Latha Nrugham’s research while affiliated with University of Oslo and other places

What is the position of the ancient Hindu scriptures on suicide and attempted suicide? Are these human processes condemned? If yes, do the scriptures explain why and how? If they are not condemned, do these scriptures approve or glorify suicidal behaviour? Is there adequate consistency among the various ancient scriptures on recommended attitudes towards suicide and attempted suicide? The Prasthanatrayi, or literally, the three points of departure are the Upanishad texts, the Brahma Sutra text and the Bhagavad Gita text. All other scriptures of India admit the authority of these three texts. Among these three, the Upanishads are accepted as being the highest, being a part of Shruti, or literally, heard scriptures as the Smriti, or literally memory, is the product of the human mind. This chapter reviews the ten principal Upanishads and the Srimad Bhagavad Gita, which has the status of an Upanishad. In addition, the Brahma Sutra and the Yoga Sutra texts will also be reviewed. The commentaries of Adi Shankaracharya on the first twelve texts will be used to understand the positions of these texts on suicidal behaviour correctly. The Yoga Sutra, a text elucidating the practical aspects of Vedanta, was not commented upon by Adi Shankaracharya but has an ancient commentary by Maharishi Vyasa himself, which will be used in this chapter. The chapter examines the relevance of the position of these texts on suicidal behaviour to modern Indian culture and laws, spanning several thousands of years.

Studies from several countries suggest that erecting fences on popular bridges may be an effective way of reducing the risk of suicide by jumping from these bridges. Distribution of suicides by jumping off bridges has not yet been studied on a national level in any country. This study included all suicides by jumping from high places registered in the Norwegian Cause of Death Registry (COD) in the period 1999-2010 (n = 319). Combining data from the COD registry and information from police records, 71 cases of suicide by jumping off a bridge were identified involving 36 bridges. This form of suicide constituted approximately 1% of all suicides in Norway in the period 1999-2010. Almost half of these suicides were registered at only six bridges. Three Norwegian bridges were secured during the observation period of this study. Two bridges had barriers installed on the full length of the bridge with 11 suicides registered before barriers were installed, and none after. On the one bridge that was only partially secured, no change in numbers of suicides was observed after barriers were installed. One-third of jumps from bridges occurred over land. We found that although suicide by jumping off bridges was a relatively rare event, there is a potential for saving lives by installing physical barriers on bridges that are more commonly used for suicide by jumping.

Background & Aim: The current study examined non-attempters, attempters and repeaters of suicide attempts in relation to stressful life events and their levels of depression symptoms in an extracted subset that was followed up from adolescence into early adulthood. Did repeaters consistently report more stressful events and depression than single attempters and non-attempters? If yes, was this increase of events located in the family or at school or in the domain of self and friends? Method: A representative sample of high school students (T1, n = 2464, mean age = 13.7 years, 50.8% female, 88.3% participation) was re-assessed with the same questionnaire after a year (T2Q). High scorers of depression on the Mood and Feelings Questionnaire (MFQ) were matched for gender and age with low-and-middle scorers and assessed diagnostically by face-to-face interviews at T2I (n = 345, 94% participation). The interviewed subset was reassessed again 5 years later (T3) with the same questionnaire (n = 252, mean age = 20.0 years, 73% participation) and by telephone interviews. Stressful events were detected from a list of three domains. Results: Repeaters of suicide attempts reported more stressful events and were consistently more depressed. Differences in domains of stressful life events were also observed. Conclusion: Interventions including healthy coping in relation to stressful events and depression among adolescents may prevent suicide. Key words: longitudinal, K-SADS, adolescents, young adults.

Adulthood psychiatric and psychosocial outcomes of early adolescence suicidal acts were studied. A representative sample of school adolescents (T1, mean age, 13.7 years; n = 2464; 50.8% female; 88.3% participation) was followed up a year later with the same questionnaire (T2). High scorers of depression were matched with low or moderate scorers and interviewed using the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime version (mean age, 14.9 years; n = 345; 94% participation). They were reassessed after 5 years (T3, mean age, 20.0 years; n = 242; 73% participation). Those who attempted suicide before the age of 14 years and repeated suicidal acts between ages 14 and 15 years had worser prognostic profiles than incident cases between ages 14 and 15 years. Male attempters had better psychiatric prognosis than female attempters. Attempters were more likely to have contacted child protection services but not mental health services. Clinicians need to be aware of long-term pervasive outcomes of adolescent suicidality.

Background and aim: The Nordic countries provide a suitable setting for comparing trends in suicide mortality. The aim of this report is to compare suicide trends by age, gender, region and methods in Denmark, Finland, Iceland, Norway and Sweden 1980-2009. Methods: Suicide statistics 1980-2009 were analyzed for men and women aged 15 years and above and the age group 15-24 years. Regional suicide rates in 2009 were presented in maps. Results: The suicide rates across the Nordic countries declined from 25-50 per 100,000 in 1980 to 20-36 in 2009 for men and from 9-26 in 1980 to 8-11 in 2009 for women. The rates in Finland were consistently higher than those of the other countries. A significant increase of suicides in young women in Finland and Norway and a lack of a decline among young women in Sweden were noted. The male- female ratio of suicide converged to approximately 3:1 across the region during the study period. Rural areas in Finland, Norway and Sweden saw the highest suicide rates, whereas the rates in the capital regions of Denmark, Norway and Sweden were lower than the respective national rates. Conclusions: We hold that the overall decline of suicide rates in the Nordic countries reflects the socio-economic development and stability of the region, including the well-functioning healthcare. The increasing rates in Finland and Norway and the unchanged rate in Sweden of suicide in young women are an alarming trend break that calls for continued monitoring.

Relationships between depression and coping among nonattempters, attempters, and repeaters of suicidal acts were examined across adolescence. A representative sample of students (T1: n = 2464; mean age, 13.7 years; 50.8% female; 88.3% participation) was reassessed with the same questionnaire after 1 year (T2). High scorers on the Mood and Feelings Questionnaire were gender- and age-matched randomly with low and middle scorers. This subset was assessed using diagnostic interviews at T2 (n = 345, 94% participation) and 5 years later using the same interview and questionnaire (T3, n = 252; mean age, 20.0 years; 73% participation). The Coping Inventory for Stressful Situations measured coping as three stable traits. Coping changed partly with age, depression, and attempt status. Differences in depression emerged before coping differences and remained stable. Consistently, repeaters reported higher depression and lesser task-oriented coping. Antecedent depression predicted decreased task-oriented coping and increased emotional coping at age 20 years.

This chapter examines existing research literature on sleep difficulties, primarily insomnia and the various dimensions of suicidality among adolescents and young adults as compared to adults. Studies have been grouped into epidemiological studies, clinical studies and reviews. Findings on gender have been given special importance. The literature overview has been complemented by case vignettes from a major corporate hospital in New Delhi (India). The chapter concludes by stating that a relationship appears to exist between insomnia and suicidality, especially with completed suicide, regardless of age. However, far too little is known about the relationship for clinicians to be able to use it as research evidence, as almost all the findings on suicidal behaviour came from cross-sectional studies, whether epidemiological or clinical. Therefore, the conclusion calls for research studies with a prospective design.

Depression may be a sufficient but not a necessary condition for either suicide or attempted suicide. However, it is the depressive aspect of psychopathology which has been consistently found to be related to suicidality. Depression may be present before or during or after suicidality and its role and function may change according to various factors. The relationship between depression and suicidality is extremely important and simultaneously complex. This chapter will examine some of the most important studies on the links of depression to suicidality in adults. It will focus on an often-forgotten vulnerability: gender. It will present clinically useful findings from selected reviews and studies, both cross-sectional and longitudinal. This chapter also examines the treatment options for those who are depressed and or suicidal. Some case-histories are used as illustrative examples.

Objectives Were violent/non-violent traumatic life events and victimization by/witnessing violence associates of attempted suicide among depressed adolescents who were also less resilient at early adulthood? Method The present study examined a subset of mainly depressed, age-and-gender matched, adolescents derived from a representative sample of 2464 students (T1, mean age = 13.7 years) followed-up after one year (T2Q) and reassessed 5 years later (T3, n = 252, mean age = 20.0 years, 73% participation), with a questionnaire, including the Connor-Davidson Resilience Scale and K-SADS-PL psychiatric interviews which also tapped traumatic life events. Results & Conclusion Logistic regression analyses revealed that attempters were victims, not witnesses of violence; more depressed and less resilient than non-attempters, and that resilience was a moderator of lifetime violent events and attempted suicide, even in the presence of antecedent depression.