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      Suicide prevention from a public health perspective. What makes life meaningful? The opinion of some suicidal patients

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          Abstract

          Background and aim of the work:

          Suicide is a worldwide phenomenon, with a relevant number of victims. Moreover, repercussions of suicidality-across its entire spectrum-involve not only the individual but also survivors and communities, in a profound and lasting way. As such, suicidality represents a crucial public mental health concern, in which risk/protection factors’ study represent a key issue. However, research primarily focused on suicidality risk factors. This study, moving from Frankl’s first observations on “Meaning in Life” (MiL) as protective against suicidality, aimed to identify the main themes that suicidal patients identified as MiL carriers, or potential carriers, in their existences.

          Methods:

          Qualitative study on 144 patients admitted to the Geneva University Hospital’s emergency department for suicidal ideation (SI) and suicide attempt (SA).

          Results:

          Interpersonal/affective relationships constituted the main theme (71.53%), with emphasis on family (39.80%), children/grandchildren (36.89%). Profession/education, intellectual/non-intellectual pleasures, and transcendental dimension also emerged.

          Conclusions:

          These aspects could be considered among a public health agenda’s points for suicide prevention programs taking into account also protective factors promotion/support, including community’s mental health resources. Reconnecting to introduction’s historical part, our findings are consistent with Frankl’s observations. Even if exposed to “absurd” and reluctant to deliberate on this, he seems approach Camus conceptualization who, confronted to the necessity of predictable and conform to recognizable personal patterns transcending chaos for a sense-giving perspective, invited to imagine that a meaning, even a “non-absolute meaning”, may lie in apparent smallest things and that Sisyphus can have “the possibility to revolt by trying to be happy”.

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          Most cited references37

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          Thematic networks: an analytic tool for qualitative research

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            Impact of 2008 global economic crisis on suicide: time trend study in 54 countries

            Objective To investigate the impact of the 2008 global economic crisis on international trends in suicide and to identify sex/age groups and countries most affected. Design Time trend analysis comparing the actual number of suicides in 2009 with the number that would be expected based on trends before the crisis (2000-07). Setting Suicide data from 54 countries; for 53 data were available in the World Health Organization mortality database and for one (the United States) data came the CDC online database. Population People aged 15 or above. Main outcome measures Suicide rate and number of excess suicides in 2009. Results There were an estimated 4884 (95% confidence interval 3907 to 5860) excess suicides in 2009 compared with the number expected based on previous trends (2000-07). The increases in suicide mainly occurred in men in the 27 European and 18 American countries; the suicide rates were 4.2% (3.4% to 5.1%) and 6.4% (5.4% to 7.5%) higher, respectively, in 2009 than expected if earlier trends had continued. For women, there was no change in European countries and the increase in the Americas was smaller than in men (2.3%). Rises in European men were highest in those aged 15-24 (11.7%), while in American countries men aged 45-64 showed the largest increase (5.2%). Rises in national suicide rates in men seemed to be associated with the magnitude of increases in unemployment, particularly in countries with low levels of unemployment before the crisis (Spearman’s rs =0.48). Conclusions After the 2008 economic crisis, rates of suicide increased in the European and American countries studied, particularly in men and in countries with higher levels of job loss.
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              Alone and Without Purpose: Life Loses Meaning Following Social Exclusion.

              Four studies (N = 643) supported the hypothesis that social exclusion would reduce the global perception of life as meaningful. Social exclusion was manipulated experimentally by having a confederate refuse to meet participants after seeing their videotaped introduction (Study 1) and by ostracizing participants in a computerized ball-tossing game (Study 2). Compared to control condition and acceptance conditions, social exclusion led to perceiving life as less meaningful. Exclusion was also operationalized as self-reported loneliness, which was a better predictor of low meaning than other potent variables (Study 3). Study 4 found support for Baumeister's model of meaning (1991), by demonstrating that the effect of exclusion on meaning was mediated by purpose, value, and positive self-worth.
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                Author and article information

                Journal
                Acta Biomed
                Acta Biomed
                Acta Bio Medica : Atenei Parmensis
                Mattioli 1885 (Italy )
                0392-4203
                2531-6745
                2020
                10 April 2020
                : 91
                : Suppl 3
                : 128-134
                Affiliations
                [1 ] Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland
                [2 ] Department of Psychiatry, ASO Santi Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
                [3 ] Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
                [4 ] IRCCS Ospedale Policlinico San Martino, Genoa, Italy
                [5 ] Mood Disorders Program, Tufts Medical Center, Boston, MA, USA
                [6 ] Vita-Salute San Raffaele University, Milan, Italy
                [7 ] Service of General Psychiatry and Psychotherapy, Nant Foundation, Montreux, Switzerland
                [8 ] Service of Psychiatric Specialties, Department of Psychiatry, University Hospitals of Geneva, Geneva, Switzerland
                [9 ] Division of Institutional Measures, Medical Direction, University Hospitals of Geneva, Geneva, Switzerland
                [10 ] Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Italy.
                Author notes
                Correspondence: Andrea Amerio Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, IRCCS San Martino, Largo Rosanna Benzi 10, 16100 Genova, Italy. Phone:+39 0103537668 Fax: +39 0103537669 E-mail: andrea.amerio@unige.it
                Article
                ACTA-91-128
                10.23750/abm.v91i3-S.9417
                7975898
                32275277
                2348eb87-5897-45bf-adb8-059e39b22fc2
                Copyright: © 2020 ACTA BIO MEDICA SOCIETY OF MEDICINE AND NATURAL SCIENCES OF PARMA

                This work is licensed under a Creative Commons Attribution 4.0 International License

                History
                : 15 February 2020
                : 15 March 2020
                Categories
                Original Article

                suicide,suicidality,prevention,public health,meaning in life,protective factors

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