451
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Choi SB, Lee W, Yoon JH, Won JU, Kim DW. Ten-year prediction of suicide death using Cox regression and machine learning in a nationwide retrospective cohort study in South Korea. J Affect Disord 2018; 231:8-14. [PMID: 29408160 DOI: 10.1016/j.jad.2018.01.019] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 01/16/2018] [Accepted: 01/29/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Death by suicide is a preventable public health concern worldwide. The aim of this study is to investigate the probability of suicide death using baseline characteristics and simple medical facility visit history data using Cox regression, support vector machines (SVMs), and deep neural networks (DNNs). METHOD This study included 819,951 subjects in the National Health Insurance Service (NHIS)-Cohort Sample Database from 2004 to 2013. The dataset was divided randomly into two independent training and validation groups. To improve the performance of predicting suicide death, we applied SVM and DNN to the same training set as the Cox regression model. RESULTS Among the study population, 2546 people died by intentional self-harm during the follow-up time. Sex, age, type of insurance, household income, disability, and medical records of eight ICD-10 codes (including mental and behavioural disorders) were selected by a Cox regression model with backward stepwise elimination. The area of under the curve (AUC) of Cox regression (0.688), SVM (0.687), and DNN (0.683) were approximately the same. The group with top .5% of predicted probability had hazard ratio of 26.21 compared to that with the lowest 10% of predicted probability. LIMITATIONS This study is limited by the lack of information on suicidal ideation and attempts, other potential covariates such as information of medication and subcategory ICD-10 codes. Moreover, predictors from the prior 12-24 months of the date of death could be expected to show better performances than predictors from up to 10 years ago. CONCLUSIONS We suggest a 10-year probability prediction model for suicide death using general characteristics and simple insurance data, which are annually conducted by the Korean government. Suicide death prevention might be enhanced by our prediction model.
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Affiliation(s)
- Soo Beom Choi
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul, Republic of Korea; Graduate Program in Biomedical Engineering, Yonsei University, Seoul, Republic of Korea
| | - Wanhyung Lee
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Republic of Korea; Graduate School of Public Health, Yonsei University College of Medicine, Seoul, Republic of Korea; Incheon Worker's Health Center, Incheon, Republic of Korea
| | - Jin-Ha Yoon
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Republic of Korea; Graduate School of Public Health, Yonsei University College of Medicine, Seoul, Republic of Korea; Incheon Worker's Health Center, Incheon, Republic of Korea
| | - Jong-Uk Won
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Republic of Korea; Graduate School of Public Health, Yonsei University College of Medicine, Seoul, Republic of Korea; Incheon Worker's Health Center, Incheon, Republic of Korea
| | - Deok Won Kim
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul, Republic of Korea; Graduate Program in Biomedical Engineering, Yonsei University, Seoul, Republic of Korea.
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452
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Kim C. The Impacts of Social Protection Policies and Programs on Suicide: A Literature Review. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2018; 48:512-534. [PMID: 29614903 DOI: 10.1177/0020731418767548] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Despite vigorous interest in showing the association between economic determinants and suicide, not many studies have focused on the social protection that can moderate the detrimental impact of the economic environment on suicide. This article is the first to review the relationship between suicide and social protection. In this article, I summarize the empirical findings and theoretical approaches in published papers on the relationship between suicide and social protection, and I identify knowledge gaps for future studies. The review included all quantitative and qualitative articles published in peer-reviewed journals, regardless of study setting, language, and time period. Among 19 papers meeting the inclusion criteria, 16 studies reported at least one negative association, 2 studies failed to prove a statistical association, and 1 study showed ambiguous results. However, due to the heterogeneity of contexts, the diversity of indicators of social protection, and the paucity of theoretical mechanisms for interpreting the results, further research is required in this area.
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Affiliation(s)
- Chungah Kim
- 1 Department of Health Policy, McMaster University, Hamilton, Ontario, Canada
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453
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The Impact of Forced Migration on Mortality: A Cohort Study of 242,075 Finns from 1939-2010. Epidemiology 2018; 28:587-593. [PMID: 28368943 DOI: 10.1097/ede.0000000000000669] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The stresses and life changes associated with migration may have harmful long-term health effects, especially for mental health. These effects are exceedingly difficult to establish, because migrants are typically a highly selected group. METHODS We examined the impact of migration on health using "naturally occurring" historical events. In this article, we use the forced migration of 11% of the Finnish population after WWII as such a natural experiment. We observed the date and cause of death starting from 1 January 1971 and ending in 31 December 2010 for the cohort of 242,075 people. Data were obtained by linking individual-level data from the 1950 and 1970 population censuses and the register of death certificates from 1971 to 2010 (10% random sample). All-cause and cause-specific mortalities were modeled using Poisson regression. RESULTS Models with full adjustment for background variables showed that both all-cause mortality (RR 1.03, 95% CI 1.01, 1.05), and ischemic heart disease mortality (RR 1.11, 95% CI 1.08, 1.15) were higher in the displaced population than in the nondisplaced population. Suicide mortality was lower (RR 0.77, 95% CI 0.64, 0.92) in displaced than in the general population. CONCLUSIONS In our long-term follow-up study, forced migration was associated with increased risk of death due to ischemic heart diseases. In contrast, lower suicide mortality was observed in association with forced migration 25 years or more.
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454
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Rodríguez-Cintas L, Daigre C, Braquehais MD, Palma-Alvarez RF, Grau-López L, Ros-Cucurull E, Rodríguez-Martos L, Abad AC, Roncero C. Factors associated with lifetime suicidal ideation and suicide attempts in outpatients with substance use disorders. Psychiatry Res 2018; 262:440-445. [PMID: 28951146 DOI: 10.1016/j.psychres.2017.09.021] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 07/24/2017] [Accepted: 09/09/2017] [Indexed: 12/11/2022]
Abstract
Risks factors for suicide are multiple and highly prevalent in addicted patients (previous suicide attempts, substance abuse, impulsivity, history of sexual abuse and other factors). The aim of this study is to identify and to compare the clinical and socio-demographic profile of SUD outpatients with lifetime suicidal behavior (previous suicidal ideation and/or suicide attempts) and to analyze the factors related to it. A retrospective cohort study of 696 addicted patients, according to DSM-IV-TR criteria (APA, 2000) were collected from the Addiction Unit of Vall d'Hebron University Hospital. Lifetime suicidal ideation in addicted patients is associated with presence of: borderline personality disorder (BPD), depressive disorders, sexual abuse, polydrug abuse, attention-deficit hyperactivity disorder, and motor impulsivity. The factors associated with suicide attempts were: borderline personality disorder, lifetime abuse (whether emotional, physical or sexual), co-occurrent psychotic disorders, polydrug abuse, anxiety disorders and depressive symptoms. We conclude that previous suicidal ideation and lifetime suicide attempts should be considered in the clinical care of addicted patients. Factors related to both suicidal behaviors share similarities and differences according to our findings and need to be deeply explored in the future.
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Affiliation(s)
- Laia Rodríguez-Cintas
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain; Department of Psychiatry, Vall d'Hebron University Hospital, CIBERSAM, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Constanza Daigre
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain; Department of Psychiatry, Vall d'Hebron University Hospital, CIBERSAM, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - María Dolores Braquehais
- Department of Psychiatry, Vall d'Hebron University Hospital, CIBERSAM, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Raúl Felipe Palma-Alvarez
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain; Department of Psychiatry, Vall d'Hebron University Hospital, CIBERSAM, Barcelona, Spain
| | - Lara Grau-López
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain; Department of Psychiatry, Vall d'Hebron University Hospital, CIBERSAM, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elena Ros-Cucurull
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain; Department of Psychiatry, Vall d'Hebron University Hospital, CIBERSAM, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lola Rodríguez-Martos
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain; Department of Psychiatry, Vall d'Hebron University Hospital, CIBERSAM, Barcelona, Spain
| | - Alfonso Carlos Abad
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain; Department of Psychiatry, Vall d'Hebron University Hospital, CIBERSAM, Barcelona, Spain
| | - Carlos Roncero
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain; Department of Psychiatry, Vall d'Hebron University Hospital, CIBERSAM, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
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455
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Burke TA, Jacobucci R, Ammerman BA, Piccirillo M, McCloskey MS, Heimberg RG, Alloy LB. Identifying the relative importance of non-suicidal self-injury features in classifying suicidal ideation, plans, and behavior using exploratory data mining. Psychiatry Res 2018; 262:175-183. [PMID: 29453036 PMCID: PMC6684203 DOI: 10.1016/j.psychres.2018.01.045] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 11/29/2017] [Accepted: 01/24/2018] [Indexed: 10/18/2022]
Abstract
Individuals with a history of non-suicidal self-injury (NSSI) are at alarmingly high risk for suicidal ideation (SI), planning (SP), and attempts (SA). Given these findings, research has begun to evaluate the features of this multi-faceted behavior that may be most important to assess when quantifying risk for SI, SP, and SA. However, no studies have examined the wide range of NSSI characteristics simultaneously when determining which NSSI features are most salient to suicide risk. The current study utilized three exploratory data mining techniques (elastic net regression, decision trees, random forests) to address these gaps in the literature. Undergraduates with a history of NSSI (N = 359) were administered measures assessing demographic variables, depression, and 58 NSSI characteristics (e.g., methods, frequency, functions, locations, scarring) as well as current SI, current SP, and SA history. Results suggested that depressive symptoms and the anti-suicide function of NSSI were the most important features for predicting SI and SP. The most important features in predicting SA were the anti-suicide function of NSSI, NSSI-related medical treatment, and NSSI scarring. Overall, results suggest that NSSI functions, scarring, and medical lethality may be more important to assess than commonly regarded NSSI severity indices when ascertaining suicide risk.
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Affiliation(s)
- Taylor A Burke
- Temple University, Department of Psychology, Philadelphia, PA, USA.
| | - Ross Jacobucci
- University of Notre Dame, Department of Psychology, Notre Dame, IN, USA
| | | | - Marilyn Piccirillo
- Washington University in St. Louis, Department of Psychology, St. Louis, MO, USA
| | | | | | - Lauren B Alloy
- Temple University, Department of Psychology, Philadelphia, PA, USA
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456
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Pitman A, Khrisna Putri A, De Souza T, Stevenson F, King M, Osborn D, Morant N. The Impact of Suicide Bereavement on Educational and Occupational Functioning: A Qualitative Study of 460 Bereaved Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040643. [PMID: 29614731 PMCID: PMC5923685 DOI: 10.3390/ijerph15040643] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 03/28/2018] [Accepted: 03/29/2018] [Indexed: 11/16/2022]
Abstract
People bereaved by suicide are at an increased risk of suicide and of dropping out of education or work. Explanations for these associations are unclear, and more research is needed to understand how improving support in educational or work settings for people bereaved by suicide might contribute to reducing suicide risk. Our objective was to explore the impact of suicide on occupational functioning. We conducted a cross-sectional online study of bereaved adults aged 18-40, recruited from staff and students of British higher educational institutions in 2010. We used thematic analysis to analyse free text responses to two questions probing the impact of suicide bereavement on work and education. Our analysis of responses from 460 adults bereaved by suicide identified three main themes: (i) specific aspects of grief that impacted on work performance, cognitive and emotional domains, and social confidence; (ii) structural challenges in work or educational settings including a lack of institutional support, the impact of taking time off, and changes to caring roles; and (iii) new perspectives on the role of work, including determination to achieve. Institutional support should be tailored to take account of the difficulties and experiences described.
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Affiliation(s)
- Alexandra Pitman
- UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK.
- Camden and Islington NHS Foundation Trust, St Pancras Hospital, London NW1 0PE, UK.
| | - Adelia Khrisna Putri
- UGM Faculty of Psychology, Universitas Gadjah Mada, Jl. Sosio Humaniora 1, Sleman, Yogyakarta 55281, Indonesia.
| | - Tanisha De Souza
- North East London NHS Foundation Trust, Memory Service, Broad Street Health Centre, Morland Road, Dagenham, Essex, RM10 9HU, UK.
| | - Fiona Stevenson
- UCL Research Department of Primary Care & Population Health, Rowland Hill St, London NW3 2PF, UK.
| | - Michael King
- UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK.
| | - David Osborn
- UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK.
- Camden and Islington NHS Foundation Trust, St Pancras Hospital, London NW1 0PE, UK.
| | - Nicola Morant
- UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK.
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457
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Sadeghi Bahmani D, Faraji P, Faraji R, Lang UE, Holsboer-Trachsler E, Brand S. Is emotional functioning related to academic achievement among university students? Results from a cross-sectional Iranian sample. ACTA ACUST UNITED AC 2018. [PMID: 29538489 PMCID: PMC6899408 DOI: 10.1590/1516-4446-2017-2434] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objective: Whereas several studies have predicted academic achievement (AA) as a function of favorable cognitive factors and low negative emotional functioning (such as depression and anxiety), little is known about its associations with cognitive-emotional states of positive emotional functioning, such as social satisfaction. The present study sought to evaluate associations of AA with dimensions of negative and positive emotional functioning. Method: This cross-sectional study enrolled 275 students (mean age, 21.24 years; 66.1% females), who completed questionnaires covering sociodemographic parameters and AA scores, as well as measures of loneliness and depression (representing negative emotional functioning) and social satisfaction (representing positive emotional functioning). Results: Lower scores for negative and higher scores for positive emotional functioning were associated with higher AA scores. Multiple regression analysis showed that AA was predicted independently by both low negative and high positive emotional functioning. No gender differences were observed. Conclusions: The pattern of results observed in this study suggests that opposing dimensions of emotional functioning are independently related to AA. Students, educators, and health professionals dealing with students should focus both on increasing social satisfaction and on decreasing feelings of loneliness and depression.
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Affiliation(s)
- Dena Sadeghi Bahmani
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland.,Sleep Disorders Research Center, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
| | - Parviz Faraji
- Ardabil University of Medical Sciences, Ardabil, Iran
| | - Robab Faraji
- Faculty of Education and Psychology, University of Tabriz, Tabriz, Iran
| | - Undine E Lang
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland
| | - Edith Holsboer-Trachsler
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland
| | - Serge Brand
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland.,Division of Sport Science and Psychosocial Health, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.,Substance Abuse Prevention Research Center and Sleep Disorders Research Center, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
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458
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Gvion Y, Levi-Belz Y. Serious Suicide Attempts: Systematic Review of Psychological Risk Factors. Front Psychiatry 2018; 9:56. [PMID: 29563886 PMCID: PMC5845877 DOI: 10.3389/fpsyt.2018.00056] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 02/08/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND One of the main obstacles in studying suicide risk factors is the difference between cases in which the individual died by suicide and those in which the individual engaged in suicidal behavior. A promising strategy that overcomes this obstacle is the study of survivors of serious suicide attempt (SSA), i.e., an attempt that would have been lethal had it not been for the provision of rapid and effective emergency treatment. Serious suicide attempters are epidemiologically very much like those who died by suicide, and thus may serve as valid proxies for studying suicides. This paper aims to define the specific risk factors for SSAs by conducting a qualitative data synthesis of existing studies. METHODS Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a systematic search of the literature in PubMed, ProQuest, and Psychlit electronic research-literature databases. Search terms were "serious" "OR" "near lethal," combined with the Boolean "AND" operator with "suicide*." In addition, we performed a manual search on Google Scholar for further studies not yet identified. RESULTS The preliminary search identified 683 citations. A total of 39 research reports that met the predefined criteria were analyzed. Mental pain, communication difficulties, decision-making impulsivity, and aggression, as well as several demographic variables, were found to be major risk factors for SSAs. LIMITATIONS We found a variability of definitions for SSA that hamper the ability to draw a model for the risk factors and processes that facilitate it. Moreover, the role of suicide intent and planning in SSA is still unclear. Further studies should aim to clarify and refine the concepts and measures of SSA, thereby enabling more specific and concrete modeling of the psychological element in its formation. CONCLUSION SSA is a distinguishable phenomenon that needs to be addressed specifically within the scope of suicidal behavior. Interpersonal problems, as well as impulsivity and aggression, seem to facilitate SSA when mental pain serves as a secondary factor. Healthcare professionals should be aware of SSA, and familiar with its specific risk factors. Moreover, psychological and suicidal risk assessment should include a designated evaluation of these risk factors as part of intervention and prevention models for SSA.
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459
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Peters EM, John A, Bowen R, Baetz M, Balbuena L. Neuroticism and suicide in a general population cohort: results from the UK Biobank Project. BJPsych Open 2018; 4:62-68. [PMID: 29971148 PMCID: PMC6020311 DOI: 10.1192/bjo.2017.12] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 12/12/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Neuroticism has often been linked to suicidal thoughts and behaviour. AIMS To examine whether neuroticism is associated with suicide deaths after adjusting for known risks. METHOD UK Biobank participants (n = 389 365) were assessed for neuroticism as well as social, demographic and health-related variables at study entry and followed for up to 10 years. Suicide risk was modelled using Cox regression stratified by gender. RESULTS Neuroticism increased the risk of suicide in both men (hazard ratio (HR) = 1.15, 95% CI 1.09-1.22) and women (HR = 1.16, 95% CI 1.06-1.27). In a subsample who were assessed for mood disorders, neuroticism remained a significant predictor for women (HR 1.25, 95% CI 1.03-1.51) but not for men. CONCLUSIONS Screening and therapeutic interventions for neuroticism may be important for early suicide prevention. DECLARATION OF INTEREST None.
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Affiliation(s)
- Evyn M. Peters
- Department of Psychiatry, University of
Saskatchewan, Saskatoon, SK,
Canada
| | - Ann John
- Swansea University Medical School and the Farr
Institute, Swansea, Wales,
UK
| | - Rudy Bowen
- Department of Psychiatry, University of
Saskatchewan, Saskatoon, SK,
Canada
| | - Marilyn Baetz
- Department of Psychiatry, University of
Saskatchewan, Saskatoon, SK,
Canada
| | - Lloyd Balbuena
- Department of Psychiatry, University of
Saskatchewan, Saskatoon, SK,
Canada
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460
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Holmes EA, Ghaderi A, Harmer CJ, Ramchandani PG, Cuijpers P, Morrison AP, Roiser JP, Bockting CLH, O'Connor RC, Shafran R, Moulds ML, Craske MG. The Lancet Psychiatry Commission on psychological treatments research in tomorrow's science. Lancet Psychiatry 2018; 5:237-286. [PMID: 29482764 DOI: 10.1016/s2215-0366(17)30513-8] [Citation(s) in RCA: 315] [Impact Index Per Article: 52.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 11/10/2017] [Accepted: 11/24/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Emily A Holmes
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Ata Ghaderi
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Catherine J Harmer
- Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Health NHS Trust Foundation, Warneford Hospital, Oxford, UK
| | | | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Anthony P Morrison
- Psychosis Research Unit, Greater Manchester Mental Heath Trust, Manchester, UK; School of Psychological Sciences, University of Manchester, Manchester, UK
| | - Jonathan P Roiser
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Claudi L H Bockting
- Academic Medical Center, Department of Psychiatry, University of Amsterdam, Amsterdam, Netherlands
| | - Rory C O'Connor
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Roz Shafran
- University College London Great Ormond Street Institute of Child Health, London, UK
| | - Michelle L Moulds
- School of Psychology, The University of New South Wales, UNSW, Sydney, NSW, Australia
| | - Michelle G Craske
- Department of Psychology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
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461
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Helbich M, de Beurs D, Kwan MP, O'Connor RC, Groenewegen PP. Natural environments and suicide mortality in the Netherlands: a cross-sectional, ecological study. Lancet Planet Health 2018; 2:e134-e139. [PMID: 29546252 PMCID: PMC5846805 DOI: 10.1016/s2542-5196(18)30033-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
BACKGROUND Natural outdoor environments, such as green spaces (ie, grass, forests, or parks), blue spaces (ie, visible bodies of fresh or salt water), and coastal proximity, have been increasingly shown to promote mental health. However, little is known about how and the extent to which these natural environments are associated with suicide mortality. Our aim was to investigate whether the availability of green space and blue space within people's living environments and living next to the coast are protective against suicide mortality. METHODS In this cross-sectional, ecological study, we analysed officially confirmed deaths by suicide between 2005 and 2014 per municipality in the Netherlands. We calculated indexes to measure the proportion of green space and blue space per municipality and the coastal proximity of each municipality using a geographical information system. We fitted Bayesian hierarchical Poisson regressions to assess associations between suicide risk, green space, blue space, and coastal proximity, adjusted for risk and protective factors. FINDINGS Municipalities with a large proportion of green space (relative risk 0·879, 95% credibility interval 0·779-0·991) or a moderate proportion of green space (0·919, 0·846-0·998) showed a reduced suicide risk compared with municipalities with less green space. Green space did not differ according to urbanicity in relation to suicide. Neither blue space nor coastal proximity was associated with suicide risk. The geographical variation in the residual relative suicide risk was substantial and the south of the Netherlands was at high risk. INTERPRETATION Our findings support the notion that exposure to natural environments, particularly to greenery, might have a role in reducing suicide mortality. If confirmed by future studies on an individual level, the consideration of environmental exposures might enrich suicide prevention programmes. FUNDING European Research Council (grant agreement number 714993).
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Affiliation(s)
- Marco Helbich
- Department of Human Geography and Spatial Planning, Utrecht University, Utrecht, Netherlands
- Correspondence to: Dr Marco Helbich, Department of Human Geography and Spatial Planning, Utrecht University, 3584 CS Utrecht, NetherlandsCorrespondence to: Dr Marco Helbich, Department of Human Geography and Spatial PlanningUtrecht UniversityUtrechtCS3584Netherlands
| | - Derek de Beurs
- Netherlands Institute for Health Services Research, Utrecht, Netherlands
| | - Mei-Po Kwan
- Department of Human Geography and Spatial Planning, Utrecht University, Utrecht, Netherlands
- Department of Geography and Geographic Information Science, University of Illinois at Urbana–Champaign, Urbana, IL, USA
| | - Rory C O'Connor
- Suicidal Behaviour Research Laboratory, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK
| | - Peter P Groenewegen
- Department of Human Geography and Spatial Planning, Utrecht University, Utrecht, Netherlands
- Netherlands Institute for Health Services Research, Utrecht, Netherlands
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462
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Boyda D, Feeters DM, Dhingra K, Galbraith N, Hinton D. Parental psychopathology, adult attachment and risk of 12-month suicidal behaviours. Psychiatry Res 2018; 260:272-278. [PMID: 29220685 DOI: 10.1016/j.psychres.2017.11.084] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 09/06/2017] [Accepted: 11/28/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND The mechanisms by which parental psychopathology and vulnerability to suicide is transmitted to offspring is not well understood. parental psychopathology and behaviour may impact upon the normal emotional and psychological adjustment of their offspring in various ways. Research shows attachment insecurities may also be a key factor in the facilitation of suicidal behaviours. OBJECTIVE To examine adult attachment insecurities as a potential mediating pathway between parental psychopathology and 12-month suicidality. METHOD The study utilized data from the National co-morbidity Survey-Replication (NCS-R, N = 5692). Parental psychopathology was assessed using items from the Familial History of Psychiatric Disorders section of the NSC-R in conjunction with items designed to capture dimensions of attachment and suicidal behaviours. RESULTS Resultant analyses demonstrated specificity effects in that, parental psychopathology was associated with specific suicidal components through specific dimensions of attachment. DISCUSSION The results align with literature linking parental psychopathology to both attachment insecurities and risk of suicide. Crucially, this study bridges these research areas by presenting attachment insecurity as possible risk indicator and intervening factor between parental mental health and behaviour and specific indicators of suicide.
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Affiliation(s)
- David Boyda
- Faculty of Education Health and Wellbeing, Institute of Psychology, University of Wolverhampton, West Midlands WV1 1LY, United Kingdom.
| | - Danielle Mc Feeters
- Faculty of Education Health and Wellbeing, Institute of Psychology, University of Wolverhampton, West Midlands WV1 1LY, United Kingdom
| | | | - Niall Galbraith
- Faculty of Education Health and Wellbeing, Institute of Psychology, University of Wolverhampton, West Midlands WV1 1LY, United Kingdom
| | - Danny Hinton
- Faculty of Education Health and Wellbeing, Institute of Psychology, University of Wolverhampton, West Midlands WV1 1LY, United Kingdom
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463
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Owen R, Dempsey R, Jones S, Gooding P. Defeat and Entrapment in Bipolar Disorder: Exploring the Relationship with Suicidal Ideation from a Psychological Theoretical Perspective. Suicide Life Threat Behav 2018; 48:116-128. [PMID: 28276599 DOI: 10.1111/sltb.12343] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 11/08/2016] [Indexed: 11/28/2022]
Abstract
Contemporary psychological theoretical models of suicide hypothesize that defeat and entrapment underlie the development of suicidal ideation. This hypothesis has never been tested in people who experience bipolar disorder. Regression analysis revealed that defeat and entrapment significantly predicted suicidal ideation at 4-month follow-up. The relationship between defeat and suicidal ideation was mediated by total entrapment and internal entrapment, but not external entrapment. Results suggest that perceived defeat and entrapment underlie the development of prospective suicidal ideation in bipolar disorder. Findings could potentially improve the assessment of suicide risk in people who experience bipolar disorder.
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Affiliation(s)
- Rebecca Owen
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - Robert Dempsey
- Staffordshire Centre for Psychological Research, Staffordshire University, Stoke-on-Trent, UK
| | - Steven Jones
- Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK
| | - Patricia Gooding
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
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464
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O'Connor DB, Green JA, Ferguson E, O'Carroll RE, O'Connor RC. Effects of childhood trauma on cortisol levels in suicide attempters and ideators. Psychoneuroendocrinology 2018; 88:9-16. [PMID: 29144990 DOI: 10.1016/j.psyneuen.2017.11.004] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 11/08/2017] [Accepted: 11/08/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Suicide is a global health issue. Dysregulated hypothalamic-pituitary-adrenal (HPA) axis activity, as measured by cortisol levels, has been identified as one potential risk factor for suicide. Recent evidence has indicated that blunted cortisol reactivity to stress is associated with suicidal behavior. The current study investigated whether childhood trauma was associated with blunted cortisol reactivity to a laboratory stressor and resting cortisol levels in suicide attempters and ideators. METHODS 160 Participants were recruited and grouped according to history of previous suicidal attempt, suicidal ideation or as control participants. Participants completed background questionnaires, including the Childhood Trauma Questionnaire, before completing a laboratory stress task. Cortisol levels were assessed at rest and during the stress task. RESULTS The highest levels of childhood trauma were reported in those who had attempted suicide (78.7%), followed by those who thought about suicide (37.7%) and then those with no suicidal history (17.8%). Moreover, regression analyses showed that childhood trauma was a significant predictor of blunted cortisol reactivity to stress and resting cortisol levels, such that higher levels of trauma were associated with lower cortisol levels in those with a suicidal history. Family history of suicide did not interact with the effects of childhood trauma on cortisol levels. CONCLUSIONS These results indicate that childhood trauma is associated with blunted HPA axis activity in vulnerable populations in adulthood. The challenge for researchers is to elucidate the precise causal mechanisms linking trauma, cortisol and suicide risk and to investigate whether the effects of childhood trauma on cortisol levels are amendable to psychological intervention.
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Affiliation(s)
| | | | - Eamonn Ferguson
- School of Psychology, University of Nottingham, Nottingham, UK
| | | | - Rory C O'Connor
- Suicidal Behavior Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
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465
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Melia R, Francis K, Duggan J, Bogue J, O'Sullivan M, Chambers D, Young K. Mobile Health Technology Interventions for Suicide Prevention: Protocol for a Systematic Review and Meta-Analysis. JMIR Res Protoc 2018; 7:e28. [PMID: 29374003 PMCID: PMC5807620 DOI: 10.2196/resprot.8635] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Revised: 09/19/2017] [Accepted: 09/20/2017] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Previous research has reported that two of the major barriers to help-seeking for individuals at risk of suicide are stigma and geographical isolation. Mobile technology offers a potential means of delivering evidence-based interventions with greater specificity to the individual, and at the time that it is needed. Despite documented motivation by at-risk individuals to use mobile technology to track mental health and to support psychological interventions, there is a shortfall of outcomes data on the efficacy of mobile health (mHealth) technology on suicide-specific outcomes. OBJECTIVE The objective of this study is to develop a protocol for a systematic review and meta-analysis that aims to evaluate the effectiveness of mobile technology-based interventions for suicide prevention. METHODS The search includes the Cochrane Central Register of Controlled Trials (CENTRAL: The Cochrane Library), MEDLINE, Embase, PsycINFO, CRESP and relevant sources of gray literature. Studies that have evaluated psychological or nonpsychological interventions delivered via mobile computing and communication technology, and have suicidality as an outcome measure will be included. Two authors will independently extract data and assess the study suitability in accordance with the Cochrane Collaboration Risk of Bias Tool. Studies will be included if they measure at least one suicide outcome variable (ie, suicidal ideation, suicidal intent, nonsuicidal self-injurious behavior, suicidal behavior). Secondary outcomes will be measures of symptoms of depression. Where studies are sufficiently homogenous and reported outcomes are amenable for pooled synthesis, meta-analysis will be performed. A narrative synthesis will be conducted if the data is unsuitable for a meta-analysis. RESULTS The review is in progress, with findings expected by summer 2018. CONCLUSIONS To date, evaluations of mobile technology-based interventions in suicide prevention have focused on evaluating content as opposed to efficacy. Indeed, previous research has identified mobile applications that appear to present harmful content. The current review will address a gap in the literature by evaluating the efficacy of stand-alone mobile technology tools in suicide prevention. It is imperative that research identifies the evidence base for such tools in suicide prevention in order to inform policy, guide clinical practice, inform users and focus future research. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42017072899; https:// www.crd.york.ac.uk/prospero/display_record.asp?ID=CRD42017072899 (Archived by WebCite at http://www.webcitation.org/ 6tZAj0yqJ).
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Affiliation(s)
- Ruth Melia
- Psychology Department, Health Service Executive Mid-West, Ennis, Ireland
| | - Kady Francis
- Psychology Department, Health Service Executive West, Roscommon, Ireland
| | - Jim Duggan
- College of Engineering and Informatics, National University of Ireland Galway, Galway, Ireland
| | - John Bogue
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Mary O'Sullivan
- Suicide Prevention Resource Office, Health Service Executive West, Galway, Ireland
| | | | - Karen Young
- College of Engineering and Informatics, National University of Ireland Galway, Galway, Ireland
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466
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Forkmann T, Teismann T, Stenzel JS, Glaesmer H, de Beurs D. Defeat and entrapment: more than meets the eye? Applying network analysis to estimate dimensions of highly correlated constructs. BMC Med Res Methodol 2018; 18:16. [PMID: 29370770 PMCID: PMC5785844 DOI: 10.1186/s12874-018-0470-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 01/02/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Defeat and entrapment have been shown to be of central relevance to the development of different disorders. However, it remains unclear whether they represent two distinct constructs or one overall latent variable. One reason for the unclarity is that traditional factor analytic techniques have trouble estimating the right number of clusters in highly correlated data. In this study, we applied a novel approach based on network analysis that can deal with correlated data to establish whether defeat and entrapment are best thought of as one or multiple constructs. METHODS Explanatory graph analysis was used to estimate the number of dimensions within the 32 items that make up the defeat and entrapment scales in two samples: an online community sample of 480 participants, and a clinical sample of 147 inpatients admitted to a psychiatric hospital after a suicidal attempt or severe suicidal crisis. Confirmatory Factor analysis (CFA) was used to test whether the proposed structure fits the data. RESULTS In both samples, bootstrapped exploratory graph analysis suggested that the defeat and entrapment items belonged to different dimensions. Within the entrapment items, two separate dimensions were detected, labelled internal and external entrapment. Defeat appeared to be multifaceted only in the online sample. When comparing the CFA outcomes of the one, two, three and four factor models, the one factor model was preferred. CONCLUSIONS Defeat and entrapment can be viewed as distinct, yet, highly associated constructs. Thus, although replication is needed, results are in line with theories differentiating between these two constructs.
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Affiliation(s)
- Thomas Forkmann
- Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Pauwelsstraße 19, 52074, Aachen, Germany.
| | - Tobias Teismann
- Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Bochum, Germany
| | - Jana-Sophie Stenzel
- Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Pauwelsstraße 19, 52074, Aachen, Germany
| | - Heide Glaesmer
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Derek de Beurs
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands
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467
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Batty GD, Kivimäki M, Bell S, Gale CR, Shipley M, Whitley E, Gunnell D. Psychosocial characteristics as potential predictors of suicide in adults: an overview of the evidence with new results from prospective cohort studies. Transl Psychiatry 2018; 8:22. [PMID: 29353878 PMCID: PMC5802587 DOI: 10.1038/s41398-017-0072-8] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 10/05/2017] [Accepted: 10/15/2017] [Indexed: 01/21/2023] Open
Abstract
In this narrative overview of the evidence linking psychosocial factors with future suicide risk, we collected results from published reports of prospective studies with verified suicide events (mortality or, less commonly, hospitalisation) alongside analyses of new data. There is abundant evidence indicating that low socioeconomic position, irrespective of the economic status of the country in question, is associated with an increased risk of suicide, including the suggestion that the recent global economic recession has been responsible for an increase in suicide deaths and, by proxy, attempts. Social isolation, low scores on tests of intelligence, serious mental illness (both particularly strongly), chronic psychological distress, and lower physical stature (a marker of childhood exposures) were also consistently related to elevated suicide rates. Although there is some circumstantial evidence for psychosocial stress, personality disposition, and early-life characteristics such as bullying being risk indices for suicide, the general paucity of studies means it is not currently possible to draw clear conclusions about their role. Most suicide intervention strategies have traditionally not explored the modification of psychosocial factors, partly because evidence linking psychosocial factors with suicide risk is, as shown herein, largely in its infancy, or, where is does exist, for instance for intelligence and personality disposition, the characteristics in question do not appear to be easily malleable.
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Affiliation(s)
- G. David Batty
- 0000000121901201grid.83440.3bDepartment of Epidemiology and Public Health, University College London, London, UK
| | - Mika Kivimäki
- 0000000121901201grid.83440.3bDepartment of Epidemiology and Public Health, University College London, London, UK
| | - Steven Bell
- 0000000121885934grid.5335.0Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Catharine R. Gale
- 0000 0004 1936 7988grid.4305.2Centre for Cognitive Ageing & Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK ,0000 0004 1936 9297grid.5491.9MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Martin Shipley
- 0000000121901201grid.83440.3bDepartment of Epidemiology and Public Health, University College London, London, UK
| | - Elise Whitley
- 0000 0001 2193 314Xgrid.8756.cMRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - David Gunnell
- 0000 0004 1936 7603grid.5337.2School of Social and Community Medicine, University of Bristol, Bristol, UK ,0000 0004 0380 7336grid.410421.2National Institute of Health Research Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust, Bristol, UK
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468
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Interpersonal trauma moderates the relationship between personality factors and suicidality of individuals with posttraumatic stress disorder. PLoS One 2018; 13:e0191198. [PMID: 29329352 PMCID: PMC5766138 DOI: 10.1371/journal.pone.0191198] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 12/30/2017] [Indexed: 11/25/2022] Open
Abstract
Individuals with posttraumatic stress disorder (PTSD) are more prone to suicidal ideation and behavior. While those who have experienced interpersonal trauma exhibit more suicidality than those who have experienced non-interpersonal trauma, it is unclear how the traumatic effects are related to an individual’s personality characteristics. This study examined the association between interpersonal trauma and personality factors with suicidality, and elucidated the moderating role of interpersonal trauma in individuals with PTSD. The study included 6,022 participants from the Korean Epidemiologic Catchment Area Study 2011. The Korean Version of Composite International Diagnostic Interview was used for the survey, including the participants’ history of suicidality, the traumas they have experienced, and their PTSD symptoms. The 11-item version of the Big Five Inventory (BFI-11) was used to assess the participants’ personality factors. 76 individuals were diagnosed with PTSD, while 810 had been exposed to trauma but were not diagnosed with any DSM-IV mental disorder. Among the individuals with PTSD, those who had experienced interpersonal trauma were more likely to have suicidal ideation than those who had experienced non-interpersonal trauma (p = .020; odds ratio [OR] = 3.643; 95% confidence interval of OR = [1.226, 10.825]). High agreeableness and conscientiousness predicted less suicidality in those exposed to non-interpersonal trauma, while predicting more suicidality in those exposed to interpersonal trauma. Clinicians examining individuals with PTSD should pay closer attention to the trauma that they have experienced, as well as their personality factors, to provide appropriate treatment.
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469
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O'Neill S, Ennis E, Corry C, Bunting B. Factors Associated with Suicide in Four Age Groups: A Population Based Study. Arch Suicide Res 2018; 22:128-138. [PMID: 28166461 DOI: 10.1080/13811118.2017.1283265] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Life events and circumstances leading to death change throughout the life course. In this study, 4 age groups within those who have died by suicide are compared in terms method of suicide, sex, occupation, mental disorders, prior suicide attempts, and life events prior to death. Analyses were based on a database of deaths by suicide and undetermined intent based on data in the Northern Ireland (NI) coronial files from 2005-2011 (N = 1667). Research determined that hanging is very prominent as a method of death within the under-20 age group. Women who die by suicide are more likely to have a known mental disorder than men, and the proportions increase with age group. Relationship difficulties are associated with many of these deaths and particularly for males aged under 40 years. Physical health and life events were more relevant than mental illness per se, in males aged over 61 years. For a sizeable proportion of the cases included in the current database there was no information on the life events prior to death. Understanding the factors associated with suicide across age groups is essential to informing suicide prevention strategy and programs and the development of more nuanced and effective interventions.
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470
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Lewis KC. The Treacherous Path: Developmental Psychopathology and the Evolution of Risk for Suicide. PSYCHOANALYTIC STUDY OF THE CHILD 2018. [DOI: 10.1080/00797308.2017.1415070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Katie C. Lewis
- Erikson Institute for Education and Research, Austen Riggs Center
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471
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Glenn CR, Kleiman EM, Cha CB, Deming CA, Franklin JC, Nock MK. Understanding suicide risk within the Research Domain Criteria (RDoC) framework: A meta-analytic review. Depress Anxiety 2018; 35:65-88. [PMID: 29064611 PMCID: PMC5760472 DOI: 10.1002/da.22686] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 07/07/2017] [Accepted: 08/28/2017] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The field is in need of novel and transdiagnostic risk factors for suicide. The National Institute of Mental Health's Research Domain Criteria (RDoC) provides a framework that may help advance research on suicidal behavior. METHOD We conducted a meta-analytic review of existing prospective risk and protective factors for suicidal thoughts and behaviors (ideation, attempts, and deaths) that fall within one of the five RDoC domains or relate to a prominent suicide theory. Predictors were selected from a database of 4,082 prospective risk and protective factors for suicide outcomes. RESULTS A total of 460 predictors met inclusion criteria for this meta-analytic review and most examined risk (vs. protective) factors for suicidal thoughts and behaviors. The overall effect of risk factors was statistically significant, but relatively small, in predicting suicide ideation (weighted mean odds ratio: wOR = 1.72; 95% CI: 1.59-1.87), suicide attempt (wOR = 1.66 [1.57-1.76), and suicide death (wOR = 1.41 [1.24-1.60]). Across all suicide outcomes, most risk factors related to the Negative Valence Systems domain, although effect sizes were of similar magnitude across RDoC domains. CONCLUSIONS This study demonstrated that the RDoC framework provides a novel and promising approach to suicide research; however, relatively few studies of suicidal behavior fit within this framework. Future studies must go beyond the "usual suspects" of suicide risk factors (e.g., mental disorders, sociodemographics) to understand the processes that combine to lead to this deadly outcome.
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Affiliation(s)
- Catherine R. Glenn
- Department of Clinical and Social Sciences in Psychology, University of Rochester
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472
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Macrynikola N, Miranda R, Soffer A. Social connectedness, stressful life events, and self-injurious thoughts and behaviors among young adults. Compr Psychiatry 2018; 80:140-149. [PMID: 29091780 PMCID: PMC10569818 DOI: 10.1016/j.comppsych.2017.09.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 09/06/2017] [Accepted: 09/16/2017] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES Preventing self-injurious thoughts and behaviors (SITBs) is particularly challenging on commuter campuses, given lower social cohesion and higher levels of stress than among traditional college populations. The present study examined the relationship between stressful life events (SLEs) and risk for different forms of SITBs, along with the potential buffering role of social connectedness, in a diverse sample of young adults from a commuter college. METHODS Participants were 1712 (81% female; 61% racial/ethnic minority; 20% sexual minority) undergraduate and graduate students from a public commuter college in New York City. Participants completed an anonymous survey that inquired about lifetime and recent (past 12months) history of suicidal ideation, suicide attempts, and non-suicidal self-injury (NSSI), along with social connectedness and lifetime history of SLEs. RESULTS Lower levels of social connectedness and exposure to a higher number of SLEs were associated with engaging in SITBs in the past year, particularly both suicide attempts and non-suicidal self-injury. However, social connectedness did not buffer against the impact of SLEs on SITBs. LIMITATIONS Data are cross-sectional, limiting conclusions about directionality, and females were overrepresented. CONCLUSIONS Identifying ways to increase social connectedness on diverse commuter campuses may help decrease risk of SITBs. However, it may not buffer against the impact of SLEs on risk of SITBs. Future studies should examine contextual variables (e.g., type and timing of social support) that may play a role in protecting against SITBs, particularly for those with a history of adversity.
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Affiliation(s)
- Natalia Macrynikola
- Hunter College, City University of New York, 695 Park Ave., Room 611HN, New York, NY 10065, USA; The Graduate Center, City University of New York, 365 5th Ave., New York, NY 10016, USA
| | - Regina Miranda
- Hunter College, City University of New York, 695 Park Ave., Room 611HN, New York, NY 10065, USA; The Graduate Center, City University of New York, 365 5th Ave., New York, NY 10016, USA.
| | - Ariella Soffer
- Hunter College, City University of New York, 695 Park Ave., Room 611HN, New York, NY 10065, USA
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473
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Angelakis I, Austin JL, Slater C, Roderique-Davies G. Experiencing Adverse Social Relationships: the Development and Validation of a Self-Report Scale that Measures Individuals’ Histories of Social Punishment (HoSP). JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2017. [DOI: 10.1007/s10862-017-9641-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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474
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Pitman A, Nesse H, Morant N, Azorina V, Stevenson F, King M, Osborn D. Attitudes to suicide following the suicide of a friend or relative: a qualitative study of the views of 429 young bereaved adults in the UK. BMC Psychiatry 2017; 17:400. [PMID: 29237447 PMCID: PMC5729247 DOI: 10.1186/s12888-017-1560-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 11/28/2017] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND People bereaved by suicide are at increased risk of suicide attempt and suicide, but explanations for these associations remain theoretical. It is possible that the experience of suicide bereavement modifies personal attitudes towards suicide, but the nature of these changes remains unexplored. There is a need to understand personal attitudes to suicide following suicide bereavement, as this may inform the development of suicide prevention interventions. Our aim was to explore the attitudes of young adults bereaved by suicide towards their own likelihood of dying by suicide. METHODS We conducted a cross-sectional study of staff and students aged 18-40 at 37 United Kingdom (UK) higher educational institutions in 2010. Ethical approval was granted by the UCL Research Ethics Committee. Qualitative responses to a question probing attitudes to own suicide were provided by 429 respondents who had experienced bereavement by the suicide of a close contact. We identified key themes in this dataset using thematic analysis. RESULTS Analysis identified four main themes: suicide as a more tangible option (whether feared or not); identification with the deceased and awareness of shared vulnerabilities to suicide; personal determination to avoid suicide; and beliefs regarding safeguards against suicide. These themes reflected a broad split in participants' views regarding own likelihood of dying by suicide, influenced by the degree to which own suicide was feared and the extent to which they felt in control of determining a suicide death. Whilst the majority described an aversion to the idea of attempting suicide themselves, largely through an awareness of the impact on others, a minority described their experiences as having normalised suicide as a personal option. CONCLUSIONS The views of a sample of UK-based adults bereaved by suicide suggest that exposure to the suicide of a close friend or relative can influence attitudes to suicide in ways that could influence own risk of suicide attempt. The normalising attitudes to suicide observed in a minority of respondents could contribute to the observed association between suicide bereavement and suicide attempt.
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Affiliation(s)
- Alexandra Pitman
- UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK. .,Camden and Islington NHS Foundation Trust, St Pancras Hospital, St Pancras Way, London, NW1 0PE, UK.
| | - Hedvig Nesse
- UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Nicola Morant
- UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Valeriya Azorina
- UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Fiona Stevenson
- 0000000121901201grid.83440.3bUCL Research Department of Primary Care and Population Health, UCL Medical School, Royal Free Campus, Rowland Hill St, London NW3 2PF, UK
| | - Michael King
- UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK ,grid.439468.4Camden and Islington NHS Foundation Trust, St Pancras Hospital, St Pancras Way, London, NW1 0PE UK
| | - David Osborn
- UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK ,grid.439468.4Camden and Islington NHS Foundation Trust, St Pancras Hospital, St Pancras Way, London, NW1 0PE UK
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475
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Kim J, Dawson V, Hartzell G, Furman AC. A Perfect Day for Bananafish: Learning the Imperfect Art of Predicting Suicide. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2017; 41:733-736. [PMID: 28936794 DOI: 10.1007/s40596-017-0818-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 09/11/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Jungjin Kim
- Emory University School of Medicine, Atlanta, GA, USA
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476
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Fonseca-Pedrero E, Inchausti F, Pérez-Gutiérrez L, Aritio Solana R, Ortuño-Sierra J, Sánchez-García MªÁ, Lucas-Molina B, Domínguez C, Foncea D, Espinosa V, Gorría A, Urbiola-Merina E, Fernández M, Merina Díaz C, Gutiérrez C, Aures M, Campos MS, Domínguez-Garrido E, Pérez de Albéniz Iturriaga A. Suicidal ideation in a community-derived sample of Spanish adolescents. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2017; 11:76-85. [PMID: 29102308 DOI: 10.1016/j.rpsm.2017.07.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 07/24/2017] [Accepted: 07/26/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Suicide is a current public health problem and among the main causes of mortality in adolescents and young adults. The main goal of this study was to analyse suicidal ideation in a representative sample of Spanish adolescents. Specifically, the prevalence rates of suicide ideation, the psychometric properties of the Paykel Suicide Scale (PSS) scores, and the socio-emotional adjustment of adolescents at risk for suicide were analysed. MATERIAL AND METHODS The sample consisted of 1,664 participants (M=16.12 years, SD=1.36, range 14-19 years), selected by stratified sampling by clusters. The instruments used were the PSS, the Strengths and Difficulties Questionnaire, the Personal Wellbeing Index-School Children, and the Oviedo Infrequency Scale. RESULTS The results showed that 4.1% of the sample indicated that they had tried to commit suicide in the previous year. Statistically significant differences were found according to gender but not according to age in the PSS mean scores. The analysis of the internal structure of the PSS showed that the one-dimensional model presented excellent goodness of fit indexes. This model showed measurement invariance across gender. The reliability of the scores, estimated with ordinal alpha, was 0.93. Participants who reported suicide ideation showed poorer mental health status and lower life satisfaction compared to the non-suicide ideation group. CONCLUSIONS Suicidal ideation is present during adolescence and is associated with poor subjective well-being and increased emotional and behavioural problems. PSS seems to show adequate psychometric behaviour to assess suicidal ideation in adolescents. These findings have clear implications, both in health and education systems, to improve the promotion of emotional well-being and prevention of psychological and psychiatric problems in this sector of the population.
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Affiliation(s)
- Eduardo Fonseca-Pedrero
- Departamento de Ciencias de la Educación, Universidad de La Rioja, Logroño, España; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, España.
| | - Félix Inchausti
- Centro de Salud Mental Ermitagaña, Complejo Hospitalario de Navarra, Pamplona, España
| | | | - Rebeca Aritio Solana
- Departamento de Ciencias de la Educación, Universidad de La Rioja, Logroño, España
| | - Javier Ortuño-Sierra
- Departamento de Ciencias de la Educación, Universidad de La Rioja, Logroño, España
| | | | | | - César Domínguez
- Departamento de Matemáticas y Computación, Universidad de La Rioja, Logroño, España
| | - David Foncea
- Departamento de Ciencias de la Educación, Universidad de La Rioja, Logroño, España
| | - Virginia Espinosa
- Departamento de Ciencias de la Educación, Universidad de La Rioja, Logroño, España
| | - Ana Gorría
- Consejería de Salud, Gobierno de La Rioja, Logroño, España
| | | | | | | | | | - Marta Aures
- Consejería de Salud, Gobierno de La Rioja, Logroño, España
| | - María S Campos
- Consejería de Salud, Gobierno de La Rioja, Logroño, España
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477
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O'Neill S, Ennis E, McFeeters D, Gallagher L. Financial Sector Workers' Experiences of Managing Suicidal Clients. CRISIS 2017; 39:159-165. [PMID: 29052433 DOI: 10.1027/0227-5910/a000483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Financial sector workers interface with indebted clients, who may be distressed and have heightened vulnerability to suicidality. AIM(S) This study examined the experiences of 10 Irish financial sector workers who had experiences of encountering distressed clients who discuss suicide. METHOD Semistructured interviews (open-ended questions) were used. RESULTS Interpretative phenomenological analysis (IPA) identified four themes, namely: (1) avoidance versus confrontation of reality (management of the debt); (2) role conflict (recovering the debt vs. supporting the client); (3) emotional impact and distancing from clients (coping with concerns for client welfare); (4) desire for support (practical and emotional training and support needs). LIMITATIONS The frequency with which such clients were encountered was not assessed. CONCLUSION These themes demonstrate the need to provide support to this group, and also the difficulties in providing training to manage suicidal clients in a context where the staff member's goal is to recover debt.
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Affiliation(s)
- Siobhan O'Neill
- 1 School of Psychology, Ulster University, L. Derry, Northern Ireland, UK
| | - Edel Ennis
- 1 School of Psychology, Ulster University, L. Derry, Northern Ireland, UK
| | - Danielle McFeeters
- 1 School of Psychology, Ulster University, L. Derry, Northern Ireland, UK
| | - Lia Gallagher
- 1 School of Psychology, Ulster University, L. Derry, Northern Ireland, UK
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478
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Coppersmith DDL, Nada-Raja S, Beautrais AL. Non-suicidal self-injury and suicide attempts in a New Zealand birth cohort. J Affect Disord 2017; 221:89-96. [PMID: 28641148 PMCID: PMC5569384 DOI: 10.1016/j.jad.2017.06.029] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 05/23/2017] [Accepted: 06/14/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) and suicide attempts are related, but distinct behaviors. The primary aim of the current study was to identify factors that distinguish those with different lifetime histories of self-injury. A secondary aim was to test whether lifetime history of self-injury at age 26 predicted current suicide ideation at age 32. METHODS Participants were 26 year olds from a large birth cohort with a lifetime history of no self-injury (n = 466), a lifetime history of NSSI (n = 191), or a lifetime history of NSSI and a suicide attempt (NSSI+SA; n = 52). They were compared on a history of psychiatric disorders, 12-month suicide ideation, lifetime history of childhood sexual abuse, and lifetime exposure to suicide. RESULTS An anxiety disorder, a substance dependence disorder, suicide ideation, and a history of childhood sexual abuse distinguished the NSSI+SA and NSSI only groups. Longitudinal results demonstrated that a history of NSSI predicted future suicide ideation after adjusting for other selected risk factors. LIMITATIONS The majority of analyses are cross-sectional which limits inferences about causality. The retrospective self-report for lifetime behavior could be subject to reporting biases. CONCLUSIONS Adults with a history of NSSI and adults with a history of NSSI and a suicide attempt are clinically distinct groups that are both at risk of future suicide ideation. Identifying and treating NSSI could be a key preventive factor in reducing subsequent suicide risk.
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Affiliation(s)
| | - Shyamala Nada-Raja
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Annette L Beautrais
- School of Health Sciences, University of Canterbury, Christchurch, New Zealand
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479
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Gnoth M, Glaesmer H, Steinberg H. Suizidalität in der deutschsprachigen Schulpsychiatrie. DER NERVENARZT 2017; 89:828-836. [DOI: 10.1007/s00115-017-0425-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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480
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Bartoli F, Di Brita C, Crocamo C, Clerici M, Carrà G. Lipid profile and suicide attempt in bipolar disorder: A meta-analysis of published and unpublished data. Prog Neuropsychopharmacol Biol Psychiatry 2017. [PMID: 28627446 DOI: 10.1016/j.pnpbp.2017.06.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Evidence suggests an association between low lipid levels and suicidality in subjects with severe mental disorders. This is the first systematic review and meta-analysis aimed at exploring differences in lipid profile between suicide attempters and non-attempters with bipolar disorder. We included observational studies providing comparative cross-sectional data on total cholesterol, LDL-cholesterol and triglycerides levels. We searched main Electronic Databases, identifying 11 studies that met our inclusion criteria, including also unpublished data. Meta-analyses based on random-effects models were carried out, generating pooled standardized mean differences (SMDs). Heterogeneity among studies was estimated using the I2 index. The meta-analyses included data on lipid profile from 11 studies based on 288 subjects with and 754 without suicide attempt, respectively. No differences in total cholesterol (SMD: -0.10; 95%CI: -0.30 to 0.10; p=0.34), LDL-cholesterol (SMD: -0.26; 95%CI: -0.65 to 0.13; p=0.19), and triglycerides (SMD: -0.06; 95%CI: -0.31 to 0.19; p=0.63) were detected. Heterogeneity across studies was low-moderate and no risk of publication bias was found. Subgroup analyses showed no differences on effect size across different study characteristics, including different time-frames of suicide attempt, except for small sample size. Therefore, the evidence for an association between serum lipid profile and suicidality in bipolar disorder cannot be claimed. More research is needed to better understand the mechanisms underlying suicidal behaviours in bipolar patients, exploring further peripheral biomarkers as this may help clinicians screen and prevent suicidality.
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Affiliation(s)
- Francesco Bartoli
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy.
| | - Carmen Di Brita
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Cristina Crocamo
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Massimo Clerici
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Giuseppe Carrà
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy; Division of Psychiatry, University College London, London, UK
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481
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Pietrzak RH, Pitts BL, Harpaz‐Rotem I, Southwick SM, Whealin JM. Factors protecting against the development of suicidal ideation in military veterans. World Psychiatry 2017; 16:326-327. [PMID: 28941099 PMCID: PMC5608823 DOI: 10.1002/wps.20467] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Robert H. Pietrzak
- US Department of Veterans Affairs National Center for Posttraumatic Stress DisorderVA Connecticut Healthcare SystemWest HavenCTUSA,Department of Psychiatry, Yale University School of MedicineNew HavenCTUSA
| | - Barbara L. Pitts
- US Department of Veterans Affairs VA Pacific Islands Healthcare SystemHonoluluHIUSA
| | - Ilan Harpaz‐Rotem
- US Department of Veterans Affairs National Center for Posttraumatic Stress DisorderVA Connecticut Healthcare SystemWest HavenCTUSA,Department of Psychiatry, Yale University School of MedicineNew HavenCTUSA
| | - Steven M. Southwick
- US Department of Veterans Affairs National Center for Posttraumatic Stress DisorderVA Connecticut Healthcare SystemWest HavenCTUSA,Department of Psychiatry, Yale University School of MedicineNew HavenCTUSA
| | - Julia M. Whealin
- US Department of Veterans Affairs VA Pacific Islands Healthcare SystemHonoluluHIUSA,University of Hawaii School of MedicineManoaHIUSA
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482
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Dutta R, Ball HA, Siribaddana SH, Sumathipala A, Samaraweera S, McGuffin P, Hotopf M. Genetic and other risk factors for suicidal ideation and the relationship with depression. Psychol Med 2017; 47:2438-2449. [PMID: 28478783 PMCID: PMC5964447 DOI: 10.1017/s0033291717000940] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 03/16/2017] [Accepted: 03/21/2017] [Indexed: 12/02/2022]
Abstract
BACKGROUND There is a genetic contribution to the risk of suicide, but sparse prior research on the genetics of suicidal ideation. METHODS Active and passive suicidal ideation were assessed in a Sri Lankan population-based twin registry (n = 3906 twins) and a matched non-twin sample (n = 2016). Logistic regression models were used to examine associations with socio-demographic factors, environmental exposures and psychiatric symptoms. The heritability of suicidal ideation was assessed using structural equation modelling. RESULTS The lifetime prevalence of any suicidal ideation was 13.0% (11.7-14.3%) for men; 21.8% (20.3-23.2%) for women, with no significant difference between twins and non-twins. Factors that predicted suicidal ideation included female gender, termination of marital relationship, low education level, urban residence, losing a parent whilst young, low standard of living and stressful life events in the preceding 12 months. Suicidal ideation was strongly associated with depression, but also with abnormal fatigue and alcohol and tobacco use. The best fitting structural equation model indicated a substantial contribution from genetic factors (57%; CI 47-66) and from non-shared environmental factors (43%; CI 34-53) in both men and women. In women this genetic component was largely mediated through depression, but in men there was a significant heritable component to suicidal ideation that was independent of depression. CONCLUSIONS These are the first results to show a genetic contribution to suicidal ideation that is independent of depression outside of a high-income country. These phenomena may be generalizable, because previous research highlights similarities between the aetiology of mental disorders in Sri Lanka and higher-income countries.
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Affiliation(s)
- R. Dutta
- Department of Psychological Medicine,
Institute of Psychiatry, Psychology and Neurosciences, King's College
London, London SE5 9RJ, UK
| | - H. A. Ball
- Department of Psychological Medicine,
Institute of Psychiatry, Psychology and Neurosciences, King's College
London, London SE5 9RJ, UK
| | - S. H. Siribaddana
- Sri Lanka Twin Registry, Institute of Research and
Development, Battaramulla, Sri
Lanka
- Faculty of Medicine,
Rajarata University of Sri Lanka,
Saliyapura, Sri Lanka
| | - A. Sumathipala
- Department of Psychological Medicine,
Institute of Psychiatry, Psychology and Neurosciences, King's College
London, London SE5 9RJ, UK
- Sri Lanka Twin Registry, Institute of Research and
Development, Battaramulla, Sri
Lanka
- Keele University,
Stoke-on-Trent, UK
| | - S. Samaraweera
- Sri Lanka Twin Registry, Institute of Research and
Development, Battaramulla, Sri
Lanka
| | - P. McGuffin
- Department of Psychological Medicine,
Institute of Psychiatry, Psychology and Neurosciences, King's College
London, London SE5 9RJ, UK
| | - M. Hotopf
- Department of Psychological Medicine,
Institute of Psychiatry, Psychology and Neurosciences, King's College
London, London SE5 9RJ, UK
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483
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Lutz PE, Mechawar N, Turecki G. Neuropathology of suicide: recent findings and future directions. Mol Psychiatry 2017; 22:1395-1412. [PMID: 28696430 DOI: 10.1038/mp.2017.141] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 05/21/2017] [Accepted: 05/26/2017] [Indexed: 12/11/2022]
Abstract
Suicide is a major public health concern and a leading cause of death in most societies. Suicidal behaviour is complex and heterogeneous, likely resulting from several causes. It associates with multiple factors, including psychopathology, personality traits, early-life adversity and stressful life events, among others. Over the past decades, studies in fields ranging from neuroanatomy, genetics and molecular psychiatry have led to a model whereby behavioural dysregulation, including suicidal behaviour (SB), develops as a function of biological adaptations in key brain systems. More recently, the unravelling of the unique epigenetic processes that occur in the brain has opened promising avenues in suicide research. The present review explores the various facets of the current knowledge on suicidality and discusses how the rapidly evolving field of neurobehavioural epigenetics may fuel our ability to understand, and potentially prevent, SB.
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Affiliation(s)
- P-E Lutz
- McGill Group for Suicide Studies, McGill University, Douglas Mental Health University Institute, Montreal, QC, Canada
| | - N Mechawar
- McGill Group for Suicide Studies, McGill University, Douglas Mental Health University Institute, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Douglas Mental Health University Institute, Montreal, QC, Canada
| | - G Turecki
- McGill Group for Suicide Studies, McGill University, Douglas Mental Health University Institute, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Douglas Mental Health University Institute, Montreal, QC, Canada
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484
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Argento E, Strathdee SA, Tupper K, Braschel M, Wood E, Shannon K. Does psychedelic drug use reduce risk of suicidality? Evidence from a longitudinal community-based cohort of marginalised women in a Canadian setting. BMJ Open 2017; 7:e016025. [PMID: 28939573 PMCID: PMC5623475 DOI: 10.1136/bmjopen-2017-016025] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE This study aimed to longitudinally investigate whether ever having used a psychedelic drug can have a protective effect on incidence of suicidality among marginalised women. DESIGN Longitudinal community-based cohort study. SETTING Data were drawn from a prospective, community-based cohort of marginalised women in Metro Vancouver, Canada. PARTICIPANTS 766 women completed the baseline questionnaire between January 2010 and August 2014. Participants who did not report suicidality at baseline and who completed at least one follow-up visit were included. MAIN OUTCOME MEASURE Extended Cox regression was used to model predictors of new suicidality (suicide ideation or attempts) over 54-month follow-up. RESULTS Nearly half (46%; n=355) of participants reported prior suicidality and were thus excluded from the present analyses. Of 290 women eligible at baseline, 11% (n=31) reported recent suicidality during follow-up, with an incidence density of 4.42 per 100 person-years (95% CI 3.10 to 6.30). In multivariable analysis, reported lifetime psychedelic drug use was associated with a 60% reduced hazard for suicidality (adjusted HR (AHR) 0.40; 95% CI 0.17 to 0.94). Crystal methamphetamine use (AHR 3.25; 95% CI 1.47 to 7.21) and childhood abuse (AHR 3.54; 95% CI 1.49 to 8.40) remained independent predictors of suicidality. CONCLUSION The high rate of suicidality identified in this study is of major concern. Alongside emerging evidence on the potential of psychedelic-assisted therapy to treat some mental illness and addiction issues, our findings demonstrate that naturalistic psychedelic drug use is independently associated with reduced suicidality, while other illicit drug use and childhood trauma predispose women to suicidality. While observational, this study supports calls for further investigation of the therapeutic utility of psychedelic drugs in treating poor mental health and promoting mental wellness.
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Affiliation(s)
- Elena Argento
- Gender and Sexual Health Initiative, St. Paul’s Hospital, Vancouver, Canada
- Interdisciplinary Studies Graduate Program, University of British Columbia, Vancouver, Canada
| | | | - Kenneth Tupper
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
- BC Centre on Substance Use, St. Paul’s Hospital, Vancouver, Canada
| | - Melissa Braschel
- Gender and Sexual Health Initiative, St. Paul’s Hospital, Vancouver, Canada
| | - Evan Wood
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
- BC Centre on Substance Use, St. Paul’s Hospital, Vancouver, Canada
| | - Kate Shannon
- Gender and Sexual Health Initiative, St. Paul’s Hospital, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
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485
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Siau CS, Wee LH, Yacob S, Yeoh SH, Binti Adnan TH, Haniff J, Perialathan K, Mahdi A, Rahman AB, Eu CL, Binti Wahab S. The Attitude of Psychiatric and Non-psychiatric Health-care Workers Toward Suicide in Malaysian Hospitals and Its Implications for Training. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2017; 41:503-509. [PMID: 28168406 DOI: 10.1007/s40596-017-0661-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 01/08/2017] [Indexed: 06/06/2023]
Abstract
OBJECTIVES This research is aimed to examine the attitude of health-care workers toward suicidal patients in Malaysian hospitals, comparing responses from psychiatric and non-psychiatric workers, and to identify specific needs in suicide prevention and management training. METHOD This is a multi-site cross-sectional study. The authors conducted a survey based on a translated self-administered questionnaire to participants from seven core hospital departments. RESULTS While most health-care workers regardless of department and specialty took their duty to prevent suicide seriously, a large majority of them expressed negative attitudes such as finding suicidal behavior irritating, and more than half believed suicidal attempts were a way of making others sorry. However, psychiatric workers were less likely to have judgmental attitudes that included believing suicide attempters as being selfish or trying to get sympathy from others. CONCLUSIONS As there were more similarities than differences in health-care workers' attitudes toward suicide, recommendations on basic and continuous suicide prevention and management training among hospital workers were made. The interventions focused on improving knowledge, affective, and skill-based areas that were aimed to correct the wrongful understanding of and to minimize the negative attitudes toward suicidal individuals indicated by the study results.
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Affiliation(s)
| | - Lei-Hum Wee
- National University of Malaysia, Kuala Lumpur, Malaysia.
| | - Sapini Yacob
- Hospital Putrajaya, Ministry of Health, Putrajaya, Malaysia
| | - Seen Heng Yeoh
- Universiti Tunku Abdul Rahman, Kajang, Selangor, Malaysia
| | | | - Jamaiyah Haniff
- National Clinical Research Centre, Ministry of Health, Kuala Lumpur, Malaysia
| | - Komathi Perialathan
- Institute for Health Behavioral Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Aziman Mahdi
- Institute for Health Behavioral Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Abu Bakar Rahman
- Institute for Health Behavioral Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Choon Leng Eu
- National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia
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486
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Early maladaptive schemas of emotional deprivation, social isolation, shame and abandonment are related to a history of suicide attempts among patients with major depressive disorders. Compr Psychiatry 2017. [PMID: 28636896 DOI: 10.1016/j.comppsych.2017.05.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Patients with psychiatric disorders have an exceptionally high risk of completed or attempted suicide. This holds particularly true for patients with major depressive disorders. The aim of the present study was to explore whether patients with major depressive disorders (MDD) and a history of suicide attempts differed in their early maladaptive schemas from patients with MDD but without such a history or from healthy controls. METHOD Ninety participants took part in the study. Of these, 30 were patients with MDD who had made a recent suicide attempt; 30 were patients with MDD but no suicide attempts, and 30 were gender- and age-matched healthy controls. Participants completed questionnaires covering socio-demographic characteristics and the Young Schema Questionnaire (YSQ- RE2R) to assess early maladaptive schemas. Experts rated patients' MDD with the Montgomery-Asberg Depression Rating Scale. RESULTS Patients did not differ in experts' ratings of symptoms of depression. Compared to healthy controls, patients with MDD recorded higher scores on maladaptive schemas such as recognition seeking, negativity/pessimism, and insufficient self-control. Compared to patients without suicide attempts and healthy controls, those who had made a suicide attempt had higher scores on dimensions such as failure, mistrust, emotional inhibition, social isolation, and abandonment/instability. CONCLUSION Compared to healthy controls, patients with MDD had more pronounced maladaptive schemas, but this was more marked in patients with a history of suicide attempts. The results suggest that suicide attempts and poorer psychological functioning are related.
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487
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O'Connor RC, Portzky G. The relationship between entrapment and suicidal behavior through the lens of the integrated motivational-volitional model of suicidal behavior. Curr Opin Psychol 2017; 22:12-17. [PMID: 30122271 DOI: 10.1016/j.copsyc.2017.07.021] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 07/12/2017] [Accepted: 07/17/2017] [Indexed: 12/12/2022]
Abstract
Suicide and suicidal behavior are major public health concerns. As a result, a number of psychological models have been developed to better understand the emergence of suicidal ideation and suicide attempts. One such model is the integrated motivational-volitional model, a tri-partite model of suicidal behavior, which posits that entrapment is central to the final common pathway to suicide. In this review, we summarize the extant research evidence for the relationship between entrapment and suicidal ideation and behavior. Although there is robust evidence for the relationship between entrapment and suicidal ideation and behavior, there are gaps in our knowledge. We discuss the clinical implications and suggest key directions for future research.
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Affiliation(s)
- Rory C O'Connor
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK.
| | - Gwendolyn Portzky
- Unit for Suicide Research and Flemish Suicide Prevention Centre, Ghent University, Ghent, Belgium
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488
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Krysinska K, Westerlund M, Niederkrotenthaler T, Andriessen K, Carli V, Hadlaczky G, Till B, Wasserman D. A Mapping Study on the Internet and Suicide. CRISIS 2017; 38:217-226. [DOI: 10.1027/0227-5910/a000444] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Abstract. Background: Since the mid-1990s concerns have been raised regarding the possible links between suicide and the Internet, especially among adolescents and young adults. Aims: To identify the nature and extent of the scientific publications, especially original research studies, on suicide and the Internet, and to investigate how the field has developed over time. In particular, this mapping study looks at types of publications, topic areas, focus of original research papers, and suicide-related variables of interest in publications. Method: A search of three major databases (PubMED, PsycINFO, and Sociological Abstracts) was conducted to identify papers published until the end of January 2015. Results: The study identified 237 publications on suicide and the Internet published from 1997 to the end of January 2015. These included 122 original research papers. The three most frequent topic areas covered in publications were searching for information on suicide, online interventions, and online suicide-related behaviors. The online mediums most frequently studied were online forums/message boards, search engines, intervention and information websites, and social media. Limitations: The mapping study did not include an analysis of results of research studies and did not assess their quality. Conclusion: The field is rapidly evolving, as seen in the recent increase in the number of publications. However, there are gaps in terms of the countries where research is conducted and the coverage of topics.
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Affiliation(s)
| | | | - Thomas Niederkrotenthaler
- Medical University of Vienna, Center for Public Health, Institute of Social Medicine, Suicide Research Unit, Vienna, Austria
| | - Karl Andriessen
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Vladimir Carli
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institutet, Stockholm, Sweden
| | - Gergö Hadlaczky
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institutet, Stockholm, Sweden
| | - Benedikt Till
- Medical University of Vienna, Center for Public Health, Institute of Social Medicine, Suicide Research Unit, Vienna, Austria
| | - Danuta Wasserman
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institutet, Stockholm, Sweden
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489
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Do thought control strategies applied to thoughts of suicide influence suicide ideation and suicide risk? PERSONALITY AND INDIVIDUAL DIFFERENCES 2017. [DOI: 10.1016/j.paid.2017.01.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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490
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Treatment of Intrusive Suicidal Imagery Using Eye Movements. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14070714. [PMID: 28665329 PMCID: PMC5551152 DOI: 10.3390/ijerph14070714] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 06/19/2017] [Accepted: 06/26/2017] [Indexed: 12/18/2022]
Abstract
Suicide and suicidal behavior are major public health concerns, and affect 3–9% of the population worldwide. Despite increased efforts for national suicide prevention strategies, there are still few effective interventions available for reducing suicide risk. In this article, we describe various theoretical approaches for suicide ideation and behavior, and propose to examine the possible effectiveness of a new and innovative preventive strategy. A model of suicidal intrusion (mental imagery related to suicide, also referred to as suicidal flash-forwards) is presented describing one of the assumed mechanisms in the etiology of suicide and the mechanism of therapeutic change. We provide a brief rationale for an Eye Movement Dual Task (EMDT) treatment for suicidal intrusions, describing techniques that can be used to target these suicidal mental images and thoughts to reduce overall behavior. Based on the available empirical evidence for the mechanisms of suicidal intrusions, this approach appears to be a promising new treatment to prevent suicidal behavior as it potentially targets one of the linking pins between suicidal ideation and suicidal actions.
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491
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Quinlivan L, Cooper J, Meehan D, Longson D, Potokar J, Hulme T, Marsden J, Brand F, Lange K, Riseborough E, Page L, Metcalfe C, Davies L, O'Connor R, Hawton K, Gunnell D, Kapur N. Predictive accuracy of risk scales following self-harm: multicentre, prospective cohort study. Br J Psychiatry 2017; 210:429-436. [PMID: 28302702 PMCID: PMC5451643 DOI: 10.1192/bjp.bp.116.189993] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 10/05/2016] [Accepted: 11/13/2016] [Indexed: 11/23/2022]
Abstract
BackgroundScales are widely used in psychiatric assessments following self-harm. Robust evidence for their diagnostic use is lacking.AimsTo evaluate the performance of risk scales (Manchester Self-Harm Rule, ReACT Self-Harm Rule, SAD PERSONS scale, Modified SAD PERSONS scale, Barratt Impulsiveness Scale); and patient and clinician estimates of risk in identifying patients who repeat self-harm within 6 months.MethodA multisite prospective cohort study was conducted of adults aged 18 years and over referred to liaison psychiatry services following self-harm. Scale a priori cut-offs were evaluated using diagnostic accuracy statistics. The area under the curve (AUC) was used to determine optimal cut-offs and compare global accuracy.ResultsIn total, 483 episodes of self-harm were included in the study. The episode-based 6-month repetition rate was 30% (n = 145). Sensitivity ranged from 1% (95% CI 0-5) for the SAD PERSONS scale, to 97% (95% CI 93-99) for the Manchester Self-Harm Rule. Positive predictive values ranged from 13% (95% CI 2-47) for the Modified SAD PERSONS Scale to 47% (95% CI 41-53) for the clinician assessment of risk. The AUC ranged from 0.55 (95% CI 0.50-0.61) for the SAD PERSONS scale to 0.74 (95% CI 0.69-0.79) for the clinician global scale. The remaining scales performed significantly worse than clinician and patient estimates of risk (P<0.001).ConclusionsRisk scales following self-harm have limited clinical utility and may waste valuable resources. Most scales performed no better than clinician or patient ratings of risk. Some performed considerably worse. Positive predictive values were modest. In line with national guidelines, risk scales should not be used to determine patient management or predict self-harm.
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Affiliation(s)
- Leah Quinlivan
- Leah Quinlivan, PhD, Jayne Cooper, PhD, Centre for Suicide Prevention, Manchester Academic Health Science Centre, University of Manchester, Manchester; Declan Meehan, RMN, Damien Longson, FRCPsych, Greater Manchester Mental Health and NHS Foundation Trust, Manchester; John Potokar, MRCPsych, Avon & Wiltshire Mental Health Foundation Trust, Bristol, University Hospitals Bristol, NHS Foundation Trust, Bristol and School of Social and Community Medicine, University of Bristol, Bristol; Tom Hulme, MSc, University Hospitals Bristol, NHS Foundation Trust, Bristol, Bristol; Jennifer Marsden, BA, Derbyshire Healthcare NHS Foundation Trust, Derby; Fiona Brand, RMN, Kezia Lange, MRCPsych, Oxford Health NHS Foundation Trust, Oxford; Elena Riseborough, RMN, Lisa Page, PhD, Sussex Partnership NHS Foundation Trust, Worthing; Chris Metcalfe, PhD, School of Social and Community Medicine, University of Bristol, Bristol; Linda Davies, Institute of Population Health, University of Manchester, Manchester; Rory O' Connor, PhD, Institute of Health and Wellbeing, University of Glasgow, Glasgow; Keith Hawton, DSc, Centre for Suicide Research, University Department of Psychiatry, Warneford Hospital, Oxford; David Gunnell, DSc, School of Social and Community Medicine, University of Bristol, Bristol; Nav Kapur, MBChB, MMedSci, MD, FRCPsych, Centre for Suicide Prevention, Manchester Academic Health Science Centre, University of Manchester, and Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
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492
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A brief psychological intervention to reduce repetition of self-harm in patients admitted to hospital following a suicide attempt: a randomised controlled trial. Lancet Psychiatry 2017; 4:451-460. [PMID: 28434871 PMCID: PMC5447136 DOI: 10.1016/s2215-0366(17)30129-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Revised: 02/17/2017] [Accepted: 02/20/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND We investigated whether a volitional helpsheet (VHS), a brief psychological intervention, could reduce repeat self-harm in the 6 months following a suicide attempt. METHODS We did a prospective, single-site, randomised controlled trial. Patients admitted to a hospital in Edinburgh, UK, after a suicide attempt were deemed eligible for the study if they were over the age of 16 years, had a self-reported history of self-harm, were fluent in English, were medically fit to interview, and were not participating in other research studies within the hospital. Eligible patients were randomly assigned (1:1), via web-based randomisation, to receive either VHS plus usual treatment (intervention group) or only treatment as usual (control group). Randomisation was stratified by sex and self-reported past self-harm history. The Information Services Division of the National Health Service (NHS-ISD) staff and those extracting data from medical notes were masked to the study group the participant was allocated to. Clinical staff working within the hospital were also masked to participants' randomisation status. There were three primary outcomes: the proportion of paticipants who re-presented to hospital with self-harm during the 6-month follow-up period; the number of times a participant re-presented to hospital with self-harm during the 6-month follow-up period; and cost-effectiveness of the VHS as measured by estimated incremental cost per self-harm event averted. Primary outcomes were analysed in all randomised patients. Follow-up data collection was extracted from the Information Services Division of the NHS and from patient medical records. The trial is registered with International Standard Randomised Controlled Trial Number Registry, number ISRCTN99488269. FINDINGS Between May 9, 2012, and Feb 24, 2014, we assessed 1308 people for eligibility. Of these, 259 patients were randomly assigned to the intervention group and 259 to the control group. We obtained complete follow-up data on 512 (99%) of 518 patients (five participants were lost to follow-up in the intervention group and one in the control group). 11 patients assigned to the intervention group did not complete the VHS in hospital. Overall, the intervention did not affect the number of people who re-presented with self-harm (67 [26%] of 254 patients in the intervention group vs 71 [28%] of 258 patients in the control group, odds ratio [OR] 0·90, 95% CI 0·58-1·39, p=0·63). The intervention had no effect on the number of re-presentations per patient (mean 0·67 [SD 2·55] re-presentations for the intervention group vs 0·85 [2·79] for the control group, incident rate ratio [IRR] 1·65, 95% CI 0·74-3·67, p=0·21). Mean total costs per person for NHS hospital services in the VHS intervention group over the 6 months were £513 versus £561 in the control group but this difference was not significant (95% CI-£353 to £257, p=0·76). Three patients died by suicide in the 6 months following their index suicide attempt (one in the intervention group and two in the control group). There were no reported unintended effects or adverse events in either group. INTERPRETATION For the primary outcomes, there were no significant differences between groups. Although the VHS had no overall effect, post-hoc analyses suggest VHS might be effective in reducing the number of self-harm repetitions following a suicide attempt in people who complete the helpsheet and who have been previously admitted to hospital with self-harm. This is the first study to investigate the usefulness of the VHS to reduce self-harm among those who have attempted suicide. These subgroup findings require replication. The potential use of the VHS in those who self-harm for different motives requires further exploration. FUNDING Chief Scientist Office (CZH/4/704).
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493
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Pisetsky EM, Peterson CB, Mitchell JE, Wonderlich SA, Crosby RD, Le Grange D, Hill L, Powers P, Crow SJ. A comparison of the frequency of familial suicide attempts across eating disorder diagnoses. Int J Eat Disord 2017; 50:707-710. [PMID: 28199032 PMCID: PMC5459656 DOI: 10.1002/eat.22694] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 01/25/2017] [Accepted: 01/28/2017] [Indexed: 11/07/2022]
Abstract
This study examined the prevalence of reported suicide attempts among family members of individuals with an eating disorder (ED). 1870 individuals presenting for ED treatment reported whether their family members ever made a suicide attempt using the Eating Disorders Questionnaire. A lifetime suicide attempt by any family member was reported by 10.8% (n = 202) of the sample and ranged from 7.0% of those with eating disorder not otherwise specified to 16.1% of those with purging disorder. Controlling for age and gender, individuals with bulimia nervosa had a higher prevalence of any familial suicide attempt and mother suicide attempt than individuals with EDNOS; no other differences were observed across ED diagnoses. There were no differences in prevalence of reported suicide attempts made by fathers, brothers, sisters, uncles, or aunts by ED diagnosis. Findings support a growing literature indicating a familial association between EDs and suicide risk.
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Affiliation(s)
| | - Carol B. Peterson
- Department of Psychiatry, University of Minnesota, Minneapolis, MN
- The Emily Program, St. Paul, Minnesota
| | - James E. Mitchell
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND
| | - Stephen A. Wonderlich
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND
| | - Ross D. Crosby
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND
| | - Daniel Le Grange
- Department of Psychiatry, University of California, San Francisco, CA
| | - Laura Hill
- The Center for Balanced Living, Columbus, OH
| | | | - Scott J. Crow
- Department of Psychiatry, University of Minnesota, Minneapolis, MN
- The Emily Program, St. Paul, Minnesota
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494
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Suicidal Behavior Among People Living with HIV (PLHIV) in Medical Care in Estonia and Factors Associated with Receiving Psychological Treatment. AIDS Behav 2017; 21:1709-1716. [PMID: 27664013 DOI: 10.1007/s10461-016-1561-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
People living with HIV (PLHIV) have higher rates of suicidal behavior than the general population. This study assessed suicidal behavior (ideation and/or attempts, ever and in the past 12 months) among PLHIV receiving outpatient HIV medical care in Estonia and associations between suicidal behavior and psychological treatment. The cross-sectional study collected data from January to November 2013 using a self-report questionnaire. Eight hundred PLHIV participated, 39 % (n = 306) of whom had been suicidal. Lifetime prevalence was 36 % for suicidal ideation and 20 % for attempts. Younger age, incarceration, having ever abused alcohol and also injected drugs, having lived with HIV for more than 10 years, and being depressed were associated with lifetime suicidal behavior. Suicidal behavior within the past 12 months was reported by 20 % (n = 156) of respondents. Of these, 27 % received psychological treatment (counseling and/or psychotherapy), 20 % had taken antidepressants, and 49 % sedatives. Individuals perceiving a need for treatment were significantly more likely to receive psychological treatment when experiencing suicidal behavior (OR 25.65, 95 % CI 2.92-225.47). In conclusion, suicidal behavior is frequent among PLHIV but psychological treatment is not often received. One of the barriers to treatment is patients' lack of perceived need for help.
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495
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Francis W, Bance LO. Protective Role of Spirituality from the Perspective of Indian College Students with Suicidal Ideation: "I am here Because God Exists". JOURNAL OF RELIGION AND HEALTH 2017; 56:962-970. [PMID: 27510528 DOI: 10.1007/s10943-016-0296-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Spiritual beliefs are found to be having a significant effect during times of struggles and trials in peoples' lives. India being a multi-religious society, it is imperative to establish the relevance of spirituality in the lives of the college students with suicidal ideation. The current study therefore utilized focus group methodology to explore the Indian female college students' perceptions on the protective role of spirituality as a factor contributing to their positive adaptation in times of adversity. Twenty students participated in the discussion. The results interestingly surfaced themes supporting the significance of them on how individuals rely on spiritual beliefs and the possible implications of the need to address it for positive adaptation. Most of the participants analogically stated the themes emerged as "something to stay afloat in the rough sea of life's realities."
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Affiliation(s)
- Wilsy Francis
- University of Santo Tomas, Espana, Boulevard, Manila, 1015, Philippines.
- Mother Ignacia Ladies Dormitory, 1655 Singalong Street, Paco, Manila, 1007, Philippines.
| | - Lucila Ortiz Bance
- Counseling and Career Center, University of Santo Tomas, Manila, Philippines
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496
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Assessing Decision Making Capacity for Do Not Resuscitate Requests in Depressed Patients: How to Apply the "Communication" and "Appreciation" Criteria. HEC Forum 2017; 29:303-311. [PMID: 28534181 DOI: 10.1007/s10730-017-9323-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The Patient Self Determination Act (PSDA) of 1991 brought much needed attention to the importance of advance care planning and surrogate decision-making. The purpose of this law is to ensure that a patient's preferences for medical care are recognized and promoted, even if the patient loses decision-making capacity (DMC). In general, patients are presumed to have DMC. A patient's DMC may come under question when distortions in thinking and understanding due to illness, delirium, depression or other psychiatric symptoms are identified or suspected. Physicians and other healthcare professionals working in hospital settings where medical illness is frequently comorbid with depression, adjustment disorders, demoralization and suicidal ideation, can expect to encounter ethical tension when medically sick patients who are also depressed or suicidal request do not resuscitate orders.
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497
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Rossetti MC, Tosone A, Stratta P, Collazzoni A, Santarelli V, Guadagni E, Rossi R, Rossi A. Different roles of resilience in depressive patients with history of suicide attempt and no history of suicide attempt. ACTA ACUST UNITED AC 2017; 39:216-219. [PMID: 28538755 PMCID: PMC7111383 DOI: 10.1590/1516-4446-2016-2045] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 12/18/2016] [Indexed: 11/22/2022]
Abstract
Objective: Suicidal ideation is modulated by several risk and protective factors. The aim of this study was to evaluate differences between patients with a history of suicide attempt and those with no such history, with special attention to depression, interpersonal sensitivity, humiliation, and resilience. Methods: One hundred consecutively admitted patients with an index depressive episode were recruited. The Brief Symptom Inventory, Humiliation Inventory, and Resilience Scale for Adult were administered. Results: Scores for humiliation, interpersonal sensitivity, and depression were higher in subjects with history of suicide attempt, while higher scores for resilience were observed in the group with no such history. Different patterns of relationships among the variables of interest were found in the two groups. Resilience dimensions such as social resources and familial cohesion were strongly and negatively correlated with humiliation, interpersonal sensitivity, and depression in subjects with a past suicide attempt. Conclusions: Resilience factors can modulate and reduce the impact of suicide risk. Assessing risk and protective factors could enhance the ability to intervene appropriately.
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Affiliation(s)
- Maria C Rossetti
- U.O.C. Psichiatria, Ospedale Civile San Salvatore, L'Aquila, Italy
| | - Adele Tosone
- U.O.C. Psichiatria, Ospedale Civile San Salvatore, L'Aquila, Italy
| | - Paolo Stratta
- Dipartimento di Salute Mentale ASL 1, L'Aquila, Italy
| | - Alberto Collazzoni
- Dipartimento di Scienze Cliniche Applicate e Biotecnologiche, Universita degli Studi dell'Aquila, L'Aquila, Italy
| | | | | | - Rodolfo Rossi
- Dipartimento di Scienze Cliniche Applicate e Biotecnologiche, Universita degli Studi dell'Aquila, L'Aquila, Italy
| | - Alessandro Rossi
- U.O.C. Psichiatria, Ospedale Civile San Salvatore, L'Aquila, Italy.,Dipartimento di Scienze Cliniche Applicate e Biotecnologiche, Universita degli Studi dell'Aquila, L'Aquila, Italy
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498
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Oprescu F, Scott-Parker B, Dayton J. An analysis of child deaths by suicide in Queensland Australia, 2004-2012. What are we missing from a preventative health services perspective? J Inj Violence Res 2017; 9:75-82. [PMID: 28513530 PMCID: PMC5556629 DOI: 10.5249/jivr.v9i2.837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 02/22/2017] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND This article analyzes case descriptions of child suicides from 2004 to 2012 to inform future policy and practice. METHODS Quantitative data and case descriptions for 159 child suicides (less than 18 years) in Queensland, Australia, were analyzed quantitatively using SPSS and qualitatively using automated content analysis (Leximancer). RESULTS More than three quarters of child suicides involved hanging and 81% of suicides occurred in the family home. Less than 20% of the deceased left a note, however there was evidence of planning in 54% of cases. Most common triggering events were family conflicts. CONCLUSIONS Effective suicide prevention interventions require a comprehensive understanding of risk factors. Quality of case descriptions varied widely, which can hamper injury prevention efforts through an incomplete understanding of characteristics of and important factors in child suicide. Additional attention and resources dedicated to this public health issue could enhance the development and implementation of effective intervention strategies targeting child and adolescent suicide.
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Affiliation(s)
| | - Bridie Scott-Parker
- Adolescent Risk Research Unit (ARRU), School of Social Sciences, Faculty of Arts and Business, University of the Sunshine Coast, Queensland, Australia.
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499
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Abstract
Suicide remains a major public health issue. There have been more than 40,000 deaths by suicide in 2014. Understanding both the neuroscience and psychological development is key for nursing care so adequate interventions and treatment strategies are developed when working with people thinking about suicide. It is critical to assess and recognize risk and protective factors to ensure patient safety. The older adult, children, and adolescent populations remain vulnerable to suicide. A discussion regarding the psychiatric, psychosocial, and treatment considerations for these populations is included. An overview of communication, suicide assessment, and safety planning is discussed.
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Affiliation(s)
- Jeffery Ramirez
- Department of Nursing and Human Physiology, Gonzaga University, 502 E. Boone Avenue, Spokane, WA 99258, USA.
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500
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Hallensleben N, Spangenberg L, Forkmann T, Rath D, Hegerl U, Kersting A, Kallert TW, Glaesmer H. Investigating the Dynamics of Suicidal Ideation. CRISIS 2017; 39:65-69. [PMID: 28468557 DOI: 10.1027/0227-5910/a000464] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Although the fluctuating nature of suicidal ideation (SI) has been described previously, longitudinal studies investigating the dynamics of SI are scarce. AIM To demonstrate the fluctuation of SI across 6 days and up to 60 measurement points using smartphone-based ecological momentary assessments (EMA). METHOD Twenty inpatients with unipolar depression and current and/or lifetime suicidal ideation rated their momentary SI 10 times per day over a 6-day period. Mean squared successive difference (MSSD) was calculated as a measure of variability. Correlations of MSSD with severity of depression, number of previous depressive episodes, and history of suicidal behavior were examined. RESULTS Individual trajectories of SI are shown to illustrate fluctuation. MSSD values ranged from 0.2 to 21.7. No significant correlations of MSSD with several clinical parameters were found, but there are hints of associations between fluctuation of SI and severity of depression and suicidality. LIMITATIONS Main limitation of this study is the small sample size leading to low power and probably missing potential effects. Further research with larger samples is necessary to shed light on the dynamics of SI. CONCLUSION The results illustrate the dynamic nature and the diversity of trajectories of SI across 6 days in psychiatric inpatients with unipolar depression. Prediction of the fluctuation of SI might be of high clinical relevance. Further research using EMA and sophisticated analyses with larger samples is necessary to shed light on the dynamics of SI.
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Affiliation(s)
- Nina Hallensleben
- 1 Department of Medical Psychology and Medical Sociology, University of Leipzig, Germany
| | - Lena Spangenberg
- 1 Department of Medical Psychology and Medical Sociology, University of Leipzig, Germany
| | - Thomas Forkmann
- 2 Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Germany
| | - Dajana Rath
- 2 Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Germany
| | - Ulrich Hegerl
- 3 Department of Psychiatry and Psychotherapy, University of Leipzig, Germany
| | - Anette Kersting
- 4 Clinic of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Germany
| | - Thomas W Kallert
- 5 Psychiatric Health Care Facilities of Upper Franconia, Bayreuth, Germany
| | - Heide Glaesmer
- 1 Department of Medical Psychology and Medical Sociology, University of Leipzig, Germany
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