«Suicidology» № 1 – 2022
Lyubov E.B. Put in a word about poor Ellen: one hundred years of psychiatric discrepancies. Suicidology. 2022; 13 (1): 3-44. doi.org/10.32878/suiciderus.22-13-01(46)-3-44 (In Russ / Engl)
A modern psychopathological interpretation and critical evaluation of Ellen West's classic psychotherapeutic case is proposed in the light of the historical context of psychiatric concepts and experience.
Keywords: clinical case, psychopathological analysis, suicidal behavior
Orlov F.V., Golenkov A.V., Deomidov E.S., Bulygina I.E. Household gas explosion as a method of homicides and suicides committed by persons with mental disorders: a series of cases in the regions of Russia (2012-2021). Suicidology. 2022; 13 (1): 45-58. doi.org/10.32878/suiciderus.22-13-01(46)-45-58 (In Russ / Engl)
Every month there are reported household gas explosions with fatalities in various regions Russian Federation (RF). At the same time, methane explosions as a way of suicide and murder of other people committed by patients with mental disorders (MD) are not fully considered. The aim of the study is to study cases of natural gas explosions in the regions of the Russian Federation, committed with suicidal and homicidal intentions. Materials and methods. Through the electronic media we collected information about 10 cases of household gas explosions in 10 regions of the Russian Federation that occurred in 2012-2021. We only considered cases with the presence of MD and deliberate suicidal behavior in the instigators of the explosion. The detonators were 10 males aged 19 to 70 (mean age 41.7±16.5), the victims were 37 people (14 males and 23 females, including five children) aged 1,5 months to 84 years (mean age 45.5±23.0). For each case of the explosion, socio-demographic indicators and psychopathological features of the delict were collected from all participants in the incident. Results. In seven cases, the incidents can be qualified as post- homicidal suicides carried out with the help of a household gas explosion, two cases can be classified as suicides without the death of other residents, and one case is classified as the murder of hostile neighbors. All the causes of the gas explosion that caused the collapse of a residential building with the death of people were suicide attempts and/or murders committed in a generally dangerous way. Besides suicidal behavior (five cases) due to family disagreements, conflicts with neighbors, financial problems with court decisions to confiscate an apartment for a loan taken, waiting for a court decision for a criminal offense, suicide bombers suffered from addiction to alcohol and other psychoactive substances, mental retardation, chronic MD complicated by alcohol abuse. The murder with the help of a gas explosion was committed by a patient with schizophrenia under the influence of auditory hallucinations and recognized by the court as insane. Another case is analyzed as an attempt to kill neighbors under the influence of passive and active variants of delusional defense. Conclusion. The explosions of domestic gas with the purpose of murder and/or suicide, as a rule, are accompanied by mass casualties. The perpetrators of the incidents were, on average, younger than their victims; they had a history of suicidal behavior and various MDs. It makes sense to appoint complex forensic medical examinations with the involvement of forensic psychiatrists to clarify the psychopathological motives for such incidents.
Keywords: household gas (methane) explosions in apartment buildings, murders, suicides, post- homicidal suicides, mental disorders
Merinov A.V., Baykova M.A., Polkova K.V., Gazaryan Z.E., Kramoreva A.S., Alekseeva A.Yu. Extended suicidological characteristics of youth and girls who have previously attempted suicide. Suicidology. 2022; 13 (1): 59-73. doi.org/10.32878/suiciderus.22-13-01(46)-59-73 (In Russ / Engl)
According to official WHO statistics in 2015 the number of suicides among young people aged 20-24 in the world reached 83,692, compared with teenagers aged 15-19 the percentage is higher by 34.1% (55,228) and by 2% compared to the age group of 25-29. According to 2019 Rosstat data in the Russian Federation, 17,192 people died by suicide, of whom 14,299 were men and 2,893 were women. The article is devoted to the issue of auto-aggressive behavior in a group of young people from a relatively well-off social stratum of society who have a history of suicide attempt. The aim of this study is to study the behavioral characteristics of young parasuicide attempters by comparing groups of students with and without a history of a suicide attempt. Tasks: to identify the distinctive features of students who committed parasuicides comparing them to the control sample; to compare parasuicide attempters by gender; to search for strong points for the application of preventive activities in this age group. Materials and methods. The study involved 983 subjects: 245 young men (30 with a suicide attempt and 215 without it), 738 girls (56 with a suicide attempt and 682 without it). The study group included 86 students of both sexes, and the control group consisted of 897 subjects. The criterion for inclusion in the study group was a history of suicide attempt. Mathematical data processing was carried out using the SPSS program. Results and its discussion. Girls who had a suicide attempt in the past were statistically significantly characterized by a history of serious physical abuse, intentional self-injurious behavior and the presence of TBI. Indicators for these traits exceed those in the control group by 4.5; 2.6; 4.3 times. Three times more often, the respondents of the study group self-assess themselves as alcohol abusers, almost 45% of them smoke (17.7% in the control group), 21.4% used narcotic drugs and/or other psychoactive substances. In the group, the indicators on the basis of "the presence of suicide in a relative" are twice as high. 79% of the respondents of the study group tend to experience periods of low mood, 64% experience moments of hopelessness; 62.5% experience moments of acute loneliness, which significantly distinguishes them from the representatives of the control group. Young men who had a suicide attempt in the past were statistically significantly characterized by a number of non-suicidal autoaggressive phenomena. In addition to the facts of serious physical abuse in history, non- suicidal self-damaging behavior, which, by the way, are more common than similar indicators among the studied group of girls, there are also life-threatening hobbies (43.3%), a tendency to unjustified risk (40%). The "narcological spectrum" of the realization of auto-aggressive impulses in young men of the study group is represented by non-systematic use of psychoactive substances (40%), smoking (46.7%), subjective self-assessment as an alcohol abuser (36.7%). Frequent periods of low mood and moments of hopelessness (in both cases, 63.3%) should also be noted. 50% of the respondents in the study group reported that they experience an obsessive sense of shame, in the control group this figure is 3.5 times lower. In 36.7%, the persons of the study group admitted that they do not have a clear meaning of life. Differences in a series of comparisons of girls and boys who had a suicidal attempt in the past are insignificant, which speaks in favor of their relationship, but we can talk about a certain sex-role coloring of the detected spectrum: a significantly higher frequency of non-systematic use of psychoactive substances, intentional self-harm and life-threatening hobbies in the youth group. Conclusions. Groups of parasuicidal girls and boys are, on the whole, very specific sections of the studied age and educational part of the population, concentrating a significant number of all patterns of autoaggression, which once again emphasizes the "kinship" of all patterns aimed at self-destruction. The results obtained in the study can be used in diagnostic algorithms for assessing suicidal risk.
Keywords: parasuicide, suicide attempt, autoaggression, suicide, suicidology
Doroshenko S.V., Sanaeva O.V. Structural topic modeling in studies of the relationship between financial debt and suicide. Suicidology. 2022; 13 (1): 74-87. doi.org/10.32878/suiciderus.22-13-01(46)-74-87 (In Russ / Engl)
Suicide factors and ways to prevent it are in the constant attention focus of the international scientific community. Research interest covers various areas, not excluding the economy, since suicide entails serious economic losses since it is one of the causes of death among the working population. The aim of this work is to establish additional determinants of the relationship between suicide and financial debt using modern machine learning methods, the use of which makes it possible to more effectively analyze a significantly larger number of publications in a short time. The research method is Structural Topic Modeling. This method works well on short texts and allows the use of metadata. The information base consists of 3324 abstracts of scientific articles on relevant issues posted in the international Scopus database during 2015-2021. Articles were selected from various fields of knowledge: social sciences; medicine; arts and humanities; economics, econometrics and finance; psychology. The research was conducted in the RStudio package. Results: 1) the analysis of statistical data showed an increase in interest in the study of the connection between suicide and financial debt from 400 publications in 2015 to 600 in 2021; 2) based on three criteria – the quality of model prediction, exclusivity and semantic coherence – we formed 21 topics, which confirms both the high research interest in the problem and its versatility and complexity; 3) we confirmed the growing importance and relevance of research on such assumptions as the strengthening of the link between debt, suicide and economic crises; the importance of preserving traditional values; the need for special, including medical, attention in conditions of social restrictions; increased predisposition to suicide against the background of financial difficulties of certain social groups and professional communities. The results obtained can be implemented by researchers, including by using exclusive words in selected topics to search for literature of interest on the problems of the interdependence of suicide and financial debt.
Keywords: suicide, financial debt, Structural Topic Modeling, factors, relationship
Chistopolskaya K.A., Rogers M.L., Enikolopov S.N., Nikolaev E.L., Kravtsova N.A., Sadovnichaya V.S., Drovosekov S.E. Adaptation of the Suicide Crisis Inventory (SCI-2) in a Russian internet sample during the COVID-19 epidemic. Suicidology. 2022; 13 (1): 88-104. doi.org/10.32878/suiciderus.22-13-01(46)-88-104 (In Russ / Engl)
The article presents a new diagnostic category, Suicide Crisis Syndrome (SCS), which was proposed to the next revision of Diagnostic and Statistical Manual of Mental Disorders (DSM). Study objective: Adaptation of the Suicide Crisis Inventory (SCI-2) on a Russian sample. Participants: 618 responses to an internet-survey were used, the study lasted from June 16, 2020 to April 26, 2021. Age of the participants: 18-99 (М=26.9; SD=12.8). Gender: 451 females (74.2%), 135 males (22.2%), 32 participants preferred not to answer or chose other gender identity. Instruments: Suicide Crisis Inventory (SCI-2), Suicidal Narrative Inventory (SNI), Stressful Life Events Questionnaire, Columbia Suicide Severity Rating Scale (C-SSRS), questions about recent and lifetime suicidal behavior. Results: Confirmatory factor analyses confirmed the five-factor (χ2[1420]=5003.56, p< .001, CFI= .99, TLI= .99, RMSEA= .07, SRMR= .06) and one-factor (χ2[1430] = 9847.34, p< .001, CFI= .98, TLI= .98, RMSEA= .10, SRMR= .07) solutions of the inventory, with five-factor as a better solution (Δχ2[10] = 4843.78, p < .001). Based on retrospective data (self-reports on suicidal attempts during the last month), SCI-2 showed good diagnostic qualities (AUC= .85, 95% CI [.72; .97]). The cut-off score was established (80), which indicates the presence of acute suicidal risk. Conclusions: Adaptation of the Suicide Crisis Inventory (SCI-2) went well, the instrument is ready for use for clinical and research purposes.
Keywords: suicide, suicidal ideation, suicide crisis syndrome, suicide crisis inventory, narrative-crisis model of suicide, COVID-19
Golenkov A.V. Spousal (partner) post-homicidal suicides (according to electronic media in the regions of Russia). Suicidology. 2022; 13 (1): 105-117. doi.org/10.32878/suiciderus.22-13-01(46)-105-117 (In Russ)
Spousal (partner) post-homicidal suicide (PHSU) are most frequent type such delict which were practically not analyzed in Russian Federation (RF). The aim of the study is to study cases of spousal PHSU in the regions of the Russian Federation, their variety and motives for committing them. Materials and methods. It was possible to collect information in the electronic media for over 20 years (2002-2021) on 130 cases of PHSU in 59 regions of the Russian Federation (from 1 to 9 cases in the region), 128 men and 2 women aged 21 to 86 (mean age 45.9±12.1) who committed murders followed by suicide, and 156 victims (19 males and 137 females) aged 1.5 months to 84 (mean age 39.6±15,7). For each case of PHSU, socio-demographic and criminological indicators, features of the delict (presence of mental disorders, probable motives) were written out. Mathematical and statistical processing was carried out using descriptive statistics and χ2-distribution. Results. In 80% of spousal (partner) PHSUs the victim was only the wife (partner, beloved). In 6.2% victims were the spouse and her children, in 6.2% victims were the spouse and one of the family members (adult children, grandchildren, relatives, mother-in-law), in 7.6% victims were the spouse and her lovers, or male acquaintances. In only two cases women killed their elderly husbands with a knife because of conflicts (64 and 84 years of age). The average age of the aggressors and victims turned out to be the lowest in the spousal and child PHSU and the oldest age in the spousal and family PHSU. At the same time, the murdered wives from the subgroup of spousal and out-of-family PHSU were about 10 years younger than their husbands' aggressors, as were their lovers and murdered men. In these cases, firearms were used as a method of both murders and subsequent suicides, and strong jealousy was the leading motive for aggression. The males (lovers) were, on average, the same age (38.3±10.7, from 21 to 53 years of age) as the murdered women in this group. Murders were most often committed with the help of piercing objects (41.5%), firearms (39.2%) and by strangulation (6.2%), and suicides were committed with firearms (42.3%) and cold weapons (23. 1%), hanging (20%). Jealousy (Othello's syndrome for pathological jealousy) was the most common motive for lethal aggression (26.2%), but in isolated cases there were encountered psychotic incidents. Relationship breakup (separation) was observed in 14.6%, conflicts, quarrels were reported in 11.6%, divorce was reported in 9.2%. Mental disorders were indicated in 10.8% of cases, most often (60%) psychoactive substances (alcohol) addiction. In 20.8% the reasons for the aggression were not known. Conclusion. Spouse PHSUs are significantly more often performed by men who, on average, are older than their wives (partners). The proposed typology of marital PHSU is working and suitable for practice. The leading causes of PHSU are jealousy, relationship breakup, divorce, conflicts and quarrels. PHSUs are also committed by people with mental disorders, which suggests a psychopathological factor as aggression and auto-aggression.
Keywords: spouses (partners, lovers), post-homicidal suicides, jealousy (Othello syndrome), mental disorders
Vasilyeva S.N., Simutkin G.G., Schastnyy E.D., Bokhan N.A. Risk factors for suicidal behavior in bipolar affective disorder. Suicidology. 2022; 13 (1): 118-127. doi.org/10.32878/suiciderus.22-13-01(46)-118-127 (In Russ / Engl)
Aim: Identification of risk factors for suicidal behavior in patients with bipolar affective disorder (BAD). Materials. In a specialized psychiatric department, 164 patients with a verified diagnosis of bipolar disorder were examined. The examined group mostly consisted of women (70.1%) with mean age of 44 [28; 54], while the mean age for men was 35 [30; 51]. A comparative analysis of socio-demographic indicators and clinical-dynamic characteristics of BAD was carried out in two groups of patients with the presence (n=42) and absence (n=122) of suicidal attempts during an affective disorder episode. Statistical data processing was carried out using the SPSS program Statistics v26. Results. A significant proportion of patients with bipolar disorder who made a suicidal attempt (25.6%) was revealed. Patients with a history of suicide attempt, compared with patients without it, were more likely to suffer from BAD type 1, had comorbid personality disorder and alcohol addiction, an earlier age of onset of affective disorder, more frequent exacerbation of affective symptoms, and mixed episodes during BAD. Also, these patients were less adapted: they were more often unmarried, had incomplete higher education, were unemployed or had a disability due to mental illness. Conclusions. A more severe course of bipolar disorder, the presence of comorbid mental pathology and a decrease in the level of social functioning increase the risk of suicidal behavior in patients.
Keywords: suicide, suicidal behavior, risk factors, bipolar affective disorder, BAD
Zotov P.B., Lyubov E.B., Mikushin I.A., Skryabin E.G., Akselrov M.A., Prilensky B.Yu., Kicherova O.A., Zhmurov V.A., Buhna A.G. arsenic among means of suicide. Suicidology. 2022; 13 (1): 128-153. doi.org/10.32878/suiciderus.22-13-01(46)-128-153 (In Russ / Engl)
Arsenic is one of the most severe toxicants known to mankind for many centuries. Despite the wide choice and availability in the modern world of other chemical agents, it is still used as a means of suicide, although these cases in Russia and foreign countries are extremely rare. The casuistry limits the possibility of a more complete study and description of the leading characteristics of the suicidal contingent, the identification of risk groups, key motives and anti-suicidal factors. Preventive measures have been worked out little and need to be improved. Summarizing the data of predominantly single observations presented in scientific literature, the authors note that men predominate among those who use arsenic to commit suicide (which is not typical for intentional self-poisoning). As a rule, these are people of young and middle age with only base education, suffering from depression. True motives to die prevail. Usually, arsenic trioxide or its salts are taken orally, less often intravenously. The first symptoms of poisoning are nonspecific, which, in the absence of the possibility of collecting an anamnesis, causes difficulties in making a diagnosis. Antidote therapy, started in the first hours, often saves the life of the victim. In conclusion, the authors point out the need for further in-depth research.
Keywords: suicide, suicide attempt, arsenic, arsenic trioxide, herbicides, intentional poisoning, poisoning
«Suicidology» № 2 – 2022
Sakharov A.V., Stupina O.P., Pasyutina M.S. Suicidal behavior in the Trans-Baikal region: epidemiological characteristics, the impact of the COVID-19 pandemic and the implementation of the WHO tool for improvement of monitoring systems. Suicidology. 2022; 13 (2): 3-17. doi.org/10.32878/suiciderus.22-13-02(47)-3-17 (In Russ / Engl)
The article provides an analysis of the current epidemiological characteristics of suicidal behavior in the Trans-Baikal Region, an assessment of the impact of the COVID -19 pandemic on the indicators of suicidal activity of the population, and also presents the first results of self-harm monitoring implemented in the subject based on the WHO tool. It has been established that in Transbaikalia a positive trend continues in a significant decrease in the number of suicides, although the rate of completed suicides in the Territory is 2.5 times higher than the national average and 1.5 times higher than in the Far Eastern Federal District. The spread of a new coronavirus infection COVID -19 and its associated adverse socioeconomic impacts have resulted in a slowdown in the decline in suicide rates and a 1.5-fold increase in the number of suicide attempts among the population of the region in 2020. The monitoring of self-injurious behavior standardized by WHO has allowed a more detailed analysis of the epidemiological features of suicide attempts in the region.
Keywords: mortality, suicidal behavior, suicide, suicide attempt, monitoring, COVID-19
Golenkov A.V., Zotov P.B. Comparison of post-homicidal suicides with common homicides and suicides at the federal level. Suicidology. 2022; 13 (2): 18-27. doi.org/10.32878/suiciderus.22-13-02(47)-18-27 (In Russ / Engl)
Post-homicidal suicide (PHSU) is a rare delict that is accompanied by the death of two or more people. In the Russian Federation (RF), PHSUs have not been studied fully enough; they have not been compared with other types of violent death. The aim of the study: to compare PHSU with murders and suicides committed in the regions of the Russian Federation. Materials and methods. We collected data on 348 PHSUs (287 men and 61 women, aged 15 to 86; mean age 42.6±14.1 years) published in the Russian electronic media of 76 regions in 2002-2021. Similar data in the media was collected about 400 murders (259 men and 141 women, aged 12 to 86; mean age 38.2±13.2 years) and 400 suicides (191 men and 209 women, aged from 11 to 86; mean age 29.5±14.1 years) in the Russia. Mathematical and statistical processing was carried out using descriptive statistics and distribution (test) χ2. Results. Men who committed PHSU were the oldest in age (43.2±14.1 years on average), most often (46.7%) killed their spouses (partners), and then themselves using firearms and explosions as a result of personal family problems and work-related conflicts. Women who committed PHSU, as a rule (78.7%), strangled their underage children or made them fall from a height or drowned them. Sometimes they used several instruments of aggression due to various health conditions. To escape from life, they jumped from a height or used several suicide methods. In the group of murderers, most often there was one or another mental disorder detected (38.6-39.7%), as well as previous criminal record (18.4-34.4%), the state of intoxication (58.9-66.8%) in moment of delict. They usually directed aggression (46.8-54.4%) at their acquaintances (rarely strangers), using cutting weapons (women), blunt weapons and arson (men); had conflicts associated with an antisocial environment. Suicide attempters of both sexes turned out to be the youngest people among all compared groups. Men (mean age 33.3±15.4 years) committed suicides by falling under transport and causing transport accidents in the presence of financial and domestic difficulties; the state of intoxication was detected in 47.1% cases. Women (mean age 26.2±11.1 years) used poisonous substances and self-hanging more often than other suicide methods, often being in a state of intoxication (65.6%) and having personal and family conflicts. Conclusion. All six compared groups with various cases of violent death differed from each other according to the indicated socio-demographic, clinical, criminological indicators and the reasons for their commission. PHSU is significantly different from ordinary murders and ordinary suicides, PHSU by men is different from PHSU by women.
Keywords: post-homicidal suicides, murders, suicides, demographic groups, motives (reasons), regions of the Russian Federation
Lyubov E.B. Suicidal contract in pictures and images. Part I: definition, typology, distribution and methods. Suicidology. 2022; 13 (2): 28-49. doi.org/10.32878/suiciderus.22-13-02(47)-28-49 (In Russ / Engl)
The first part of the literary review shows the features, typology, prevalence and ways of committing suicidal contracts within the framework of "pair deaths", based on scientific articles, media information, with the involvement of relevant examples of their fiction and cinema.
Keywords: pair death, suicidal contract, options, methods, prevalence
Kramoreva A.S., Merinov A.V., Gazaryan Z.E., Uslontsev D.N. Impact of COVID-19 on suicidological indicators in the city of Ryazan, Ryazan and Rybnov regions. Suicidology. 2022; 13 (2): 50-60. doi.org/10.32878/suiciderus.22-13-02(47)-50-60 (In Russ / Engl)
According to a WHO scientific review global prevalence of anxiety and depression increased by 25% in the first year of the COVID-19 pandemic. Features of the pandemic, both related and not directly related to the virus, can lead to various types of suicidal behavior. Aim. To find out if COVID-19 affects the quantitative characteristics and structure of suicidality using the example of Ryazan, Ryazan and Rybnovsky districts of the Ryazan region. Materials and methods. A study of 9616 death certificates was carried out on the basis of the Ryazan Region State Budgetary Institution “Bureau of Forensic Medical Examination named after D.I. Mastbaum", which made it possible to study the three largest districts of the Ryazan region: the city of Ryazan, the Ryazan and Rybnovsky districts. Of the analyzed acts, those were selected that include causes of death that demonstrate the most likely suicidal orientation. The inclusion criteria were the following causes of death: falls from a height (Group 1), death by hanging (Group 2), and fatal cuts to the forearm and wrist (Group 3). These death certificates were assessed by age and gender among those who committed suicide. Results and its discussion. According to the analysis for 2019, the SSR (standardized suicidality rate) was 10.9, and for 2021 it raised to 14.5, that is, an increase of 33% was noticed. The results of the calculation when disaggregated by sex are different: female SSR in 2019 is 2.59 and in 2021 it is 6.96. Male SSR in 2019 is 21.14 and in 2021 it is 20.79. In 2019 there were 70 cases classified as intentional self-harm, and in 2021 there were 92 such cases based on the criterion for including causes, resulting in a 31% increase in suicidality in relative numbers. In group No. 1 (a fall from a height), there was an increase by 78% recorded in the number of suicidal cases. Moreover, the proportion of women in the group of falls increased significantly: from 21.4% in 2019 to 40% in 2021. In group No. 2, the number of suicides with the cause “mechanical asphyxia due to compression of the neck with a noose” increased by 28%. In this group, the difference is less pronounced: 13.6% in 2019 and 17.2% in 2021. In group No. 3 deaths were recorded only among men. As for age analysis: in group No. 1, the mean age of the deceased decreased by 10 years – from 54.4 in 2019 to 44.9 in 2021. In group No. 2, the mean age of suicide attempters was 51.7 in 2019 and 49.2 year in 2021. It is noteworthy that 5.43% of all suicide attempters were diagnosed with the novel coronavirus infection COVID-19. When analyzing dynamic changes and the distribution of suicidal cases over time, it was not possible to identify a direct relationship in terms of specific months when the largest number of suicides was detected, with the "peaks" of the incidence of infection. Conclusions. In the first calendar year of the pandemic, the number of suicidal cases increased. Significant changes in the gender and age structure are also visible, which suggests the objective significance of the role of the novel coronavirus infection pandemic as an external factor influencing the quantitative and qualitative structure of suicidality in the Ryazan region.
Keywords: COVID -19, new coronavirus infection, suicide, infodemic
Filonenko A.V., Golenkov A.V., Filonenko V.A., Sergueeva A.I. Suicidal-homicidal behavior of carers of persons with dementia. Suicidology. 2022; 13 (2): 61-73. doi.org/10.32878/suiciderus.22-13-02(47)-61-73 (In Russ / Engl)
The relevance of assessing and taking care of mental health of caregivers of people with dementia is caused not only by their suicidal intentions towards themselves, but also thoughts about harming the persons they should give care to. Suicidal-homicidal intentions develop gradually, do not manifest themselves, and pose a potential danger for murder. The aim of the review is to summarize the motivational factors that encourage caregivers to commit suicidal and homicidal actions and to increase the medical and social effectiveness of preventing murders with the development of probable directions for prevention. Knowledge of the factors associated with suicide is essential to prevent tragic outcomes. Results. Socio-demographic characteristics are presented in relation to different motives and types of suicide. Risk groups that can lead to the murder of a disabled person are described. Reporting and practical use of the identified socio-demographic features will reduce the level of homicide in society. There is a clear need to support caregivers of people with dementia and disabilities. Family members who provide care to people with dementia have high rates of suicidal and homicidal thoughts, with depression being a risk factor and older age and lifestyle being protective factors. Interventions to reduce the risk of suicide in caregivers of people with dementia should focus on relieving depression and motivating them to continue their lives and those of their caregivers, teaching caregivers and social support.
Keywords: social support; caregivers; dementia; disability; homicide; suicide
Kasimova L.N., Svyatogor M.V., Sychugov E.M. The role of clinical and social risk factors in the onset and development of suicidal behavior in adolescents and young adults. Suicidology. 2022; 13 (2): 74-91. doi.org/10.32878/suiciderus.22-13-02(47)-74-91 (In Russ / Engl)
Worldwide, suicide remains one of the leading causes of death among adolescents. Currently, there is no single concept of the onset and development of suicidal behavior, which is necessary for the implementation of effective preventive measures. Aim. To analyze data from studies on assessment of clinical and social risk factors for suicidal behavior of young people. Material. National and foreign publications of recent years. Results and conclusion. The research has shown a connection between the quality of mental health and suicidal behavior. In many ways, suicidal behavior is influenced by the characteristics of the course of mental illness at young age. The risk of suicide increases significantly in case of several mental disorders combination. Antecedent suicidal thoughts and attempts are one of the strongest risk factors for future suicidal behavior in young people. Personal and behavioral factors that determine the occurrence of suicidal tendencies in young people are low self-esteem, impulsivity, feelings of hopelessness and lack of coping skills. All forms of bullying and negative attitudes are strongly associated with suicide attempts. There has been found a connection between suicidal phenomena and stress at school. Young people who grew up in adverse conditions are more prone to suicide. Measures to prevent suicide should consider the versatility of the specifics of suicidal behavior at young age and take into account the role of not only clinical, but also social and cultural factors in suicidegenesis.
Keywords: suicide, suicidal behavior, suicidogenesis, adolescents, youth, risk factors
Zotov P.B., Skryabin E.G., Reikhert L.I., Zhmurov V.A., Spaderova N.N., Buhna A.G., Zenkevich А.А., Plotnikova D.S. helium among means of suicide. Suicidology. 2022; 13 (2): 92-116. doi.org/10.32878/suiciderus.22-13-02(47)-92-116 (In Russ / Engl)
The issues of using the inert gas helium in suicidal acts are discussed. The appearance of this method is shown to be a consequence of the wide access of helium for the population, combined with the active promotion of information in Internet resources as an "effective and peaceful means" for suicide. Being a technology proposed in countries where euthanasia is allowed, it is currently becoming more and more popular in many countries across the world, and the number of deaths from deliberate helium inhalation keeps growing every year. Most suicide attempters are men, mostly young. Risk factors include depression, social and financial disadvantage. The data presented in the review testify to the high relevance of this topic. However, many issues have not been fully studied and covered in the specialized literature, and require more in-depth research. A direct consequence is the difficulty in determining the range of effective prevention measures. The traditional measures proposed today to restrict access to gas are expected to be unilateral and not effective enough. With a certain degree of confidence, it can be assumed that in the absence of due attention to the topic the opportunity for the population to access gas will preserve and, most importantly, with potentiating information in the media the number of He consumers and victims will increase, and it will be able to take a more significant place in the overall structure of suicides. In Russia, at present, the “helium” means of suicide stays a relatively rare occurrence. Therefore, timely, large-scale, comprehensive and targeted implementation of differentiated preventive measures can be the key to limiting the spread of this method of suicide in the population being one of the measures to reduce suicidal mortality.
Keywords: suicide, helium, inert gas, helium poisoning, helium inhalation, "helium" death
«Suicidology» № 3 – 2022
Rozanov V.A. Aggression and autoagression (suicide) – a neurobiological analysis. Suicidology. 2022; 13 (3): 3-38. doi.org/10.32878/suiciderus.22-13-03(48)-3-38 (In Russ / Engl)
In suicidology, the concept of "autoaggression" is often used both as aggression directed at the subject and as a synonym for suicidality, mainly based on psychoanalytic ideas formulated by Z. Freud. The aim of this descriptive review is to analyze these ideas as objectively as possible using neurobiological, neuropsychological, and neurogenomic data. Results. In modern suicidological discourse, the concept of "aggressive suicide" is substantiated, that is, suicide committed in the most lethal ways, in which aggression acts as a personality trait that directly predisposes to committing suicide. We reviewed the basic ideas about the relationship between aggression and auto-aggression from the standpoint of the conceptual apparatus, some statistical data and general neurobiological factors. The data presented in the review indicate that the modern understanding of aggressive behavior (for example, in the context of psychopathy or antisocial personality disorder) and suicidal behavior, with all the variety of approaches, comes from largely coinciding ideas. In both cases, the same neurobiological systems are involved (serotonin, catecholamine, neuroendocrine regulation system, and a number of others), neuropsychological and psychophysiological parameters are very similar, neuromorphological deviations (volumetric and functional assessments of the activity of the prefrontal cortex, amygdala, and emotional structures) have similar features. A significant number of genetic markers are common for aggression and suicide. Neurobiological evidence reveals the factors that underlie the close association between aggressiveness and suicidality as measured by questionnaires and psychological tools. The aggressive instinct or trait acts as a suicidal endophenotype, along with other endophenotypes such as stress vulnerability and some personality traits. The heterogeneity of aggression (reactive, impulsive and emotionally loaded, and proactive, planned, prudent and cold) has its analogies in the form of impulsive suicide against the background of the disinhibitory effect of alcohol and conscious and planned suicide against the background of depressive states. Conclusion. The neurobiological approach confirms the productivity of the ideas expressed by psychoanalysts and opens up new perspectives on the study of both aggression and suicide.
Keywords: aggression, autoaggresion, suicide, neurobiological mechanisms
Golenkov A.V., Zotov P.B. Analysis of suicide aggressors after mass murder. Suicidology. 2022; 13 (3): 39-57. doi.org/10.32878/suiciderus.22-13-03(48)-39-57 (In Russ / Engl)
Mass murders (MM) usually include an act of aggression that is committed within a short time in one place and within the framework of one event and includes three or more victims. The readiness to die or commit suicide is a very common characteristic of such a criminal, so there is every reason to consider the features of MM including within the framework of murder-suicide (MMS). The aim of the study is to study the cases of MMS in the Russian Federation (RF) that occurred in 2002-2021 by comparing them with ordinary mass murders (OMM) and so-called post- homicidal suicides (HSU) with one or two victims. Materials and Methods. We analyzed 47 cases of MMS from 32 regions of the Russian Federation (44 men and 3 women, aged 16 to 70 years; mean age 39.9±13.9 years). The comparison groups included 67 cases of MM (63 and 4, 15-64 years of age; 34.3±10.4), but without suicides of the aggressors (OMM) from 41 regions of the Russian Federation and 348 HSU s from 69 regions of the Russian Federation (287 and 61, 15-86 years of age; 42 ,6±14.1). Mathematical and statistical processing was carried out using descriptive statistics, chi-distribution and t-test. Results. Almost every fourth MMS ended in the death of five or more people (on average – 3.94 victims), with OMM in 91% of cases there were less than five victims (3.48), HSU was limited to one victim in 72.1% (1.28). The analysis also showed that the MMS is usually family (domestic) murder (often of spouses and children) followed by suicide, associated with marital conflicts and committed, as a rule, in a generally dangerous way (firearms and explosions) with the largest number of victims. OMM is predominantly extra-family murder associated with conflicts involving strangers, committed by people of young and mature age, more often in a state of intoxication, using piercing objects, arson and several methods of aggression. HSU with one or two victims is more often marital or child murder associated with conflicts in the family, committed in other ways (suffocation, etc.). The aggressors of the HSU turned out to be the oldest, less likely to have a criminal record in the past. Most of them were women and people aged 60 and over. Conclusion. The selected groups – MMS, OMM and HSU differ significantly from each other in a number of socio-psychological (demographic) and criminological indicators.
Keywords: murders, suicides, post-homicidal suicides, Russian Federation
Lyubov E.B. Suicidal contract in pictures and images. Part II: characteristics and expertise. Suicidology. 2022; 13 (3): 58-87. doi.org/10.32878/suiciderus.22-13-03(48)-58-87 (In Russ / Engl)
In the second part of the literature review, based on scientific articles, media reports, using relevant examples from fiction and cinema, typical characteristics of suicide contracts are shown that distinguish them from murder-suicides and individual suicides.
Keywords: suicide pact, murder-suicide, characteristics
Polkova K.V., Merinov A.V., Starostenko A.E. Suicidal characteristics of young men with hazardous alcohol consumption. Suicidology. 2022; 13 (1): 88-102. doi.org/10.32878/suiciderus.22-13-03(48)-88-102 (In Russ / Engl)
The fact that auto-aggressive behavior is associated with alcohol abuse is widely known among the scientific community. A number of works relating to the association of suicidal behavior with alcoholization often used the criterion of volumetric doses of alcohol consumption per capita, and also estimated the number of suicides in a particular region or country, where a positive correlation was often found between an increase in alcohol consumption and an increase in the number of suicides. However, alcohol consumption per capita (per capita) is formed not only by people who already have alcohol addiction, but also by those who abuse alcohol at the prenosological level. The latter, of course, can contribute to the total paraalcoholic indicators of suicidal mortality. Currently, there are no data on the suicidological characteristics of individuals with prenosological forms of alcohol abuse, in particular, with dangerous forms of consumption. Materials and methods. 456 men aged 20 to 27 years old, studying at the university, were studied. Of these, 56 had "dangerous alcohol consumption" and were included in the study group. The control group consisted of 400 young men who were not assessed as dangerous users. RUS-AUDUT was used as the main research tool. To assess the presence of suicidologically significant patterns, a questionnaire was used to identify auto-aggressive patterns in the past and present. Mathematical data processing was carried out using the SPSS program. Results and discussion. The number of suicide attempts in the study group was ten times higher than that in the control group in the last two years, and throughout life in general it exceeded five times. Preclinical alcohol abuse in the group of young men affected the frequency of detection of suicidal thoughts (60.71% in the study group versus 27.5% in the control group). Self-harm in the last two years also prevailed in the study group (14.29% versus 3.5% in the control group). Conclusions. The studied group of males with patterns of dangerous alcohol consumption is a very unfavorable category in terms of suicidology, requiring further, more detailed study. The data obtained during the study should be used in the assessment of suicidal risk among young men.
Keywords: dangerous alcohol consumption, suicide attempt, suicide, autoaggression, suicidology, prenosological forms of alcohol abuse, domestic drunkenness
Kozlov V.A., Sapozhnikov S.P., Golenkov A.V. Regional dynamics of gender suicidality rate. Suicidology. 2022; 13 (3): 103-113. doi.org/10.32878/suiciderus.22-13-03(48)-103-113 (In Russ / Engl)
The aim of the work is to compare the dynamics of the gender suicidality coefficient (GSC) of the population of cities and rural areas. The article deals with the issues of regional dynamics (rural/urban) of the GSC (quotient from the division of the relative coefficient of suicide in men by the coefficient of suicide in women) in the Chuvash Republic (ChR) for the period 1995-2002. The data obtained are compared with the same indicator for the same period in the Russian Federation (RF), as well as the WHO data for the period 2003-2019. The data obtained allowed us to conclude that for the period 1995-2002 the dynamics of changes in the GSC in the villages and cities of the Chuvash Republic differed significantly, the shape of the graphs resembled sinusoids that are in antiphase. In the villages, there was a trend towards an increase in the GSC, and in cities there was observed a trend towards a decrease. When calculating GSC in the Russian Federation without differentiating between a city or a village in the period 2003-2019, there was both an annual decrease in suicide coefficient s and a much smaller GSC, changes associated with a significant decrease in the frequency of suicide among men than with a much less pronounced decrease in the frequency of suicide in women. The dynamics of GSC over the studied period among the rural and urban population differs significantly, while from 1998 to 2002 in cities there was a trend towards equalizing the frequency of suicides among men and women, in the villages the trend was the opposite. GSC when assessed in large populations is stable over significant time periods. The data obtained are indirect evidence of the multifactorial nature of the suicidal phenotype.
Keywords: suicide, gender paradox, coefficient of gender suicidality, village, city
Garagasheva E.P., Spaderova N.N., Prilenskaya A.V., Kicherova O.A., Akselrov M.A., Bukhna A.G., Zhmurov D.V., Prilensky А.B. Suicidological situation in a small territory: experience in system analysis. Message II: suicidal attempts. Suicidology. 2022; 13 (3): 114-133. doi.org/10.32878/suiciderus.22-13-03(48)-114-133 (In Russ / Engl)
The study of suicide attempts is an important stage of research that allows assessing the level and key characteristics of suicidal activity in the population in the region. The study of this most suicidal contingent gives a clearer idea of the factors and risk groups, helps to identify priority areas and preventive measures. The data on suicides obtained in the city of Yalutorovsk and the region (Western Siberia) showed an excess of women among them, characteristic of the Russian Federation (the M : F ratio is 1 : 1.2-1.5). At the same time, the average age of those who made an attempt in the district center was 35.9 years and 34.7 years in the village. The revealed negative fact was the almost absence of differences in age among women in rural areas – 33.3 (attempted suicide) and 34.2 (completed suicide), which may indicate a lack of necessary psychological assistance in the territory and access to it. This may well be a significant reason for the previously marked significant “rejuvenation” of female suicides in the study region. Among other features there can pointed out lower than in the Russian Federation indicators in the structure of self-harm of intentional self-poisoning (urban – 35.9%, rural – 37.7%), with high values of mechanical asphyxia (urban – 11.7%, rural – 20, 3%) and the complete absence of attempts with the use of firearms, despite the high percentage of their use among the dead (city – 13.1%, village – 10.7%). Significant elements of suicidal dynamics include alcohol, which was detected in 34.5% of suicides in the urban population and 39.1% of the villagers. It was found that alcohol is associated with more brutal methods of self-harm – mechanical asphyxia and self- cutting, regardless of the residence of the victim. In general, the dynamic analysis of suicide attempts presented in this paper in the period 2012-2020 showed a fairly complete picture of what is happening in the study region. The noted shortcomings indicate the need to improve individual elements of the registration system and suicide prevention, including by increasing the availability of assistance to the population provided by mental health professionals.
Keywords: suicide, suicide, suicidological situation, dynamic assessment of the suicidal situation, small territories, suicide prevention, Yalutorovsk, Tyumen region, West Siberia
«Suicidology» № 4 – 2022
Lyubov E.B. The joys and tortures of ludwig boltzmann, or permanence of A chance. Part I: biography elements. Suicidology. 2022; 13 (4): 3-26. doi.org/10.32878/suiciderus.22-13-04(49)-3-26 (In Russ / Engl)
The triumph and tragedy of Ludwig Boltzmann, a romantic thinker, luminary of physics and man for all time, are embodied in the cataclysms of science and the world of the late 19th and early 20th centuries. The stages of a long journey in science and life are traced with signs of suicidal behavior maturing over the years against the background of cumulation of chronic mental and somatic ailments, a vicious circle of multiplying psychosocial distress. At the same time, mutual devotion to the family and the cause of life (creativity) served as protective (anti-suicidal) factors and brightened up the darkest days. If possible, the testimonies of contemporaries, biographers, excerpts from personal letters and speeches of Professor Boltzmann are given, emphasizing the incarnations of a personality unique in its versatility: a subverter of dogmas and traditions, a rebel-demon of the most tender quivering soul and a passion-bearer.
Keywords: Boltzmann, life history, illness, suicide
Golenkov A.V. Suicides after Mercy killing. Suicidology. 2022; 13 (4): 27-37. doi.org/10.32878/suiciderus.22-13-04(49)-27-37 (In Russ / Engl)
Mercy killing (MK) is based on the premise that a person's quality of life has reached the point where death by killing becomes an act of compassion, regardless of the sufferer's consent. The small number of publications on the topic of MK with subsequent suicide, especially in the national scientific literature, makes this work relevant and in demand. The aim of the study is to study the cases of suicides after MK in the subjects of the Russian Federation (RF) that occurred in 2006-2021. Materials and Methods. We analyzed 10 cases of MK (5 men and 5 women, aged 33 to 76 years; mean age 57.0±13.2) from nine regions of the Russian Federation. Results. MK was more often committed by parents (7), and the victims were adult children (4), or young children (2) with mental retardation (disability since childhood), less often these were patients with dementia (3), childhood autism (1). The aggressors in most cases turned out to be older than their victims (6 males and 4 females, aged from 5 to 83; mean age 42.1±23.9). The means of both murders and suicides more often (50-60%) were piercing and cutting objects, less often (20%) strangulation (self-hanging). The aggressors did not use firearms. Conclusion. Cases of MK in the Russian Federation are mainly the killing by parents of children (incapacitated disabled since childhood, aged 18 years and older) with intellectual-mnestic disorders, due to the inability to care for them, associated with the incurable disease of the guardian and its progression.
Keywords: Mercy killing, suicides, poisoning with psychotropic drugs, Russian Federation
Polkova K.V. Merinov A.V., Komarov E.V., Starostenko A.E., Leonov Y.V., Мerinov N.L., Burshinov A.O. Suicidal characteristics of young women with hazardous alcohol consumption. Suicidology. 2022; 13 (4): 38-57. doi.org/10.32878/suiciderus.22-13-04(49)-38-57 (In Russ / Engl)
The problem of alcohol abuse is relevant regardless of gender, but women are more often stigmatized and condemned by society. The topic of alcohol problems among them, as before, remains uncomfortable and less studied. Most publications on this topic concerns alcohol addiction in women, which is often characterized by greater progression and a more “malignant” course. Considering the fact of a direct relationship between the amount of alcohol consumed per capita and the level of suicides in a certain area studied by a number of researchers, it is not difficult to understand that among this total proportion of alcohol drinkers there are also prenosologically abusers, including those with the so-called "dangerous alcohol consumption" (new heading in ICD-11). They also make up a significant proportion of those who commit suicide and are of particular interest in terms of studying them as a potential suicidal risk group. The article is devoted to the study of auto-aggressive features in a group of young women with a pattern of dangerous alcohol consumption. Aim of research: investigating the association of hazardous alcohol consumption in young women with their auto-aggressive characteristics. Materials and methods. The study involved 435 women aged 20 to 27 studying at a university (86 people with hazardous alcohol consumption and 349 without it). The main instrument for diagnosing hazardous alcohol consumption was the RUS - AUDIT test adapted for Russia. The study group included individuals who consumed alcohol on average more than two standard drinks per day and/or more than six per week, who scored 5-9 points on the RUS-AUDIT test. The control group included young women who scored 0-4 points on the RUS-AUDIT test, drinking alcohol on average less than the above doses per day and week. Mathematical data processing was carried out using the SPSS program. Results and discussion. According to the classical autoaggressive patterns, no statistically significant differences were found among the studied groups (only quantitative predominance in the study group). Girls with hazardous alcohol consumption were more likely to inflict self-harm, especially in the last two years (more than 2.5 times). Among the study group, there was found prevalence of non-systematic consumption of drugs in the last two years (a difference of more than 3 times). In the last two years, only 5.81% of the study group recognized themselves as subjectively abusing alcohol, which can be considered as a protective model of normalization, or a mechanism of alcohol denial that has turned on. 68.05% of girls with hazardous alcohol consumption wanted to see a psychiatrist or psychotherapist, including because of "complexes", which is reflected in their more frequent body shame in the last two years (72.09% vs. 54.15%), as well as the feeling of having a physical handicap (25.58%). The predominant psychological defense mechanisms in the study group were regression (which is consistent with the increased affectivity identified in the study) and compensation. Conclusions. Young women with hazardous alcohol consumption did not show statistically significant differences in the presence of suicidal thoughts and attempts, which can be associated with the young age of the respondents, which does not exclude the growth of indicators over time. The impact of hazardous alcohol consumption on suicidological characteristics is likely to have gender differences that need to be specified. The introduction of a new category in the ICD-11 "hazardous alcohol consumption" will provide an opportunity to develop preventive measures in relation to the possible suicidological and narcological consequences of this pattern.
Keywords: dangerous alcohol consumption, suicide attempt, autoaggression, suicidology, pre-nosology, domestic drunkenness
Zotov P.B., Skryabin E.G., Kalashnikov A.A., Akselrov M.A., Kicherova O.A., Ponomareva M.N., Bukhna A.G., Prilensky А.B., Yudina S.S. Self-cuts of dead by suicide: main and associated characteristics. Suicidology. 2022; 13 (4): 58-79. doi.org/10.32878/suiciderus.22-13-04(49)-58-79 (In Russ / Engl)
The article presents post mortem analysis of self-cuts made by 271 people who died from suicide (235 men and 36 women aged 11 to 91, M : F ratio – 6.5 : 1). It is shown that acute wounds and traces of self- cutting, with the exception of fatal stab wounds as the main method of suicide, are recorded in 9.9% of the dead, with a minimal difference in men and women – 9.8% and 11.1% respectively. In 5.5%, these are acute wounds as an additional traumatic element inflicted during the implementation of a suicidal act, in 4.4% there are scars from previous self-harm. These groups are clearly separated, the combination of acute wounds and scars occurs only in isolated cases, which indicates two different behavioral algorithms. The main area of damage is the forearms (100%), the abdomen, lower limbs, chest and neck are much less often damaged. In most cases (88.9%), wounds and scars are multiple in nature; every second (51.9%) of the deceased has them located on both sides of the body. Alcohol in the blood is detected in 55.6% of suicide attempters with traces of self-harm, slightly higher than in the group of persons without additional wounds (46.3%), which will allow it to be considered as a universal and common risk factor for both groups. Most people with acute and cicatricial wounds choose another way to commit suicide, different from self-inflicted stab wounds, but with a high degree of lethality. The authors conclude that the data obtained during the study indicate an important practical conclusion – a more careful examination of patients by a doctor of any specialty, active identification of traces of self-harm, suicidal behavior and the study of suicidal anamnesis are significant elements of suicide prevention as they allow to identify a risk group and refer the person to a mental health professional in a timely manner. The proposed direction of research allows to obtain significant data for clinical suicidology, forensic medicine, forensic science and other disciplines, which indicates the importance of continuing work.
Keywords: suicide, self-cutting, self-harm, wounds
Kozlov V.A., Golenkov A.V., Ivanova D.A., Bachman E.K. Suicides in the Chuvash Republic (according to electronic media in 2002-2021). Suicidology. 2022; 13 (4): 80-90. doi.org/10.32878/suiciderus.22-13-04(49)- 80-90 (In Russ)
The aim of the study: to study the structure, dynamics and motives of completed suicides in Chuvashia from 2002 to 2021. Materials and methods. In the electronic media of the Chuvash Republic for 20 years (2002-2021) it was possible to collect information on 409 cases (men – 281, women – 128) of suicides (from 2 to 54 cases per year) committed by persons aged 11 to 93 years old (mean age 35.8±16.9 years). For each case of suicide, demographic indicators (gender, age), the presence of mental disorders, alcohol use, probable causes (motives) were written out. Results. The majority (78.2%) of suicides were of working age (18-59 years of age). Hanging was the most common way of voluntary death (54.5%), which was more common in men (59.4% vs 43.8% in women), especially in the group of 18-59 years old. This was followed by jumping (falling) from a height (30.6%); here, among suicides, women were already in the lead (43.8% vs 24.6% for men). The other methods of suicide accounted for about 15% in total. At the same time, there were cases of death with the help of firearms, which were resorted to only by men (7.5%). Of the causes of suicide, conflicts in interpersonal relationships were in the lead (28.3%). Particularly significant was the break in relations with the opposite sex for girls, as a result of which they committed suicide (41.1% vs 18.2% for men). In almost half of the cases (48.2%), the motives for leaving life could not be established. In men, suicide was more often caused by various administrative punishments (7.4%), and in women, it was the behavior of others leading them to commit suicide (6.3% vs 1.8% in men). Mental disorders in suicides occurred in isolated cases (2%), intoxication - somewhat more often (13%). Hanging in the last decade was mentioned much less often in journalistic reports (64.4% vs 45.6% in 2012-2021), and jumping from a height more than twice as often (40.9% vs 19.1%). Conclusion. Over the past 20 years, the age of suicides has decreased, the structure of suicide methods and their causes have changed somewhat. More research is needed to develop effective suicide prevention programs in the republic.
Keywords: suicide, demography, causes, Chuvashia (Cheboksary)
Lyubov E.B., Zotov P.B. "Suicidal disease" as psychiatric diagnosis: scientific and practical rationale. Suicidology. 2022; 13 (4): 91-112. doi.org/10.32878/suiciderus.22-13-04(49)-91-112 (In Russ / Engl)
Suicidal behavior (SB) is a constantly relevant multidisciplinary and interdepartmental problem. SB disorder (Suicide behavior disorder, hereinafter SBD) is introduced into the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) "conditionally": for further study and possible adoption in new versions of the classification of mental disorders. The review provides evidence for the validity of SBD and discusses the potential benefits and limitations of the diagnosis, with some significant limitations; possible alternative additions will increase the scientific and practical significance of SBD in future diagnostic systems.
Keywords: suicidal behavior, DSM-5, criteria, scientific rationale