[Attempted suicide by firearms: a retrospective study of 161 cases].

OBJECTIVES To determine the specific clinical aspects of patients with suicidal behaviour by firearm and investigate the specificities of the suicide method. BACKGROUND Suicidal behaviour represents a major public health problem throughout the world. Attempted suicide and completed suicide by firearms rates are very high both in Europe and in the United States. Preventive aspects presently preoccupy the physicians and the politicians. However, methods of suicide are understudied in Europe for the benefit of psychopathological and epidemiological aspects of suicide. Only a minority of studies enquire into the clinical aspects according to the method of suicide. Nevertheless, most of the international studies have already demonstrated the efficacy of reducing the accessibility of weapons. METHODS A retrospective study including suicide attempters by firearm hospitalized in the general hospital of Poitiers between 1992 and 2005. RESULTS We included 161 patients with self-inflicted gunshot wounds, among which 88% of patients were males. Most of them did not live alone and had children. Some of them had a past history of attempted suicide, some of them using a violent method. The acting out has mostly been committed at home and the firearm used was frequently a hunting gun. Interpersonal conflicts have been mostly reported by the patient with self-inflicted gunshot wounds. The prevalence of alcoholic behaviour and major depression is very important. Personality disorders are overrepresented in the study, notably paranoiac and borderline disorders. DISCUSSION Our sample is one of the largest compared to the other studies that often did not exceed 30 patients. Some results are contrary to those of populations of suicide attempters, whereas there are some similarities within the completed suicide population. Finally, paranoiac personality disorder is significantly associated with suicidal behaviour by firearm. CONCLUSIONS Some clinical characteristics have been reported as far as suicide attempters by firearm are concerned. Actually, there are some significant differences between suicide attempters by firearm and other suicide attempters. These results are very important for the perspective of preventing suicidal behaviour. However, it is essential to continue studies on the clinical aspects according to the method used in attempted and completed suicide.