| Forms of Lunacy. | Per Cent. | |
|---|---|---|
| Males. | Females. | |
| Religious mania | 0·7 | 0·6 |
| Monomania | 0·6 | 0·5 |
| Melancholia | 68·7 | 69· |
| Brain fever | 5· | 2·8 |
| Mania | 5·1 | 2·6 |
| Imbecility | 5·7 | 5·0 |
| Unnamed | 14·2 | 19·5 |
With regard to our own country, the last Report of the Lunacy Commissioners for England and Wales shows that of 13,581 patients admitted to the register of lunatics for 1882, 3,877 were stated to have a suicidal propensity, viz., 1,785, or 26·8 per cent. of the males; and 2,092, or 30·2 per cent. of the females.
The total number of lunatics in charge for the year 1882 was 76,765, and of these 17 committed suicide: 10 males and 4 females in asylums, 1 male before admission, and 1 male and 1 female while “on leave.” There were 17 suicides also in the year 1881. This small number of actual deaths speaks volumes for the care and attention which must be bestowed on the suicidal patients.
The proportion of suicidal tendency was higher among pauper than among well-to-do lunatics.
The highest rate of suicidal propensity was found in cases of melancholia, a proportion of 57, compared to mania 21, ordinary dementia 16, senile dementia 15, and idiocy 8.
The states of family life gave these proportions: marriage 32, celibacy 24, and widowhood 29, and of married persons, more females than males.
The Report also subdivides these cases with respect to the causes assigned for the insanity; the following were the most fertile causes, with the relative proportions:─
Domestic trouble, 9·7 (twice as many females as males); adverse circumstances, 6·0; overwork, worry, 7·5; religious excitement, 3·6; love affairs, 1·9; nervous shock, 1·4; alcoholic excess, 12·1 (nineteen males to six females); sexual excess, 0·5; sunstroke, 0·7; venereal disease, 0·3; self-abuse, 1·0; accidents, 3·2; pregnancy and parturition, 3·6; change of life (females), 2·9; privation, 2·0; old age, 3·0; bodily disease, 11·0; hereditary transmission, 22·8; and previous attacks, 15·8.
In England it is not practicable to form any reliable estimate of the true proportion of insane suicides, as compared with those occurring from disease and mental trouble. On the Continent an attempt is made in most States to assign the proportion; but it is easy to point out the difficulty of the task and the numerous errors that are liable to creep into such calculations. The following rates per 1,000 suicides have been published in the “Asylum Journal,” vol. 27: France, 300 insane per 1,000; Belgium, 470; Prussia, 333; Italy, 343; and Bavaria, 342.
M. Prévost, in a learned investigation of cases of voluntary death, estimated that 18 per cent. occurred in insane persons.