Main Article Content
suicide, suicidal behaviour, prevention, public health, meaning in life, protective factors
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”.
2. WHO. Preventing Suicide: A global Imperative. World Health Organization: Geneva Switzerland, 2014.
3. WHO Mental Health. Prevention of Suicidal Behaviours: A task for All. World Health Organization: Geneva Switzerland, 2017. Available online: http://www.who.int/mental_health/prevention/suicide/background.
4. Odone A, Landriscina T, Amerio A, Costa G. The impact of the current economic crisis on mental health in Italy: evidence from two representative national surveys. European Journal of Public Health 2018;28(3):490-495.
5. Gunnel D. A Population Health Perspective on Suicide Research and Prevention. What we know, what we need to know, and policy priorities. Crisis 2015; 36: 155–160.
6. Wang MC, Lightsey OR Jr, Pietruszka T, Uruk AC, Wells AG. Purpose in life and reasons for living as mediators of the relationship between stress, coping, and suicidal behavior. J Posit Psychol 2007; 2: 195–204.
7. Frankl VE. Man’s Search for Meaning. From Death Camp to Existentialism. 1st ed. Beacon Press: New York, NY, USA, 1959.
8. Frankl VE, Crumbaugh JC, Gerz HO, Maholick LT. Psychotherapy and Existentialism: Selected Papers on Logotherapy. Simon and Schuster: New York, NY, USA: 1967.
9. Frankl VE. The will to meaning: Foundations and applications of logotherapy. New American Library: New York, NY, USA, 1988.
10. Costanza A, Prelati M, Pompili M. The meaning in life in suicidal patients: The presence and the search for constructs. A systematic review. 2019; 55: 465.
11. Baertschi M, Costanza A, Richard-Lepouriel H, et al. The application of the interpersonal-psychological theory of suicide to a sample of Swiss patients attending a psychiatric emergency department for a non-lethal suicidal event. J Affect Disord 2017; 210: 323–331.
12. Baertschi M, Costanza A, Canuto A, Weber K. The function of personality in suicidal ideation from the perspective of the interpersonal-psychological theory of suicide. Int J Environ Res Public Health 2015; 15 :636.
13. Baertschi M, Costanza A, Canuto A, Weber K. The dimensionality of suicidal ideation and its clinical implications. Int J Methods Psychiatr Res 2019; 28: e1755.
14. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006; 3: 77–101.
15. Boyatzis RE. Transforming qualitative information: Thematic analysis and code development. Sage Publications: Inc, Thousand Oaks, CA, USA, 1988.
16. Attride-Stirling J. Thematic networks: an analytic tool for qualitative research. Qual Res 2001; 1: 385-405.
17. Smith JA, Osborn M. Interpretative Phenomenological Analysis. In JA. Smith (Ed.), Qualitative Psychology: A Practical Guide to Methods. Sage Publications Ltd, London, UK, 2003, p. 51–80.
18. Smith JA, Flowers P, Larkin M. Interpretative Phenomenological Analysis: Theory, Method and Research. Sage Publications Ltd, London, UK, 2009.
19. Holloway I, Todres L. The status of the method: flexibility, consistency and coherence. Qual Res 2003; 3: 345–57.
20. Sheehan DV, Lecrubier Y, Sheehan KH, et al. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 1998;59: 22–3.
21. Goldsmith SK, Pellmar TC, Kleinman AM, Bunney WE. Reducing suicide: A national imperative. National Academies Press, Washington (DC), US, 2002.
22. Qin P, Mortensen PB. The impact of parental status on the risk of completed suicide. Arch Gen Psychiatry 2003; 60: 797–802.
23. Kyung-Sook W, SangSoo S, Sangjin S, Young-Jeon S. Marital status integration and suicide: A meta-analysis and meta-regression. Soc Sci Med 2018; 197: 116–26.
24. Dong X, Chang ES, Zeng P, Simon MA. Suicide in the global chinese aging population: a review of risk and protective factors, consequences, and interventions. Aging Dis 2015; 6: 121-30.
25. Kleiman EM, Liu RT. Social support as a protective factor in suicide: findings from two nationally representative samples. J Affect Disord 2013; 150: 540–5.
26. Daniel SS, Goldston DB. Hopelessness and lack of connectedness to others as risk factors for suicidal behavior across the lifespan. Cogn Behav Pract 2012; 19: 288–300.
27. Van Orden, KA, Bamonti PM, King DA, Duberstein PR. Does perceived burdensomeness erode meaning in life among older adults? Aging Ment Health, 2012; 16: 855-60.
28. Van Orden KA, Wiktorsson S, Duberstein P, Berg AI, Fässberg MM, Waern M. Reasons for attempted suicide in later life. Am J Geriatr Psychiatry 2015; 23: 536-44
29. Stillman TF, Baumeister RF, Lambert NM, Crescioni AW, DeWall CN, Fincham F D. Alone and without purpose: Life loses meaning following social exclusion. J Exp Soc Psychol 2009; 45: 686–94.
30. Holm AL, Lyberg A, Berggren I, Aström S, Severinsson E. Going around in a Circle: A Norwegian Study of Suicidal Experiences in Old Age. Nurs Res Pract 2014; 734635.
31. Chang SS, Stuckler D, Yip P, Gunnell D. Impact of 2008 global economic crisis on suicide: time trend study in 54 countries. BMJ 2013; 347: f5239.
32. Mann JJ, Metts AV. The economy and suicide. Crisis 2017; 38: 141–6.
33. Stack S, Lester D. The effect of religion on suicide ideation. Soc Psychiatry Psychiatr Epidemiol 1991; 26: 168–70.
34. Rasic DT, Belik SL, Elias B, et al. Spirituality, religion and suicidal behavior in a nationally representative sample. J Affect Disord 2009; 114: 32–40.
35. Lawrence RE, Oquendo MA, Stanley B. Religion and suicide risk: a systematic review. Arch Suicide Res 2016; 20: 1–21.
36. Potter LB. Powel, KE, Kachur SP. Suicide Prevention from a Public Health Perspective. Suicide Life Threat Behav 1995, 25: 82–91.
37. Camus A. Le mythe de Sisyphe (Vol. 179). Gallimard coll: Paris, France, 1942.