% present at least one externalising disorder. Moreover results indicate that children have more suicidal ideation and more psychiatric disorders than adolescents. The logistic regression will help us to determine the effect of age on the association between psychiatric disorders and suicidal ideation.
Discussion: Two main topics will be discussed: 1) the main hypothesis of this presentation is that psychiatric disorders (mostly depression) will be associated with an increased likelihood of suicidal ideation in youths. This hypothesis is based on the importance of the comorbidity generally observed among young people (Fergusson et al., 2000; Lewinshon et al., 1996); 2) results according to the age of apparition of suicide ideation is a matter of serious concern (Mazza & Reynolds, 1998): research and clinical implications will be presented.

Attitudes towards suicide reflect values towards human life and may influence both the content and effectiveness of intervention and treatment. By means of the Attitudes Towards Suicide questionnaire (ATTS; Salander Renberg and Jacobsson, 2003) we compared the attitudes towards suicide and suicide prevention among future gate-keepers (i.e., psychology students) in two different cultural contexts, namely Norway (N=217) and South Africa (N=79). The ATTS contains a number of items to be scored on a five-point Likert scale; from strongly agree (5) to strongly disagree (1), with a possibility to tick 3 if one is undecided on the matter. The Norwegian and South African students scored in the same direction on the scale on most items (that is, both groups were either agreeing or disagreeing), but there were some significant differences between the groups in terms of how high and how low they scored on the scale. The Norwegian students expressed a more accepting attitude towards suicide than did the South Africans. The Norwegians also tied suicide to mental illness more often than the South Africans. Compared to the South Africans, the Norwegians were more positive towards the possibility to prevent suicide, both in theory as well as in their willingness to contribute themselves by helping people in suicidal crises. The South African psychology students in general seemed to be able to express clearer attitudes towards suicide compared to their Norwegian counterparts, that is, larger proportions of the Norwegian students ticked the undecided alternative on the scale. Implications for suicide preventive efforts in the two countries will be discussed.

Introduction
Suicidal behaviours are presently a serious public health problem. According to the models of suicidal behaviour, the main risk factors are the experience of early negative events associated with the development of specific psychological characteristics such as perfectionism, hopelessness, dysfunctional cognitive styles and styles of insecure attachment (Cruz, 2006; Wenzel & Beck, in press). Although most studies use quantitative approaches, the narrative approach has recently proved to be a way to fully understand the uniqueness of thoughts, feelings and behaviours of a potential suicide (Mitchell et al., 2003). Under this approach, human beings are perceived as creators of meanings about their personal experiences (Pennebaker, 2004). 
Objectives
The study aims to assess the psychological vulnerability and predisposition to suicidal behaviour from qualitative analysis. 
Design
Twenty narratives of life stories, written by subjects who have attempted suicide with high lethality, were transcribed and analysed. The data was treated according to the assumptions of Grounded Theory of Glaser and Strauss (1999).
Results
Results showed that 91.4% of references were about early negative life events compared with 8.6% of references to positive life events. Situations of psychological abuse, adverse living conditions, physical abuse, sexual abuse and loss were the most significant ones. Moreover, the analysis brought out certain personality characteristics (perfectionism, hopelessness, impulsivity, neuroticism and low problem solving ability), insecure attachment styles and dysfunctional cognitive styles.
Conclusions
The need to conceptualize a theory from the results led us to propose a new model of suicidal behaviour that complements the models above. The study also allows us to state that self-narratives of life stories are a useful way to identify the risk factors and to design therapeutic interventions.

Introduction
Previous investigations show that the history of negative childhood experiences is one of the best predictors of the occurrence of future suicidal behaviours. When comparing suicidal groups with control groups (without suicide attempts) one notices that the suicidal groups experienced more cases of abuse, parental loss, parental mental illness, among others (Dieserud et al., 2002; Ystgaard et al., 2004). Furthermore, according to  Floen and Elklit (2007), 69% of suicidal individuals reported repeated traumatic experiences in their life story.
Objectives
The study aims to assess the extent to which the experience of negative events in childhood may predict the levels of suicidal ideation in adulthood.
Design
390 individuals participated in the study and completed the Socio-Demographic Questionnaire, Negative Life Events Inventory (Brás & Cruz, 2008) and the Suicide Ideation Questionnaire (Reynolds, 1988).
Results
The results indicated that the experience of early negative life events have a significant contribution in the prediction of suicide (in predicting suicide) (R²=.18), emphasizing the role of psychological abuse situations (β=.35; p=.000) and loss (β=.15, p=.014). Physical and sexual abuse situations have a marginally significant contribution (β=.12; p=.054).
Conclusion
The occurrence of negative experiences during childhood, especially those that put in question the self-esteem and self-efficacy or the emotional loss of significant relationships, increases the likelihood of suicidal ideation in adulthood. Implications for prevention of negative events, as well as clinical intervention in these cases are discussed.
 

Introducción: Ao longo da história, a medicina vem construindo um saber que tem permitido exercer um controle sobre a saúde e a doença, a vida e a morte. Esse saber vem conferindo ao médico um poder cujos efeitos refletem na sua relação com o paciente: de um lado, o médico deve lutar com todos os recursos para a manutenção da vida, essa é a ordem médica; do lado do paciente, espera-se aquiescência, resignação e reconhecimento. Existe, entretanto, um paciente que com seu ato subverte a ordem médica: o paciente suicida. Objetivos: Informar a equipe de saúde sobre a complexidade do ato suicida, desmitificando-o e tratando-o como uma manifestação humana; advertir à equipe sobre os efeitos adversos presentes no atendimento ao paciente suicida, e suas implicações. Metodo: Um estudo descritivo da relação médico-paciente suicida e o impacto desta na terapêutica. Resultados: O suicida recusa o saber médico, desafiando seu princípio básico, a manutenção da vida. Seu ato pode provocar na equipe reações de raiva, indignação, ironia, desprezo, etc. Sabendo-se da importância da relação médico-paciente no restabelecimento da saúde de um doente, a relação do médico com o suicida se torna fundamental, na medida em que este paciente, como qualquer outro, necessita de cuidados, mas, sobretudo, de uma atitude imparcial. Quando o médico reage com descaso, ironia ou irritação pode estar reeditando uma situação vivida pelo paciente na família ou na sociedade, corroborando com a idéia de que matar-se é a melhor alternativa. Conclusiones: Conclui-se que a equipe de saúde que atende pacientes suicidas deva passar por um processo de treinamento e capacitação, com a finalidade de prestar uma assistência mais humana e imparcial, contribuindo na prevenção de novas tentativas.

Background: The role of the internet in influencing suicidal behaviours is debated. We conducted a NZ-based extension of the UK study of Biddle et al focusing on suicide methods. Aims: 1) To include NZ search engines and the first 30 hits to more fully determine the relative positioning of sites; 2) To create a ‘map’ showing the linking structure between commonly hit sites. Method: Using a variety of search engines and search restriction to NZ domains, we applied the search terms published by Biddle et al. Key findings: The 72 searches yielded 2160 hits, comprising 718 unique websites. The most common hits were academic/policy (21%), irrelevant/broken links (18%), news reports (13%) and education (statistics, other facts neutrally presented) sites (11%). Twelve percent of hits were pro-suicide sites. 21% (464) of the 1260 sites were interactive, either as chat-rooms or forums, and 29% of these were pro-suicide. 52% of all pro-suicide sites were interactive compared with 7% of all support sites. Pro-suicide sites had the highest frequency of number one ranks, and that three of the top 10 sites were pro-suicide. The site ‘map’ showed strong linkages with obvious source and target sites.Support sites were less strongly linked with each other. Conclusion: The overall pattern was similar to Biddle et al’s study. The perception of the internet as dynamic may refer to individual sites and not its overall composition, at least in regard to suicide methods content. Individual sites are difficult to influence, but approaches to influencing the overall composition and structure of the web content on suicide methods can be developed. To do this, understanding the ‘landscape’ of the web is as important as understanding the content. Suggestions for progress will be discussed. Biddle L, Donovan J, Hawton K, Kapur N, Gunnell D. Suicide and the internet. BMJ 2008;336(7648):800-802.

“feelok”  is an internet based intervention programme addressing young people aged between 12-18 yrs old. It was launched in 2002 containing relevant life-, health- and prevention information for adolescents and school teachers on the following topics: alcohol, smoking, physical exercise, self-confidence and self-esteem, work, love and sexuality, stress, nutrition, and cannabis. The module “suicidality” was added in summer 2007.
 “feelok” is very popular by the target group which is reflected by 1200 visits per day. By embedding the delicate issue ‘suicidality’ as a module on the well used platform “feelok” we aimed to breach the taboo of suicidality, to offer factual information and to provide the young people and school teachers with concrete information on how to act and where to seek further help.

The aim of this paper is to highlight the importance of working with suicide survivors, in order to prevent further suicidal behaviours and several psychopathological symptoms and diagnoses, especially concerning teenage suicide. Starting with a clinical vignette from a thirteen years old student who committed suicide, we will describe the strategies used at her school, focused on partners and friends, their families and school staff, so as to facilitate their bereavement.
This work also intends to present a literature review on this subject: historical perspective, grief process on a suicide death – theoretical perspectives and empirical data, survivors’ psychological experiences and their social stigma.

ObjetivosConhecer a experiência de pacientes e seus acompanhantes (familiares, vizinhos e amigos) com o suicídio, através das representações sociais relacionadas com a narrativa de quadros depressivos, com a percepção do risco de suicídio, assim como problemas na utilização de serviços de urgência psiquiátrica. MétodoForam realizados 25 grupos focais com 131 usuários recrutados em uma amostra de conveniência na sala de espera, permitindo maior proximidade com questões críticas do atendimento de urgência. Utilizou-se análise de conteúdo e grounded theory. Categorias que representam a experiência ampla com o suicídio e sua interface com a assistência foram investigadas. ResultadosA rede assistencial foi considerada ineficaz, deficiente nas síndromes depressivas e a adesão ao tratamento emergiu como questão. Ideação, intento e realização aparecem indistintamente nas narrativas de suicídio. A repetição do parasuicídio não causa espanto.Identificou-se baixo nível de literacy em saúde mental, existindo forte interesse em receber informação por parte de todos os estratos avaliados

Introducción: Objetivos: A partir das entrevistas realizadas, serão desenvolvidos um manual e um vídeo como ferramentas de educação em saúde mental voltadas para o risco de suicídio, (suporte gráfico e suporte vídeo). Estes produtos visam intervenções no espaço assistencial , voltadas para equipe de profissionais de saúde mental e usuários da emergência.A Construção de dispositivos de educação em saúde mental específicos, estratificados, voltados para o risco de suicídio, visam ações de promoção de saúde assim como prevenção secundária e terciária em psiquiatria clínica. Metodo: O projeto consiste em uma pesquisa empírica qualitativa realizada através de entrevistas semi-estruturadas, utilizando análise do discurso, estudo de representações sociais e análise de script discursivo com usuários de uma emergência psiquiátrica (CPRJ) (pacientes, familiares e acompanhantes) focando a percepção do risco de suicídio. Resultados: Esta investigação admite a hipótese de estratificação e multiplicidade de representações envolvidas na compreensão do risco de suicídio, de acordo com o recorte sociológico pertinente. Os resultados de campo serão analisados, discutidos e processados durante todas as etapas, gerando diretrizes  sobre a forma e o conteúdo que serão adotados nos produtos da pesquisa. Entrevistas prévias apontam para  a necessidade de se obter mais informações sobre o tema suicídio, com o propósito que se tivessem acesso a maior informações, poderiam ter identificado alguns sinais de risco e por conseguinte ajudado a pessoa doente. Conclusiones: O suicídio é um problema de grande importância nas sociedades contemporâneas. Seu estudo ainda é incipiente no Brasil. Carecemos de intervenções em saúde pública voltadas para a promoção de saúde mental e a prevenção secundária ou terciária. A Construção de dispositivos de educação em saúde mental específicos, estratificados, voltados para o risco de suicídio, visam esta promoção da saúde e a prevenção.

Introducción: O projeto consiste em uma pesquisa empírica qualitativa realizada através de entrevistas semi-estruturadas com usuários de uma emergência psiquiátrica (pacientes, familiares e acompanhantes) focando a percepção do risco de suicídio. Objetivos:  Serão desenvolvidos um manual e um vídeo como ferramentas de educação em saúde mental voltadas para o risco de suicídio, (suporte gráfico e suporte vídeo). Estes produtos visam intervenções no espaço assistencial e seus entornos, voltadas para os principais atores sociais envolvidos: equipe de profissionais de saúde mental e usuários da emergência. Metodo: 1 Pesquisa empírica com usuários e profissionais utilizando metodologia qualitativa com entrevistas semi-estruturadas. 2 Pesquisa bibliográfica e discussão de campo voltada para desenvolvimento de produtos: manual e vídeo. >Resultados: Intervenções em Psicoeducação: produtos desenvolvidos 1 Desenvolvimento e implemento de protocolo de primeiros socorros em saúde mental voltado para acompanhantes de usuários e para a comunidade. Consiste em material produzido como ferramenta tecnológica para educação em saúde mental. 2 Criação de folder informativo a partir do estudo qualitativo. Desenvolvimento de suportes diferentes (alternativos ou suplementares) para o conteúdo do folder convencional: cartilha, “santinho”, cordel ou outros. Consiste em material produzido (=suporte midiático) como ferramenta tecnológica para educação em saúde mental. 3 Criação de Vídeo/VCR-DVD informativo a partir do estudo qualitativo: edição de DVD curto, desenhado para divulgação de informações básicas em domicílio, rede de ensino, escolas e ambiente hospitalar. Consiste em material produzido como ferramenta tecnológica para educação em saúde mental. 4 Desenvolvimento de manual de condutas no risco de suicídio voltado para profissionais de saúde mental; Consiste em material produzido como instrumento de apoio à atividade de ensino e formação permanente. Conclusiones:

Introdução: Alternativas à hospitalização convencional têm sido tentadas no risco eminente de suicídio (avaliado por instrumentos fidedignos). O AT constitui modalidade de intervenção em psiquiatria de urgência com a complexidade do home-care, sugerindo efetividade pouco estudada. Objetivos: Apresentar o AT simultaneamente como intervenção psicoterápica e protocolo de cuidados em domicílio. Indicar seus fundamentos e discutir o conjunto de medidas protocolares de avaliação, follow-up e intervenção em risco de suicídio, que podem ser desenvolvidos no AT. Método: Discussão da literatura sobre intervenções no paciente em risco. Análise e problematização de casos e práticas envolvendo estes protocolos. Resultados: Algumas dimensões do home-care no risco de suicídio mostram-se racionalmente justificados e sancionados por trabalhos anteriores como: limites técnicos e deontológicos do procedimento, formalização de contrato de risco de suicídio com o paciente e sua família,  monitoramento de condições propiciadoras ou impeditivas do desfecho mórbido, acompanhamento da evolução clínica e  utilização de instrumentos de avaliação do risco. Conclusões: A atuação do acompanhamento terapêutico no risco de suicídio insere-se no âmbito do atendimento especializado em saúde mental. Desenvolvem-se cuidados intensivos no domicílio do paciente visando uma alternativa racional à internação psiquiátrica, com evidência de eficácia embora limitada em seu alcance.

Introducción:
Objetivos:
O propósito deste projeto é coletar informações bibliográficas produzidas sobre suicídio e risco de suicídio nos últimos dez anos (1997-2007) e viabilizar a difusão de conhecimentos científicos para alunos, professores, profissionais da área da saúde e a comunidade em geral, focando a prestação de serviços de referência e informação com qualidade e proporcionando a democratização do acesso às informações coletadas. Tais ações proporcionarão apoio estratégico ao Sistema Único de Saúde, objetivando ,com isso, a melhoria da qualidade dos serviços prestados à população
Metodo:
A metodologia seguirá preceitos de revisão sistemática utilizando Medline, PubMed, PsychoINFO, BVS e Bireme através de busca indexada, realizando levantamento de textos da literatura relacionada com representações sociais de usuários e profissionais acerca do suicídio e literatura acerca dos protocolos, intervenções e condutas (prioritariamente evidence-based com metanálises e buscando consenso de especialistas e guidelines).
Resultados:
Criou-se novas formas de mediação na obtenção e na disseminação da informação. Contribuiu para o fortalecimento da Fiocruz como centro de referência e excelência em informações sobre suicídio. Contribuiu para o desenvolvimento da pesquisa na área de saúde mental. Reflexão sobre a produção encontrada e produção de artigo sobre a pesquisa. E instrumentalização da psiquiatria clínica.
Conclusiones:: Levantamento bibliográfico e revisão teórica do suicídio vem demandando maior conhecimento para ações em saúde pública. A partir do maior conhecimento da construção jornalística e midiática sobre o tema e seu papel na formação dos consumidores/usuários, pode-se propor intervenções que promovam saúde e aumento na percepção do problema na comunidade. Desta forma, pode-se haver uma avaliação/intervenção precoce no risco de suicídio.  

Introd O suicídio é um problema de grande importância nas sociedades contemporâneas. Seu estudo ainda é incipiente no Brasil. Isso pode ser observado por intermédio de um levantamento bibliográfico realizado no período de agosto de 2007 a fevereiro de 2008, abrangendo as publicações de 1996 a 2007. Foram encontrados: 397 artigos de periódicos indexados, 173 livros, 341 produções acadêmicas (teses e dissertações), resultantes do trabalho de 952 autores brasileiros. Este projeto teve por objetivo identificar essa literatura, com suas variações temáticas em torno do suicido. Os resultados serviram para reconhecer as áreas que atuam nesse tema e para identificar as necessidades de implementação ou intensificação na produção de conhecimentos a serem utilizados na prevenção do suicídio. A difusão de dessas informações será útil para alunos, professores, profissionais da área da saúde, para a comunidade em geral e, especialmente, para o Sistema Único de Saúde (SUS), objetivando com isso a melhoria da qualidade dos serviços prestados à população, no tocante à promoção de saúde mental e à prevenção do agravamento de transtornos mentais que possam ter como desfecho o suicídio.ucción:
Objetivos:
Metodo:
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The internet plays an increasing role in everyday life all over the world. Suicide researchers have warned against websites with suicide manuals and indicated that it might lead to more suicides, but the important possibilies for suicide prevention though the internet should not be overlooked. Young people use these internetbased possibilities increasingly. A review of Danish suicide preventive websites and chatrooms will be presented together with a model to link these services to assertive professional care. Often the counselors working in the chatrooms and in help-lines are volunteers, and even though supervision is provided, it would be helpful for them to have possibilities for direct referral to a program with a non-bureaucratic assertive flexible outreach team, staffed with nurses and social workers. A model for linking volunteer first aid programs to professional outreach programs will be presented.

Background: The limited studies on the consequences of the separation process on suicidal behaviour seem to indicate that separated people are at increased risk of suicide. Aims: The current study aims to compare suicidality immediately after the separation process among males and females, and to analyse possible differences in predictors of serious suicidal ideation. Method: Separated males and females who had contacted relationship counselling services, help-line services, and a variety of support and self-help groups were asked to participate in the study. Participants were required to be 18 years old or older, and have separated from their married/de facto partner within the previous 18 months but not yet divorced. For categorical variables odds ratios with 95% CI and for continuing variables t-tests were calculated. Multinomial logistic regression was applied to estimate the independent contribution of significant predictors. Results: Separated males (n=228) were at an increased risk of developing suicidality during the separation process compared to separated females (n=142), even after adjusting for age, education, employment and children with the separated partner. The psycho-social risk factors identified in the development of serious suicidal ideation were mental health problems (during the previous year), history of suicide attempts and internalised shame. For separated males, significant predictors also included lower education, separation-related shame and stress from legal negotiations, especially about property/financial issues.  Conclusions: The findings provide a better understanding of suicidal behaviours in the aftermath of marital or de facto separation. This knowledge could be used in the implementation of future suicide prevention strategies in people who are going through the process of a marital/de facto separation.

To investigate whether the 5HTTLPR gene affects long-term prognosis in suicide attempters. Several studies have reported that the long allele of the 5HTTLPR polymorphism protects people against depression, and possibly suicidal behaviour, in the face of adversities. Method: 42 suicide attempters were followed up 13 years after a suicide attempt. They were psychiatrically re-assessed, interviewed about life-time adversities, and genotyped. Only adversities reported to have happened before the suicide attempt were considered. Results: Suicide attempters with two short alleles reported fewest adversities, those with two long alleles reported most adversities, and heterozygote suicide attempters reported an intermediate amount (P = 0.03). However, the 5HTTLPR polymorphism had no effect on the chances of recovery. Furthermore, still-ill individuals who reported many adversities also experienced many psychiatric symptoms; however, there was no evidence of the long allele moderating the impact of adversities on symptoms. Conclusion: We find evidence suggesting that the long 5HTTLPR allele protects the never-ill from becoming ill. However, we find no evidence that the 5HTTLPR gene alters chances of recovery, or reduces long-term morbidity caused by adversities in suicide attempters.

To investigate whether anatomical and biochemical changes together relate to temperament in suicide attempters. Background: We previously found serotonin transporter density to be associated with temperament in suicide attempters, but not controls. We also found evidence suggesting the globus pallidum to be involved in suicidal behaviour. Method: We re-analyzed MR and SPECT images from 7 suicide attempters and 6 matched controls without a history of psychiatric illness. Volumes of relevant brain structures were determined from the MR scans using an automated process (FreeSurfer). Serotonin transporter density was determined using 123I-beta-CIT SPECT. A trait called solidity (reflecting stability of preferences and opinions, and a correct and formal interpersonal style), was measured using the Marke-Nyman Temperament scale. Results: Significant correlations were only found in suicide attempters (but not in controls) between: globus pallidum size and solidity (rs = –0.8, P = 0.03); and globus pallidum volume and serotonin transporter density (rs = –0.9, P = 0.008). Conclusion: Anatomical changes in the globus pallidum, hand-in-hand with altered serotonin transport into cells, may relate to temperament in suicide attempters.

Background: There is limited research examining the roles of shame and marital breakdown in suicide. Aim: The present paper examines internalised and event-related (marital separation) shame in the development of suicidal behaviours including mental health problems as possible mediating factors. Method: Separated males and females who had contacted relationship counselling services, help-line services, and a variety of support and self-help groups were asked to participate in the study. Participants were required to be 18 years old or older, and have separated from their married de facto partner within the previous 18 months but not yet divorced. Pearsons correlation coefficients and Structural Equation Modelling were applied to analyse the data. Results: Internalised shame, event(separation)-related shame and mental health problems were significantly correlated with the score for suicidality during separation in both genders. Tested structural equation model indicated that internalised shame was not directly linked to suicidality, but was mediated by mental health problems or separation-related shame in separated males.  The model did not fit for separated females. Conclusions: Our findings indicate that there are associations between internalised shame, event(separation)-related shame, mental health problems and suicidality among people experiencing marital breakdown. Separation-related shame may directly lead to male suicidality.

Previous studies have shown that among those who die by suicide, contact with mental health services is common. This study aims to examine the last clinical contact suicide victims had with health professionals in order to determine whether this contact offers an opportunity for suicide prevention. Specifically examined are the individual context of suicide victim’s last health-care contact, the potential warning signs displayed, and the abilities of health professionals to identify and intervene prior to the event. This study is a controlled psychological autopsy (PA) study which gathers detailed information on suicide victims over the age of 35 from two Australian sites (QLD and NSW). This information is compared to a matched control group of sudden death victims. This study interviews family and/or friends of the suicide and sudden death victims and the healthcare professionals, who had had contact with the deceased in the six months prior to their death. Health records are also obtained for these deaths where possible. In total 277 suicide next-of-kin interviews (262 suicide cases) and 183 sudden death next-of-kin interviews (179 sudden death cases) were completed. In addition, 213 healthcare professional interviews (154 suicide cases), and 93 healthcare professional interviews (80 sudden death cases) were completed. At the time of this abstract, data analysis has just begun, but results of the study will surely be ready for presentation and discussion at the congress.

Causal relationship between personality disorders and suicidal behavior it is still unclear whether personality disorders or certain personality traits directly lead to suicidal gestures, independently from other risk factors.
Objectives: The purpose of the authors is to identify personality traits which place subjects with personality disorders and suicidal behavior at higher risk than a control group of subjects with personality disorders without suicidal behavior.
Method: 131 subjects divided in 2 groups were included in the study: an experimental group of patients diagnosed with personality disorder and suicidal behavior (n=46), a group with personality disorder without suicidal behavior (n=85). SCID II was employed as an assessment tool for categorial diagnosis of personality disorders. The dimensional approach offered by the Temperament and Character Inventory (TCI) suggested a possible causal relationship between certain specific personality traits and suicidal behavior. Results: Scores with high statistical significance in harm avoidance (HA) such as pesimism (HA1), shyness (HA2), asthenia (HA4) for suicidal patients prove the relationship between suicide and the personality dimension harm avoidance in personality disorders. Low scores in the character traits self-directedness (SD) like blaming (SD1), lack of goal direction (SD2)  and cooperativeness (C) like social intolerance (C1), social disinterest (C2), unhelpfulness (C3) and revengfulness (C4) appear to be risk factors for suicidal behavior. Patients with personality disorders without suicidal behavior have significantly higher scores for the temperament dimension reward dependence (RD) at attachment (RD3), when compared with patients  personality disorder and suicidal behavior.
Conclusions: The assessment of the data from the studied subjects suggests that the best protection against suicidal behavior is the presence of high scores in all character traits: self-directedness, cooperativeness and self-transcendence.

Suicide statistics for Romania were reported to the World Health Organization only after 1989 - the fall of the communist regime. Suicidality in post-communist Romania decreased from 23.8 suicides per 100,000 population in 1985 to 13.38 per 100,000 in 2005. Major socioeconomical changes in Romanian post-communist society underline a pattern of suicidal behavior in Romania which requires thorough comments. Thus, ethnic differences in suicide rates are still present, but specific social underpinnings have changed. Suicide rates vary among Romanian counties – from 4 per 100,000 in counties with majoritary Romanian ethnic population to 33.03 per 100,000 in areas with mixed Hungarian and Romanian population in 2007, but also from one year to another in the same county. Comprehensive epidemiological assessment is required for appropriate understanding of all Developmental, cultural, social factors which influence suicide trends in Romania. The assessment of this social phenomenon is still hindered by certain mindframes, and we can regard suicide as a mental health problem and an important, yet preventable cause of death in Romanian population. As a preventive measure, the Romanian Ministry of Health established free maintenance treatment for mood disorders and psychoses.and psychoses.

Organisations representing Lesbian, Gay, Bisexual and Transgender groups (LGBT) expressed concern that the suicide prevention strategy did not address the perceived disproportionate levels of suicide and self-harm amongst these groups. As a result of such concerns a literature review into the risk of suicide and self-harm amongst these groups was commissioned. The report of this review was published in February 2008 - mental disorders, suicide and deliberate self-harm in lesbian, gay and bisexual people. After studying the findings of the review the NMHDU decided to commission a review of what interactive or non-interactive services are available on line for LGBT people which provide information, support and advice to individuals who may be vulnerable and at risk of developing mental health problems and suicidal thoughts and behaviour. In addition, the review will map what mental health services, support or advice is currently available for LGBT people and identify gaps in provision. The review will also establish if any services undertake routine monitoring of sexual orientation of their client group.This review will begin in May 2009 and is expected to report back to the NMHDU by September.  The review will set out the range of on-line support and advice services for LGBT people in England and make recommendations as to the most appropriate intervention measures that will lead to improvements in the mental health and well-being of individuals.  It will also set out what mental health services, support and advice is currently  available within the community and identify any gaps in provision. 

Context: According to the literature 22% to 39% of psychologists, 51% to 82 % of psychiatrists and 33% of social workers have lost a patient/client to suicide during their career. Patient/client suicide is therefore considered as an “occupational hazard” which affects professionals both on a personal and a professional level.  Patient/client suicide possibly engenders shock, sadness helplessness, anger and low self-esteem. It might trigger also feelings of professional failure and incompetence, lead professionals to question their expertise, practices, status and role, raise concerns about possible legal.
Population and Method: Two studies (2005-2007, 2008-2010) taking place in the French-speaking cantons in Switzerland, supported by the Swiss National Science Foundation, investigated the impact of a patient’s suicide on professionals, on their working practices and support seeking strategies. 4951 professionals (physicians and psychiatrists, nurses, social workers, social educators, psychologists and health auxiliaries) working either in institutional settings (3416) or in private practice (1535) were surveyed. A self administered questionnaire composed of 69 questions (included 9 scales) was completed by 869 professionals who experienced a patient’s suicide. Multivariate statistics, especially factor analysis and regression analysis, have been performed.  
Results: The communication will present findings from both studies with regard to the emotional impact (Horn 1995 and Horowitz et al. 1979 scales) among professionals working in institutional settings ( N= 663, group A) versus those working in private practice (N= 206, group B). Particularly, are professionals B more impacted then professionals A? What are the predictors of the emotional impact in both groups? Are there common predictors?  Are they related to professional’s, patient’s or setting’s characteristics? What are the greatest challenges that professionals have to deal with?
Discrepancies and similarities with previous studies will be addressed and discussed as well as recommendations for clinical practices and professionals’support protocols.
 

Background: Recent studies showed that cannabis use were longitudinally associated with schizophrenia, depression, and anxiety.  Methods: Using data from Wave 1, Wave 2, and Wave 3 (W1, W2, W3) of the Baltimore ECA Program, incidence cases of suicidal behaviors, including attempted suicide and suicide ideation, between first and the latest wave were identified. Baseline (W1) history of cannabis abuse and other mental disorders were also identified. Logistic regression model were utilized to determine the longitudinal association between suicidal behaviors and cannabis abuse. Results: While gender and racial background were not associated with suicide ideation, cannabis abusers were 3 times greater in developing suicide ideation than non-abusers (adjusted odds ratio=3.00, CI=1.46-6.18). Even after adjusting for the baseline diagnoses of depressive episode and alcohol abuse, cannabis abuse remained a significant risk factor for incident suicide ideation (adjusted odds ratio=2.72, CI=1.52-6.50). After dividing by gender, we found that the association of cannabis abuse and later suicide ideation was only manifested in women (adjusted odds ratio=3.91, CI=1.84-8.28) but not in men (adjusted odds ratio=1.82, CI=0.71-4.66). We did not find any longitudinal association between cannabis abuse and incidence of suicide attempts (adjusted odds ratio=1.73, CI=0.72-4.14, Wald ÷ =1.52, df=1, p<0.22) Conclusion: History of cannabis abuse was a longitudinal risk factors for developing suicide ideation among women but not among men. History of cannabis was only associated with later suicide ideation but not attempts suggested that the adverse effects of cannabis might contribute more to thoughts instead of behaviors. 

Context: In older populations, the psychiatric model explains suicide in terms of the predominant role of mental disorders. Objective: Verify the fit between the psychiatric model of suicide and research data on children and young adolescents. Method: Analysis of the literature on suicide in children and young adolescents and examination of the files of the Québec coroner´s office for 8- to 14-year-olds, from 1987 to 1997(suicide N=125; undetermined N=21; accidents N=107). Results: Gender ratio differs from adults: rather than marked gender differences, there is an equal or sometimes an inverse ratio. The rarity of child suicide and low frequency of young adolescent suicide has been explained by the rarity of depression and substance abuse prior to puberty and their low frequency in early adolescence. However, the prevalence of mental disorders in young people who died of suicide is lower than in older groups, the younger the age of the suicide, the less likely to find a mental disorder. Although there are serious doubts regarding the quality of suicide data for this age group, these data have nonetheless been the focus of exhaustive studies. Researchers have suggested that cases which do not present the usual risk factors such as the presence of a mental disorder or that do not correspond to the usual criteria for serious suicidal intent should not be included in child suicide cases. Therefore, suicides that appear to be related to imitation, peer pressure and belief in life after death appear receive little or no attention. These suicides merit further investigation. Implications: The unique characteristics of suicide in childhood and early adolescence would seem to call into question the psychiatric explanation. The development of a psycho-socio-cultural autopsy might be better adapted to research in this field than the use of more psychiatric oriented psychological autopsy methodologies.

This poster presents a preliminary analysis of male suicide and Deliberate Self Harm in rural areas and forms part of the overall Ph.D. which is examining, from a sociological perspective male suicide in rural Ireland. A qualitative approach is being used to explore men’s decisions to engage in suicidal behaviour.   A sharp rise in male suicides in rural areas has been documented in the literature (Page et al 2007; Baume et al 997) and in some countries rates in rural areas exceed those in urban areas.  The highest rates are evident in areas with the lowest population density.  In the US, the predominantly rural state of Nevada has the highest rate of suicide in the United States - 24.5 per 100,000 in comparison to the more ‘urbanised’ state, New York (7.6).  Similar trends are evident in Australia, Ireland and Scotland.   Remote areas of Australia have a male suicide rate of 31.1 per 100,000 in comparison to a rate of 13.0 in the Australian Capital Territory (ACT). Scotland’s Shetland Islands have a male suicide rate of 36.2 compared to a rate of 20.3 in Edinburgh and predominantly rural counties in the West of Ireland have male suicide rate of 23.2 per 100,000 in comparison to the national average of 15.0.    Explanations for this rural/urban disparity include factors such as social isolation, lack of services and access to firearms in rural areas (Charles et al 2004; Dudley et al 1998).  Yet a gender, masculinities, perspective is required to explore why these factors impact more on male, rather than female, suicide rates.  This poster will present a comparative analysis of male suicide and Deliberate Self Harm (DSH) data from rural areas in Ireland, Scotland, Australia and the USA. It will also draw on gender and masculinities frameworks to explain this behaviour.

Objectives:  The suicide risk of widowed persons is increased in the days, weeks and months after bereavement, as we could show in analyses based on person-year calculations (V. Ajdacic-Gross et al., Psychol Med (2008), 38, 673–676). In this study we will extend the analysis using survival analysis models.   Methods:  The data was extracted from Swiss mortality statistics for the period 1987-2007. The time between bereavement and subsequent death – specifically by suicide – was determined by linkage of individual records of married persons. The survival analysis (Cox regression) presented here will include predictors such as age, sex, religion and region. We extended the analysis by implementing simulated matched controls representing the general population. Thus, we were able to differentiate the overall risk factors for suicide and the extra effect of bereavement  Results / Conclusions:  We will present findings from survival analysis on suicide after bereavement including simulated population data.   

            Considering the pervasive apprehension and stigmatization present in many societies regarding gay, lesbian, bisexual, and transgender (GLBT) youth, many of these adolescents face a greater struggle in the process of forging a firm sense of self-awareness, self-esteem, and sense of identity than their heterosexual counterparts. Finding one’s niche within a social circle, increasing independence and autonomy, and coming to terms with one’s sexuality and sexual orientation are fundamental tasks in adolescence. GLBT adolescents may be confronted with a greater sense of distress, uncertainty, and shame when navigating these milestones as they lack a variety of necessary resources and support. These youth frequently encounter ostracism from peers, rejection from family members, and a general fear for their safety. While some GLBT youth may transition into adulthood less-scathed, some develop depression, anxiety, or engage in self-injurious behaviors. Others will attempt or complete suicide. Rates of attempted suicide are as high as 30-40% in GLBT youth, a statistic that more than triples that of their heterosexual counterparts.              With emerging awareness of their sexual orientation, GLBT youth are forced to cope with the lonely experience of being different from their heterosexual peers. These teens often struggle as they seek information to help them understand their sexual orientation identity development in a culture where resources are often limited and stigmatization abounds. Owing to this dearth, GLBT youth often lack affirmative social networks, leaving them more susceptible to a broad range of risk factors associated with increased suicidality, such as substance use disorders, violence and victimization, and homelessness.  It is critical for mental health professionals to design and implement interventions that address these risk factors and enhance the well-being and sense of self-worth of GLBT youth in an effort to increase resiliency and reduce suicidality among this group.

Introducción:Segundo a Organização Mundial de Saúde (OMS), acontece no mundo, hoje, um suicídio a cada trinta segundos, totalizando cerca de três mil suicídios diários. A OMS estima, ainda, que a maioria suicídios poderia ser prevista e evitada. Evidências sugerem que a presença de comportamentos impulsivos e impulsivo-agressivos é um denominador comum entre a maioria dos sujeitos que cometem suicídio.
Objetivos:Realizar pesquisa bibliográfica sobre a influência da impulsividade, presente em alguns transtornos psiquiátricos, no comportamento suicida, e ainda verificar a prevalência de suicídios ou tentativas de suicídio em pacientes portadores dos transtornos dos controles dos impulsos.
Metodo:Realizou-se levantamento de artigos publicados em base de dados da LILACS-BIREME, SCIELO e PUBMED-MEDLINE, no período de 2003 a 2008. Também foram utilizados livros como fonte de pesquisa.
Resultados: A relação entre impulsividade e comportamento suicida foi bem demonstrada nos transtornos de personalidade, principalmente no tipo borderline, e no transtorno bipolar. Poucos estudos foram encontrados acerca dos transtornos do controle dos impulsos e comportamento suicida. Encontrou-se uma alta prevalência de pensamentos de morte e tentativas de suicídio nos portadores de jogo patológico.
Conclusiones:A fim de prevenir o suicídio, deve-se ter muita atenção ao avaliar um paciente e seu comportamento, para não desvalorizar os aspectos impulsivos de sua personalidade ou patologia psiquiátrica. Novos estudos deverão ser realizados a fim de esclarecer de caracterizar melhor a relação entre impulsividade e comportamento suicida.

Objective: Suicide rates are often high in rural areas. Despite the known association between deliberate self-harm (DSH) and suicide, few studied rural residence and DSH. Self-poisonings dominate DSH hospital presentations. We investigate a previously-reported association between rural residence and medical severity (defined as a subsequent medical/surgical inpatient stay) among emergency department presentations for medicinal self-poisoning (SP) to determine whether differences in agents taken, mental health service use or hospital-level resources explain the relationship.
Method:  A cohort of n=16,294 12-64 year-olds presenting with SP to hospital emergency departments in Ontario, Canada in 2001/02 were linked to their service records over time. 
Results:  The rural-medical severity association was best explained by differences in hospital resources; presenting to hospitals providing inpatient psychiatric services appeared to reduce medical/surgical inpatient stays in favor of psychiatric ones. Among those with a recent psychiatric admission, more intensive ambulatory psychiatric contact may be protective of a psychiatric inpatient stay subsequent to the SP presentation. Compared to non-rural residents, deliberate intent was identified less often in rural residents, particularly males.Conclusions:  The rural-medical severity association was best explained by disparities in the delivery systems serving rural and non-rural residents, important to rural suicide prevention efforts.  

Introduction: In 1999 the World Health Organization (WHO) launched a worldwide initiative for the prevention of suicide, called SUPRE, with the overall goal of reducing mortality and morbidity associated with suicidal behaviours. This organization considers that intervention from outside the health sector is also required. In Brazil, the Firefighters Corporation has an important paper as a provider of initial care for different injuries, including suicidal behaviours, and should be involved in suicide prevention strategies. Objetives: This research aimed to identify the conceptions of Firefighters about suicide and attempted suicide, to verify their knowledge about suicide prevention and if they make use of the prevention opportunity offered by the emergency care of suicide attempters.
Methods: This research was carried out in a city of the Brazilian state Minas Gerais, where eight male firefighters were interviewed and their answers to five open questions were analysed using a qualitative approach.
Results: According to them, suicidal behaviors are related to sociocultural, religious, economic, marital, psychological and psychiatric factors. They showed great concern with the problem of suicide, knowledge about the issues in question and suicide prevention in the community, as the offered by mental health teams. However, they seemed not to know how to prevent new suicide attempts, or it’s consummation, while attending a call.
Conclusion: We concluded that training firefighters on this issue is an important strategie for suicide prevention.

          African Americans have consistently demonstrated a significantly lower incidence of suicide than other ethnic groups in the United States; however, a marked increase has been observed among African American adolescents over the last several decades. This presentation will discuss research conducted collaboratively by the Florida Initiative for Solving Problems and the Suicide Prevention among Adolescents: Research and Evaluation (SPARE) group at Nova Southeastern University.           Participants were 227 predominantly African American or Black (54.2%), male (70.8%) adolescents, aged 12 to 18 years (M = 14.92, SD = 1.81) who were recruited from several juvenile justice facilities, after-school programs, and other community groups. All participants were assigned to a 10-week, problem-solving skills group. The Suicidal Ideation Questionnaire-Junior version (SIQ-Jr.), the Health Risk-Taking Assessment, and the Problem-Solving Skills Test were administered prior to initiation of the groups and at group completion.
           Participants were partitioned into two groups for data analysis, African American or Black, non-Hispanic (n = 150) and all other ethnicities (n = 125). Groups did not significantly differ on knowledge of problem-solving skills or suicidal ideation. Most risk factors were only marginally lower for the Black group. Group membership was not a significant moderator in the relationship between any of the risk factors and suicidal ideation or between knowledge of problem-solving skills and suicidal ideation. Furthermore, according to results of a stepwise multiple regression analysis, only two risk factors (i.e., self-inflicted injury and family dysfunction) were found to be significant predictors of suicidal ideation for the Black group at pretest. Thus, risk factors assessed in this study do not appear to predict suicidality among the Black sample to the extent anticipated by these researchers in accordance with the present literature. Individual, ecological, socio-cultural, and environmental factors that may have contributed to these results will be discussed.

Gender differences in suicidal behaviour entail a challenging paradox: more women attempt suicide then men, while more men commit suicide that women. Also, men suicides are more likely to have experienced personality and substance abuse disorders, while women suicides more often meet criteria for history with major depression disorder (MDD). The majority of suicide victims have a history of MDD, though only a small minority of those suffering from MDD will die by suicide. Among individuals with a history of MDD, suicide completers have higher levels of impulsive-aggressive traits than controls. The present study aimed to identify whether gender moderates the risk for suicide entailed by personality traits (e.g. impulsive-aggressivity), while controlling for the effect of MDD. In the context of a case-control design, 201 suicide completers (160 men and 41 women) and 129 living controls (90 men and 39 women) with a history of MDD were recruited in Montreal, Canada. Participants were evaluated via the psychological autopsy method, encompassing diagnostic and trait assessment by means of personal interviews and self-reports with best informants for each participant. A significant interaction was found between gender and impulsive-aggressive behaviours, such that these may have different relative contributions to suicide in men and women with MDD.

Introducción: o projeto PLUS em perdas, luto e separação realiza estudos sobre a morte no âmbito do suicídio, do luto e da psico-oncologia. Objetivo: destacar na produção científica brasileira as pesquisas stricto sensu- doutorado que abordam sobre a metáfora da doença e da morte, com foco no suicídio.
Metodo: a busca ocorreu de abril a maio de 2008 no banco de dados CAPES de 1987-2006 a partir da palavra metáfora com 1.438 investigações, sendo 1.000 dissertações, 425 teses e 13 mestrados profissionalizantes em diversas áreas do conhecimento. Ao refinar com a palavra doença foram identificadas 36 investigações, sendo 11 de doutorado. Ao incluir a palavra morte apareceram 89 pesquisas, mas ao destacar aquelas por suicídio constam apenas três pesquisas de doutorado.
Resultados: das onze pesquisas de doutorado sobre a metáfora da doença, seis abordam sobre: diabetes, câncer (2), tuberculose/aids, doença metal e psoríase; quanto as três sobre o suicídio, duas são estudos da literatura e a outra sobre o uso de agrotóxico. Conclusiones: constatou-se ainda que é incipiente o interesse na saúde por esta figura de linguagem entendendo que mais estudos possibilitariam uma melhor compreensão das temáticas que são de difícil comunicação entre os profissionais da área.   

Introducción: a língua portuguesa possui diversos recursos que a enriquecem, sendo um destes a metáfora, uma figura de linguagem que utiliza comparações diretas e indiretas. O sub-grupo de estudos -  Suicídio do Projeto PLUS, discute mensalmente sobre filmes relacionados à temática.
Objetivo: identificar as metáforas do filme AS HORAS, analisando as relacionadas ao suicídio.
Metodo: as autoras assistiram em maio/08 o filme AS HORAS, de Stephen Daldry, com 114 minutos e debateram a partir dos diálogos das três mulheres envolvidas com a leitura de “Mrs. Dalloway", de Virginia Woolf que trata da angústia da alma feminina.
Resultados: as metáforas encontradas denotam o sofrimento psíquico das personagens suicidas: “eu não escolhi a anestesia sufocante dos subúrbios e sim o choque violento da capital”; “minha vida foi roubada”; “período nebuloso e não vou me recuperar dessa vez”; ”você vem me dizer que vive sob ameaça da minha extinção (morte)”; continuarei vivo por você, mas agora tem que me deixar ir(morrer)”
Conclusiones: a produção cinematográfica lança mão de metáforas em seus roteiros com o fim de impactar de alguma forma o espectador. Os filmes são importantes meio para transmissão de informações e cultura, podendo ser utilizados para fins de aprendizagem.

Many suicidal persons surf on the internet looking for information and help. Many like to remain anonymous and contact telephone hotlines.To reach suicidal persons as soon as possible a new Dutch initiative is released this year combining webbased information and intervention and telephonic crisis counselling, and immediate referral and contact with professional treatment if necessary. In this presentation the outline of this initiative is given alongside recent results. The website offers information for suicidal persons (under and above 23 years of age), for relatives who look for information, for survivors, for care givers, and for the broader audience such as students and journalists. The website offers a self examination (how suicidal am I?), and depending upon the testresult the visitor can have a telephone conversation with a volunteer or with a mental health care specialist (psychologist, psychiatrist),  telephone crisis counseling, a e-mail treatment (max 5 correspondences),  and can have a referral to immediate crisis contact with an acute service of a mental health care service in the zipcode area of the visitor. Visitors even can follow a self-help intervention for six weeks aiming at decreasing intensity and frequency of suicidal thoughts. This may come handy for those who for whatever reason want to remain anonymous, or who don´t want to see a therapist.
The idea is to offer understanding and easy contact at any moment in time and as soon as possible in the suicidal development. The initiative has received financial support by the Dutch government. The website / hotline is continuously monitored and subject to scuientific research. At the time of the Montevideo conference, the first results will be available.

Since antiquity suicide has been a popular subject in the Western art and Fred Cutter (1983) in his book Art and the Wish to Die identified more than 250 artists who had painted suicide themes over centuries. One of the questions arising from a study of iconography of suicide is a question regarding the relationship between artists’ personal lives, especially own experience with death and suicide and their art. Are artists who paint images of suicide suicidal themselves? If this is the case, does their artistic expression serve a cathartic role or increase the risk of suicide? Can we see or trace indicators of suicide risk in paintings and other forms of art created by artists who died by their own hand? Does a personal experience of a significant other’s suicide affect the content and form of art? In an attempt to tackle these questions, the authors of this paper will present biographies and art of two prominent 20 century European artists who died by suicide: a Belgian abstract and figurative painter Jan Cox (1919-1980) and a Polish painter, photographer, playwright, novelist and philosopher Stanislaw Ignacy Witkiewicz (a.k.a. Witkacy) (1885-1939). Though often associated with the Cobra movement, Jan Cox was, on the contrary, a very classical artist. Living to the ideals of the ‘Homo Universalis’ he suffered from various personal/intellectual adversities leading to increasing alcoholism and existential crises. Eventually he killed himself leaving behind a plethora of paintings referring to death (and suicide). Witkacy who killed himself by taking an overdose of Veronal and by cutting his throat in a suicide pact with his lover, was a survivor of suicide himself and seems to have suffered from chronic suicidality during his life. He left numerous self-portraits and other art which may relate to his personal experiences related to suicide.

The Suicide Prevention Program (SPP) of the Mental Health Centres (CMHC) started at the end of 1997 with a contract between the Flemish government, the CMHC and their umbrella organisations. The SPP was then developed during successive three-year contracts.  The SPP intended to develop suicide prevention on a long term basis in the CMHC, and in collaboration with all relevant actors in society. The aims were:  1) to optimise the care offered to mental health centres’ clients at risk,  2) to develop networks to enable follow-up of clients, 3) to lend support to and to share know-how with other caregivers, 4) to advance postvention,  5) to advocate suicide prevention in local networks,  6) to participate in regional and (inter-)national suicide prevention activities.  During many years the coordinated SPP was a leading force, and one of the few suicide prevention initiatives in Belgium. At the end of 2006 the Flemish government launched the Suicide Prevention Action (SPA) Plan. This plan integrated the existing initiatives and intended to start various new suicide prevention activities.  As a result, in 2008, when the SPP had to prepare a new three-year policy, the suicide prevention scenery had changed significantly. This led to an evaluation and subsequent reformulation of the aims and the structure of the original SPP. In addition, we assessed the position of SPP to the SPA and its various aspects/actors. All this was done in close communication with the MHC and the Health Department. The paper presents the development of the new policy document and its aims grouped in three clusters:  1) to optimise the care offered to mental health centres’ clients at risk,  2) to provide training and support regarding suicide prevention/postvention to other caregivers and networks,  3) to establish collaboration alliances with other relevant actors.

Introducción: Las derivaciones del acto suicida en los intentos de suicidio y en especial en los suicidios consumados son factores determinantes en la mayoría de los casos de problemáticas severas y trastornos de la vinculación, como también de problemáticas sociales que exceden los argumentos con base en lo traumático y que quedan sin resolver durante años. Antecedentes familiares de suicidio y factor de riesgo se enlazan y es importante establecer los argumentos que lo sustentan. Objetivos: Determinar las razones que llevan a los familiares y allegados a un suicida a virar la propia vida y orientarla en relación al acto. Transmitir la experiencia de tratamiento desde la clínica de la afectación - como llamamos a esta clínica particular. Transmitir asimismo la experiencia del CAFS en las intervenciones comunitarias- orientaciones telefónicas y presenciales- que desde el 2002 realiza y que resultaron adecuadas y operativas para cada situación. Metodo:Se presentará una clínica de casos individuales, grupales (familiares y no familiares) y comunitarios que evidencias trastornos que se prolongan en el tiempo bajo los lineamientos de la transmisión generacional e histórica. Resultados: Se establecieron en el 80% de los casos coordenadas que evidencian una impronta cultural y una construcción intrafamiliar histórica que remite a un sujeto y a un grupo social conciente y/o inconcientemente hacia una atadura psíquica invalidante, opresiva y mortìfera que lo empuja a lo autodestructivo o a acciones heroicas extremas en salvaguarda de otros. Conclusiones: El tratamiento en los tres niveles de atención de la salud desde la visión de una psicología profunda es fundamental y permite a un sujeto (y a la sociedad donde se incluye) ir restableciendo una posición subjetiva que cambió a partir del acto suicida y que desnivela cualquier construcción vital posible.

Introducción:La afectación que un suicidio cercano ocaciona a un sujeto y a una comunidad es muchas veces vista como efecto de una situación traumática perdiendo la posibilidad de una comprensión profunda de los efectos de un acto que conmueve las raices de lo humano. Objetivos: Prevenir es trabajar clínica y socialmente a inmediato, mediato y largo plazo. En el caso del entorno social en los actos suicidas, la prevención requiere de preparación profesional en el abordaje de situaciones de crisis y experiencia en clínica profunda con una visión de trabajo en equipo interdisciplinario y de continuidad en el tiempo. Metodo:Se analizarán situaciones comunitarias y casos clínicos donde la intervenicón temprana en suicidios consumados permite reducir el impacto del acto, comprender las diferencias individuales y grupales y permitir una construcción histórica mejor que aquella a la que el acto impulsa. Los factores de protección de un sujeto, de un grupo familiar y de una comunidad social, escolar o laboral son componentes que se potencian cuando se reconocen en los otros del entorno cercano. Se analizará asimismo casos de orientación telefónica a familiares. Resultados: Se presentará entre otras la experiencia del equipo de atención del CAFS que desde el 2002 realiza orientación a afectados, individual y/o grupalmente, asistencia clínica e intervenciones comunitarias en ámbitos escolares y laborales. Conclusiones: Teniendo en consideración que ser familiar de suicida es uno de los principales factores de riesgo suicida la comunidad internacional debe propender a facilitar acciones diversas que operen como construcción positiva frente a uno de los flagelos más difíciles de revertir de la contemporaneidad.

Introduction – In previous studies, our research unit found an increasing non-fatal suicidal behaviour during the last decade in our country, mainly among young women.  Also because of this situation, we promoted, together with other colleagues, the creation of the Portuguese Society of Suicidology in 2000. Objectives – Our aim is to characterize a social and clinical profile in order to develop a better understanding and approach to medication and psychotherapeutic settings, especially CBT.  The study focuses on childhood traumas, family, development vulnerabilities, personal and family antecedents, risk factors, psychopathologic and cognitive schemas.  Methods – The study is based on a semi-structured questionnaire (EACOS) designed by our research unit, including socio-demographic and clinical components. Based on a 17-year clinical experience involving 446 young suicide attempters (15-24 years), we used standard statistical measures for an acute knowledge.  Results– With regard to socio-demographic variables, we summarize the following data: female prevalence (77%), low social classes (80%), abnormal pregnancy / childbirth (26%), father absence (13%), education without parents at an institution (10%) , physical abuse (31%), sexual abuse / rape (14%), academic failure (75%), absence of engagement in group activities (26%), without confidence (27%),  without religion (20%), poor family relationship (61%), smoking habits (46%), alcohol abuse (15%), drug abuse (8%). Concerning personality, borderline disorders are more prevalent, followed by histrionic and dependent.  We found previous psychiatric admissions (12%) and family mental disorders (63%), including suicidal behaviours (37%). The most common method was medication (72%), mainly psychotropics, followed by pesticides (14%). The main reason was an affective quarrel with a key person (79%), at home (81%), leaving a letter (25%), and asking for help after act (44%). Conclusions- These important features inspire us to propose new interventions aimed to primary prevention and a more proficient follow-up in secondary prevention.

460 TS. 8.8 % mujeres. Edad media 40.9 años. Recogida protocolizada de datos descriptivos, sociodemográficos y clínicos,. Análisis de todas las tentativas de suicidio (TS) en Hospital Parc Taulí en 2008. Recogida protocolizada de todas las TS llegadas a Urgencias. 50% había realizado alguna tentativa autolítica previamente. 85,1% TS impulsivas. Conclusiones: El perfil típico asistido es el de mujer joven que realiza tentativas de alta impulsividad y baja letalidad con tendencia a la repetición.

Introducción: El Centro de Información Toxicológica de Rio Grande del Sur (CIT/RS) es un departamento técnico de la Fundación Estadual de Producción y Pesquisa en Salud que tiene como principal objetivo el atendimiento de casos de intoxicación.Objetivos: Realizar un estudio retrospectivo analítico de los casos de intoxicaciones humanas relacionadas a los intentos de suicidio envolviendo pacientes del sexo femenino.Metodo: En este estudio transversal fueron analizados los registros de intoxicación humana con pacientes del sexo femenino donde la circunstancia de la intoxicación fuese definida como intento suicida. Resultados:   En el período analizado  la guardia de emergencia del CIT/RS atendió 78.097 solicitaciones envolviendo exposiciones humanas a agentes tóxicos. De ese total, 15.132 (19,4%) de los atendimientos fueron intentos suicidas – 71,8% enel sexo femenino. Las principales clases envueltas en esas intoxicaciones son los benzodiazepínicos (24,16%) y los antidepresivos (21,46%).  En la distribución por edad se verifica que más del 52,15% de los casos ocurren entre los 20 y los 39 años, en acuerdo con la literatura psiquiátrica sobre el tema. La mayor frecuencia de atendimientos ocurrió entre las 18h00min y las 23h59min con 41,09% de los registros analizados. El período comprendido entre sábado y lunes presentó la mayor frecuencia de intentos de suicidio en mujeres (47,47. En el grupo de pacientes del sexo femenino con intento de suicidio, el promedio de óbitos es de 0,35% o de 3,50 óbitos registrados para cada 1.000 atendimientos. Conclusiones: Las intoxicaciones relacionadas a intentos de suicidio envolviendo mujeres representan más del 13,9% de todos los atendimientos. La mortalidad específica de los intentos de suicidio en mujeres es superiores a la tasa de mortalidad general por intoxicaciones. Los datos destacan agravadores como el fácil acceso a múltiples substancias de uso terapéutico de alto potencial tóxico. La mortalidad bastante superior a la población en general derrumba la idea ya sedimentada de la benignidad evolutiva de intentos de suicidio envolviendo ingestión de substancias, y apunta para nuevas actitudes preventivas en la prescripción, dispensación y uso de estos agentes. Conclusiones:

This study was carried out to look at the changes in the trend of suicidal behavior in a hill resort in Cameron Highlands Malaysia. Data on suicides and parasuicides from the year of 1973-2005 were collected from the only hospital in Cameron Highlands and also from police headquarters for the district in Brinchang. The results showed that the suicide rate in Cameron Highlands has declined greatly to about 15 per 100,000 compared to 60 per 100,000 in the preceding two decades. Some of the possible reasons for the drop in the suicide rate and attempted suicide rate will be discussed. 

Background: The risk of suicide is higher among physicians than among the general population. The aim of this study was to investigate whether or not suicide methods differed between physicians and other human service professions 1960-2000. Methods: Census data from 1960, 1970, 1980 and 1990 relating to occupational status were linked to suicide as a cause of death data from Statistics Norway. Physicians were compared to other human service professions (dentists, nurses, theologians and police). Chi square tests were used for comparisons between groups. Results: In all, 127 suicides (12 women) among Norwegian physicians were identified during the study period and 286 suicides (180 women) among other human service professions. Self-poisoning was the most commonly used method both among physicians (53%) and among others (37%), but the proportion was significantly larger among physicians (p=0.003). Among female phycisians, self-poisoning as suicide method was used by 83%, compared to 44% among other human service professions (p=0.009). Among males, self-poisoning was used by 50% and 25%, respectively (p <0.001). Hanging was less common among physicians than among other human service professions, 12% vs. 25% (p=0.003). Drowning was also less common among physicians, 6% vs. 12% (p=0.046). There were no other statistically significant differences in suicide methods between phycisians and the others. Self-poisoning was the most commonly used method in each ten year period for both groups, but statistically significant more common among physicians than other human service professions only during the last two decades of the study. Conclusions: Phycisians used self-poisoning as suicide method more often than other human service professions, both among males and females. The difference in choice of suicide method tended to increase during the period studied.  

STOP SUICIDE, created in Geneva (Switzerland) in 2000, has been campaigning for the World Suicide Prevention Day since 2004. Every year, a sensitizing campaign is organised with a poster campaigns and activities during the month of september to increase public awareness of suicide and especially of youth suicide. Youth suicide, between the ages of 15 and 25, is the fist mortality cause in Switzerland with the car accidents. STOP SUICIDE plans it campaigns carefully, so as to touch a large part of the population without endangering the more fragile. In 2008, the campaign was based on communication promotion. We promoted trough two kinds of posters: i) The first one advertising the speech; and ii) the second one promoting the act of listening. We had two catch phrases that could be translated roughly so: “To talk is a beginning of solution” and “Listening attentively is a beginning of answer”. This poster campaign was followed by a proximity campaign, where STOP SUICIDE went to the schools and the youth centres to hand out suicide prevention aids. Those visual aids, built up on the same theme as the posters, contained helpline numbers and websites as well as some infromation on how to deal with feelings or with a youth expressing suicidal thoughts. We call them “ready to prevent” and spread them as widely as possible. The 2009 slogan is “Let’s stop him together!”. The aim is to cast the suicide as a serial killer and emphasise on the number of victims per year. People should be united around a single message. Thus, it’s framed by simple and plain colours, and on the back we can see shapes of people outlined in black like shadows. Those are impersonal so as to emphasise the fact that the suicide can touch everybody and they can both represent the victims or the bystanders whom we’d like to involve.

A mass media report about suicide in certain ways, publishing pictures, or testimonies, might have a dangerous effect on sensible people. In Switzerland, a Media Council exists (http://www.presserat.ch). It regroups journalist, editors, and media experts. The Council edited rules that all journalists and editors have to respect in their reporting. The Council also admits complaints against media.
Since 2004, STOP SUICIDE has filed four complaints. The Council ruled in favour of STOP SUICIDE and recommended to journalists and editors to pay attention to the effect of their reports (see: http://www.stopsuicide.ch/medias/?page_id=4).
The Council at each ruling published precise recommendations:
STOP SUICIDE vs. “L’Illustré” (30/2006): necessity to pay special attention to the close family of a person who committed suicide and to show particular respect by not publishing pictures of the person who committed suicide;
STOP SUICIDE vs. “Matin” & “Le Matin Bleu” (20/2007): necessity to be particularly retained when reporting on the suicide or the suicide attempt of a well known cinema actor and to be very careful not to publish false or not verified news about a suicide attempt;
STOP SUICIDE vs. “Matin” (8/2008): necessity, even when covering the assistance to suicide, to be carrefull on the effect such articles can produce and not to mention the lethal methods;
STOP SUICIDE vs. “Matin” (not ruled in May 2009): STOP SUICIDE has addressed a complaint against the mass media newspaper “Matin”, which published three pages about the suicide in the Wales (Great Britain) with pictures on the first page of the youth who committed suicide.
In the view of above-mentioned experience, STOP SUICIDE can talk about the Swiss example of mass media suicide coverage.

Several risk and protective factors for suicidal ideation and suicide attempts among adolescents have been identified yet few studies have explored suicidal behavior among Puerto Ricans.  Our objective was to determine the association between ideation and attempts with socio-demographic, individual, family, peer/social, school, and community characteristics.  This study is a secondary analysis of the "Consulta Juvenil VI" survey, an island-wide cross-sectional survey.  The sample (n=55,227) was selected using a multi-stage stratified cluster sampling design, and is representative of all 7^th-12^th grade public school students in Puerto Rico.  Weighted prevalence estimates for suicidal behavior were calculated.  Multiple logistic regression analyses were performed to assess the strength of the association between each behavior and the characteristics under study.  Individual and family characteristics were more important predictors for ideation and attempts among adolescents than peer/social, school, and community characteristics.  The presence of depressive symptoms and sensation seeking behaviors were the strongest individual predictors.  Family conflict was the most important family characteristic. A significant interaction term between the presence of depression symptoms and family conflict was identified among females.  The level of community disorganization was also an important predictor.  Few school factors and no peer/social characteristic remained in the final model after adjustment.  This is the first study in PR to examine suicidal behavior in a representative sample of students.  These results have profound implications for suicide prevention programs, pointing to the need for increased focus in addressing depression in adolescents, particularly when expressed as part of family conflict.   

Prevalence reports show suicide is among the leading causes of death in young people. This is not an isolated phenomenon as there has been a 60% worldwide increase in suicide rates over the last 45 years, with approximately 1 million people dying every year.  This paper examines the phenomenon of suicidal behaviours with and without suicidal intent, across identified sub-groups of the population within West Central Scotland.  Rates of behaviours were examined together with suicide risk and cognitive behavioural style.  The article draws upon research conducted among students in secondary and tertiary education, aged 11 years and above, across 6 local authority regions in West Central Scotland.  This paper discusses the factors that may be involved in predisposing an individual to self-destructive cognitions and suicidal behaviours.  The findings are discussed in relation to existing research and the implications for future research in addressing suicide and suicidal behaviour in Scotland.