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Associations between quality of relationships and life satisfaction of older mothers in Estonia, Germany, Russia and China
- JING WU, KAIRI KASEARU, AIRI VÄRNIK, LIINA-MAI TOODING, GISELA TROMMSDORFF
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- Journal:
- Ageing & Society / Volume 36 / Issue 6 / July 2016
- Published online by Cambridge University Press:
- 11 May 2015, pp. 1272-1294
- Print publication:
- July 2016
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The aim of the current study is to examine the associations between the quality of relationships and life satisfaction of older mothers in Estonia, Germany, Russia and the People's Republic of China, based on the assumptions of the Family Change Theory. The role of satisfaction with family life as the probable mediating factor is considered. Estonian older mothers reported the least admiration and intimacy in their relationships with their adult daughters, and the least satisfaction with family life compared to German, Russian and Chinese mothers. German older mothers perceived the most admiration from their adult daughters and were the most satisfied with both their family and general life. Russian older mothers were the least satisfied with their general life compared to their counterparts in Estonia, Germany and China. The results from the Structural Equation Modelling showed that the relationship between satisfaction with family life and general life satisfaction was statistically significant in all countries except Russia. The satisfaction with family life as a mediating factor might strengthen the positive and negative aspects of intergenerational relationships on the life satisfaction of older mothers. The findings indicated that the emotional closeness and intergenerational relationships in families during the process of transition and globalisation play an important role in the life satisfaction of older mothers in these four countries.
Social inclusion affects elderly suicide mortality
- Andriy Yur`yev, Lauri Leppik, Liina-Mai Tooding, Merike Sisask, Peeter Värnik, Jing Wu, Airi Värnik
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- Journal:
- International Psychogeriatrics / Volume 22 / Issue 8 / December 2010
- Published online by Cambridge University Press:
- 14 September 2010, pp. 1337-1343
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Background: National attitudes towards the elderly and their association with elderly suicide mortality in 26 European countries were assessed, and Eastern and Western European countries compared.
Methods: For each country, mean age-adjusted, gender-specific elderly suicide rates in the last five years for which data had been available were obtained from the WHO European Mortality Database. Questions about citizens’ attitudes towards the elderly were taken from the European Social Survey. Correlations between attitudes and suicide rates were analyzed using Pearson's test. Differences between mean scores for Western and Eastern European attitudes were calculated, and data on labor-market exit ages were obtained from the EUROSTAT database.
Results: Perception of the elderly as having higher status, recognition of their economic contribution and higher moral standards, and friendly feelings towards and admiration of them are inversely correlated with suicide mortality. Suicide rates are lower in countries where the elderly live with their families more often. Elderly suicide mortality and labor-market exit age are inversely correlated. In Eastern European countries, elderly people's status and economic contribution are seen as less important. Western Europeans regard the elderly with more admiration, consider them more friendly and more often have elderly relatives in the family. The data also show gender differences.
Conclusions: Society's attitudes influence elderly suicide mortality; attitudes towards the elderly are more favorable among Western European citizens; and extended labor-market inclusion of the elderly is a suicide-protective factor.
9 - Suicide and self-harm
- from Part II - Clinical issues
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- By Sandra Dietrich, research fellow at the Department of Psychiatry, Leipzig University, Germany, Lisa Wittenburg, project manager for the European Alliance Against Depression at the Department of Psychiatry, University of Leipzig, Germany, Ella Arensman, Director of Research at the National Suicide Research Foundation, and Honorary Senior Lecturer, Airi Värnik, Professor of Mental Health at Tallinn University, Estonia, Ulrich Hegerl, Head and Medical Director of the Clinic of Psychiatry at Leipzig University, Germany
- Edited by Linda Gask, Helen Lester, Tony Kendrick, Robert Peveler
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- Book:
- Primary Care Mental Health
- Published online:
- 02 January 2018
- Print publication:
- 01 October 2009, pp 125-144
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Summary
Terminology and definitions
There has been much discussion about the most suitable terminology for suicidal acts and researchers have tried to find a common terminology and classification as well as operational definitions for the range of suicidal behaviours (O'Carroll et al, 1996; Maris, 2002; De Leo et al, 2004). In this chapter, we use the outcome-based term ‘fatal suicidal acts’ for suicidal behaviour that results in death and ‘non-fatal suicidal acts’ for suicidal actions that do not result in death.
There is no consensus on the definition of fatal suicidal acts, making it difficult, for instance, to collect accurate, comparable total rates of suicide. Numerous definitions are used, the most widely accepted being the definition produced by the World Health Organization (WHO, 2007a): ‘the act of deliberately killing oneself’. Apart from fatal suicidal acts, it is also of great importance to consider non-fatal suicidal acts, because they are one of the strongest predictors of suicide and have significant economic, medical and social costs. Non-fatal suicidal acts are also often called ‘attempted suicide’ (especially in the USA), ‘parasuicide’ and ‘deliberate self-harm’ (especially in Europe), but also ‘non-fatal suicidal behaviour’, ‘non-fatal self-inflicted harm’, ‘self-injury’ and ‘self-directed violence’. The usage of these terms varies considerably between countries.
Epidemiology
Approximately one million people died from fatal suicidal acts in the year 2000, reflecting a ‘global’ mortality rate of 16 per 100 000, or one death every 30 seconds. Suicide is now among the three leading causes of death among those aged 15–45 years (both sexes) and in a growing number of countries the first cause of mortality among men aged 15–34. These figures do not include non-fatal suicidal acts, which are up to 20 times more frequent than fatal suicidal acts (WHO, 2007b). According to WHO estimates, approximately 1.53 million people will die from fatal suicidal acts in 2020, and 10–20 times more people will attempt suicide worldwide. This represents on average one death every 20 seconds and one attempt every 1–2 seconds (WHO, 1999).
The role of alcohol in suicide: a case-control psychological autopsy study
- KAIRI KÕLVES, AIRI VÄRNIK, LIINA-MAI TOODING, DANUTA WASSERMAN
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- Journal:
- Psychological Medicine / Volume 36 / Issue 7 / July 2006
- Published online by Cambridge University Press:
- 02 May 2006, pp. 923-930
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Background. The purpose of the study was to estimate the proportion of alcohol abuse and dependence (AAD) among suicides and controls, and to compare the incidence of AAD documented by clinicians with diagnoses derived from a research protocol.
Method. AAD according to DSM-IV was diagnosed on the basis of interviews with relatives of people who committed suicide and with controls. A total of 427 people who committed suicide during one year were paired by region, gender, age and nationality with controls randomly selected from general practitioners' lists.
Results. Alcohol abuse was found in 10% and alcohol dependence in 51% of suicide cases. The corresponding figures for controls were 7% and 14% respectively. AAD was a statistically significant predictor of completed suicides, while abstinence was a significant predictor for female suicides and former use a significant predictor for older male suicides. AAD was diagnosed in 68% of male and 29% of female suicides. Middle-aged (35–59 years) males who committed suicide had the highest risk of alcohol dependence. Among suicide cases only 29% had received a lifetime diagnosis of AAD, against 23% of controls.
Conclusions. AAD was significantly more prevalent among suicides than controls. Overall, the proportion of male suicides affected by alcohol was the same in the present psychological autopsy study as in our previous findings for Estonia on the aggregate level, while the share of female suicides with an AAD diagnosis was dramatically higher on the individual level. AAD is markedly underdiagnosed by general practitioners and clinicians.
Suicide attempts, plans, and ideation in culturally diverse sites: the WHO SUPRE-MISS community survey
- JOSÉ M. BERTOLOTE, ALEXANDRA FLEISCHMANN, DIEGO De LEO, JAFAR BOLHARI, NEURY BOTEGA, DAMANI DE SILVA, HUONG TRAN THI THANH, MICHAEL PHILLIPS, LOURENS SCHLEBUSCH, AIRI VÄRNIK, LAKSHMI VIJAYAKUMAR, DANUTA WASSERMAN
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- Journal:
- Psychological Medicine / Volume 35 / Issue 10 / October 2005
- Published online by Cambridge University Press:
- 22 July 2005, pp. 1457-1465
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Background. The objectives were to assess thoughts about suicide, plans to commit suicide and suicide attempts in the community, to investigate the use of health services following a suicide attempt, and to describe basic socio-cultural indices of the community.
Method. The community survey was one component of the larger WHO multisite intervention study on suicidal behaviours (SUPRE-MISS). In each site, it aimed at randomly selecting and interviewing at least 500 subjects of the general population living in the catchment area of the emergency department where the intervention component of the study was conducted. Communities of eight SUPRE-MISS sites (in Brazil, China, Estonia, India, Iran, South Africa, Sri Lanka, and Viet Nam) participated plus two additional sites from Australia and Sweden conducting similar surveys.
Results. Suicide attempts (0·4–4·2%), plans (1·1–15·6%), and ideation (2·6–25·4%) varied by a factor of 10–14 across sites, but remained mostly within the ranges of previously published data. Depending on the site, the ratios between attempts, plans, and thoughts of suicide differed substantially. Medical attention following a suicide attempt varied between 22% and 88% of the attempts.
Conclusions. The idea of the suicidal process as a continuous and smooth evolution from thoughts to plans and attempts of suicide needs to be further investigated as it seems to be dependent on the cultural setting. There are indications, that the burden of undetected attempted suicide is high in different cultures; an improved response from the health sector on how to identify and support these individuals is needed.