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Q 6. Parasuicide: Norman Kreitman, Is A Conscious Often Impulsive, Manipulative Act, Undertaken To Get Rid of

Parasuicide is a non-fatal act of deliberately harming oneself without the intention to die, such as a suicide attempt or self-harm. Common methods include overdosing on drugs. Worldwide, the yearly prevalence of parasuicidal acts ranges from 2-20% and attempts are 10-20 times more common than completed suicides. Parasuicide is influenced by factors like age, sex, education level, and social status. While parasuicide poses risks, it is often used to communicate distress or escape difficult life circumstances rather than a true desire to end one's life. Thorough psychiatric evaluation and treatment can help prevent further attempts.

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157 views2 pages

Q 6. Parasuicide: Norman Kreitman, Is A Conscious Often Impulsive, Manipulative Act, Undertaken To Get Rid of

Parasuicide is a non-fatal act of deliberately harming oneself without the intention to die, such as a suicide attempt or self-harm. Common methods include overdosing on drugs. Worldwide, the yearly prevalence of parasuicidal acts ranges from 2-20% and attempts are 10-20 times more common than completed suicides. Parasuicide is influenced by factors like age, sex, education level, and social status. While parasuicide poses risks, it is often used to communicate distress or escape difficult life circumstances rather than a true desire to end one's life. Thorough psychiatric evaluation and treatment can help prevent further attempts.

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Sandeep Bansal
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Q 6.

Parasuicide
[AA – 551, GB – 406, Dr Putul Mahanta, Parasuicide: A Case Report, Journal of
Punjab Academy of Forensic Medicine & Toxicology 9 (2009),
https://gpnotebook.com/simplepage.cfm?ID=-328531967]

Ans:
Parasuicide (Greek ‘para’ = "near" or " resembling") or pseudocide a term coined by
Norman Kreitman, is a conscious often impulsive, manipulative act, undertaken to get rid of
an intolerable situation. Means suicide attempts or gestures and self-harm where there is
no actual intention to die.

It is a non-fatal act in which a person deliberately causes injury to himself or ingests


any drug in excess. The most common method is taking an overdose of drug.

World health report puts that, the yearly global prevalence of parasuicidal acts varies
between 2% to 20%. The prevalence of parasuicidal acts is estimated to be 10-20 times
higher than that of completed suicides. In the elderly the ratio of attempts to one suicide can
be 3:1.

The incidence of parasuicide is greatly influenced by the differences in age, sex,


race, religion, culture, marital status, habitat, climate and social systems. Low education is
an important risk factor in parasuicidal acts, more so in adolescence.

The ratio between suicide “attempt” and “commits” varies widely. One committed
suicide for every eight attempts.

Differences between suicide attempt and parasuicide are

Suicide attempt Parasuicide (Non-suicidal self-injury)


The person intends to die No suicidal intent
May be impulsive, but in majority of people, Usually the person experience
chronic feeling of hopelessness and increasing anger, tension, anxiety,
loneliness is present dysphoria and general distress or
depersonalization
Typically, patients express more severe and Less severe methods of self-harm are
life-threatening methods of self-harm e.g. – used e.g. – skin lesions by biting, cutting,
self poisoning, hanging, jumping, use of burning etc
firearms
Increased risk of repeated suicide attempts Recurrent self-injury is common
(but to a lesser frequency than parasuicide)
Typically, the person is aware that his/her Typically, the person is aware that
act may result in serious injury but life his/her behaviour may result in serious
threatening injury, but is not life threatening

The differences between parasuicide and suicide are:

Parasuicide Suicide
Trend Now stationary Increasing in males
Sex Females > males Males > females
Age below 45 above 45
marital status: divorced, single divorced, single & widowed
social class: low no clear gradient
urban/rural: urban > rural rural/urban
Reason unemployed unemployed and retired
seasonal variation: none spring peak
broken home common common
physical illness no association Association usually present
psychiatric situational, reaction, affective disorder
diagnosis depression, alcoholism
personality type psychopathy common none special

Parasuicide mostly done to threaten relatives by taking sublethal dose of a poison, e


g. a few sleeping pills. Youngsters resort to it when their parents disallow marriage with
their loved ones.

In a study on 50 consecutive patients of parasuicide, reports that 74% of the patients


had psychiatric morbidity and majorities were diagnosed with a spectrum of depressive
disorders.

All suicidal people are not death seekers. Some attempt to communicate pain, to
reduce isolation, to avoid consequences of social status change, to seek revenge and
convey a lot of other meanings that are essentially individualistic.

It could not be taken as a lighter entity for it may prove as equally dangerous as
suicide itself and sometimes more than that because of so many residual temporary or
permanent disabilities.

Parasuicidal act are strong predisposing factor for completion of his previous
attempts. Therefore, thorough analysis of risk factors is of paramount importance for
prevention of further such attempts with detailed psychiatric evaluation and management.

Legal status

Before Mental Health Care Act 2017, as per Section 309 IPC, whoever attempt to
commit suicide and does any act towards the commission of such offence shall be
punished with simple imprisonment for a term which may extend to one year, or with
fine, or with both.

However, Sec 115 of MHA 2017. Which states, notwithstanding anything contained
in section 309 of the Indian Penal Code any person who attempts to commit suicide shall
be presumed, unless proved otherwise, to have severe stress and shall not be tried and
punished under the said Code.

The appropriate Government shall have a duty to provide care, treatment and
rehabilitation to a person, having severe stress and who attempted to commit suicide, to
reduce the risk of recurrence of attempt to commit suicide.

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