Many suicides go unreported, as it can be difficult to identify indirect suicide attempts as suicide, and even some of the more direct methods of suicide may not be clearly identifiable attempts. There are other indirect methods some attempters may employ, such as behaving recklessly or not taking vitally required medications. The most commonly employed methods of suicide are by gunshot, hanging, drug overdose or other poisoning, jumping, asphyxiation, vehicular impact, drowning, exsanguination, and electrocution. While rates of completed suicides tend to be higher among men than women and higher among middle aged or older adults than among younger people, rates of nonfatal suicidal behavior are higher among females and adolescents and young adults. There were no reported differences in the rates of suicide attempts by geographical region, though people living in the Midwest region of the US were most likely to have made a suicide plan in the last year, and those in the Midwest and Western region of the US reported the highest prevalence of suicidal ideation. According to a 2011 report 2 released by the CDC, in 2008, the highest prevalence of suicidal thoughts, plans, and attempts among those surveyed in the US was reported by adults aged 18 to 29 years, non-Hispanic white males, people who were unemployed, and people with less than a high school education. 2 Rates of suicidal thoughts and behaviors vary by age, gender, occupation, region, ethnicity, and time of year. There were just under 37 000 reported deaths by suicide (completed suicides) during the same time period, and almost 20 times that number of emergency room visits after nonfatal suicide attempts. During 2008-2009, 8.3 million people over age 18 in the United States (3.7% of the adult US population) reported having suicidal thoughts in the last year, and approximately 1 million people (0.5% of the adult US population) reported having made a suicide attempt in the last year. Worldwide, suicide ranks among the three leading causes of death among adolescents and young adults. 1 Suicide is one of the top ten leading causes of death across all age groups. Nearly 1 million people die by suicide globally each year. Après une brève description de l'épidémiologie et des circonstances du suicide, nous analysons l'état actuel de la recherche sur le deuil après un suicide, sur la douleur morale compliquée et son traitement chez ceux qui survivent au suicide d'un proche. Les survivants ont donc besoin de mesures de soutien particulières et d'un traitement cible pour faire face a leur perte. Le stigmate considérable qui s'ajoute au fardeau initial peut éloigner les survivants du soutien nécessaire et des possibilités de guérison. Les survivants a une perte par suicide ont en outre un risque plus élevé de développer une dépression majeure, un état de stress post-traumatique et des comportements suicidaires, ainsi qu'une douleur morale prolongée appelée deuil complique. Les sentiments de perte, de tristesse et de solitude ressentis après la perte d'un être cher sont souvent amplifies, chez les survivants d'un suicide, par des sentiments de culpabilité, de confusion, de refus, de honte, de peur et les effets du stigmate et du traumatisme. Perdre un être aime par suicide est l'une des expériences les plus douloureuses de la vie. Después de una breve descripción de la epidemiología y de las circunstancias del suicidio se revisa el estado actual de la investigación en el duelo por suicidio, el duelo complicado en deudos de suicidas y el tratamiento del duelo en sobrevivientes de suicidas. Porlo tanto los deudos pueden requerir de medidas de soporte especiales y de un tratamiento particular para afrontar sus pérdidas. Añadido al peso que esto implica está el importante estigma, el cual puede mantener a los deudos alejados de la tan necesaria ayuda y de los recursos curativos. Además, los sobrevivientes de pérdidas por suicidio tienen un alto riesgo de desarrollar depresión mayor, trastorno por estrés postraumático y conductas suicidas, como también una forma prolongada de duelo llamada duelo complicado. Los sentimientos de perdida, tristeza y soledad experimentados después de cualquier muerte de un ser querido a menudo se amplían en los sobrevivientes de suicidas con sentimientos de culpa, confusión, rechazo, vergüenza e ira, y también con los efectos del estigma y del trauma. El perder a un ser amado por suicidio es una de las experiencias más dolorosas de la vida.
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