Eileen Williamson

A preliminary statistical model for identifying repeaters of parasuicide

This paper presents a statistical model constructed using logisticregression to identify those at high-risk of repeating parasuicide. Thesubjects in the study are Cork city residents who exhibited parasuicidalbehaviour between 1 January and 30 June 1995. Repetition of the behaviourwithin six months of the index episode distinguishes repeaters fromnon-repeaters. The model was designed so that it could be used bynon-clinicians and hence does not require information relating topsychiatric diagnosis or use of psychiatric services. The proportion ofsubjects correctly classified remained stable across a range of cut-pointprobabilities (mean = 86%, range: 83.9–87.5%). Using acut-point of 0.2, 96% of repeaters and 81% of non-repeaters were correctly classified. Using 0.45 led to the correct identification of81% of repeaters and 90% of non-repeaters. If these highlevels of sensitivity and specificity are maintained in validation tests onfuture cohorts in Cork city then the model could form the basis of anintervention programme designed to prevent the repetition of parasuicide.

Differences in Irish Urban and Rural Suicide Rates, 1976–1994

The recent rise in the Irish suicide rate is a male phenomenon. The present paper calculates urban and rural suicide rates for Ireland and looks at some possible explanatory variables for the differences observed. Irish suicide and undetermined death rates, age-adjusted to the European Standard Population, are calculated for the years 1976 to 1994 to determine if there are any discernible trends between urban and rural areas. Possible associated factors are then examined, including the distribution of psychiatric illness using the National Psychiatric In-Patient Reporting Scheme. Between 1980 and 1990, the Irish rural male suicide rate rose by 50% while there was no increase in the male urban rate. The most radical increases have occurred in the young and elderly rural males. A. t the start of the study period, the urban female suicide rate was higher than the rural rate but the two rates have been almost identical since 1985. Some factors associated with suicide were examined but failed to provide sufficient explanation for the difference in rates. Further research is needed to clarify the reasons for these differences and to monitor ongoing trends.

Suicide among young people and adults in Ireland: method characteristics, toxicological analysis and substance abuse histories compared.

Objective Information on factors associated with suicide among young individuals in Ireland is limited. The aim of this study was to identify socio-demographic characteristics and circumstances of death associated with age among individuals who died by suicide. Methods The study examined 121 consecutive suicides (2007–2012) occurring in the southern eastern part of Ireland (Cork city and county). Data were obtained from coroners, family informants, and health care professionals. A comparison was made between 15-24-year-old and 25-34-year-old individuals. Socio-demographic characteristics of the deceased, methods of suicide, history of alcohol and drug abuse, and findings from toxicological analysis of blood and urine samples taken at post mortem were included. Pearson’s χ2 tests and binary logistic regression analysis were performed. Results Alcohol and/or drugs were detected through toxicological analysis for the majority of the total sample (79.5%), which did not differentiate between 15-24-year-old and 25-34-year-old individuals (74.1% and 86.2% respectively). Compared to 25-34-year-old individuals, 15-24-year-old individuals were more likely to engage in suicide by hanging (88.5%). Younger individuals were less likely to die by intentional drug overdose and carbon monoxide poisoning compared to older individuals. Younger individuals who died between Saturday and Monday were more likely to have had alcohol before dying. Substance abuse histories were similar in the two age groups. Conclusion Based on this research it is recommended that strategies to reduce substance abuse be applied among 25-34-year-old individuals at risk of suicide. The wide use of hanging in young people should be taken into consideration for future means restriction strategies.