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Table 1 Suicide in deaf populations: studies included in this review

From: Suicide in deaf populations: a literature review

Author Design Aims Participants/setting Main outcome measures Key findings
Black and Glickman, 2006 Prevalence study To examine demographic and clinical characteristics of deaf and hearing psychiatric in- patients A total of 64 deaf adult patients of specialist deaf unit at Westborough State Hospital, USA. All discharged between 1999 – 2004 (55% male; 45% female). No mention of age. Controls: 64 hearing patients discharged between 1999 – 2004. A total of 180 hearing patients seen on one day in March 2006. The Clinical Evaluation of Risk and Functioning Scale, revised. The Allen Cognitive Levels Scale. Language Rating Scale. Deaf psychiatric inpatients rated at significantly higher risk of self-harm than hearing psychiatric patients by clinicians. A total of 23.4% of deaf patients diagnosed with major depressive disorder.
Boyechko, 1992 Prevalence study To explore attitudes, experience and associated risk factors for suicide among hearing impaired college students. To explore the relationship between suicidal behaviour and depression, hopelessness and social support. 60 deaf college students of Gallaudet University, Washington DC, USA, recruited via personal appeal and by post. Nine excluded for recording 'outlying results.' Suicide Opinion Questionnaire, Suicide Information Questionnaire, Provision of Social Relations, Beck Depression Inventory Hopelessness Scale. Over lifetime: 30% attempted suicide, 30% seriously considered suicide. During past year: 18% attempted suicide, 18% seriously considered suicide. No completed suicides.
Critchfield et al, 1987 Survey To determine the types and levels of suicide intervention techniques in place at various educational settings for the deaf and hearing impaired. To investigate frequency of suicidal behaviour over 1 year period in these settings. A total of 92 (from 153 approached) US schools for the deaf; 45% were deaf-only programmes, 31% combined deaf/hearing, 24% deaf post-secondary. A total of 45% had residential students, 55% had day students. All students of junior high school age or above. Questionnaire (not provided) concerning frequency of suicidal 'attempts/gestures'; verbalization and hospitalisation of students. A total of 503 (6.3%) incidents of suicidal behaviour during past year among 8 020 students; 134 suicidal attempts/gestures (1.7%), 69 hospitalisations for suicidal or depressive episode. No completed suicides.
De Leo et al, 1999 Prevalence study To investigate the physiological and pathological reactions to sight loss. To understand pathological reactions to fear of going blind. To investigate a population of suicides involving the fear of blindness. A total of 3 654 autopsy case reports for suicide over the period 1990 – 1997 in Queensland, Australia. Coroner's post-mortem reports, detailing: age; gender; psychiatric history; major life changes resulting from impairment; social and family support and other events. Police reports and questionnaires. Cases included if there was mention of visual/hearing impairment in coroners' records. A total of 19 cases (0.52% of sample) found to have sensory impairment. Twelve cases (0.3% of sample) found to be visually impaired. Seven cases (0.19% of sample) found to be hearing impaired. In two cases, hearing loss described as 'major contributing factor' to suicide.
Dudzinski, 1998 Survey To explore the presence, perception and impact of suicidal ideation in deaf students (focus on young adults). To assess response patterns to suicidal behaviour in deaf schools. A total of 42 (from 83 approached) US residential and day educational programmes for the deaf. No information on attending students (e.g. age, gender). Eight-item suicide ideation questionnaire, completed by principals, associate principals, senior counsellors and supervisors. Estimated prevalence from results: 8% of all students were referred to counselling for suicidal ideation during academic careers, representing approximately 17% of all students referred to counselling.
Jacobsen and McCaslin, 2001 Literature review To establish evidence of a direct relationship between tinnitus and suicide. Clinical populations Medline and HealthStar electronic databases, using search terms 'tinnitus' and 'suicide'. Four articles found directly addressing tinnitus and suicidal behaviour. No evidence of causal relationship.
Leigh et al, 1988 Cross-sectional study To modify the Beck Depression Inventory for use with the deaf. A total of 214 college students: 112 hearing, 102 deaf (students at National Technical Institute for the Deaf, USA.) Hearing loss > 80 db. No mention of participant selection methods. Beck Depression Inventory. Beck Depression Inventory, revised for use with the deaf. Mean BDI: 10 (deaf); 7.8 (hearing). No difference among hearing group in scores of original and revised test versions. Lower internal consistency in scores of revised version among deaf than hearing students.
Leigh et al, 1989 Cross-sectional study To investigate whether deaf and hearing populations differ in experiences of depressive symptoms. A total of 214 college students: 112 hearing, 102 deaf (students at National Technical Institute for the Deaf, USA). Hearing loss > 80 db. Beck Depression Inventory. Sociotropy-Autonomy Scale. Parental Bonding Instrument. All revised for use with the deaf. A total of 43% of deaf students compared to 27% of hearing students scored within range of mild depression; 8% of deaf students compared to 4% of hearing students scored within range of moderate depression.
Lewis et al, 1992 Case study To investigate tinnitus as a possible risk factor for suicide. To consider additional risk factors for suicide. Six case studies of suicidal behaviour in tinnitus sufferers known to one clinic in Cardiff, Wales (Mar 1990 – April 1991). Case reports of suicide, detailing social and demographic information, psychiatric history and type and severity of tinnitus. Suicide rate: 118 per 100 000 for clinic attenders with tinnitus .Suicide risk factors: male gender; low SE class; social isolation; depression and other psychological problems.
Lewis et al, 1994 Survey To inform practitioners of the risk factors for suicide among tinnitus sufferers. A total of 50 audiology clinics contacted worldwide, from which 17 practitioners responded. A total of 23 cases of suicide in tinnitus sufferers, with five additional cases known to researchers. A 20-item tinnitus and suicide questionnaire, requesting social and demographic information, psychiatric history and type and severity of tinnitus. Suicide risk factors: male gender; low SES class; social isolation; bereavement; depression. A total of 90% of suicides in those aged > 40 years; 50% died within 2 years of onset of tinnitus.
Lewis and Stephens, 1995 Prevalence study To determine the rate of attempted suicide among tinnitus sufferers. A total of 184 patients admitted to poisons unit of one hospital in Glamorgan, South Wales. A five-item tinnitus questionnaire, eliciting information on type, severity and duration of condition. Three cases of tinnitus in 184 patients, representing 1.6% of entire sample. (General population prevalence of tinnitus around 7%.)
Marcus, 1991 Prevalence study To provide a videotaped version of the Beck Depression Inventory in American sign language. To investigate the frequency of depression among deaf college students. Experiment 1: 28 deaf college students. Experiment 2: 129 deaf college students. All paid volunteers from Gallaudet University, Washington DC. Beck Depression Inventory. Brauer – Gallaudet Beck Depression Inventory (BGBDI; videotaped in American Sign Language for use with the deaf). MMPI-depression scale (videotaped in American Sign Language for use with the deaf). Average score on BGBDI of 14.1; 61% had some depressive symptoms, 35% scored within range indicating mild depression. A total of 19% scored within range indicating moderate to severe depression; 7% scored within range indicating severe depression
Watt and Davis, 1991 Cross-sectional study To explore the relationship between boredom-proneness and depression in deaf residential school students. A total of 110 college students: 50 deaf (residential school), 60 hearing (junior high school) in south-eastern Unites States. Boredom Proneness Scale. Beck Depression Inventory. Two versions of each: original and revised (for use with deaf). A total of 40% of deaf vs 17% of hearing students recorded mild depression; 6% of deaf vs 3% of hearing students recorded moderate depression. Deaf students significantly more boredom-prone than hearing students.