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Lombera MA, Marshall AD, Such S, Jackson Y. Measurement Models of Child Maltreatment and Associations With Suicidal Ideation Endorsement by Youth in Foster Care: A Multiverse Analytic Approach. CHILD MALTREATMENT 2024; 29:700-713. [PMID: 37917022 PMCID: PMC11063127 DOI: 10.1177/10775595231210017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
Youth suicidal ideation is a prevalent experience, particularly among youth exposed to maltreatment, with a variety of indicators such as youth statements of ideation. To better understand suicidal ideation, and the associations with youth mental health outcomes, a fruitful path may be through the study of the dimensions (e.g., severity, frequency) of maltreatment exposure. While there exists extensive work on methods to best operationalize casefile records of maltreatment, such work has not been undertaken for youth self-reports, which are an important indicator of youth functioning following exposure. To address the lack of clarity of how to best operationalize youth self-reports of maltreatment, a multiverse analytic approach was taken to operationalize severity and frequency in a sample of 471 8- to 17-year-old children in foster care. We examined differences across measurement models and the models' associations with caregiver reports of youth suicidal ideation statements. Results indicate that the operationalizations used to define maltreatment resulted in differing measurement models that further differed in their associations with reports of youth suicidal ideation. This study highlights the importance of how researchers operationalize their data and the role dimensions of maltreatment have in further elucidating differential outcomes for youth exposed to maltreatment.
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Affiliation(s)
| | - Amy Dyanna Marshall
- Department of Psychology, The Pennsylvania State University, University Park, PA, USA
| | - Sara Such
- Department of Psychology, The Pennsylvania State University, University Park, PA, USA
| | - Yo Jackson
- Department of Psychology, The Pennsylvania State University, University Park, PA, USA
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Lindström S, Ehnvall A, Bergqvist E, Waern M, Dahlin M, Westrin Å. A study protocol of the effectiveness of the Attempted Suicide Short Intervention Program (ASSIP) for recent suicide attempters: a randomized controlled trial. BMC Psychiatry 2024; 24:655. [PMID: 39367366 PMCID: PMC11453000 DOI: 10.1186/s12888-024-06109-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Accepted: 09/23/2024] [Indexed: 10/06/2024] Open
Abstract
BACKGROUND Given the limited research focusing on psychotherapeutic interventions for suicide attempters, it is noteworthy that the Attempted Suicide Short Intervention Program (ASSIP) has demonstrated promising results in previous studies. In this investigation, we aim to evaluate the effectiveness of ASSIP across diverse healthcare settings, outlining the study design and planned evaluation. METHODS Using a Randomized Controlled Trial (RCT) design with four assessment points (baseline, 3, 12- and 24-month follow-up), we aim to assess the effect of the 3-session psychotherapeutic intervention and hereafter brief contact via structured letters during 2 years in a clinical sample of recent suicide attempters (suicide attempts within three months before inclusion). Participants are randomly assigned to one of two groups; treatment as usual plus ASSIP or the control condition, treatment as usual. Assessments include measures of suicidal intent, coping, symptoms of depression, quality of life, self-stigma, and sick leave. The primary outcome is suicide attempt(s) within 3, 12, and 24 months and the secondary outcome is suicidal ideation within the same time frames after study inclusion. DISCUSSION Findings from this study will provide novel insights regarding the effects of ASSIP on not only subsequent suicidal behavior but also other outcomes including self-stigma, quality of life, social network, sick leave, and symptoms of depression. TRIAL REGISTRATION The trial was registered at ClinicalTrial.gov NCT04746261 on 2020-10-15.
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Affiliation(s)
- Sara Lindström
- Department of Clinical Sciences, Lund, Psychiatry, Lund University, SE-221 84, Lund, Sweden
- Office of Psychiatry and Habilitation, Region Skåne, SE-221 85, Lund, Sweden
| | - Anna Ehnvall
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, SE-413 45, Gothenburg, Sweden
- Psychiatric Outpatient Clinic, Region Halland, SE-432 43, Varberg, Sweden
| | - Erik Bergqvist
- Department of Clinical Sciences, Lund, Psychiatry, Lund University, SE-221 84, Lund, Sweden
- Psychiatric In-patient Clinic, Hallands Sjukhus Varberg, Region Halland, SE-432 81, Varberg, Sweden
| | - Margda Waern
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute, & Stockholm Health Care Services, Region Stockholm, SE-112 81, Stockholm, Sweden
| | - Marie Dahlin
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, SE-413 45, Gothenburg, Sweden
- Department of Psychotic Disorders, Sahlgrenska University Hospital, Region Västra Götaland, SE-431 30, Mölndal, Sweden
| | - Åsa Westrin
- Department of Clinical Sciences, Lund, Psychiatry, Lund University, SE-221 84, Lund, Sweden.
- Office of Psychiatry and Habilitation, Region Skåne, SE-221 85, Lund, Sweden.
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Brooks MA, Dasgupta A, Khadra M, Bawaneh A, Kaushal N, El-Bassel N. Suicidal behaviors among refugee women in Jordan: post-traumatic stress disorder, social support and post-displacement stressors. BMC Public Health 2024; 24:2677. [PMID: 39350144 PMCID: PMC11443886 DOI: 10.1186/s12889-024-20128-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 09/18/2024] [Indexed: 10/04/2024] Open
Abstract
BACKGROUND This paper examines the frequency of suicidal behaviors (suicidal ideation or attempt) among a sample of Syrian refugee women living in non-camp settings in Jordan. We asked several questions surrounding suicide and examined the associations between post-traumatic stress disorder (PTSD), social connectedness, post-displacement stressors and suicidal behaviors. METHODS Participants (n = 507) were recruited using a clinic-based systematic sampling from four health clinics throughout Jordan in 2018. We used a multivariable logistic regression to examine the hypothesis of whether positive screening for PTSD (PCL-5), social isolation (have no friends or family members available to help), and greater number of post-displacement stressors (PMLD Checklist) is associated with suicidal behaviors. RESULTS Approximately one-tenth (9.86%) of participants surveyed reported suicidal behaviors (suicidal ideation or attempt) in the past six months. Our hypothesis was partially supported. In the adjusted multivariable analyses, screening positive for PTSD [OR:4.02 (95% CI:1.33, 12.15)] increased odds of suicidal behaviors, while having one friend or family member available to help when in need [OR:0.31 (95% CI:0.13, 0.78)] decreased odds of suicidal behaviors. We did not find any associations between the number of post-displacement stressors and suicidal behaviors in the multivariable model. CONCLUSION Agencies and practitioners addressing suicidal behaviors among Syrian refugee women should provide interventions that aim to reduce PTSD symptoms and social isolation. Potential intervention includes screening for mental health symptoms and suicidal behaviors during routine visits with service providers, as well as providing proper mental health and psychosocial support services according to the mapping of available services.
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Affiliation(s)
| | - Anindita Dasgupta
- Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, New York, USA
| | - Maysa' Khadra
- University of Jordan School of Medicine, Amman, Jordan
| | | | - Neeraj Kaushal
- Columbia University School of Social Work, New York, USA
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Ricci C, Leuci E, Quattrone E, Palmisano D, Pellegrini P, Menchetti M, Pupo S, Pelizza L. Persistent negative symptoms in young people at clinical high risk of psychosis treated with an Italian early intervention program: a longitudinal study. Eur Arch Psychiatry Clin Neurosci 2024; 274:1311-1326. [PMID: 38668766 PMCID: PMC11362215 DOI: 10.1007/s00406-024-01808-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/02/2024] [Indexed: 08/30/2024]
Abstract
Negative symptoms in CHR-P people are generally not responsive to treatments and commonly related to poorer functional outcome. However, less research attention has been dedicated to Persistent Negative Symptoms (PNS), defined as clinically stable negative symptoms of moderate severity evident for at least 6 months. This study aims to (a) determine the prevalence of PNS in a sample of young people at CHR-P; (b) investigate any association of PNS with functioning and clinical features; (c) examine longitudinal course of PNS across 2 years of follow-up and changes in PNS severity levels with specialized treatments. One Hundred Eighty CHR-P participants were recruited and were divided into CHR-P/PNS + and CHR-P/PNS- subgroups. The clinical assessments were based on the PANSS and the GAF and were conducted at baseline and every 12 months during the follow-up. Twenty four participants showed PNS at entry. Of them, 21 concluded the 2-year follow-up period. At baseline, the CHR-P/PNS + participants showed more educational and employment deficits, and more social and functioning impairment. During the follow-up, the CHR-P/PNS + subgroup had a significant longitudinal decrease in negative symptoms, which was specifically related to antidepressant treatment. CHR-P/PNS + subjects also showed a higher incidence of new hospitalization and a lower functional recovery over time. Our findings support that the persistence of negative symptoms in CHR-P people is longitudinally related to worse daily functioning and more severe clinical conditions that are at higher risk of hospitalization and are less responsive to specialized treatments.
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Affiliation(s)
- Camilla Ricci
- Department of Biomedical and Neuromotor Sciences, "Alma Mater Studiorum" Università degli Studi di Bologna, Via Pepoli 5, 40123, Bologna, Italy
| | - Emanuela Leuci
- Department of Mental Health and Pathological Addictions, Azienda USL di Parma, Largo Palli 1/a, 43100, Parma, Italy
| | - Emanuela Quattrone
- Department of Mental Health and Pathological Addictions, Azienda USL di Parma, Largo Palli 1/a, 43100, Parma, Italy
| | - Derna Palmisano
- Department of Mental Health and Pathological Addictions, Azienda USL di Parma, Largo Palli 1/a, 43100, Parma, Italy
| | - Pietro Pellegrini
- Department of Mental Health and Pathological Addictions, Azienda USL di Parma, Largo Palli 1/a, 43100, Parma, Italy
| | - Marco Menchetti
- Department of Biomedical and Neuromotor Sciences, "Alma Mater Studiorum" Università degli Studi di Bologna, Via Pepoli 5, 40123, Bologna, Italy
| | - Simona Pupo
- Division of Pain Medicine, Department of Medicine and Surgery, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci 14, 43100, Parma, Italy
| | - Lorenzo Pelizza
- Department of Biomedical and Neuromotor Sciences, "Alma Mater Studiorum" Università degli Studi di Bologna, Via Pepoli 5, 40123, Bologna, Italy.
- Department of Mental Health and Pathological Addictions, Azienda USL di Parma, Largo Palli 1/a, 43100, Parma, Italy.
- "Paolo Ottonello" Psychiatry Institute, Via Pepoli 5, 40123, Bologna, BO, Italy.
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Hidalgo-Fuentes S, Caro-Cañizares I, Izquierdo-Sotorrío E. Frequency of suicidal ideation inventory: A reliability generalization meta-analysis. DEATH STUDIES 2024:1-12. [PMID: 39141592 DOI: 10.1080/07481187.2024.2390904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
The objectives of this reliability generalization meta-analysis were to estimate the overall reliability of the Frequency of Suicidal Ideation Inventory (FSII), a short, easily administered test developed to assess suicidal ideation and to examine possible moderating variables. A systematic search was conducted in five databases from the year of publication (2016) of the FSII until March 2024. All studies that applied the FSII and reported a Cronbach's alpha coefficient were included. Analyses were performed using a random effects model applying Bonett's transformation. Our analysis of 32 studies (k = 39) yielded an overall alpha of .91 (95% CI = .90, .92). We found that the type of administration, population, and language of the FSII moderated its reliability, which is high overall and appropriate for use in both research and clinical settings.
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Affiliation(s)
- Sergio Hidalgo-Fuentes
- Departamento de Psicología y Salud, Facultad de Ciencias de la Salud y la Educación, Universidad a Distancia de Madrid, Collado Villalba, Madrid, Spain
- Departamento de Psicología Básica, Facultad de Psicología y Logopedia, Universitat de València, Valencia, Spain
| | - Irene Caro-Cañizares
- Departamento de Psicología y Salud, Facultad de Ciencias de la Salud y la Educación, Universidad a Distancia de Madrid, Collado Villalba, Madrid, Spain
| | - Eva Izquierdo-Sotorrío
- Departamento de Psicología y Salud, Facultad de Ciencias de la Salud y la Educación, Universidad a Distancia de Madrid, Collado Villalba, Madrid, Spain
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Peiper LJ, Cramer RJ, Cacace SC, Peters A, Corral AR, Post AF, Prowten SD, Moxie J. Development and implementation of a self-directed violence prevention training program for correctional behavioral health providers: a clinical trial study protocol. Pilot Feasibility Stud 2024; 10:107. [PMID: 39118161 PMCID: PMC11308153 DOI: 10.1186/s40814-024-01533-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 07/29/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Self-directed violence (SDV) comprises both suicide and self-injury and represents a pressing problem among incarcerated persons. Negative impacts of SDV in correctional settings also extend to behavioral health clinicians (BHCs) (e.g., job turnover). Correctional SDV risk assessment and management standards include staff training as part of the comprehensive approach. The Core Competency Model for Corrections (CCM-C) is a novel, evidence-informed training program for BHCs covering both clinician self-management and clinical care skills. METHODS This pilot trial is a type 3 hybrid implementation-effectiveness approach. It will employ a wait-list control sequential cross-over design. Participants (N = 50-100) will be BHCs employed by the North Carolina Department of Adult Corrections. Following stratification for years of clinical experience, BHCs will be randomly assigned to (1) a training group that receives CCM-C immediately and (2) a wait-list control receiving CCM-C approximately 6 weeks later. Electronically administrated survey evaluation will occur across baseline and two follow-up (i.e., 2 weeks after each training session) time points. DISCUSSION The primary outcome is feasibility assessed through collaboration with a Corrections Advisory Panel and feedback from BHCs. Secondary effectiveness outcomes that will be evaluated over time include SDV-related knowledge, attitudes, stigma, and intent to use training content. We will examine a tertiary outcome, namely compassion fatigue. Clinical trial limitations and impacts are discussed. TRIAL REGISTRATION Clinicaltrials.gov, NCT06359574. This study was registered on 04/05/2024.
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Affiliation(s)
- Lewis J Peiper
- NC Department of Adult Correction, 831 W. Morgan Street, Raleigh, NC, 27699, USA
| | - Robert J Cramer
- Department of Epidemiology and Community Health, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28223, USA.
| | - Sam C Cacace
- Department of Epidemiology and Community Health, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28223, USA
| | - Ava Peters
- Department of Epidemiology and Community Health, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28223, USA
| | - Adria R Corral
- NC Department of Adult Correction, 831 W. Morgan Street, Raleigh, NC, 27699, USA
| | - Abigail F Post
- Department of Epidemiology and Community Health, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28223, USA
| | - Skyler D Prowten
- Department of Epidemiology and Community Health, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28223, USA
| | - Jessamyn Moxie
- Department of Epidemiology and Community Health, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28223, USA
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Alacreu-Crespo A, Innamorati M, Courtet P, Fiorillo A, Pompili M. Are visual analogue scales valid instruments to measure psychological pain in psychiatric patients? J Affect Disord 2024; 358:150-156. [PMID: 38705528 DOI: 10.1016/j.jad.2024.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 04/24/2024] [Accepted: 05/02/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVE The Psychological-Physical-Pain Visual Analogue Scale (PPP-VAS) was thought to probably help in identifying patients at risk of suicide. However, no data on its validity to measure psychological pain was available. Our main aim was to investigate the convergent validity of the PPP-VAS using two well-validated scales of psychological pain, the Orbach and Mikulincer Mental Pain scale (OMMP) and the Holden et al. Psychache Scale. METHODS This multicentre study recruited a total of 1618 adult psychiatric inpatients and outpatients in Italy. Psychological pain was evaluated using the OMMP, Holden et al., and PPP-VAS scales. Psychiatric status, suicidal status, physical pain, depression, and hopelessness were also assessed. RESULTS A structural equation model (SEM) using the items of psychological pain from the PPP-VAS showed that items loaded significantly on the psychological pain factor and showed good fit. Similarly, a second SEM model using the three scales of psychological pain showed acceptable fit and converged into a psychological pain construct. Correlations between the PPP-VAS and depression, hopelessness, and physical pain showed moderate correlations (r = 0.43 to r = 0.67). Finally, psychological pain evaluated with the PPP-VAS was significantly related with recent suicidal ideation in all patients (OR [95 % CI] = 1.07 [1.05, 1.09]) and recent suicide attempts in moderately to severely depressed patients, OR [95 % CI] = 1.01 [1.02, 1.03]. CONCLUSION The PPP-VAS showed good psychometric properties in evaluating psychological pain. The characteristics of the PPP-VAS makes this scale a great option for its use in clinical practice to detect patients at risk of suicide.
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Affiliation(s)
- Adrián Alacreu-Crespo
- Department of Psychology and Sociology, Area of Personality, Assessment and Psychological Treatment, University of Zaragoza, Teruel, Spain.
| | - Marco Innamorati
- Department of Human Sciences, European University of Rome, Rome, Italy
| | - Philippe Courtet
- PSNREC, University of Montpellier, INSERM, Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health, and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapieza University of Rome, Rome, Italy
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Kim C, Dusing GJ, Jin H, Chum A. Examining the effects of social assistance on suicide-related behaviour among impoverished older adults in Korea using a nationwide cohort study from 2010-2019. Sci Rep 2024; 14:16632. [PMID: 39025874 PMCID: PMC11258222 DOI: 10.1038/s41598-024-61845-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/10/2024] [Indexed: 07/20/2024] Open
Abstract
Suicide rates among older adults in Korea are one of the highest in the world. Although prior research found that poverty is associated with suicide mortality among older adults in Korea, it is unknown whether being a recipient of social assistance may reduce suicide risk among older adults living in poverty. We examined the impact of the public assistance program on suicide-related behaviour (SRB). Data from a nationwide cohort in the Korean National Health Insurance Database, including demographic and medical treatment information, linked to the vital statistics for 2010-19 was used. The entire Korean population born before 1951 was included (n = 7,889,086). Flexible parametric survival model was performed to assess whether the risk of SRB hospitalisation and death differed across a) different levels of socioeconomic status, and b) social assistance status among the poor, using gender-stratified models. Older age, chronic disease, poverty, and being out of the labour market were associated with higher SRB hospitalisation and death for both genders. Among those living in poverty, social assistance recipients had lower rates for SRB death and hospitalisation, compared to the low-income non-recipients. Men who were non-recipients had 0.21 higher hazards ratio (95%CI 0.20 to 0.22) for SRB deaths compared to recipients, and the difference was 0.11 (95%CI 0.10 to 0.11) in women, with similar patterns for SRB hospitalizations. Poverty was associated with higher SRB death and hospitalisation among older adults in Korea. Social assistance targeting the older population may help reduce SRB.
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Affiliation(s)
- Chungah Kim
- School of Kinesiology and Health Science, York University, 4700 Keele St, Toronto, ON, M3J 1P3, Canada
| | - Gabriel John Dusing
- School of Kinesiology and Health Science, York University, 4700 Keele St, Toronto, ON, M3J 1P3, Canada
| | - Hyunju Jin
- Zhejiang Normal University, Zhejiang, China
- Seoul National University, Seoul, South Korea
| | - Antony Chum
- School of Kinesiology and Health Science, York University, 4700 Keele St, Toronto, ON, M3J 1P3, Canada.
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M7, Canada.
- Unity Health Toronto, St. Michael's Hospital, 30 Bond St, Toronto, ON, M5B 1W8, Canada.
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Littlefield AK, Himes KP, Conner KR, Bagge CL. Warning signs in a period of acute risk for suicide attempt: The utility of count- and combination-based classification. Gen Hosp Psychiatry 2024; 89:55-59. [PMID: 38795612 DOI: 10.1016/j.genhosppsych.2024.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 05/10/2024] [Accepted: 05/10/2024] [Indexed: 05/28/2024]
Abstract
OBJECTIVE This study sought to establish if models involving the specific combinations of identifiable behavioral warning signs (WS; i.e., alcohol use, suicidal communications, preparation of personal affairs, experiencing negative interpersonal life events) for a suicide attempt outperformed a simpler count model of WS to distinguish an acute risk period (the six hours prior to a suicide attempt) from a control period (a matched six-hour period the day prior). METHOD Generalized linear mixed models tested all logical combinations of four behavioral WS in addition to a count variable of the number of behavioral warning signs. For the count variable, receiver operating characteristic curve analysis was utilized to determine the optimal cut point for the number of endorsed WS. RESULTS Area under the curve (AUC) compared classification across all models, with the count model demonstrating similar classification performance to the best multivariate model (AUCs of 0.72 and 0.73, respectively), with an optimal cut point of endorsing one or more WS. CONCLUSION Although determinations of acute risk should be informed by multiple sources of information, this study suggests a relatively simple count-based approach that considers the presence of one (or more) behavioral WS may be used as a potential indication of increased acute risk for suicide attempt.
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Affiliation(s)
| | - Katie P Himes
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
| | - Kenneth R Conner
- Department of Emergency Medicine and Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Courtney L Bagge
- Department of Psychiatry, University of Michigan Medical Center, Ann Arbor, MI, USA; VA Center for Clinical Management Research, Department of Veteran Affairs, Ann Arbor, MI, USA
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Pelizza L, Leuci E, Quattrone E, Azzali S, Pupo S, Paulillo G, Menchetti M, Pellegrini P. Adverse outcome analysis in people at clinical high risk for psychosis: results from a 2-year Italian follow-up study. Soc Psychiatry Psychiatr Epidemiol 2024; 59:1177-1191. [PMID: 38091031 DOI: 10.1007/s00127-023-02597-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 11/20/2023] [Indexed: 06/15/2024]
Abstract
PURPOSE Since January 2016, the Parma Department of Mental Health (in Italy) developed a specialized care program for Early Intervention (EI) in individuals at Clinical High Risk for Psychosis (CHR-P). As unfavorable outcomes other than transition to psychosis were not systematically reported in the current literature (thereby compromising more sophisticated prognostic stratifications), the aims of this research were (1) to investigate adverse outcome indicators (i.e., service disengagement, psychosis transition, hospitalization, prolonged functioning impairment, prolonged persistence of CHR-P criteria, suicide attempts) in an Italian CHR-P population enrolled within a specialized EI service across a 2-year follow-up period, and (2) to examine their relevant associations with sociodemographic and clinical characteristics of the CHR-P total sample at baseline. METHODS All participants were young CHR-P help-seekers aged 12-25 years. They completed the "Comprehensive Assessment of At-Risk Mental States" (CAARMS) and the Health of the Nation Outcome Scale (HoNOS). Both univariate and multivariate Cox regression analyses were performed. RESULTS 164 CHR-P individuals were enrolled in this study. Across the follow-up, 30 (18.0%) dropped out the EI program, 23 (14%) transitioned to psychosis, 24 (14.6%) were hospitalized, 23 (14%) had a prolonged persistence of CHR-P criteria and 54 (47%) showed prolonged impairment in socio-occupational functioning. CONCLUSION As almost half of our participants did not functionally remit over time, sustained clinical attention for young CHR individuals people should be offered in the longer term, also to monitor unfavorable outcomes and to improve long-term prognosis.
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Affiliation(s)
- Lorenzo Pelizza
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, PR, Italy.
- Department of Biomedical and Neuromotor Sciences, Istituto di Psichiatria "Paolo Ottonello", "Alma Mater Studiorum"-Università di Bologna, Via Pepoli, 5, 40126, Bologna, BO, Italy.
| | - Emanuela Leuci
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, PR, Italy
| | - Emanuela Quattrone
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, PR, Italy
| | - Silvia Azzali
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, RE, Italy
| | - Simona Pupo
- Pain Therapy Service, Department of Medicine and Surgery, Azienda Ospedaliero-Universitaria di Parma, Parma, PR, Italy
| | - Giuseppina Paulillo
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, PR, Italy
| | - Marco Menchetti
- Department of Biomedical and Neuromotor Sciences, Istituto di Psichiatria "Paolo Ottonello", "Alma Mater Studiorum"-Università di Bologna, Via Pepoli, 5, 40126, Bologna, BO, Italy
| | - Pietro Pellegrini
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, PR, Italy
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Mournet AM, Bal VH, Kleiman EM. Concordance Between the Ask Suicide Screening Questions (ASQ) and Self-Injurious Thoughts and Behaviors Interview-Self Report (SITBI-SR) Among Autistic and Non-Autistic Adults. Arch Suicide Res 2024; 28:905-916. [PMID: 37641571 DOI: 10.1080/13811118.2023.2252027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
OBJECTIVE This study sought to examine concordance between two commonly used measures of suicidal thoughts and behaviors: the Ask Suicide-Screening Questions (ASQ) and the Self-Injurious Thoughts and Behaviors Interview-Self Report (SITBI-SR). Agreement was operationalized as the presence past month suicidal ideation and lifetime suicide attempts. To explore the utilization of these tools among neurodiverse samples, we also examined the concordance across autistic and non-autistic adults. METHODS The sample consisted of 200 individuals recruited online. Half of the sample self-reported a diagnosis of autism. A series of Cohen's kappas and confidence intervals were computed to assess agreement between the ASQ and SITBI-SR. Cohen's kappa was computed separately for each set of comparisons for the autistic and non-autistic samples. RESULTS Past month suicidal ideation had a kappa of 0.61 (95%CI = 0.48-0.73). The kappa for lifetime suicide attempts was 0.86 (95%CI = 0.78-0.94). There were no significant differences in agreement between the two measures for autistic versus non-autistic individuals. CONCLUSIONS Current findings suggest that the ASQ and SITBI-SR have high concordance with one another. Given that the ASQ and the SITBI-SR are both validated in the general population and that concordance was high and not significantly different based on autism status, the current study provides preliminary evidence that the ASQ and the SITBI-SR function similarly for autistic individuals.HIGHLIGHTSPeople do not always respond consistently to different STB assessment methods.Findings suggest that the ASQ and SITBI-SR have high concordance with one another.Evidence provided that these measures function similarly for autistic individuals.
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Kaurin A, Wright AGC, Porta G, Hamilton E, Poling K, Bero K, Brent D, Goldstein TR. Weekly links among irritability and suicidal thoughts and behaviors in high-risk youth. J Child Psychol Psychiatry 2024. [PMID: 38651278 DOI: 10.1111/jcpp.13988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/20/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Previous studies demonstrate a link between irritability and suicidal thoughts and behaviors (STBs) in youth samples. However, they have mostly assessed irritability in community samples and as a largely dispositional (i.e. trait-like) construct. Thus, it remains unclear to what extent links between irritability and STBs reflect within-person processes of elevated risk in clinically meaningful time periods. METHODS The present study used clinical data from 689 adolescents aged 12-19 years attending a total of 6,128 visits at a specialty Intensive Outpatient Program for depressed and suicidal youth to examine patterns in weekly assessments of irritability and STBs throughout treatment, including associations among trends and fluctuations departing from these trends via multilevel structural equation modeling. Youth completed self-report measures of irritability, depression, and STBs weekly as part of standard IOP clinical care. RESULTS Overall, two-thirds of variance in weekly irritable mood was accounted for by between-person differences and the remaining portion by weekly fluctuations. After controlling for depression, during weeks when youth were more irritable they experienced increased STBs. Rates of change in irritability and STBs tended to track together at early stages of treatment, but these effects were generally accounted for by depression severity. CONCLUSIONS Our results suggest that although changes in STBs are best accounted for by depression, irritability can be understood as a specific, proximal risk factor for youth STBs that exacerbates youth STBs in clinically informative timeframes above and beyond depression.
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Affiliation(s)
- Aleksandra Kaurin
- Department of Psychology, University of Wuppertal, Wuppertal, Germany
| | - Aidan G C Wright
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Giovanna Porta
- Western Psychiatric Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Edward Hamilton
- Western Psychiatric Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Kimberly Poling
- Western Psychiatric Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Kelsey Bero
- Western Psychiatric Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - David Brent
- Western Psychiatric Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Tina R Goldstein
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
- Western Psychiatric Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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Kim C, Jin H, Kang G, Dusing GJ, Chum A. Patterns of follow-up mental health care after hospitalization for suicide-related behaviors among older adults in South Korea. J Affect Disord 2024; 350:313-318. [PMID: 38237869 DOI: 10.1016/j.jad.2024.01.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 01/03/2024] [Accepted: 01/05/2024] [Indexed: 01/21/2024]
Abstract
OBJECTIVE This study aimed to investigate the sociodemographic and clinical factors associated with receiving follow-up mental healthcare within 7 days and 30 days after hospitalization for suicide-related behaviors (SRB) among older adults in South Korea. METHODS Data from the Korean National Health Information Database were used, including information on sociodemographic variables and healthcare utilization. The study cohort consisted of individuals born in 1950 or before with a prior hospitalization record for suicide attempts or probable suicide attempts. Logistic regression analysis was conducted to predict the odds of receiving follow-up care within 7 days and 30 days, adjusting for covariates. RESULTS Among the 37,595 older adults discharged from hospitalization for SRB, 29.13 % and 37.86 % received follow-up care within 7 days and 30 days, respectively. Follow-up care was more common among younger individuals, women, those with higher socio-economic status (SES), urban residents, and individuals with comorbidities. CONCLUSION The provision of mental health follow-up care for older adults after hospitalization for suicide attempts is inadequate in South Korea. Increasing access to follow-up care among those with lower income, residing in rural areas, and older age is crucial. Public awareness campaigns, stigma reduction training for healthcare providers, and system-level changes, such as telemedicine and integrated care pathways, can help bridge the healthcare gap and reduce suicide mortality among older adults.
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Affiliation(s)
- Chungah Kim
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Hyunju Jin
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China; Seoul National University Institute of Sport Science, Seoul, South Korea
| | - Goneui Kang
- Department of Economics, Korea University, Seoul, South Korea
| | | | - Antony Chum
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
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Pelizza L, Leuci E, Quattrone E, Azzali S, Paulillo G, Pupo S, Pellegrini P, Gammino L, Biancalani A, Menchetti M. Borderline personality disorder vs. schizophrenia spectrum disorders in young people recruited within an "Early Intervention in Psychosis" service: clinical and outcome comparisons. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01772-5. [PMID: 38472469 DOI: 10.1007/s00406-024-01772-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 01/28/2024] [Indexed: 03/14/2024]
Abstract
Borderline Personality Disorder (BPD) is under-recognized in First-Episode Psychosis (FEP) and its psychotic manifestations are difficult to differentiate from Schizophrenia Spectrum Disorders (SSD). The aim of this investigation was to compare clinical, sociodemographic, and outcome characteristics between FEP patients with BPD vs. FEP subjects with SSD both at baseline and across a 2-year follow-up period. Participants completed the Health of the Nation Outcome Scale (HoNOS), the Positive And Negative Syndrome Scale (PANSS), and the Global Assessment of Functioning (GAF) scale both at entry and every 12 months during the follow-up. A mixed-design ANOVA model was conducted to investigate the temporal stability of clinical scores within and between the two subgroups. Among 356 FEP participants, 49 had a BPD diagnosis. Compared to FEP/SSD (n = 307), FEP/BPD patients showed higher prevalence of employment, current substance use, and past attempted suicide. They had a lower equivalent dose of antipsychotic medication at entry and lower levels of negative symptoms. Finally, they had a higher 2-year drop-out rate and a significant improvement in psychopathological scores limited to the first year of treatment. BPD as categorical entity represents a FEP subgroup with specific clinical challenges. Appropriate treatment guidelines for this FEP subgroup are thus needed.
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Affiliation(s)
- Lorenzo Pelizza
- Department of Biomedical and Neuromotor Sciences, Psychiatry Institute, "Alma Mater Studiorum" Università degli Studi di Bologna, Via Pepoli 5, 40123, Bologna, BO, Italy.
- Department of Mental Health and Pathological Addictions, Azienda USL di Parma, Largo Palli 1/a, 43100, Parma, Italy.
| | - Emanuela Leuci
- Department of Mental Health and Pathological Addictions, Azienda USL di Parma, Largo Palli 1/a, 43100, Parma, Italy
| | - Emanuela Quattrone
- Department of Mental Health and Pathological Addictions, Azienda USL di Parma, Largo Palli 1/a, 43100, Parma, Italy
| | - Silvia Azzali
- Department of Mental Health and Pathological Addictions, Azienda USL-IRCCS di Reggio Emilia, Via Amendola 2, 43100, Reggio Emilia, Italy
| | - Giuseppina Paulillo
- Department of Mental Health and Pathological Addictions, Azienda USL di Parma, Largo Palli 1/a, 43100, Parma, Italy
| | - Simona Pupo
- Division of Pain Medicine, Department of Medicine and Surgery, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci 14, 43100, Parma, Italy
| | - Pietro Pellegrini
- Department of Mental Health and Pathological Addictions, Azienda USL di Parma, Largo Palli 1/a, 43100, Parma, Italy
| | - Lorenzo Gammino
- Department of Mental Health and Pathological Addictions, Azienda USL di Bologna, Via Castiglione 29, 40124, Bologna, Italy
| | - Arianna Biancalani
- Department of Biomedical and Neuromotor Sciences, Psychiatry Institute, "Alma Mater Studiorum" Università degli Studi di Bologna, Via Pepoli 5, 40123, Bologna, BO, Italy
| | - Marco Menchetti
- Department of Biomedical and Neuromotor Sciences, Psychiatry Institute, "Alma Mater Studiorum" Università degli Studi di Bologna, Via Pepoli 5, 40123, Bologna, BO, Italy
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Liu X, Yang Y, Liu ZZ, Jia CX. Life stress and suicidality mediated by insomnia and depressive symptoms in adolescents: a three-wave longitudinal study. Sleep 2024; 47:zsad121. [PMID: 37075813 DOI: 10.1093/sleep/zsad121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 04/07/2023] [Indexed: 04/21/2023] Open
Abstract
STUDY OBJECTIVES Little empirical work has investigated the associations between life stress (LS), insomnia, depression, and suicidality in multi-wave longitudinal studies. With three waves of data collection 1-year apart, this longitudinal study with a large sample of adolescents examined the predicting effects of LS on suicidality 1-year later and 2 years later and the mediating roles of insomnia and depression in the LS-suicidality link. METHODS A total of 6995 adolescents (mean age = 14.86 years, 51.4% male) participated in a three-wave longitudinal study of behavior and health in Shandong, China. A self-administered structured questionnaire and standardized scales were used to assess suicidality (including suicidal thought [ST], suicide plan [SP], and suicide attempt [SA]), LS, insomnia, and depression in 2015 (T1), 1-year later (T2), and 2 years later (T3). Mediation effects were examined with path models. RESULTS The overall prevalence rates of past-year suicidality were 13.4% at T1, 10.0% at T2, and 9.5% at T3, respectively. The prevalence rates of suicidality across T1-T3 significantly increased with elevated levels of baseline LS, insomnia, and depression (p < .001). Path models indicated that the relationship between baseline LS and suicidal ideation (i.e., ST/SP) 2 years later was significantly mediated by both insomnia and depression. Depression was also a significant mediator between LS and SA. CONCLUSIONS LS is a significant predictor of suicidality 1-2 years later in adolescents. Depression mediates the association between LS and suicidal ideation and suicide attempt while insomnia appears to be a mediator for suicidal ideation rather than suicide attempt.
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Affiliation(s)
- Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, USA
| | - Yanyun Yang
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, FL, USA
| | - Zhen-Zhen Liu
- School of Psychology, Northeast Normal University, Changchun, China
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo Medical College, Shandong University, Jinan, China
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16
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Seong E, Lee KH, Lee JS, Kim S, Seo DG, Yoo JH, Han DH, Hwang H, Choi CH, Kim JW. Depression and posttraumatic stress disorder in adolescents with nonsuicidal self-injury: comparisons of the psychological correlates and suicidal presentations across diagnostic subgroups. BMC Psychiatry 2024; 24:138. [PMID: 38373899 PMCID: PMC10877746 DOI: 10.1186/s12888-024-05533-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 01/18/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Nonsuicidal self-injury (NSSI) combined with suicide ideation increases the risk of suicidal behaviors. Depression and posttraumatic stress disorder (PTSD) are comorbidities of NSSI compounding this relationship. The present study compared diagnostic subgroups of NSSI based on current depression and PTSD on psychological correlates (i.e., vulnerabilities and impairment) and suicidal presentations (i.e., suicidal cognitions and behaviors) in a psychiatric sample of adolescents. METHODS Eighty-seven adolescents meeting DSM-5 criteria for NSSI and 104 age-range-matched nonclinical controls (NC) participated. Participants completed self-report measures on psychological vulnerabilities and impairment (e.g., emotion regulation difficulties, negative cognitions). Adolescents with NSSI also completed clinical interviews on psychiatric diagnoses and a recent self-injurious behavior (SIB). Scores on the psychological correlates of NSSI were compared between adolescents with NSSI and NC, and across three diagnostic subgroups of NSSI (A: NSSI+/depression-/PTSD-, n = 14; B: NSSI+/depression+/PTSD-, n = 57; C: NSSI+/depression+/PTSD+, n = 14). Differences between NSSI diagnostic subgroups were tested on the motives for SIB and accompanying suicidal presentations (e.g., desire, intent, motive, lethality). RESULTS Common comorbidities of NSSI included depression, panic disorder, generalized anxiety disorder, and PTSD. The NSSI subgroup classification was significantly associated with panic disorder, which was controlled for in the subsequent group comparisons. Overall, adolescents who engage in NSSI with vs. without depression reported more psychological vulnerabilities and impairment and a greater degree of suicidal thoughts/desire in SIB (i.e., groups B, C >A), which remained significant after controlling for panic disorder. An increased odds of the suicidal motive for SIB was found in adolescents with all three conditions (i.e., group C: NSSI+/depression+/PTSD+) compared to those with NSSI but neither depression nor PTSD (i.e., group A: NSSI+/depression-/PTSD-); however, this was not significant after controlling for panic disorder. CONCLUSIONS Psychological underpinnings of adolescent NSSI in clinical contexts may be largely associated with concurrent depression. Suicidal motives in adolescents who engage in NSSI in the presence of depression and PTSD may be confounded by the co-occurrence of panic disorder. This study warrants the importance of attending to the comorbid depression with NSSI in adolescents as it is related to an increase in suicidal desire accompanying SIB.
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Affiliation(s)
- Eunice Seong
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Kyung Hwa Lee
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jong-Sun Lee
- Department of Psychology, Kangwon National University, 1 Gangwondaehak-gil, Chuncheon, Gangwon-do, 24341, Republic of Korea
| | - Sojung Kim
- Department of Psychology, Yeungnam University, 280 Daehak-ro, Gyeongsan, Gyeongbuk, 38541, Republic of Korea
| | - Dong Gi Seo
- Department of Psychology, Hallym University, 1 Hallymdaehak-gil, Chuncheon, Gangwon-do, 24252, Republic of Korea
| | - Jae Hyun Yoo
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Doug Hyun Han
- Department of Psychiatry, Chung-Ang University College of Medicine, 84 Heukseok-ro, Dongjak-gu, Seoul, 06973, Republic of Korea
| | - Hyunchan Hwang
- Department of Psychiatry, Chung-Ang University College of Medicine, 84 Heukseok-ro, Dongjak-gu, Seoul, 06973, Republic of Korea
| | - Chi-Hyun Choi
- Seoul Alpha Neuropsychiatric Clinic, 511 Nonhyeon-ro, Gangnam-gu, Seoul, 06131, Republic of Korea
| | - Jae-Won Kim
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
- Department of Psychiatry, Institute of Human Behavioral Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
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Bayliss LT, Hughes CD, Lamont-Mills A, du Plessis C. Fluidity in capability: Longitudinal assessments of suicide capability using ecological momentary assessments. Suicide Life Threat Behav 2024; 54:138-153. [PMID: 38009897 DOI: 10.1111/sltb.13025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 11/02/2023] [Accepted: 11/14/2023] [Indexed: 11/29/2023]
Abstract
INTRODUCTION Suicide capability is posited to facilitate the movement from ideation-to-action. Emerging evidence suggests capability comprises both trait- and state-like facets. This study examined fluctuations in and associations of acquired, dispositional, practical, and perceived capabilities, and suicidal mental imagery, and suicidal ideation. METHOD Seventy-five adults (48 females, Mage = 36.53 years) with lived experience of suicidal ideation and/or attempt responded to four prompts per day for 2 weeks that assessed suicide capability and suicidal ideation. Mean-squared successive differences and probability of acute change indices and multilevel models were used for analyses. RESULTS All facets of suicide capability fluctuated. Acquired and dispositional capabilities were trait-like, with practical and perceived capabilities being state-like. Suicidal mental imagery was the only facet of suicide capability that distinguished participants with a suicide attempt in the past 12 months from participants with a suicide attempt more than 1 year ago and suicide ideators. Suicidal mental imagery was associated with concurrent suicidal ideation and predictive of next assessment suicidal ideation. CONCLUSION Suicidal mental imagery may be uniquely associated with suicide capability. This study suggests there are trait- and state-like facets of capability that can combine to potentially ready an individual to engage in suicidal behaviors.
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Affiliation(s)
- Luke T Bayliss
- School of Psychology and Wellbeing, University of Southern Queensland, Ipswich, Queensland, Australia
- Centre for Health Research, University of Southern Queensland, Springfield, Queensland, Australia
| | - Christopher D Hughes
- Butler Hospital and Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Andrea Lamont-Mills
- Centre for Health Research, University of Southern Queensland, Springfield, Queensland, Australia
- Academic Affairs Division, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Carol du Plessis
- School of Psychology and Wellbeing, University of Southern Queensland, Ipswich, Queensland, Australia
- Centre for Health Research, University of Southern Queensland, Springfield, Queensland, Australia
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18
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Minian N, Gayapersad A, Coroiu A, Dragonetti R, Zawertailo L, Zaheer J, O’Neill B, Lange S, Thomson N, Crawford A, Kennedy SH, Selby P. Prototyping the implementation of a suicide prevention protocol in primary care settings using PDSA cycles: a mixed method study. Front Psychiatry 2024; 15:1286078. [PMID: 38333892 PMCID: PMC10850298 DOI: 10.3389/fpsyt.2024.1286078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 01/04/2024] [Indexed: 02/10/2024] Open
Abstract
Introduction In Canada, approximately 4,500 individuals die by suicide annually. Approximately 45% of suicide decedents had contact with their primary care provider within the month prior to their death. Current versus never smokers have an 81% increased risk of death by suicide. Those who smoke have additional risks for suicide such as depression, chronic pain, alcohol, and other substance use. They are more likely to experience adverse social determinants of health. Taken together, this suggests that smoking cessation programs in primary care could be facilitators of suicide prevention, but this has not been studied. Study objectives The objectives of the study are to understand barriers/facilitators to implementing a suicide prevention protocol within a smoking cessation program (STOP program), which is deployed by an academic mental health and addiction treatment hospital in primary care clinics and to develop and test implementation strategies to facilitate the uptake of suicide screening and assessment in primary care clinics across Ontario. Methods The study employed a three-phase sequential mixed-method design. Phase 1: Conducted interviews guided by the Consolidated Framework for Implementation Research exploring barriers to implementing a suicide prevention protocol. Phase 2: Performed consensus discussions to map barriers to implementation strategies using the Expert Recommendations for Implementing Change tool and rank barriers by relevance. Phase 3: Evaluated the feasibility and acceptability of implementation strategies using Plan Do Study Act cycles. Results Eleven healthcare providers and four research assistants identified lack of training and the need of better educational materials as implementation barriers. Participants endorsed and tested the top three ranked implementation strategies, namely, a webinar, adding a preamble before depression survey questions, and an infographic. After participating in the webinar and reviewing the educational materials, all participants endorsed the three strategies as acceptable/very acceptable and feasible/very feasible. Conclusion Although there are barriers to implementing a suicide prevention protocol within primary care, it is possible to overcome them with strategies deemed both acceptable and feasible. These results offer promising practice solutions to implement a suicide prevention protocol in smoking cessation programs delivered in primary care settings. Future efforts should track implementation of these strategies and measure outcomes, including provider confidence, self-efficacy, and knowledge, and patient outcomes.
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Affiliation(s)
- Nadia Minian
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Institute of Medical Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Allison Gayapersad
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Adina Coroiu
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Rosa Dragonetti
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Laurie Zawertailo
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Juveria Zaheer
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Braden O’Neill
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Shannon Lange
- Institute of Medical Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Nicole Thomson
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Allison Crawford
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Sidney H. Kennedy
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Arthur Sommer Rotenberg Program in Suicide Studies, Unity Health Toronto, Toronto, ON, Canada
| | - Peter Selby
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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López-Díaz Á, Palermo-Zeballos FJ, Gutierrez-Rojas L, Alameda L, Gotor-Sánchez-Luengo F, Garrido-Torres N, Métrailler J, Alerci L, Bonnarel V, Cano-Domínguez P, Avanesi-Molina E, Soto-Ontoso M, Torrecilla-Olavarrieta R, Muñoz-Manchado LI, Torres-Hernández P, González-Higueras F, Prados-Ojeda JL, Herrera-Cortés M, Meca-García JM, Gordillo-Urbano RM, Sánchez-Robles C, Delgado-Durán T, Soriano-Peña MF, Golay P, Conus P, Crespo-Facorro B, Ruiz-Veguilla M. Proxy measures for the assessment of psychotic and affective symptoms in studies using electronic health records. BJPsych Open 2024; 10:e22. [PMID: 38179604 PMCID: PMC10790217 DOI: 10.1192/bjo.2023.623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/31/2023] [Accepted: 11/14/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND There is a lack of standardised psychometric data in electronic health record (EHR)-based research. Proxy measures of symptom severity based on patients' clinical records may be useful surrogates in mental health EHR research. AIMS This study aimed to validate proxy tools for the short versions of the Positive and Negative Syndrome Scale (PANSS-6), Young Mania Rating Scale (YMRS-6) and Montgomery-Åsberg Depression Rating Scale (MADRS-6). METHOD A cross-sectional, multicentre study was conducted in a sample of 116 patients with first-episode psychosis from 12 public hospitals in Spain. Concordance between PANSS-6, YMRS-6 and MADRS-6 scores and their respective proxies was evaluated based on information from EHR clinical notes, using a variety of statistical procedures, including multivariate tests to adjust for potential confounders. Bootstrapping techniques were used for internal validation, and an independent cohort from the Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne, Switzerland) for external validation. RESULTS The proxy versions correlated strongly with their respective standardised scales (partial correlations ranged from 0.75 to 0.84) and had good accuracy and discriminatory power in distinguishing between patients in and not in remission (percentage of patients correctly classified ranged from 83.9 to 91.4% and bootstrapped optimism-corrected area under the receiver operating characteristic curve ranged from 0.76 to 0.89), with high interrater reliability (intraclass correlation coefficient of 0.81). The findings remained robust in the external validation data-set. CONCLUSIONS The proxy instruments proposed for assessing psychotic and affective symptoms by reviewing EHR provide a feasible and reliable alternative to traditional structured psychometric procedures, and a promising methodology for real-world practice settings.
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Affiliation(s)
- Álvaro López-Díaz
- Mental Health Clinical Management Unit, Virgen Macarena University Hospital, Seville, Spain; Translational Psychiatry Research Group (PsyNal), Seville Biomedical Research Centre (IBiS), Spain; Spanish Network for Research in Mental Health, Carlos III Institute (CIBERSAM, ISCIII), Seville, Spain; Department of Psychiatry, School of Medicine, University of Seville, Spain; and First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain
| | - Fernanda Jazmín Palermo-Zeballos
- Mental Health Clinical Management Unit, Virgen Macarena University Hospital, Seville, Spain; and First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain
| | - Luis Gutierrez-Rojas
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; Mental Health Clinical Management Unit, San Cecilio University Hospital, Granada, Spain; Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, Spain; and Department of Psychiatry, University of Granada, Spain
| | - Luis Alameda
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP), Lausanne University Hospital and University of Lausanne, Switzerland; and Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Francisco Gotor-Sánchez-Luengo
- Department of Psychiatry, School of Medicine, University of Seville, Spain; First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Virgen del Rocío University Hospital, Seville, Spain
| | - Nathalia Garrido-Torres
- Translational Psychiatry Research Group (PsyNal), Seville Biomedical Research Centre (IBiS), Spain; Spanish Network for Research in Mental Health, Carlos III Institute (CIBERSAM, ISCIII), Seville, Spain; First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Virgen del Rocío University Hospital, Seville, Spain
| | - Johann Métrailler
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP), Lausanne University Hospital and University of Lausanne, Switzerland
| | - Livia Alerci
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP), Lausanne University Hospital and University of Lausanne, Switzerland
| | - Vincent Bonnarel
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP), Lausanne University Hospital and University of Lausanne, Switzerland
| | - Pablo Cano-Domínguez
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Virgen de la Victoria University Hospital, Málaga, Spain
| | - Elma Avanesi-Molina
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Virgen de la Victoria University Hospital, Málaga, Spain
| | - Miguel Soto-Ontoso
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Torrecárdenas University Hospital, Almería, Spain
| | - Rocio Torrecilla-Olavarrieta
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Jerez University Hospital, Cádiz, Spain
| | - Leticia Irene Muñoz-Manchado
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Jerez University Hospital, Cádiz, Spain
| | - Pedro Torres-Hernández
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Jaén University Hospital, Spain
| | - Fermín González-Higueras
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Jaén University Hospital, Spain
| | - Juan Luis Prados-Ojeda
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Reina Sofía University Hospital, Córdoba, Spain
| | - Mario Herrera-Cortés
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Reina Sofía University Hospital, Córdoba, Spain
| | - José Miguel Meca-García
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Poniente University Hospital, Almería, Spain
| | - Rafael Manuel Gordillo-Urbano
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Infanta Margarita Hospital, Córdoba, Spain
| | - Cristina Sánchez-Robles
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Juan Ramón Jiménez Hospital, Huelva, Spain
| | - Tomás Delgado-Durán
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Juan Ramón Jiménez Hospital, Huelva, Spain
| | - María Felipa Soriano-Peña
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, San Agustín University Hospital, Linares, Spain
| | - Philippe Golay
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP), Lausanne University Hospital and University of Lausanne, Switzerland
| | - Philippe Conus
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP), Lausanne University Hospital and University of Lausanne, Switzerland
| | - Benedicto Crespo-Facorro
- Translational Psychiatry Research Group (PsyNal), Seville Biomedical Research Centre (IBiS), Spain; Spanish Network for Research in Mental Health, Carlos III Institute (CIBERSAM, ISCIII), Seville, Spain; Department of Psychiatry, School of Medicine, University of Seville, Spain; First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Virgen del Rocío University Hospital, Seville, Spain
| | - Miguel Ruiz-Veguilla
- Translational Psychiatry Research Group (PsyNal), Seville Biomedical Research Centre (IBiS), Spain; Spanish Network for Research in Mental Health, Carlos III Institute (CIBERSAM, ISCIII), Seville, Spain; Department of Psychiatry, School of Medicine, University of Seville, Spain; First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Virgen del Rocío University Hospital, Seville, Spain
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20
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Berardelli I, Aguglia A, Amerio A, Sarubbi S, Rogante E, Trocchia MA, Zelletta D, Longhini L, Erbuto D, Pastorino F, Lamis DA, Innamorati M, Serafini G, Pompili M. Characterization of Psychiatric Inpatients: The Role of Gender Differences in Clinical and Pharmacological Patterns. J Psychiatr Pract 2024; 30:2-12. [PMID: 38227722 DOI: 10.1097/pra.0000000000000756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
BACKGROUND Severe mental disorders that require hospitalization are disabling conditions that contribute to the burden of mental diseases. They pose increased clinical challenges and highlight the need to thoroughly explore variables emerging from daily clinical practice. In this study, we assessed to what extent gender differences may characterize a large population of psychiatric inpatients. METHODS We conducted a cross-sectional study in 2 Italian teaching medical centers, which included 2358 patients who were consecutively admitted to the psychiatric emergency units. We explored and characterized gender differences for variables such as prevalence of psychiatric diagnosis, presence of suicidal ideation, suicide attempts, age at onset of psychiatric illness, presence of substance or alcohol abuse, length of stay, number of hospitalizations, presence of involuntary admission, type of discharge from the hospital, and pharmacological treatment at discharge. RESULTS Female patients were primarily diagnosed with bipolar disorder or personality disorders. Female patients had a significantly higher prevalence of lifetime suicide attempts (23.1% vs. 16.5%, P<0.001) and a longer length of hospitalization (11.43±10.73 d vs. 10.52±10.37 d, t=-2.099, gl=2356, P=0.036) compared with male patients. Male patients had more involuntary admissions (25.1% vs. 19.7%, χ2=9.616, gl=1, P=0.002), more use of illicit substances (34.1% vs. 20.9%, χ2=51.084, gl=1, P<0.001), and higher rates of alcohol abuse (21.3% vs. 14.7%, χ2=17.182, gl=1, P<0.001) compared with female patients. Finally, antidepressants and lithium were prescribed more frequently to the female patients, whereas other mood stabilizers were more often prescribed to the male patients. CONCLUSIONS Our real-world results highlighted gender differences among patients with severe mental disorders admitted to psychiatric units, and suggest further investigations that may help in understanding trajectories accompanying disabling clinical conditions.
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21
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Pedrola-Pons A, Sanchez-Carro Y, Pemau A, Garcia-Ramos A, De la Torre-Luque A. Efficiency of psychological interventions in the prevention of suicidal behavior and self-injury in penitentiary population: A systematic review. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2024; 92:101948. [PMID: 38219472 DOI: 10.1016/j.ijlp.2023.101948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 12/21/2023] [Accepted: 12/22/2023] [Indexed: 01/16/2024]
Abstract
INTRODUCTION Suicidal behavior is an important public health problem, with a high prevalence in penitentiary context. Nowadays, there is a wide variety of specific treatment programs, aimed to prevent suicidal and self-injurious behavior in incarcerated people. These programs show relative efficiency depending on the model of the psychological intervention applied. This systematic review evaluates the efficiency of suicidal and self-injurious behavior prevention programs in prisons. METHOD Empirical studies, evaluating prevention programs for suicidal and self-injurious behavior in penitentiary context were considered for inclusion. PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) directives were followed. Studies from 1990 to 2022 were reviewed, based on the review developed by Winicov (2019) that covered the time lapse between 1990 and 2015. Articles from 2015 to 2022 were located by database research (EBSCOHost, ScienceDirect, PubMed & ProQuest). RESULTS 44,050 potential studies were identified. Eighteen were included in this systematic review (9 studies by Winicov, 2019). 14 studies showed efficacy of intervention programs on self-injury behavior. The use of Cognitive Behavioral Therapy (CBT) reduced suicidal ideation. In addition, positive results were observed in 3 studies using third-generation therapies as an intervention. CONCLUSIONS Suicidal and self-injurious behavior in prison shows lower levels of incidence when specific treatment programs are applied. It's crucial to increase the evaluation in relation to the implementation of new treatment models (i.e., Dialectical Behavior Therapy - DBT, Acceptance and Commitment Therapy - ACT, Mindfulness, Functional Analytic Psychotherapy - FAP) as to better orientate prevention strategies. Further research is needed in gender sensitive interventions.
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Affiliation(s)
- Anna Pedrola-Pons
- Valencian International University, Spain; Institute of Social Work and Social Services (INTRESS), Spain
| | - Yolanda Sanchez-Carro
- Center for Biomedical Research in Mental Health (CIBERSAM), Carlos III Health Institute, Spain
| | | | | | - Alejandro De la Torre-Luque
- Complutense University of Madrid, Spain; Center for Biomedical Research in Mental Health (CIBERSAM), Carlos III Health Institute, Spain
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22
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Beaton MA, Gratch I, Cha CB. Specificity, frequency, and intent: Multiple characteristics of adolescents' suicide plan correlate with their history of suicidal behavior. Suicide Life Threat Behav 2023; 53:1025-1037. [PMID: 37720928 DOI: 10.1111/sltb.13002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 08/12/2023] [Accepted: 08/30/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND Suicide plans (SP) can be a common precipitant to suicidal behavior (SB) during adolescence, and SPs can vary in how specific they are, how frequently they are thought about, and how strongly they are intended to be enacted. To date, we have limited understanding of how discrete SP characteristics (i.e., specificity, frequency, and intent to act) present among adolescents, and whether they relate to SB. In the current study, we investigated SP characteristics and their association with SB history among adolescents who had previously considered suicide. METHODS Participants were 142 community-based adolescents (14-19 years; M = 17.6, SD = 1.4) who reported a history of suicidal ideation. Adolescents provided responses pertaining to their SP history, SP characteristics, and SB history, via the Self-Injurious Thoughts and Behaviors Interview-Revised (SITBI-R). RESULTS Greater specificity, frequency, and intent were each associated with modestly increased odds of reporting an SB history. The associations between plan specificity and SB history, as well as between frequency of thinking about one's SP and SB history, were mediated by adolescents' intent to act on their SP. CONCLUSIONS It may not only be whether, but how, adolescents plan for suicide that relates to their tendency to engage in SB.
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Affiliation(s)
- Maura A Beaton
- Department of Counseling & Clinical Psychology, Teachers College - Columbia University, New York, New York, USA
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, New York, USA
| | - Ilana Gratch
- Department of Counseling & Clinical Psychology, Teachers College - Columbia University, New York, New York, USA
| | - Christine B Cha
- Department of Counseling & Clinical Psychology, Teachers College - Columbia University, New York, New York, USA
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23
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de la Torre-Luque A, Essau CA, Lara E, Leal-Leturia I, Borges G. Childhood emotional dysregulation paths for suicide-related behaviour engagement in adolescence. Eur Child Adolesc Psychiatry 2023; 32:2581-2592. [PMID: 36418505 DOI: 10.1007/s00787-022-02111-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 11/13/2022] [Indexed: 11/24/2022]
Abstract
This study aimed at identifying the heterogeneous trajectories of emotional dysregulation across childhood and to study the relationship between specific trajectories and adolescent suicide-related behaviour (SRB). Data from the Millennium Cohort Study (N = 13,853 children; 49.07% female, M = 3.13 years at baseline, SD = 0.2) were used to identify the emotional dysregulation trajectories from 3 to 8 years old, using growth mixture modelling. Moreover, 1992 participants (52.86% female) from the initial sample were used to study the relationship between childhood emotional dysregulation trajectory and engagement in both self-harm and suicide attempt at age 17, using logistic regression. Some other time-invariant and proximal (adolescent) risk factors were incorporated into this analysis. Six emotional dysregulation trajectories were identified. Self-harm at age 17 was significantly associated with the history of self-harm and other proximal factors, but not with emotional dysregulation trajectory membership. Childhood trajectories featured by earlier emotional dysregulation were associated with higher risk of lifetime suicide attempt, as well as other proximal factors (concurrent self-harm). This study found differential risk profiles involved in both SRB forms. A relationship between early emotional dysregulation and suicide attempt engagement in adolescence was identified. Early interventions should be developed to deal with SRB risk factors from childhood.
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Affiliation(s)
- Alejandro de la Torre-Luque
- Department of Legal Medicine, Psychiatry and Pathology, Centre for Biomedical Research in Mental Health (CIBERSAM)School of Medicine, Universidad Complutense de Madrid, 2 Seneca Avenue, 28046, Madrid, Spain.
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain.
| | | | - Elvira Lara
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Universidad Autonoma de Madrid, Madrid, Spain
| | - Itziar Leal-Leturia
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Universidad Autonoma de Madrid, Madrid, Spain
- Department of Psychiatry, Instituto de Investigacion Sanitaria Princesa (IIS-IP), Madrid, Spain
| | - Guilherme Borges
- Instituto Nacional de Psiquiatria Ramon de la Fuente Muñiz, Mexico City, Mexico
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24
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Xing DG, Horan T, Bhuiyan MS, Faisal ASM, Densmore K, Murnane KS, Goeders NE, Bailey SR, Conrad SA, Vanchiere JA, Patterson JC, Kevil CG, Bhuiyan MAN. Social-geographic disparities in suicidal ideations among methamphetamine users in the USA. Psychiatry Res 2023; 329:115524. [PMID: 37852161 PMCID: PMC10841467 DOI: 10.1016/j.psychres.2023.115524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 10/01/2023] [Accepted: 10/02/2023] [Indexed: 10/20/2023]
Abstract
IMPORTANCE Methamphetamine use is a growing public health concern nationwide. Suicide is the second leading cause of death in 2019 for US citizens aged 10-14 years and 25-34 years and is also a significant public health concern. Understanding the intersection of methamphetamine use and suicidal ideation (SI) is necessary to develop public health and policy solutions that mitigate these ongoing severe public health issues. OBJECTIVE Our objective was to examine SI in methamphetamine users to allow us to determine prevalence and trends by age, sex, race, and geographical region. DESIGN, SETTINGS, AND PARTICIPANTS Using data collected between 2008 and 2019 from the National Inpatient Sample (NIS) database, we identified hospital admissions (HA) of patients ≥18 years of age with a primary or secondary diagnosis of SI who were also diagnosed as methamphetamine users. Those who used other substances with methamphetamine were excluded from the analysis. MAIN OUTCOME AND MEASURES To determine the trend and prevalence of hospital admissions due to SI and SI among methamphetamine users, we used trend weights to calculate the national estimates and performed design-based analysis to account for complex survey design and sampling weights on data collected between 2008 and 2019 in the US. RESULTS The prevalence ratio (PR) of hospitalizations with concurrent SI and methamphetamine use increased 16-fold from 2008 to 2019. The most significant increase occurred between 2015 and 2016; the PR doubled from 6.07 to 12.14. The PR of hospitalizations with concurrent SI and methamphetamine use was highest in patients aged 26-40 (49.08%) and 41-64 (28.49%). Patients aged 41-64 showed the most significant increase from 2008 to 2019 (15.8-fold). While non-Hispanic White patients comprised most of these hospitalizations (77.02%), non-Hispanic Black patients showed the highest proportional increase (39.1-fold). The Southern and Western regions in the US showed the highest PR for these hospitalizations (34.86% and 34.31%, respectively). CONCLUSION AND RELEVANCE Our findings indicate that SI in methamphetamine users has been increasing for some time and is likely to grow. In addition, our results suggest that these patients are demographically different. Both conditions are associated with a lesser likelihood of seeking and receiving care. Therefore, when addressing increased SI or methamphetamine use, learning more about patients who share both conditions is necessary to ensure proper care.
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Affiliation(s)
- Diensn G Xing
- Department of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States
| | - Teresa Horan
- Department of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States
| | - Md Shenuarin Bhuiyan
- Department of Molecular and Cellular Physiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States; Department of Pathology and Translational Pathobiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States
| | - Abu Saleh Mosa Faisal
- Department of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States
| | - Kenneth Densmore
- Office of Research, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States
| | - Kevin S Murnane
- Department of Pharmacology, Toxicology & Neuroscience, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States; Department of Psychiatry and Behavioral Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States; Louisiana Addiction Research Center, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States
| | - Nicholas E Goeders
- Department of Pharmacology, Toxicology & Neuroscience, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States; Department of Psychiatry and Behavioral Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States; Louisiana Addiction Research Center, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States
| | - Steven R Bailey
- Department of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States
| | - Steven A Conrad
- Department of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States; Department of Pediatrics, LSU Health Sciences Center Shreveport, Shreveport, LA, United States
| | - John A Vanchiere
- Department of Pharmacology, Toxicology & Neuroscience, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States; Department of Pediatrics, LSU Health Sciences Center Shreveport, Shreveport, LA, United States
| | - James C Patterson
- Department of Pharmacology, Toxicology & Neuroscience, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States; Department of Psychiatry and Behavioral Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States; Louisiana Addiction Research Center, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States
| | - Christopher G Kevil
- Department of Molecular and Cellular Physiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States; Department of Pathology and Translational Pathobiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States
| | - Mohammad Alfrad Nobel Bhuiyan
- Department of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States; Louisiana Addiction Research Center, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States.
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25
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Wang Z, Wang X, Lu K, He J, Zheng J, Peng Y, Zhao F. Profiles, Transitions, and Resilience Factors of Suicide Risk in Early Chinese Adolescents. J Youth Adolesc 2023; 52:2300-2313. [PMID: 37460878 DOI: 10.1007/s10964-023-01821-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 07/06/2023] [Indexed: 09/13/2023]
Abstract
As a severe public health concern directly endangering life safety, adolescent suicide has been extensively investigated in variable-centered studies. However, gaps remain in the knowledge of heterogeneous suicide risk patterns and their developmental nature. Additionally, little is known about protective factors associated with suicide risk patterns and changes. This study applied person-centered approaches to explore suicide risk profiles and transitions over time in early Chinese adolescents, along with their protective factors. A total of 1518 junior high school students (49.6% girls, Mage = 13.57, SD = 0.75) participated in two surveys within a 12-month interval. Latent Profile Analysis and Latent Transition Analysis were used to model the profiles and transitions of suicide risk. Three risk profiles were identified at both time points: low risk profile (73.9, 78.3%), medium risk-high threat profile (16.2, 10.2%), and high risk profile (9.9, 10.2%). Low risk profile was stable, while medium risk-high threat and high risk profiles showed great transitions over 12 months. Sense of control, meaning in life, and regulatory emotional self-efficacy served as protective factors against suicide risk profiles and transitions. Findings underscore the importance of comprehensively illustrating suicide risk states from multiple aspects, as well as understanding the fluid nature of transitions between different risk states. Prevention and intervention strategies aimed at enhancing resilience, such as increasing sense of control, perceived meaningfulness, and belief in emotional regulation, may contribute to reducing the risk of suicide among adolescents.
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Affiliation(s)
- Zhongjie Wang
- School of Education, Zhengzhou University, No.100 Science Avenue, Henan Province, 450001, Zhengzhou, China
| | - Xuezhen Wang
- School of Education, Renmin University of China, Beijing, China
| | - Kaiyuan Lu
- School of Education, Zhengzhou University, No.100 Science Avenue, Henan Province, 450001, Zhengzhou, China
| | - Jingke He
- School of Education, Zhengzhou University, No.100 Science Avenue, Henan Province, 450001, Zhengzhou, China
| | - Juanjuan Zheng
- School of Education, Zhengzhou University, No.100 Science Avenue, Henan Province, 450001, Zhengzhou, China
| | - Ying Peng
- School of Education, Zhengzhou University, No.100 Science Avenue, Henan Province, 450001, Zhengzhou, China
| | - Fengqing Zhao
- School of Education, Zhengzhou University, No.100 Science Avenue, Henan Province, 450001, Zhengzhou, China.
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26
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Berardelli I, Rogante E, Sarubbi S, Trocchia MA, Longhini L, Erbuto D, Innamorati M, Pompili M. Interpersonal Needs, Mental Pain, and Hopelessness in Psychiatric Inpatients with Suicidal Ideation. PHARMACOPSYCHIATRY 2023; 56:219-226. [PMID: 37699529 DOI: 10.1055/a-2154-0828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
INTRODUCTION Suicide is a leading cause of death worldwide and models may help the understanding of the phenomenon and ultimately reduce its burden through effective suicide prevention strategies. The Interpersonal Theory of Suicide and Shneidman's Model have tried to describe different unmet needs related to suicidal ideation. The study aims to assess the association between thwarted belongingness, perceived burdensomeness, and suicidal ideation in a sample of psychiatric inpatients and the mediating role of hopelessness and mental pain in this association. METHODS 112 consecutive adult psychiatric inpatients were administered the Columbia Suicide Severity Rating Scale (C-SSRS), the Italian version of the Interpersonal Needs Questionnaire-15-I (INQ-15-I), the Physical and Psychological Pain Scale, and the Beck Hopelessness Scale (BHS). RESULTS Mediation models indicated a significant indirect effect of perceived burdensomeness (with thwarted belongingness as covariates) on suicidal ideation intensity with hopelessness as a mediator. When thwarted belongingness (controlling for perceived burdensomeness as a covariate) was included in a model as an independent variable, direct and indirect effects on suicidal ideation intensity were not significant. CONCLUSIONS Psychosocial interventions focusing on identifying and decreasing the perception of being a burden for others and the feeling hopeless could represent a powerful pathway for reducing suicidal ideation. Moreover, the attention toward unmet interpersonal needs may help increase and focus clinical discussions on risk factors, which may help engagement toward psychiatric care and downsize the stigma related to suicide. Raising awareness toward mental health topics is a goal of healthcare services globally.
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Affiliation(s)
- Isabella Berardelli
- Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Elena Rogante
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università Rome, Italy
| | - Salvatore Sarubbi
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università Rome, Italy
| | - Maria Anna Trocchia
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, Psychiatry Unit, Sant'Andrea Hospital, Rome
| | - Ludovica Longhini
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, Psychiatry Unit, Sant'Andrea Hospital, Rome
| | - Denise Erbuto
- Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Marco Innamorati
- Department of Human Sciences, European University of Rome, Rome, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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27
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Gyori D, Farkas BF, Komaromy D, Horvath LO, Kollarovics N, Garas P, Balazs J. The Association between Nonsuicidal Self-Injury and Perfectionism in Adolescence: The Role of Mental Disorders. Eur J Investig Health Psychol Educ 2023; 13:2299-2327. [PMID: 37998053 PMCID: PMC10670610 DOI: 10.3390/ejihpe13110163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/14/2023] [Accepted: 10/18/2023] [Indexed: 11/25/2023] Open
Abstract
Previous evidence has drawn attention to the fact that maladaptive perfectionism is a risk factor for engagement in nonsuicidal self-injury (NSSI). Until now, few studies have examined this topic, especially among community adolescents. The aim of this study was to explore the relationship between perfectionism dimensions and NSSI functions to examine the potential mediating effect of mental disorders. Altogether, 146 Hungarian community adolescents (ages 13-18 years) were involved. All participants completed the Hungarian adaptation of the Inventory of Statements about Self-Injury (ISAS), the Frost Multidimensional Perfectionism Scale (FMPS), and the Mini International Neuropsychiatric Interview Kid. To analyse the interrelationships among NSSI, perfectionism, and mental disorders, we conducted regression and network analysis. Of the 146 adolescents, 90 (61.64%, girls: 71.11%) engaged in NSSI. The Concern over Mistakes and Doubts about Action scales of the FMPS significantly and positively predicted both NSSI intrapersonal and interpersonal motivation, with comparable effect sizes, and this association was fully mediated by anxiety disorders. There was a significant direct negative relationship between the FMPS Organisation dimension and both main NSSI functions. This study draws attention to an increasing trend and the extremely high NSSI prevalence rate among community adolescents. Adolescents with perfectionistic concerns are at heightened risk for anxiety disorders, which can increase their vulnerability to NSSI engagement.
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Affiliation(s)
- Dora Gyori
- Doctoral School of Psychology, Eotvos Lorand University, 1075 Budapest, Hungary
- Institute of Psychology, Eotvos Lorand University, 1075 Budapest, Hungary; (D.K.); (L.O.H.)
| | - Bernadett Frida Farkas
- Mental Health Sciences Doctoral School, Semmelweis University Doctoral School, 1083 Budapest, Hungary; (B.F.F.); (N.K.); (P.G.)
| | - Daniel Komaromy
- Institute of Psychology, Eotvos Lorand University, 1075 Budapest, Hungary; (D.K.); (L.O.H.)
- Department of Behavioural and Movement Sciences, Vrije Universiteit, 1081 HV Amsterdam, The Netherlands
| | - Lili Olga Horvath
- Institute of Psychology, Eotvos Lorand University, 1075 Budapest, Hungary; (D.K.); (L.O.H.)
- Pedagogical Services, 1141 Budapest, Hungary
| | - Nora Kollarovics
- Mental Health Sciences Doctoral School, Semmelweis University Doctoral School, 1083 Budapest, Hungary; (B.F.F.); (N.K.); (P.G.)
| | - Peter Garas
- Mental Health Sciences Doctoral School, Semmelweis University Doctoral School, 1083 Budapest, Hungary; (B.F.F.); (N.K.); (P.G.)
| | - Judit Balazs
- Institute of Psychology, Eotvos Lorand University, 1075 Budapest, Hungary; (D.K.); (L.O.H.)
- Department of Psychology, Oslo New University College, 0456 Oslo, Norway
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Aguglia A, Corsini GP, Berardelli I, Berti A, Conio B, Garbarino N, Gnecco GB, Magni C, Venturini E, Costanza A, Amerio A, Amore M, Serafini G. Mechanical Restraint in Inpatient Psychiatric Unit: Prevalence and Associated Clinical Variables. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1847. [PMID: 37893565 PMCID: PMC10607962 DOI: 10.3390/medicina59101847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/09/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: mechanical restraint (MR) is a controversial issue in emergency psychiatry and should be better studied to implement other alternative therapeutic interventions. The aim of this study was to estimate the prevalence of MR in an Italian psychiatric unit and identify the sociodemographic and clinical characteristics as well as the pharmacological pattern associated with MR. Materials and Methods: all subjects (N = 799) consecutively admitted to an Italian psychiatric inpatient unit were recruited. Several sociodemographic and clinical characteristics were recorded. Results: The prevalence of MR was 14.1%. Males, a younger age, and a single and migrant status were associated with the MR phenomenon. MR was more prevalent in patients affected by other diagnoses and comorbid illicit substance use, in patients with aggressive behaviors, and those that were involuntary admitted, leading significantly to hospitalization over 21 days. Furthermore, the patients that underwent MR were taking a lower number of psychiatric medications. Conclusions: Unfortunately, MR is still used in emergency psychiatry. Future research should focus on the dynamics of MR development in psychiatry, specifically considering ward- and staff-related factors that could help identify a more precise prevention and alternative intervention strategies.
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Affiliation(s)
- Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.B.); (N.G.); (G.B.G.); (C.M.); (E.V.); (A.A.); (M.A.); (G.S.)
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Ospedale Policlinico San Martino, 16132 Genoa, Italy; (G.P.C.); (B.C.)
| | - Giovanni Pietro Corsini
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Ospedale Policlinico San Martino, 16132 Genoa, Italy; (G.P.C.); (B.C.)
| | - Isabella Berardelli
- Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant’Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy;
| | - Andrea Berti
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.B.); (N.G.); (G.B.G.); (C.M.); (E.V.); (A.A.); (M.A.); (G.S.)
| | - Benedetta Conio
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Ospedale Policlinico San Martino, 16132 Genoa, Italy; (G.P.C.); (B.C.)
| | - Nicolò Garbarino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.B.); (N.G.); (G.B.G.); (C.M.); (E.V.); (A.A.); (M.A.); (G.S.)
| | - Giovanni Battista Gnecco
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.B.); (N.G.); (G.B.G.); (C.M.); (E.V.); (A.A.); (M.A.); (G.S.)
| | - Caterina Magni
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.B.); (N.G.); (G.B.G.); (C.M.); (E.V.); (A.A.); (M.A.); (G.S.)
| | - Enrico Venturini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.B.); (N.G.); (G.B.G.); (C.M.); (E.V.); (A.A.); (M.A.); (G.S.)
| | - Alessandra Costanza
- Department of Psychiatry, Adult Psychiatry Service, University Hospitals of Geneva (HUG), 1207 Geneva, Switzerland
- Department of Psychiatry, Faculty of Biomedical Sciences, University of Italian Switzerland (USI), 6900 Lugano, Switzerland
- Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), 1211 Geneva, Switzerland
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.B.); (N.G.); (G.B.G.); (C.M.); (E.V.); (A.A.); (M.A.); (G.S.)
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Ospedale Policlinico San Martino, 16132 Genoa, Italy; (G.P.C.); (B.C.)
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.B.); (N.G.); (G.B.G.); (C.M.); (E.V.); (A.A.); (M.A.); (G.S.)
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.B.); (N.G.); (G.B.G.); (C.M.); (E.V.); (A.A.); (M.A.); (G.S.)
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Ospedale Policlinico San Martino, 16132 Genoa, Italy; (G.P.C.); (B.C.)
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Stanley IH, Marx BP, Fina BA, Young-McCaughan S, Tyler HC, Sloan DM, Blankenship AE, Dondanville KA, Walker JL, Boffa JW, Bryan CJ, Brown LA, Straud CL, Mintz J, Abdallah CG, Back SE, Blount TH, DeBeer BB, Flanagan J, Foa EB, Fox PT, Fredman SJ, Krystal J, McDevitt-Murphy ME, McGeary DD, Pruiksma KE, Resick PA, Roache JD, Shiroma P, Taylor DJ, Wachen JS, Kaplan AM, López-Roca AL, Nicholson KL, Schobitz RP, Schrader CC, Sharrieff AFM, Yarvis JS, Litz BT, Keane TM, Peterson AL. Psychometric Properties of the Self-Injurious Thoughts and Behaviors Interview-Short Form Among U.S. Active Duty Military Service Members and Veterans. Assessment 2023; 30:2332-2346. [PMID: 36644835 DOI: 10.1177/10731911221143979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
We assessed the interrater reliability, convergent validity, and discriminant validity of the Self-Injurious Thoughts and Behaviors Interview-Short Form (SITBI-SF) in a sample of 1,944 active duty service members and veterans seeking services for posttraumatic stress disorder (PTSD) and related conditions. The SITBI-SF demonstrated high interrater reliability and good convergent and discriminant validity. The measurement properties of the SITBI-SF were comparable across service members and veterans. Approximately 8% of participants who denied a history of suicidal ideation on the SITBI-SF reported suicidal ideation on a separate self-report questionnaire (i.e., discordant responders). Discordant responders reported significantly higher levels of PTSD symptoms than those who denied suicidal ideation on both response formats. Findings suggest that the SITBI-SF is a reliable and valid interview-based measure of suicide-related thoughts and behaviors for use with military service members and veterans. Suicide risk assessment might be optimized if the SITBI-SF interview is combined with a self-report measure of related constructs.
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Affiliation(s)
- Ian H Stanley
- VA Boston Healthcare System, MA, USA
- Boston University, School of Medicine, MA, USA
- University of Colorado, School of Medicine, Aurora, USA
| | - Brian P Marx
- VA Boston Healthcare System, MA, USA
- Boston University, School of Medicine, MA, USA
| | - Brooke A Fina
- University of Texas Health Science Center at San Antonio, USA
| | - Stacey Young-McCaughan
- University of Texas Health Science Center at San Antonio, USA
- South Texas Veterans Health Care System, San Antonio, USA
| | - Hannah C Tyler
- University of Texas Health Science Center at San Antonio, USA
- South Texas Veterans Health Care System, San Antonio, USA
| | - Denise M Sloan
- VA Boston Healthcare System, MA, USA
- Boston University, School of Medicine, MA, USA
| | | | | | - James L Walker
- University of Texas Health Science Center at San Antonio, USA
| | - Joseph W Boffa
- Southeast Louisiana Veterans Health Care System, New Orleans, USA
- South Central Mental Illness Research, Education and Clinical Center, Houston, TX, USA
- Tulane University School of Medicine, New Orleans, LA, USA
| | - Craig J Bryan
- The Ohio State University Wexner Medical Center, Columbus, USA
| | | | - Casey L Straud
- University of Texas Health Science Center at San Antonio, USA
- South Texas Veterans Health Care System, San Antonio, USA
- University of Texas at San Antonio, USA
| | - Jim Mintz
- University of Texas Health Science Center at San Antonio, USA
- South Texas Veterans Health Care System, San Antonio, USA
| | - Chadi G Abdallah
- Baylor College of Medicine, Houston, TX, USA
- Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Sudie E Back
- Medical University of South Carolina, Charleston, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | | | - Bryann B DeBeer
- University of Colorado, School of Medicine, Aurora, USA
- Rocky Mountain Regional VA Medical Center, Aurora, CO, USA
| | - Julianne Flanagan
- Medical University of South Carolina, Charleston, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - Edna B Foa
- University of Pennsylvania, Philadelphia, USA
| | - Peter T Fox
- University of Texas Health Science Center at San Antonio, USA
- South Texas Veterans Health Care System, San Antonio, USA
| | | | - John Krystal
- VA Connecticut Healthcare System, West Haven, USA
- Yale University, New Haven, CT, USA
| | | | - Donald D McGeary
- University of Texas Health Science Center at San Antonio, USA
- South Texas Veterans Health Care System, San Antonio, USA
- University of Texas at San Antonio, USA
| | - Kristi E Pruiksma
- University of Texas Health Science Center at San Antonio, USA
- South Texas Veterans Health Care System, San Antonio, USA
| | | | - John D Roache
- University of Texas Health Science Center at San Antonio, USA
| | - Paulo Shiroma
- Minneapolis VA Medical Center, MN, USA
- University of Minnesota, Minneapolis, USA
| | | | | | | | | | - Karin L Nicholson
- Carl R. Darnall Army Medical Center, Fort Hood, TX, USA
- Kaiser Permanente Woodland Hills Medical Center, Woodland Hills, CA, USA
| | | | | | - Allah-Fard M Sharrieff
- Carl R. Darnall Army Medical Center, Fort Hood, TX, USA
- U.S. Department of Homeland Security, Miami, FL, USA
| | - Jeffrey S Yarvis
- Tulane University School of Medicine, New Orleans, LA, USA
- Carl R. Darnall Army Medical Center, Fort Hood, TX, USA
| | - Brett T Litz
- VA Boston Healthcare System, MA, USA
- Boston University, School of Medicine, MA, USA
- Boston University, MA, USA
| | - Terence M Keane
- VA Boston Healthcare System, MA, USA
- Boston University, School of Medicine, MA, USA
| | - Alan L Peterson
- University of Texas Health Science Center at San Antonio, USA
- South Texas Veterans Health Care System, San Antonio, USA
- University of Texas at San Antonio, USA
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Pelizza L, Rossi E, Zambelli U, Violante E, Scarci M, Mammone E, Adriani A, Pupo S, Paulillo G, Pellegrini P. Psychological screening service for men newly admitted to an Italian prison: Preliminary clinical outcome analysis after 1 year of clinical activity. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2023; 33:342-353. [PMID: 37695266 DOI: 10.1002/cbm.2310] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 08/27/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Screening for mental disorders among prisoners is crucial for early detection and intervention of psychopathology and substance use disorders. In Italy, only a minority of prisons have implemented a structured screening process, and there is not yet a standard approach to this worldwide. AIMS First, to describe a systematic psychological screening for early identification of mental disorder, including drug use disorders, and suicide risk among men on reception into one Italian prison, designed to inform management and, secondly, to describe mental health outcomes among those prisoners accepted into the in-reach mental health service as a result of the assessment. METHODS All prisoners newly received in the Parma Penitentiary Institute at any time in 2020 were screened using the Jail Screening Assessment Tool. Those who screened positive for any mental disorder, including substance use disorders and suicide indicators, were asked to complete the Parma Scale for the treatment evaluation of offenders with psychiatric disorders (Pr-Scale), a locally developed tool that allows for the measurement of mental state change as well as changes in treatment and management. Scores on this scale soon after reception were compared with scores after 1 year of work with the in-reach team. RESULTS Among 303 newly admitted male prisoners in 2020, 167 (55%) screened positive for substance use disorder and 30 (10%) for other primary mental disorders. Most of these (n = 151) were offered and accepted care by the mental health in-reach service. After 1 year, those who had been treated by this service showed significant improvement in all Pr-Scale clinical variables. CONCLUSIONS Our findings support the extension of a psychological screening into a service for new receptions to Italian prisons. They add evidence for the utility of the Pr-Scale for detecting those newly admitted prisoners likely to benefit from early mental health interventions provided by in-reach services and for evidencing resultant change. Future studies are needed to replicate our results in other Italian prisons as a precursor to systems improvement, while other countries might also benefit from using similar evaluation and reevaluation routinely.
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Affiliation(s)
- Lorenzo Pelizza
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Enrico Rossi
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Ursula Zambelli
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Elisa Violante
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Melania Scarci
- Department of Humanities, Social Sciences and Cultural Industries, Università degli Studi di Parma, Parma, Italy
| | - Elena Mammone
- Department of Humanities, Social Sciences and Cultural Industries, Università degli Studi di Parma, Parma, Italy
| | - Adriana Adriani
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Simona Pupo
- Pain Therapy Service, Department of Medicine and Surgery, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Giuseppina Paulillo
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Pietro Pellegrini
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
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31
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Zhang J, Liang S, Liu X, Li D, Zhou F, Xiao L, Liu J, Sha S. Factors associated with suicidal attempts in female patients with mood disorder. Front Public Health 2023; 11:1157606. [PMID: 37818303 PMCID: PMC10560740 DOI: 10.3389/fpubh.2023.1157606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 09/08/2023] [Indexed: 10/12/2023] Open
Abstract
Aim This study aims to establish a nomogram model to predict the relevance of SA in Chinese female patients with mood disorder (MD). Method The study included 396 female participants who were diagnosed with MD Diagnostic Group (F30-F39) according to the 10th Edition of Disease and Related Health Problems (ICD-10). Assessing the differences of demographic information and clinical characteristics between the two groups. LASSO Logistic Regression Analyses was used to identify the risk factors of SA. A nomogram was further used to construct a prediction model. Bootstrap re-sampling was used to internally validate the final model. The Receiver Operating Characteristic (ROC) curve and C-index was also used to evaluate the accuracy of the prediction model. Result LASSO regression analysis showed that five factors led to the occurrence of suicidality, including BMI (β = -0.02, SE = 0.02), social dysfunction (β = 1.72, SE = 0.24), time interval between first onset and first dose (β = 0.03, SE = 0.01), polarity at onset (β = -1.13, SE = 0.25), and times of hospitalization (β = -0.11, SE = 0.06). We assessed the ability of the nomogram model to recognize suicidality, with good results (AUC = 0.76, 95% CI: 0.71-0.80). Indicating that the nomogram had a good consistency (C-index: 0.756, 95% CI: 0.750-0.758). The C-index of bootstrap resampling with 100 replicates for internal validation was 0.740, which further demonstrated the excellent calibration of predicted and observed risks. Conclusion Five factors, namely BMI, social dysfunction, time interval between first onset and first dose, polarity at onset, and times of hospitalization, were found to be significantly associated with the development of suicidality in patients with MD. By incorporating these factors into a nomogram model, we can accurately predict the risk of suicide in MD patients. It is crucial to closely monitor clinical factors from the beginning and throughout the course of MD in order to prevent suicide attempts.
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Affiliation(s)
- Jinhe Zhang
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, The Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, Capital Medical University, Beijing, China
- The Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Sixiang Liang
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, The Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, Capital Medical University, Beijing, China
- The Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xinyu Liu
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, The Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, Capital Medical University, Beijing, China
- The Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Dan Li
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, The Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, Capital Medical University, Beijing, China
- The Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Fuchun Zhou
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, The Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, Capital Medical University, Beijing, China
- The Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Le Xiao
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, The Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, Capital Medical University, Beijing, China
- The Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Jun Liu
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, The Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, Capital Medical University, Beijing, China
- The Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Sha Sha
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, The Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, Capital Medical University, Beijing, China
- The Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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Fekih-Romdhane F, Abassi B, Ghrissi F, Loch AA, Cherif W, Damak R, Ellini S, Hallit S, Cheour M. Suicide risk among individuals at Ultra-High Risk (UHR) of psychosis in a developing North African country: A 12-month naturalistic prospective cohort study from the TRIP project. Psychiatry Res 2023; 327:115409. [PMID: 37633155 DOI: 10.1016/j.psychres.2023.115409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 08/02/2023] [Accepted: 08/07/2023] [Indexed: 08/28/2023]
Abstract
BACKGROUND The limited studies that focused on suicidality in individuals at Ultra-High Risk (UHR) of psychosis were predominantly cross-sectional, emerging from Western countries. We aimed to examine suicide risk among Tunisian UHR and First Episode Psychosis (FEP) patients at baseline, and to evaluate the evolution and correlates of suicidal ideation over a 12-month period in the UHR group exclusively. METHODS 35 UHR (aged 22.8 ± 4.0 years, 45.7% male) and 33 FEP (aged 27.3 ± 4.8 years, 63.6% male) participants were included. The Comprehensive Assessment of at Risk Mental States, the Positive and Negative Syndrome Scale (PANSS), The Rosenberg Self-Esteem Scale, and The Multidimensional Scale of Perceived Social Support were used. RESULTS No significant differences were found between the UHR and the FEP groups with regard to levels of suicidal ideation at baseline. Suicidal ideation scores showed a significant decrease over time in UHR participants (p=.014; η2=0.242). An increase in total PANSS scores at 1 year (Beta=0.03; p=.048; 95%CI 0.001, 0.060; η2=0.182) significantly increased suicidal ideation scores at 1 year in the UHR group. CONCLUSION Our findings contribute to the limited body of evidence on this topic by providing new prospective data from a population, country and region that has never been researched previously.
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Affiliation(s)
- Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi hospital, Manouba 2010, Tunisia; Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia.
| | - Bouthaina Abassi
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi hospital, Manouba 2010, Tunisia; Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Farah Ghrissi
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi hospital, Manouba 2010, Tunisia; Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Alexandre Andrade Loch
- Laboratorio de Neurociencias (LIM 27), Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR, Brazil; Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBION), Conselho Nacional de Desenvolvimento Cientifico e Tecnológico, Sao Paulo, Brazil
| | - Wissal Cherif
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi hospital, Manouba 2010, Tunisia; Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Rahma Damak
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi hospital, Manouba 2010, Tunisia; Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Sana Ellini
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi hospital, Manouba 2010, Tunisia; Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446 Jounieh, Lebanon; Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon; Applied Science Research Center, Applied Science Private University, Amman, Jordan.
| | - Majda Cheour
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi hospital, Manouba 2010, Tunisia; Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia
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Chum A, Kim C, Nielsen A, Dusing GJ, O'Campo P, Matheson FI, Barker L, Vigod S, Ling V, Fung K, Kennedy S. Disparities in Suicide-Related Behaviors Across Sexual Orientations by Gender: A Retrospective Cohort Study Using Linked Health Administrative Data. Am J Psychiatry 2023; 180:660-667. [PMID: 37282552 DOI: 10.1176/appi.ajp.20220763] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE The authors used a population-representative sample and health administrative data to quantify suicide-related behavior leading to acute care or deaths across self-identified heterosexual, gay/lesbian, and bisexual individuals. METHODS Data from a population-based survey (N=123,995) were linked to health administrative data (2002-2019), and differences in time to suicide-related behavior events across sexual orientations were examined using Cox proportional hazards regression. RESULTS The crude incidence rates of suicide-related behavior events per 100,000 person-years were 224.7 for heterosexuals, 664.7 for gay/lesbian individuals, and 5,911.9 for bisexual individuals. In fully adjusted (gender-combined) models, bisexual individuals were 2.98 times (95% CI=2.08-4.27) more likely to have an event, and gay men and lesbians 2.10 times (95% CI=1.18-3.71) more likely, compared with heterosexual individuals. CONCLUSIONS In a large population-based sample of Ontario residents, using clinically relevant outcomes, the study found gay/lesbian and bisexual individuals to be at elevated risk of suicide-related behavior events. Increased education among psychiatric professionals is needed to improve awareness of and sensitivity to the elevated risk of suicide-related behavior among sexual minority individuals, and further research on interventions is needed to reduce such behaviors.
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Affiliation(s)
- Antony Chum
- School of Kinesiology and Health Science, York University, Toronto (Chum, Kim, Dusing); Dalla Lana School of Public Health, University of Toronto, Toronto (Chum, Matheson); MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto (Chum, Nielsen, O'Campo, Matheson); Department of Psychiatry, Women's College Hospital, Toronto (Barker, Vigod); Department of Psychiatry, University of Toronto, Toronto (Vigod); Institute for Clinical Evaluative Sciences, Toronto (Ling, Fung); Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto (Kennedy)
| | - Chungah Kim
- School of Kinesiology and Health Science, York University, Toronto (Chum, Kim, Dusing); Dalla Lana School of Public Health, University of Toronto, Toronto (Chum, Matheson); MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto (Chum, Nielsen, O'Campo, Matheson); Department of Psychiatry, Women's College Hospital, Toronto (Barker, Vigod); Department of Psychiatry, University of Toronto, Toronto (Vigod); Institute for Clinical Evaluative Sciences, Toronto (Ling, Fung); Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto (Kennedy)
| | - Andrew Nielsen
- School of Kinesiology and Health Science, York University, Toronto (Chum, Kim, Dusing); Dalla Lana School of Public Health, University of Toronto, Toronto (Chum, Matheson); MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto (Chum, Nielsen, O'Campo, Matheson); Department of Psychiatry, Women's College Hospital, Toronto (Barker, Vigod); Department of Psychiatry, University of Toronto, Toronto (Vigod); Institute for Clinical Evaluative Sciences, Toronto (Ling, Fung); Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto (Kennedy)
| | - Gabriel John Dusing
- School of Kinesiology and Health Science, York University, Toronto (Chum, Kim, Dusing); Dalla Lana School of Public Health, University of Toronto, Toronto (Chum, Matheson); MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto (Chum, Nielsen, O'Campo, Matheson); Department of Psychiatry, Women's College Hospital, Toronto (Barker, Vigod); Department of Psychiatry, University of Toronto, Toronto (Vigod); Institute for Clinical Evaluative Sciences, Toronto (Ling, Fung); Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto (Kennedy)
| | - Patricia O'Campo
- School of Kinesiology and Health Science, York University, Toronto (Chum, Kim, Dusing); Dalla Lana School of Public Health, University of Toronto, Toronto (Chum, Matheson); MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto (Chum, Nielsen, O'Campo, Matheson); Department of Psychiatry, Women's College Hospital, Toronto (Barker, Vigod); Department of Psychiatry, University of Toronto, Toronto (Vigod); Institute for Clinical Evaluative Sciences, Toronto (Ling, Fung); Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto (Kennedy)
| | - Flora I Matheson
- School of Kinesiology and Health Science, York University, Toronto (Chum, Kim, Dusing); Dalla Lana School of Public Health, University of Toronto, Toronto (Chum, Matheson); MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto (Chum, Nielsen, O'Campo, Matheson); Department of Psychiatry, Women's College Hospital, Toronto (Barker, Vigod); Department of Psychiatry, University of Toronto, Toronto (Vigod); Institute for Clinical Evaluative Sciences, Toronto (Ling, Fung); Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto (Kennedy)
| | - Lucy Barker
- School of Kinesiology and Health Science, York University, Toronto (Chum, Kim, Dusing); Dalla Lana School of Public Health, University of Toronto, Toronto (Chum, Matheson); MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto (Chum, Nielsen, O'Campo, Matheson); Department of Psychiatry, Women's College Hospital, Toronto (Barker, Vigod); Department of Psychiatry, University of Toronto, Toronto (Vigod); Institute for Clinical Evaluative Sciences, Toronto (Ling, Fung); Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto (Kennedy)
| | - Simone Vigod
- School of Kinesiology and Health Science, York University, Toronto (Chum, Kim, Dusing); Dalla Lana School of Public Health, University of Toronto, Toronto (Chum, Matheson); MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto (Chum, Nielsen, O'Campo, Matheson); Department of Psychiatry, Women's College Hospital, Toronto (Barker, Vigod); Department of Psychiatry, University of Toronto, Toronto (Vigod); Institute for Clinical Evaluative Sciences, Toronto (Ling, Fung); Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto (Kennedy)
| | - Vicki Ling
- School of Kinesiology and Health Science, York University, Toronto (Chum, Kim, Dusing); Dalla Lana School of Public Health, University of Toronto, Toronto (Chum, Matheson); MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto (Chum, Nielsen, O'Campo, Matheson); Department of Psychiatry, Women's College Hospital, Toronto (Barker, Vigod); Department of Psychiatry, University of Toronto, Toronto (Vigod); Institute for Clinical Evaluative Sciences, Toronto (Ling, Fung); Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto (Kennedy)
| | - Kinwah Fung
- School of Kinesiology and Health Science, York University, Toronto (Chum, Kim, Dusing); Dalla Lana School of Public Health, University of Toronto, Toronto (Chum, Matheson); MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto (Chum, Nielsen, O'Campo, Matheson); Department of Psychiatry, Women's College Hospital, Toronto (Barker, Vigod); Department of Psychiatry, University of Toronto, Toronto (Vigod); Institute for Clinical Evaluative Sciences, Toronto (Ling, Fung); Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto (Kennedy)
| | - Sidney Kennedy
- School of Kinesiology and Health Science, York University, Toronto (Chum, Kim, Dusing); Dalla Lana School of Public Health, University of Toronto, Toronto (Chum, Matheson); MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto (Chum, Nielsen, O'Campo, Matheson); Department of Psychiatry, Women's College Hospital, Toronto (Barker, Vigod); Department of Psychiatry, University of Toronto, Toronto (Vigod); Institute for Clinical Evaluative Sciences, Toronto (Ling, Fung); Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto (Kennedy)
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Moro L, Orri M, Sicotte R, Thibaudeau É, Joober R, Malla A, Lepage M. Sociodemographic and clinical risk factors associated with suicidal ideation and attempt during a 2-year early intervention program for first-episode psychosis. Schizophr Res 2023; 258:61-68. [PMID: 37506577 DOI: 10.1016/j.schres.2023.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 04/12/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Identifying risk factors for suicidal ideation and attempt among first-episode psychosis patients is essential to prevent suicide in this high-risk population. We investigated risk factors at admission for suicidal ideation and attempt during a 2-year early intervention program. METHODS Our sample included patients aged 18-35 years who were consecutively admitted to an early intervention program (2003-2017). Sociodemographic and clinical variables were obtained from a longitudinal study, while data on suicidal ideation and attempt were collected via systematic file review. Univariable and multivariable logistic regressions assessed the association of these variables with suicide ideation and attempt. RESULTS Of 446 participants, 35 (7.8 %) attempted suicide during the 2-year follow up, including two resulting in death (0.45 %), and 168 (37.7 %) reported solely suicidal ideation. Multivariable analyses indicated living alone (OR = 4.01, CI = 2.11-7.63), affective psychosis (OR = 1.95, CI = 1.22-3.14) and depressive symptomatology (OR = 1.45, CI = 1.13-1.86) were associated with increased risk for suicidal ideation. Attempting suicide close to admission (OR = 10.29, CI = 3.63-29.22), living alone (OR = 4.17, CI = 1.40-12.35), and depressive (OR = 1.67, CI = 1.06-2.63) and positive symptomatology (OR = 1.60, CI = 1.02-2.50) were associated with increased risk for suicide attempt. Attempting suicide close to admission (OR = 11.65, CI = 4.08-33.30), being part of an ethnic minority (OR = 3.71, CI = 1.59-8.63), and presenting lower anxiety (OR = 0.58, CI = 0.36-0.94) were the only factors specifically associated with suicide attempt compared to ideation. CONCLUSION Close monitoring of patients who recently attempted suicide, live alone, are part of an ethnic minority, and present with affective and positive symptomatology may help reduce the risk of suicide-related outcomes during early intervention programs.
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Affiliation(s)
- Laura Moro
- Department of Psychology, University of Montreal, Montreal, Canada; Douglas Research Centre, Montreal, Canada
| | - Massimiliano Orri
- Douglas Research Centre, Montreal, Canada; McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada
| | - Roxanne Sicotte
- Douglas Research Centre, Montreal, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Canada
| | - Élisabeth Thibaudeau
- Douglas Research Centre, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada
| | - Ridha Joober
- Department of Psychiatry, McGill University, Montreal, Canada; Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montreal, Canada
| | - Ashok Malla
- Department of Psychiatry, McGill University, Montreal, Canada; Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montreal, Canada
| | - Martin Lepage
- Douglas Research Centre, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada.
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Gohar SM, Hegelstad WTV, Auestad B, Haahr UH, Joa I, Johannessen JO, Larsen TK, Opjordsmoen S, Rund BR, Røssberg JI, Simonsen E, Friis S, Melle I. Association between early suicidal trajectories in first-episode psychosis and 10-year follow-up: TIPS registry-linked study. Lancet Psychiatry 2023; 10:528-536. [PMID: 37353264 DOI: 10.1016/s2215-0366(23)00156-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 04/24/2023] [Accepted: 04/27/2023] [Indexed: 06/25/2023]
Abstract
BACKGROUND Although the risk of suicidality is high in first-episode psychosis, patterns and individual variability in suicidal thoughts and behaviours over time are under-researched. We aimed to identify early trajectories of suicidality over a 2-year follow-up, assess their baseline predictors, and explore associations between those trajectories and later suicidality. METHODS This longitudinal follow-up study was a part of the Early Treatment and Intervention in Psychosis (TIPS)study. Participants, linked to Norwegian and Danish death registries, were recruited from four catchment areas (665 000 inhabitants) in Norway and Denmark (both inpatient and outpatient). We included participants aged 15-65 years, with an intelligence quotient of more than 70, willing to give informed consent, and with a first episode of active psychotic symptoms. Individuals with comorbid neurological or endocrinal disorders, or those with contraindications to antipsychotics, were excluded. Growth mixture modelling was used to identify trajectories of suicidal thoughts and behaviours over the first 2 years. Multinomial logistic regression was applied to examine the baseline predictors of those trajectories and their associations with suicidality at 10-year follow-up. FINDINGS A total of 301 participants were recruited from Jan 1, 1997, to Dec 31, 2000. Of the 299 with completed suicidality data at baseline, 271 participated in 1-year follow-up, 250 in 2-year follow-up, 201 in 5-year follow-up, and 186 at 10-year follow-up. At baseline, 176 (58%) were male, 125 (42%) were female. The mean age was 27·80 years (SD 9·64; range 15-63). 280 (93%) participants were of Scandinavian origin. Four trajectories over 2 years were identified: stable non-suicidal (217 [72%]), stable suicidal ideation (45 [15%]), decreasing suicidal thoughts and behaviours (21 [7%]), and worsening suicidal thoughts and behaviours (18 [6%]). A longer duration of untreated psychosis (odds ratio [OR] 1·24, 95% CI 1·02-1·50, p=0·033), poorer premorbid childhood social adjustment (1·33, 1·01-1·73, p=0·039), more severe depression (1·10, 1·02-1·20, p=0·016), and substance use (2·33, 1·21-4·46, p=0·011) at baseline predicted a stable suicidal ideation trajectory. Individuals in the stable suicidal ideation trajectory tended to have suicidal thoughts and behaviours at 10-year follow-up (3·12, 1·33-7·25, p=0·008). Individuals with a worsening suicidal trajectory were at a higher risk of death by suicide between 2 and 10 years (7·58, 1·53-37·62, p=0·013). INTERPRETATION Distinct suicidal trajectories in first-episode psychosis were associated with specific predictors at baseline and distinct patterns of suicidality over time. Our findings call for early and targeted interventions for at-risk individuals with persistent suicidal ideation or deteriorating patterns of suicidal thoughts and behaviours, or both. FUNDING Health West, Norway; the Norwegian National Research Council; the Norwegian Department of Health and Social Affairs; the National Council for Mental Health and Health and Rehabilitation; the Theodore and Vada Stanley Foundation; the Regional Health Research Foundation for Eastern Region, Denmark; Roskilde County, Helsefonden, Lundbeck Pharma; Eli Lilly; Janssen-Cilag Pharmaceuticals, Denmark; a National Alliance for Research on Schizophrenia and Depression Distinguished Investigator Award and The National Institute of Mental Health grant; a National Alliance for Research on Schizophrenia & Depression Young Investigator Award from The Brain & Behavior Research Foundation; Health South East; Health West; and the Regional Centre for Clinical Research in Psychosis.
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Affiliation(s)
- Sherif M Gohar
- The Early Treatment and Intervention in Psychosis Study (TIPS) Centre for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway; Department of Public Health, Faculty of Health Sciences, Network for Medical Sciences, University of Stavanger, Stavanger, Norway; Department of Psychiatry, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Wenche Ten Velden Hegelstad
- The Early Treatment and Intervention in Psychosis Study (TIPS) Centre for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway; Department of Social Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway
| | - Bjørn Auestad
- Research Department, Stavanger University Hospital, Stavanger, Norway; Department of Mathematics and Physics, University of Stavanger, Stavanger, Norway
| | - Ulrik Helt Haahr
- Psychiatric Research Unit, Psychiatry Region Zealand, Slagelse, Denmark
| | - Inge Joa
- The Early Treatment and Intervention in Psychosis Study (TIPS) Centre for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway; Department of Public Health, Faculty of Health Sciences, Network for Medical Sciences, University of Stavanger, Stavanger, Norway
| | - Jan Olav Johannessen
- The Early Treatment and Intervention in Psychosis Study (TIPS) Centre for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway; Department of Public Health, Faculty of Health Sciences, Network for Medical Sciences, University of Stavanger, Stavanger, Norway
| | - Tor Ketil Larsen
- The Early Treatment and Intervention in Psychosis Study (TIPS) Centre for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway; Institute of Psychiatry, University of Bergen, Bergen, Norway
| | - Stein Opjordsmoen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Bjørn Rishovd Rund
- Department of Psychology, University of Oslo, Oslo, Norway; Vestre Viken Hospital Trust, Drammen, Norway
| | - Jan Ivar Røssberg
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Erik Simonsen
- Psychiatric Research Unit, Psychiatry Region Zealand, Slagelse, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Svein Friis
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Ingrid Melle
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; NORMENT Centre, Oslo University Hospital, Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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Avedillo-Salas A, Pueyo-Val J, Fanlo-Villacampa A, Navarro-Pemán C, Lanuza-Giménez FJ, Ioakeim-Skoufa I, Vicente-Romero J. Prescribed Drugs and Self-Directed Violence: A Descriptive Study in the Spanish Pharmacovigilance Database. Pharmaceuticals (Basel) 2023; 16:ph16050772. [PMID: 37242555 DOI: 10.3390/ph16050772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 05/12/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023] Open
Abstract
Self-inflicted violence is a major and growing public health problem and its prediction and prevention is challenging for healthcare systems worldwide. Our aim was to identify prescribed drugs associated with self-directed violent behaviors in Spain. A descriptive, longitudinal and retrospective study of spontaneous reports of adverse drug reactions corresponding to self-directed violence was recorded in the Spanish Pharmacovigilance Database (FEDRA®) from 1984 to 31 March 2021. A total of 710 cases were reported in the study period. The mean age was 45.52 years (range 1-94). There were no gender differences except in children, where most reports were of male children. The main therapeutic groups that were involved included drugs for the nervous system (64.5%) and anti-infectives for systemic use (13.2%). The most commonly reported drugs were varenicline, fluoxetine, lorazepam, escitalopram, venlafaxine, veralipride, pregabalin, roflumilast and bupropion. There were reports of montelukast, hydroxychloroquine, isotretinoin, methylphenidate, infliximab, natalizumab, ribavirin and efavirenz, which were less known to be involved in self-directed violence. This study shows that self-directed violence is a rare adverse drug reaction, and can be related to the use of some medicines. It is important for healthcare professionals to consider this risk in their clinical praxis, implementing person-centred approaches. Further studies are needed, considering comorbidities and potential interactions.
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Affiliation(s)
- Ana Avedillo-Salas
- Department of Pharmacology, Physiology and Legal and Forensic Medicine, Faculty of Medicine, University of Zaragoza, ES-50009 Zaragoza, Spain
| | - Javier Pueyo-Val
- Department of Pharmacology, Physiology and Legal and Forensic Medicine, Faculty of Medicine, University of Zaragoza, ES-50009 Zaragoza, Spain
| | - Ana Fanlo-Villacampa
- Department of Pharmacology, Physiology and Legal and Forensic Medicine, Faculty of Medicine, University of Zaragoza, ES-50009 Zaragoza, Spain
| | - Cristina Navarro-Pemán
- Department of Pharmacology, Physiology and Legal and Forensic Medicine, Faculty of Medicine, University of Zaragoza, ES-50009 Zaragoza, Spain
- Aragon Pharmacovigilance Center, ES-50017 Zaragoza, Spain
| | - Francisco Javier Lanuza-Giménez
- Department of Pharmacology, Physiology and Legal and Forensic Medicine, Faculty of Medicine, University of Zaragoza, ES-50009 Zaragoza, Spain
| | - Ignatios Ioakeim-Skoufa
- Department of Pharmacology, Physiology and Legal and Forensic Medicine, Faculty of Medicine, University of Zaragoza, ES-50009 Zaragoza, Spain
- WHO Collaborating Centre for Drug Statistics Methodology, Department of Drug Statistics, Division of Health Data and Digitalisation, Norwegian Institute of Public Health, NO-0213 Oslo, Norway
- EpiChron Research Group, Aragon Health Research Institute (IIS Aragón), Miguel Servet University Hospital, ES-50009 Zaragoza, Spain
- Research Network on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III (ISCIII), ES-28029 Madrid, Spain
- Drug Utilization Work Group, Spanish Society of Family and Community Medicine (semFYC), ES-08009 Barcelona, Spain
| | - Jorge Vicente-Romero
- Department of Pharmacology, Physiology and Legal and Forensic Medicine, Faculty of Medicine, University of Zaragoza, ES-50009 Zaragoza, Spain
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Donnelly HK, Han Y, Kim S, Lee DH. Predictors of suicide ideation among South Korean adolescents: A machine learning approach. J Affect Disord 2023; 329:557-565. [PMID: 36828148 DOI: 10.1016/j.jad.2023.02.079] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 02/16/2023] [Accepted: 02/18/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND The current study developed a predictive model for suicide ideation among South Korean (Korean) adolescents using a comprehensive set of factors across demographic, physical and mental health, academic, social, and behavioral domains. The aim of this study was to address the pressing public health concerns of adolescent suicide in Korea and the methodological limitations of suicidal research. METHODS This study used machine learning methods (decision tree, logistic regression, naive Bayes classifier) to improve the accuracy of predicting suicidal ideation and related factors among a nationally representative sample of Korean middle school students (N = 6666). RESULTS Factors within all domains, including demographic characteristics, physical and mental health, and academic, social, and behavioral, were important in predicting suicidal thoughts among Korean adolescents, with mental health being the most important factor. LIMITATIONS The predictive model of the current research does not infer causality, and there may have been some loss of information due to measurement issues. CONCLUSIONS Study results provide insights for taking a multidimensional approach when identifying adolescents at risk of suicide, which may be used to further address their needs through intervention programs within the school setting. Considering the cultural stigma attached to disclosing suicidal ideation and behavior, the current study proposes the need for a preventive screening process based on the observation and assessment of adolescents' general characteristics and experiences in everyday life.
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Affiliation(s)
- Hayoung Kim Donnelly
- Boston University, Department of Counseling Psychology and Applied Human Development, USA.
| | - Yoonsun Han
- Seoul National University, Department of Social Welfare, South Korea.
| | - Suna Kim
- Seoul National University, Department of International Studies, South Korea.
| | - Dong Hun Lee
- Sungkyunkwan University, Traumatic Stress Center, Department of Education, South Korea.
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Liu Z, Sun L, Zhang Y, Wang J, Sun F, Zhang Z, Sun G, Sun L, Yang R. The prevalence of underweight and obesity in Chinese children and adolescents with major depressive disorder and relationship with suicidal ideation and attempted suicide. Front Psychiatry 2023; 14:1130437. [PMID: 37215666 PMCID: PMC10196048 DOI: 10.3389/fpsyt.2023.1130437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 04/17/2023] [Indexed: 05/24/2023] Open
Abstract
Background The high rates of obesity and suicide have become serious public health problems worldwide, especially in children and adolescents with major depressive disorder (MDD). This research aimed to explore the rates of underweight, overweight or obesity, suicidal ideation and attempted suicide in hospitalized children and adolescents with MDD. Then, we analyzed the correlation between underweight or obesity and suicidal ideation and attempted suicide, and finally obtained the independent influencing factors of underweight or obesity. Methods A total of 757 subjects in the Third People's Hospital of Fuyang from January 2020 to December 2021 were enrolled in this study. According to the underweight, overweight and obesity screening table for school-age children and adolescents published and implemented by the health industry standard of China, all subjects were divided into different body mass index (BMI) categories. We measured fasting blood glucose (FBG) and lipid levels in all subjects and assessed suicidal ideation, attempted suicide, and the severity of depressive symptoms. The socio-demographic and clinical data were collected and analyzed by SPSS 22.0. Results The rates of underweight, overweight, obesity, suicidal ideation and attempted suicide were 8.2% (62/757), 15.5% (117/757), 10.4% (79/757), 17.2% (130/757), and 9.9% (75/757), respectively. Correlation analysis indicated that BMIs level was positively correlated with age, age of first hospitalization, total duration of disease, number of hospitalizations, FBG, TG (triglyceride), TC (total cholesterol), LDL (low density lipoprotein), and negatively correlated with HDL (high density lipoprotein). Binary logistic regression analysis showed that male and high level of HDL were risk factors for MDD inpatients with underweight, while high level of TG was a protective factor. Meanwhile, higher levels of FBG, TG and CGI-S were risk factors and suicidal ideation and high dose of antidepressant drugs were protective factors for obesity in children and adolescents with MDD. Conclusion The prevalence of underweight, obesity, suicidal ideation and attempted suicide were high in children and adolescents with MDD, and severe depressive symptoms are independent risk factors for obesity, while suicidal ideation and high dose of antidepressants may be protective factors for obesity.
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Affiliation(s)
- Zhiwei Liu
- Department of Psychiatry, The Third People’s Hospital of Fuyang, Fuyang, China
- Department of Psychiatry, Fuyang Mental Health Center, Fuyang, China
| | - Liang Sun
- Department of Psychiatry, The Third People’s Hospital of Fuyang, Fuyang, China
- Department of Psychiatry, Fuyang Mental Health Center, Fuyang, China
| | - Yulong Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Juan Wang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
- Department of Psychiatry, The Fourth People’s Hospital of Chengdu, Chengdu, China
| | - Feng Sun
- Department of Psychiatry, The Third People’s Hospital of Fuyang, Fuyang, China
- Department of Psychiatry, Fuyang Mental Health Center, Fuyang, China
| | - Zhaokun Zhang
- Department of Psychiatry, The Third People’s Hospital of Fuyang, Fuyang, China
- Department of Psychiatry, Fuyang Mental Health Center, Fuyang, China
| | - Guangying Sun
- Department of Psychiatry, The Third People’s Hospital of Fuyang, Fuyang, China
- Department of Psychiatry, Fuyang Mental Health Center, Fuyang, China
| | - Longlong Sun
- Department of Psychiatry, The Third People’s Hospital of Fuyang, Fuyang, China
- Department of Psychiatry, Fuyang Mental Health Center, Fuyang, China
| | - Rongchun Yang
- Department of Psychiatry, The Third People’s Hospital of Fuyang, Fuyang, China
- Department of Psychiatry, Fuyang Mental Health Center, Fuyang, China
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Bagge CL, Littlefield AK, Wiegand TJ, Hawkins E, Trim RS, Schumacher JA, Simons K, Conner KR. A controlled examination of acute warning signs for suicide attempts among hospitalized patients. Psychol Med 2023; 53:2768-2776. [PMID: 35074021 PMCID: PMC10235647 DOI: 10.1017/s0033291721004712] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 07/28/2021] [Accepted: 10/28/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Near-term risk factors for suicidal behavior, referred to as 'warning signs' (WS), distinguish periods of acute heightened risk from periods of lower risk within an individual. No prior published study has examined, using a controlled study design, a broad set of hypothesized WS for suicide attempt. This study addressed this gap through examination of hypothesized behavioral/experiential, cognitive, and affective WS among patients recently hospitalized following a suicide attempt. METHODS Participants were recruited during hospitalization from five medical centers across the USA including two civilian hospitals and three Veterans Health Administration facilities (n = 349). A within-person case-crossover study design was used, where each patient served as her/his own control. WS were measured by the Timeline Follow-back for Suicide Attempts Interview and were operationalized as factors that were present (v. absent) or that increased in frequency/intensity within an individual during the 6 h preceding the suicide attempt (case period) compared to the corresponding 6 h on the day before (control period). RESULTS Select WS were associated with near-term risk for suicide attempt including suicide-related communications, preparing personal affairs, drinking alcohol, experiencing a negative interpersonal event, and increases in key affective (e.g. emptiness) and cognitive (e.g. burdensomeness) responses. CONCLUSIONS The identification of WS for suicidal behavior can enhance risk recognition efforts by medical providers, patients, their families, and other stakeholders that can serve to inform acute risk management decisions.
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Affiliation(s)
- Courtney L. Bagge
- Department of Psychiatry, University of Michigan Medical Center and VA Center for Clinical Management Research, Department of Veteran Affairs, Ann Arbor, MI 48109-2800, USA
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | | | - Timothy J. Wiegand
- Department of Emergency Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Eric Hawkins
- Veteran Affairs Center of Excellence in Substance Addiction Treatment and Education, Seattle, WA 98108, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195, USA
| | - Ryan S. Trim
- Psychology Service, Veterans Administration San Diego Healthcare System and Department of Psychiatry, University of California-San Diego, CA 92161, USA
| | - Julie A. Schumacher
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Kelsey Simons
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Kenneth R. Conner
- Department of Emergency Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY 14642, USA
- VISN 2 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, Canandaigua, NY 14424, USA
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Ramos-Martín J, Contreras-Peñalver MÁ, Moreno-Küstner B. Classification of suicidal behavior calls in emergency medical services: a systematic review. Int J Emerg Med 2023; 16:27. [PMID: 37069512 PMCID: PMC10108483 DOI: 10.1186/s12245-023-00504-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 04/02/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND The aim of this systematic review was to examine the classification of calls for suicidal behavior in emergency medical services (EMS). METHODS A search strategy was carried out in four electronic databases on calls for suicidal behavior in EMS published between 2010 and 2020 in Spanish and English. The outcome variables analyzed were the moment of call classification, the professional assigning the classification, the type of classification, and the suicide codes. RESULTS Twenty-five studies were included in the systematic review. The EMS classified the calls at two moments during the service process. In 28% of the studies, classification was performed during the emergency telephone call and in 36% when the professional attended the patient at the scene. The calls were classified by physicians in 40% of the studies and by the telephone operator answering the call in 32% of the studies. In 52% of the studies, classifications were used to categorize the calls, while in 48%, this information was not provided. Eighteen studies (72%) described codes used to classify suicidal behavior calls: a) codes for suicidal behavior and self-injury, and b) codes related to intoxication, poisoning or drug abuse, psychiatric problems, or other methods of harm. CONCLUSION Despite the existence of international disease classifications and standardized suicide identification systems and codes in EMS, there is no consensus on their use, making it difficult to correctly identify calls for suicidal behavior.
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Affiliation(s)
- Javier Ramos-Martín
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico. Universidad de Málaga, Doctor Ortiz Ramos, S/N 29010, Málaga, Spain.
| | - M Ángeles Contreras-Peñalver
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico. Universidad de Málaga, Doctor Ortiz Ramos, S/N 29010, Málaga, Spain
| | - Berta Moreno-Küstner
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico. Universidad de Málaga, Doctor Ortiz Ramos, S/N 29010, Málaga, Spain
- Grupo Andaluz de Investigación Psicosocial (GAP) (CTS-945), Málaga, Spain
- Instituto de Biomedicina de Málaga (IBIMA), Málaga, Spain
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Nielsen A, Azra KK, Kim C, Dusing GJ, Chum A. Is the association between sexual minority status and suicide-related behaviours modified by rurality? A discrete-time survival analysis using longitudinal health administrative data. Soc Sci Med 2023; 325:115896. [PMID: 37084702 DOI: 10.1016/j.socscimed.2023.115896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 03/08/2023] [Accepted: 04/06/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND While self-reported data shows that lesbian, gay, and bisexual (LBG) individuals have a greater suicide-related behaviours (SRB) risk, little is known about how rurality may amplify SRB risk associated with sexual minority status. Sexual minority individuals in rural areas may experience unique stressors due to stigma and a lack of LGB-specific social and mental health services. Using a population-representative sample linked to clinical SRB outcomes, we examined whether rurality modifies the association between sexual minority status and SRB risk. METHODS A nationally representative survey linked to administrative health data was used to construct a cohort of individuals (unweighted n = 169,091; weighted n = 8,778,115) in Ontario, Canada, and captured all SRB-related emergency department visits, hospitalizations, and deaths between 2007 and 2017. Sex-stratified discrete-time survival analyses were used to examine interactions between rurality and sexual minority status on SRB risk while controlling for potential confounders. RESULTS Sexual minority men had 2.18 times higher SRB odds compared to their heterosexual counterparts (95%CI 1.21-3.91), while sexual minority women had 2.07 times higher odds (95%CI 1.48-2.89) after adjusting for the confounders. The Rurality Index of Ontario and the Index of Remoteness were associated with the odds of SRB in a dose-response manner. No significant interactions were observed between rural and sexual minority status. CONCLUSIONS Our study provides evidence that rural and sexual minority status both independently contribute to an elevated likelihood of SRB; however, rurality did not appear to modify SRB risk by sexual orientation. Implementation and evaluation of interventions to reduce SRB in both rural and sexual minority populations are required.
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Affiliation(s)
- Andrew Nielsen
- Canadian Institute for Health Information, 4110 Yonge St Suite 300, North York, ON M2P 2B7, Canada
| | - Karanpreet Kaur Azra
- Ontario Shores Centre for Mental Health Sciences, 700 Gordon St, Whitby, Ontario, L1N 5S9, Canada
| | - Chungah Kim
- School of Kinesiology and Health Science, York University, 4700 Keele St, Toronto, Ontario, M3J 1P3, Canada
| | - Gabriel John Dusing
- School of Kinesiology and Health Science, York University, 4700 Keele St, Toronto, Ontario, M3J 1P3, Canada
| | - Antony Chum
- School of Kinesiology and Health Science, York University, 4700 Keele St, Toronto, Ontario, M3J 1P3, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, Ontario, M5T 3M7, Canada; Unity Health Toronto, MAP Centre for Urban Health Solutions, 209 Victoria Street, 3rd floor, Toronto, Ontario, M5B 1T8, Canada.
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A meta-analysis of targeted interventions for reducing suicide-related behaviour and ideation in adolescents: Implications for trial design. Compr Psychiatry 2023; 122:152374. [PMID: 36758338 DOI: 10.1016/j.comppsych.2023.152374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 01/19/2023] [Accepted: 01/28/2023] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Suicidality among young people is a significant societal issue. The current study conducted a meta-analysis of community and clinical interventions targeting suicide attempts, self-harm, and suicidal ideation in adolescents. METHODS Interventions targeting suicide attempts, self-harm and suicidal ideation were identified by searching PsychINFO, Medline, CINAHL and Embase in line with the PRISMA statement. Study quality was determined using a risk of bias tool. Meta-analyses examined the efficacy of the interventions. Effect sizes were calculated for suicidal ideation data (continuous data) using Hedge's g for standardised mean differences. Suicide attempts and self-harm (dichotomous data) were calculated using odds ratios (ORs). RESULTS Seventeen RCTs were included in the meta-analysis. No significant differences were found between treatment and control groups on measures of suicide attempts or self-harm. A small effect-size was observed on measures of suicidal ideation (g = 0.47). A secondary meta-analysis investigated change over time in treatment as usual conditions, finding significant large effect-sizes for suicide attempts (OR = 18.67), self-harm (OR = 12.77), and suicidal ideation (g = 0.86). LIMITATIONS The methodological decision to focus on specific outcomes over a broad definition of self-harm excluded some papers, which have been included in other reviews. It is unlikely to have significantly affected the overall results. The review was not preregistered. CONCLUSIONS These twin findings highlight the importance overcoming the methodological difficulty of discerning effective interventions during a period of baseline improvement. We suggest that future trials should move away from broadly addressing "suicidality/self-harm" and encourage a greater targeting of at-risk individuals.
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Travis-Lumer Y, Kodesh A, Goldberg Y, Frangou S, Levine SZ. Attempted suicide rates before and during the COVID-19 pandemic: interrupted time series analysis of a nationally representative sample. Psychol Med 2023; 53:2485-2491. [PMID: 34664545 PMCID: PMC8564043 DOI: 10.1017/s0033291721004384] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/03/2021] [Accepted: 10/07/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND To characterize the association between the protracted biopsychosocial coronavirus disease 2019 (COVID-19) pandemic exposures and incident suicide attempt rates. METHODS Data were from a nationally representative cohort based on electronic health records from January 2013 to February 2021 (N = 852 233), with an interrupted time series study design. For the primary analysis, the effect of COVID-19 pandemic on incident suicide attempts warranting in-patient hospital treatment was quantified by fitting a Poisson regression and modeling the relative risk (RR) and the corresponding 95% confidence intervals (CIs). Scenarios were forecast to predict attempted suicide rates at 10 months after social mitigation strategies. Fourteen sensitivity analyses were performed to test the robustness of the results. RESULTS Despite the increasing trend in the unexposed interval, the interval exposed to the COVID-19 pandemic was statistically significant (p < 0.001) associated with a reduced RR of incident attempted suicide (RR = 0.63, 95% CI 0.52-0.78). Consistent with the primary analysis, sensitivity analysis of sociodemographic groups and methodological factors were statistically significant (p < 0.05). No effect modification was identified for COVID-19 lockdown intervals or COVID-19 illness status. All three forecast scenarios at 10 months projected a suicide attempt rate increase from 12.49 (7.42-21.01) to 21.38 (12.71-35.99). CONCLUSIONS The interval exposed to the protracted mass social trauma of the COVID-19 pandemic was associated with a lower suicide attempt rate compared to the unexposed interval. However, this trend is likely to reverse 10 months after lifting social mitigation policies, underscoring the need for enhanced implementation of public health policy for suicide prevention.
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Affiliation(s)
- Yael Travis-Lumer
- Faculty of Industrial Engineering and Management, Israel Institute of Technology, Haifa, Israel
| | - Arad Kodesh
- Department of Community Mental Health, University of Haifa, Haifa, Israel
- Meuhedet Health Services, Tel-Aviv, Israel
| | - Yair Goldberg
- Faculty of Industrial Engineering and Management, Israel Institute of Technology, Haifa, Israel
| | - Sophia Frangou
- Department of Psychiatry, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stephen Z. Levine
- Department of Community Mental Health, University of Haifa, Haifa, Israel
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Shin HD, Durocher K, Sequeira L, Zaheer J, Torous J, Strudwick G. Information and communication technology-based interventions for suicide prevention implemented in clinical settings: a scoping review. BMC Health Serv Res 2023; 23:281. [PMID: 36959599 PMCID: PMC10037806 DOI: 10.1186/s12913-023-09254-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 03/07/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND A large number of information and communication technology (ICT) based interventions exist for suicide prevention. However, not much is known about which of these ICTs are implemented in clinical settings and their implementation characteristics. In response, this scoping review aimed to systematically explore the breadth of evidence on ICT-based interventions for suicide prevention implemented in clinical settings and then to identify and characterize implementation barriers and facilitators, as well as evaluation outcomes, and measures. METHODS We conducted this review following the Joanna Briggs Institute methodology for scoping reviews. A search strategy was applied to the following six databases between August 17-20, 2021: MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, and Library, Information Science and Technology Abstracts. We also supplemented our search with Google searches and hand-searching reference lists of relevant reviews. To be included in this review, studies must include ICT-based interventions for any spectrum of suicide-related thoughts and behaviours including non-suicidal self-injury. Additionally, these ICTs must be implemented in clinical settings, such as emergency department and in-patient units. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist to prepare this full report. RESULTS This review included a total of 75 citations, describing 70 studies and 66 ICT-based interventions for suicide prevention implemented in clinical settings. The majority of ICTs were computerized interventions and/or applications (n = 55). These ICTs were commonly used as indicated strategies (n = 49) targeting patients who were actively presenting with suicide risk. The three most common suicide prevention intervention categories identified were post-discharge follow-up (n = 27), screening and/or assessment (n = 22), and safety planning (n = 20). A paucity of reported information was identified related to implementation strategies, barriers and facilitators. The most reported implementation strategies included training, education, and collaborative initiatives. Barriers and facilitators of implementation included the need for resource supports, knowledge, skills, motivation as well as engagement with clinicians with research teams. Studies included outcomes at patient, clinician, and health system levels, and implementation outcomes included acceptability, feasibility, fidelity, and penetration. CONCLUSION This review presents several trends of the ICT-based interventions for suicide prevention implemented in clinical settings and identifies a need for future research to strengthen the evidence base for improving implementation. More effort is required to better understand and support the implementation and sustainability of ICTs in clinical settings. The findings can also serve as a future resource for researchers seeking to evaluate the impact and implementation of ICTs.
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Affiliation(s)
- Hwayeon Danielle Shin
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
| | - Keri Durocher
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada
- School of Health, Community Service & Creative Design, Lambton College, Sarnia, Ontario, Canada
| | - Lydia Sequeira
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Juveria Zaheer
- Health Outcomes and Performance Evaluation (HOPE) Research Unit, Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Gerald Sheff and Shanitha Kachan Emergency Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - John Torous
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Gillian Strudwick
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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Poletti M, Pelizza L, Loas G, Azzali S, Paterlini F, Garlassi S, Scazza I, Chiri LR, Pupo S, Raballo A. Anhedonia and suicidal ideation in young people with early psychosis: Further findings from the 2-year follow-up of the ReARMS program. Psychiatry Res 2023; 323:115177. [PMID: 37003168 DOI: 10.1016/j.psychres.2023.115177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 03/02/2023] [Accepted: 03/21/2023] [Indexed: 04/03/2023]
Abstract
Hedonic deficits have been extensively studied in schizophrenia, but little is known about their association with suicidal ideation in early psychosis. The aim of this research was to examine the relationship between anhedonia and suicidal thoughts across a 2-year follow-up period in people with First Episode Psychosis (FEP) and at Ultra High Risk (UHR) of psychosis. Ninty-six UHR and 146 FEP, aged 13-35 years, completed the Comprehensive Assessment of At-Risk Mental States (CAARMS) and the Beck Depression Inventory-II (BDI-II). The BDI-II "Anhedonia" subscale score to assess anhedonia and the CAARMS "Depression" item 7.2 subscore to measure depression were used across the 2 years of follow-up. Hierarchical regression analyses were performed. No difference in anhedonia scores between FEP and UHR individuals was found. In the FEP group, a significant enduring association between anhedonia and suicidal ideation was found at baseline and across the follow-up, independent of clinical depression. In the UHR subgroup, the enduring relationship between anhedonia and suicidal thoughts were not completely independent from depression severity. Anhedonia is relevant in predicting suicidal ideation in early psychosis. Specific pharmacological and/or psychosocial interventions on anhedonia within specialized EIP program could reduce suicide risk overtime.
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Affiliation(s)
- Michele Poletti
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, RE, Italy
| | - Lorenzo Pelizza
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, RE, Italy; Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna (BO), Italy.
| | - Gwenole Loas
- Department of Psychiatry & Laboratory of Psychiatric Research (ULB 266), Cliniques Universitaires de Bruxelles, Universitè Libre de Bruxelles (ULB), Bruxelles, Belgium
| | - Silvia Azzali
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, RE, Italy
| | - Federica Paterlini
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, RE, Italy
| | - Sara Garlassi
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, RE, Italy
| | - Ilaria Scazza
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, RE, Italy
| | | | - Simona Pupo
- Pain Therapy Unit, Department of Medicine and Surgery, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci n.14, 43100 Parma, Italy
| | - Andrea Raballo
- Department of Medicine, Division of Psychiatry, Clinical Psychology and Rehabilitation, University of Perugia, Perugia, PG, Italy; Center for Translational, Phenomenological and Developmental Psychopathology, Perugia University Hospital, Perugia, PG, Italy
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Pérez-Pérez L, Cárdaba-García I, Madrigal-Fernández MA, Montero-Cuadrado F, Sobas EM, Soto-Cámara R. COVID-19 Pandemic Control Measures and Their Impact on University Students and Family Members in a Central Region of Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4470. [PMID: 36901480 PMCID: PMC10001487 DOI: 10.3390/ijerph20054470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 02/26/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
The first waves of the COVID-19 pandemic were times of great change in the lives of university students and their families in Spain. The aim of this study was to explore the psychosocial aspects and preventive measures carried out during the COVID-19 pandemic by students and family members of the nursing degree students of the University of Valladolid (Spain). The number of people surveyed was 877, by means of an ad hoc questionnaire. Relationships between variables were established by means of the Chi-square test and Student's t-test. In addition, multivariate logistic regression was generated. The significance level used was 0.05. Students and family members maintained preventive measures= such as hand washing, correct use of masks =in closed places, avoiding crowds and maintaining social distance, but at low rates (close to 20% in all cases). Regarding psychosocial aspects, 41.07% of the participants suffered from anxiety and loneliness, while 5.2% needed to take drugs to reduce anxiety or sleep and 66.07% were dependent on technology. Suicidal behavior is related to stress, anxiety, loneliness, poor family relationships, psychotropic drug use and technology abuse. The pandemic has caused life changes in university students and their families at the psychosocial level, generating high figures of suicidal ideation regardless of age. Preventive measures adopted to control the pandemic have not been followed for the most part.
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Affiliation(s)
- Lucía Pérez-Pérez
- Nursing Department, Faculty of Nursing, University of Valladolid, 47005 Valladolid, Spain
- Health Service of Castilla y León (Sacyl), 47007 Valladolid, Spain
| | | | | | - Federico Montero-Cuadrado
- Health Service of Castilla y León (Sacyl), 47007 Valladolid, Spain
- East-Valladolid Primary Care Management (Sacyl), 47010 Valladolid, Spain
- Unit for Active Coping Strategies for Pain in Primary Care, 47011 Valladolid, Spain
| | - E. M. Sobas
- Nursing Department, Faculty of Nursing, University of Valladolid, 47005 Valladolid, Spain
- Institute of Applied Ophthalmobiology (IOBA), University of Valladolid, 47011 Valladolid, Spain
| | - Raúl Soto-Cámara
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain
- Emergency Medical Service of Castilla y León (Sacyl), 47007 Valladolid, Spain
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KELLY LM, SWENSON LP, WOLFF JC. Application of the Three-Step Ideation-to-Action Theory to Passive and Active Suicidal Ideation in College Students. MINERVA PSYCHIATRY 2023; 64:1-12. [PMID: 38979102 PMCID: PMC11229377 DOI: 10.23736/s2724-6612.21.02263-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
Background Few studies have tested the three-step theory of suicide (3ST), particularly in college students, who have unique developmental experiences of connectedness and high rates of suicidal ideation (SI). This study tested if factors purported in the 3ST distinguish undergraduate students with no SI, passive SI, and active SI using two conceptualizations of connectedness: social connection and meaning in life. Methods A sample of undergraduate students aged 18-26 from an urban university completed an online survey (n=265). Results Results showed some support for the 3ST. Greater psychological pain increased likelihood of passive SI (OR=3.74, p<.001); the model accurately identified 36% of students with passive SI. Greater pain (OR=2.74, p=.01) and hopelessness (OR=17.17, p<.05) differentiated students with active SI from those without SI in social connection models. In meaning models, greater pain relative to meaning in life differentiated students with passive SI (OR=2.29, p<.01) and active SI (OR=1.81, p<.05) relative to no SI. Each model accurately identified 68% of students with active SI. No 3ST factors differentiated students with passive SI from those with active SI. Conclusions There was limited applicability for 3ST in differentiating college students with passive SI from those with no SI or active SI, with better differentiation of students with active SI relative to no SI. Interventions for college students with passive and active SI could target psychological pain, foster hope, and cultivate meaning.
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Affiliation(s)
- Lourah M. KELLY
- Suffolk University, Department of Psychology, Boston, MA, USA
- University of Connecticut School of Medicine, Farmington, CT, USA
| | | | - Jennifer C. WOLFF
- Brown University, Warren Alpert Medical School, Providence, RI, USA
- Bradley Hasbro Children’s Research Center, Providence, RI, USA
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Wang Y, Ma Z, Lu S, Duan Z, Wilson A, Jia Y, Yang Y, Chen R. Associations between sex differences, eating disorder behaviors, physical and mental health, and self-harm among Chinese adolescents. J Eat Disord 2023; 11:30. [PMID: 36850005 PMCID: PMC9972801 DOI: 10.1186/s40337-023-00754-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 02/10/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND AND AIM Eating Disorders (ED) result in impaired well-being, but there exist an insufficient number of studies that have focused on the influence of sex and sexual orientation disparities within ED behaviors. Thus, we aimed to investigate ED behaviors among male and female adolescents with different sexual orientations in a school sample to understand prevalence and correlates of different ED behaviors. METHOD Data was analysed from 11,440 Chinese school adolescents with a mean age of 14.74 years (SD = 1.46). Reported data was gathered on sociodemographic information including sexual orientation, ED behaviors, health factors (reported health, cognitive function), mental health factors (depression, anxiety, suicidal ideation, non-suicidal self-injurious behavior), and social functioning (school bully victimization, and school bully perpetration). Logistic regression models were used to estimate the associations with ED behaviors, using the heterosexual orientation as the reference group as they are the majority. RESULTS Compared to female adolescents, male adolescents reported lower anxiety symptoms (t = - 12.39, p < 0.001, Cohen's d = - 0.233), were more likely to be the perpetrator of school bullying (χ2 = 190.61, p < 0.001, φ = 0.129), and reported a lower likelihood of taking dietary restriction (χ2 = 290.08, p < 0.001, φ = 0.160). Overall, the prevalence of dietary restriction presented sex disparities. Adolescents who reported no sexual attraction were less likely to engage in ED behaviors. Using heterosexual orientation as the reference group, the group who reported no sexual attraction was associated with lower risk in dietary restriction and purging in both male and female adolescents. Using the heterosexual orientation as the reference group, female sexual minority groups were at high risk of ED behaviors, with bisexual orientation and gay/lesbian orientation having a higher likelihood of engaging in objective binge eating. CONCLUSIONS The results revealed significant sex and sexual orientation differences of ED behaviors. The study suggests that adolescents is a period of sexuality development and could be critical for understanding adolescents' eating behaviors. It is important to guide adolescents to healthy eating during their development and considerations should be made by clinicians when creating interventions for ED behaviors among the different sex and sexual orientation groups.
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Affiliation(s)
- Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, South China Normal University, Guangzhou, China.,Guangdong Key Laboratory of Mental Health and Cognitive Science, School of Psychology, Center for Studies of Psychological Application, South China Normal University, Guangzhou, China
| | - Zhihao Ma
- Computational Communication Collaboratory, School of Journalism and Communication, Nanjing University, Nanjing, 210023, China
| | - Su Lu
- Department of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Zhizhou Duan
- Preventive Health Service, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, 152 Aiguo Road, Nanchang, Jiangxi, China
| | - Amanda Wilson
- Department of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Yinwei Jia
- Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, China
| | - Yong Yang
- Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, China.
| | - Runsen Chen
- Vanke School of Public Health, Tsinghua University, No.30, Shuangqing Road, Haidian District, Beijing, China. .,Institute for Healthy China, Tsinghua University, Beijing, China.
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Sastre-Buades A, Caro-Cañizares I, Ochoa S, Lorente-Rovira E, Barajas A, Gutiérrez-Zotes A, Sánchez-Alonso S, López-Carrilero R, Grasa E, Pousa E, Pélaez T, Cid J, González-Higueras F, Ruiz-Delgado I, Baca-Garcia E, Barrigon ML. Relationship between cognition and suicidal behavior in recent-onset psychosis. Schizophr Res 2023; 252:172-180. [PMID: 36652834 DOI: 10.1016/j.schres.2022.12.042] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 08/22/2022] [Accepted: 12/28/2022] [Indexed: 01/17/2023]
Abstract
Suicidal behavior (SB) is common in first-episode psychosis (FEP), and cognitive impairment has also been described in psychosis. Despite well-established risk factors for SB in psychosis, the role of cognition and insight remains unclear. This study aimed to explore the relationship between history of SB and cognition in recent-onset FEP, distinguishing between neurocognition, social cognition, and metacognition, and including cognitive insight (CI) as a metacognitive variable. The sample consisted of 190 participants with recent-onset FEP recruited from two multicentric studies. Two groups were formed based on presence/absence of a history of SB. Demographic, clinical, and cognitive data were compared by group, including significance level adjustments and size effect calculation. No differences were found regarding demographic, clinical, neurocognitive, social cognition, and metacognitive variables except for CI (18.18 ± 4.87; t = -3.16; p = 0.0020; d = -0.635), which showed a medium effect size. Small to medium effect size were found for attributional style (externalizing bias) (1.15 ± 3.94; t = 2.07; d = 0.482), theory of mind (ToM) (1.73 ± 0.22; t = 2.04; d = -0.403), jumping to conclusions bias (JTC) (23.3 %; X2 = 0.94; V = 0.178). In recent-onset psychosis, neurocognitive functioning was not related to the history of SB. As novelty, individuals with previous SB showed higher CI. Also, regarding social cognition and metacognition, individuals with prior SB tended to present extremely low externalizing bias, better ToM, and presence of JTC.
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Affiliation(s)
- Aina Sastre-Buades
- Department of Psychiatry, Jimenez Diaz Foundation Hospital, Madrid, Spain
| | - Irene Caro-Cañizares
- Department of Psychology, Universidad a Distancia de Madrid (UDIMA), Collado-Villalba, Spain.
| | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
| | | | - Ana Barajas
- Department of Research, Centre d'Higiene Mental Les Corts, Barcelona, Spain; Department of Clinical and Health Psychology, Autonomous University of Barcelona, Bellaterra, Cerdanyola del Vallès, Spain; Serra Húnter Programme, Goverment of Catalonia, Barcelona, Spain.
| | - Alfonso Gutiérrez-Zotes
- Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Hospital Universitari Institut Pere Mata, Institut d'Investigació Sanitària Pere Virgili (IISPV), Universitat Rovirai Virgili, Reus, Spain.
| | | | - Raquel López-Carrilero
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Fundació Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.
| | - Eva Grasa
- Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Esther Pousa
- Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain; Salut Mental Parc Taulí. Sabadell (Barcelona), Hospital Universitari - UAB Universitat Autònoma de Barcelona, Barcelona, Spain; Neuropsiquiatria i Addiccions, Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
| | - Trinidad Pélaez
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
| | - Jordi Cid
- Mental Health & Addiction Research Group, IdiBGi, Institut d'Assistencia Sanitària, Girona, Spain
| | | | | | - Enrique Baca-Garcia
- Department of Psychiatry, Jimenez Diaz Foundation Hospital, Madrid, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Fundación Jimenez Diaz Health Research Institute, Madrid, Spain; Department of Psychiatry, Madrid Autonomous University, Madrid, Spain; Department of Psychiatry, Hospital Universitario Rey Juan Carlos, Móstoles, Spain; Department of Psychiatry, Hospital Universitario Infanta Elena, Valdemoro, Spain; Department of Psychiatry, Hospital General de Villalba, Madrid, Spain; Carlos III Institute of Health, Madrid, Spain; Universidad Católica del Maule, Talca, Chile; Department of Psychiatry, Nimes University Hospital, Nimes, France.
| | | | - Maria Luisa Barrigon
- Department of Psychiatry, Jimenez Diaz Foundation Hospital, Madrid, Spain; Fundación Jimenez Diaz Health Research Institute, Madrid, Spain; Department of Psychiatry, Madrid Autonomous University, Madrid, Spain; Department of Psychiatry, University Hospital Puerta de Hierro, Majadahonda, Spain.
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50
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Berardelli I, Tarsitani L, Sarubbi S, Pinucci I, Rogante E, Cifrodelli M, Erbuto D, Lester D, Innamorati M, Pompili M. Suicide risk and suicide risk factors among immigrants in Italy: A bi-center matched sample study. Int J Soc Psychiatry 2023; 69:111-116. [PMID: 35083933 DOI: 10.1177/00207640211072425] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Italy has the third-largest immigrant population of European Union countries, but only a few research papers have examined suicide risk in immigrant psychiatric patients in Italy. The main aim of this paper was to compare suicidal ideation and suicide attempts in a sample of 304 psychiatric patients. We included 152 immigrant patients matched with 152 Italian patients admitted to the same wards during the same time period by age, gender, and diagnosis. We also investigated sociodemographic and clinical characteristics of the two samples including psychiatric diagnosis, age of illness onset, duration of illness, previous hospitalizations, length of hospitalization, previous suicide attempts, and substance and alcohol abuse. There were no differences between immigrant and Italian patients in either suicidal ideation (previous or current) or suicide attempts (previous or current). Immigrant patients were more likely to have a shorter duration of illness than the Italian patients and Italian patients were more likely to report substance abuse than were immigrant patients. Despite similar suicide rates between immigrants and Italian psychiatric inpatients, appropriate assessment of suicide risk in these patients is essential in implementing therapeutic suicide prevention strategies.
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Affiliation(s)
- Isabella Berardelli
- Department of Neurosciences, Mental Health, and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Lorenzo Tarsitani
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Salvatore Sarubbi
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Irene Pinucci
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Elena Rogante
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Mariarosaria Cifrodelli
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, Psychiatry Unit, Sant'Andrea Hospital, Rome, Italy
| | - Denise Erbuto
- Department of Neurosciences, Mental Health, and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - David Lester
- Psychology Program, Stockton University, Galloway, NJ, USA
| | - Marco Innamorati
- Department of Human Sciences, European University of Rome, Rome, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health, and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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