Suicide Attempt

Mulki H
13.122

 Secara umum, bunuh diri berasal dari

bahasa Latin suicidium, dengan sui
yang berarti sendiri dan cidium yang
berarti pembunuhan .
Schneidman mendefinisikan bunuh diri
sebagai sebuah perilaku pemusnahan
secara sadar yang ditujukan pada diri
sendiri oleh seorang individu yang
memandang bunuh diri sebagai solusi
terbaik dari sebuah isu.

 Menurut Maris, Berman, Silverman, dan Bongar

(2000), bunuh diri memiliki 4 pengertian, antara lain:
1. Bunuh diri adalah membunuh diri sendiri secara
intensional
2. Bunuh diri dilakukan dengan intensi
3. Bunuh diri dilakukan oleh diri sendiri kepada diri
sendiri
4. Bunuh diri bisa terjadi secara tidak langsung (aktif)
atau tidak langsung (pasif), misalnya dengan tidak
meminum obat yang menentukan kelangsungan hidup
atau secara sengaja berada di rel kereta api.

 Richman percaya bahwa metode memiliki makna

khusus atau simbolisasi dari individu.
Secara umum, metode bunuh diri terdiri dari 6
kategori utama yaitu:
1. obat (memakan padatan, cairan, gas, atau uap)
2. menggantung diri (mencekik dan menyesakkan
nafas)
3. senjata api dan peledak
4. menenggelamkan diri
5. melompat
6. memotong (menyayat dan menusuk)

 Berdasarkan hubungan tersebut, Durkheim (dalam

Corr, Nabe, & Corr, 2003) membagi bunuh diri menjadi
4 tipe yaitu:
1. Egoistic Suicide
Inidividu yang bunuh diri di sini adalah individu yang
terisolasi dengan masyarakatnya, dimana individu
mengalami underinvolvement dan underintegration.
Individu menemukan bahwa sumber daya yang
dimilikinya tidak cukup untuk memenuhi kebutuhan,
dia lebih beresiko melakukan perilaku bunuh diri.
2. Altruistic Suicide
Individu di sini mengalami overinvolvement dan
overintegration. Pada situasi demikian, hubungan
yang menciptakan kesatuan antara individu dengan
masyarakatnya begitu kuat sehingga mengakibatkan
bunuh diri yang dilakukan demi kelompok. Identitas
personal didapatkan dari identifikasi dengan
kesejahteraan kelompok, dan individu menemukan
makna hidupnya dari luar dirinya. Pada masyarakat

3. Anomic Suicide
Bunuh diri ini didasarkan pada bagaimana masyarakat
mengatur anggotanya. Masyarakat membantu individu
mengatur hasratnya (misalnya hasrat terhadap materi,
aktivitas seksual, dll.). Ketika masyarakat gagal
membantu mengatur individu karena perubahan yang
radikal, kondisi anomie (tanpa hukum atau norma) akan
terbentuk. Individu yang tiba-tiba masuk dalam situasi ini
dan mempersepsikannya sebagai kekacauan dan tidak
dapat ditolerir cenderung akan melakukan bunuh diri.
Misalnya remaja yang tidak mengharapkan akan ditolak
oleh kelompok teman sebayanya.
4. Fatalistic Suicide
Tipe bunuh diri ini merupakan kebalikan dari anomic
suicide, dimana individu mendapat pengaturan yang
berlebihan dari masayarakat. Misalnya ketika seseorang
dipenjara atau menjadi budak.

Persons who attempt suicide also pose a major health

problem.
In the United Kingdom, there are 100,000 hospital
admissions each year because of deliberate selfpoisoning (2.5 percent of all admissions).
In England and Wales, self-poisoning is the most
common diagnosis of admitted patients under 50 years
of age; among women it is the most common reason for
emergency medical admission whereas among men it is
second only to heart attacks.
Attempted suicide is in many ways an unsatisfactory
term. For example, most
attempters do not actually wish to commit suicide; their
motives are different.

epidemiology
A review of the world literature showed that attempted suicide rates
varied between
100 and 300 per 100,000;
that there was a preponderance of females in all countries;
that about 50 percent of attempters were under 30 years of age; there
was
an excess of divorced persons;
the lower social classes were overrepresented; and
that a diagnosis of depression was made in between 35 to 79 percent of
cases.

Females aged 15 to 19 years have the highest rate of suicide

attempts.
Up to 1 in 100 in this group may be expected to attempt suicide each
year.
The highest rate for males is found among those aged 25 to 29,
of whom 1 in 200 attempts suicide eachyear.

Acute Problems
The circumstances surrounding a suicide
attempt invariably involve
recent life change,
particularly interpersonal stress.

Suicide attempters report five particular events

significantly more frequently than controls:
serious arguments with the spouse,
having a new person in the home,
serious illness of a family member,
serious personal physical illness, and
having to appear as a defendant in court.

Chronic problem
Persons who attempt suicide also tend to have
chronic problems with
marriage,
children,
work,
finances,
health, or
alcohol.

The Oxford group found that two thirds of married

attempters had chronic marital problems and one
half had been involved in a recent extramarital
affair. One fourth of patients had problems with
their children; parents who neglect or abuse their
children are particularly likely to attempt suicide.

 Among adolescents who attempt suicide,

three quarters report difficulties with
one or both parents,
one half report problems with their school work
or teachers, and
One half report difficulties with a boyfriend or
girlfriend;
others have work problems or
experience social isolation.

Psychiatric Disorders
Hospital studies show that about 40 percent
of those who attempt suicide have a history
of psychiatric treatment.
Psychiatric assessments
reveal that about 50 percent have a personality
disorder,
up to 40 percent have other psychiatric disorders.
The most common diagnoses that are not
personality disorders are depressive
disorders (up to 40 percent of women and 30
percent of men).

Risk of Repetition
About 40 percent of attempters have made a previous
attempt.
Follow-up studies show that between 13 and 35 percent
will repeat the attempt
during the next 2 years.
During this time up to 7 percent will make two or more
attempts, 2.5 percent three or more attempts, and 1
percent, five or more attempts.
Thus, there appear to be three subgroups of repeaters: the
very occasional repeater,
the person who repeats several times within a short
period, and the chronic on
habitual repeater.

7 items

There are seven main items that may

be helpful in identifying the patient at
risk of
making another suicide attempt:
problems with alcohol,
antisocial personality disorder,
impulsivity,
previous inpatient psychiatric treatment,
previous outpatient psychiatric treatment,
previous attempt that led to admission, and
living alone.

reference
Kaplan & Sadock's Comprehensive
Textbook of Psychiatry 7th ed Benjamin J. Sadock

Motivations, Explanations, and

Consequences
Two thirds of such persons report that they had
thought about the act for less than an hour
beforehand.
There is often a discrepancy between the
motivations for the attempt as perceived by the
medical staff and the explanations given by the
patient.
In one study, over one third of patients stated
that they wanted to die, but their psychiatrists
agreed with this in only 50 percent of cases.
The most common reason, given by up to 40
percent of both patients and their psychiatrists,
was that the suicide attempt was made to get
relief from a terrible state of mind.