Psychosocial Profiles of Patients Who Attempted Suicide: A Qualitative Analysis Based on Psychiatric Consultation Records

Abstract

Objective: The aim of this study was to qualitatively evaluate the psychosocial characteristics, triggering factors, and help-seeking behaviors of individuals who attempted suicide and to identify patterns that could inform clinical interventions. Method: The sample of our study, which was designed as a retrospective thematic qualitative analysis, consists of 20 people with suicide attempt or suicidal ideation. The past records of all patients admitted to the university hospital who had attempted suicide or reported suicidal ideation were analyzed. Structured consultation records in the hospital electronic system were used in the analyses. Sociodemographic information, attempt triggers, method of attempt, psychiatric history and mental examination findings were analysed and manually coded according to Braun and Clarke's thematic analysis steps. Results: Four main themes were identified: (1) triggering after interpersonal conflict, (2) accumulated stress and helplessness, (3) planned attempts and impulsive attempts, and (4) help seeking behaviour. Suicide attempts usually developed impulsively after sudden conflicts and regret and help-seeking behaviour were frequently observed. In a small number of individuals, attempts were planned, related to chronic family/economic problems and more determined. In older individuals, themes of loneliness, worthlessness and being a burden were prominent. Some patients described the suicide attempt as a ‘final exit’ or ‘honourable withdrawal’. Conclusion: Suicide attempts occur with different triggers and emotional dynamics from person to person. Therefore, sociodemographic characteristics and the presence of mental illness should be taken into account in clinical assessment and interventions; especially social support, crisis management and referral to psychiatric treatment should be individualised.

Keywords

• Suicide attempt
• qualitative research
• thematic analysis
• psychiatric assessment
• age groups

İntihar Girişiminde Bulunan Hastaların Psikososyal Profilleri: Psikiyatri Konsültasyon Kayıtlarına Dayalı Nitel Bir İnceleme

Öz

Amaç: Bu çalışmanın amacı, intihar girişiminde bulunan bireylerin psikososyal özelliklerini, tetikleyici etmenlerini ve yardım arama davranışlarını nitel yöntemle değerlendirmek ve klinik müdahale süreçlerine katkı sunabilecek örüntüleri ortaya koymaktır. Yöntem: Geçmişe dönük tematik nitel analiz olarak tasarlanan çalışmamızın örneklemi intihar girişimi ya da düşüncesi ile başvurmuş olan 20 kişiden oluşmaktadır. Üniversite hastanesine başvuran intihar girişiminde bulunmuş veya düşüncesini bildirmiş tüm hastaların geçmiş kayıtları ele alınmıştır. Hastane elektronik sistemindeki yapılandırılmış konsültasyon kayıtları analizlerde kullanılmıştır. Sosyodemografik bilgiler, girişim tetikleyicileri, girişim yöntemi, psikiyatrik öyküler ve ruhsal muayene bulguları analiz edilmiş Braun ve Clarke’ın tematik analiz adımlarına göre elle kodlanmıştır. Bulgular: Dört ana tema saptanmıştır: (1) kişilerarası çatışma sonrası tetiklenme, (2) birikmiş stres ve çaresizlik, (3) planlı girişimler ve dürtüsel girişimler (4) yardım arayışı. İntihar girişimi genellikle ani çatışmalar sonrası dürtüsel olarak gelişmiş, pişmanlık ve yardım arama davranışı sık gözlenmiştir. Az sayıda kişide ise girişimler planlı, kronik ailevi/ekonomik sıkıntılara bağlı ve daha kararlı nitelikte gerçekleşmiştir. İleri yaştaki bireylerde ise yalnızlık, değersizlik ve yük olma temaları belirgindir. Bazı hastalar intihar girişimini “son çıkış” veya “onurlu geri çekilme” olarak tanımlamıştır. Sonuç: İntihar girişimlerinin kişiden kişiye farklı tetikleyici ve duygusal dinamiklerle ortaya çıktığı görülmüştür. Bu nedenle klinik değerlendirme ve müdahalelerde sosyodemografik özellikler ve ruhsal hastalık varlığı dikkate alınmalı; özellikle sosyal destek, kriz yönetimi ve psikiyatrik tedaviye yönlendirme bireyselleştirilmelidir.

Anahtar Kelimeler

• İntihar girişimi
• nitel araştırma
• tematik analiz
• psikiyatrik değerlendirme
• yaş grupları

Kaynakça

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