ObjectivesExplore international consensus on nomenclatures of suicidal behaviours and analyse differences in terminology between high-income countries (HICs) and low/middle-income countries (LMICs).DesignAn online survey of members of the International Organisation for Suicide Prevention (IASP) used multiple-choice questions and vignettes to assess the four dimensions of the definition of suicidal behaviour: outcome, intent, knowledge and agency.SettingInternational.ParticipantsRespondents included 126 individuals, 37 from 30 LMICs and 89 from 33 HICs. They included 40 IASP national representatives (65% response rate), IASP regular members (20% response rate) and six respondents from six additional countries identified by other organisations.Outcome measuresDefinitions of English-language terms for suicidal behaviours.ResultsThe recommended definition of ‘suicide’ describes a fatal act initiated and carried out by the actors themselves. The definition of ‘suicide attempt’ was restricted to non-fatal acts with intent to die, whereas definition of ‘self-harm’ more broadly referred to acts with varying motives, including the wish to die. Almost all respondents agreed about the definitions of ‘suicidal ideation’, ‘death wishes’ and ‘suicide plan’. ‘Aborted suicide attempt’ and ‘interrupted suicide attempt’ were not considered components of ‘preparatory suicidal behaviour’. There were several differences between representatives from HICs and LMICs.ConclusionThis international opinion survey provided the basis for developing a transcultural nomenclature of suicidal behaviour. Future developments of this nomenclature should be tested in larger samples of professionals, including LMICs may be a challenge.

According to international and Mexican official statistics, there is a dramatic rise in suicide in Mexico; however, research in this area is severely limited. This is the first study of suicide notes from Mexico in the international literature. From a population of 747 registered suicides, a sample of 106 note-writers and 106 non-note writers was examined. Using the demographic (descriptive) scheme of Ho, Yip, Chiu, and Halliday (1998), the results indicate that note writers do not differ greatly from other suicides. The less educated understandably wrote fewer notes. The most intriguing finding was that suicide in Mexico was associated with an array of factors, notably interpersonal problems.

The presence of deliberate self-harm (DSH) among adolescents in Guanajuato State in 2003 was identified by sex, age, educational attainment and health jurisdiction and the characteristics were described by sex according to number of times, age of only/first/last DSH, motive, method, purpose and death wish. The sample design was stratified, bistage and by conglomerates. A total of 2,530 students from high school affiliated to the University of Guanajuato participated. The results showed that 3.1% of males and 10.7% of females had engaged in at least one episode of DSH; age of first DSH was 13 in both males and females; age at last DSH was 13 in males and 14 in females. The characteristics of the DSH were also described.

In Mexico, suicides are increasing in certain latitudes where local rates have grown to levels of alert; suicide is also the second most common cause of death for the group aged 15 to 19. The psychological autopsy method was utilized to uncover and analyze common factors in all of the registered suicides within 2011 and 2012 in a small town of the state of Guanajuato, located in the center of Mexico. A total of nine decedents were analyzed, and 22 interviews were conducted. The most salient factors were as follows: poverty, financial stress, substance abuse, low levels of education, conflictive relationships, and a poor handling of emotions. The concepts of social exclusion and vulnerability were employed to analyze suicides as symptoms of a much deeper problem of this country, suggesting that anomie and social malady are nowadays important suicidal factors, mostly for children and young people.

Suicide notes from Mexico and the United States: a thematic analysis. Salud Publica Mex 2009;51:314-320. AbstractObjective. This study sought to investigate suicide notes drawn from Mexico and the United States (US) as these countries share geographical proximity, but markedly different cultures and suicide rates. Material and Methods. A theoretical conceptual analysis of 102 suicide notes drawn from these countries, matched for age and sex, was undertaken based on a thematic model of suicide developed by Leenaars, 1,2 across countries. Results. The inter-judge reliability was adequate (.86 coefficient of concordance). Conclusions. The results suggested that there are more psychological commonalities than differences. Yet, as this study marks the first one using suicide notes, between Mexico and the USA, much greater study is warranted. Chávez-Hernández AM, Leenaars AA, Chávez-de Sánchez MI, Leenaars L. Notas suicidas de México y Estados Unidos: un análisis temático. Salud Publica Mex 2009;51:314-320. ResumenObjetivo. Este estudio tuvo por objetivo la comparación de notas suicidas (póstumas) de México y de Estados Unidos, países que aunque vecinos geográficos, presentan marcadas diferencias culturales y porcentajes de suicidio. Material y métodos. Se realizó un análisis conceptual de 102 notas (51 mexicanas, 51 estadunidenses), pareadas por edad y sexo. Se utilizó el Modelo temático de suicidio desarrollado por Leenaars 1,2 y que ha sido la base de varios estudios en diversos países. Resultados. La técnica de Análisis de contenido obtuvo un adecuado nivel de concordancia (86%) con el Método de interjueces. Conclusiones. Los resultados informan que existen más semejanzas que diferencias psicológicas entre ambas muestras. El presente es el primer estudio que utiliza notas suicidas entre ambos países.Palabras clave: suicidio/psicología; análisis temático; estudio comparativo; México, Estados Unidos (1) Universidad de Guanajuato. León Guanajuato, México.(2) Investigadores independientes.

Previous research reports a significant prevalence of child depression worldwide and self-concept as a predictor of depression and suicide behavior. Although suicide in children is an increasing problem in Mexico, there are scarce studies reporting risk factors and none of children in foster care institutions. This was a comparative, ex post facto study whose aim was to analyze associations between suicidal ideation, depression, and self-concept in two paired samples of Mexican children (83 institutionalized and 83 noninstitutionalized). Results show 16% of the children reported suicidal ideation and statistically significant differences among variables in both samples. Suggestions are made to address this problem from early ages.

ResumenEl propósito del estudio fue identificar el uso del tiempo libre y su relación con la tentativa suicida en una muestra mexicana adolescente. Participaron 1290 estudiantes de nivel secundaria, entre 12 a 18 años (36 % varones, 64 % mujeres); el instrumento incluyó reactivos cerrados y formato libre. De las 11 categorías del tiempo libre obtenidas, la de relaciones fuera del ámbito familiar obtuvo el mayor puntaje (96 %) y el menor las actividades escolares (1,8 %). Se encontraron asociaciones estadísticamente significativas de riesgo suicida en las actividades pasivas, del hogar, relaciones familiares y cuidar el propio cuerpo; se encontraron actividades con efecto protector las relaciones sociales fuera del ámbito familiar y recreativas (artísticas, deportivas). Se presentan reflexiones sobre la producción y utilización creativa del tiempo libre en jóvenes y familias contemporáneas. . Realizado de julio 2015 a mayo del 2016.Tentativa suicida y uso del tiempo libre en adolescentes mexicanos 6 AbstractThe aim of the present study was to identify leisure time and its association to suicide attempts in a sample of 1290 Mexican adolescents aged 12-18 (36 % male, 64 % female). The instrument included both, closed and open items. Out of 11 leisure categories, relationships outside their families were the most prevalent at 96 % while school-related activities were the least prevalent (at 1.8 %). Statistically significant differences were found for suicidal behavior and passive activities, home activities, family relationships, and body selfcare. Recreation activities such as sports and arts, and relationships outside their families were found to be protective factors. Concluding considerations about the creative use of leisure for contemporary adolescents and families are included. ResumoO objetivo deste estudo foi identificar a relação entre o uso do tempo livre e a tentativa de suicídio em uma amostra de adolescentes mexicanos. Participaram 1290 estudantes de ensino médio, entre 12 e 18 anos (36 % homens, 64 % mulheres). O instrumento de avaliação incluiu perguntas fechadas e abertas. Das 11 categorias estabelecidas para tempo livre, a que obteve maior pontuação (96 %) foi a de relações fora do âmbito familiar e a de menor pontuação (1.8 %) foi de atividades escolares. Foram encontradas associações estatísticas significativas entre o risco de suicídio e atividades passivas, tais como, atividades de casa, relações familiares e cuidados com o corpo próprio; atividades protetoras foram encontradas em relações sociais fora do âmbito familiar e de recreação (artísticas e esportivas). Apresenta-se reflexões sobre a produção e utilização criativa do tempo livre em jovens e famílias contemporâneas. Palavras-chave: Tentativas suicidas; risco suicida; tempo livre; adolescentes; México.

La ideación suicida es un predictor del suicidio en jóvenes. El objetivo de este estudio fue identificar las estructuras cognoscitivas, afectivas y comportamentales particulares de la ideación suicida y su relación con la dinámica familiar. Con un diseño correlacional, participaron 743 estudiantes de tres bachilleratos de Guadalajara, Jalisco, México. Se utilizó la Escala de Evaluación de Potencialidad Suicida (Valadez-Figueroa & Amezcua), específicamente se midieron las estructuras cognoscitivas, afectivas y comportamentales (a = 0.88) y situaciones problemáticas familiares (α = 0.71). Los participantes escribieron sus experiencias vividas dentro de su familia, particularizando en las cinco dimensiones exploradas de la dinámica familiar y se realizó el análisis de contenido de dichos testimonios, a través de la técnica de Inter jueces. Se encontraron asociaciones estadísticamente significativas en la dimensión inadecuada comunicación familiar con los elementos implicados en la ideación suicida pienso acabar con mi vida (OR = 5.76; IC 2.8-13.7), tengo deseos de quitarme la vida, (OR = 4.23; IC 2.11-8.7) he amenazado con quitarme la vida (OR = 6.43; IC 2.15-21.13), y siento que mi familia estaría mejor si yo estuviera muerto (OR = 6.25; IC 3.2-12.3); y esta última además  con la dimensión agresión y manejo  de conflictos (OR = 4.88; IC 2.9-8.0). Los testimonios permitieron configurar un contexto sobre las circunstancias que pueden dar lugar a la presencia, u ocurrencia, de pensamientos, deseos  y  estados de ánimo. Los resultados aportan elementos para la comprensión del impacto de los factores estudiados en el riesgo y comportamiento suicida.