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.