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      Study of deaths by suicide of homosexual prisoners in Nazi Sachsenhausen concentration camp

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          Abstract

          Living conditions in Nazi concentration camps were harsh and inhumane, leading many prisoners to commit suicide. Sachsenhausen (Oranienburg, Germany) was a concentration camp that operated from 1936 to 1945. More than 200,000 people were detained there under Nazi rule. This study analyzes deaths classified as suicides by inmates in this camp, classified as homosexuals, both according to the surviving Nazi files. This collective was especially repressed by the Nazi authorities. Data was collected from the archives of Sachsenhausen Memorial and the International Tracing Service in Bad Arolsen. Original death certificates and autopsy reports were reviewed. Until the end of World War II, there are 14 death certificates which state “suicide” as cause of death of prisoners classified as homosexuals, all of them men aged between 23 and 59 years and of various religions and social strata. Based on a population of 1,200 prisoners classified as homosexuals, this allows us to calculate a suicide rate of 1,167/100,000 (over the period of eight years) for this population, a rate 10 times higher than for global inmates (111/100,000). However, our study has several limitations: not all suicides are registered; some murders were covered-up as suicides; most documents were lost during the war or destroyed by the Nazis when leaving the camps and not much data is available from other camps to compare. We conclude that committing suicides in Sachsenhausen was a common practice, although accurate data may be impossible to obtain.

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          Suicide and Suicide Risk in Lesbian, Gay, Bisexual, and Transgender Populations: Review and Recommendations

          Despite strong indications of elevated risk of suicidal behavior in lesbian, gay, bisexual, and transgender people, limited attention has been given to research, interventions or suicide prevention programs targeting these populations. This article is a culmination of a three-year effort by an expert panel to address the need for better understanding of suicidal behavior and suicide risk in sexual minority populations, and stimulate the development of needed prevention strategies, interventions and policy changes. This article summarizes existing research findings, and makes recommendations for addressing knowledge gaps and applying current knowledge to relevant areas of suicide prevention practice.
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            Lifetime Prevalence of Suicide Attempts Among Sexual Minority Adults by Study Sampling Strategies: A Systematic Review and Meta-Analysis

            Previous reviews have demonstrated a higher risk of suicide attempts for lesbian, gay, and bisexual (LGB) persons (sexual minorities), compared with heterosexual groups, but these were restricted to general population studies, thereby excluding individuals sampled through LGB community venues. Each sampling strategy, however, has particular methodological strengths and limitations. For instance, general population probability studies have defined sampling frames but are prone to information bias associated with underreporting of LGB identities. By contrast, LGB community surveys may support disclosure of sexuality but overrepresent individuals with strong LGB community attachment.
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              Suicide in prisoners: a systematic review of risk factors.

              To examine factors associated with suicide in prisoners. Studies were identified through electronic searches of MEDLINE (1950-February 2007), PsycINFO (1806-February 2007), EMBASE (1974-February 2007), and CINAHL (1982-February 2007) without language restriction using the search terms prison, jail, felon, detainee, penal, and custody combined with suicide. Included studies were investigations that reported on prisoners dying by suicide who were compared with prisoners in control groups (which were randomly selected or matched, or consisted of the total or average prison population). Subgroup analysis and meta-regression were used to explore sources of heterogeneity. Thirty-four studies (comprising 4780 cases of prison suicide) were identified for inclusion in the review, of which 12 were based in the United States. Demographic factors associated with suicide included white race/ethnicity (OR = 1.9, 95% CI = 1.7 to 2.2), being male (OR = 1.9, 95% CI = 1.4 to 2.5), and being married (OR = 1.5, 95% CI = 1.3 to 1.7). Criminological factors included occupation of a single cell (OR = 9.1, 95% CI = 6.1 to 13.5), detainee/remand status (OR = 4.1, 95% CI = 3.5 to 4.8), and serving a life sentence (OR = 3.9, 95% CI = 1.1 to 13.3). Clinical factors were recent suicidal ideation (OR = 15.2, 95% CI = 8.5 to 27.2), history of attempted suicide (OR = 8.4, 95% CI =6.2 to 11.4), having a current psychiatric diagnosis (OR = 5.9, 95% CI = 2.3 to 15.4), receiving psychotropic medication (OR = 4.2, 95% CI = 2.9 to 6.0), and having a history of alcohol use problems (OR = 3.0, 95% CI = 1.9 to 4.6). Black race/ethnicity was inversely associated with suicide (OR = 0.4, 95% CI = 0.3 to 0.4). Few differences were found in risk estimates when compared by study design or publication type. Several demographic, criminological, and clinical factors were found to be associated with suicide in prisoners, the most important being occupation of a single cell, recent suicidal ideation, a history of attempted suicide, and having a psychiatric diagnosis or history of alcohol use problems. As some of these associations included potentially modifiable environmental and clinical factors, there is scope for targeting these factors in suicide prevention strategies for individuals in custody. Copyright 2008 Physicians Postgraduate Press, Inc.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                20 April 2017
                2017
                : 12
                : 4
                : e0176007
                Affiliations
                [1 ]Department of Human Anatomy and Embryology, Rey Juan Carlos University, Alcorcón, Madrid, Spain
                [2 ]Faculty of Health Sciences, Camilo José Cela University, Madrid, Spain
                [3 ]Neuropsychopharmacology Unit, Hospital 12 de Octubre Research Institute (i+12), Madrid, Spain
                [4 ]Institute of the History, Philosophy and Ethics of Medicine, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
                [5 ]Memorial and Museum Sachsenhausen, Oranienburg, Germany
                Medical University of Vienna, AUSTRIA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                • Conceptualization: ECG FLM.

                • Data curation: ECG FLM MK.

                • Formal analysis: ECG FLM MK.

                • Funding acquisition: FLM.

                • Investigation: ECG FLM.

                • Methodology: ECG FLM.

                • Project administration: FLM ECG.

                • Resources: ECG AL.

                • Software: ECG FLM.

                • Supervision: FLM ECG.

                • Validation: ECG AL.

                • Visualization: ECG FLM MK.

                • Writing – original draft: ECG FLM.

                • Writing – review & editing: ECG FLM MK.

                Author information
                http://orcid.org/0000-0002-5188-6038
                Article
                PONE-D-16-04896
                10.1371/journal.pone.0176007
                5398659
                28426734
                80548526-9fbb-432d-a02d-6c8b7db7fb78
                © 2017 Cuerda-Galindo et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 3 February 2016
                : 3 April 2017
                Page count
                Figures: 0, Tables: 1, Pages: 10
                Funding
                This project was supported by a grant (UCJC 2013-47) of the Camilo José Cela University (II Convocatoria de Ayudas a la Investigación Competitiva). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                People and Places
                Population Groupings
                Sexuality Groupings
                Homosexuals
                Social Sciences
                Law and Legal Sciences
                Criminal Justice System
                Prisons
                Prisoners
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Suicide
                Biology and Life Sciences
                Psychology
                Sexual Identity
                Homosexuality
                Social Sciences
                Psychology
                Sexual Identity
                Homosexuality
                Research and Analysis Methods
                Research Facilities
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                Archives
                Social Sciences
                Anthropology
                Cultural Anthropology
                Religion
                Social Sciences
                Sociology
                Religion
                Social Sciences
                Sociology
                Social Discrimination
                People and Places
                Demography
                Death Rates
                Custom metadata
                All relevant data are within the paper. Original data of this study are available from the archives of Sachsenhausen KZ and Bundesarchiv (Berlin). The researchers meet the criteria for access to these data. To consult the original data is necessary to request authorization from those responsible for both files. German Federal Archives of Berlin: berlin@ 123456bunderarchive.de . Sachsenhausen, Astrid Ley; ley@ 123456stiftung-bg.de .

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