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Kazan D, Calear AL, Batterham PJ. The impact of intimate partner relationships on suicidal thoughts and behaviours: A systematic review. J Affect Disord 2016; 190:585-598. [PMID: 26583348 DOI: 10.1016/j.jad.2015.11.003] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 10/13/2015] [Accepted: 11/01/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND A systematic review was conducted to identify the impact of intimate partner relationships on suicidality. The aim of the review was to identify factors within intimate partner relationships that influence suicidal ideation, attempts and completion. METHOD Fifty-one articles were identified through Scopus, PubMed and PsycINFO databases. Due to the high heterogeneity of the included studies, a narrative data synthesis was conducted. RESULTS The research drew attention to specific contingents of the population, for example examining suicide risk in individuals under the age of 35 or lesbian, gay, bisexual and transgender (LGBT) individuals who are experiencing relationship discord, and in males who have recently separated. LIMITATIONS Interpretation of these findings is constrained by methodological limitations prevalent in much of the literature. Limitations of the existing literature and corresponding directions for future research are discussed. CONCLUSIONS Relationship separation and poor quality relationships are likely to be important risk factors for suicidal thoughts and behaviours and are frequent triggers for a suicide attempt. This review highlights intimate partner relationships as a significant component in a suicide risk assessment, regardless of the clinical setting. Consequently, clinicians should be aware that individuals reporting relationship problems are likely to be at increased risk of suicidal thoughts and behaviours.
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Affiliation(s)
- Dominique Kazan
- National Institute for Mental Health Research, The Australian National University, Canberra, Australia.
| | - Alison L Calear
- National Institute for Mental Health Research, The Australian National University, Canberra, Australia
| | - Philip J Batterham
- National Institute for Mental Health Research, The Australian National University, Canberra, Australia
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Abstract
Nearly half of all combat veterans suffer from serious psychological disorders and reintegration issues. Veterans shy away from typical talk therapy and are seeking alternative treatments. Equine-facilitated mental health therapy has shown promise in treating veterans with depressive and anxiety disorders and reintegration issues. This article reports on an institutional review board-approved pilot program designed to address the mental health needs of veterans. Furthermore, this article discusses future directions for evolving development of equine treatment programming.
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Huguet N, DeVoe JE. Suicide Prevention in Primary Care Medicine. Mayo Clin Proc 2015; 90:1459-61. [PMID: 26455885 DOI: 10.1016/j.mayocp.2015.09.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 09/14/2015] [Indexed: 11/16/2022]
Affiliation(s)
- Nathalie Huguet
- Department of Family Medicine, Oregon Health and Science University, Portland.
| | - Jennifer E DeVoe
- Department of Family Medicine, Oregon Health and Science University, Portland
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Cheung G, Merry S, Sundram F. Late-life suicide: Insight on motives and contributors derived from suicide notes. J Affect Disord 2015; 185:17-23. [PMID: 26142690 DOI: 10.1016/j.jad.2015.06.035] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 06/23/2015] [Accepted: 06/23/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aims of this study were: (i) to investigate the proportion of older people writing suicide notes in New Zealand; (ii) to compare the socio-demographic and clinical variables of older suicide note writers and non-note writers; and (iii) to perform a thematic analysis of the content of suicide notes. METHODS The Coronial Services provided records of all suicide cases aged 65 years and over (n=225) between July 2007 and December 2012. We were able to determine whether there was a suicide note written in 212 cases. The content of 39 coroners/medical examiners' excerpts and 5 suicide notes was available for thematic analysis using a general inductive approach. FINDINGS 88 (41.5%) older people left a suicide note. Logistic regression showed that female gender (OR=2.8, 95% CI=1.4-5.7, p=0.005) and Caucasian ethnicity (OR=13.7, 95% CI=1.7-111.0, p=0.014) are significantly associated with older people writing suicide notes. 33.3% of those who left a suicide note gave health-related reasons for their suicide and a significant proportion (73.3%) of them had underlying medical conditions. Another common theme is around people leaving specific instructions and wishes. CONCLUSIONS Apart from gender and ethnicity, suicide note writers are similar to non-writers on broad socio-demographic and clinical factors. Suicide notes indicated free will in and reasons for their suicide and emotional/farewell messages to their loved ones. Many documented poor quality of life or physical illness but the progression of these factors to suicide in older people should be further researched.
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Affiliation(s)
- Gary Cheung
- Department of Psychological Medicine, The University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland 1142, New Zealand.
| | - Sally Merry
- Department of Psychological Medicine, The University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland 1142, New Zealand
| | - Frederick Sundram
- Department of Psychological Medicine, The University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland 1142, New Zealand
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Cheung G, Merry S, Sundram F. Medical examiner and coroner reports: uses and limitations in the epidemiology and prevention of late-life suicide. Int J Geriatr Psychiatry 2015; 30:781-92. [PMID: 25962908 DOI: 10.1002/gps.4294] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 04/10/2015] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Late-life suicide is a growing public health concern in many parts of the world. Understanding the contributory factors to completed suicide is essential to inform the development of effective suicide risk assessment and management. The aim of this study is to synthesise the findings in studies that used coroner or medical examiner records to determine these contributory factors. METHODS The databases of Scopus (from 1960), MEDLINE (from 1946) and PsychINFO (from 1806) were searched in August 2013, to identify studies that used coroner or medical examiner records for investigating the epidemiological, sociodemographic characteristics and clinical aspects of late-life suicide. RESULTS In total, 25 studies were identified. There was a lack of standardisation of variables assessed between studies leading to incomplete datasets in some work. However, a diagnosis of depression was found in 33%, and depressive mood/symptoms in 47% of cases. About 55% had a physical health problem. Terminal illness was associated with a smaller proportion (7.1%) of the cases. Older people were more likely to have had contact with primary care rather than mental health services prior to suicide. CONCLUSIONS Despite their limitations, coroner and medical examiner records provide an opportunity for examining suicide epidemiology. Targeting primary care providers where late-life depression and physical illness can be detected and treated is a potential strategy to address late-life suicide.
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Affiliation(s)
- Gary Cheung
- Department of Psychological Medicine, The University of Auckland, Auckland, 1142, New Zealand
| | - Sally Merry
- Department of Psychological Medicine, The University of Auckland, Auckland, 1142, New Zealand
| | - Frederick Sundram
- Department of Psychological Medicine, The University of Auckland, Auckland, 1142, New Zealand
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Caetano R, Kaplan MS, Huguet N, Conner K, McFarland BH, Giesbrecht N, Nolte KB. Precipitating Circumstances of Suicide and Alcohol Intoxication Among U.S. Ethnic Groups. Alcohol Clin Exp Res 2015; 39:1510-7. [PMID: 26173709 PMCID: PMC4515182 DOI: 10.1111/acer.12788] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 05/19/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Our goal was to assess the prevalence of 9 different types of precipitating circumstances among suicide decedents, and examine the association between circumstances and postmortem blood alcohol concentration (BAC ≥ 0.08 g/dl) across U.S. ethnic groups. METHODS Data come from the restricted 2003 to 2011 National Violent Death Reporting System, with postmortem information on 59,384 male and female suicide decedents for 17 U.S. states. RESULTS Among men, precipitating circumstances statistically associated with a BAC ≥ 0.08 g/dl were physical health and job problems for Blacks, and experiencing a crisis, physical health problems, and intimate partner problem for Hispanics. Among women, the only precipitating circumstance associated with a BAC ≥ 0.08 g/dl was substance abuse problems other than alcohol for Blacks. The number of precipitating circumstances present before the suicide was negatively associated with a BAC ≥ 0.08 g/dl for Whites, Blacks, and Hispanics. CONCLUSIONS Selected precipitating circumstances were associated with a BAC ≥ 0.08 g/dl, and the strongest determinant of this level of alcohol intoxication prior to suicide among all ethnic groups was the presence of an alcohol problem.
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Affiliation(s)
- Raul Caetano
- Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, California
| | - Mark S Kaplan
- Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, California
| | | | - Kenneth Conner
- VA VISN 2 Center of Excellence for Suicide Prevention, Canandaigua, New York
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York
| | - Bentson H McFarland
- Department of Psychiatry, Oregon Health & Science University, Portland, Oregon
| | - Norman Giesbrecht
- Social & Epidemiological Research Department, Centre for Addiction & Mental Health, Toronto, Ontario, Canada
| | - Kurt B Nolte
- Office of the Medical Investigator, University of New Mexico School of Medicine, Albuquerque, New Mexico
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Younes N, Chollet A, Menard E, Melchior M. E-mental health care among young adults and help-seeking behaviors: a transversal study in a community sample. J Med Internet Res 2015; 17:e123. [PMID: 25979680 PMCID: PMC4468604 DOI: 10.2196/jmir.4254] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Revised: 03/09/2015] [Accepted: 03/14/2015] [Indexed: 11/21/2022] Open
Abstract
Background The Internet is widely used by young people and could serve to improve insufficient access to mental health care. Previous information on this topic comes from selected samples (students or self-selected individuals) and is incomplete. Objective In a community sample of young adults, we aimed to describe frequency of e-mental health care study-associated factors and to determine if e-mental health care was associated with the use of conventional services for mental health care. Methods Using data from the 2011 wave of the TEMPO cohort study of French young adults (N=1214, aged 18-37 years), we examined e-mental health care and associated factors following Andersen’s behavioral model: predisposing factors (age, sex, educational attainment, professional activity, living with a partner, children, childhood negative events, chronic somatic disease, parental history of depression), enabling factors (social support, financial difficulties, parents’ income), and needs-related factors (lifetime major depression or anxiety disorders, suicidal ideation, ADHD, cannabis use). We compared traditional service use (seeking help from a general practitioner, a psychiatrist, a psychologist; antidepressant or anxiolytics/hypnotics use) between participants who used e-mental health care versus those who did not. Results Overall, 8.65% (105/1214) of participants reported seeking e-mental health care in case of psychological difficulties in the preceding 12 months and 15.7% (104/664) reported psychological difficulties. Controlling for all covariates, the likelihood of e-mental health care was positively associated with 2 needs-related factors, lifetime major depression or anxiety disorder (OR 2.36, 95% CI 1.36-4.09) and lifetime suicidal ideation (OR 1.91, 95% CI 1.40-2.60), and negatively associated with a predisposing factor: childhood life events (OR 0.60, 95% CI 0.38-0.93). E-mental health care did not hinder traditional care, but was associated with face-to-face psychotherapy (66.2%, 51/77 vs 52.4%, 186/355, P=.03). Conclusions E-mental health care represents an important form of help-seeking behavior for young adults. Professionals and policy makers should take note of this and aim to improve the quality of online information on mental health care and to use this fact in clinical care.
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Affiliation(s)
- Nadia Younes
- Centre Hospitalier de Versailles, Le Chesnay, France.
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58
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Abstract
Passive suicidal ideation is an important indicator of suicide risk because it is associated with significantly high levels of depression and suicidality, comparable to individuals experiencing active suicidal ideation. Passive suicidal ideation, or a passive desire to die, can be differentiated from active suicidal ideation (where individuals have a specific plan and intent to die). The present study examined passive suicidal ideation to determine how it relates to suicide risk and depression severity in 140 veterans from a psychiatric outpatient program at a local Veterans Affairs Medical Center. Participants were assessed for a depressive disorder using a structured clinical interview and completed self-report measures. Individuals with passive suicidal ideation scored similarly to active ideators and significantly higher than nonsuicidal ideators on measures of depression, suicidal behavior, and hopelessness. Asking about passive suicidal ideation in suicide risk assessment may allow clinicians to intervene earlier and decrease the likelihood of a suicide attempt.
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Affiliation(s)
- Christine N. May
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - James C. Overholser
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, USA
| | | | - Danielle Raymond
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, USA
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59
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Finley EP, Bollinger M, Noël PH, Amuan ME, Copeland LA, Pugh JA, Dassori A, Palmer R, Bryan C, Pugh MJV. A national cohort study of the association between the polytrauma clinical triad and suicide-related behavior among US Veterans who served in Iraq and Afghanistan. Am J Public Health 2015; 105:380-7. [PMID: 25033126 DOI: 10.2105/ajph.2014.301957] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVES We examined the association of posttraumatic stress disorder (PTSD), traumatic brain injury, and chronic pain-the polytrauma clinical triad (PCT)-independently and with other conditions, with suicide-related behavior (SRB) risk among Operation Enduring Freedom (OEF; Afghanistan) and Operation Iraqi Freedom (OIF) veterans. METHODS We used Department of Veterans Affairs (VA) administrative data to identify OEF and OIF veterans receiving VA care in fiscal years 2009-2011; we used International Classification of Diseases, Ninth Revision, Clinical Modification codes to characterize 211652 cohort members. Descriptive statistics were followed by multinomial logistic regression analyses predicting SRB. RESULTS Co-occurrence of PCT conditions was associated with significant increase in suicide ideation risk (odds ratio [OR] = 1.9; 95% confidence interval [CI]=1.5, 2.4) or attempt and ideation (OR=2.6; 95% CI=1.5, 4.6), but did not exceed increased risk with PTSD alone (ideation: OR=2.3; 95% CI=2.0, 2.6; attempt: OR=2.0; 95% CI=1.4, 2.9; ideation and attempt: OR=1.8; 95% CI=1.2, 2.8). Ideation risk was significantly elevated when PTSD was comorbid with depression (OR=4.2; 95% CI=3.6, 4.8) or substance abuse (OR=4.7; 95% CI = 3.9, 5.6). CONCLUSIONS Although PCT was a moderate SRB predictor, interactions among PCT conditions, particularly PTSD, and depression or substance abuse had larger risk increases.
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Affiliation(s)
- Erin P Finley
- Erin P. Finley, Mary Bollinger, Polly H. Noël, Jacqueline A. Pugh, Albana Dassori, and Mary Jo V. Pugh are with South Texas Veterans Health Care System, San Antonio. Raymond Palmer is with Department of Epidemiology and Biostatistics, University of Texas Health Science Center, San Antonio. Megan E. Amuan is with Center for Health Quality, Outcomes and Economic Research, Edith Nourse Rogers Memorial VA Hospital, Bedford, MA. Laurel A. Copeland is with Center for Applied Health Research, jointly sponsored by Central Texas Veterans, Health Care System and Scott and White Healthcare System, Temple, TX. Craig Bryan is with National Center for Veterans Studies and Department of Psychology, The University of Utah, Salt Lake City, UT
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Maguen S, Skopp NA, Zhang Y, Smolenski DJ. Gender differences in suicide and suicide attempts among US Army soldiers. Psychiatry Res 2015; 225:545-9. [PMID: 25530416 DOI: 10.1016/j.psychres.2014.11.050] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 11/19/2014] [Accepted: 11/25/2014] [Indexed: 10/24/2022]
Abstract
In order to best tailor suicide prevention initiatives and programs, it is critical to gain an understanding of how service members׳ suicide risk factors may differ by gender. We aimed to better understand gender differences in suicide and suicide attempts among soldiers, including demographic, military, mental health, and other risk factors. We also examined risk factors uniquely associated with suicide and suicide attempts. We conducted a retrospective study of 1857 US Army soldiers who died by suicide or attempted suicide between 2008 and 2010 and had a Department of Defense Suicide Event Report. Female and male soldiers had more similarities than differences when examining risk factors associated with suicide. The only gender difference approaching significance was workplace difficulties, which was more strongly associated with suicide for female soldiers, compared to their male counterparts. Among suicide decedents, the most common risk factor was having a failed intimate relationship in the 90 days prior to suicide. Among those who attempted suicide, the most common risk factor was a major psychiatric diagnosis. Better understanding both gender differences and risk factors uniquely associated with suicide has critical prevention and public health implications as we work to better understand preventable mortality in our youngest generation of service members.
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Affiliation(s)
- Shira Maguen
- San Francisco VA Medical Center, San Francisco, CA, USA; Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA.
| | - Nancy A Skopp
- National Center for Telehealth & Technology, Defense Centers of Excellence for Psychological Health & Traumatic Brain Injury, Joint Base Lewis-McChord, Tacoma, WA, USA; Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Ying Zhang
- National Center for Telehealth & Technology, Defense Centers of Excellence for Psychological Health & Traumatic Brain Injury, Joint Base Lewis-McChord, Tacoma, WA, USA
| | - Derek J Smolenski
- National Center for Telehealth & Technology, Defense Centers of Excellence for Psychological Health & Traumatic Brain Injury, Joint Base Lewis-McChord, Tacoma, WA, USA
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Blosnich JR, Kopacz MS, McCarten J, Bossarte RM. Mental Health and Self-directed Violence Among Student Service Members/Veterans in Postsecondary Education. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2015; 63:418-426. [PMID: 24918517 PMCID: PMC4263812 DOI: 10.1080/07448481.2014.931282] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVES Using a sample of student service members/veterans, the current study aimed to examine the prevalence of psychiatric diagnoses and suicide-related outcomes and the association of hazardous duty with mental health. PARTICIPANTS Data are from the Fall 2011 National College Health Assessment (N = 27,774). METHODS Logistic regression was used to examine (1) the association of student service member/veteran status with mental health outcomes and (2) the association of hazardous duty with mental health outcomes among student service members/veterans (n = 706). RESULTS Student service members/veterans had higher odds of self-harm than students without military experience. Among student service members/veterans, hazardous duty was positively associated (odds ratio [OR] = 2.00, 95% confidence interval [CI] [1.30, 3.07]) with having a psychiatric diagnosis but negatively associated (OR = 0.41, 95% CI [0.20, 0.85]) with suicidal ideation. CONCLUSIONS Self-harm may be a unique phenomenon among service members/veterans. Suicide prevention with this population should include information about self-harm, and future research should explore whether suicidal intent underlies self-harm.
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Affiliation(s)
- John R. Blosnich
- University of Rochester, Department of Psychiatry
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System
| | - Marek S. Kopacz
- U.S. Department of Veterans Affairs, VISN-2 Center of Excellence for Suicide Prevention
| | - Janet McCarten
- U.S. Department of Veterans Affairs, VISN-2 Center of Excellence for Suicide Prevention
| | - Robert M. Bossarte
- University of Rochester, Department of Psychiatry
- U.S. Department of Veterans Affairs, VISN-2 Center of Excellence for Suicide Prevention
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62
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Blosnich JR, Gordon AJ, Bossarte RM. Suicidal ideation and mental distress among adults with military service history: results from 5 U.S. states, 2010. Am J Public Health 2014; 104 Suppl 4:S595-602. [PMID: 25100426 DOI: 10.2105/ajph.2014.302064] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined the association of military service history with past-year suicidal ideation and past-30-days mental distress in a probability-based sample of adults. METHODS We gathered 2010 Behavioral Risk Factor Surveillance System data from 5 states that asked about past-year suicidal ideation. Military service was defined as current or former active-duty service or National Guard or Reserves service. We stratified analyses into 18 to 39 years, 40 to 64 years, and 65 years and older age groups and used multiple logistic regression analyses, adjusted for demographic confounders, to discern the association of military service history with past-year suicidal ideation and past-30-days mental distress. RESULTS Among the 26,736 respondents, 13.1% indicated military service history. After adjusting for several confounders, we found military history status among those aged 40 to 64 years was associated with both past-year suicidal ideation and past-30-days mental distress. We found no significant associations among the younger or older age groups. CONCLUSIONS Differences in suicidal ideation between military and nonmilitary individuals may occur in midlife. Future research should examine the possibility of cohort effects, service era effects, or both.
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Affiliation(s)
- John R Blosnich
- At the time of the study, John R. Blosnich and Adam J. Gordon were with the US Department of Veterans Affairs Center for Health Equity Research and Promotion, Pittsburgh, PA. John R. Blosnich was also with the Department of Psychiatry, University of Rochester, NY. Adam J. Gordon was also with the School of Medicine, University of Pittsburgh. Robert M. Bossarte was with the VISN 2 Center of Excellence for Suicide Prevention, Canandaigua, NY, and the Department of Psychiatry, University of Rochester
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Copeland LA, McIntyre RT, Stock EM, Zeber JE, MacCarthy DJ, Pugh MJ. Prevalence of suicidality among Hispanic and African American veterans following surgery. Am J Public Health 2014; 104 Suppl 4:S603-8. [PMID: 25100427 PMCID: PMC4151897 DOI: 10.2105/ajph.2014.301938] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2014] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We evaluated factors associated with suicidal behavior and ideation (SBI) during 3 years of follow-up among 89,995 Veterans Health Administration (VHA) patients who underwent major surgery from October 2005 to September 2006. METHODS We analyzed administrative data using Cox proportional hazards models. SBI was ascertained by International Classification of Disease, 9th Revision codes. RESULTS African Americans (18% of sample; 16,252) were at an increased risk for SBI (hazard ratio [HR] = 1.21; 95% confidence interval [CI] = 1.10, 1.32), whereas Hispanics were not (HR = 1.10; 95% CI = 0.95, 1.28). Other risk factors included schizophrenia, bipolar disorder, depression, posttraumatic stress disorder, pain disorders, postoperative new-onset depression, and postoperative complications; female gender and married status were protective against SBI. CONCLUSIONS The postoperative period might be a time of heightened risk for SBI among minority patients in the VHA. Tailored monitoring and postoperative management by minority status might be required to achieve care equity.
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Affiliation(s)
- Laurel A Copeland
- Laurel A. Copeland, Raphael T. McIntyre, Eileen M. Stock, and John E. Zeber are with the Center for Applied Health Research, Central Texas Veterans Health Care System jointly with Scott & White Healthcare, Temple. Daniel J. MacCarthy is with University of Texas Health Science Center, San Antonio. Mary Jo Pugh is with the South Texas Veterans Health Care System, San Antonio
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64
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Abstract
Suicides in the military have increased over the last ten years. Much effort has been focused on suicide prevention and treatment, as well as understanding the reasons for the sharp increase in military suicides. Despite this effort, the definitive causes of military suicides remain elusive. Further, highly effective suicide prevention and treatment approaches have not yet been developed. The purpose of this article is to present a short review of the current state of suicide prevention interventions within the context of the military. The root causes of suicidal behavior and the role of combat in the military are each discussed. Interpersonal-psychological theory of suicide and the military transition theory are introduced as guiding frameworks for understanding suicides and suicidal behavior amongst active military personnel and military veterans. The article concludes with a set of recommendations for moving forward in understanding and addressing suicides in the military.
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Affiliation(s)
- Carl Andrew Castro
- School of Social Work, Center for Innovation and Research on Veterans and Military Families, University of Southern California, 1150 South Olive, Suite 1400, Los Angeles, CA, 90015-2211, USA,
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Bozzay ML, Liu RT, Kleiman EM. Gender and age differences in suicide mortality in the context of violent death: findings from a multi-state population-based surveillance system. Compr Psychiatry 2014; 55:1077-84. [PMID: 24793560 DOI: 10.1016/j.comppsych.2014.03.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 03/24/2014] [Accepted: 03/25/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Males are more likely than females to die by all forms of violent death, including suicide. The primary purpose of the present study was to explore whether the gender difference in suicide rates is largely accounted for by males' general greater tendency to experience violent deaths. The current study examined gender and age differences in suicides and other violent deaths, using data from a population-based surveillance system. METHOD Pearson's chi-square tests and logistic regression analyses were conducted with data for 32,107 decedents in the 2003-2005 National Violent Death Reporting System (NVDRS). Decedents were categorized by gender, age, and death by suicide versus other violent means. RESULTS When suicides were examined in the greater context of violent death, the total proportion of violent deaths due to suicide did not differ across gender. When deaths were examined by age group, after controlling for ethnicity, marital status, and U.S. location in which the death occurred, males in early to mid childhood were significantly more likely than same-aged females to die by suicide relative to all other violent deaths. The portion of deaths due to suicide was for the most part equal across both genders in late childhood, young adulthood, and mid-adulthood. Older males were more likely than older females to die by suicide relative to other violent deaths. CONCLUSION Our findings suggest that that the risk of dying by suicide relative to other violent deaths may be more pronounced at certain developmental stages for each gender. This knowledge may be valuable in tailoring prevention strategies.
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Affiliation(s)
- Melanie L Bozzay
- Department of Psychology, University of South Florida, Tampa, FL, USA.
| | - Richard T Liu
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Evan M Kleiman
- Department of Psychology, Temple University, Philadelphia, PA, USA
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Abstract
Efforts toward early detection of Alzheimer disease (AD) have focused on refinement and identification of diagnostic markers, with the goal of preventing or delaying disease progression. Mild cognitive impairment (MCI) has emerged as a potential precursor to dementia. Though not without controversy, MCI has been associated with an increased risk for conversion to AD. In this article, with emphasis on meta-analyses, randomized controlled trials, and extant literature reviews, considerations and recommendations for optimal clinical management of MCI are offered. Given the substantial heterogeneity of this patient population and inconsistent research methodologies, the need for informed, clinical judgment is critical.
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Houle JN, Light MT. The home foreclosure crisis and rising suicide rates, 2005 to 2010. Am J Public Health 2014; 104:1073-9. [PMID: 24825209 PMCID: PMC4062039 DOI: 10.2105/ajph.2013.301774] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2013] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined the association between state-level foreclosure and suicide rates from 2005 to 2010 and considered variation in the effect of foreclosure on suicide by age. METHODS We used hybrid random- and fixed-effects models to examine the relation between state foreclosure rates and total and age-specific suicide rates from 2005 to 2010 (n = 306 state-years). RESULTS Net of other factors, an increase in the within-state total foreclosure rate was associated with a within-state increase in the crude suicide rates (b = 0.04; P < .1), and effects were stronger for the real estate-owned foreclosure rate (b = 0.16; P < .05). Analysis of age-specific suicide rates indicated that the effects were strongest among the middle-aged (46-64 years: total foreclosure rate, b = 0.21; P < .001; real estate-owned foreclosure rate, b = 0.83; P < .001). Rising home foreclosure rates explained 18% of the variance in the middle-aged suicide rate between 2005 and 2010. CONCLUSIONS The foreclosure crisis has likely contributed to increased suicides, independent of other economic factors associated with the recession. Rising foreclosure rates may be partially responsible for the recent uptick in suicide among middle-aged adults.
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Affiliation(s)
- Jason N Houle
- At the time of the study, Jason N. Houle was with the University of Wisconsin-Madison. Michael T. Light is with the Department of Sociology, Purdue University, West Lafayette, IN
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Dobscha SK, Denneson LM, Kovas AE, Corson K, Helmer DA, Bair MJ. Primary care clinician responses to positive suicidal ideation risk assessments in veterans of Iraq and Afghanistan. Gen Hosp Psychiatry 2014; 36:310-7. [PMID: 24650585 DOI: 10.1016/j.genhosppsych.2013.11.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 11/21/2013] [Accepted: 11/25/2013] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To examine primary care clinician actions following positive suicide risk assessments administered to Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans. METHODS We identified OEF/OIF veterans with positive templated suicide risk assessments administered in primary care settings of three Veterans Affairs (VA) Medical Centers. National VA datasets and manual record review were used to identify and code clinician discussions and actions following positive assessments. Bivariate analyses were used to examine relationships between patient characteristics and discussions of firearms access and alcohol/drug use. RESULTS Primary care clinicians documented awareness of suicide risk assessment results for 157 of 199 (79%) patients with positive assessments. Most patients were assessed for mental health conditions and referred for mental health follow-up. Clinicians documented discussions about firearms access for only 15% of patients. Among patients whose clinicians assessed for substance abuse, 34% received recommendations to reduce alcohol or drug use. Depression diagnoses and suicidal ideation/behavior severity were significantly associated with firearms access discussions, while patient sex, military service branch, and substance abuse diagnoses were significantly associated with recommendations to reduce substance use. CONCLUSION Greater efforts are needed to understand barriers to clinicians' assessing, documenting and counseling once suicidal ideation is detected, and to develop training programs and systems changes to address these barriers.
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Affiliation(s)
- Steven K Dobscha
- VA HSR&D Center to Improve Veteran Involvement in Care (CIVIC), Portland Veterans Affairs Medical Center, Portland, OR, USA; Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA.
| | - Lauren M Denneson
- VA HSR&D Center to Improve Veteran Involvement in Care (CIVIC), Portland Veterans Affairs Medical Center, Portland, OR, USA; Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | - Anne E Kovas
- VA HSR&D Center to Improve Veteran Involvement in Care (CIVIC), Portland Veterans Affairs Medical Center, Portland, OR, USA; Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | - Kathryn Corson
- VA HSR&D Center to Improve Veteran Involvement in Care (CIVIC), Portland Veterans Affairs Medical Center, Portland, OR, USA; Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | - Drew A Helmer
- War-Related Illness and Injury Study Center, VA New Jersey Health Care System, East Orange, NJ, USA; Rutgers University, New Jersey Medical School, Newark, NJ, USA
| | - Matthew J Bair
- Richard L. Roudebush Veteran Affairs Medical Center, Indianapolis, IN, USA
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Thompson JM, Zamorski MA, Sweet J, VanTil L, Sareen J, Pietrzak RH, Hopman WH, MacLean MB, Pedlar D. Roles of physical and mental health in suicidal ideation in Canadian Armed Forces Regular Force veterans. Canadian Journal of Public Health 2014; 105:e109-15. [PMID: 24886845 DOI: 10.17269/cjph.105.4217] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 04/05/2014] [Accepted: 02/12/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Suicide in recent veterans is an international concern. An association between mental disorders and suicide has been established, but less information is available about an association between physical health problems and suicide among veterans. This study extends this area of inquiry by examining the relationship of both physical and mental health problems with suicidal ideation in a representative national sample of Canadian veterans. METHODS Subjects were a stratified random sample of 2,658 veterans who had been released from the Canadian Armed Forces Regular Force during 1998-2007 and had participated in the 2010 Survey on Transition to Civilian Life. Associations between physical and mental health and past-year suicidal ideation were explored in multivariable regression models using three measures of physical and mental health. RESULTS The prevalence of suicidal ideation was 5.8% (95% confidence interval [CI]: 5.0%-6.8%). After adjustment for covariates, ideation was associated with gastrointestinal disorders (adjusted odds ratio [AOR] 1.66, CI: 1.03-2.65), depression or anxiety (AOR 5.06, CI: 2.97-8.62) and mood disorders (AOR 2.91, CI: 1.67-5.07); number of physical (AOR 1.22, CI: 1.05-1.42) and mental conditions (AOR 2.32, CI: 2.01-2.68); and SF-12 Health Survey physical health (AOR 0.98, CI: 0.96-0.99 for each 1 point increase) and mental health (AOR 0.88, CI: 0.87-0.89). CONCLUSIONS Physical health was independently associated with suicidal ideation after adjustment for mental health status and socio-demographic characteristics. The findings underscore the importance of considering physical health in population-based suicide prevention efforts and in mitigating suicide risk in individual veterans.
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Hoffmire CA, Bossarte RM. A reconsideration of the correlation between veteran status and firearm suicide in the general population. Inj Prev 2014; 20:317-21. [DOI: 10.1136/injuryprev-2013-041029] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Poulin C, Shiner B, Thompson P, Vepstas L, Young-Xu Y, Goertzel B, Watts B, Flashman L, McAllister T. Predicting the risk of suicide by analyzing the text of clinical notes. PLoS One 2014; 9:e85733. [PMID: 24489669 PMCID: PMC3904866 DOI: 10.1371/journal.pone.0085733] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 11/30/2013] [Indexed: 12/21/2022] Open
Abstract
We developed linguistics-driven prediction models to estimate the risk of suicide. These models were generated from unstructured clinical notes taken from a national sample of U.S. Veterans Administration (VA) medical records. We created three matched cohorts: veterans who committed suicide, veterans who used mental health services and did not commit suicide, and veterans who did not use mental health services and did not commit suicide during the observation period (n = 70 in each group). From the clinical notes, we generated datasets of single keywords and multi-word phrases, and constructed prediction models using a machine-learning algorithm based on a genetic programming framework. The resulting inference accuracy was consistently 65% or more. Our data therefore suggests that computerized text analytics can be applied to unstructured medical records to estimate the risk of suicide. The resulting system could allow clinicians to potentially screen seemingly healthy patients at the primary care level, and to continuously evaluate the suicide risk among psychiatric patients.
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Affiliation(s)
- Chris Poulin
- The Geisel School of Medicine at Dartmouth College & The Thayer School of Engineering at Dartmouth College, Hanover, New Hampshire, United States of America
- The Durkheim Project, Portsmouth, New Hampshire, United States of America
| | - Brian Shiner
- United States Department of Veterans Affairs, White River Junction VA Medical Center, White River Junction, Vermont, United States of America
| | - Paul Thompson
- The Geisel School of Medicine at Dartmouth College & The Thayer School of Engineering at Dartmouth College, Hanover, New Hampshire, United States of America
- The Durkheim Project, Portsmouth, New Hampshire, United States of America
| | - Linas Vepstas
- The Durkheim Project, Portsmouth, New Hampshire, United States of America
| | - Yinong Young-Xu
- United States Department of Veterans Affairs, White River Junction VA Medical Center, White River Junction, Vermont, United States of America
| | | | - Bradley Watts
- United States Department of Veterans Affairs, White River Junction VA Medical Center, White River Junction, Vermont, United States of America
| | - Laura Flashman
- The Geisel School of Medicine at Dartmouth College & The Thayer School of Engineering at Dartmouth College, Hanover, New Hampshire, United States of America
| | - Thomas McAllister
- The Geisel School of Medicine at Dartmouth College & The Thayer School of Engineering at Dartmouth College, Hanover, New Hampshire, United States of America
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Huguet N, Kaplan MS, McFarland BH. The effects of misclassification biases on veteran suicide rate estimates. Am J Public Health 2013; 104:151-5. [PMID: 24228669 DOI: 10.2105/ajph.2013.301450] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We assessed the impact that possible veteran suicide misclassification biases (i.e., inaccuracy in ascertainment of veteran status on the death certificate and misclassification of suicide as other manner of death) have on veteran suicide rate estimates. METHODS We obtained suicide mortality data from the 2003-2010 National Violent Death Reporting System and the 2003-2010 Department of Defense Casualty Analysis System. We derived population estimates from the 2003-2010 American Community Survey and 2003-2010 Department of Veterans Affairs data. We computed veteran and nonveteran suicide rates. RESULTS The results showed that suicide rates were minimally affected by the adjustment for the misclassification of current military personnel suicides as veterans. Moreover, combining suicides and deaths by injury of undetermined intent did not alter the conclusions. CONCLUSIONS The National Violent Death Reporting System is a valid surveillance system for veteran suicide. However, more than half of younger (< 25 years) male and female suicides, labeled as veterans, were likely to have been current military personnel at the time of their death and misclassified on the death certificate.
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Affiliation(s)
- Nathalie Huguet
- Nathalie Huguet is with the Center for Public Health Studies, Portland State University, Portland, OR. At the time of the study, Mark S. Kaplan was with the School of Community Health, Portland State University. Bentson H. McFarland is with the Department of Psychiatry, Oregon Health and Science University, Portland
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Liu RT, Kraines MA, Puzia ME, Massing-Schaffer M, Kleiman EM. Sociodemographic predictors of suicide means in a population-based surveillance system: findings from the National Violent Death Reporting system. J Affect Disord 2013; 151:449-454. [PMID: 23845386 DOI: 10.1016/j.jad.2013.06.023] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Accepted: 06/14/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Multivariate studies of specific suicide means are relatively rare, given the logistical challenges associated with the low base rate of suicide in the general population. Thus, information on individual characteristics associated with specific suicide means remains relatively wanting. The current study provided the largest examination to date of sociodemographic characteristics associated with different means of lethality among suicide decedents, using data from a multi-state population-based surveillance system. METHODS Multivariate logistic regression was used with data for 20,577 suicide decedents in the National Violent Death Reporting System from 2003 to 2005. RESULTS Firearm decedents were more likely male, elderly, non-Hispanic white, married, veterans, and born in the U.S. Hanging and suffocation decedents were more likely male, young, racial/ethnic minorities, never married, non-veterans, and foreign-born. Decedents that jumped from heights were more likely female, older, non-Hispanic black, never married, non-veterans, and foreign-born. Decedents who used sharp instruments were more likely older, never married, and foreign-born. Self-poisoned decedents were more likely female, middle-age, non-Hispanic white, and not married. Regarding specific poisons, alcohol was more likely to be used by middle-age decedents; gas by males, elderly, and married individuals; over-the-counter drugs by females, adolescents, and foreign-born decedents; prescription drugs by females, middle-aged, and U.S. born individuals; and street drugs by males and racial/ethnic minorities. LIMITATIONS The data were drawn from 18 states and so cannot be regarded as nationally representative. CONCLUSIONS Substantial sociodemographic variability exists across different suicide means. Recognition of this variability may help to tailor prevention efforts involving means restriction.
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Affiliation(s)
- Richard T Liu
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA.
| | - Morganne A Kraines
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
| | - Megan E Puzia
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
| | - Maya Massing-Schaffer
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
| | - Evan M Kleiman
- Department of Psychology, George Mason University, Fairfax, VA, USA
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Younes N, Chee CC, Turbelin C, Hanslik T, Passerieux C, Melchior M. Particular difficulties faced by GPs with young adults who will attempt suicide: a cross-sectional study. BMC FAMILY PRACTICE 2013; 14:68. [PMID: 23706018 PMCID: PMC3674947 DOI: 10.1186/1471-2296-14-68] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Accepted: 05/17/2013] [Indexed: 12/14/2022]
Abstract
Background Suicide is a major public health problem in young people. General Practitioners (GPs) play a central role in suicide prevention. However data about how physicians deal with suicidal youths are lacking. This study aims to compare young adult suicide attempters (from 18 to 39 years old) with older adults in a primary care setting. Methods A cross-sectional study was carried. All suicide attempts (N=270) reported to the French Sentinel surveillance System from 2009 to 2011 were considered. We conducted comparison of data on the last GP’s consultation and GPs’ management in the last three months between young adults and older adults. Results In comparison with older adults, young adults consulted their GP less frequently in the month preceding the suicidal attempt (40.9 vs. 64.6%, p=.01). During the last consultation prior to the suicidal attempt, they expressed suicidal ideas less frequently (11.3 vs. 21.9%, p=.03). In the year preceding the suicidal attempt, GPs identified depression significantly less often (42.0 vs. 63.4%, p=.001). In the preceding three months, GPs realized significantly less interventions: less psychological support (37.5 vs. 53.0%, p=.02), prescribed less antidepressants (28.6 vs. 54.8%, p<.0001) or psychotropic drugs (39.1 vs. 52.9%, p=.03) and made fewer attempts to refer to a mental health specialist (33.3 vs. 45.5%, p=.05). Conclusion With young adults who subsequently attempt suicide, GPs face particular difficulties compared to older adults, as a significant proportion of young adults were not seen in the previous six months, as GPs identified less depressions in the preceding year and were less active in managing in the preceding three months. Medical training and continuing medical education should include better instruction on challenges relative to addressing suicide risk in this particular population.
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Affiliation(s)
- Nadia Younes
- EA 40-47 Université Versailles Saint-Quentin-en-Yvelines, Versailles F-7800, France.
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Hoffmire CA, Piegari RI, Bossarte RM. Misclassification of veteran status on Washington state death certificates for suicides from 1999 to 2008. Ann Epidemiol 2013; 23:298-300. [DOI: 10.1016/j.annepidem.2013.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 03/10/2013] [Indexed: 11/15/2022]
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Dobscha SK, Corson K, Helmer DA, Bair MJ, Denneson LM, Brandt C, Beane A, Ganzini L. Brief assessment for suicidal ideation in OEF/OIF veterans with positive depression screens. Gen Hosp Psychiatry 2013; 35:272-8. [PMID: 23351524 DOI: 10.1016/j.genhosppsych.2012.12.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Revised: 12/07/2012] [Accepted: 12/11/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVES We describe processes, rates, and patient and system correlates of brief structured assessments (BSAs) for suicidal ideation among Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans with positive depression screens. METHODS Electronic Veterans Affairs (VA) medical record and Department of Defense data were used to identify individual-level and BSA-process variables for 1662 OEF/OIF veterans at three VA Medical Centers. RESULTS Overall, 1349/1662 (81%) veterans received BSAs for suicidal ideation within 1 month of depression screening; 94% of BSAs were conducted within 1 day. Stratified analyses revealed significant intersite differences in veteran demographics, instruments used, clinical setting and staff performing assessments, and correlates of assessment completion. At two sites, men were more likely to be assessed than women [odds ratio (OR)=2.15 (95% confidence interval {CI}=1.06-4.38) and 3.14 (CI=1.27-7.76)]. In a combined model adjusted for intrasite correlation, assessment was less likely during months 8-12 and 13-18 of the study period [OR=0.39 (CI=0.28-0.54) and OR=0.48 (95% CI=0.35-0.68), respectively] and more likely to occur among veterans receiving depression or posttraumatic stress disorder diagnoses on the day of depression screening [OR=1.83 (CI=1.36-2.46) and OR=1.50 (CI=1.13-1.98), respectively]. CONCLUSIONS Most veterans with positive depression screens receive timely BSAs for suicidal ideation. Processes used for brief assessment for suicidal ideation vary substantially across VA settings.
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Affiliation(s)
- Steven K Dobscha
- Portland Center for the Study of Chronic, Comorbid Physical and Mental Disorders, Portland Veterans Affairs Medical Center, Portland, OR 97207, USA.
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Langford L, Litts D, Pearson JL. Using science to improve communications about suicide among military and veteran populations: looking for a few good messages. Am J Public Health 2013; 103:31-8. [PMID: 23153130 PMCID: PMC3518352 DOI: 10.2105/ajph.2012.300905] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2012] [Indexed: 11/04/2022]
Abstract
Concern about suicide in US military and veteran populations has prompted efforts to identify more effective prevention measures. Recent expert panel reports have recommended public communications as one component of a comprehensive effort. Messaging about military and veteran suicide originates from many sources and often does not support suicide prevention goals or adhere to principles for developing effective communications. There is an urgent need for strategic, science-based, consistent messaging guidance in this area. Although literature on the effectiveness of suicide prevention communications for these populations is lacking, this article summarizes key findings from several bodies of research that offer lessons for creating safe and effective messages that support and enhance military and veteran suicide prevention efforts.
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Affiliation(s)
- Linda Langford
- Suicide Prevention Resource Center, Education Development Center Inc., Waltham, MA 02453, USA.
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Kaplan MS, McFarland BH, Huguet N, Newsom JT. Estimating the risk of suicide among US veterans: how should we proceed from here? Am J Public Health 2012; 102 Suppl 1:S21-3. [PMID: 22390594 PMCID: PMC3496465 DOI: 10.2105/ajph.2011.300611] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2011] [Indexed: 11/04/2022]
Affiliation(s)
- Mark S Kaplan
- School of Community Health, Portland State University, Portland, OR 97207, USA.
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