Über einen möglichen Zusammenhang zwischen der Methode und dem auslösenden Motiv bei Suizid

Zusammenfassung

Anliegen: Das Ziel der vorliegenden Studie war die Untersuchung der Wahl der Suizidmethode im Hinblick auf das Alter und das auslösende Motiv unter Berücksichtigung des Geschlechts. Methode: Es wurde eine deskriptive populationsbasierte Studie über 2062 Suizide in Mittelfranken zwischen 1998 und 2003 durchgeführt. Ergebnisse: Die Assoziation zwischen Methode und ermitteltem Motiv war hochsignifikant (χ² = 268,5, p < 0,0001), sowohl bei Männern (χ² = 166,7, p < 0,0001) als auch bei Frauen (χ² = 132,7, p < 0,0001). Außerdem fanden sich Unterschiede der Suizidmethode in Abhängigkeit von Alter und Geschlecht. Schlussfolgerungen: Die Wahl der Suizidmethode scheint unter anderem auch von den auslösenden Umständen beeinflusst zu sein, was zum Verständnis dieses multifaktoriellen Geschehens beitragen könnte.

Abstract

Objective: The choice of the suicide method is influenced by the individual's sex, age, cultural value system and the method's availability. Therefore, we studied the chosen method in relation to the investigated motive, age and sex. Method: The study included all residents of Middle Franconia, dying from suicide due to death certificate and police investigations. 2062 suicides were included. Data was categorized by method and underlying reason. Results: Women preferred self-poisoning and men predominantly chose hanging with the distribution changing with regard to the underlying motive, especially in suicide due to family distress and lovesickness. The association between method and underlying reason of suicide was highly significant (χ²-test, χ² = 268.5, p < 0.0001), in male (χ² = 166.7, p < 0.0001) and in female subjects (χ² = 132.7, p < 0.0001). Furthermore, there were differences regarding the suicide method concerning the age. Conclusions: Certain motives tended to be associated with some suicide methods, so that the means to commit suicide should be further taken into account in preventive as well as in therapeutic measures.

Literatur

• 1 Appleby L, Cooper J, Amos T, Faragher B. Psychological autopsy of suicides of people under 35.  Br J Psychiatry. 1999;  175 169-174
• 2 Pirkola S, Isometsa E, Lonnqvist J. Do means matter?: Differences in characteristics of Finnish suicide completers using different methods.  J Nerv Ment Dis. 2003;  191 745-750
• 3 Heeringen K HK van, Williams J MG. Pathways to suicide: an integrated approach. In: Hawton K, Heeringen K van (eds) The International Handbook of Suicide and Attempted Suicide. Chichester; John Wiley and Sons 2000
• 4 Diekstra R F, Gulbinat W. The epidemiology of suicidal behaviour: a review of three continents.  World Health Stat Q. 1993;  46 52-68
• 5 Germany FSOo .Cause of death statistics 2001. online publication 2001
• 6 Bille-Brahe U, Jessen G. Suicide in Denmark, 1922 - 1991: the choice of method.  Acta Psychiatr Scand. 1994;  90 91-96
• 7 Lester D, Yang B. Fertility and suicide rates: a time series analysis in the United States.  J Biosoc Sci. 1992;  24 97-101
• 8 Lester D. The toxicity of car exhaust and its use as a method for suicide.  Psychol Rep. 1995;  77 1090
• 9 McClure G MG. Changes in suicide in England and Wales, 1960 - 1997.  Br J Psychiatry. 2000;  176 271-280
• 10 Wiedenmann A WS. The impact of availability, attraction and lethality of suicide methods on suicide rates in Germany.  Acta Psychiatr Scand. 1993;  88 364-368
• 11 Brent D A, Johnson B A, Perper J, Connolly J, Bridge J, Bartle S, Rather C. Personality disorder, personality traits, impulsive violence, and completed suicide in adolescents.  J Am Acad Child Adolesc Psychiatry. 1994;  33 1080-1086
• 12 Fischer E P, Comstock G W, Monk M A, Sencer D J. Characteristics of completed suicides: implications of differences among methods.  Suicide Life Threat Behav. 1993;  23 91-100
• 13 Cantor C H, Baume P J. Access to methods of suicide: what impact?.  Aust N Z J Psychiatry. 1998;  32 8-14
• 14 Farmer R DT, Rohde J. Effect of availability and acceptability of lethal instruments on suicide mortality: An analysis of some international data.  Acta Psychiatr Scand. 1980;  62 436-446
• 15 Sainsbury P. The epidemiology of suicide. In: Roy A (ed) Suicide. Baltimore; Williams and Wilkins 1986: 17-40
• 16 Rhyne C ET, D I, Brown L G, Peters N B. Dimensions of Suicide: Perceptions of Lethality, Time and Agony.  Suicide Life Threat Behav. 1995;  25 373-380
• 17 Denning D G, Conwell Y, King D, Cox C. Method choice, intent, and gender in completed suicide.  Suicide Life Threat Behav. 2000;  30 282-288
• 18 Lester D. Changes in the methods used for suicide in 16 countries from 1960 to 1980.  Acta Psychiatr Scand. 1990;  81 260-261
• 19 Canetto S S, Sakinofsky I. The gender paradox in suicide.  Suicide Life Threat Behav. 1998;  28 1-23
• 20 Marzuk P M, Leon A C, Tardiff K, Morgan E B, Stajic M, Mann J J. The effect of access to lethal methods of injury on suicide rates.  Arch Gen Psychiatry. 1992;  49 451-458
• 21 Cantor C H, Hill M A, McLachlan E K. Suicide and related behaviour from river bridges: A clinical perspective.  Br J Psychiatry. 1989;  155 829-835
• 22 Chipuer H M, Eye A von. Suicide trends in Canada and West Germany: An application of configural frequency analysis.  Suicide Life Threat Behav. 1989;  19 264-276
• 23 Schmidtke A, Häfner H. Imitation effects after fictional television suicides. In: Möller HJ, Schmidtke A, Welz R (eds) Current issues on suicidology. Berlin; Springer Verlag 1988
• 24 Quan H, Arboleda-Florez J. Elderly suicide in Alberta: difference by gender.  Can J Psychiatry. 1999;  44 762-768
• 25 Lester D, Wood P, Williams C, Haines J. Motives for Suicide - A Study of Australian Suicide Notes.  Crisis. 2004;  25 33-34
• 26 Druss B, Pincus H. Suicidal ideation and suicide attempts in general medical illnesses.  Arch Int Med. 2000;  160 1522-1526
• 27 Runeson B, Asberg M. Family history of suicide among suicide victims.  Am J Psychiatry. 2003;  160 1525-1526
• 28 Blakely T ACS, Atkinson J. Unemployment and suicide. Evidence for a causal association?.  J Epidemiol Community Health. 2003;  57 594-600
• 29 Kushner H I. Women and suicidal behaviour: Epidemiology, gender and lethality in historical perspective. In: Canetto SS, Lester D (eds) Women and suicidal behaviour. New York; Springer 1995: 11-34
• 30 Marks A. Sex differences and their effect upon cultural evaluation of methods of self-destruction.  Omega. 1977;  8 65-70
• 31 Beautrais A L. Gender issues in youth suicidal behaviour.  Emerg Med (Fremantle). 2002;  14 35-42
• 32 Heikkinen M, Isometsa E T, Aro H M, Sarna S J, Lönnqvist J K. Age-related variation in recent life events preceding suicide.  J Nerv Ment Dis. 1995;  183 325-324
• 33 Rothberg J M, McDowell C P. Suicide in United States Air Force personnel, 1981 - 1985.  Military Medicine. 1988;  153 645-648
• 34 Kotila L, Lonnqvist J. Adolescent suicide attempts: Sex differences predicting suicide.  Acta Psychiatr Scand. 1988;  77 264-270
• 35 Moeller-Leimkuehler A M. The gender gap in suicide and premature death or: why are men so vulnerable?.  Eur Arch Psychiatry Clin Neurosci. 2003;  253 1-8