An Epidemic of Suicide Attempts by Burning in a Psychiatric Hospital

Zemishlany, Zvi; Weinberger, Andrea H.; Ben-Bassat, M; Mell, Howard K.

doi:10.1192/bjp.150.5.704

Cited by 27 publications

(19 citation statements)

References 9 publications

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“…19 A high level of suicide by burning has been reported among Indian and West Indian immigrant groups in England, Wales. The same tendency has been observed amongst Latin American women in United States and among African-and Asian-born women in the Israeli Jewish population, 27,35 possibly reflecting ethnocultural determinates. 1 It is remarkable that aside from India, Iran has the highest frequency rate of self-immolation as a chosen method for suicides or suicide attempts.…”

Section: Discussionsupporting

confidence: 67%

“…It may be transmitted, slowly and unconsciously, interpersonally or from one generation to the next in an absurd cycle through a pattern of imitation. 1,27,35 Unconsciously, vulnerable subjects learn that during times of psychological stress (eg, ambivalence of cognitive and constriction of perceptual states), a person can use selfimmolation as an escape or solution. Kerosene and matches are also available.…”

Section: Imitative Of Self-immolationmentioning

confidence: 99%

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Suicide by Self-Immolation: Comprehensive Overview, Experiences and Suggestions

Ahmadi

2007

Journal of Burn Care & Research

118

131

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Suicide by burning is a rare condition in the developed countries (0.06-1% of all suicides) but is more frequent in the developing countries (accounting for as many as 40.3% of all suicides). In different parts of Iran, between 1.39% and 9.50% of patients that attempted suicide and 25.0% and 40.3% of patients who committed suicide were via deliberate self-burning. Self-burning (immolation) comprises between 0.37% and 40% of total burn center admissions around the world and, in Iran, it comprises between 4.1% and 36.6% of admissions in Iranian burn centers. Approximately 80% of hospitalized self-immolation patients die. The goal of this study was to identify the epidemiologic features, causes, and potential protective factors regarding suicide by burning in Kermanshah province, in the west of Iran, and to develop the effective intervention programs based on the Public Health Approach to Prevention. During the course of a year, from March 21, 2004, to March 20, 2005 (based on the Iranian calendar), the author examined all the suicidal patients who were admitted to the emergency department of hospitals in Kermanshah University of Medical Science. Examination included a retrospective cross-section study, via demographic questionnaires and suicidal checklists. During the period of study, 1820 patients who attempted suicide and 90 patients who successfully committed suicide were admitted. A total of 41% (37 cases) of patients who committed suicide were via self-immolation. Of these, 81% of self-immolation patients were female (P < .0005), and the female:male ratio was 4.3:1. A total of 86.5% of the patients were in the 11 to 30 years of age group. The mean age was 24.9 years (range, 14-50 years). Forty-nine percent of cases were single, 84% were illiterate or had a low level of education, 78.5% were housewives, and 14% were unemployed. Also, most of the patients (53%) were living in rural area, 97% did not have a previous history of suicide attempt, and 67.5% regretted their self-immolation act. The majority of the self-immolations (64.8%) occurred during daylight hours, and the most common self-immolation motivation factor was marital conflict (32.5%). Overall, this study demonstrates that self-immolation should be considered as a mental health problem in our society, and it is necessary to implement programs and strategies to prevent it. The public health approach provides a framework for a National Prevention Strategy to address this serious national problem. Local data on victims and victim stories from self-immolation provided the stimulus for community action.

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Section: Discussionsupporting

confidence: 67%

Section: Imitative Of Self-immolationmentioning

confidence: 99%

Suicide by Self-Immolation: Comprehensive Overview, Experiences and Suggestions

Ahmadi

2007

Journal of Burn Care & Research

118

131

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“…Without either a priori standardization or empirical demonstration of metrics for time, space, or social connection, the process for defining connection or contact becomes potentially unreliable. As well, we found no consensus or common approach to establishing the degree of similarity among suicidal behaviors to quality as a “cluster.” While a few studies grouped suicide deaths by using the same method [17], [23], many lumped suicides using various methods, or combined suicide deaths and suicide attempts.…”

Section: Resultsmentioning

confidence: 99%

Suicide Contagion: A Systematic Review of Definitions and Research Utility

Cheng

Silenzio

et al. 2014

PLoS ONE

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ObjectivesDespite the common use of contagion to analogize the spread of suicide, there is a lack of rigorous assessment of the underlying concept or theory supporting the use of this term. The present study aims to examine the varied definitions and potential utility of the term contagion in suicide-related research.Methods100 initial records and 240 reference records in English were identified as relevant with our research objectives, through systematic literature screening. We then conducted narrative syntheses of various definitions and assessed their potential value for generating new research.Results20.3% of the 340 records used contagion as equivalent to clustering (contagion-as-cluster); 68.5% used it to refer to various, often related mechanisms underlying the clustering phenomenon (contagion-as-mechanism); and 11.2% without clear definition. Under the category of contagion-as-mechanism, four mechanisms have been proposed to explain how suicide clusters occurred: transmission (contagion-as-transmission), imitation (contagion-as-imitation), contextual influence (contagion-as-context), and affiliation (contagion-as-affiliation). Contagion-as-cluster both confounds and constrains inquiry into suicide clustering by blending proposed mechanism with the phenomenon to be studied. Contagion-as-transmission is, in essence, a double or internally redundant metaphor. Contagion-as-affiliation and contagion-as-context involve mechanisms that are common mechanisms that often occur independently of apparent contagion, or may serve as a facilitating background. When used indiscriminately, these terms may create research blind spots. Contagion-as-imitation combines perspectives from psychology, sociology, and public health research and provides the greatest heuristic utility for examining whether and how suicide and suicidal behaviors may spread among persons at both individual and population levels.ConclusionClarifying the concept of “suicide contagion” is an essential step for more thoroughly investigating its mechanisms. Developing a clearer understanding of the apparent spread of suicide-promoting influences can, in turn, offer insights necessary to build the scientific foundation for prevention and intervention strategies that can be applied at both individual and community levels.

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“…We believe that this powerful process of identification explains why four of the inpatients described above chose the same method of suicide: jumping off the balcony. The risk of psychotic identification seems to increase when the method of suicide has been exceptional (Zemishlany et al, 1987). Psychotic identification is probably the most dangerous of the four factors contributing to suicide contagion.…”

Section: Discussionmentioning

confidence: 99%

“…The method of suicide, especially an exceptional one, is also prone to imitation (Zemishlany et al, 1987). In the case of Patient 4 the power of imitation was so great that she climbed to the closed balcony by the fire escape.…”

Section: Discussionmentioning

confidence: 99%

A Suicide Epidemic in a Psychiatric Hospital

Taiminen,

Salmenperä,

Lehtinen

1992

Suicide & Life Threat Behav

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The authors report in detail on an epidemic of six inpatient suicides in a psychiatric hospital in Finland. Suggestion and identification had an effect on the timing as well as on the method of four of the suicides. The epidemic is viewed from individual, network, and organizational perspectives. The authors speculate on how such epidemics could be avoided. An increase in inpatient suicide rates has been reported from many countries, and the Werther effect may thus become a topic of considerable importance in psychiatric hospitals in the future.

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An Epidemic of Suicide Attempts by Burning in a Psychiatric Hospital

Cited by 27 publications

References 9 publications

Suicide by Self-Immolation: Comprehensive Overview, Experiences and Suggestions

Suicide by Self-Immolation: Comprehensive Overview, Experiences and Suggestions

Suicide Contagion: A Systematic Review of Definitions and Research Utility

A Suicide Epidemic in a Psychiatric Hospital

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