45 Other scientists: J. R. Kaplan, S. B. Manuck, M. Fontenot, M. F. Muldoon, C. A. Shively, and J. J. Mann, “The Cholesterol-Serotonin Hypothesis: Interrelationships Among Dietary Lipids, Central Serotonergic Activity, and Social Behavior in Monkeys,” in M. Hillbrand and R. T. Spitz, eds., Lipids, Health, and Behavior (Washington, D.C.: American Psychological Association, 1997), pp. 139–165; J. R. Kaplan, M. F. Muldoon, S. B. Manuck, and J. J. Mann, “Assessing the Observed Relationship Between Low Cholesterol and Violence-Related Mortality,” Annals of the New York Academy of Sciences, 836 (1997): 57–80.
46 important lipid players: M. E. Virkkunen, D. F. Horrobin, D. K. Jenkins, and M. S. Manku, “Plasma Phospholipids, Essential Fatty Acids and Prostaglandins in Alcoholic, Habitually Violent and Impulsive Offenders,” Biological Psychiatry, 22 (1987): 1087–1096; T. Hirayama, Life-Style and Mortality (Basel: Karger, 1990); J. R. Hibbeln and N. Salem, “Dietary Polyunsaturated Fatty Acids and Depression: When Cholesterol Does Not Satisfy,” American Journal of Clinical Nutrition, 62 (1995): 1–9; J. R. Hibbeln, M. Linnoila, J. C. Umhau, R. Rawlings, D. T. George, and N. Salem, “Essential Fatty Acids Predict Metabolites of Serotonin and Dopamine in Cerebrospinal Fluid Among Healthy Control Subjects and Early- and Late-Onset Alcoholics,” Biological Psychiatry, 44 (1998): 235–242; J. R. Hibbeln, J. C. Umhau, M. Linnoila, D. T. George, P. R. Ragan, S. E. Shoaf, M. R. Vaughan, R. Rawlings, and N. Salem, “A Replication Study of Violent and Nonviolent Subjects: Cerebrospinal Fluid Metabolites of Serotonin and Dopamine Are Predicted by Plasma Essential Fatty Acids,” Biological Psychiatry, 44 (1998): 243–249; D. Horrobin and C. N. Bennett, “New Gene Targets Related to Schizophrenia and Other Psychiatric Disorders: Enzymes, Binding Proteins and Transport Proteins Involved in Phospholipid and Fatty Acid Metabolism,” Prostaglandins, Leukotrienes and Essential Fatty Acids, 60 (1999): 141–167.
47 Societies that consume: J. R. Hibbeln, “Fish Consumption and Major Depression,” Lancet, 351 (1998): 1213.
48 Paleolithic and modern: B. S. Eaton and M. Konner, “Paleolithic Nutrition: A Consideration of Its Nature and Current Implications,” New England Journal of Medicine, 312 (1985): 283–289.
49 fatty acid metabolism and schizophrenia: D. F. Horrobin, “The Membrane Phospholipid Hypothesis as a Biochemical Basis for the Neurodevelopmental Concept of Schizophrenia,” Schizophrenia Research, 30 (1998): 193–208.
50 Australian aborigines: S. J. Pyne, World Fire: The Culture of Fire on Earth (Seattle: University of Washington Press, 1995), p. 31.
51 “Suicide, I suspect”: J. Conrad, Chance: A Tale in Two Parts (Garden City, N.Y.: Doubleday, Page & Company, 1926), p. 183.
52 John Mann: J. J. Mann, C. Waternaux, G. L. Haas, and K. M. Malone, “Toward a Clinical Model of Suicidal Behavior in Psychiatric Patients,” American Journal of Psychiatry, 156 (1999): 181–189.
53 “the attacks of manic-depressive insanity”: E. Kraepelin, Manic-Depressive Insanity and Paranoia, trans. R. M. Barclay, ed. G. M. Robertson (New York: Arno Press, 1976; first published, 1921), p. 181.
54 Suicide, we know, is rare: D. Shaffer, “Suicide in Childhood and Early Adolescence,” Journal of Child Psychology and Psychiatry, 15 (1974): 275–291; D. Shaffer and P. Fisher, “The Epidemiology of Suicide in Children and Young Adolescents,” Journal of the American Academy of Child Psychiatry, 20 (1981): 545–565; C. R. Pfeffer, R. Plutchik, M. S. Mizruchi, and R. Lipkins, “Suicidal Behavior in Child Psychiatric Inpatients and Outpatients and in Nonpatients,” American Journal of Psychiatry, 143 (1986): 733–738; H. M. Hoberman and B. D. Garfinkel, “Completed Suicide in Youth,” Canadian Journal of Psychiatry, 33 (1988): 494–504; R. Harrington, H. Rudge, M. Rutter, A. Pickles, and J. Hill, “Adult Outcomes of Childhood and Adolescent Depression,” Archives of General Psychiatry, 47 (1990): 465–473; M. Kovacs, D. Goldston, and C. Gatsonis, “Suicidal Behaviors and Childhood-Onset Depressive Disorders: A Longitudinal Investigation,” Journal of the American Academy of Child and Adolescent Psychiatry, 32 (1993): 8–20; U. Rao, M. M. Weissman, J. A. Martin, and R. W. Hammond, “Childhood Depression and Risk of Suicide: A Preliminary Report of a Longitudinal Study,” Journal of the American Academy of Child and Adolescent Psychiatry, 32 (1993): 21–27; C. R. Pfeffer, S. W. Hurt, T. Kakuma, J. R. Peskin, C. A. Siefker, and S. Nagabhairava, “Suicidal Children Grow Up: Suicidal Episodes and Effects of Treatment During Follow-up,” Journal of the American Academy of Child and Adolescent Psychiatry, 33 (1994): 225–230; D. N. Klein, P. M. Lewinsohn, and J. R. Seeley, “Hypomanic Personality Traits in a Community Sample of Adolescents,” Journal of Affective Disorders, 38 (1996): 135–143. There were, however, disturbingly high rates of suicide in young children during the fifteenth through eighteenth centuries in England; see M. MacDonald and T. R. Murphy, Sleepless Souls: Suicide in Early Modern England (Oxford: Clarendon Press, 1990), pp. 248–252.
55 believe that death is reversible: M. S. McIntyre and C. A. Angle, “The Child’s Concept of Death,” paper presented at the Workshop in Methodology, Ambulatory Pediatric Society, Atlantic City, N.J., April 1970; M. W. Speece and S. B. Brent, “Children’s Understanding of Death: A Review of Three Components of a Death Concept,” Child Development, 55 (1984): 1671–1686; C. R. Pfeffer, The Suicidal Child (New York: Guilford, 1986); D. Gothelf, A. Apter, A. Brand-Gothelf, N. Offer, H. Ofek, S. Tyano, and C. R. Pfeffer, “Death Concepts in Suicidal Adolescents,” Journal of the American Academy of Child and Adolescent Psychiatry, 37 (1998): 1279–1286.
56 average age of onset: F. K. Goodwin and K. R. Jamison, Manic-Depressive Illness (New York: Oxford University Press, 1990); L. N. Robins and D. A. Regier, Psychiatric Disorders in America: The Epidemiologic Catchment Area Study (New York: Free Press, 1991).
57 Gender, as well as age: The nature and extent of gender differences in suicide rates were discussed in Chapter 2 and differences in choice of methods in Chapter 5; see also C. L. Rich, J. E. Ricketts, R. C. Fowler, and D. Young, “Some Differences Between Men and Women Who Commit Suicide,” American Journal of Psychiatry, 145 (1988): 718–722; S. S. Canetto and D. Lester, eds., Women and Suicidal Behavior (New York: Springer, 1995); S. S. Canetto, “Gender and Suicidal Behavior: Theories and Evidence,” in R. W. Maris, M. M. Silverman, and S. S. Canetto, Review of Suicidology, 1997 (New York: Guilford Press, 1997), pp. 138–167.
58 blood levels of serotonin: S. O’Reilly and M. Loncin, “Ceruloplasmin and 5-Hydroxindole Metabolism in Pregnancy,” American Journal of Obstetrics and Gynecology, 98 (1967): 8–14; M. Uluitu, L. Dusleag, D. Constantinescu, G. Petcu, G. Catrinescu, and S. Pana, “Serotonin Through Pregnancy: Comparative Researches in Different Species and in Mankind,” Physiologie, 12 (1975): 275–280.
59 lower rate of suicide: G. J. Kleiner and W. M. Greston, eds., Suicide in Pregnancy (London: John Wright, 1984); A. L. Dannenberg, D. M. Carter, H. W. Lawson, D. M. Ashton, S. F. Dorfman, and E. H. Graham, “Homicide and Other Injuries as Causes of Maternal Death in New York City, 1987 through 1991,” American Journal of Obstetrics and Gynecology, 172 (1995): 1557–1564; P. M. Marzuk, K. Tardiff, A. C. Leon, C. S. Hirsch, L. Portera, N. Hartwell, and M. Irfan Iqbal, “Lower Risk of Suicide During Pregnancy,” American Journal of Psychiatry, 154 (1997): 122–123.
60 in the year following childbirth: L. Appleby, “Suicide During Pregnancy and in the First Postnatal Year,” British Medical Journal, 302 (1991): 137–140; L. Appleby, P. B. Mortensen, and E. B. Faragher, “Suicide and Other Causes of Mortality After Post-Partum Psychiatric Admission,” British Journal of Psychiatry, 173 (1998): 209–211; L. Appleby and G. Turnbull, “Parasuicide in the First Postnatal Year,” Psychological Medicine, 173 (1998): 209–211.
61 different phases of the mentrual cycle: A. J. Mandell and M. P. Mandell, “Suicide and the Menstrual Cycle,” Journal of the American Medical Association, 200 (1967): 792–793; R. D. Wetzel, T. Reich, and J. N. McClure, “Phase of the Menstrual Cycle and Self-Referrals to a Suicide Prevention Service,” British Journal of Psychiatry, 119 (1971): 523–524; E. Baca-García
, A. Sánchez González, P. González Diaz-Corralero, I. González Garcia, and J. de Leon, “Menstrual Cycle and Profiles of Suicidal Behaviour,” Acta Psychiatrica Scandinavica, 97 (1998): 32–35.
62 A London autopsy study: P. C. B. MacKinnon and I. L. MacKinnon, “Hazards of the Menstrual Cycle,” British Medical Journal, (1956): 555.
63 Autopsies of Hindu women: A. L. Ribeiro, “Menstruation and Crime,” British Medical Journal, 1 (1962): 640.
64 low levels of estrogen: V. Fourestié, B. de Lignières, F. Roudot-Thoraval, I. Fulli-Lemaire, D. Cremniter, K. Nahoul, S. Fournier, and I.-L. Lejone, “Suicide Attempts in Hypo-Estrogenic Phases of the Menstrual Cycle,” Lancet, 2 (1986): 1357–1360.
65 more than 180,000: C. Pritchard, “A Comparison of Youth Suicide in Hong Kong, the Developed World, and the People’s Republic of China,” Hong Kong Journal of Mental Health, 22 (1993): 6–16; World Bank, World Development Report 1993: Investing in Health (New York: Oxford University Press for the World Bank, 1993); C. J. L. Murray and A. D. Lopez, The Global Burden of Disease (Cambridge, Mass.: Harvard University Press, 1996); C. Pritchard, “Suicide in the People’s Republic of China Categorized by Age and Gender: Evidence of the Influence of Culture on Suicide,” Acta Psychiatrica Scandinavica, 93 (1996): 362–367; P. Brown, “No Way Out,” New Scientist, March 22, 1997, pp. 34–37; E. Rosenthal, “Women’s Suicides Reveal Rural China’s Bitter Roots,” New York Times, January 24, 1999.
66 Most suicides occur: E. Morselli, Suicide: An Essay on Comparative Moral Statistics (London: Kegan Paul, 1881); C. P. Seager and R. A. Flood, “Suicide in Bristol,” British Journal of Psychiatry, 111 (1965): 919–932; D. R. Nalin, “Epidemic of Suicide by Malathion Poisoning in Guyana: Report of 264 Cases,” Tropical Geographical Medicine, 25 (1973): 8–14; J. R. Aston and S. Donnan, “Suicide by Burning as an Epidemic Phenomenon: An Analysis of 82 Deaths and Inquests in England and Wales in 1978–9,” Psychological Medicine, 11 (1981): 735–739; D. De Maio, F. Carpenter, and C. Riva, “Evaluation of Circadian, Circsepten and Cirannual Periodicity of Attempted Suicides,” Chronobiologia, 9 (1982): 185–193; D. W. Johnston and J. P. Waddell, “Death and Injury Patterns: Toronto Subway System,” Journal of Trauma, 24 (1984): 619–622; P. Williams and M. Tansella, “The Time for Suicide,” Acta Psychiatrica Scandinavica, 75 (1987): 532–535; R. Hanzlick, K. Masterson, and B. Walker, “Suicide by Jumping from High-Rise Hotels: Fulton County, Georgia, 1967–1986,” American Journal of Forensic Medicine and Pathology, 11 (1990): 294–297; Y. Motohashi, “Circadian Variation in Suicide Attempts in Tokyo from 1978 to 1985,” Suicide and Life-Threatening Behavior, 20 (1990): 352–361; G. Maldonado and J. F. Kraus, “Variation in Suicide Occurrence by Time of Day, Day of the Week, Month, and Lunar Phase,” Suicide and Life-Threatening Behavior, 21 (1991): 174–187; I. O’Donnell and R. D. T. Farmer, “Suicidal Acts on Metro Systems: An International Perspective,” Acta Psychiatrica Scandinavica, 86 (1992): 60–63; M. Gallerani, F. M. Avato, D. Dal Monte, S. Caracciolo, C. Fersini, and R. Manfredi, “The Time for Suicide,” Psychological Medicine, 26 (1996): 867–870; L. B. Lerer and R. G. Matzopoulos, “Fatal Railway Injuries in Cape Town, South Africa,” American Journal of Forensic Medicine and Pathology, 18 (1997): 144–147; C. Altamura, A. VanGastel, R. Pioli, P. Mannu, and M. Maes, “Seasonal and Circadian Rhythms in Suicide in Cagliari, Italy,” Journal of Affective Disorders, 53 (1999): 77–85.
67 “Shocks and reverses”: S. A. K. Strahan, Suicide and Insanity: A Physiological and Sociological Study (London: Swan Sonnenschein & Co., 1893), p. 158.
68 Hospital suicides: G. R. Jameison and J. H. Wall, “Some Psychiatric Aspects of Suicide,” Psychiatric Quarterly, 7 (1933): 211–229; L. S. Lipschutz, “Some Administrative Aspects of Suicide in the Mental Hospital,” American Journal of Psychiatry, 99 (1942): 181–187; A. D. Pokorny, “Characteristics of Forty-Four Patients Who Subsequently Committed Suicide,” Archives of General Psychiatry, 2 (1960): 314–323; A. R. Beisser and J. E. Blanchette, “A Study of Suicides in a Mental Hospital,” Diseases of the Nervous System, 22 (1961): 365–369; P. H. Salmons, “Suicide in High Buildings,” British Journal of Psychiatry, 145 (1984): 469–472.
69 the well-established diurnal variation: G. Winokur, P. J. Clayton, and T. Reich, Manic Depressive Illness (St. Louis: C. V. Mosby, 1969); T. A. Wehr and F. K. Goodwin, eds., Circadian Rhythms in Psychiatry (Pacific Grove, Calif.: Boxwood Press, 1983); F. K. Goodwin and K. R. Jamison, Manic-Depressive Illness (New York: Oxford University Press, 1990); A. P. R. Moffott, R. E. O’Carroll, J. Bennie, S. Carroll, H. Dick, K. P. Ebmeier, and G. M. Goodwin, “Diurnal Variation of Mood and Neuropsychological Function in Major Depression with Melancholia,” Journal of Affective Disorders, 32 (1994): 257–269.
70 Cognitive impairment: R. C. Casper, E. Redmond, M. M. Katz, C. B. Shaffer, J. M. Davis, and S. H. Koslow, “Somatic Symptoms in Primary Affective Disorder: Presence and Relationship to the Classification of Depression,” Archives of General Psychiatry, 42 (1985): 1098–1104.
71 suicide and the lunar cycle: P. K. Jones and S. L. Jones, “Lunar Association with Suicide,” Suicide and Life-Threatening Behavior, 7 (1977): 31–39; D. Lester, “Temporal Variation in Suicide and Homicide,” American Journal of Epidemiology, 109 (1979): 517–520; K. MacMahon, “Short-Term Temporal Cycles in the Frequency of Suicide, United States, 1972–1978,” American Journal of Epidemiology, 117 (1983): 744–750; G. Maldonado and J. F. Kraus, “Variation in Suicide Occurrence by Time of Day, Day of the Week, Month, and Lunar Phase,” Suicide and Life-Threatening Behavior, 21 (1991): 174–187.
72 before modern lighting: C. L. Raison, H. M. Klein, and M. Steckler, “The Moon and Madness Reconsidered,” Journal of Affective Disorders, 53 (1999): 99–106.
73 national holidays: D. Lester and A. T. Beck, “Suicide and National Holidays,” Psychological Reports, 36 (1975): 52; D. P. Phillips and J. Liu, “The Frequency of Suicides Around Major Public Holidays: Some Surprising Findings,” Suicide and Life-Threatening Behavior, 10 (1980): 41–50; D. P. Phillips and J. S. Wills, “A Drop in Suicides Around Major National Holidays,” Suicide and Life-Threatening Behavior, 17 (1987): 1–12; S. M. Davenport and J. Birtle, “Association Between Parasuicide and Saint Valentine’s Day,” British Medical Journal, 300 (1990): 783–784; L. A. Panser, D. E. McAlpine, S. L. Wallrichs, D. W. Swanson, W. M. O’Fallon, and L. J. Melton, “Timing of Completed Suicides Among Residents of Olmsted County, Minnesota, 1951–1985,” Acta Psychiatrica Scandinavica, 92 (1995): 214–219.
74 suicides on Mondays: W. W. K. Zung and R. L. Green, “Seasonal Variation of Suicide and Depression,” Archives of General Psychiatry, 30 (1974): 89–91; D. Lester, “Temporal Variation in Suicide and Homicide,” American Journal of Epidemiology, 109 (1979): 517–520; K. Bollen, “Temporal Variations in Mortality,” Demography, 20 (1983): 45–49; K. MacMahon, “Short-Term Temporal Cycles in the Frequency of Suicide: United States, 1972–1978,” American Journal of Epidemiology, 117 (1983): 744–750; J. M. Rothberg and F. D. Jones, “Suicide in the U.S. Army,” Suicide and Life-Threatening Behavior, 17 (1987): 119–132; G. Maldonado and J. F. Kraus, “Variation in Suicide Occurrence by Time of Day, Day of Week, Month, and Lunar Phase,” Suicide and Life-Threatening Behavior, 21 (1991): 174–187.
75 a “broken-promise” effect: H. Gabennesch, “When Promises Fail: A Theory of Temporal Fluctuations in Suicide,” Social Forces, 67 (1988): 129–145.
76 In the late 1800s: E. Morselli, Suicide: An Essay on Comparative Moral Statistics (London: Kegan Paul, 1881), pp. 56–57.
77 Several years ago: F. K. Goodwin and K. R. Jamison, Manic-Depressive Illness (New York: Oxford University Press, 1990); J. Zhang, “Suicides in Beijing, China, 1992–1993,” Suicide and Life-Threatening Behavior, 26 (1996): 175–180; A. J. Flisher, C. D. H. Parry, D. Bradshaw, and J. M. Juritz, “Seasonal Variation of Suicide in South Africa,” Psychiatry Research, 66 (1997): 13–22.
78 in the Southern Hemisphere: M. B. Trucco, “Suicídios en el Gran Sanriago: II. Variación Estacional,” Rev
ista Clínica Española, 105 (1977): 47–49; G. Parker and S. Walter, “Seasonal Variation in Depressive Disorders and Suicidal Deaths in New South Wales,” British Journal of Psychiatry, 140 (1982): 626–632; K. S. Y. Chew and R. McCleary, “The Spring Peak in Suicides: A Cross-National Analysis,” Social Science and Medicine, 40 (1995): 223–230; A. J. Flisher, C. D. H. Parry, D. Bradshaw, and J. M. Juritz, “Seasonal Variation of Suicide in South Africa,” Psychiatry Research, 66 (1979): 13–22.
79 men have one peak: S. M. Kevan, “Perspectives on Season of Suicide: A Review,” Social Science and Medicine, 14 (1980): 369–378; R. Meares, F. O. Mendelsohn, and J. Milgrom-Friedman, “A Sex Difference in the Seasonal Variation of Suicide Rate: A Single Cycle for Men, Two Cycles for Women,” British Journal of Psychiatry, 138 (1981): 321–325; S. Näyhä, “The Biseasonal Incidence of Some Suicides,” Acta Psychiatrica Scandinavica, 67 (1983): 32–42; R. Micciolo, C. Zimmerman-Tansella, P. Williams, and M. Tansella, “Seasonal Variation in Suicide: Is There a Sex Difference?” Psychological Medicine, 19 (1989): 199–203; H. Hakko, P. Räsänen, and J. Tiihonen, “Seasonal Variation in Suicide Occurrence in Finland,” Acta Psychiatrica Scandinavica, 98 (1998): 92–97.
80 Sources of data for graph: Morselli, Suicide; Strahan, Suicide and Insanity; E. Takahaski, “Seasonal Variation of Conception and Suicide,” Tohoku Journal of Experimental Medicine, 84 (1964): 215–227; M. MacDonald and T. R. Murphy, Sleepless Souls: Suicide in Early Modern England (Oxford: Clarendon Press, 1990); the data for U. S. suicides 1980–1995 were provided by Dr. Alex Crosby of the Centers for Disease Control and Prevention in Atlanta and Ken Kochanek, M.A., Vital Statistics Mortality Branch, National Center for Health Statistics, Hyattsville, Md.
81 This lessening in amplitude: K. Dreyer, “Comparative Suicide Statistics: II. Death Rates from Suicide in Denmark Since 1921, and Seasonal Variations Since 1835,” Danish Medical Bulletin, 6 (1959): 75–81; W. R. Lyster, “Seasonal Variation in Suicide Rates,” Lancet, 1 (1973): 725; S. M. Kevan, “Perspectives on Season of Suicide: A Review,” Social Science and Medicine, 14 (1980): 369–378; R. Meares, F. A. D. Mendelsohn, and J. Milgrom-Friedman, “A Sex Difference in the Seasonal Variation of Suicide Rate: A Single Cycle for Men, Two Cycles for Women,” British Journal of Psychiatry, 138 (1981): 321–325; H. Hakko, P. Rasanen, and J. Tiihonen, “Secular Trends in the Rates and Seasonality of Violent and Nonviolent Suicide Occurences in Finland During 1980–1995,” Journal of Affective Disorders, 50 (1998): 49–54; Z. Rihmer, W. Rutz, H. Pihlgren, and P. Pestality, “Decreasing Tendency of Seasonality in Suicide May Indicate Lowering Rate of Depressive Suicides in the Population,” Psychiatry Research, 81 (1998): 233–240, P. S. F. Yip, A. Chao, and T. P. Ho, “A Re-Examination of Seasonal Variation in Suicide in Australia and New Zealand,” Journal of Affective Disorders, 47 (1998): 141–150; Z. Rihmer, “Education of Primary Care Providers in the Reduction of Suicide Risk: Does the Gotland Model Work in Hungary Too?” paper presented at Treatment Research with Suicidal Patients Meeting, jointly sponsored by the National Institute of Mental Health and the American Foundation for Suicide Prevention, Washington, D.C., March 1999.
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