Gender differences in deliberate self-poisoning in Hungary: analyzing the effect of precipitating factors and their relation to depression.
BACKGROUND
The suicide rate in Hungary is one of the highest in the European Union, with a male-female ratio of 3.55:1. Suicide rates correlate positively with suicide attempts, for which depression is the most frequent underlying disorder.


OBJECTIVE
The aim of this qualitative study was to examine gender differences in suicide attempts, with a focus on the effect of precipitating factors on depression.


METHODS
Semistructured interviews were conducted among 150 suicide attempters. Data on circumstances, reason, and method of attempt were recorded. Patients completed the Shortened Beck Depression Inventory, the Beck Hopelessness Scale, the Sense of Coherence Scale, and the Social Support Questionnaire.


RESULTS
Interpersonal conflict was found to be the most frequent precipitating factor. There were significant gender differences in depressive symptoms among patients with interpersonal conflicts. We found differences in depressive symptoms according to presence or absence of interpersonal conflicts among men, but not among women. Male suicide attempters who indicated interpersonal conflicts had lower levels of depression.


CONCLUSIONS
Depressive symptoms are frequent among suicide attempters. However, a subgroup of male attempters reporting interpersonal conflicts are characterized by a lower level of depression. This subgroup of attempters would probably not be detected with depression screening programs and may have an unmet need for other forms of screening and prevention.
<location>Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary</location>
Mónika Ditta
MD
Tóth
<location>Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary</location>
Szilvia
S
Ádám
<location>Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary</location>
Emma
E
Birkás
<location>Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary</location>
András
A
Székely
<location>Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary</location>
Adrienne
A
Stauder
<location>Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary</location>
György
G
Purebl
D000328:Adult; D003863:Depression / Q000150:complications* / Q000523:psychology; D005260:Female; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D007398:Interpersonal Relations; D007407:Interviews as Topic; D008297:Male; D011569:Psychiatric Status Rating Scales; D036301:Qualitative Research; D012307:Risk Factors; D060685:Sense of Coherence; D012737:Sex Factors; D012944:Social Support; D013406:Suicide, Attempted / Q000523:psychology*
deliberate self-poisoning; depression; gender differences; interpersonal conflict