Methods used in suicide attempts are mostly 'non-violent'. In the WHO Multicentre Study 64 per cent of males and 80 per cent of females used self-poisoning. Cutting, mostly wrist cutting, was employed in 17 per cent of male cases and 9 per cent of female cases. There are some differences between European countries in the use of particular methods. In Szeged (Hungary) for example, 19 per cent of males and 15 per cent of females used poisoning with pesticides, herbicides, or other toxic agricultural chemicals. In Sor-Trondelag, Norway, higher percentages attempted suicide by deliberate alcohol overdose (6 per cent of males, and 5 per cent of females). In general, somewhat older men used the method of jumping or jumping in front of a moving object. In the Oxford studies between 1985 and 1995, 88 per cent of all episodes involved self-poisoning, 8 per cent involved self-injury, and 4 per cent involved both. There was an increase in the use of paracetamol from 31 per cent of poisoning cases in 1985 to 50 per cent in 1995.(6) There was also an increase in antidepressant overdoses, and a decrease in overdoses of minor tranquillizers and sedatives. The differences in methods between countries may be related to differences in the accessibility of certain methods. Until recently, paracetamol was available in large quantities in the United Kingdom, unlike other European countries. (26) The ingestion of alcohol during or before the act sometimes can be considered to be a part of the actual method of attempted suicide (when used to bring about unconsciousness, or to increase the risk of a fatal outcome), as part of the preparation (to lower the treshold for engaging in an attempt because of disinhibition), or as a long-term risk factor. Hawton et al. (2,28) found that 22 to 26 per cent of attempted suicide patients had consumed alcohol at the time of the attempt (males more frequent than females), and that 44 to 50 per cent had consumed alcohol during the 6 h before the episodes, this again being more common in males than in females. About 28 per cent of attempted suicide patients in Oxford could be labelled substance misusers (alcohol and drugs).

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