Operational Criteria for the Determination of Suicide

Rosenberg, Mark L.; Davidson, Lucy; Smith, Jack C.; Berman, Alan L.; Buzbee, Herb; Gantner, George E.; Moore-Lewis, Barbara; Mills, Don Harper; Murray, D. H.; O’Carroll, Patrick W.; Jobes, David A.

doi:10.1520/jfs12589j

Cited by 203 publications

(126 citation statements)

References 15 publications

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“…The World Health Organization Regional Office for Europe (WHO/EURO) defined suicide as "an act with fatal outcome which the deceased, knowing or expecting a fatal outcome had initiated and carried out with the purpose of provoking the changes he desired" (8;9). The US Centers for Disease Control (CDC) presented a new nomenclature where suicide was defined as "death arising from an act inflicted upon oneself with the intent to kill oneself" and developed the Operational Criteria for the Determination of Suicide (OCDS) (10). The Diekstra criteria for classification of suicidal behavior (11) differentiate between suicide, attempted suicide and parasuicide, depending on whether the result of the conduct is mortal or not, and on severity of such conduct.…”

Section: Figure 1: Traffic Accidents Vs Suicides: Catalonia 1999-2013mentioning

confidence: 99%

Effectiveness of a telephone management programme for patients discharged from an emergency department after a suicide attempt: Controlled study in a Spanish population

Cebrià

Parra

Pàmias

et al. 2013

Journal of Affective Disorders

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En aquest temps (llarg de la tesis), ha estat un plaer tenir al meu costat persones que m'han recolzat, orientat i animat, a tots ells moltes gràcies. Voldria agrair als meus director i tutor, Diego i Víctor la confiança que van dipositar en mi. Gràcies als dos per guiar-me al llarg d'aquesta tesis, i sobretot per estar sempre disponibles per atendre els meus dubtes.Gràcies Diego, pel teu exemple en perseverança, capacitat de treball i dedicació, per ensenyarme a trobar fortalesa i concreció per tirar endavant aquesta tesis. Per tots aquests anys d'aprenentatge.Gràcies Víctor per donar-me la oportunitat de començar. Per aconsellar-me sempre tan sincera i certerament. Per fer-me veure fàcil lo difícil. Pel teu recolzament i la teva ajuda en els moments que més ho he necessitat.Gràcies Joan Carles Oliva pel teu didàctic assessorament sobre l'estadística. Un valuós aprenentatge.Gràcies Anna Escayola, per la teva gestió i constància en tirar endavant el projecte. Al Marc Martí, Esther Patro i MªAngels per prioritzar la vostra atenció, tant professional, als pacients i intentar ajudar-los cada dia una mica més.Gràcies Quim Punti i Isabel Parra pel vostre companyerisme en aquest llarg camí que hem recorregut junts. Equip de suicidòlegs del Taulí!!! Gràcies Iris, per les converses compartides, per la teva saviesa e il·lusió, ha estat un plaer compartir-ho amb tu. Molta sort!! Moltes gràcies Jose Antonio Monreal pel teu suport i recolzament en tot moment.Gràcies a les psicòlogues del Taulí pel seu companyerisme durant tot aquest temps. En especial a la Miriam Santamaria, pels teus ànims i consells en aquest llarg camí de la tesis.Gracies al Vicenç Vallès i als companys de Terrassa, per la seva col·laboració en tot allò que em necessitat per fer possible aquest estudi.També vull agrair a tots els pacients que malgrat es trobaven en un moment difícil de la seva vida, van voler participar en aquest estudi. Ells són el objectiu de tot el que hem fet i és només gràcies a ells que ha estat possible.In 2013, Professors Pim Cuijpers and Ad Kerkhof received me in the Vrije Universiteit in Amsterdam. They and their team were really nice to me. Thank you all for making of Amsterdam a second home.Agrair a la Fundació Parc Taulí, i en especial a la Dra Coloma Moreno per la seva ajuda i suport, per la Beca concedida al projecte i per la ajuda econòmica a la mobilitat a la Vrije University.La meva família, la meva gran sort, Papa, Mama i germà, gràcies per estar sempre allà, incondicionals, els meus èxits son els vostres. Gràcies Antònia i Ramón per transmetre la vostra il·lusió en l'estudi i en aquesta tesis enPage 8 of 84 particular.A l'Anna i la Maria per lo immensament afortunada que sóc de tenir-vos.I per últim, al Ramón per acompanyar-me amb entusiasme en aquest projecte. Sempre has estat al meu costat donant-me força, amor i comprensió. Per lo important que ets a la meva vida. Gràcies.A tots els qui heu compartit amb mi aquests anys, moltes gràcies! PREFACESuicidal behaviors are among the leading global causes of injury and de...

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Section: Figure 1: Traffic Accidents Vs Suicides: Catalonia 1999-2013mentioning

confidence: 99%

Effectiveness of a telephone management programme for patients discharged from an emergency department after a suicide attempt: Controlled study in a Spanish population

Cebrià

Parra

Pàmias

et al. 2013

Journal of Affective Disorders

View full text Add to dashboard Cite

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“…Fortunately, smoking misclassification is small in the general population, 74 and the general accuracy of self-report responses among this sample of health professionals was corroborated by various validity checks. 19,75,76 Suicides are generally considered to be underreported, 77 and the reporting process itself is variable. 78 Nevertheless, death certificates often provide the only available data on suicides and are generally used in epidemiologic research.…”

mentioning

confidence: 99%

Cigarettes and suicide: a prospective study of 50,000 men

Miller

Hemenway²,

Rimm³

2000

Am J Public Health

123

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A B S T R A C TObjectives. This study examined the relation between smoking and suicide, controlling for various confounders.Methods. More than 50 000 predominantly White, middle-aged and elderly male health professionals were followed up prospectively with biennial questionnaires from 1986 through 1994. The primary end point was suicide. Characteristics controlled for included age, marital status, body mass index, physical activity, alcohol intake, coffee consumption, and history of cancer.Results. Eighty-two members of the cohort committed suicide during the 8-year follow-up period. In age-adjusted analyses with never smokers as the comparison group, the relative risk of suicide was 1.4 (95% confidence interval [CI] = 0.8, 2.3) among former smokers, 2.6 (95% CI = 0.9, 7.5) for light smokers (<15 cigarettes/day), and 4.5 (95% CI = 2.3, 8.8) among heavier smokers. After adjustment for potential confounders, the relative risks were 1.4 (95% CI = 0.9, 2.4), 2.5 (95% CI = 0.9, 7.3), and 4.3 (95% CI = 2.2, 8.5), respectively.Conclusion. We found a positive, dose-related association between smoking and suicide among White men. Although inference about causality is not justified, our findings indicate that the smoking-suicide connection is not entirely due to the greater tendency among smokers to be unmarried, to be seden- 1 Although the nature of the relation between cigarette smoking and disease has been most convincingly demonstrated for physical illness, several researchers have linked smoking to mental illness, especially depression. 2-14Almost a dozen studies have shown a significant association between smoking and suicide. However, many of these studies were small and did not control for characteristics common to both smokers and persons who commit suicide.13,15-25 For example, only 2 prospective studies with more than 20 suicides controlled for alcohol intake-and these yielded conflicting results. 18,22 In this article, we present data on more than 50 000 men followed up prospectively for 8 years. Our analysis controlled for several potentially important behavioral, situational, and demographic factors that have been identified in the suicide, smoking, and depression literature. In addition, the investigation evaluated the relation between suicide and smoking, while taking into account changes in smoking status during follow-up. The study also examined prospectively the contribution of developing cancer to the association between smoking and suicide.

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“…The determination of suicide is often difficult; ME/Cs must base a determination of suicide on appropriate investigative information and postmortem findings and be able to defend this determination. Published guidelines from the CDC indicate that in a suicide the fatal injury must be consistent with being self-inflicted and that there should be indication of intent of self-harm [28,29]. By these criteria, intentional misuse of opioids in excess amounts for self-treatment or for the sensations that the drugs cause, while dangerous, does not by itself constitute a suicide.…”

Section: Manner Of Deathmentioning

confidence: 99%

Complete Republication: National Association of Medical Examiners Position Paper: Recommendations for the Investigation, Diagnosis, and Certification of Deaths Related to Opioid Drugs

2013

J. Med. Toxicol.

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The American College of Medical Toxicology and the National Association of Medical Examiners convened an expert panel to generate evidence-based recommendations for the practice of death investigation and autopsy, toxicological analysis, interpretation of toxicology findings, and death certification to improve the precision of death certificate data available for public health surveillance. The panel finds the following:1. A complete autopsy is necessary for optimal interpretation of toxicology results, which must also be considered in the context of the circumstances surrounding death, medical history, and scene findings.2. A complete scene investigation extends to reconciliation of prescription information and pill counts.3. Blood, urine, and vitreous humor, when available, should be retained in all cases. Blood from the femoral vein is preferable to blood from other sites.4. A toxicological panel should be comprehensive and include opioid and benzodiazepine analytes, as well as other potent depressant, stimulant, and anti-depressant medications.5. Interpretation of postmortem opioid concentrations requires correlation with medical history, scene investigation, and autopsy findings.6. If death is attributed to any drug or combination of drugs (whether as cause or contributing factor), the certifier should list all the responsible substances by generic name in the autopsy report and on the death certificate.7. The best classification for manner of death in deaths due to the misuse or abuse of opioids without any apparent intent of self-harm is "accident." Reserve "undetermined" as the manner for the rare cases in which evidence exists to support more than one possible determination.

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Operational Criteria for the Determination of Suicide

Cited by 203 publications

References 15 publications

Effectiveness of a telephone management programme for patients discharged from an emergency department after a suicide attempt: Controlled study in a Spanish population

Effectiveness of a telephone management programme for patients discharged from an emergency department after a suicide attempt: Controlled study in a Spanish population

Cigarettes and suicide: a prospective study of 50,000 men

Complete Republication: National Association of Medical Examiners Position Paper: Recommendations for the Investigation, Diagnosis, and Certification of Deaths Related to Opioid Drugs

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