MYKOLAS ROMERIS UNIVERSITY INSTITUTE OF FORENSIC MEDICINE THE SUICIDE FORMULA Collective Scientific Study Edited by Gediminas Zukauskas Vilnius 2004 UDK 616.89-008 Þu-11 Recenzavo: Vilniaus universiteto Psichiatrijos klinikos vadovas prof. habil. dr. Algirdas Dembinskas; Valstybinio psichikos Sveikatos Centro direktorë Ona Davidonienë Monografija svarstyta Lietuvos teisës universiteto Teisës fakulteto Civilinës ir komercinës teisës katedros 2004 vasario 5 d. posëdyje (pro- tokolo iðraðas Nr. CKK–9) ir rekomenduota spausdinti Lietuvos teisës universiteto vadovëliø, monografijø, moksliniø, moko- møjø, metodiniø bei kitø leidiniø aprobavimo spaudai komisija 2004 m. rugsëjo 14 d. posëdyje (protokolas Nr. 2L-1) leidiná patvirtino spausdinti Visos leidinio leidybos teisės saugomos. Šis leidinys arba kuri nors jo dalis negali būti dauginami, taisomi ar kitu būdu platinami be leidėjo sutikimo. ISBN 9955-19-003-5 © Mykolo Romerio universitetas, 2004 THE SUICIDE FORMULA CONTENTS Let’s hear and talk to them............................................................... 4 (G. Zukauskas) DENGIS.............................................................................................. 12 Depression-Endocrinological-Nervous system Genetical- Immunological-Somatic problems (G. Zukauskas) Sexual Violence Against Women – One of Possible Causes of Suicide................................................................................................. 60 (K. Maciuliene) Post-Traumatic Stress Disorder........................................................ 69 (V. Danileviciute, V. Adomaitiene) Suicide and Aggression. Opposed or interconnected?.................... 86 (V. Justickis) The Problem of Violence Against Women....................................... 104 (G. Slavickaite) Terrorism............................................................................................ 120 (D. Vaitkaitis) Disasters.............................................................................................. 140 (D. Vaitkaitis) Deaths Among the Drug Users in Klaipeda Region........................ 170 (G. Sniepiene, R. Damijonaitiene) Suicide Prevention and Opportunities for Young People in Lithuania............................................................................................. 187 (N. Buvalaja) 3 THE SUICIDE FORMULA LET’S HEAR AND TALK TO THEM Prof. Habil. Dr. Gediminas Zukauskas, M.D. Institute of Forensic Medicine at Law University of Lithuania, Str. S. Zukauskas 12, 08234 Vilnius, LITHUANIA [email protected] It is always sad when man leaves this world. It is understandable – diseases, age, accidents, natural disasters. You can blame fate, circum- stances, Lord, but apparently such is your fate. I do not understand when man is gone by his own wish, with his own hand cuts off such a tiny Ariadne’s clew. How to consider the per- son who has done it: is he a hero not afraid to overstep a step leading only to one side. Or is he a coward who has chosen an absolutely quiet way out of the situation – I do not exist any more, let it be the Flood af- ter me. Relatives and surroundings remain deceived – the dead do not help to fight with the lack and hardships. We lose one more member of the society. A deserter. How else can he be called: everybody sweat their guts out and he is lying blessed in the candle light. We can always find an excuse or condemn. To my mind the most important thing is to understand. Maybe it is not so difficult to part. After all when you leave for a trip don’t you often think about never meeting again, parting for- ever? So – lots of travels, travelers, reaching new lands and lots of the missing. If we consider it deeper there are lots of the missing, but they may consider us having gone out of their world. Nevertheless a suicide is an extraordinary event. And not only in the existence of an individual. In the community, society. The event which makes us stop, think, check up our behavior, look for mistakes both in the dead person’s and our lives. No matter how we talk, this exit by one’s free wish shocks us. None of the left messages brings light to the brutality of the behaviour, maybe only enables the prosecution and 4 THE SUICIDE FORMULA legal institutions to finish the investigation of the event. Depths of the soul remain dark and the suicide remains all by himself. As a title of this report I have chosen a paraphrased title of Al- madovar’s film. We need to speak. To talk. Most of us are lonely, alone with our problems which are most important to us. We have a wish to tell them, to partially transfer our burden onto other people’s shoulders. Just at least for a while. But usually we do not hear the call of those ask- ing for help. We ourselves shout, wait for help. In such a way we get drowned in the sea of shouts, chaos in which we do not see any sense. And we neither receive nor provide any help. Recently there is even abundance of us on the Earth. More and more we dive into the virtual world from which we surely will receive no help. That is why I liked the title of the film – let’s talk, let’s hear one another. Let’s do just this if at present we are not able to help oth- erwise. This problem - of those gone out of this world - is global as it is fashionable to say. It has become global. In many countries more and more people commit suicide and the statistics is quite impressive. Both in the USA and in Lithuania people commit suicide by 1.7-2 times more than those who die from violence: in motor transport accidents, killing, drowning, burning. 10 times more often somebody is trying to commit suicide than coming. So annually in Lithuania 1500 people commit sui- cide and 15 000 try to do it. About 17 000 people per year – less officers serve in the police. Globalization of suicides makes us consider the reasons, encourag- ing and provoking such an action. If there were only one reason it could have received a “deadly” blow and only failures who can not distinguish between existence and non-existence would commit suicide. Apparently a lot, complex of reasons exist, the whole of which causes such a shock- ing reaction. And there is a specific complex and unambiguous reaction for each individual. In this report I would like to discuss a number of reasons the ex- amination of which might help to reduce the tension, helped to find time for the analysis of the situation and a more optimistic way out. These are not reasons in the narrow sense of the word but complexes of reasons which more or less influence the number and increase of suicides. I’d like to emphasize one more thing. We should see more optimism at the end of the tunnel, not only black gaunt hopelessness and no way out of 5 THE SUICIDE FORMULA the situation. Let’s create a ray of light, belief, help, the help and conso- lation of a listener and companion. DALGEI (Depression–Alcohol, drugs–Genetics–Endocrine system – Immunology) The human organism is a wonderful instrument which consists of well balanced interdependent systems: nervous, endocrine, immunologic the formula of which is transferred from one generation to another. Without going deep into specific things it can be stated that even small- est disorders of one system, a squeak in interteeth immediately respond to the functions of all systems till at last the whole organism starts slip- ping. All the systems are most easily infringed by alcohol and drugs, as the result of this psychic disorders, depression and as the last stop – a suicide attempt or suicide comes. There is much space for optimism – self-education, lectures on healthy way of life, etc. SEX Two organism functions exist in the development from unicellular to the human being: to protect from the damaging and killing environ- mental factors – assailants, diseases, traumas, to feed oneself and sec- ondly – to prolong the life of your tribe, race, family. At different stages of the evolution it is done individually. Sex plays an important role in man’s life. If the animal’s sex is only prolonging of the species, man gets satisfaction and earns money from sex. A broad sex industry flour- ishes, and on the other hand it stimulates gales of spiritual strength. Dur- ing different periods of the development of humanity various tendencies prevailed: matriarchy, mono-polygamy, orgies of sex gourmands and periods of total asceticism. A sexual explosion, sex revolution began hardly more than fifty years ago, but much has been achieved. In Russia a law legitimating marriages from 14 years of age is under preparation though sexual intercourse under 16 years of age is defined by articles of the Penal Code. Sex is in a tight relationship not only with external sexual organs but also with psyche, its fluctuations. Since early times dramas and tragedies provoked by sex or appearing as a result of sexual games are 6 THE SUICIDE FORMULA known. It is the sphere where in order to protect psyche sexual educa- tion (including both contraception, abortion and hygiene), sexual educa- tion on the sex par basis can be of great use. One of the sexual devia- tions is known as sexual aggression. Beginning with paedophilia and ending with gerontophilia, necrophilia and sexual maniacs. The sexual spark long and strongly smoulders in man’s psyche uncontrolled flames of which can burn not only the master but also the surrounding people. It is possible and sex should be subjected to creative power, not to de- struction. There are all possibilities for this. CRISES Factors throwing man off balance are observed not so rarely. Ac- cording to the data of many authors up to 20-30% of people experience negative emotions which if lasting for a long time can destroy psyche. The most common causes of crises are conflicts at home, school- university, work. We happen to meet people who go to work, schools as if they went to servitude. On the other hand a constant fear to lose a job also adds to damaging people’s health. Delinquency among the unem- ployed several times exceeds that of the working people.